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Title: Metal artifact reduction strategies for improved attenuation correction in hybrid PET/CT imaging

Abstract

Metallic implants are known to generate bright and dark streaking artifacts in x-ray computed tomography (CT) images, which in turn propagate to corresponding functional positron emission tomography (PET) images during the CT-based attenuation correction procedure commonly used on hybrid clinical PET/CT scanners. Therefore, visual artifacts and overestimation and/or underestimation of the tracer uptake in regions adjacent to metallic implants are likely to occur and as such, inaccurate quantification of the tracer uptake and potential erroneous clinical interpretation of PET images is expected. Accurate quantification of PET data requires metal artifact reduction (MAR) of the CT images prior to the application of the CT-based attenuation correction procedure. In this review, the origins of metallic artifacts and their impact on clinical PET/CT imaging are discussed. Moreover, a brief overview of proposed MAR methods and their advantages and drawbacks is presented. Although most of the presented MAR methods are mainly developed for diagnostic CT imaging, their potential application in PET/CT imaging is highlighted. The challenges associated with comparative evaluation of these methods in a clinical environment in the absence of a gold standard are also discussed.

Authors:
; ;  [1];  [2];  [3]
  1. Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, 9700 RB Groningen (Netherlands)
  2. (Switzerland)
  3. (Switzerland) and Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, 9700 RB Groningen (Netherlands)
Publication Date:
OSTI Identifier:
22100639
Resource Type:
Journal Article
Resource Relation:
Journal Name: Medical Physics; Journal Volume: 39; Journal Issue: 6; Other Information: (c) 2012 American Association of Physicists in Medicine; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
07 ISOTOPES AND RADIATION SOURCES; ATTENUATION; CAT SCANNING; GOLD; IMAGES; POSITRON COMPUTED TOMOGRAPHY; RADIATION SOURCE IMPLANTS; STANDARDS; X RADIATION

Citation Formats

Abdoli, Mehrsima, Dierckx, Rudi A. J. O., Zaidi, Habib, Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospital, CH-1211 Geneva, and Geneva Neuroscience Center, Geneva University, CH-1205 Geneva. