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      On transcending the impasse of respiratory motion correction applications in routine clinical imaging – a consideration of a fully automated data driven motion control framework

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          Abstract

          Positron emission tomography (PET) is increasingly used for the detection, characterization, and follow-up of tumors located in the thorax. However, patient respiratory motion presents a unique limitation that hinders the application of high-resolution PET technology for this type of imaging. Efforts to transcend this limitation have been underway for more than a decade, yet PET remains for practical considerations a modality vulnerable to motion-induced image degradation. Respiratory motion control is not employed in routine clinical operations. In this article, we take an opportunity to highlight some of the recent advancements in data-driven motion control strategies and how they may form an underpinning for what we are presenting as a fully automated data-driven motion control framework. This framework represents an alternative direction for future endeavors in motion control and can conceptually connect individual focused studies with a strategy for addressing big picture challenges and goals.

          Electronic supplementary material

          The online version of this article (doi: 10.1186/2197-7364-1-8) contains supplementary material, which is available to authorized users.

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          Respiratory motion correction in oncologic PET using T1-weighted MR imaging on a simultaneous whole-body PET/MR system.

          Andreas Boss, Christian Würslin, Lars Stegger … (2013)
          Hybrid PET/MR combines the exceptional molecular sensitivity of PET with the high resolution and versatility of MR imaging. Simultaneous data acquisition additionally promises the use of MR to enhance the quality of PET images, for example, by respiratory motion correction. This advantage is especially relevant in thoracic and abdominal areas to improve the visibility of small lesions with low radiotracer uptake and to enhance uptake quantification. In this work, the applicability and performance of an MR-based method of respiratory motion correction for PET tumor imaging was evaluated in phantom and patient studies. PET list-mode data from a motion phantom with (22)Na point sources and 5 patients with tumor manifestations in the thorax and upper abdomen were acquired on a simultaneous hybrid PET/MR system. During the first 3 min of a 5-min PET scan, the respiration-induced tissue deformation in the PET field of view was recorded using a sagittal 2-dimensional multislice gradient echo MR sequence. MR navigator data to measure the location of the diaphragm were acquired throughout the PET scan. Respiration-gated PET data were coregistered using the MR-derived motion fields to obtain a single motion-corrected PET dataset. The effect of motion correction on tumor visibility, delineation, and radiotracer uptake quantification was analyzed with respect to uncorrected and gated images. Image quality in terms of lesion delineation and uptake quantification was significantly improved compared with uncorrected images for both phantom and patient data. In patients, in head-feet line profiles of 14 manifestations, the slope became steeper by 66.7% (P = 0.001) and full width at half maximum was reduced by 20.6% (P = 0.001). The mean increase in maximum standardized uptake value, lesion-to-background ratio (contrast), and signal-to-noise ratio was 28.1% (P = 0.001), 24.7% (P = 0.001), and 27.3% (P = 0.003), respectively. Lesion volume was reduced by an average of 26.5% (P = 0.002). As opposed to the gated images, no increase in background noise was observed. However, motion correction performed worse than gating in terms of contrast (-11.3%, P = 0.002), maximum standardized uptake value (-10.7%, P = 0.003), and slope steepness (-19.3%, P = 0.001). The proposed method for MR-based respiratory motion correction of PET data proved feasible and effective. The short examination time and convenience (no additional equipment required) of the method allow for easy integration into clinical routine imaging. Performance compared with gating procedures can be further improved using list-mode-based motion correction.
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            Respiratory motion correction in 3-D PET data with advanced optical flow algorithms.

            Reham M Dawood, Florian Büther, Xiaoyi Jiang … (2008)
            The problem of motion is well known in positron emission tomography (PET) studies. The PET images are formed over an elongated period of time. As the patients cannot hold breath during the PET acquisition, spatial blurring and motion artifacts are the natural result. These may lead to wrong quantification of the radioactive uptake. We present a solution to this problem by respiratory-gating the PET data and correcting the PET images for motion with optical flow algorithms. The algorithm is based on the combined local and global optical flow algorithm with modifications to allow for discontinuity preservation across organ boundaries and for application to 3-D volume sets. The superiority of the algorithm over previous work is demonstrated on software phantom and real patient data.
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              Respiratory gating enhances imaging of pulmonary nodules and measurement of tracer uptake in FDG PET/CT.

