Data-driven gated CT: An automated respiratory gating method to enable data-driven gated PET/CT.
Data-driven gated CT: An automated respiratory gating method to enable data-driven gated PET/CT.
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DOI：
10.1002/mp.15620
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发表时间：
2022-06
期刊：
影响因子：
3.8
通讯作者：
Luo, Dershan
中科院分区：
文献类型：
--
作者：
Pan, Tinsu;Thomas, M. Allan;Luo, Dershan
如果在正电子发射断层扫描(PET)/CT中使用错误配准的计算机断层扫描(CT)进行衰减校正(AC)，则会影响PET定量和定位的准确性。随着数据驱动门控(DDG)在临床应用中的持续增长，这些问题与门控CT的解决方案变得更加相关。在这项工作中，开发了一种新的自动DDG CT方法，分别为PET和DDG PET的AC提供平均CT和DDG CT。开发了一种自动DDG CT，用于从低剂量电影CT图像中提供呼气末(EE)和吸气末(EI)的图像，并对所有阶段进行平均以生成平均CT。根据肺区Hounsfield单位(HU)值和人体轮廓确定EE和EI的呼吸时相。基础PET采用平均CT扫描，静止期或EE期采用DDG CT扫描。DDG CT获得的EI和EE相用于评估呼吸运动的大小。将所提出的DDG CT与两种商业CT门控方法：(1)4D CT(基于外部设备)和(2)D4D CT(基于DDG)在38个患者数据集的呼吸期图像选择、肺HU、肺体积和图像伪影方面进行比较。在一组包含18F-FDG、68Ga-Dotatate和64Cu-Dotatate扫描的20个连续的PET/CT研究中，比较了建议的DDG CT和D4D CT对DDG PET/CT的注册和量化的影响。在EE期，DDG CT和4D CT选择图像的符合率为62.5%±21.6%，DDG CT和D4D CT选择图像的符合率为6.5%±9.7%，4D CT和D4D CT选择图像的符合率为8.6%±12.2%。这些差异在EE时相图像选择上有显著差异(P<；0.0001)。在EI期，DDG CT和4D CT选择图像的符合率为68.2%±18.9%，DDG CT和D4D CT选择图像的符合率为63.9%±18.8%，4D CT和D4D CT选择图像的符合率为61.2%±19.8%，差异无统计学意义。三种方法测得的平均肺HU和肺体积差异无统计学意义(P>；0.1)。在一些研究中，DDG CT在正确选择EE和EI期方面优于D4D或4D CT，D4D CT可通过肉眼检查发现反转EE和EI期或不能正确选择图像。PET定量分析显示，DDG CT的AC值明显高于D4D CT。当电影CT存在不规则呼吸周期时，可以用DDG CT代替普通CT，以改善基线PET的AC。为了解决PET/CT成像中的配准错误和肿瘤运动问题，研制了一种新的全自动DDG CT。在选择EE期图像作为4D CT的临床标准时，DDG CT的一致性明显高于D4D CT。与4D和D4D两种商业门控CT方法相比，DDG CT在下肺和上横隔区表现出更强的健壮性，这些区域经常发生配准错误和肿瘤运动。与D4D CT相比，DDG CT可提高DDG PET的AC。在有不规则呼吸运动的病例中，DDG CT使基线PET的AC高于平均CT。新的DDG CT具有4D CT的优点，无需外部设备选通。
The accuracy of positron emission tomography (PET) quantification and localization can be compromised if a misregistered computed tomography (CT) is used for attenuation correction (AC) in PET/CT. As data-driven gating (DDG) continues to grow in clinical use, these issues are becoming more relevant with respect to solutions for gated CT. In this work, a new automated DDG CT method was developed to provide average CT and DDG CT for AC of PET and DDG PET, respectively. An automatic DDG CT was developed to provide the end-expiratory (EE) and end-inspiratory (EI) phases of images from low-dose cine CT images, with all phases being averaged to generate an average CT. The respiratory phases of EE and EI were determined according to lung region Hounsfield unit (HU) values and body outline contours. The average CT was used for AC of baseline PET and DDG CT at EE phase was used for AC of DDG PET at the quiescent or EE phase. The EI and EE phases obtained with DDG CT were used for assessing the magnitude of respiratory motion. The proposed DDG CT was compared to two commercial CT gating methods: (1) 4D CT (external device based) and (2) D4D CT (DDG based) in 38 patient datasets with respect to respiratory phase image selection, lung HU, lung volume, and image artifacts. In a separate set of twenty consecutive PET/CT studies containing a mix of 18F-FDG, 68Ga-Dotatate, and 64Cu-Dotatate scans, the proposed DDG CT was compared with D4D CT for impacts on registration and quantification in DDG PET/CT. In the EE phase, the images selected by DDG CT and 4D CT were identical 62.5% ± 21.6% of the time, whereas DDG CT and D4D CT were 6.5% ± 9.7%, and 4D CT and D4D CT were 8.6% ± 12.2%. These differences in EE phase image selection were significant (p < 0.0001). In the EI phase, the images selected by DDG CT and 4D CT were identical 68.2% ± 18.9% of the time, DDG CT and D4D CT were 63.9% ± 18.8%, and 4D CT and D4D CT were 61.2% ± 19.8%.These differences were not significant. The mean lung HU and volumes were not statistically different (p > 0.1) among the three methods. In some studies, DDG CT was better than D4D or 4D CT in the appropriate selection of the EE and EI phases, and D4D CT was found to reverse the EE and EI phases or not select the correct images by visual inspection. A statistically significant improvement of DDG CT over D4D CT for AC of DDG PET was also demonstrated with PET quantification analysis. When irregular breath cycles were present in the cine CT, DDG CT could be used to replace average CT for the improved AC of baseline PET. A new automatic DDG CT was developed to tackle the issues of misregistration and tumor motion in PET/CT imaging. DDG CT was significantly more consistent than D4D CT in selecting the EE phase images as the clinical standard of 4D CT. When compared to both commercial gated CT methods of 4D CT and D4D CT, DDG CT appeared to be more robust in the lower lung and upper diaphragm regions where misregistration and tumor motion often occur. DDG CT offered improved AC for DDG PET relative to D4D CT. In cases with irregular respiratory motion, DDG CT improved AC over average CT for baseline PET. The new DDG CT provides the benefits of 4D CT without the need for external device gating.
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影响因子：
3.5
作者：
Carnes, Greg;Gaede, Stewart;Lee, Ting-Yim
通讯作者：
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影响因子：
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DOI：
10.1016/j.ijrobp.2020.11.014
发表时间：
2021-04-01
期刊：
International journal of radiation oncology, biology, physics
影响因子：
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通讯作者：
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影响因子：
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