Impact of CT-based Attenuation Correction on the Registration Between Dual-gated Cardiac PET and High-Resolution CT

A high-resolution CT (HRCT) used as anatomical prior information during PET reconstruction can enhance the quality of a corresponding low-resolution PET image, provided that it is accurately registered to the PET dataset of interest. In this work, the impact of different PET/CT attenuation correction (AC) protocols on the registration between a dual-gated cardiac 18F-FDG PET image and an HRCT image is investigated. The aim is to explore the impact of AC on PET-to-HRCT registration, and to identify the AC strategy that yields the best alignment between the left-ventricles in the PET and the HRCT images for subsequent partial volume correction. Simulations were performed using XCAT phantoms. Shallow breathing and a regular beating pattern were simulated and both noise-free and noisy data were evaluated. Respiratory motion during the acquisition of the CT used for attenuation correction strongly affected the dual-gated PET reconstructions, resulting in artefacts and quantification errors in the PET image and poor PET-to-HRCT registration accuracy. The blurring introduced by the beating heart, on the other hand, proved to have a negligible effect on PET-CT registration. Dual-gated PET images reconstructed without attenuation correction could be well registered to the HRCT if a good initial alignment between the starting images was provided. A commercially available strategy to deal with an AC CT that is acquired in the wrong respiratory phase was also evaluated, and yielded not only enhanced quantitative accuracy but also accurate PET-to-HRCT registration. The effect of a high level of noise, as present in a dual-gated cardiac PET study, was also investigated. Registrations proved to be sensitive to noise, but noise is not a major limiting factor for PET-to-HRCT registration. A selection of the investigated attenuation correction procedures was also evaluated using cardiac PET/CT data measured in sheep. The PET-to-HRCT registration performance confirmed the XCAT-based predictions.

[1]  Maurizio Conti,et al.  Simultaneous Reconstruction of Activity and Attenuation in Time-of-Flight PET , 2012, IEEE Transactions on Medical Imaging.

[2]  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.

[3]  K. Williams,et al.  Effect of lateral wall scar on reverse remodeling with cardiac resynchronization therapy. , 2009, Heart rhythm.

[4]  G. Sutherland,et al.  Patient Selection and Echocardiographic Assessment of Dyssynchrony in Cardiac Resynchronization Therapy Crt: from Origins to Routine Clinical Practice Selection of Candidates in Crt Clinical Trials Defining Response to Therapy Contemporary Reviews in Cardiovascular Medicine , 2022 .

[5]  Paul E Kinahan,et al.  The impact of respiratory motion on tumor quantification and delineation in static PET/CT imaging , 2009, Physics in medicine and biology.

[6]  Khawar Khurshid,et al.  Automated cardiac motion compensation in PET/CT for accurate reconstruction of PET myocardial perfusion images. , 2008, Physics in medicine and biology.

[7]  Roberta Matheoud,et al.  Performance characteristics obtained for a new 3-dimensional lutetium oxyorthosilicate-based whole-body PET/CT scanner with the National Electrical Manufacturers Association NU 2-2001 standard. , 2005, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[8]  M. Cerqueira,et al.  Standardized myocardial segmentation and nomenclature for tomographic imaging of the heart: A statement for healthcare professionals from the Cardiac Imaging Committee of the Council on Clinical Cardiology of the American Heart Association , 2002, The international journal of cardiovascular imaging.

[9]  A J Reader,et al.  List-mode-based reconstruction for respiratory motion correction in PET using non-rigid body transformations , 2007, Physics in medicine and biology.

[10]  Guy Marchal,et al.  Multimodality image registration by maximization of mutual information , 1997, IEEE Transactions on Medical Imaging.

[11]  Tao Sun,et al.  Interpolated average CT for attenuation correction in PET - a simulation study , 2011 .

[12]  R. Boellaard.  Standards for PET Image Acquisition and Quantitative Data Analysis , 2009, Journal of Nuclear Medicine.