              Matthias Werner, David R. J. Palmer, Gerald M Kolodny … (2009)
              The aim of this study was to evaluate prospectively the effects of respiratory gating during FDG PET/CT on the determination of lesion size and the measurement of tracer uptake in patients with pulmonary nodules in a clinical setting. Eighteen patients with known pulmonary nodules (nine women, nine men; mean age, 61.4 years) underwent conventional FDG PET/CT and respiratory-gated PET acquisitions during their scheduled staging examinations. Maximum, minimum, and average standardized uptake values (SUVs) and lesion size and volume were determined with and without respiratory gating. The results were then compared using the two-tailed Student's t test and the nonparametric Wilcoxon's test to assess the effects of respiratory gating on PET acquisitions. Respiratory gating reduced the measured area of lung lesions by 15.5%, the axial dimension by 10.3%, and the volume by 44.5% (p = 0.014, p = 0.007, and p = 0.025, respectively). The lesion volumes in gated studies were closer to those assessed by standard CT (difference decreased by 126.6%, p = 0.025). Respiratory gating increased the measured maximum SUV by 22.4% and average SUV by 13.3% (p < 0.001 and p = 0.002). Our findings suggest that the use of PET respiratory gating in PET/CT results in lesion volumes closer to those assessed by CT and improved measurements of tracer uptake for lesions in the lungs.
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                Author and article information

                Contributors
                Adam L Kesner: adam.kesner@ucdenver.edu
                Paul J Schleyer: paul.schleyer@kcl.ac.uk
                Florian Büther: florian.buether@uni-muenster.de
                Martin A Walter: martin.alexander.walter@gmail.com
                Klaus P Schäfers: schafkl@uni-muenster.de
                Phillip J Koo: Phillip.Koo@ucdenver.edu
                Journal
                Journal ID (nlm-ta): EJNMMI Phys
                Journal ID (iso-abbrev): EJNMMI Phys
                Title: EJNMMI Physics
                Publisher: Springer International Publishing (Cham )
                ISSN (Electronic): 2197-7364
                Publication date (Electronic): 17 June 2014
                Publication date PMC-release: 17 June 2014
                Publication date Collection: December 2014
                Volume: 1
                Electronic Location Identifier: 7
                Affiliations
                [ ]Division of Nuclear Medicine, Department of Radiology, Anschutz Medical Campus, University of Colorado Denver, 12700 E 19th Ave, Box C-278, Aurora, CO 80045 USA
                [ ]Division of Imaging Sciences and Biomedical Engineering, King’s College London, London, WC2R 2LS UK
                [ ]European Institute for Molecular Imaging, University of Münster, Münster, 48149 Germany
                [ ]Institute of Nuclear Medicine and Department of Clinical Research, University Hospital Bern, Bern, 3010 Switzerland
                Article
                Publisher ID: 7
                DOI: 10.1186/2197-7364-1-8
                PMC ID: 4673082
                PubMed ID: 26501450
                SO-VID: 0f5fdcf7-b973-4e4e-b9fa-f640e210165a
                Copyright © © Kesner et al.; licensee Springer. 2014
                License:

                This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited.

                History
                Date received : 7 March 2014
                Date accepted : 23 May 2014
                Categories
                Subject: Teaching File
                Custom metadata
                issue-copyright-statement © The Author(s) 2014

                Keywords: respiratory gating,motion correction,motion control framework,data-driven gating,signal optimization,pet
                Data availability:
                Keywords: respiratory gating, motion correction, motion control framework, data-driven gating, signal optimization, pet

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