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Composite 68Ge attenuation correction for quantitative brain PET/MR
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Radiology.ORCID iD: 0000-0002-1498-1327
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Radiology.
GE Healthcare.
Department of Neurology, Uppsala University Hospital.
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(English)Manuscript (preprint) (Other academic)
Abstract [en]

Accurate attenuation correction (AC) in positron emission tomography (PET) imaging is a prerequisite for obtaining quantitatively correct images and 68Ge-AC is considered the gold standard for PET AC. In this study we developed an alternative AC method for PET/MR, based on the registration of a database of 68Ge-AC maps and T1-weighted MR image pairs. The present work aimed to evaluate this composite 68Ge transmission AC (CTR-AC) method’s reliability compared to 68Ge-AC. The CTR database comprised 125 pairs of previously acquired 68Ge-AC maps and T1-MRI scans. Ten patients underwent 80-min dynamic PET scans with the dopamine transporter ligand [11C]PE2I on a SIGNA PET/MR. Images were reconstructed using a CTR-AC map and a previously acquired patient-specific 68Ge-AC map on a stand-alone PET scanner. SUV as well as outcome parameters of [11C]PE2I kinetic analysis, i.e., relative delivery (R1) and dopamine transporter availability (BPND), were compared on a VOI and voxel-by-voxel basis.

CTR-AC showed high accuracy, with a mean bias of 0 ± 3% for whole-brain SUV, -0.1 ± 3.2% for whole-brain R1, and 3.7 ± 8.1% for striatal BPND. The precision of SUV and R1 was modest and lowest in the anterior cortex, with an R1 bias of -1.1 ± 6.4%.

CTR-AC is straightforward and provides MRAC maps with continuous linear attenuation coefficient values. The method’s accuracy is comparable to the best MRAC methods published so far, with a near-zero bias in SUV and a bias similar to that previously found for ZTE-AC in outcome parameters of kinetic modelling.

Keywords [en]
Attenuation correction; 68Ge database; Dopamine transporter; [11C]PE2I, PET/MR, Quantification
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
URN: urn:nbn:se:uu:diva-440382OAI: oai:DiVA.org:uu-440382DiVA, id: diva2:1545110
Available from: 2021-04-18 Created: 2021-04-18 Last updated: 2021-04-21
In thesis
1. Assessment of attenuation correction methods for quantitative neuro-PET/MR
Open this publication in new window or tab >>Assessment of attenuation correction methods for quantitative neuro-PET/MR
2021 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Hybrid PET/magnetic resonance (MR) can provide physiological, functional, and structural information simultaneously, facilitating research in neurological disorders. For quantitative PET, correction for photon attenuation (AC) is necessary. However, in contrast to dedicated PET and PET/computed tomography (CT) systems, PET/MR has no direct possibility to measure photon attenuation. As such, MR-based methods are required for AC (MRAC), and these need to be thoroughly validated before clinical implementation.

The primary aim of this thesis was to evaluate two vendor-provided MRAC methods (single-atlas and zero echo time, ZTE), a previously published maximum probability (MaxProb) method, and a composite transmission scan atlas (CTR) method for a SIGNA PET/MR. This evaluation was done both in terms of absolute quantification in static scans and of outcome measures of tracer kinetic modelling based on dynamic scans. The secondary aim was to compare quantitative brain PET measurements acquired on the SIGNA PET/MR with those acquired on a dedicated PET scanner. Ten patients with parkinsonism who underwent dynamic dopamine transporter scans using 11C-PE2I in a PET/MR and dedicated PET were included. Standardized uptake values (SUV), binding potential (BPND), and relative delivery (R1) were assessed at volume of interest (VOI) and voxel level to compare the various MRAC methods with the gold-standard, a 68Ge transmission scan, and to compare quantitative outcomes between scanners.

In general, ZTE provided the highest precision in SUV, R1 and BPND, showing the least inter-subject variability in bias compared to 68Ge-transmission AC, whereas MaxProb and CTR showed the lowest precision. Contrary to this, accuracy of absolute SUV values was best for CTR followed by MaxProb, with ZTE showing a homogeneous positive bias of about 10%. ZTE provided the highest accuracy in outcome measures of tracer kinetic analysis. Differences in quantitative results between stand-alone PET and PET/MR exceeded what can be explained by difference in AC alone, although they were still comparable to previously published test-retest variability of 11C-PE2I. Additionally, an activation in the auditory cortex was seen in PET data from the PET/MR because of the noise produced by the MR gradients.

ZTE-MRAC appears to be the best method for dynamic scanning and tracer kinetic analysis using reference methods, while CTR- and MaxProb-MRAC appear the most appropriate for absolute quantification. Also, attention should be taken to the auditory cortex activation in R1 images when comparing data from PET/MR and other PET- systems.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2021. p. 65
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1751
Keywords
PET, MRI, attenuation correction, 68Ge transmission, quantification, 11C-PE2I, MRAC, DAT, CBF
National Category
Radiology, Nuclear Medicine and Medical Imaging
Research subject
Medical Radiophysics
Identifiers
urn:nbn:se:uu:diva-440386 (URN)978-91-513-1215-6 (ISBN)
Public defence
2021-06-11, H:son-Holmdahlsalen, Akademiska sjukhuset, 100/101, 2 tr, Uppsala, 13:00 (English)
Opponent
Supervisors
Available from: 2021-05-19 Created: 2021-04-21 Last updated: 2021-06-21

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