PET/CT imaging techniques, considerations, and artifacts.

In the past few years, positron emission tomography/computed tomography (PET/CT) imaging has increasingly been used for the diagnosis, staging, and restaging of malignant diseases. The success of this emerging modality has primarily been due to its ability to combine the advantages of both PET and CT imaging while minimizing their separate weaknesses. The aim of this paper is to provide an overview of the basis behind PET/CT imaging, its advantages, and discuss its imaging artifacts with special emphasis on proposed correction techniques. A brief discussion regarding the use of PET/CT imaging for radiation treatment planning is also presented.

[1]  M. Spieth,et al.  A tabulated summary of the FDG PET literature. , 2002, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[2]  Soo Chin Liew,et al.  Object-specific attenuation correction of SPECT with correlated dual-energy X-ray CT , 1993, IEEE Transactions on Nuclear Science.

[3]  E Yorke,et al.  Four-dimensional (4D) PET/CT imaging of the thorax. , 2004, Medical physics.

[4]  Cyrill Burger,et al.  PET-CT image co-registration in the thorax: influence of respiration , 2002, European Journal of Nuclear Medicine and Molecular Imaging.

[5]  Val J Lowe,et al.  Clinical 18F-FDG oncology patient preparation techniques. , 2003, Journal of nuclear medicine technology.

[6]  Tim Mulnix,et al.  PET performance measurements for an LSO-based combined PET/CT scanner using the National Electrical Manufacturers Association NU 2-2001 standard. , 2004, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[7]  Thomas Beyer,et al.  Acquisition protocol considerations for combined PET/CT imaging. , 2004, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[8]  A. Buck,et al.  PET attenuation coefficients from CT images: experimental evaluation of the transformation of CT into PET 511-keV attenuation coefficients , 2002, European Journal of Nuclear Medicine and Molecular Imaging.

[9]  Tinsu Pan,et al.  Quantifying the effect of IV contrast media on integrated PET/CT: clinical evaluation. , 2006, AJR. American journal of roentgenology.

[10]  G. Gladish,et al.  Integrated Positron Emission Tomography/Computed Tomography in Patients With Non-Small Cell Lung Cancer: Normal Variants and Pitfalls , 2005, Journal of computer assisted tomography.

[11]  Suleman Surti,et al.  Imaging characteristics of a 3-dimensional GSO whole-body PET camera. , 2004, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[12]  Douglas K Owens,et al.  Test performance of positron emission tomography and computed tomography for mediastinal staging in patients with non-small-cell lung cancer: a meta-analysis. , 2003, Annals of internal medicine.

[13]  Chuanyong Bai,et al.  A generalized model for the conversion from CT numbers to linear attenuation coefficients , 2002, 2002 IEEE Nuclear Science Symposium Conference Record.

[14]  O. Mawlawi,et al.  Performance characteristics of a newly developed PET/CT scanner using NEMA standards in 2D and 3D modes. , 2004, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[15]  C. Rübe,et al.  Comparison of different methods for delineation of 18F-FDG PET-positive tissue for target volume definition in radiotherapy of patients with non-Small cell lung cancer. , 2005, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[16]  Thomas Beyer,et al.  Dual-modality PET/CT imaging: the effect of respiratory motion on combined image quality in clinical oncology , 2003, European Journal of Nuclear Medicine and Molecular Imaging.

[17]  Yuji Nakamoto,et al.  Respiratory motion artifacts on PET emission images obtained using CT attenuation correction on PET-CT , 2003, European Journal of Nuclear Medicine and Molecular Imaging.

[18]  R. Wahl,et al.  PET-CT: accuracy of PET and CT spatial registration of lung lesions , 2003, European Journal of Nuclear Medicine and Molecular Imaging.

[19]  Catherine Beigelman-Aubry,et al.  Multi-detector row CT and postprocessing techniques in the assessment of diffuse lung disease. , 2005, Radiographics : a review publication of the Radiological Society of North America, Inc.

[20]  G. V. von Schulthess,et al.  Staging of non-small-cell lung cancer with integrated positron-emission tomography and computed tomography. , 2003, The New England journal of medicine.

[21]  Sasa Mutic,et al.  Impact of FDG-PET on radiation therapy volume delineation in non-small-cell lung cancer. , 2004, International journal of radiation oncology, biology, physics.

[22]  W. Kalender,et al.  CT-based attenuation correction : the effects of imaging with the arms in the field of view , 2001 .

[23]  Cyrill Burger,et al.  Cause and magnitude of the error induced by oral CT contrast agent in CT-based attenuation correction of PET emission studies. , 2003, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[24]  G. Cook,et al.  Pitfalls and artifacts in 18FDG PET and PET/CT oncologic imaging. , 2004, Seminars in nuclear medicine.

[25]  J. Remy,et al.  Multidimensional Imaging of the Thorax: Practical Applications , 2001, Journal of thoracic imaging.

[26]  Thomas Beyer,et al.  Non-small cell lung cancer: dual-modality PET/CT in preoperative staging. , 2003, Radiology.

[27]  Paul Kinahan,et al.  A combined PET/CT scanner for clinical oncology. , 2000, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[28]  Tinsu Pan,et al.  Correction for oral contrast artifacts in CT attenuation-corrected PET images obtained by combined PET/CT. , 2003, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[29]  J. Hsieh,et al.  A novel reconstruction algorithm to extend the CT scan field-of-view. , 2004, Medical physics.

[30]  Mehran Yazdi,et al.  An adaptive approach to metal artifact reduction in helical computed tomography for radiation therapy treatment planning: experimental and clinical studies. , 2005, International journal of radiation oncology, biology, physics.

