Technical Note: Adapting a GE SIGNA PET/MR scanner for radiotherapy.

PURPOSE: Simultaneous collection of PET and MR data for radiotherapy purposes are useful for, for example, target definition and dose escalations. However, a prerequisite for using PET/MR in the radiotherapy workflow is the ability to image the patient in treatment position. The aim of this work was to adapt a GE SIGNA PET/MR scanner to image patients for radiotherapy treatment planning and evaluate the impact on signal-to-noise (SNR) of the MR images, and the accuracy of the PET attenuation correction. METHOD: A flat tabletop and a coil holder were developed to image patients in the treatment position, avoid patient contour deformation, and facilitate attenuation correction of flex coils. Attenuation corrections for the developed hardware and an anterior array flex coil were also measured and implemented to the PET/MR system to minimize PET quantitation errors. The reduction of SNR in the MR images due to the added distance between the coils and the patient was evaluated using a large homogenous saline-doped water phantom, and the activity quantitation errors in PET imaging were evaluated with and without the developed attenuation corrections. RESULT: We showed that the activity quantitation errors in PET imaging were within ±5% when correcting for attenuation of the flat tabletop, coil holder, and flex coil. The SNR of the MRI images were reduced to 74% using the tabletop, and 66% using the tabletop and coil holders. CONCLUSION: We present a tabletop and coil holder for an anterior array coil to be used with a GE SIGNA PET/MR scanner, for scanning patients in the radiotherapy work flow. Implementing attenuation correction of the added hardware from the radiotherapy setup leads to acceptable PET image quantitation. The drop in SNR in MR images may require adjustment of the imaging protocols.

Non-Rigid Event-by-Event Continuous Respiratory Motion Compensated List-Mode Reconstruction for PET.

Respiratory motion during positron emission tomography (PET)/computed tomography (CT) imaging can cause significant image blurring and underestimation of tracer concentration for both static and dynamic studies. In this paper, with the aim to eliminate both intra-cycle and inter-cycle motions, and apply to dynamic imaging, we developed a non-rigid event-by-event (NR-EBE) respiratory motion-compensated list-mode reconstruction algorithm. The proposed method consists of two components: the first component estimates a continuous non-rigid motion field of the internal organs using the internal-external motion correlation. This continuous motion field is then incorporated into the second component, non-rigid MOLAR (NR-MOLAR) reconstruction algorithm to deform the system matrix to the reference location where the attenuation CT is acquired. The point spread function (PSF) and time-of-flight (TOF) kernels in NR-MOLAR are incorporated in the system matrix calculation, and therefore are also deformed according to motion. We first validated NR-MOLAR using a XCAT phantom with a simulated respiratory motion. NR-EBE motion-compensated image reconstruction using both the components was then validated on three human studies injected with 18F-FPDTBZ and one with 18F-fluorodeoxyglucose (FDG) tracers. The human results were compared with conventional non-rigid motion correction using discrete motion field (NR-discrete, one motion field per gate) and a previously proposed rigid EBE motion-compensated image reconstruction (R-EBE) that was designed to correct for rigid motion on a target lesion/organ. The XCAT results demonstrated that NR-MOLAR incorporating both PSF and TOF kernels effectively corrected for non-rigid motion. The 18F-FPDTBZ studies showed that NR-EBE out-performed NR-Discrete, and yielded comparable results with R-EBE on target organs while yielding superior image quality in other regions. The FDG study showed that NR-EBE clearly improved the visibility of multiple moving lesions in the liver where some of them could not be discerned in other reconstructions, in addition to improving quantification. These results show that NR-EBE motion-compensated image reconstruction appears to be a promising tool for lesion detection and quantification when imaging thoracic and abdominal regions using PET.

Data-driven event-by-event respiratory motion correction using TOF PET list-mode centroid of distribution.

Data-driven respiratory gating techniques were developed to correct for respiratory motion in PET studies, without the help of external motion tracking systems. Due to the greatly increased image noise in gated reconstructions, it is desirable to develop a data-driven event-by-event respiratory motion correction method. In this study, using the Centroid-of-distribution (COD) algorithm, we established a data-driven event-by-event respiratory motion correction technique using TOF PET list-mode data, and investigated its performance by comparing with an external system-based correction method. Ten human scans with the pancreatic ß-cell tracer 18F-FP-(+)-DTBZ were employed. Data-driven respiratory motions in superior-inferior (SI) and anterior-posterior (AP) directions were first determined by computing the centroid of all radioactive events during each short time frame with further processing. The Anzai belt system was employed to record respiratory motion in all studies. COD traces in both SI and AP directions were first compared with Anzai traces by computing the Pearson correlation coefficients. Then, respiratory gated reconstructions based on either COD or Anzai traces were performed to evaluate their relative performance in capturing respiratory motion. Finally, based on correlations of displacements of organ locations in all directions and COD information, continuous 3D internal organ motion in SI and AP directions was calculated based on COD traces to guide event-by-event respiratory motion correction in the MOLAR reconstruction framework. Continuous respiratory correction results based on COD were compared with that based on Anzai, and without motion correction. Data-driven COD traces showed a good correlation with Anzai in both SI and AP directions for the majority of studies, with correlation coefficients ranging from 63% to 89%. Based on the determined respiratory displacements of pancreas between end-expiration and end-inspiration from gated reconstructions, there was no significant difference between COD-based and Anzai-based methods. Finally, data-driven COD-based event-by-event respiratory motion correction yielded comparable results to that based on Anzai respiratory traces, in terms of contrast recovery and reduced motion-induced blur. Data-driven event-by-event respiratory motion correction using COD showed significant image quality improvement compared with reconstructions with no motion correction, and gave comparable results to the Anzai-based method.

