The impact of respiratory motion on tumor quantification and delineation in static PET/CT imaging

Liu, Chi; Pierce, Larry A.; Alessio, Adam M.; Kinahan, Paul E.

doi:10.1088/0031-9155/54/24/007

Cited by 216 publications

(187 citation statements)

References 40 publications

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“…[1][2][3][4][5] Various motion compensation methods have been proposed and some of them, such as phase gating, have been implemented on clinical systems.…”

Section: Introductionmentioning

confidence: 99%

Quiescent period respiratory gating for PET/CT

et al. 2010

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Purpose: To minimize respiratory motion artifacts, this work proposes quiescent period gating ͑QPG͒ methods that extract PET data from the end-expiration quiescent period and form a single PET frame with reduced motion and improved signal-to-noise properties. Methods: Two QPG methods are proposed and evaluated. Histogram-based quiescent period gating ͑H-QPG͒ extracts a fraction of PET data determined by a window of the respiratory displacement signal histogram. Cycle-based quiescent period gating ͑C-QPG͒ extracts data with a respiratory displacement signal below a specified threshold of the maximum amplitude of each individual respiratory cycle. Performances of both QPG methods were compared to ungated and five-bin phase-gated images across 21 FDG-PET/CT patient data sets containing 31 thorax and abdomen lesions as well as with computer simulations driven by 1295 different patient respiratory traces. Image quality was evaluated in terms of the lesion SUV max and the fraction of counts included in each gate as a surrogate for image noise. Results: For all the gating methods, image noise artifactually increases SUV max when the fraction of counts included in each gate is less than 50%. While simulation data show that H-QPG is superior to C-QPG, the H-QPG and C-QPG methods lead to similar quantification-noise tradeoffs in patient data. Compared to ungated images, both QPG methods yield significantly higher lesion SUV max . Compared to five-bin phase gating, the QPG methods yield significantly larger fraction of counts with similar SUV max improvement. Both QPG methods result in increased lesion SUV max for patients whose lesions have longer quiescent periods. Conclusions: Compared to ungated and phase-gated images, the QPG methods lead to images with less motion blurring and an improved compromise between SUV max and fraction of counts. The QPG methods for respiratory motion compensation could effectively improve tumor quantification with minimal noise increase.

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“…[1][2][3][4][5] Various motion compensation methods have been proposed and some of them, such as phase gating, have been implemented on clinical systems.…”

Section: Introductionmentioning

confidence: 99%

Quiescent period respiratory gating for PET/CT

et al. 2010

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“…( 15 , 16 ) Others have proposed that errors due to attenuation correction can be reduced by using a Cine‐CT to produce an averaged (or max) image dataset for correction purposes. ( 17 – 20 ) …”

Section: Introductionmentioning

confidence: 99%

Motion artifacts occurring at the lung/diaphragm interface using 4D CT attenuation correction of 4D PET scans

Killoran

Gerbaudo

Mamede

et al. 2011

J Applied Clin Med Phys

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For PET/CT, fast CT acquisition time can lead to errors in attenuation correction, particularly at the lung/diaphragm interface. Gated 4D PET can reduce motion artifacts, though residual artifacts may persist depending on the CT dataset used for attenuation correction. We performed phantom studies to evaluate 4D PET images of targets near a density interface using three different methods for attenuation correction: a single 3D CT (3D CTAC), an averaged 4D CT (CINE CTAC), and a fully phase matched 4D CT (4D CTAC). A phantom was designed with two density regions corresponding to diaphragm and lung. An 8 mL sphere phantom loaded with 18F‐FDG was used to represent a lung tumor and background FDG included at an 8:1 ratio. Motion patterns of sinfalse(normalxfalse) and sin4false(normalxfalse) were used for dynamic studies. Image data was acquired using a GE Discovery DVCT‐PET/CT scanner. Attenuation correction methods were compared based on normalized recovery coefficient (NRC), as well as a novel quantity “fixed activity volume” (FAV) introduced in our report. Image metrics were compared to those determined from a 3D PET scan with no motion present (3D STATIC). Values of FAV and NRC showed significant variation over the motion cycle when corrected by 3D CTAC images. 4D CTAC‐ and CINE CTAC–corrected PET images reduced these motion artifacts. The amount of artifact reduction is greater when the target is surrounded by lower density material and when motion was based on sin4false(normalxfalse). 4D CTAC reduced artifacts more than CINE CTAC for most scenarios. For a target surrounded by water equivalent material, there was no advantage to 4D CTAC over CINE CTAC when using the sinfalse(normalxfalse) motion pattern. Attenuation correction using both 4D CTAC or CINE CTAC can reduce motion artifacts in regions that include a tissue interface such as the lung/diaphragm border. 4D CTAC is more effective than CINE CTAC at reducing artifacts in some, but not all, scenarios.PACS numbers: 87.57.qp, 87.57.cp

