Effects of attenuation correction and reconstruction method on PET activation studies

Experimental evaluation of iterative reconstruction versus filtered back projection for 3D [ 15O]water PET activation studies using statistical parametric mapping analysis

Objective: Attenuation has a significant influence on data and consequently on image quality. Attenuation correction corrects the weakening of the gamma photons in various depths. Non-diagnostic, low-dosage CT is usually used for attenuation correction when images are taken with a SPECT/CT. The purpose of the study was to determine the influence of attenuation correction in SPECT/CT on image quality in NEMA body phantom analysis in different background/sphere ratios.
 Material and Methods: The NEMA IEC Body Phantom was filled with isotope technetium-99m (99mTc), with a different ratio between the phantom background and spheres. The images were reconstructed using filtered back projection (FBP), non-corrected iterative reconstruction (IR), and iterative reconstruction using computer tomography for attenuation correction (CT-AC). The average number of counts in the background and in all six spheres was measured. This was followed by a comparison of the contrast in images that were reconstructed using different methods.
 Results: The average number of counts in sphere increased as we increased the activity concentration ratio between the background and sphere. Statistical analysis showed that contrast is significantly divergent between different methods of reconstruction.
 Conclusion: The use of iterative reconstruction with CT-AC improves the contrast and image quality compared to iterative reconstruction and FBP.

In pelvic bone SPECT using Tc-99m labeled compounds, physical effects such as nonhomogeneous attenuation and the accumulation of activity into the bladder during the data acquisition process can often result in data inconsistencies. With filtered backprojection (FBP) reconstruction, this may result in streak artifacts. Various methods for attenuation compensation can be employed to account for some of these streaks, but if the rate of uptake of tracer in to the bladder is sufficient, the resultant streaks may be significant enough to impair lesion detection. We have investigated various reconstruction methods in an effort to reduce these artifacts. In order to assess the impact of inconsistent bladder activities on the detection of pelvic lesions, SPECT imaging was simulated using the Zubal voxelized phantom, for cases of both a static bladder activity and a changing activity distribution. Reconstructions were performed using FBP, ordered subset-expectation maximization (OSEM) and dynamic expectation maximization (dEM) and was assessed for lesion detectability using a channelized, nonprewhitening (CNPW) numerical observer model. This observer model was used to optimize reconstruction strategies for a human LROC observer study. The human LROC observer study was performed in order to assess the various reconstruction methods in terms of lesion detectability. Three human observers were used in this test. The results of this test indicate that FBP performs significantly worse than static OSEM iterative reconstruction with attenuation correction when assessed using the area under the LROC curve (maximal ALROC=0.47 for FBP versus 0.71 for OSEM). Visually, the dEM algorithm produces images with slightly reduced streak artifacts compared to OSEM, but this improvement was not reflected in significantly improved ALROC values. In fact, when assessed using human LROC methodology, detectability actually decreased slightly when using dEM (maximal ALROC=0.71 for OSEM versus 0.66 for dEM), although this reduction was not determined to be statistically significant. It is possible that the slightly reduced performance of the dEM algorithm may be due, in part, to not performing an optimization in the number of reconstruction iterations as was performed for the OSEM method

Objective To study the effect of the reconstruction method on the semi-quantitative distribution of dopamine transporter (DAT) in the brain, 2β-carbomethoxy-3β-(4-fluorophe-nyl)-(N-11C-methyl)tropane (11C-CFT) PET images of healthy subjects were reconstructed by different PET reconstruction methods. Methods From March 2014 to June 2015, the 11C-CFT PET images of 41 healthy subjects were reconstructed by filtering back projection(FBP) method and ordered subsets expectation maximization (OSEM) iterative method. The brain regions of interest (ROI), namely, caudate nucleus, anterior putamen, and posterior shell nucleus, were automatically sketched with the parietal and occipital cortex lacking of DAT distribution as reference regions. The semi-quantitative value of DAT distribution was calculated using the following formula: radioactivity count of ROI/radioactivity count of parietal and occipital cortex-1. Paired t-test was used to compare the semi-quantitative values of DAT distribution. Correlation analysis was performed using the Pearson correlation analysis. Results The values of DAT distribution based on OSEM were as follows: caudate nucleus (1.77-2.15), anterior putamen (2.17-2.39), and posterior putamen (1.71-2.06). The values of DAT distribution based on FBP were as follows: caudate nucleus (1.68-2.10), anterior putamen (2.07-2.37), and posterior putamen (1.62-1.96). In the bilateral caudate nucleus and anterior and posterior putamen, the 11C-CFT of DAT distribution by OSEM was significantly higher than that by FBP(t=9.658-15.859, all P=0.000). The Pearson correlation analysis showed that the semi-quantitative values of DAT distribution by FBP and OSEM were positively correlated with each other in the bilateral caudate nucleus and anterior and posterior putamen (R2=0.907-0.951, all P=0.000). The DAT distribution by OSEM and FBP decreased with aging in the caudate nucleus and anterior and posterior putamen. Conclusions A significant difference was found in the semi-quantitative value of the DAT distribution in the brain of healthy subjects by different PET reconstruction methods. Therefore, a consistent PET image reconstruction method should be used in a multicenter or longitudinal study. Key words: Dopamine plasma membrane transport proteins; Positron-emission tomography; Filtered backprojection; Iterative

