Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Apr;27(2):494-504.
doi: 10.1007/s12350-018-1317-5. Epub 2018 Jun 11.

Optimization of reconstruction and quantification of motion-corrected coronary PET-CT

Mhairi K Doris  1   2 , Yuka Otaki  2 , Sandeep K Krishnan  2 , Jacek Kwiecinski  1   2 , Mathieu Rubeaux  2 , Adam Alessio  3 , Tinsu Pan  4 , Sebastien Cadet  2 , Damini Dey  2 , Marc R Dweck  1 , David E Newby  1 , Daniel S Berman  2 , Piotr J Slomka  5   6
Affiliations

Optimization of reconstruction and quantification of motion-corrected coronary PET-CT

Mhairi K Doris et al. J Nucl Cardiol. 2020 Apr.

Abstract

Background: Coronary PET shows promise in the detection of high-risk atherosclerosis, but there remains a need to optimize imaging and reconstruction techniques. We investigated the impact of reconstruction parameters and cardiac motion-correction in 18F Sodium Fluoride (18F-NaF) PET.

Methods: Twenty-two patients underwent 18F-NaF PET within 22 days of an acute coronary syndrome. Optimal reconstruction parameters were determined in a subgroup of six patients. Motion-correction was performed on ECG-gated data of all patients with optimal reconstruction. Tracer uptake was quantified in culprit and reference lesions by computing signal-to-noise ratio (SNR) in diastolic, summed, and motion-corrected images.

Results: Reconstruction using 24 subsets, 4 iterations, point-spread-function modelling, time of flight, and 5-mm post-filtering provided the highest median SNR (31.5) compared to 4 iterations 0-mm (22.5), 8 iterations 0-mm (21.1), and 8 iterations 5-mm (25.6; all P < .05). Motion-correction improved SNR of culprit lesions (n = 33) (24.5[19.9-31.5]) compared to diastolic (15.7[12.4-18.1]; P < .001) and summed data (22.1[18.9-29.2]; P < .001). Motion-correction increased the SNR difference between culprit and reference lesions (10.9[6.3-12.6]) compared to diastolic (6.2[3.6-10.3]; P = .001) and summed data (7.1 [4.8-11.6]; P = .001).

Conclusions: The number of iterations and extent of post-filtering has marked effects on coronary 18F-NaF PET quantification. Cardiac motion-correction improves discrimination between culprit and reference lesions.

Keywords: Atherosclerosis; Cardiac motion; Computed tomography; Positron emission tomography.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest Disclosure

This research was supported in part by grant 1R01HL135557 from the National Heart, Lung, and Blood Institute/National Institute of Health (NHLBI/NIH). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The study was also supported by a grant (“Cardiac Imaging Research Initiative”) from the Adelson Medical Research Foundation.

David Newby (CH/09/002) and Marc Dweck (FS/14/78) are supported by the British Heart Foundation. David Newby is also the recipient of a Wellcome Trust Senior Investigator Award (WT103782AIA). No other potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1
The impact of different PET reconstructions on visual image quality in diastolic and motion-corrected images in a patient with a positive culprit lesion in the left main coronary artery. The PET reconstruction using 4 iterations and 5-mm post-filtering was considered to provide superior image quality (TBR=1.92 for motion-corrected image).
Fig. 2
Fig. 2
Signal-to-Noise Ratio (SNR) and Target-to-Background Ratio (TBR) in diastolic, summed and motion-corrected images for each reconstruction. In the diastolic, summed and motion-corrected images, median SNR was highest when PET data was reconstructed using 4 iterations and 5mm post-filtering. Conversely, TBR was highest when more iterations were used without applying post-filtering (*p<0.01).
Fig. 3
Fig. 3
The impact of Time of Flight (TOF) and Resolution Recovery (RR) on SNR in diastolic, summed and motion-corrected images in a patient with a PET-positive plaque in the mid right coronary artery. In the summed and motion-corrected images, median SNR was higher with TOF and RR (p<0.01).
Fig. 4
Fig. 4
The effect of Time of Flight (TOF) and Resolution Recovery (RR) on SNR. SNR improved following TOF and RR, summed (27 vs 15; p=0.007) and motion-corrected (32 vs 17; p=0.005) data.
Fig. 5
Fig. 5
Motion correction of physiological motion of the right coronary artery. Systolic excursion of the tricuspid annular plane leads to displacement of the PET signal during the cardiac cycle (zoomed area of interest in blue squares). The difference in the shift of PET from reference is shown on the end-systolic (top-right) and late-diastolic (mid right) images. Green arrows represent the vectors of mid RCA motion. By co-registration of all PET data to the reference end-diastolic gate, the final motion corrected image is corrected for the 14mm mid RCA motion (bottom-right).
Fig. 6
Fig. 6
Fused PET-CTA images before and after motion-correction. An example of a PET-positive lesion in the right coronary artery (arrows) using the diastolic (A), summed (B) and motion-corrected (C) PET data.
Fig. 7
Fig. 7
(A) Image noise in diastolic, summed and motion-corrected data. The median noise improves from 0.12 in the diastolic data to 0.08 following motion correction (median; p<0.001) and (B) Signal-to-Noise Ratio (SNR) before and after motion-correction. Median SNR for the motion-corrected data was highest in the positive lesions (n=33), and similar to SNR of the summed data for negative lesions (n=23)
See this image and copyright information in PMC

Comment in

References

    1. Joshi NJ, Vesey AT, Williams MC, et al. 18F-fluoride positron emission tomography for identification of ruptured and high-risk coronary atherosclerotic plaques: a prospective clinical trial. The Lancet. 2014;383(9918):705–713. - PubMed
    1. Lee JM, Bang J-I, Koo BK, et al. Clinical Relevance of 18F-Sodium Fluoride Positron-Emission Tomography in Noninvasive Identification of High-Risk Plaque in Patients With Coronary Artery Disease. Circ Cardiovasc Imaging. 2017;10(11):e006704. - PubMed
    1. Kitagawa T, Yamamoto H, Toshimitsu S, et al. Data on analysis of coronary atherosclerosis on computed tomography and 18F-sodium fluoride positron emission tomography. Data Brief. 2017;13:341–345. doi: 10.1016/j.dib.2017.06.011. - DOI - PMC - PubMed
    1. Kitagawa T, Yamamoto H, Toshimitsu S, et al. 18F-sodium fluoride positron emission tomography for molecular imaging of coronary atherosclerosis based on computed tomography analysis. Atherosclerosis. 2017;263:385–392. - PubMed
    1. Rubeaux M, Joshi N, Dweck MR, et al. Motion correction of 18F-sodium fluoride PET for imaging coronary atherosclerotic plaques. J Nucl Med. 2016;57(1):54–59. - PubMed

Publication types