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Correction for Oral Contrast Artifacts in CT Attenuation-Corrected PET Images Obtained by Combined PET/CT

Sadek A. Nehmeh, PhD1, Yusuf E. Erdi, DSc1, Hovanes Kalaigian, MS1, Katherine S. Kolbert, MS1, Tinsu Pan, PhD2, Henry Yeung, MD3, Olivia Squire, BA3, Arvind Sinha, MD3, Steve M. Larson, MD3 and John L. Humm, PhD1

1 Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, New York
2 Applied Science Laboratory, General Electric Medical Systems, Waukesha, Wisconsin
3 Nuclear Medicine Service, Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, New York



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  		FIGURE 1. Drawing of transaxial cross-section of phantom 1, with 9 syringes fixed in Styrofoam (The Dow Chemical Co.) sheet and filled with BaSO4 contrast agent at concentrations of 0%–80% (represented by numbers in circles that represent syringes).

 


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  		FIGURE 2. Transaxial CT image of phantom 2, with shell filled with 18F-FDG and containing simulated lesion inside bottle of BaSO4 contrast agent and human vertebra.

 


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  		FIGURE 3. CT number in HU versus concentration of oral BaSO4 contrast agent. As concentration of BaSO4 increases, CT number reaches plateau at 3,071 HU because of maximum of 12 bits of allocated memory in CT.

 


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  		FIGURE 4. Linear attenuation coefficients at PET energy of 511 keV as function of CT number of BaSO4 measured experimentally at different concentrations. Linear attenuation values calculated by Discovery LS algorithm ({blacklozenge}), optimized for human tissues, by transformation optimized for BaSO4 contrast agent ({blacktriangleup}), and by use of 68Ge rod sources (•) are shown.

 


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  		FIGURE 5. Patient’s lesion as it appears in corresponding sagittal slices reconstructed with 68Ge rod source-based attenuation correction (A), CTAC (B), and CTAC with SCC (C). Lesion is marked by arrows in panels A and C; it was not possible to determine extent of lesion in panel B because of uptake of contrast agent in bowel.

 


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  		FIGURE 6. Measured activity concentration, reconstructed with CTAC, as function of concentration of BaSO4 contrast agent ({blacklozenge}). Plateau is attained at high concentrations because of truncation of CT number. Readings measured with 68Ge rod source-based attenuation correction are shown for comparison ({blacksquare}).

 




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