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External radioactive markers for PET data-driven respiratory gating in positron emission tomography

  • Florian BütherEmail author
  • Iris Ernst
  • James Hamill
  • Hans T. Eich
  • Otmar Schober
  • Michael Schäfers
  • Klaus P. Schäfers
Original Article

Abstract

Purpose

Respiratory gating is an established approach to overcoming respiration-induced image artefacts in PET. Of special interest in this respect are raw PET data-driven gating methods which do not require additional hardware to acquire respiratory signals during the scan. However, these methods rely heavily on the quality of the acquired PET data (statistical properties, data contrast, etc.). We therefore combined external radioactive markers with data-driven respiratory gating in PET/CT. The feasibility and accuracy of this approach was studied for [18F]FDG PET/CT imaging in patients with malignant liver and lung lesions.

Methods

PET data from 30 patients with abdominal or thoracic [18F]FDG-positive lesions (primary tumours or metastases) were included in this prospective study. The patients underwent a 10-min list-mode PET scan with a single bed position following a standard clinical whole-body [18F]FDG PET/CT scan. During this scan, one to three radioactive point sources (either 22Na or 18F, 50–100 kBq) in a dedicated holder were attached the patient’s abdomen. The list mode data acquired were retrospectively analysed for respiratory signals using established data-driven gating approaches and additionally by tracking the motion of the point sources in sinogram space. Gated reconstructions were examined qualitatively, in terms of the amount of respiratory displacement and in respect of changes in local image intensity in the gated images.

Results

The presence of the external markers did not affect whole-body PET/CT image quality. Tracking of the markers led to characteristic respiratory curves in all patients. Applying these curves for gated reconstructions resulted in images in which motion was well resolved. Quantitatively, the performance of the external marker-based approach was similar to that of the best intrinsic data-driven methods. Overall, the gain in measured tumour uptake from the nongated to the gated images indicating successful removal of respiratory motion was correlated with the magnitude of the respiratory displacement of the respective tumour lesion, but not with lesion size.

Conclusion

Respiratory information can be assessed from list-mode PET/CT through PET data-derived tracking of external radioactive markers. This information can be successfully applied to respiratory gating to reduce motion-related image blurring. In contrast to other previously described PET data-driven approaches, the external marker approach is independent of tumour uptake and thereby applicable even in patients with poor uptake and small tumours.

Keywords

List-mode PET Respiratory motion Respiratory gating Data-driven gating 

Notes

Acknowledgments

The authors thank Ulrike Althof, Anette Langnickel, Yvonne Heurich, Ines Markötter and Katarzyna Quirós-Hoppe for excellent technical assistance, and Judson Jones and Charles Watson of Siemens Molecular Imaging (Knoxville, TN) for valuable ideas and discussions. This study was supported by the Deutsche Forschungsgemeinschaft (DFG), Sonderforschungsbereich 656 (Molecular Cardiovascular Imaging, SFB 656 projects B2 and B3) and a research grant to the European Institute for Molecular Imaging (EIMI) from Siemens Medical Solutions (Erlangen, Germany).

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Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • Florian Büther
    • 1
    Email author
  • Iris Ernst
    • 2
  • James Hamill
    • 3
  • Hans T. Eich
    • 2
  • Otmar Schober
    • 4
  • Michael Schäfers
    • 1
  • Klaus P. Schäfers
    • 1
  1. 1.European Institute for Molecular ImagingUniversity of MünsterMünsterGermany
  2. 2.Department of Radiotherapy and RadiooncologyUniversity of MünsterMünsterGermany
  3. 3.Siemens Molecular ImagingKnoxvilleUSA
  4. 4.Department of Nuclear MedicineUniversity of MünsterMünsterGermany

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