BackgroundPositron Emission Tomography (PET), Computed Tomography (CT), PET/CT and Single Photon Emission Tomography (SPECT) are non-invasive imaging tools used for creating two dimensional (2D) cross section images of three dimensional (3D) objects. PET and SPECT have the potential of providing functional or biochemical information by measuring distribution and kinetics of radiolabelled molecules, whereas CT visualizes X-ray density in tissues in the body. PET/CT provides fused images representing both functional and anatomical information with better precision in localization than PET alone.Images generated by these types of techniques are generally noisy, thereby impairing the imaging potential and affecting the precision in quantitative values derived from the images. It is crucial to explore and understand the properties of noise in these imaging techniques. Here we used autocorrelation function (ACF) specifically to describe noise correlation and its non-isotropic behaviour in experimentally generated images of PET, CT, PET/CT and SPECT.MethodsExperiments were performed using phantoms with different shapes. In PET and PET/CT studies, data were acquired in 2D acquisition mode and reconstructed by both analytical filter back projection (FBP) and iterative, ordered subsets expectation maximisation (OSEM) methods. In the PET/CT studies, different magnitudes of X-ray dose in the transmission were employed by using different mA settings for the X-ray tube. In the CT studies, data were acquired using different slice thickness with and without applied dose reduction function and the images were reconstructed by FBP. SPECT studies were performed in 2D, reconstructed using FBP and OSEM, using post 3D filtering. ACF images were generated from the primary images, and profiles across the ACF images were used to describe the noise correlation in different directions. The variance of noise across the images was visualised as images and with profiles across these images.ResultsThe most important finding was that the pattern of noise correlation is rotation symmetric or isotropic, independent of object shape in PET and PET/CT images reconstructed using the iterative method. This is, however, not the case in FBP images when the shape of phantom is not circular. Also CT images reconstructed using FBP show the same non-isotropic pattern independent of slice thickness and utilization of care dose function. SPECT images show an isotropic correlation of the noise independent of object shape or applied reconstruction algorithm. Noise in PET/CT images was identical independent of the applied X-ray dose in the transmission part (CT), indicating that the noise from transmission with the applied doses does not propagate into the PET images showing that the noise from the emission part is dominant. The results indicate that in human studies it is possible to utilize a low dose in transmission part while maintaining the noise behaviour and the quality of the images.ConclusionThe combined effect of noise correlation for asymmetric objects and a varying noise variance across the image field significantly complicates the interpretation of the images when statistical methods are used, such as with statistical estimates of precision in average values, use of statistical parametric mapping methods and principal component analysis. Hence it is recommended that iterative reconstruction methods are used for such applications. However, it is possible to calculate the noise analytically in images reconstructed by FBP, while it is not possible to do the same calculation in images reconstructed by iterative methods. Therefore for performing statistical methods of analysis which depend on knowing the noise, FBP would be preferred.

