• Korean Journal of Digital Imaging in Medicine
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• v.13 no.3
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• pp.111-115
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• 2011

PET/CT(Positron Emission Tomography/Computed Tomography) is an examination combining morphological and functional information in one examination. The purpose of this study is to see the lowest CT dose for attenuation correction in the PET/CT maintaining good image quality when considering CT scan dose to the patients. We injected $^{18}F$-FDG and water into the cylinder shaped phantom, and obtained emission images for 3 mins and transmission images(140 kVp, 8 sec, 10~200 mA for transmission images), and reconstructed the images to PET/CT images with Iterative method. Data(Maximum, Minimum, Average, Standard Deviation) were obtained by drawing a circular ROI(Region Of Interest) on each sphere in each image set with Image J program. And then described SD according to the CT and PEC/CT images as graphes. Through the graphes, we got the relationships of mA and quality of images. SDs according to CT graph were 16.25 at 10 mA, 7.26 at 50 mA, 5.5 at 100 mA, 4.29 at 150 mA, and 3.83 at 200 mA, i.e. the higer mA, the better image quality was presented. SDs according to PET/CT graph were 1823.2 at 10 mA, 1825.1 at 50 mA, 1828.4 at 100 mA, 1813.8 at 150 mA, and 1811.3 at 200 mA. Calculated SDs at PET/CT images were maintained. This means images quality is maintained having nothing to do with mA of high and low.

• The Korean Journal of Nuclear Medicine Technology
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• v.17 no.2
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• pp.53-58
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• 2013

Purpose: To optimize correction method for SPECT/CT, image quality consisting of resolution and contrast was evaluated using three radioisotopes ($^{99m}Tc$, $^{201}Tl$ and $^{131}I$) and three different correction methods; attenuation correction (AC), scatter correction (SC) and both attenuation and scatter correction (ACSC). Materials and Methods: Images were acquired with a SPECT/CT scanner and a conventional CT protocol with an OESM reconstruction algorithm (2 iterations and 10 subsets). For resolution measurement, fixed radioactivity (2.22 kBq) was infused into a spatial resolution phantom and full width at half maximum (FWHM) was measured using a vendor-provided software. For contrast evaluation, radioactive source with a ratio of 1:8 to background was filled in a Flanged Jaszczak phantom and percent contrast (%) were calculated. All the parameters for image quality were compared with non-correction (NC) method. Results: As compared with NC, image resolution of all three isotopes were significantly improved by AC and ACSC, not by SC. In particular, ACSC showed better resolution than AC alone for $^{99m}Tc$ and $^{201}Tl$. Image contrast of all three radioisotopes in a sphere with the largest diameter were enhanced by all correction methods. ACSC showed the highest contrast in all three radioisotopes, which was the most accurate in $^{99m}Tc$ (85.9%). Conclusion: Image quality of SPECT/CT was improved in all the radioisotopes by CT-based attenuation correction methods, except SC alone. SC failed to improve resolution in any radioisotopes, but it was effective in contrast enhancement. ACSC would be the best correction method as it improved resolution in radioisotopes with low energy levels and contrast in radioisotope with low energy levels. However, in radioisotope with high energy level, AC would be better than ACSC for resolution improvement.

• Journal of Radiopharmaceuticals and Molecular Probes
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• v.1 no.2
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• pp.130-136
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• 2015

We evaluate the influence of MR contrast agent on positron emission tomography (PET) image using phantom, animal and human studies. Phantom consisted of 15 solutions with the mixture of various concentrations of Gd-based MR contrast agent and fixed activity of [$^{18}F$]FDG. Animal study was performed using rabbit and two kinds of MR contrast agents. After injecting contrast agent, CT or MRI scanning was performed at 1, 2, 5, 10, and 20 minutes. PET image was obtained using clinical PET/CT scan, and attenuation correction was performed using the all CT images. The values of HU, PET activity and MRI intensity were obtained from ROIs in each phantom and organ regions. In clinical study, patients (n=20) with breast cancer underwent sequential acquisitions of early [$^{18}F$]FDG PET/CT, MRI and delayed PET/CT. In phantom study, as the concentration increased, the CT attenuation and PET activity also increased. However, there was no relationship between the PET activity and the concentration in the clinical dose range of contrast agent. In animal study, change of PET activity was not significant at all time point of CT scan both MR contrast agents. There was no significant change of HU between early and delayed CT, except for kidney. Early and delayed SUV in tumor and liver showed significant increase and decrease, respectively (P<0.05). Under the condition of most clinical study (< 0.2 mM), MR contrast agent did not influence on PET image quantitation.

