• The Korean Journal of Nuclear Medicine Technology
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• v.20 no.2
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• pp.21-26
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• 2016

Purpose Because of many advantages, PET-CT Scanners generally use CT Data for attenuation correction. By using CT based attenuation correction, we can get anatomical information, reduce scan time and make more accurate correction of attenuation. However in case metal artifact occurred during CT scan, CT-based attenuation correction can induce artifacts and quantitative errors that can affect the PET images. Therefore this study infers true SUV of metal artifact region from attenuation corrected image count -to- non attenuation corrected image count ratio. Materials and Methods Micro phantom inserted $^{18}F-FDG$ 4mCi was used for phantom test and Biograph mCT S(40) is used for medical test equipment. We generated metal artifact in micro phantom by using metal. Then we acquired both metal artifact region of correction factor and non metal artifact region of correction factor by using attenuation correction image count -to- non attenuation correction image count ratio. In case of clinical image, we reconstructed both attenuation corrected images and non attenuation corrected images of 10 normal patient($66{\pm}15age$) who examined PET-CT scan in SNUH. After that, we standardize several organs of correction factor by using attenuation corrected image count -to- non attenuation corrected count ratio. Then we figured out metal artifact region of correction factor by using metal artifact region of attenuation corrected image count -to- non attenuation corrected count ratio And we compared standard organs correction factor with metal artifact region correction factor. Results according to phantom test results, metal artifact induce overestimation of correction factor so metal artifact region of correction factors are 12% bigger than the non metal artifact region of correction factors. in case of clinical test, correction factor of organs with high CT number(>1000) is $8{\pm}0.5%$, correction factor of organs with CT number similar to soft tissue is $6{\pm}2%$ and correction factor of organs with low CT number(-100>) is $3{\pm}1%$. Also metal artifact correction factors are 20% bigger than soft tissue correction factors which didn't happened metal artifact. Conclusion metal artifact lead to overestimation of attenuation coefficient. because of that, SUV of metal artifact region is overestimated. Thus for more accurate quantitative evaluation, using attenuation correction image count -to-non attenuation correction image count ratio is one of the methods to reduce metal artifact affect.

• Nuclear Medicine and Molecular Imaging
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• v.41 no.1
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• pp.49-53
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• 2007

Purpose: It was reported that CT-based measured attenuation correction (CT-MAC) produced radioactivity concentration values significantly higher than $^{68}Ge$-based segmented attenuation correction (Ge-SAC) in PET images. However, it was unknown whether the radioactivity concentration difference resulted from different sources (CT vs. Ge) or types (MAC vs. SAC) of attenuation correction (AC). We evaluated the influences of the source and type of AC on the radioactivity concentration differences between reconstructed PET images in normal subjects and patients. Material and Methods: Five normal subjects and 35 patients with a known or suspected cancer underwent $^{18}F-FDG$ PET/CT. In each subject, attenuation corrected PET images using OSEM algorithm (28 subsets, 2 iterations) were reconstructed by 4 methods: CT-MAC, CT-SAC, Ge-MAC, and Ge-SAC. The physiological uptake in normal subjects and pathological uptake in patients were quantitatively compared between the PET images according to the source and type of AC. Results: The SUVs of physiological uptake measured in CT-MAC PET images were significantly higher than other 3 differently corrected PET images. Maximum SUVs of the 145 foci with abnormal FDG uptake in CT-MAC images were significantly highest among 4 differently corrected PET images with a difference of 2.4% to 5.1% (p<0.001). The SUVs of pathological uptake in Ge-MAC images were significantly higher than those in CT-SAC and Ge-MAC PET images (p<0.001). Conclusion: Quantitative radioactivity values were highest in CT-MAC PET images. The adoption of MAC may make a more contribution than the adoption of CT attenuation map to such differences.

