Contrast enhancement in emission tomography by way of synergistic PET/CT image combination.

UNLABELLED: The display of image fusion is well accepted as a powerful tool in visual image analysis and comparison. In clinical practice, this is a mandatory step when studying images from a dual PET/CT scanner. However, the display methods that are implemented on most workstations simply show both images side by side, in separate and synchronized windows. Sometimes images are presented superimposed in a single window, preventing the user from doing quantitative analysis. In this article a new image fusion scheme is presented, allowing performing quantitative analysis directly on the fused images. METHODS: The objective is to preserve the functional information provided by PET while incorporating details of higher resolution from the CT image. The process relies on a discrete wavelet-based image merging: both images are decomposed into successive details layers by using the "à trous" transform. This algorithm performs wavelet decomposition of images and provides coarser and coarser spatial resolution versions of them. The high-spatial frequencies of the CT, or details, can be easily obtained at any level of resolution. A simple model is then inferred to compute the lacking details of the PET scan from the high frequency detail layers of the CT. These details are then incorporated in the PET image on a voxel-to-voxel basis, giving the fused PET/CT image. RESULTS: Aside from the expected visual enhancement, quantitative comparison of initial PET and CT images with fused images was performed in 12 patients. The obtained results were in accordance with the objectives of the study, in the sense that the organs' mean intensity in PET was preserved in the fused image. CONCLUSION: This alternative approach to PET/CT fusion display should be of interest for people interested in a more quantitative aspect of image fusion. The proposed method is actually complementary to more classical visualization tools.

FDG PET in epithelioid hemangioendothelioma.

Epithelioid hemangioendothelioma (EH) is an uncommon tumor of endothelial origin. It can develop in any tissue and can be multicentric or metastatic. The usual course is a slow progression. Imaging techniques are generally useful in determining the extent of the disease. A case of EH involving bone marrow and mediastinum is described. We discuss the use of FDG PET scanning in EH, showing its use in detecting bone marrow involvement and determining the extent of the disease.