Challenges and current methods for attenuation correction in PET/MR

Quantitative PET imaging requires an attenuation map to correct for attenuation. In stand-alone PET or PET/CT, the attenuation map is usually derived from a transmission scan or CT image, respectively. In PET/MR, these methods will most likely not be used. Therefore, attenuation correction has long been regarded as one of the major challenges in the development of PET/MR. In the past few years, much progress has been made in this field. In this review, the challenges faced in attenuation correction for PET/MR are discussed. Different methods have been proposed to overcome these challenges. An overview of the MR-based (template-based and voxel-based), transmission-based and emission-based methods and the results that have been obtained is provided. Although several methods show promising results, no single method fulfils all of the requirements for the ideal attenuation correction method for PET/MR. Therefore, more work is still necessary in this field. To allow implementation in routine clinical practice, extensive evaluation of the proposed methods is necessary to demonstrate robustness and automation.     

Image artifacts from MR-based attenuation correction in clinical, whole-body PET/MRI

Purpose

Integrated whole-body PET/MRI tomographs have become available. PET/MR imaging has the potential to supplement, or even replace combined PET/CT imaging in selected clinical indications. However, this is true only if methodological pitfalls and image artifacts arising from novel MR-based attenuation correction (MR-AC) are fully understood.

Results

Here we present PET/MR image artifacts following routine MR-AC, as most frequently observed in clinical operations of an integrated whole-body PET/MRI system.

Conclusion

A clinical adoption of integrated PET/MRI should entail the joint image display and interpretation of MR data, MR-based attenuation maps and uncorrected plus attenuation-corrected PET images in order to recognize potential pitfalls from MR-AC and to ensure clinically accurate image interpretation.     

Quantitative accuracy of attenuation correction in the Philips Ingenuity TF whole-body PET/MR system: a direct comparison with transmission-based attenuation correction

Objective

Evaluation of the quantitative accuracy of MR-based attenuation correction (MRAC) in the Philips Ingenuity TF whole-body PET/MR.

Materials and methods

In 13 patients, PET emission data from the PET/MR were reconstructed using two different methods for attenuation correction. In the first reconstruction, the vendor-provided standard MRAC was used. In the second reconstruction, a coregistered transmission-based attenuation map from a second immediately preceding investigation with a stand-alone Siemens ECAT EXACT HR⁺ PET scanner was used (TRAC). The two attenuation maps were compared regarding occurrence of segmentation artifacts in the MRAC procedure. Standard uptake values (SUVs) of multiple VOIs (liver, cerebellum, hot focal structures at various locations in the trunk) were compared between both reconstructed data sets. Furthermore, a voxel-wise intensity correlation analysis of both data sets in the lung and trunk was performed.

Results

VOI averaged SUV differences between MRAC and TRAC were as follows (relative differences, mean ± standard deviation): (+12 ± 6) % cerebellum, (?4 ± 9) % liver, (?2 ± 11) % hot focal structures. The fitted slopes of the voxel-wise correlations in the lung and trunk were 0.87 ± 0.17 and 0.95 ± 0.10 with averaged adjusted R ² values of 0.96 and 0.98, respectively. These figures include two instances with partially erroneous lung segmentation due to artifacts in the underlying MR images.

Conclusion

The MR-based attenuation correction implemented on the Philips Ingenuity PET/MR provides reasonable quantitative accuracy. On average, deviations from TRAC-based results are small (on the order of 10 %  or below) across the trunk, but due to interindividual variability of the segmentation quality, deviations of more than 20 %  can occur. Future improvement of the segmentation quality would help to increase the quantitation accuracy further and to reduce the inter-subject variability.     

Evaluation of an attenuation correction method for PET/MR imaging of the head based on substitute CT images

Object

The aim of this study was to evaluate MR-based attenuation correction of PET emission data of the head, based on a previously described technique that calculates substitute CT (sCT) images from a set of MR images.