• Journal of the Korean Institute of Telematics and Electronics
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• v.19 no.6
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• pp.33-40
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• 1982

Although ultrasonic CT is one of the useful techniques for tissue characterization, the reconstructed images, such as the velocity distribution and attenuation constant distribution, are degraded by reflection and refraction of ultrasonic beam. This paper studied the degradation effects on attenuation images using agar gel phantoms which were developed to evaluate ultrasonic CT. We found that the reconstructed attenuation constants at the center of the phantoms were less than the actual values by 0.6 dB/cm when phantom velocity differs by 25 m/s from surrounding saline. We also studied a correction method for refraction and phase cancellation effects, where the correction was made using the maximum value in the received subdata, as obtained by sub-arraying microprobes located at each sampling point. Using this method, we could obtain an improvement in the reconstructed image by the correction on the attenuation effect.

• The Korean Journal of Nuclear Medicine Technology
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• v.17 no.2
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• pp.10-14
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• 2013

Purpose: Due to developed simultaneous PET/MRI, it has become possible to obtain more anatomical image information better than conventional PET/CT. By the way, in the PET/CT, the linear absorption coefficient is measured by X-ray directly. However in case of PET/MRI, the value is not measured from MRI images directly, but is calculated by dividing as 4 segmentation ${\mu}-map$. Therefore, in this paper, we will evaluate the SUV's difference of attenuation correction PET images from PET/MRI and PET/CT. Materials and Methods: Biograph mCT40 (Siemens, Germany), Biograph mMR were used as a PET/CT, PET/MRI scanner. For a phantom study, we used a solid type $^{68}Ge$ source, and a liquid type $^{18}F$ uniformity phantom. By using VIBE-DIXON sequence of PET/MRI, human anatomical structure was divided into air-lung-fat-soft tissue for attenuation correction coefficient. In case of PET/CT, the hounsfield unit of CT was used. By setting the ROI at five places of each PET phantom images that is corrected attenuation, the maximum SUV was measured, evaluated %diff about PET/CT vs. PET/MRI. In clinical study, the 18 patients who underwent simultaneous PET/CT and PET/MRI was selected and set the ROI at background, lung, liver, brain, muscle, fat, bone from the each attenuation correction PET images, and then evaluated, compared by measuring the maximum SUV. Results: For solid $^{68}Ge$ source, SUV from PET/MRI is measured lower 88.55% compared to PET/CT. In case of liquid $^{18}F$ uniform phantom, SUV of PET/MRI as compared to PET/CT is measured low 70.17%. If the clinical study, the background SUV of PET/MRI is same with PET/CT's and the one of lung was higher 2.51%. However, it is measured lower about 32.50, 40.35, 23.92, 13.92, 5.00% at liver, brain, muscle, fat, femoral head. Conclusion: In the case of a CT image, because there is a linear relationship between 511 keV ${\gamma}-ray$ and linear absorption coefficient of X-ray, it is possible to correct directly the attenuation of 511 keV ${\gamma}-ray$ by creating a ${\mu}$map from the CT image. However, in the case of the MRI, because the MRI signal has no relationship at all with linear absorption coefficient of ${\gamma}-ray$, the anatomical structure of the human body is divided into four segmentations to correct the attenuation of ${\gamma}-rays$. Even a number of protons in a bone is too low to make MRI signal and to localize segmentation of ${\mu}-map$. Therefore, to develope a proper sequence for measuring more accurate attenuation coefficient is indeed necessary in the future PET/MRI.

• The Korean Journal of Nuclear Medicine Technology
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• v.17 no.2
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• pp.78-83
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• 2013

Purpose: SPECT/CT, a combination of SPECT and CT, is capable of expressing the results of attenuation correction on images biased by automatic program. As a result, this research evaluates the usefulness of images with CT attenuation correction, using various phantoms and images of patients. Materials and Methods: From July of 2012 to September of 2012, this research was conducted on the contrast, spatial resolution, and images of patients. We studied the contrast with IEC body phantom and Jaszczak phantom, while the spatial resolution was evaluated with NEMA triple line phantom. Further, a comparative study was carried out on the quality of the images, on the difference between the images before and after the CT attenuation correction. Results: Compared the differences between the contrast before and after the CT attenuation correction in IEC body phantom. The contrast was improved by 33.6% at minimum, 89.8% at maximum. In case of Jaszczak Phantom, the contrast was enhanced by 9.9% at minimum, 27.8% at maximum. In NEMA Triple line phantom, the resolution was raised by 4.5% in average: 4.4% in horizontal, 4.5% in vertical. In Anthropomorphic Torso Phantom, the perfusion score of the interior wall with the most severe attenuation was measured to be 29.4%. In the experiment carried out on myocardial perfusion SPECT/CT patients, 9% improvement was discovered in the interior wall, where the most dramatic attenuation occurred, after the CT attenuation correction. Conclusion: SPECT/CT proved its clinical usefulness by enabling the acquisition of images with enhanced contrast and spatial resolution compare to the ones resulted from SPECT.

