HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Delbeke, D. Articles by Sandler, M. P. Search for Related Content PubMed PubMed Citation Articles by Delbeke, D. Articles by Sandler, M. P.

Value of Iterative Reconstruction, Attenuation Correction, and Image Fusion in the Interpretation of FDG PET Images with an Integrated Dual-Head Coincidence Camera and X-Ray-based Attenuation Maps¹

¹ From the Section of Nuclear Medicine, Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, 21st Ave S and Garland, Nashville, TN 37232-2675. Received April 12, 2000; revision requested June 6; revision received June 29; accepted July 11. Supported by research grants from ELGEMS Ltd, Haifa, Israel, and GE Medical Systems, Milwaukee, Wis. Address correspondence to D.D. (e-mail: dominique.delbeke@mcmail.vanderbilt.edu).

PURPOSE: To compare lesion detectability on 2-[fluorine-18]fluoro-2-deoxy-D-glucose (FDG) positron emission tomographic (PET) images obtained with a dual-head coincidence (DHC) gamma camera equipped with an integrated x-ray tube–based transmission system (a) with images reconstructed with filtered back projection (FBP) and those reconstructed with an iterative reconstruction algorithm based on coincidence-ordered subsets expectation maximization (COSEM), (b) with images reconstructed without and with attenuation correction (AC), and (c) with images reconstructed without and with image fusion for anatomic mapping.

MATERIALS AND METHODS: Thirty-five patients known or suspected to have malignancy underwent initial imaging with a dedicated positron emission tomography (PET) unit after injection of 10 mCi (370 MBq) of FDG. Transmission computed tomographic (CT) scans and FDG emission images were then obtained with the DHC camera. The proportion of lesions detected on the various sets of FDG DHC images was determined by using FDG PET as the standard of reference. Imaging findings were correlated with those from histologic examination and clinical follow-up, in consultation with the respective referring physicians.

RESULTS: FDG PET depicted 78 lesions, 29 of which were equal to or less than 1.5 cm in diameter. FDG DHC depicted 52 of the 78 (67%), 59 of 78 (76%), and 61 of the 78 (78%) lesions, respectively, when image reconstruction was performed with FBP without AC, COSEM without AC, and both COSEM and AC. The detection rate of lesions 1.5 cm or smaller was better with COSEM and AC than with FBP (55% vs 34%, respectively). In addition, COSEM and AC allowed more confidence in the interpretation. None of these differences, however, were significant. Fusion of CT scans and FDG DHC images obtained with COSEM and AC allowed localization of lesions to the skeleton in three patients and to the liver versus adjacent bowel in three patients. Image fusion was especially helpful for localizing lesions in the neck in five patients. Anatomic mapping on fusion images was clinically relevant in 11 patients (31%).

CONCLUSION: The COSEM reconstruction algorithm should replace FBP when available. Functional anatomic mapping improved lesion localization in one-third of the patients studied.

Index terms: Fluorine, radioactive • Neoplasms, PET • Positron emission tomography (PET), comparative studies

This article has been cited by other articles:

				D. Utsunomiya, S. Shiraishi, M. Imuta, S. Tomiguchi, K. Kawanaka, S. Morishita, K. Awai, and Y. Yamashita Added Value of SPECT/CT Fusion in Assessing Suspected Bone Metastasis: Comparison with Scintigraphy Alone and Nonfused Scintigraphy and CT Radiology, December 1, 2005; 238(1): 264 - 271. [Abstract] [Full Text] [PDF]

				D. Utsunomiya, T. Nakaura, T. Honda, S. Shiraishi, S. Tomiguchi, K. Kawanaka, S. Morishita, K. Awai, H. Ogawa, and Y. Yamashita Object-specific Attenuation Correction at SPECT/CT in Thorax: Optimization of Respiratory Protocol for Image Registration Radiology, November 1, 2005; 237(2): 662 - 669. [Abstract] [Full Text] [PDF]

				E. Even-Sapir, B. Yuzefovich, E. Miller, J.-P. Bouhnik, O. Zak, H. Lerman, G. Lievshitz, and C. Levin Coincidence Imaging Using 2 Dual-Head {gamma}-Camera Systems, With and Without Attenuation Correction J. Nucl. Med. Technol., December 1, 2004; 32(4): 190 - 197. [Abstract] [Full Text] [PDF]

				H. Zaidi and B. Hasegawa Determination of the Attenuation Map in Emission Tomography J. Nucl. Med., February 1, 2003; 44(2): 291 - 315. [Abstract] [Full Text] [PDF]

				O. Israel, M. Mor, D. Gaitini, Z. Keidar, L. Guralnik, A. Engel, A. Frenkel, R. Bar-Shalom, and A. Kuten Combined Functional and Structural Evaluation of Cancer Patients with a Hybrid Camera-Based PET/CT System Using 18F-FDG J. Nucl. Med., September 1, 2002; 43(9): 1129 - 1136. [Abstract] [Full Text] [PDF]

				E. Even-Sapir, H. Lerman, A. Figer, M. Rabau, G. Livshitz, M. Inbar, and M. Gutman Role of 18F-FDG Dual-Head Gamma-Camera Coincidence Imaging in Recurrent or Metastatic Colorectal Carcinoma J. Nucl. Med., May 1, 2002; 43(5): 603 - 609. [Abstract] [Full Text] [PDF]

				E. Even-Sapir, Z. Keidar, J. Sachs, A. Engel, L. Bettman, D. Gaitini, L. Guralnik, N. Werbin, G. Iosilevsky, and O. Israel The New Technology of Combined Transmission and Emission Tomography in Evaluation of Endocrine Neoplasms J. Nucl. Med., July 1, 2001; 42(7): 998 - 1004. [Abstract] [Full Text] [PDF]