TY - JOUR
T1 - Quantitative and Visual Benefits of Data-Driven Motion Correction on Oncologic PET/CT
T2 - A Prospective Cross-sectional Study
AU - Ince, Semra
AU - Thomas, Matthew
AU - Itani, Malak
AU - Swingle, Christopher
AU - Laforest, Richard
AU - Haq, Adeel
AU - Muñoz, Genevieve
AU - Ashrafinia, Saeed
AU - Schleyer, Paul
AU - Wahl, Richard
AU - Fraum, Tyler J.
N1 - Publisher Copyright:
© 2025 The Association of University Radiologists
PY - 2025
Y1 - 2025
N2 - Rationale and Objective: Conventional positron emission tomography (PET) respiratory gating utilizes a fraction of acquired PET counts (i.e., optimal gate [OG]), whereas elastic motion correction with deblurring (EMCD) utilizes all PET counts to reconstruct motion-corrected images without increasing image noise. Our aim was to assess the quantitative and visual impacts of EMCD-based motion correction on FDG-PET and DOTATATE-PET images relative to OG and ungated (UG) images. Materials and Methods: This prospective, single-center study enrolled adults undergoing FDG or DOTATATE oncologic PET/CT between June 2020 and October 2022. Subjects underwent a standard-of-care (SOC) PET acquisition while wearing a respiratory gating belt. UG, belt-gating-derived optimal gate (BG-OG), EMCD utilizing belt gating (BG-EMCD), and EMCD utilizing data-driven gating (DDG-EMCD) images were reconstructed. Tracer-avid lesions in the lower chest or upper abdomen were segmented. Quantitative metrics were extracted. Two independent, blinded readers assessed image quality via a 4-point scale and counted lesions on each reconstruction. Differences between reconstructions were assessed via the Wilcoxon signed-rank test (alpha, 0.05). Results: This study enrolled 78 subjects; 36 subjects (mean age, 64.8 years; 20 males) with 136 tracer-avid lesions were analyzed. Data provided are medians across all tracers. Lesion SUV-max was significantly higher (P < 0.001) on motion-corrected images (BG-OG: 10.77, BG-EMCD: 10.75, DDG-EMCD: 10.74) than UG images (9.00). Lesion contrast-to-noise ratios (CNRs) were significantly lower (P < 0.001) for BG-OG (6.31) and UG images (7.89) than BG-EMCD (9.14) and DDG-EMCD (8.89) images. FDG and DOTATATE subgroup analyses produced similar results. Among motion-corrected images, both readers preferred EMCD-based images to BG-OG images for all tracers (P < 0.001) and both subgroups. EMCD-based images occasionally demonstrated more tracer-avid lesions than BG-OG or UG images. Conclusion: EMCD-based motion correction beneficially impacts lesion quantitation (including higher SUVs and CNRs) and overall image quality. Clinical Impact: When employed on capable scanners, EMCD can improve the quality of oncologic PET imaging.
AB - Rationale and Objective: Conventional positron emission tomography (PET) respiratory gating utilizes a fraction of acquired PET counts (i.e., optimal gate [OG]), whereas elastic motion correction with deblurring (EMCD) utilizes all PET counts to reconstruct motion-corrected images without increasing image noise. Our aim was to assess the quantitative and visual impacts of EMCD-based motion correction on FDG-PET and DOTATATE-PET images relative to OG and ungated (UG) images. Materials and Methods: This prospective, single-center study enrolled adults undergoing FDG or DOTATATE oncologic PET/CT between June 2020 and October 2022. Subjects underwent a standard-of-care (SOC) PET acquisition while wearing a respiratory gating belt. UG, belt-gating-derived optimal gate (BG-OG), EMCD utilizing belt gating (BG-EMCD), and EMCD utilizing data-driven gating (DDG-EMCD) images were reconstructed. Tracer-avid lesions in the lower chest or upper abdomen were segmented. Quantitative metrics were extracted. Two independent, blinded readers assessed image quality via a 4-point scale and counted lesions on each reconstruction. Differences between reconstructions were assessed via the Wilcoxon signed-rank test (alpha, 0.05). Results: This study enrolled 78 subjects; 36 subjects (mean age, 64.8 years; 20 males) with 136 tracer-avid lesions were analyzed. Data provided are medians across all tracers. Lesion SUV-max was significantly higher (P < 0.001) on motion-corrected images (BG-OG: 10.77, BG-EMCD: 10.75, DDG-EMCD: 10.74) than UG images (9.00). Lesion contrast-to-noise ratios (CNRs) were significantly lower (P < 0.001) for BG-OG (6.31) and UG images (7.89) than BG-EMCD (9.14) and DDG-EMCD (8.89) images. FDG and DOTATATE subgroup analyses produced similar results. Among motion-corrected images, both readers preferred EMCD-based images to BG-OG images for all tracers (P < 0.001) and both subgroups. EMCD-based images occasionally demonstrated more tracer-avid lesions than BG-OG or UG images. Conclusion: EMCD-based motion correction beneficially impacts lesion quantitation (including higher SUVs and CNRs) and overall image quality. Clinical Impact: When employed on capable scanners, EMCD can improve the quality of oncologic PET imaging.
KW - Motion correction
KW - Oncology
KW - PET
KW - SUV
UR - http://www.scopus.com/inward/record.url?scp=85215949778&partnerID=8YFLogxK
U2 - 10.1016/j.acra.2024.12.016
DO - 10.1016/j.acra.2024.12.016
M3 - Article
C2 - 39863497
AN - SCOPUS:85215949778
SN - 1076-6332
JO - Academic radiology
JF - Academic radiology
ER -