Materials and methods

Images from eight patients, examined with ¹⁸F-FLT PET/CT and MRI, were included. sCT images were calculated and co-registered to the corresponding CT images, and transferred to the PET/CT scanner for reconstruction. The new reconstructions were then compared with the originals. The effect of replacing bone with soft tissue in the sCT-images was also evaluated.

Results

The average relative difference between the sCT-corrected PET images and the CT-corrected PET images was 1.6 % for the head and 1.9 % for the brain. The average standard deviations of the relative differences within the head were relatively high, at 13.2 %, primarily because of large differences in the nasal septa region. For the brain, the average standard deviation was lower, 4.1 %. The global average difference in the head when replacing bone with soft tissue was 11 %.

Conclusion

The method presented here has a high rate of accuracy, but high-precision quantitative imaging of the nasal septa region is not possible at the moment.     

Investigating the state-of-the-art in whole-body MR-based attenuation correction: an intra-individual,inter-system,inventory study on three clinical PET/MR systems

Objective

We assess inter- and intra-subject variability of magnetic resonance (MR)-based attenuation maps (MRμMaps) of human subjects for state-of-the-art positron emission tomography (PET)/MR imaging systems.

Materials and methods

Four healthy male subjects underwent repeated MR imaging with a Siemens Biograph mMR, Philips Ingenuity TF and GE SIGNA PET/MR system using product-specific MR sequences and image processing algorithms for generating MRμMaps. Total lung volumes and mean attenuation values in nine thoracic reference regions were calculated. Linear regression was used for comparing lung volumes on MRμMaps. Intra- and inter-system variability was investigated using a mixed effects model.

Results

Intra-system variability was seen for the lung volume of some subjects, (p = 0.29). Mean attenuation values across subjects were significantly different (p < 0.001) due to different segmentations of the trachea. Differences in the attenuation values caused noticeable intra-individual and inter-system differences that translated into a subsequent bias of the corrected PET activity values, as verified by independent simulations.

Conclusion

Significant differences of MRμMaps generated for the same subjects but different PET/MR systems resulted in differences in attenuation correction factors, particularly in the thorax. These differences currently limit the quantitative use of PET/MR in multi-center imaging studies.

     

Potential influence of Gadolinium contrast on image segmentation in MR-based attenuation correction with Dixon sequences in whole-body 18F-FDG PET/MR

Objective

To evaluate the influence of Gadolinium contrast agent on image segmentation in magnetic resonance (MR)-based attenuation correction (AC) with four-segment dual-echo time Dixon-sequences in whole-body [18F]-fluorodeoxyglucose positron emission tomography (PET)/MR imaging, and to analyze the consecutive effect on standardized uptake value (SUV).

Materials and methods

Hybrid imaging with an integrated PET/MR system was performed in 30 oncological patients. AC was based on MR imaging with a Dixon sequence with subsequent automated image segmentation. AC maps (µmaps) were acquired and reconstructed prior to (µmap_?gd) and after (µmap_+gd) Gd-contrast agent application. For quantification purposes, the SUV of organs and tumors based on both µmaps were compared.

Results

Tissue classification based on µmap_?gd was correct in 29/30 patients; based on µmap_+gd, the brain was falsely classified as fat in 12/30 patients with significant underestimation of SUV. In all cancerous lesions, tissue segmentation was correct. All concordant µmaps_?gd/+gd resulted in no significant difference in SUV.

Conclusion

In PET/MR, Gd-contrast agent potentially influences fat/water separation in Dixon-sequences of the head with above-average false tissue segmentation and an associated underestimation of SUV. Thus, MR-based AC should be acquired prior to Gd-contrast agent application. Additionally, integrating the MR-based AC maps into the reading-routine in PET/MR is recommended to avoid interpretation errors in cases where tissue segmentation fails.