• The Korean Journal of Nuclear Medicine
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• v.39 no.3
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• pp.182-190
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• 2005

Purpose: There are differences between Standard Uptake Value (SUV) of CT attenuation corrected PET and that of $^{137}Cs$. Since various causes lead to difference of SUV, it is important to know what is the cause of these difference. Since only the X-ray CT and $^{137}Cs$ transmission data are used for the attenuation correction, in Philips GEMINI PET/CT scanner, proper transformation of these data into usable attenuation coefficients for 511 keV photon has to be ascertained. The aim of this study was to evaluate the accuracy in the CT measurement and compare the CT and $^{137}Cs$-based attenuation correction in this scanner. Methods: For all the experiments, CT was set to 40 keV (120 kVp) and 50 mAs. To evaluate the accuracy of the CT measurement, CT performance phantom was scanned and Hounsfield units (HU) for those regions were compared to the true values. For the comparison of CT and $^{137}Cs$-based attenuation corrections, transmission scans of the elliptical lung-spine-body phantom and electron density CT phantom composed of various components, such as water, bone, brain and adipose, were performed using CT and $^{137}Cs$. Transformed attenuation coefficients from these data were compared to each other and true 511 keV attenuation coefficient acquired using $^{68}Ge$ and ECAT EXACT 47 scanner. In addition, CT and $^{137}Cs$-derived attenuation coefficients and SUV values for $^{18}F$-FDG measured from the regions with normal and pathological uptake in patients' data were also compared. Results: HU of all the regions in CT performance phantom measured using GEMINI PET/CT were equivalent to the known true values. CT based attenuation coefficients were lower than those of $^{68}Ge$ about 10% in bony region of NEMA ECT phantom. Attenuation coefficients derived from $^{137}Cs$ data was slightly higher than those from CT data also in the images of electron density CT phantom and patients' body with electron density. However, the SUV values in attenuation corrected images using $^{137}Cs$ were lower than images corrected using CT. Percent difference between SUV values was about 15%. Conclusion: Although the HU measured using this scanner was accurate, accuracy in the conversion from CT data into the 511 keV attenuation coefficients was limited in the bony region. Discrepancy in the transformed attenuation coefficients and SUV values between CT and $^{137}Cs$-based data shown in this study suggests that further optimization of various parameters in data acquisition and processing would be necessary for this scanner.

• Progress in Medical Physics
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• v.16 no.4
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• pp.192-201
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• 2005

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. A variety of factors were estimated, including non-uniform enhancement of contrast agent, concentration and distribution size of contrast agent, noise level, image resolution, reconstruction algorithm, hypo-attenuation of contrast agent, and different time phases for contrast agent. Experimental studies showed that Hounsfield unit depends on the concentration of contrast agent and tube voltage. From the simulation data, contrast agents Introduced artifacts and degraded image quality on the attenuation-corrected PET images. The severity of these effects depends on a variety of factors, including the concentration and distribution size of contrast agent, the noise levels, and the Image resolution. These results Indicated that the impact of contrast agents should be considered with a full understanding of their potential problems in clinical PET/CT images.

• Journal of Radiation Industry
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• v.12 no.4
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• pp.267-276
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• 2018

