Dual gated PET/CT imaging of small targets of the heart: Method description and testing with a dynamic heart phantom

Kokki, Tommi; Sipilä, Hannu; Teräs, Mika; Noponen, Tommi; Durand-Schaefer, Nicolas; Клен, Рику; Knuuti, Juhani

doi:10.1007/s12350-009-9163-0

Cited by 25 publications

(27 citation statements)

References 28 publications

(30 reference statements)

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“…This study was conducted without cardiac or respiratory gating as count statistics per gated frame would become insufficient for dynamic quantitative H 2 15 O perfusion imaging. Nonetheless, recent studies have clearly demonstrated that such gating sequences substantially improve spatial resolution 25,26. With the aid of list mode acquisition as well as time-of-flight sequences, future studies will certainly need to focus on the applicability of cardiac and respiratory gating to increase the spatial resolution in dynamic quantitative PET imaging to facilitate measurements of transmural myocardial perfusion gradients 27,28…”

Section: Discussionmentioning

confidence: 99%

Feasibility of subendocardial and subepicardial myocardial perfusion measurements in healthy normals with 15O-labeled water and positron emission tomography

Vermeltfoort

Raijmakers

Lubberink

et al. 2011

Journal of Nuclear Cardiology

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BackgroundPositron emission tomography (PET) enables robust and reproducible measurements of myocardial blood flow (MBF). However, the relatively limited resolution of PET till recently prohibited distinction between the subendocardial and the subepicardial layers in non-hypertrophied myocardium. Recent developments in hard- and software, however, have enabled to identify a transmural gradient difference in animal experiments. The aim of this study is to determine the feasibility of subendocardial and subepicardial MBF in normal human hearts assessed with 15O-labeled water PET.MethodsTwenty-seven healthy subjects (mean age 41 ± 13 years; 11 men) were studied with 15O-labeled water PET to quantify resting and hyperaemic (adenosine) MBF at a subendocardial and subepicardial level. In addition, cardiac magnetic resonance imaging was performed to determine left ventricular (LV) volumes and function.ResultsMean rest MBF was 1.46 ± 0.49 in the subendocardium, and 1.14 ± 0.342 mL · min−1 · g−1 in the subepicardium (P < .001). MBF during vasodilation was augmented to a greater extent at the subepicardial level (subendocardium vs subepicardium: 3.88 ± 0.86 vs 4.14 ± 0.88 mL · min−1 · g−1, P = .013). The endocardial-to-epicardial MBF ratio decreased significantly during hyperaemia (1.35 ± 0.23 to 1.12 ± 0.20, P < .001). Hyperaemic transmural MBF was inversely correlated with left ventricular end-diastolic volume index (LVEDVI) (r2 = 0.41, P = .0003), with greater impact however at the subendocardial level.Conclusions15O-labeled water PET enables MBF measurements with distinction of the subendocardial and subepicardial layers in the normal human heart and correlates with LVEDVI. This PET technique may prove useful in evaluating patients with signs of ischaemia due to coronary artery disease or microvascular dysfunction.

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Section: Discussionmentioning

confidence: 99%

Feasibility of subendocardial and subepicardial myocardial perfusion measurements in healthy normals with 15O-labeled water and positron emission tomography

Vermeltfoort

Raijmakers

Lubberink

et al. 2011

Journal of Nuclear Cardiology

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“…Gating simply means dividing the acquired image into individual time-stamped bins that correlate to phases of respiratory and/or cardiac motion by overlaying corresponding time-stamped data [4]. The input signal in the clinical PET/CT image reconstructions based upon gating techniques includes trigger markers indicating the onset of systole and diastole phases on a cardiac signal or inspiration and expiration on a respiration signal.…”

Section: Methodsmentioning

confidence: 99%

“…To reduce motion-related inaccuracies, cardiac and respiratory gating methods are the most common approaches applied in clinical PET imaging [4]. Simultaneous respiratory and cardiac gating, namely dual gating, can reduce motion-related inaccuracies and correspondingly imaging resolution in cardiac PET and oncological applications [5].…”

Section: Introductionmentioning

confidence: 99%

A Miniaturized MEMS Motion Processing System for Nuclear Medicine Imaging Applications

