4D PET/CT: Radiology Imaging to Radiation Therapy

Kuykendall, C.C.; Budzevich, Mikalai M.; Latifi, Kujtim; Moros, Eduardo G.; Hoffe, Sarah E.; Zhang, G.G.; Montilla-Soler, Jaime; Eikman, Edward A.

doi:10.1016/j.prro.2013.01.096

Cited by 3 publications

(5 citation statements)

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“…For each patient, 18 F-FDG was the administered radiotracer, and the RG PET scan was acquired during the same session as the 3D PET scan in the same position per protocol for radiation treatment planning. A radiologist-approved 4D PET/CT protocol was applied for image acquisition [37] . The 3D PET/CT protocol was adapted for our institution from the Netherlands Protocol [38] .…”

Section: Methodsmentioning

confidence: 99%

Variability of Image Features Computed from Conventional and Respiratory-Gated PET/CT Images of Lung Cancer

Oliver

Budzevich

Zhang

et al. 2015

Translational Oncology

110

113

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Radiomics is being explored for potential applications in radiation therapy. How various imaging protocols affect quantitative image features is currently a highly active area of research. To assess the variability of image features derived from conventional [three-dimensional (3D)] and respiratory-gated (RG) positron emission tomography (PET)/computed tomography (CT) images of lung cancer patients, image features were computed from 23 lung cancer patients. Both protocols for each patient were acquired during the same imaging session. PET tumor volumes were segmented using an adaptive technique which accounted for background. CT tumor volumes were delineated with a commercial segmentation tool. Using RG PET images, the tumor center of mass motion, length, and rotation were calculated. Fifty-six image features were extracted from all images consisting of shape descriptors, first-order features, and second-order texture features. Overall, 26.6% and 26.2% of total features demonstrated less than 5% difference between 3D and RG protocols for CT and PET, respectively. Between 10 RG phases in PET, 53.4% of features demonstrated percent differences less than 5%. The features with least variability for PET were sphericity, spherical disproportion, entropy (first and second order), sum entropy, information measure of correlation 2, Short Run Emphasis (SRE), Long Run Emphasis (LRE), and Run Percentage (RPC); and those for CT were minimum intensity, mean intensity, Root Mean Square (RMS), Short Run Emphasis (SRE), and RPC. Quantitative analysis using a 3D acquisition versus RG acquisition (to reduce the effects of motion) provided notably different image feature values. This study suggests that the variability between 3D and RG features is mainly due to the impact of respiratory motion.

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Section: Methodsmentioning

confidence: 99%

Variability of Image Features Computed from Conventional and Respiratory-Gated PET/CT Images of Lung Cancer

Oliver

Budzevich

Zhang

et al. 2015

Translational Oncology

110

113

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“…Limited clinical acceptance of EDG PET was primarily supported by the study of 130 patients comparing EDG PET embedded in or separated from a whole-body PET scan, in which challenges were reported including long acquisition and reconstruction times and requiring a multidisciplinary team with a thorough understanding and execution of the process, from patient prep through scan acquisition. 21 This can also be supported by the use of DDG PET over EDG PET to maintain a simple and "practical" implementation in the clinic. 22 Putting or wrapping a respiratory monitoring device on the patient and increasing radiation exposure to the technologist were part of the patient prep and both limited the application of EDG PET.…”

Section: Introductionmentioning

confidence: 99%

“…22 Putting or wrapping a respiratory monitoring device on the patient and increasing radiation exposure to the technologist were part of the patient prep and both limited the application of EDG PET. 21,23,24 We have designed a new DDG CT to match with DDG PET. 17,25 The new DDG CT was derived from a low-dose cine CT scan of about 1.35 mSv for a coverage of about 15.4 cm.…”

Section: Introductionmentioning

confidence: 99%

“…This can also be supported by the use of DDG PET over EDG PET to maintain a simple and “practical” implementation in the clinic 22 . Putting or wrapping a respiratory monitoring device on the patient and increasing radiation exposure to the technologist were part of the patient prep and both limited the application of EDG PET 21,23,24 …”

Section: Introductionmentioning

confidence: 99%

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New full‐counts phase‐matched data‐driven gated (DDG) PET/CT

Sun,

Thomas,

Luo

et al. 2024

Medical Physics

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BackgroundData‐driven gated (DDG) PET has gained clinical acceptance and has been shown to match or outperform external‐device gated (EDG) PET. However, in most clinical applications, DDG PET is matched with helical CT acquired in free breathing (FB) at a random respiratory phase, leaving registration, and optimal attenuation correction (AC) to chance. Furthermore, DDG PET requires additional scan time to reduce image noise as it only preserves 35%–50% of the PET data at or near the end‐expiratory phase of the breathing cycle.PurposeA new full‐counts, phase‐matched (FCPM) DDG PET/CT was developed based on a low‐dose cine CT to improve registration between DDG PET and DDG CT, to reduce image noise, and to avoid increasing acquisition times in DDG PET.MethodsA new DDG CT was developed for three respiratory phases of CT images from a low dose cine CT acquisition of 1.35 mSv for a coverage of about 15.4 cm: end‐inspiration (EI), average (AVG), and end‐expiration (EE) to match with the three corresponding phases of DDG PET data: −10% to 15%; 15% to 30%, and 80% to 90%; and 30% to 80%, respectively. The EI and EE phases of DDG CT were selected based on the physiological changes in lung density and body outlines reflected in the dynamic cine CT images. The AVG phase was derived from averaging of all phases of the cine CT images. The cine CT was acquired over the lower lungs and/or upper abdomen for correction of misregistration between PET and FB CT as well as DDG PET and FB CT. The three phases of DDG CT were used for AC of the corresponding phases of PET. After phase‐matched AC of each PET dataset, the EI and AVG PET data were registered to the EE PET data with deformable image registration. The final result was FCPM DDG PET/CT which accounts for all PET data registered at the EE phase. We applied this approach to 14 18F‐FDG lung cancer patient studies acquired at 2 min/bed position on the GE Discovery MI (25‐cm axial FOV) and evaluated its efficacy in improved quantification and noise reduction.ResultsRelative to static PET/CT, the SUVmax increases for the EI, AVG, EE, and FCPM DDG PET/CT were 1.67 ± 0.40, 1.50 ± 0.28, 1.64 ± 0.36, and 1.49 ± 0.28, respectively. There were 10.8% and 9.1% average decreases in SUVmax from EI and EE to FCPM DDG PET/CT, respectively. EI, AVG, and EE DDG PET/CT all maintained increased image noise relative to static PET/CT. However, the noise levels of FCPM and static PET were statistically equivalent, suggesting the inclusion of all counts was able to decrease the image noise relative to EI and EE DDG PET/CT.ConclusionsA new FCPM DDG PET/CT has been developed to account for 100% of collected PET data in DDG PET applications. Image noise in FCPM is comparable to static PET, while small decreases in SUVmax were also observed in FCPM when compared to either EI or EE DDG PET/CT.

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“…4D CT can be performed with a cine CT or a low-pitch helical CT and has become a standard imaging procedure for RT [19] , [20] . 4D PET/CT, on the other hand, has not been widely utilized due to its requirement of both 4D PET and 4D CT, complexity in implementation, and limited studies to suggest its clinical utility [16] , [21] , [22] , [23] .…”

Section: Introductionmentioning

confidence: 99%