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“…The PET images were reconstructed using a standard iterative algorithm (27) (ordered-subset expectation maximization), with the CT data used for attenuation correction (28). The captured PET and CT images were sent to the Xeleris workstation (GE Healthcare) for registration and fusion.…”

Section: Methodsmentioning

confidence: 99%

Prognostic value of 18F-fluorodeoxyglucose PET parameters and inflammation in patients with nasopharyngeal carcinoma

Zhong

Ren

et al. 2017

Oncology Letters

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Abstract. The aim of the present study was to investigate the association between positron emission tomography (PET) parameters and peripheral inflammatory markers, and assess their prognostic value in nasopharyngeal carcinoma (NPC). A total of 121 patients with non-disseminated NPC were recruited. Pretreatment maximum standardized uptake values (SUVmax) of PET and peripheral inflammatory factors (leukocyte, neutrophil and monocyte counts) were recorded. Kaplan-Meier and multivariate analyses were used to identify predictors for progression-free survival (PFS), overall survival (OS), distant metastasis-free survival (DMFS) and locoregional recurrence-free survival (LRFS). The results of the present study revealed that SUVmax at the primary tumor was positively correlated with leukocytes (P= 0.025), neutrophils (P= 0.009) and monocytes (P= 0.043). SUVmax at regional lymph nodes (SUVmax-N) was significantly associated with monocytes (P= 0.024). Kaplan-Meier analysis demonstrated that SUVmax-N (>10.15) significantly predicted PFS (P=0.004) and DMFS (P= 0.003). In addition, neutrophils (>5.18) were significantly associated with PFS (P= 0.001), DMFS (P= 0.013) and LRFS (P<0.001). Multivariate analysis revealed that SUVmax-N and neutrophils retained independent prognostic significance for PFS (SUVmax-N, P= 0.026; and neutrophils, P=0.033) and DMFS (SUVmax-N, P=0.026; and neutrophils, P= 0.032). Furthermore, patients with SUVmax-N ≤10.15 and neutrophils ≤5.18 had significantly improved prognosis in PFS (96.4 vs. 58.5%, P<0.001), OS (95.7 vs. 81.1%, P=0.044), DMFS (96.4 vs. 67.0%, P<0.001) and LRFS (100 vs. 90.2%, P= 0.036) compared with those with SUVmax-N >10.15 or neutrophils >5.18. In conclusion, SUVmax may be significantly associated with cancer-associated inflammation. SUVmax-N and neutrophils were independent prognostic indicators for PFS and DMFS. Combined assessment of SUVmax-N and neutrophils may lead to refinement of risk stratification in NPC.

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The impact of respiratory motion on tumor quantification and delineation in static PET/CT imaging

Cited by 216 publications

References 40 publications

Quiescent period respiratory gating for PET/CT

Quiescent period respiratory gating for PET/CT

Motion artifacts occurring at the lung/diaphragm interface using 4D CT attenuation correction of 4D PET scans

Prognostic value of 18F-fluorodeoxyglucose PET parameters and inflammation in patients with nasopharyngeal carcinoma

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