This work is aimed at evaluating the image reconstruction techniques used in single photon emission computed tomography (SPECT/CT) imaging. The reconstruction techniques considered in this work are: the ordered subset expectation maximization (OSEM) and the Filtered Back Projection (FBP). An anthropomorphic torso phantom with lung and liver inserts was injected with 99mTc. The liver and the background were given 0.2 MBq/ml and 0.07 MBq/ml respectively. The lungs inserts were filled with polystyrene beads for humanization. A mimicked 30 ml tumor (27 mm) in the liver insert was given 2 MBq/ml sequential SPECT/CT (step and shot, 10 mins over 180° per head) and CT (120 kVp, 80 mAs) projections were acquired using dual head SPECT/16 slice CT system. The projections were reconstructed using OSEM (10 subsets for 2–10 numbers of iterations, Butterworth post filtering, 10 orders and 0.48 frequencies) and FBP (using Butterworth post filtering at 10 order and cutoff frequencies of 0.38–0.58, 0.05 gaps). Image J software was used for the image analysis. Statistical t-test tested the mean gray values of the tumor and its background. The OSEM and FBP reconstructed images were evaluated from their contrast-to-noise ratio (CNR). The optimal parameter was selected based on 3–5 CNR detection range set by the Rose criterion. The t-test showed the background and the tumors mean values to be statistically significant (P ≪ 0.05). The CNR values for FBP images were all below the detection range, maximum value at the cutoff frequency 0.48 (1.69). In OSEM images at cutoff frequency 0.48, the CNR values were within the detection range for 2–8 numbers of iteration with maximum value (4.89) at 4 numbers of iteration. OSEM was found to be the best for tumor detection and administered activity can be reduced at 4 OSEM’s of iterations (40 MLEM iterations) for patient safety. Keywords: Anthropomorphic torso phantom, 99mTc, SPECT, iterative reconstruction, CNR, P-Value, liver Cite this Article F. Usman, R. Zainon, A. Saidu, A. Bala. Evaluation of image reconstruction techniques in Single photon emission computed tomography (SPECT/CT) imaging. Research & Reviews: Journal of Physics. 2016; 5(2): 13–22p.

Assessment of the impact of model-based scatter correction on [18F]-FDG 3D brain PET in healthy subjects using statistical parametric mapping

Low energy (LE) collimator is generally used in I-123 SPECT imaging. However, the septal penetration and scattering of photons emitted with energy above 159 keV will affect the image contrast and quantitative accuracy of images. To reduce this effect, medium energy (ME) collimator has been used with the cost of lower counting statistics and spatial resolution. The effects of collimator dependency on the quantitative accuracy of attenuation corrected (AC) I-123 SPECT images using X-ray-based attenuation map was investigated. Both brain and heart/thorax phantoms were used to evaluate different degree of attenuation effect between brain and thorax. Experiments were performed at different target-to-background ratios to simulate different object contrast. Both photopeak and scatter projections were collected for dual-energy window scatter correction (SC). Images were reconstructed and compared using different reconstruction methods, which included FBP (filtered backprojection), and OSEM (ordered subset expectation maximization) without corrections, with AC, with SC, and with AC and SC. In both phantom studies, the image contrast and quantitative accuracy were both improved with the use of CT-based transmission map for AC. The image contrast provided by ME collimator was better than that of LE collimator, especially in the region with void activity of thorax phantom. From the results of phantom studies, medium energy collimator with CT-based transmission map showed improvements in image contrast and quantitative accuracy of I-123 SPECT images.

To evaluate the image quality produced by six different iterative reconstruction (IR) algorithms in four CT systems in the setting of brain CT, using different radiation dose levels and iterative image optimisation levels. An image quality phantom, supplied with a bone mimicking annulus, was examined using four CT systems from different vendors and four radiation dose levels. Acquisitions were reconstructed using conventional filtered back-projection (FBP), three levels of statistical IR and, when available, a model-based IR algorithm. The evaluated image quality parameters were CT numbers, uniformity, noise, noise-power spectra, low-contrast resolution and spatial resolution. Compared with FBP, noise reduction was achieved by all six IR algorithms at all radiation dose levels, with further improvement seen at higher IR levels. Noise-power spectra revealed changes in noise distribution relative to the FBP for most statistical IR algorithms, especially the two model-based IR algorithms. Compared with FBP, variable degrees of improvements were seen in both objective and subjective low-contrast resolutions for all IR algorithms. Spatial resolution was improved with both model-based IR algorithms and one of the statistical IR algorithms. The four statistical IR algorithms evaluated in the study all improved the general image quality compared with FBP, with improvement seen for most or all evaluated quality criteria. Further improvement was achieved with one of the model-based IR algorithms. The six evaluated IR algorithms all improve the image quality in brain CT but show different strengths and weaknesses.