A Hoffman 3D Brain Phantom was used to evaluate two PET/CT scanners, BIO_40 and D_690, according to the radiation dose of CT (low, medium and high) at a fixed kilo-voltage-peak (kVp) with the tube current(mA) varied in 17~20 stages(Bio_40 PET/CT scanner: the tube voltage was fixed to 120 kVp, the effective tube current(mAs) was increased from 33 mAs to 190 mAs in 10 mAs increments, D_690 PET/CT scanner: the tube voltage was fixed to 140 kVp, tube current(mA) was increased from 10 mAs to 200 mAs in 10 mAs increments). After obtaining the PET image, an attenuation correction was conducted based on the attenuation map, which led to an analysis of the difference in the image. First, the ratio of white to gray matter for each scanner was examined by comparing the coefficient of variation (CV) depending on the average ratio. In addition, a blind test was carried out to evaluate the image. According to the study results, the BIO_40 and D_690 scanners showed a <1% change in CV value due to the tube current conversion. The change in the coefficients of white and gray matter showed that the Z value was negative for both scanners, indicating that the coefficient of gray matter was higher than that of white matter. Moreover, no difference was observed when the images were compared in a blind test.

• The Korean Journal of Nuclear Medicine Technology
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• v.16 no.2
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• pp.68-80
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• 2012

Purpose : More recently, combined PET/MR scanners have been developed in which the MR data can be used for both anatometabolic image formation and attenuation correction of the PET data. For quantitative PET information, correction of tissue photon attenuation is mandatory. The attenuation map is obtained from the CT scan in the PET/CT. In the case of PET/MR, the attenuation map can be calculated from the MR image. The purpose of this study was to assess the quantitative differences between MR-based and CT-based attenuation corrected PET images. Materials and Methods : Using the uniform cylinder phantom of distilled water which has 199.8 MBq of $^{18}F$-FDG put into the phantom, we studied the effect of MR-based and CT-based attenuation corrected PET images, of the PET-CT using time of flight (TOF) and non-TOF iterative reconstruction. The images were acquired from 60 minutes at 15-minute intervals. Region of interests were drawn over 70% from the center of the image, and the Scanners' analysis software tools calculated both maximum and mean SUV. These data were analyzed by one way-anova test and Bland-Altman analysis. MR images are segmented into three classes(not including bone), and each class is assigned to each region based on the expected average attenuation of each region. For clinical diagnostic purpose, PET/MR and PET/CT images were acquired in 23 patients (Ingenuity TF PET/MR, Gemini TF64). PET/CT scans were performed approximately 33.8 minutes after the beginnig of the PET/MR scans. Region of interests were drawn over 9 regions of interest(lung, liver, spleen, bone), and the Scanners' analysis software tools calculated both maximum and mean SUV. The SUVs from 9 regions of interest in MR-based PET images and in CT-based PET images were compared. These data were analyzed by paired t test and Bland-Altman analysis. Results : In phantom study, MR-based attenuation corrected PET images generally showed slightly lower -0.36~-0.15 SUVs than CT-based attenuation corrected PET images (p<0.05). In clinical study, MR-based attenuation corrected PET images generally showed slightly lower SUVs than CT-based attenuation corrected PET images (excepting left middle lung and transverse Lumbar) (p<0.05). And percent differences were -8.01.79% lower for the PET/MR images than for the PET/CT images. (excepting lung) Based on the Bland-Altman method, the agreement between the two methods was considered good. Conclusion : PET/MR confirms generally lower SUVs than PET/CT. But, there were no difference in the clinical interpretations made by the quantitative comparisons with both type of attenuation map.

• The Korean Journal of Nuclear Medicine Technology
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• v.18 no.2
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• pp.3-7
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• 2014

Purpose SPECT/CT scan to be performed attenuation correction on the basis of CT induce an overestimation of the site due to the beam hardening artifact by metal cover and reduce the images quality. Therefore, this study using a phantom that has been inserted artificial hip joint investigated that effect on the SPECT/CT image causing by metal artifact for varying the parameters of the Attenuation Map. Materials and Methods Siemens Symbia T16 SPECT/CT equipment was used. Artificial hip joint was inserted to SPECT/PET phantom, 17 mm sphere of Bright Streak area in CT image was filled with Tc-99m so that the radiation activity was 8 times compared to background. And then Hot and Background was measured in varying Wide Beam Coefficient on Attenuation Map and RBR (Region to Background Ratio) of Metal and Non-Metal was calculated and analyzed depending on the presence or absence of the hip joint. Results It tended to hot count of Non-Metal and Metal to increase as the value of the manual mode is increased, hot count ratio with the group of both manual mode 0.5 and 0.4 is the best match. Also, in automatic mode, the ratio of RBRNon-Metal and RBRMetal was 1.135, statistically significant difference was not observed in the manual mode 0.5 and 0.4. Conclusion In the automatic mode of Wide Beam Coefficient in attenuation correction map, it was found that it is over-correction by 13.52%, it was possible to minimize the over-correction by the artifact in 0.5 and 0.4 of manual mode. Further studies should be performed in order to apply to a patient with the help of this and it is considered possible to reduce the over-correction by the metal artifact of an artificial hip joint for Hip-Resurfacing Arthroplasty patients, and to improve the diagnostic performance.