Tadi¹,

Lehtonen²,

Teuho³

et al. 2016

2016 Computing in Cardiology Conference (CinC)

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Cardiac, respiratory, and patient body motion artifacts degrade the image quality and quantitative accuracy of the nuclear medicine imaging which may lead to incorrect diagnosis, unnecessary treatment and insufficient therapy. We present a new miniaturized system including joint micro electromechanical (MEMS) accelerometer and gyroscope sensors for simultaneous extraction of cardiac and respiratory signals. We employ two tri-axial joint MEMS sensors for selecting an optimal trigger point in a cardiac and respiratory cycle. The 6-axis motion sensing helps to detect candidate features for cardiac and respiratory gating in Positron emission tomography (PET) imaging. The aim of this study was to validate MEMS-derived signals against traditional Real-time Position Management (RPM) and electrocardiography (ECG) measurement systems in 4 healthy volunteers. High agreement and correlation were found between cardiac and respiratory cycle intervals. These promising first results warrant for further investigations. IntroductionIn cardiac and oncologic Positron emission tomography (PET)/computed tomography (CT) imaging, cardiac, respiratory, and patient body motions may impair the image quality and the quantitative accuracy of heart imaging [1][2][3]. To reduce motion-related inaccuracies, cardiac and respiratory gating methods are the most common approaches applied in clinical PET imaging [4]. Simultaneous respiratory and cardiac gating, namely dual gating, can reduce motion-related inaccuracies and correspondingly imaging resolution in cardiac PET and oncological applications [5]. Cardiac gating is accomplished by an electrocardiography (ECG) measurement system, while respiratory gating can be performed by external devices such as spirometry, elastic belts (consisting of pressure or load cell sensors) monitors or using optical techniques including a camera and laser sensor that track chest wall or abdomen displacement [3,6,7]. However, respiratory gating devices have been considered for only research purposes due to the need for complex logistics and long data processing which may increase patient discomfort and be laborious for the clinicians [2,3]. Additionally, ECG is able to show only electrical activity of the heart and still fails to trace the instantaneous mechanical state of the heart due to the stirring movements of the myocardium [8]. Thus, these challenges complicate PET imaging protocols and create a serious demand for simultaneous recording of cardiac and respiratory signals in dual gating. Recently, new techniques based on bioimpedance [2, 9] and accelerometers [10] have been suggested for concurrent acquisition of both respiratory and cardiac signals in oncologic and cardiac PET imaging. However, there is still space to optimize these methods, especially in terms of technology, accuracy, and patient comfort. We present a new framework based upon tri-axial microelectromechanical (MEMS) accelerometer and gyroscope sensors to extract cardiac and respiratory signals. Our main objective in this study is t...

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“…Broadly studied techniques to improve temporal resolution and reduce the motion artifacts include cardiac gating utilizing the ECG gating, respiratory gating, and dual gating. These techniques are mainly based on the investigation of electrical state of the heart, the chest wall movement, and the analysis of emission data in clinical studies, respectively [1, 4–6]. …”

Section: Introductionmentioning

confidence: 99%

Accelerometer-Based Method for Extracting Respiratory and Cardiac Gating Information for Dual Gating during Nuclear Medicine Imaging

Tadi

Koivisto

Pänkäälä

et al. 2014

International Journal of Biomedical Imaging

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Both respiratory and cardiac motions reduce the quality and consistency of medical imaging specifically in nuclear medicine imaging. Motion artifacts can be eliminated by gating the image acquisition based on the respiratory phase and cardiac contractions throughout the medical imaging procedure. Electrocardiography (ECG), 3-axis accelerometer, and respiration belt data were processed and analyzed from ten healthy volunteers. Seismocardiography (SCG) is a noninvasive accelerometer-based method that measures accelerations caused by respiration and myocardial movements. This study was conducted to investigate the feasibility of the accelerometer-based method in dual gating technique. The SCG provides accelerometer-derived respiratory (ADR) data and accurate information about quiescent phases within the cardiac cycle. The correct information about the status of ventricles and atria helps us to create an improved estimate for quiescent phases within a cardiac cycle. The correlation of ADR signals with the reference respiration belt was investigated using Pearson correlation. High linear correlation was observed between accelerometer-based measurement and reference measurement methods (ECG and Respiration belt). Above all, due to the simplicity of the proposed method, the technique has high potential to be applied in dual gating in clinical cardiac positron emission tomography (PET) to obtain motion-free images in the future.

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Dual gated PET/CT imaging of small targets of the heart: Method description and testing with a dynamic heart phantom

Abstract: The dual gating method improves detection of small moving targets in a phantom and it is feasible in clinical situations.

Cited by 25 publications

References 28 publications

Feasibility of subendocardial and subepicardial myocardial perfusion measurements in healthy normals with 15O-labeled water and positron emission tomography

Feasibility of subendocardial and subepicardial myocardial perfusion measurements in healthy normals with 15O-labeled water and positron emission tomography

A Miniaturized MEMS Motion Processing System for Nuclear Medicine Imaging Applications

Accelerometer-Based Method for Extracting Respiratory and Cardiac Gating Information for Dual Gating during Nuclear Medicine Imaging

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