     

PET/MRI in cancer patients: first experiences and vision from Copenhagen

Combined PET/MRI systems are now commercially available and are expected to change the medical imaging field by providing combined anato-metabolic image information. We believe this will be of particular relevance in imaging of cancer patients. At the Department of Clinical Physiology, Nuclear Medicine & PET at Rigshospitalet in Copenhagen we installed an integrated PET/MRI in December 2011. Here, we describe our first clinical PET/MR cases and discuss some of the areas within oncology where we envision promising future application of integrated PET/MR imaging in clinical routine. Cases described include brain tumors, pediatric oncology as well as lung, abdominal and pelvic cancer. In general the cases show that PET/MRI performs well in all these types of cancer when compared to PET/CT. However, future large-scale clinical studies are needed to establish when to use PET/MRI. We envision that PET/MRI in oncology will prove to become a valuable addition to PET/CT in diagnosing, tailoring and monitoring cancer therapy in selected patient populations.     

Principles and methods for automatic and semi-automatic tissue segmentation in MRI data

The development of magnetic resonance imaging (MRI) revolutionized both the medical and scientific worlds. A large variety of MRI options have generated a huge amount of image data to interpret. The investigation of a specific tissue in 3D or 4D MR images can be facilitated by image processing techniques, such as segmentation and registration. In this work, we provide a brief review of the principles and methods that are commonly applied to achieve superior tissue segmentation results in MRI. The impacts of MR image acquisition on segmentation outcome and the principles of selecting and exploiting segmentation techniques tailored for specific tissue identification tasks are discussed. In the end, two exemplary applications, breast and fibroglandular tissue segmentation in MRI and myocardium segmentation in short-axis cine and real-time MRI, are discussed to explain the typical challenges that can be posed in practical segmentation tasks in MRI data. The corresponding solutions that are adopted to deal with these challenges of the two practical segmentation tasks are thoroughly reviewed.     

Approaches for the optimization of MR protocols in clinical hybrid PET/MRI studies

Magnetic resonance imaging (MRI) is the examination method of choice for the diagnosis of a variety of diseases. MRI allows us to obtain not only anatomical information but also identification of physiological and functional parameters such as networks in the brain and tumor cellularity, which plays an increasing role in oncologic imaging, as well as blood flow and tissue perfusion. However, in many cases such as in epilepsy, degenerative neurological diseases and oncological processes, additional metabolic and molecular information obtained by PET can provide essential complementary information for better diagnosis. The combined information obtained from MRI and PET acquired in a single imaging session allows a more accurate localization of pathological findings and better assessment of the underlying physiopathology, thus providing a more powerful diagnostic tool. Two hundred and twenty-one patients were scanned from April 2011 to January 2012 on a Philips Ingenuity TF PET/MRI system. The purpose of this review article is to provide an overview of the techniques used for the optimization of different protocols performed in our hospital by specialists in the following fields: neuroradiology, head and neck, breast, and prostate imaging. This paper also discusses the different problems encountered, such as the length of studies, motion artifacts, and accuracy of image fusion including physical and technical aspects, and the proposed solutions.     

Combining prospective motion correction and distortion correction for EPI: towards a comprehensive correction of motion and susceptibility-induced artifacts

Object  

State-of-the-art MR techniques that rely on echo planar imaging (EPI), such as real-time fMRI, are limited in their applicability by both subject motion and B₀ field inhomogeneities. The goal of this work is to demonstrate that in principle it is possible to accurately predict the B₀ field inhomogeneities that occur during echo planar imaging in the presence of large scale head motion and apply this knowledge for distortion correction.     

Emerging MR methods for improved diagnosis of prostate cancer by multiparametric MRI

Magnetic Resonance Materials in Physics, Biology and Medicine - Current challenges of using serum prostate-specific antigen (PSA) level-based screening, such as the increased false positive rate,...     

DC distribution for industrial systems: opportunities and challenges

This paper investigates the opportunities and challenges associated with adopting a DC distribution scheme for industrial power systems. A prototype DC distribution system has been simulated to investigate the issues. One of the issues focused is the interaction between power converters that are used to convert AC to DC and DC to AC. Another challenging issue investigated is the system grounding. These issues become challenging mainly due to the neutral voltage shift associated with the power converters. The paper shows that converter interactions can be minimized with proper filtering and control on the converters. The paper also proposes a grounding scheme and shows that this scheme provides an effective solution by keeping the neutral voltages low under normal conditions and by limiting the fault currents during fault conditions. With these features, DC distribution provides very reliable and high-quality power.     

