Motion correction to enhance absolute myocardial blood flow quantitation by PET

Votaw, John R.; Packard, René R. Sevag

doi:10.1007/s12350-019-01912-8

Cited by 4 publications

(9 citation statements)

References 31 publications

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“…Past work addressing motion based on a similarity metric computed over the entire field of view would have likely underestimated cardiac creep events. The importance of addressing motion is well accepted as these events can alter estimates of absolute myocardial blood flow as well as introduce additional variance 14,22–25 …”

Section: Discussionmentioning

confidence: 99%

“…At the termination of pharmacologic stress, the lung volume decreases and the heart gradually returns to a resting position but not necessary the same position prior to pharmacologic stress. This motion phenomenon has a substantial impact on estimates of MBF and should be addressed 23–25 but automatic tools and validated techniques are lacking in the clinic 26 …”

Section: Introductionmentioning

confidence: 99%

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Dynamic cardiac PET motion correction using 3D normalized gradient fields in patients and phantom simulations

et al. 2021

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This work expands on the implementation of three‐dimensional (3D) normalized gradient fields to correct for whole‐body motion and cardiac creep in [N‐13]‐ammonia patient studies and evaluates its accuracy using a dynamic phantom simulation model. Methods A full rigid‐body algorithm was developed using 3D normalized gradient fields including a multi‐resolution step and sampling off the voxel grid to reduce interpolation artifacts. Optimization was performed using a weighted similarity metric that accounts for opposing gradients between images of blood pool and perfused tissue without the need for segmentation. Forty‐three retrospective dynamic [N‐13]‐ammonia PET/CT rest/adenosine‐stress patient studies were motion corrected and the mean motion parameters plotted at each frame time point. Motion correction accuracy was assessed using a comprehensive dynamic XCAT simulation incorporating published physiologic parameters of the heart's trajectory following adenosine infusion as well as corrupted attenuation correction commonly observed in clinical studies. Accuracy of the algorithm was assessed objectively by comparing the errors between isosurfaces and centers of mass of the motion corrected XCAT simulations. Results In the patient studies, the overall mean cranial‐to‐caudal translation was 7 mm at stress over the duration of the adenosine infusion. Noninvasive clinical measures of relative flow reserve and myocardial flow reserve were highly correlated with their invasive analogues. Motion correction accuracy assessed with the XCAT simulations showed an error of <1 mm in late perfusion frames that broadened gradually to <3 mm in earlier frames containing blood pool. Conclusion This work demonstrates that patients undergoing [N‐13]‐ammonia dynamic PET/CT exhibit a large cranial‐to‐caudal translation related to cardiac creep primarily at stress and to a lesser extent at rest, which can be accurately corrected by optimizing their 3D normalized gradient fields. Our approach provides a solution to the challenging condition where the image intensity and its gradients are opposed without the need for segmentation and remains robust in the presence of PET‐CT mismatch.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Dynamic cardiac PET motion correction using 3D normalized gradient fields in patients and phantom simulations

et al. 2021

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“…Image artifact is an artificial finding in an image that should not be there, often leading to an incorrect interpretation and thus an incorrect diagnosis. Three well-documented types of motion artifacts in PET that lead to image artifacts are PET-emission-CTtransmission misregistration, 2-4 motion during dynamic acquisition [5][6][7][8][9] and motion due to breathing. [10][11][12] Emission-transmission misregistration happens when using the CT transmission from a PET/CT scanner to correct for attenuation of the 511 keV photons along the body during PET imaging.…”

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confidence: 99%

“…4 More recently, motion effects have been reported in dynamic PET acquisitions used in myocardial blood flow quantification. [5][6][7][8][9] Myocardial blood flow (MBF) and flow-reserve (MFR) measurements generally require a volume-of-interest to define the blood pool to measure the input function and myocardial volume-of-interest to measure the tissue concentration over time. Misalignments between the input function VOI and the blood pool during the first pass transit of the tracer have been shown to result in low mean global MBF and MFR errors but in very significant errors in mean MBF and MFR in the right coronary artery vascular territory when the misalignment was in the inferior LV direction.…”

mentioning

confidence: 99%

“…5 Several investigators are actively developing and validating tools to detect and correct for the LV displacements between frames during dynamic PET acquisitions. [5][6][7][8][9] Methods to correct for the motion effects that degrade image quality due to breathing are also being developed. [10][11][12] A simple method is one that uses respiratory gating that tracks the respiratory cycle from inspiration to expiration.…”

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confidence: 99%

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Moving forward with motion reduction, detection and correction in cardiac PET

Garcia

Nye

2022

Journal of Nuclear Cardiology

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Downward myocardial creep during stress PET imaging is inversely associated with mortality

Kuronuma,

Miller,

Wei

et al. 2024

Eur J Nucl Med Mol Imaging

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Purpose The myocardial creep is a phenomenon in which the heart moves from its original position during stress-dynamic PET myocardial perfusion imaging (MPI) that can confound myocardial blood flow measurements. Therefore, myocardial motion correction is important to obtain reliable myocardial flow quantification. However, the clinical importance of the magnitude of myocardial creep has not been explored. We aimed to explore the prognostic value of myocardial creep quantified by an automated motion correction algorithm beyond traditional PET-MPI imaging variables. Methods Consecutive patients undergoing regadenoson rest-stress [82Rb]Cl PET-MPI were included. A newly developed 3D motion correction algorithm quantified myocardial creep, the maximum motion at stress during the first pass (60 s), in each direction. All-cause mortality (ACM) served as the primary endpoint. Results A total of 4,276 patients (median age 71 years; 60% male) were analyzed, and 1,007 ACM events were documented during a 5-year median follow-up. Processing time for automatic motion correction was < 12 s per patient. Myocardial creep in the superior to inferior (downward) direction was greater than the other directions (median, 4.2 mm vs. 1.3–1.7 mm). Annual mortality rates adjusted for age and sex were reduced with a larger downward creep, with a 4.2-fold ratio between the first (0 mm motion) and 10th decile (11 mm motion) (mortality, 7.9% vs. 1.9%/year). Downward creep was associated with lower ACM after full adjustment for clinical and imaging parameters (adjusted hazard ratio, 0.93; 95%CI, 0.91–0.95; p < 0.001). Adding downward creep to the standard PET-MPI imaging model significantly improved ACM prediction (area under the receiver operating characteristics curve, 0.790 vs. 0.775; p < 0.001), but other directions did not (p > 0.5). Conclusions Downward myocardial creep during regadenoson stress carries additional information for the prediction of ACM beyond conventional flow and perfusion PET-MPI. This novel imaging biomarker is quantified automatically and rapidly from stress dynamic PET-MPI.

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Motion correction to enhance absolute myocardial blood flow quantitation by PET

Cited by 4 publications

References 31 publications

Dynamic cardiac PET motion correction using 3D normalized gradient fields in patients and phantom simulations

Dynamic cardiac PET motion correction using 3D normalized gradient fields in patients and phantom simulations

Moving forward with motion reduction, detection and correction in cardiac PET

Downward myocardial creep during stress PET imaging is inversely associated with mortality

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