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CT images are also used for calibration (attenuation correction) of the PET
data
X-ray
acquisition
PET Emission
Acquisition
Function
Anatomical (CT)
Reconstruction
Smooth to PET
Resolution
Translate CT to PET
Energy (511 keV)
Attenuation Correct
PET Emission Data
Functional (PET)
Reconstruction
CT
Image
PET
Image
Display
of PET
and CT
DICOM
image
stacks
Note that images are not really fused, but are displayed as fused or sideby-side with linked cursors
Anatomy
scanner
FOV
t < 10 ns?
+ + e -
What is Attenuation?
The most important physical effect in PET imaging:
The number of detected photons is significantly reduced compared to the
number of source photons in a spatially-dependent manner
For PET it is mainly due to Compton scatter out of the detector ring
For CT it is a combination of Compton scatter and photoelectric absorption
annihilation
record
positron
decay
eventt
patient
scanner
data corrections
(attenuation)
detector B
image recon
image of tracer
distribution
reduced
mediastinal
uptake
'hot' lungs
Compton scatter
Nonuniform
liver
ln [cm-1]
Enhanced
skin uptake
photoelectric absorption
(x, y) PE
PET: without
attenuation correction
130 keV
511 keV
(max CT)
(PET)
at the PET energy of 511 keV basically all Compton scatter interactions
20 keV
CT image (accurate)
(x, y)CS
photon energy (E)
PET
scanner
orbiting
68Ge/68Ga
source
511 keV
annihilation
photon
photon source
near-side
detectors
rotation
y
t
(x, y)
f (x, y)
FOV
scanner
scattered TX
photon
tissue density
tracer uptake
Attenuation (AT)
gray scale
X-ray CT
detectors
Rotating
gantry
patient
30 to 140 keV
X-ray photon
I0(E)
I0(E)
E
X-ray tube
I 0 (x, y)
(x .y ,E )dL
dE
I = I 0 (E) e 0
attenuation factors
emission (sinogram) data
(x .y ,511keV ) dL
I = I 0 (x, y) dL e
PET
L2
L1
I0(E)
How can we use the CT data for CT-based attenuation correction (CTAC)?
Monoenergetic Imaging
X-ray CT Scanning
p(x,)
x
75,000
I0
50,000
x
25,000
(x,y)
I0
p( x , ) = ln
= (x, y, E0 )dy
I( x , )
50
keV
100
150
(x, y)
H (x, y) = 1000
1
water
Constant CT
number of 0 HU
Atomic
properties
(independent
of density)
X-ray CT TX
1 s acquisition
i iti
~30 to 120 keV
no quantitation
lowest noise
high contrast
not affected by FDG
activity in patient
PET TX
3-5
3
5 min acquisition
511 keV
accurate quantitation
highest noise
low contrast
affected by FDG activity
in patient
68 Ge
positron source
X-ray source
137 Cs
-ray source
Intensity
density
Schneider et al. PMB 2000
I0 (E)
0
30
120
E (keV)
511
662
Low noise
Noisy
Fast
Slow
Quantitatively accurate
for 511 keV
100,000
75,000
Transform?
50,000
100.00
Bone, Cortical
Muscle, Skeletal
10.00
Tissue, Adipose
Tissue, Lung
Air
1.00
0.10
25,000
0.01
100
200
300
400
500
600
10
100
1000
E [keV]
keV
The mass-attenuation coefficient (/) is remarkably similar for all nonbone materials since Compton scatter dominates for these materials.
Bone has a higher photoelectric absorption cross-section due to
presence of calcium
Can used two different scaling factors: one for bone and one for
everything else
0.20
0.15
100.00
Bone Cortical
Bone,
0.10
Muscle,
Skeletal
Air
10.00
0.05
1.00
bone
0.00
air
-1000
0.10
everything
else
0.01
10
70
100
keV
511
1000
water-bone
mixture
air-water
mixture
-500
soft tissue
500
dense bone
1000
1500
CT Hounsfield Uni
140 KeV
120 KeV
100 KeV
80 KeV
0.1
QuickTime and a
decompressor
are needed to see this picture.
metal
0.08
0.06
0.04
0.02
-1
50
-1 0
30
-1 0
10
0
-9
00
-7
00
-5
00
-3
00
-1
00
10
0
30
0
50
0
70
0
90
0
11
00
13
00
15
00
17
00
19
00
HU
CT images are also used for calibration (attenuation correction) of the PET
data
X-ray
acquisition
PET Emission
Acquisition
Anatomical (CT)
Reconstruction
Smooth to PET
Resolution
Translate CT to PET
Energy (511 keV)
Attenuation Correct
PET Emission Data
Functional (PET)
Reconstruction
CT
Image
PET
Image
Display
of PET
and CT
DICOM
image
stacks
Note that images are not really fused, but are displayed as fused or sideby-side with linked cursors
Metallic Objects
Types of CT Artifacts
Physics based
Scanner based
beam-hardening
partial volume effects
photon starvation
scatter
undersampling
center-of-rotation
t
f t ti
tube spitting
helical interpolation
cone-beam reconstruction
Patient based
metallic or dense implants
motion
truncation
Non-AC PET
Metal Clip
Truncation
Artifact
Courtesy O Mawlawi
MDACC
CT
50 cm CT FOV
PET AC
FUSED
70 cm PET FOV
Truncated
CT
offset 48 cm
plastic disk
EFOV method
for CTAC
QuickTime and a
TIFF (LZW) decompressor
Standard CT reconstruction
Max SUV changed from 3.4 to 12.7 with extended field of view CT
0.120
0.110
soft
tissue
Curve that
bone
should be
Bi-linea
Iodine
0.100
used for
contrast agent
0.090
-100
300
100
200
CT Hounsfield U
15% Contrast
No contrast
0.16
140 KeV
0.14
140 w/ contrast
0 12
0.12
120 KeV
0.1
100 KeV
0.08
80 KeV
metals
contrast
(only 140 keV shown)
0.06
SUV = 1.3
SUV = 1.0
SUV = 1.0
SUV = 1.0
0.04
0.02
0
-1
50
-1 0
30
-1 0
10
0
-9
00
-7
00
-5
00
-3
00
-1
00
10
0
30
0
50
0
70
0
90
0
11
00
13
00
15
00
17
00
19
00
HU
upper limit of
diaphragm
motion
Cine CT
range
lower limit of
diaphragm
motion
3. Average of helical+Cine CT
acquired is used for CTAC of
PET data
max inspiration
max expiration
10
CT helical
range
single PET
bed range
area of
impact
CT cine
range
total PET
range for 5
bed
positions
Summary
Look at images with and without attenuation correction if in
doubt
Dont assume correct alignment always between PET and
CT, at a minimum, patient and/or bed motion is a possibility
Manufacturers have new methods to help with truncation
and respiratory motion artifacts
CT artifacts and dense objects can propagate errors into the
PET image via CTAC
CINE-CTAC method can help reduce respiratory-induced
banana artifacts
REFERENCES
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