The purpose of this study was to evaluate the diagnostic value of attenuation-corrected single photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) on the inferior wall compared to uncorrected (NC) SPECT MPI between obese and nonobese patients. A total of 157 consecutive patients (122 males and 35 females, with median age: 57.4 ± 11 years) who underwent AC technetium 99m-methoxyisobutylisonitrile (AC Tc99m-sestamibi) SPECT MPI were included to the study. A hybrid SPECT and transmission computed tomography (CT) system was used for the diagnosis with 1-day protocol, and stress imaging was performed first. During attenuation correction (AC) processing on a Xeleris Workstation using Myovation cardiac software with ordered subset expectation maximization (OSEM), iterative reconstruction with attenuation correction (IRAC) and NC images filtered back projection (FBP) were used. For statistical purposes, P < 0.05 was considered significant. This study included 73 patients with body mass index (BMI) <30 and 84 patients with BMI ≥ 30. In patients with higher BMI, increased amount of both visual and semiquantitative attenuation of the inferior wall was detected. IRAC reconstruction corrects the diaphragm attenuation of the inferior wall better than FBP. AC with OSEM iterative reconstruction significantly improves the diagnostic value of stress-only SPECT MPI in patients with normal weight and those who are obese, but the improvements are significantly greater in obese patients. Stress-only SPECT imaging with AC provides shorter and lower radiation exposure.

We evaluated the feasibility of sub-millisievert (mSv) coronary CT angiography (CCTA) using low tube voltage, prospective ECG gating, and a knowledge-based iterative model reconstruction algorithm. Twenty-four non-obese healthy subjects (M:F 13:11; mean age 50.2±7.8years) were enrolled. Three sets of CT images were reconstructed using three different reconstruction methods: filtered back projection (FBP), iterative reconstruction (IR), and knowledge-based iterative model reconstruction (IMR). The scanning parameters were as follows: step-and-shoot axial scanning, 80kVp, and 200mAs. On the three sets of CT images, the attenuation and image noise values were measured at the aortic root. The signal-to-noise ratio (SNR) and the contrast-to-noise ratio (CNR) were calculated at the proximal right coronary artery and the left main coronary artery. The qualitative image quality of the CCTA with IMR was assessed using a 4-point grading scale (grade 1, poor; grade 4, excellent). The mean radiation dose of the CCTA was 0.89±0.09mSv. The attenuation values with IMR were not different from those of other reconstruction methods. The image noise with IMR was significantly lower than with IR and FBP. Compared to FBP, the noise reduction rate of IMR was 69%. The SNR and CNR of CCTA with IMR were significantly higher than with FBP or IR. On the qualitative analysis with IMR, all included segments were diagnostic (grades 2, 3, and 4), and the mean image quality score was 3.6±0.6. In conclusion, CCTA with low tube voltage, prospective ECG gating, and an IMR algorithm might be a feasible method that allows for sub-millisievert radiation doses and good image quality when used with non-obese subjects.

The Siemens Biograph TruePoint TrueV (B-TPTV) positron emission tomography (PET) scanner performs 3D PET reconstruction using a system matrix with point spread function (PSF) modeling (called the True X reconstruction). PET resolution was dramatically improved with the True X method. In this study, we assessed the spatial resolution and image quality on a B-TPTV PET scanner. In addition, we assessed the feasibility of animal imaging with a B-TPTV PET and compared it with a microPET R4 scanner. Spatial resolution was measured at center and at 8 cm offset from the center in transverse plane with warm background activity. True X, ordered subset expectation maximization (OSEM) without PSF modeling, and filtered back-projection (FBP) reconstruction methods were used. Percent contrast (% contrast) and percent background variability (% BV) were assessed according to NEMA NU2-2007. The recovery coefficient (RC), non-uniformity, spill-over ratio (SOR), and PET imaging of the Micro Deluxe Phantom were assessed to compare image quality of B-TPTV PET with that of the microPET R4. When True X reconstruction was used, spatial resolution was <3.65 mm with warm background activity. % contrast and % BV with True X reconstruction were higher than those with the OSEM reconstruction algorithm without PSF modeling. In addition, the RC with True X reconstruction was higher than that with the FBP method and the OSEM without PSF modeling method on the microPET R4. The non-uniformity with True X reconstruction was higher than that with FBP and OSEM without PSF modeling on microPET R4. SOR with True X reconstruction was better than that with FBP or OSEM without PSF modeling on the microPET R4. This study assessed the performance of the True X reconstruction. Spatial resolution with True X reconstruction was improved by 45 % and its % contrast was significantly improved compared to those with the conventional OSEM without PSF modeling reconstruction algorithm. The noise level was higher than that with the other reconstruction algorithm. Therefore, True X reconstruction should be used with caution when quantifying PET data.

