Implementation of an automated respiratory amplitude gating technique for PET/CT: clinical evaluation.
Implementation of an automated respiratory amplitude gating technique for PET/CT: clinical evaluation.
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DOI：
10.2967/jnumed.109.068759
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发表时间：
2010-01
期刊：
影响因子：
--
通讯作者：
Mawlawi OR
中科院分区：
文献类型：
--
作者：
Chang G;Chang T;Pan T;Clark JW Jr;Mawlawi OR
最近已证明振幅选通技术比相位选通更能抑制呼吸运动伪影。然而，大多数商用 PET/CT 扫描仪仅配备相位选通功能。本文的目的是利用患者研究提出并评估一种可在当前全身 PET/CT 扫描仪上实施的自动呼吸幅度门控技术。该技术的主要设计特点是自动将 CT 扫描期间捕获的呼吸幅度与 PET 扫描期间的相应幅度进行匹配。所提出的幅度选通技术包括 CT 扫描和列表模式 PET 扫描。在获取 CT 扫描的同时，监测设备记录患者的呼吸运动，该监测设备确定 CT 扫描期间捕获的呼吸运动幅度。设计了一个程序，每当患者的呼吸超过由 CT 期间捕获的振幅确定的预设振幅范围时，就会将触发器注入 PET 列表流。为了在全身 PET/CT 中实施这种拟议的幅度门控技术，需要采用 PET 优先方案来最大限度地减少 CT 和 PET 扫描之间的呼吸基线漂移。在此实施中，首先对患者的整个身体进行常规 PET 扫描，但不包括覆盖感兴趣病变的床位。然后采集全身 CT 扫描，然后在覆盖感兴趣区域（病灶）的床位上进行列表模式 PET 采集。使用 13 名患有 21 个肺部或胸部肿瘤的患者对所提出的幅度门控技术进行了测试。在患者研究中，与非门控图像相比，门控图像显示出统计上显着的改善，所有病变的最大和平均标准化摄取值平均分别增加了 27% 和 28%。此外，使用目视检查和线轮廓，门控图像中的肿瘤显示出更好的对比度。在当前的 PET/CT 扫描仪上实施所提出的呼吸幅度门控技术是可行的，并且可以使用我们提出的程序自动生成幅度匹配的 CT 和 PET 数据，而不需要患者屏住呼吸或增加辐射暴露。
Amplitude gating techniques have recently been shown to be better at suppressing respiratory motion artifacts than phase gating. However, most commercial PET/CT scanners are equipped with phase gating capabilities only. The objective of this article was to propose and evaluate using patient studies an automated respiratory amplitude gating technique that could be implemented on current whole-body PET/CT scanners. A primary design feature of the proposed technique is to automatically match the respiratory amplitude captured during the CT scan with a corresponding amplitude during the PET scan. The proposed amplitude gating technique consists of a CT scan, followed by a list-mode PET scan. The CT scan was acquired while the patient’s respiratory motion was recorded by a monitoring device that determined the respiratory motion amplitude captured during the CT scan. A program was designed to inject triggers into the PET list stream whenever the patient’s respiration crossed a preset amplitude range determined by the captured amplitude during CT. To implement this proposed amplitude gating technique in whole-body PET/CT, a PET-first protocol was necessary to minimize the respiratory baseline drift between the CT and PET scans. In this implementation, a regular PET scan was first acquired over the patient’s whole body but excluding the bed position that covered the lesion of interest. The whole-body CT scan was then acquired, followed by a list-mode PET acquisition over the bed position that covered the area of interest (lesion). The proposed amplitude gating technique was tested using 13 patients with 21 lung or thoracic tumors. In the patient studies, the gated images—when compared with the ungated images—showed statistically significant improvements, with an average 27% and 28% increase in maximum and mean standardized uptake value, respectively, for all lesions. Furthermore, the tumors in the gated images showed better contrast using visual inspection and line profiles. The implementation of the proposed respiratory amplitude gating technique on current PET/ CT scanners is feasible, and amplitude-matched CT and PET data can be automatically generated using our proposed procedures without requiring patients to hold their breath or increase their radiation exposure.
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