• The Korean Journal of Nuclear Medicine Technology
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• v.16 no.2
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• pp.120-125
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• 2012

Purpose : The purpose of this study was to compare count between Chang's method and CT-based attenuation correction (AC-CT) among the attenuation correction (AC) methods for non-attenuation correction (AC-non) images of Brain SPECT (Single Photon Emission Computed Tomography). Materials and Methods : We injected $^{99m}Tc$ 37Mbq in a Hoffman 3D phantom filled with distilled water in the phantom study, and injected intravenously $^{99m}Tc$-HMPAO 740Mbq in a normal volunteer in the patient study, and then obtained Brain SPECT images with Symbia T6 of Siemens and conducted quantitative brain analysis. Transverse images to which each method was applied were rebuilt at the same position, and 6 regions of interest (ROI) were drawn on each of Slice No. 10, 20 and 30 and then the counts of AC-non, AC-CT and Chang's method were compared. Results : The mean counts of AC-non, AC-CT and Chang's method were $4606.8{\pm}511.3$, $16794.6{\pm}2429.4$, and $8752.6{\pm}896.5$, respectively, in the phantom study and $5460.8{\pm}519.6$, $15320{\pm}1171.6$ and $12795{\pm}1422.1$, respectively, in the patient study. In the phantom study, the ratio of AC-CT to AC-non was 3.70 and the ratio of Chang's method to AC-non was 1.92, and in the patient study, they were 2.85 and 2.38, respectively. Conclusion : From this study, we found that AC-CT makes higher AC than Chang's method. In addition, when Chang's method was used, AC in the patient study was higher than that in the phantom study. These results need to be considered also in other examinations.

• Nuclear Medicine and Molecular Imaging
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• v.42 no.2
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• pp.172-180
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• 2008

PET/CT fused image with anatomical and functional information have improved medical diagnosis and interpretation. This fusion has resulted in more precise localization and characterization of sites of radio-tracer uptake. However, a motion during whole-body imaging has been recognized as a source of image quality degradation and reduced the quantitative accuracy of PET/CT study. The respiratory motion problem is more challenging in combined PET/CT imaging. In combined PET/CT, CT is used to localize tumors and to correct for attenuation in the PET images. An accurate spatial registration of PET and CT image sets is a prerequisite for accurate diagnosis and SUV measurement. Correcting for the spatial mismatch caused by motion represents a particular challenge for the requisite registration accuracy as a result of differences in PET/CT image. This paper provides a brief summary of the materials and methods involved in multiple investigations of the correction for respiratory motion in PET/CT imaging, with the goal of improving image quality and quantitative accuracy.

• Proceedings of the Korean Society of Medical Physics Conference
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• 2004.11a
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• pp.100-103
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• 2004

Experiments and simulation were done to study the impact of contrast agent when CT scan was used to attenuation correction for PET images in PET/CT system. Whole body phantom was imaged with various concentration of iodine-based contrast agent using CT. Mathematical emission and transmission density map with liver were made to simulate for whole body FDG imaging. Various transmission density maps was generated with non-uniform enhancement of contrast agent, hypo-attenuating of contrast agent for tumor, different concentration of contrast agent, and so on. Attenuation correction was done with all transmission maps. In the experiments, we confirmed that attenuation coefficient was changed by concentration of contrast agent. From the simulation data, image quality of attenuation corrected images was affected by contrast agent and artifact was produced by contrast agent. These results indicated that the contrast agent should be used with a full understanding of its potential problem in PET/CT system.