[31]  K. Bae,et al.  Efficient correction for CT image artifacts caused by objects extending outside the scan field of view. , 2000, Medical physics.

[32]  R. Shekhar,et al.  Automated 3-dimensional elastic registration of whole-body PET and CT from separate or combined scanners. , 2005, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[33]  Cyrill Burger,et al.  Artifacts at PET and PET/CT caused by metallic hip prosthetic material. , 2003, Radiology.

[34]  Thomas Beyer,et al.  Positron emission tomography/computed tomography--imaging protocols, artifacts, and pitfalls. , 2004, Molecular imaging and biology : MIB : the official publication of the Academy of Molecular Imaging.

[35]  Peter Knoll,et al.  Use of segmented CT transmission map to avoid metal artifacts in PET images by a PET-CT device , 2005, BMC nuclear medicine.

[36]  C Coolens,et al.  Calibration of CT Hounsfield units for radiotherapy treatment planning of patients with metallic hip prostheses: the use of the extended CT-scale. , 2003, Physics in medicine and biology.

[37]  Osman Ratib,et al.  PET/CT image navigation and communication. , 2004, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[38]  R. Wahl,et al.  Initial experience with oral contrast in PET/CT: phantom and clinical studies. , 2003, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[39]  Osama Mawlawi,et al.  PET/CT imaging artifacts. , 2005, Journal of nuclear medicine technology.

[40]  S. Zhao,et al.  X-ray CT metal artifact reduction using wavelets: an application for imaging total hip prostheses , 2000, IEEE Transactions on Medical Imaging.

[41]  A. Pevsner,et al.  Effect of motion on tracer activity determination in CT attenuation corrected PET images: a lung phantom study. , 2005, Medical physics.

[42]  Tinsu Pan,et al.  Truncation artifact on PET/CT: impact on measurements of activity concentration and assessment of a correction algorithm. , 2006, AJR. American journal of roentgenology.

[43]  T. A. Smith,et al.  FDG uptake, tumour characteristics and response to therapy: A review , 1998, Nuclear medicine communications.

[44]  Paul Kinahan,et al.  Attenuation correction for a combined 3D PET/CT scanner. , 1998, Medical physics.

[45]  Gerald Antoch,et al.  Focal tracer uptake: a potential artifact in contrast-enhanced dual-modality PET/CT scans. , 2002, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[46]  Yuji Nakamoto,et al.  Effects of nonionic intravenous contrast agents at PET/CT imaging: phantom and canine studies. , 2003, Radiology.

[47]  Cyrill Burger,et al.  Impact of metallic dental implants on CT-based attenuation correction in a combined PET/CT scanner , 2003, European Radiology.

[48]  D Delbeke,et al.  Oncological applications of FDG PET imaging: brain tumors, colorectal cancer, lymphoma and melanoma. , 1999, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[49]  R. Castillo,et al.  Attenuation correction of PET images with respiration-averaged CT images in PET/CT. , 2005, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[50]  Valerie Treyer,et al.  CT vs 68Ge attenuation correction in a combined PET/CT system: evaluation of the effect of lowering the CT tube current , 2002, European Journal of Nuclear Medicine and Molecular Imaging.

[51]  Rainer Raupach,et al.  A new algorithm for metal artifact reduction in computed tomography: in vitro and in vivo evaluation after total hip replacement. , 2003, Investigative radiology.

[52]  Thomas Beyer,et al.  Respiration artifacts in whole-body 18F-FDG PET/CT studies with combined PET/CT tomographs employing spiral CT technology with 1 to 16 detector rows , 2005, European Journal of Nuclear Medicine and Molecular Imaging.

[53]  Dean Billheimer,et al.  Prospective feasibility trial of radiotherapy target definition for head and neck cancer using 3-dimensional PET and CT imaging. , 2004, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[54]  A. Pevsner,et al.  The CT motion quantitation of lung lesions and its impact on PET-measured SUVs. , 2004, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[55]  G. Schulthess,et al.  Clinical molecular anatomic imaging : PET, PET/CT, and SPECT/CT , 2003 .

[56]  R. Wahl,et al.  PET/CT: comparison of quantitative tracer uptake between germanium and CT transmission attenuation-corrected images. , 2002, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[57]  A. Buck,et al.  Head and neck imaging with PET and PET/CT: artefacts from dental metallic implants , 2002, European Journal of Nuclear Medicine and Molecular Imaging.

[58]  G. V. von Schulthess,et al.  Why most PET of lung and head-and-neck cancer will be PET/CT. , 2004, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[59]  S. Rafla,et al.  The contribution of integrated PET/CT to the evolving definition of treatment volumes in radiation treatment planning in lung cancer. , 2005, International journal of radiation oncology, biology, physics.

[60]  Thomas Beyer,et al.  CT-based attenuation correction for PET/CT scanners in the presence of contrast agent , 2002, 2002 IEEE Nuclear Science Symposium Conference Record.

[61]  Yun Liang,et al.  Fundamentals of multichannel CT. , 2003, Seminars in musculoskeletal radiology.

[62]  P. Ell,et al.  Clinical role of positron emission tomography in oncology. , 2001, The Lancet. Oncology.

[63]  D. Bailey.  Transmission scanning in emission tomography , 1998, European Journal of Nuclear Medicine.

[64]  Thomas Beyer,et al.  Dual-modality PET/CT scanning with negative oral contrast agent to avoid artifacts: introduction and evaluation. , 2004, Radiology.

[65]  Abass Alavi,et al.  Whole-body FDG-PET imaging in the management of patients with cancer. , 2002, Seminars in nuclear medicine.

[66]  Frank P DiFilippo,et al.  Do implanted pacemaker leads and ICD leads cause metal-related artifact in cardiac PET/CT? , 2005, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.