Impact of MR-based attenuation correction on neurologic PET studies

Yi Su, Brian B. Rubin, Jonathan McConathy, Richard Laforest, Jing Qi, Akash Sharma, Agus Priatna, Tammie L.S. Benzinger

Research output: Contribution to journalArticlepeer-review

13 Scopus citations

Abstract

Hybrid PET and MR scanners have become a reality in recent years, with the benefits of reduced radiation exposure, reduction of imaging time, and potential advantages in quantification. Appropriate attenuation correction remains a challenge. Biases in PET activity measurements were demonstrated using the current MR-based attenuation-correction technique. We aimed to investigate the impact of using a standard MR-based attenuation correction technique on the clinical and research utility of a PET/MR hybrid scanner for amyloid imaging. Methods: Florbetapir scans were obtained for 40 participants on a hybrid scanner with simultaneous MR acquisition. PET images were reconstructed using both MR-and CT-derived attenuation maps. Quantitative analysis was performed for both datasets to assess the impact of MR-based attenuation correction to absolute PET activity measurements as well as target-to-reference ratio (SUVR). Clinical assessment was also performed by a nuclear medicine physician to determine amyloid status based on the criteria in the Food and Drug Administration prescribing information for florbetapir. Results: MR-based attenuation correction led to underestimation of PET activity for most parts of the brain, with a small overestimation for deep brain regions. There was also an overestimation of SUVRs with cerebellar reference. SUVR measurements obtained from the 2 attenuation-correction methods were strongly correlated. Clinical assessment of amyloid status resulted in identical classification as positive or negative regardless of the attenuation-correction methods. Conclusion: MR-based attenuation correction causes biases in quantitative measurements. The biases may be accounted for by a linear model, although the spatial variation cannot be easily modeled. The quantitative differences, however, did not affect clinical assessment as positive or negative.

Original languageEnglish
Pages (from-to)913-917
Number of pages5
JournalJournal of Nuclear Medicine
Volume57
Issue number6
DOIs
StatePublished - Jun 1 2016

Keywords

  • Amyloid imaging
  • Attenuation correction
  • PET/MR

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