• The Korean Journal of Nuclear Medicine Technology
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• v.16 no.2
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• pp.81-86
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• 2012

Purpose : Combined MR/PET scanners that use the MRI for PET AC face the challenge of absent surface coils in MR images and thus cannot directly account for attenuation in the coils. To make up for the weak point of MR attenuation correction, Three Modality System (PET/CT +MR) were used in Severance hospital. The goal of this work was to investigate the effects of MR Torso Coil on CT attenuation correction for PET. Materials and Methods : PET artifacts were evaluated when the MR Torso Coil was present of CTAC data with changing various kV and mA in uniformity water phantom and 1994 NEMA cylinderical phantom. They evaluated and compared the following two scenarios: (1) The uniform cylinder phantom and the MR Torso Coil scanned and reconstructed using CT-AC; (2) 1994 NEMA cylinderical phantom and the MR Torso Coil scanned and reconstructed using CT-AC. Results : Streak artifacts were present in CT images containing the MR Torso Coil due to metal components. These artifacts persisted after the CT images were converted for PET-AC. CT scans tended to over-estimate the linear attenuation coefficient when the kV and mA is increasing of the metal components when using conventional methods for converting from CT number. Conclusion : The presence of MR coils during PET/CT scanning can cause subtle artifacts and potentially important quantification errors. Alternative CT techniques that mitigate artifacts should be used to improve AC accuracy. When possible, removing segments of an MR coil prior to the PET/CT exam is recommended. Further, MR coils could be redesigned to reduce artifacts by rearranging placement of the most attenuating materials.

• Journal of radiological science and technology
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• v.39 no.4
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• pp.557-564
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• 2016

Effects of Gamma camera imaging on gamma ray counting rates as a function of use and density of the iodine contrast medium currently in primary use for clinics, and changes in gamma ray counting rates as a function of the contrast medium status upon attenuation correction using a CT absorption coefficient in an SPECT/CT attenuation correction will be considered herein. For experimental materials used $^{99m}TcO_4$ 370 MBq and Pamiray 370 mg, Iomeron 350 mg, Visipaque 320 mg, Bonorex 300 mg of iodine contrast medium. For image acquisition, planar imaging was consecutively filmed for 1, 2, 3, 4, 5 min, respectively, 30 min after administration of $^{99m}TcO_4$. while 60 views were filmed per frame for 20 min at 55 min for the SPECT/CT imaging. In planar imaging, the gamma ray counting rates as a function of filming time were reduced showing a statistically significant difference when mixed according to the type of contrast medium density rather than when the radioactive isotope $^{99m}TcO_4$ and the saline solution were mixed. In the tomography for mixing of the radioactive isotope $^{99m}TcO_4$ and saline solution, the mean counting rate without correction by the CT absorption coefficient is $182{\pm}26counts$, while the counting rate with correction by the CT absorption coefficient is $531.3{\pm}34counts$. In the tomography for mixing of the radioactive isotope $^{99m}TcO_4$ and the saline solution with the contrast medium, the mean values before attenuation correction by CT absorption coefficient were $166{\pm}29$, $158.3{\pm}17$, $154{\pm}36$, and $150{\pm}33counts$ depending on the densities of the contrast medium, while the mean values after attenuation correction were $515{\pm}03$, $503{\pm}10$, $496{\pm}31$, and $488.7{\pm}33counts$, showing significant differences in both cases when comparatively evaluated with the imaging for no mixing of the contrast medium. Iodine contrast medium affects the rate of gamma ray. Therefore, You should always be preceded before another test on the day of dignosis.