• The Korean Journal of Nuclear Medicine Technology
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• v.12 no.3
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• pp.214-221
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• 2008

Purpose: We make a qualitative analysis of whether Fusion SPECT/CT can find lesion's anatomical sites better than existing SPECT or not, and we want to show the usefulness of SPECT/CT through finding out effects of CT attenuation correction on SPECT images. Materials and Method: 1. The evaluation of fusion images: This study comprised patients who was tested $^{131}I$-MIBG, Bone, $^{111}In$-Octreotide, Meckel's diverticulum, Parathyroid MIBI with Precedence 16 or Symbia T2 from 2008 Jan to Aug. We compared SPECT/CT image with non fusion image and make a qualitative analysis. 2. The evaluation of attenuation correction: We classified 38 patients who was tested 201Tl myocardial exam with Symbia T2 into 5 sections by using Cedars Sinai' QPS program - Ant, Inf, Lat, Septum, Apex. And we showed each section's perfusion states by percentage. We compared the each section's perfusion-states differences between CT AC and Non AC by average${\pm}$standard deviation. Results: 1. The evaluation of fusion images : In high energy $^{131}I$ cases, it was hard to grasp exact anatomical lesions due to difference between regions and surrounding lesions' uptake level. After combining with CT, we could grabs anatomical lesion more exactly. And in meckel's diverticulum case or to find lesions around bowels or organs with $^{111}In$ cases, it demonstrates its superiority. Bone SPECT/CT images help to distinguish between disk spaces certainly and give correct results. 2. The evaluation of attenuation correction: There is no significant difference statistically in Ant and Lat (p>0.05), but there is a meaningful difference in Inferior, Apex and Septum (p<0.05). AC perfusion at inferior wall in the 5 sections of myocardium: The perfusion difference between Non AC perfusion image ($68.58{\pm}7.55$) and CT corrected perfusion image ($76.84{\pm}6.52$) was the largest by $8.26{\pm}4.95$ (p<0.01, t=10.29). Conclusion: Nuclear medicine physicians can identify not only molecular image which shows functional activity of lesions but also anatomical location information of lesions with more accuracy using the combination of SPECT and CT systems. Of course this combination helps nuclear medicine physician find out the abnormal parts. Moreover combined data sets help separate between normal group and abnormal group in complicated body part. So clinicians can carry out diagnosis and treatment planning at the same time with a single test image. In addition, when we examine a myocardium in thorax where attenuation can occur easily, we can trust perfusion more in a certain region in SPECT test because CT provides the capability for accurate attenuation correction. In these reasons, we think we can prove the justice after treatment fusion image.

• The Korean Journal of Nuclear Medicine Technology
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• v.15 no.2
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• pp.53-59
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• 2011

Purpose: To evaluate the dosimetry and image of very low does CT attenuation correction for phantom using pediatric PET/CT. Materials and methods: three PET / CT scanners (Discovery STe, BiographTruepoint 40, Discovery 600) as a child-size acrylic phantom and ion chamber dosimeter (Unfous Xi CT, Sweden) using a CT image acquisition parameters (10, 20, 40, 80, 100, 160 mA; 80, 100, 120, 140 kVp) by varying the depth dose and evaluate $CTDI_{vol}$ value. And each attenuation corrected PET/CT images used NEMA PET Phantom$^{TM}$ (NU2-1994) was evaluated by SUV. Results: Abdominal diagnosis CT dose in general pediatric (about 10 ages) parameter (100 kVp, 100 mA) than very low dose CT parameter (80 kVp, 10 mA) at the depth dose was reduced approximately 92%, $CTDI_{vol}$ was reduced to about 88%. Each CT attenuation corrected parameters PET images showed no change in the value of SUV. Conclusion: for pediatric patients, PET/CT scan can be obtained with very low dose attenuation correction CT (80 kVp, 10 mA), and such attenuation correction CT dose was reduced 100 fold than diagnosis CT dose. PET / CT scan used very low dose CT attenuation correction in pediatric patients can be helpful in reducing radiation dose.