Talal Alnabelsi1, Akanksha Thakkar1, Ahmed Ibrahim Ahmed1, Yushui Han1, Mouaz H Al-Mallah2,3. 1. Houston Methodist Academic Institute, Houston Methodist Debakey Heart & Vascular Center, Houston Methodist Hospital, 6550 Fannin Street, Smith Tower - Suite 1801, Houston, TX, 77030, USA. 2. Houston Methodist Academic Institute, Houston Methodist Debakey Heart & Vascular Center, Houston Methodist Hospital, 6550 Fannin Street, Smith Tower - Suite 1801, Houston, TX, 77030, USA. mal-mallah@houstonmethodist.org. 3. Weill Cornell Medicine, New York, NY, USA. mal-mallah@houstonmethodist.org.
Abstract
PURPOSE OF REVIEW: Positron emission tomography (PET) is a leading non-invasive modality for the diagnosis of coronary artery disease due to its diagnostic accuracy and high image quality. With the latest advances in PET systems, clinicians are able to assess for myocardial ischemia and myocardial blood flow while exposing patients to extremely low radiation doses. This review will focus on the basics of acquisition and processing of hybrid PET/CT systems from appropriate patient selection to common artifacts and pitfalls. RECENT FINDINGS: The continued development of hybrid PET/CT technology is producing scanners with exquisite sensitivity capable of generating high-quality images while exposing patients to low radiation doses. List mode acquisition is an essential component in all modern PET/CT scanners allowing simultaneous dynamic and ECG-gated imaging without lengthening scan duration. Various PET radiotracers are currently being developed but rubidium-82 and 13N-ammonia remain the most commonly used perfusion radiotracers. The development of mini 13N-ammonia cyclotrons is a promising tool that should increase access to this radiotracer. Misregistration, attenuation from extra-cardiac activity, and patient motion are the most common causes of artifacts during perfusion imaging. Techniques to automatically realign images and correct respiratory or patient motion artifacts continue to evolve. Despite the continuous evolution of PET imaging techniques, basic knowledge of scan parameters, acquisition techniques, and post processing tools remains essential to ensure high-quality images are produced and artifacts are recognized and corrected. Future research should focus on optimizing scanners to allow for shorter scan protocols and lower radiation exposure as well as continue developing techniques to minimize and correct for motion and misregistration artifacts.
PURPOSE OF REVIEW: Positron emission tomography (PET) is a leading non-invasive modality for the diagnosis of coronary artery disease due to its diagnostic accuracy and high image quality. With the latest advances in PET systems, clinicians are able to assess for myocardial ischemia and myocardial blood flow while exposing patients to extremely low radiation doses. This review will focus on the basics of acquisition and processing of hybrid PET/CT systems from appropriate patient selection to common artifacts and pitfalls. RECENT FINDINGS: The continued development of hybrid PET/CT technology is producing scanners with exquisite sensitivity capable of generating high-quality images while exposing patients to low radiation doses. List mode acquisition is an essential component in all modern PET/CT scanners allowing simultaneous dynamic and ECG-gated imaging without lengthening scan duration. Various PET radiotracers are currently being developed but rubidium-82 and 13N-ammonia remain the most commonly used perfusion radiotracers. The development of mini 13N-ammonia cyclotrons is a promising tool that should increase access to this radiotracer. Misregistration, attenuation from extra-cardiac activity, and patient motion are the most common causes of artifacts during perfusion imaging. Techniques to automatically realign images and correct respiratory or patient motion artifacts continue to evolve. Despite the continuous evolution of PET imaging techniques, basic knowledge of scan parameters, acquisition techniques, and post processing tools remains essential to ensure high-quality images are produced and artifacts are recognized and corrected. Future research should focus on optimizing scanners to allow for shorter scan protocols and lower radiation exposure as well as continue developing techniques to minimize and correct for motion and misregistration artifacts.
Authors: Pascal Koepfli; Thomas F Hany; Christophe A Wyss; Mehdi Namdar; Cyrill Burger; Alexander V Konstantinidis; Thomas Berthold; Gustav K Von Schulthess; Philipp A Kaufmann Journal: J Nucl Med Date: 2004-04 Impact factor: 10.057
Authors: Axel Martinez-Möller; Michael Souvatzoglou; Nassir Navab; Markus Schwaiger; Stephan G Nekolla Journal: J Nucl Med Date: 2007-02 Impact factor: 10.057