Quantitative Evaluation of Atlas-based Attenuation Correction for Brain PET in an Integrated Time-of-Flight PET/MR Imaging System.

Purpose To assess the patient-dependent accuracy of atlas-based attenuation correction (ATAC) for brain positron emission tomography (PET) in an integrated time-of-flight (TOF) PET/magnetic resonance (MR) imaging system. Materials and Methods Thirty recruited patients provided informed consent in this institutional review board-approved study. All patients underwent whole-body fluorodeoxyglucose PET/computed tomography (CT) followed by TOF PET/MR imaging. With use of TOF PET data, PET images were reconstructed with four different attenuation correction (AC) methods: PET with patient CT-based AC (CTAC), PET with ATAC (air and bone from an atlas), PET with ATACpatientBone (air and tissue from the atlas with patient bone), and PET with ATACboneless (air and tissue from the atlas without bone). For quantitative evaluation, PET mean activity concentration values were measured in 14 1-mL volumes of interest (VOIs) distributed throughout the brain and statistical significance was tested with a paired t test. Results The mean overall difference (±standard deviation) of PET with ATAC compared with PET with CTAC was -0.69 kBq/mL ± 0.60 (-4.0% ± 3.2) (P < .001). The results were patient dependent (range, -9.3% to 0.57%) and VOI dependent (range, -5.9 to -2.2). In addition, when bone was not included for AC, the overall difference of PET with ATACboneless (-9.4% ± 3.7) was significantly worse than that of PET with ATAC (-4.0% ± 3.2) (P < .001). Finally, when patient bone was used for AC instead of atlas bone, the overall difference of PET with ATACpatientBone (-1.5% ± 1.5) improved over that of PET with ATAC (-4.0% ± 3.2) (P < .001). Conclusion ATAC in PET/MR imaging achieves similar quantification accuracy to that from CTAC by means of atlas-based bone compensation. However, patient-specific anatomic differences from the atlas causes bone attenuation differences and misclassified sinuses, which result in patient-dependent performance variation of ATAC. © RSNA, 2017 Online supplemental material is available for this article.

Assessment of a three-dimensional line-of-response probability density function system matrix for PET.

To achieve optimal PET image reconstruction through better system modeling, we developed a system matrix that is based on the probability density function for each line of response (LOR-PDF). The LOR-PDFs are grouped by LOR-to-detector incident angles to form a highly compact system matrix. The system matrix was implemented in the MOLAR list mode reconstruction algorithm for a small animal PET scanner. The impact of LOR-PDF on reconstructed image quality was assessed qualitatively as well as quantitatively in terms of contrast recovery coefficient (CRC) and coefficient of variance (COV), and its performance was compared with a fixed Gaussian (iso-Gaussian) line spread function. The LOR-PDFs of three coincidence signal emitting sources, (1) ideal positron emitter that emits perfect back-to-back γ rays (γγ) in air; (2) fluorine-18 (¹8F) nuclide in water; and (3) oxygen-15 (¹5O) nuclide in water, were derived, and assessed with simulated and experimental phantom data. The derived LOR-PDFs showed anisotropic and asymmetric characteristics dependent on LOR-detector angle, coincidence emitting source, and the medium, consistent with common PET physical principles. The comparison of the iso-Gaussian function and LOR-PDF showed that: (1) without positron range and acollinearity effects, the LOR-PDF achieved better or similar trade-offs of contrast recovery and noise for objects of 4 mm radius or larger, and this advantage extended to smaller objects (e.g. 2 mm radius sphere, 0.6 mm radius hot-rods) at higher iteration numbers; and (2) with positron range and acollinearity effects, the iso-Gaussian achieved similar or better resolution recovery depending on the significance of positron range effect. We conclude that the 3D LOR-PDF approach is an effective method to generate an accurate and compact system matrix. However, when used directly in expectation-maximization based list-mode iterative reconstruction algorithms such as MOLAR, its superiority is not clear. For this application, using an iso-Gaussian function in MOLAR is a simple but effective technique for PET reconstruction.

Dynamic dual-tracer PET reconstruction.

Although of important medical implications, simultaneous dual-tracer positron emission tomography reconstruction remains a challenging problem, primarily because the photon measurements from dual tracers are overlapped. In this paper, we propose a simultaneous dynamic dual-tracer reconstruction of tissue activity maps based on guidance from tracer kinetics. The dual-tracer reconstruction problem is formulated in a state-space representation, where parallel compartment models serve as continuous-time system equation describing the tracer kinetic processes of dual tracers, and the imaging data is expressed as discrete sampling of the system states in measurement equation. The image reconstruction problem has therefore become a state estimation problem in a continuous-discrete hybrid paradigm, and H infinity filtering is adopted as the estimation strategy. As H infinity filtering makes no assumptions on the system and measurement statistics, robust reconstruction results can be obtained for the dual-tracer PET imaging system where the statistical properties of measurement data and system uncertainty are not available a priori, even when there are disturbances in the kinetic parameters. Experimental results on digital phantoms, Monte Carlo simulations and physical phantoms have demonstrated the superior performance.