Standardised Uptake Values (SUVs) are widely used in positron emission tomography (PET) as a semi-quantitative index of fluorine-18 labelled fluorodeoxyglucose uptake. The objective of this study was to investigate any bias introduced in the calculation of SUVs as a result of employing ordered subsets-expectation maximisation (OSEM) image reconstruction and segmented attenuation correction (SAC). Variable emission and transmission time durations were investigated. Both a phantom and a clinical evaluation of the bias were carried out. The software implemented in the GE Advance PET scanner was used. Phantom studies simulating tumour imaging conditions were performed. Since a variable count rate may influence the results obtained using OSEM, similar acquisitions were performed at total count rates of 34kcps and 12kcps. Clinical data consisted of 100 patient studies. Emission datasets of 5 and 15min duration were combined with 15-, 3-, 2- and 1-min transmission datasets for the reconstruction of both phantom and patient studies. Two SUVs were estimated using the average (SUVavg) and the maximum (SUVmax) count density from regions of interest placed well inside structures of interest. The percentage bias of these SUVs compared with the values obtained using a reference image was calculated. The reference image was considered to be the one produced by filtered backprojection (FBP) image reconstruction with measured attenuation correction using the 15-min emission and transmission datasets for each phantom and patient study. A bias of 5%-20% was found for the SUVavg and SUVmax in the case of FBP with SAC using variable transmission times. In the case of OSEM with SAC, the bias increased to 10%-30%. An overall increase of 5%-10% was observed with the use of SUVmax. The 5-min emission dataset led to an increase in the bias of 25%-100%, with the larger increase recorded for the SUVmax. The results suggest that OSEM and SAC with 3 and 2min transmission may be reliably used to reduce the overall data acquisition time without compromising the accuracy of SUVs.

Although post-injection transmission scan (POST-TS) after 2-[(18)F]fluoro-2-deoxy- D-glucose ((18)F-FDG) injection[A1] is useful for short examination times, the emission count of (18)F-FDG[A2] in the regional brain area was not completely subtracted with use of the POST-TS method. The purpose of this study was to investigate the effect of POST-TS and attenuation correction (AC) methods on the normal database (NDB). A 10 min pre-injection transmission scan (PRE-TS) was performed before (18)F-FDG[A3] was injected in eighteen normal volunteers. A 10 min POST-TS was then conducted beginning 40 min after (18)F-FDG[A4] injection, followed by a 10 min 2-dimentional emission scanning. To reconstruct each image of normal volunteers, the reconstruction was performed using the filtered back-projection (FBP) method and the ordered subsets expectation maximization (OSEM) method, with transmission-based measured attenuation correction (MAC) and the segmented attenuation correction (SAC) technique. Subtraction images of NDB with PRE-TS or POST-TS were evaluated using 3D-SSP. A phantom study was also performed in addition to a human study, and assessment was by region of interests and profile curves. NDB images with POST-TS were significantly lower in the bilateral frontal lobes and higher in the parietal lobes and occipital lobes, including the precuneus, than those with PRE-TS, regardless of the different AC and reconstruction algorithms. Therefore, we have to be careful to confirm not only emission scan methods and reconstruction algorithms, but also TS methods and AC methods in the NDB. It will be best to perform PET examinations using the same TS methods and AC methods between NDB and patients.

BackgroundIterative computed tomography (CT) image reconstruction shows high potential for the preservation of image quality in diagnostic CT while reducing patients’ exposure; it has become available for low-dose CT (LD-CT) in high-end hybrid imaging systems (e.g. single-photon emission computed tomography [SPECT]-CT).PurposeTo examine the effect of an iterative CT reconstruction algorithm on image quality, image noise, detectability, and the reader’s confidence for LD-CT data by a subjective assessment.Material and MethodsThe LD-CT data were validated for 40 patients examined by an abdominal hybrid SPECT-CT (U = 120 kV, I = 40 mA, pitch = 1.375). LD-CT was reconstructed using either filtered back projection (FBP) or an iterative image reconstruction algorithm (Adaptive Statistical Iterative Reconstruction [ASIR]®) with different parameters (ASIR levels 50% and 100%). The data were validated by two independent blinded readers using a scoring system for image quality, image noise, detectability, and reader confidence, for a predefined set of 16 anatomic substructures.ResultsThe image quality was significantly improved by iterative reconstruction of the LD-CT data compared with FBP (P ≤ 0.0001). While detectability increased in only 2/16 structures (P ≤ 0.03), the reader’s confidence increased significantly due to iterative reconstruction (P ≤ 0.002). Meanwhile, at the ASIR level of 100%, the detectability in bone structure was highly reduced (P = 0.003).ConclusionAn ASIR level of 50% represents a good compromise in abdominal LD-CT image reconstruction. The specific ASIR level improved image quality (reduced image noise) and reader confidence, while preserving detectability of bone structure.