[13]  B. Nowak,et al.  Cardiac resynchronization therapy homogenizes myocardial glucose metabolism and perfusion in dilated cardiomyopathy and left bundle branch block. , 2003, Journal of the American College of Cardiology.

[14]  Jan Gunnar Fjeld,et al.  A novel clinical method for quantification of regional left ventricular pressure–strain loop area: a non-invasive index of myocardial work , 2012, European heart journal.

[15]  G. Mok,et al.  Low dose interpolated average CT for thoracic PET/CT attenuation correction using an active breathing controller. , 2013, Medical physics.

[16]  J. Jarcho.  Biventricular pacing. , 2006, The New England journal of medicine.

[17]  Kris Thielemans,et al.  Comparison of different methods for data-driven respiratory gating of PET data , 2013, 2013 IEEE Nuclear Science Symposium and Medical Imaging Conference (2013 NSS/MIC).

[18]  Anthonin Reilhac,et al.  Evaluation of Three MRI-Based Anatomical Priors for Quantitative PET Brain Imaging , 2012, IEEE Transactions on Medical Imaging.

[19]  Jinyi Qi,et al.  PET image reconstruction with anatomical edge guided level set prior , 2011, Physics in medicine and biology.

[20]  Nassir Navab,et al.  Artifacts from misaligned CT in cardiac perfusion PET/CT studies: frequency, effects, and potential solutions. , 2007, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[21]  Colin Studholme,et al.  An overlap invariant entropy measure of 3D medical image alignment , 1999, Pattern Recognit..

[22]  Johan Nuyts,et al.  ML-reconstruction for TOF-PET with simultaneous estimation of the attenuation factors , 2014, 2012 IEEE Nuclear Science Symposium and Medical Imaging Conference Record (NSS/MIC).

[23]  Paul Kinahan,et al.  Cine CT for Attenuation Correction in Cardiac PET/CT , 2007, Journal of Nuclear Medicine.

[24]  O. Schober,et al.  Respiratory gating in positron emission tomography: a quantitative comparison of different gating schemes. , 2007, Medical physics.

[25]  J. Nuyts,et al.  Registration between respiratory-gated PET/CT and high-resolution CT with XCAT simulations: Evaluation and optimization for subsequent PVC , 2013, 2013 IEEE Nuclear Science Symposium and Medical Imaging Conference (2013 NSS/MIC).

[26]  Thomas K. Lewellen,et al.  Improved quantitation for PET/CT image reconstruction with system modeling and anatomical priors , 2005, SPIE Medical Imaging.

[27]  Tinsu Pan,et al.  Frequent Diagnostic Errors in Cardiac PET/CT Due to Misregistration of CT Attenuation and Emission PET Images: A Definitive Analysis of Causes, Consequences, and Corrections , 2007, Journal of Nuclear Medicine.

[28]  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.

[29]  B. Nowak,et al.  Cardiac resynchronization therapyhomogenizes myocardial glucosemetabolism and perfusion in dilatedcardiomyopathy and left bundle branch block , 2003 .

[30]  Richard D. White,et al.  2013 ACCF/ACR/ASE/ASNC/SCCT/SCMR appropriate utilization of cardiovascular imaging in heart failure: a joint report of the American College of Radiology Appropriateness Criteria Committee and the American College of Cardiology Foundation Appropriate Use Criteria Task Force. , 2013, Journal of the American College of Cardiology.

[31]  James Hamill,et al.  Optimal gating compared to 3D and 4D PET reconstruction for characterization of lung tumours , 2011, European Journal of Nuclear Medicine and Molecular Imaging.

[32]  U. Ruotsalainen,et al.  The value of quantitative analysis of glucose utilization in detection of myocardial viability by PET. , 1993, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[33]  W. Segars,et al.  4D XCAT phantom for multimodality imaging research. , 2010, Medical physics.

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