Women in engineering: challenges and opportunities

As the makeup of the electrical engineering workforce changes to include more women engineers, industry is recognizing that their competitive advantage can be strengthened by the unique perspective that women can bring to the workplace. The efforts established through academia, professional organizations, and industry have helped to attract and retain women in the engineering profession by enabling talented people to develop to their fullest potential. More importantly, a greater challenge lies with the men and women who make up the engineering profession, managers as well as co-workers. Managers need to initiate the necessary changes in the day-to-day activity in the workplace, in promotions and assignments, and in employees benefits. They also need to support programs that expose women to engineering, and co-workers need to be willing to be involved in these programs. Co-workers need to be actively involved in creating a respectful environment where everyone can feel valued. It is through these efforts that an environment will be created where competent engineers will have the opportunity to perform to the peak of their abilities and industry will reap the benefits of a diverse workforce     

Non-contrast MRI methods as a tool for the pre-operative assessment and surveillance of the arterio-venous fistula for haemodialysis

Objective

To compare non-contrast enhanced MRI with ultrasound (US) for measurement of arm blood vessel geometries and flow velocities in volunteers and patients with end-stage renal disease.

Materials and methods

Subjects were scanned using US (reference standard), and MRI 2D time-of-flight (ToF), 2D phase contrast (PC), and 3D multi-echo data image combination (MEDIC). Patients were also scanned after arteriovenous fistula (AVF) surgery.

Results

For mean vessel diameters (radial and brachial arteries; cephalic vein) MEDIC measurements were similar to US (p?>?0.05). However, ToF underestimated the mean diameter of the cephalic vein relative to US (p?<?0.05). For arterial velocity measurements, the mean values derived by PC-MR and US were similar (p?>?0.05). Post-operatively, the intra-luminal signal intensity was hypo-intense at the anastomosis site using ToF and MEDIC. At the same site the outer boundary of the vessel was consistently lost on ToF, but remained clearly delineated on the MEDIC images.

Discussion

With the exception of ToF, the MRI data demonstrated excellent agreement with US for measurements of vessel geometry and flow velocity. Further, the ability to clearly delineate the post-surgery vessel edges with MEDIC MRI suggests that the technique may be useful for surveillance after AVF creation or for patient-specific modelling studies.

     

Opportunities and challenges for MEMS in lightwave communications

Over the remarkably short interval of just a few years, optical microelectromechanical systems (MEMS) have breached the gulf from laboratory curiosity to advanced development and early trial deployment in lightwave-communications systems. This owes largely to the ease with which the technology has demonstrated high optical quality and reasonably fast tuning and switching subsystems that are compact and potentially low in cost. Lightwave micromachines now threaten to make possible functional structures for building tunable lasers and filters, dynamic gain-equalizers, chromatic dispersion-compensators, wavelength-add-drop multiplexers, and polarization-controllers that represent substantial improvements over the conventional state of the art. More extravagant yet, both in promise and in expectations, is the potential of MEMS as a means of building the large-port-count optical switches that are just now becoming needed by emerging mesh-based core transport networks. In this paper, we review the current status and prospects for MEMS in lightwave communications, with particular emphasis on high-port-count core optical cross connects, and discuss challenges that still confront this technology     

氢经济面临的机遇和挑战

从氢的生产、储运和应用三个方面概述了氢经济面临的机遇和挑战:氢的生产技术有化石燃料重整、太阳能制氢、生物制氢、热能制氢等;储氢方式和储氢材料有高压气瓶储氢、固体储氢材料(主要是金属和复合氢化物材料、纳米结构材料);氢的应用方面主要介绍了两种燃料电池技术,质子交换膜燃料电池和固体氧化物燃料电池。人类在这些方面已取得很大的进展,但是人类离氢经济的实现尚有不小的距离。发展可持续的制氢技术、高密集的储氢材料和先进的燃料电池技术是实现氢经济的关键。最后指出实现氢经济对中国的意义更大。