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Quantitative Comparison of Analytic and Iterative Reconstruction Methods in 2- and 3-Dimensional Dynamic Cardiac ¹⁸F-FDG PET

¹ Department of Nuclear Medicine and PET Research, VU University Medical Centre, Amsterdam, The Netherlands
² Department of Cardiology, VU University Medical Centre, Amsterdam, The Netherlands

The aim of this work was to compare the quantitative accuracy of iteratively reconstructed cardiac ¹⁸F-FDG PET with that of filtered backprojection for both 2-dimensional (2D) and 3-dimensional (3D) acquisitions and to establish an optimal procedure for imaging myocardial viability with ¹⁸F-FDG PET. Methods: Eight patients underwent dynamic cardiac ¹⁸F-FDG PET using an interleaved 2D/3D scan protocol, enabling comparison of 2D and 3D acquisitions within the same patient and study. A 10-min transmission scan was followed by a 10-min, 25-frame dynamic 3D scan and then by a series of 10 alternating 5-min 3D and 2D scans. Images were reconstructed with filtered backprojection (FBP) or attenuation-weighted ordered-subsets expectation maximization (OSEM), combined with Fourier rebinning (FORE) for 3D acquisitions, applying all usual corrections. Regions of interest (ROIs) were drawn in the myocardium, left ventricle, and ascending aorta, with the last 2 being used to define image-derived input functions (IDIFs). Patlak graphical analysis was used to compare net ¹⁸F-FDG uptake in the myocardium, calculated from either 2D or 3D data, after reconstruction with FBP or OSEM. Either IDIFs or arterial sampling was used as the input function. The same analysis was performed on parametric images. Results: A good correlation (r² > 0.99) was found between net ¹⁸F-FDG uptake values for a myocardium ROI determined using each acquisition and reconstruction method and blood-sampling input functions. A similar result was found for parametric images. The ascending aorta was the best choice for IDIF definition. Conclusion: Good correlation and no bias of net ¹⁸F-FDG uptake in relation to that based on FBP images, combined with less image noise, make 3D acquisition with FORE plus attenuation-weighted OSEM reconstruction the preferred choice for cardiac ¹⁸F-FDG PET studies.

Key Words: cardiac PET • ¹⁸F-FDG • iterative reconstruction • quantification

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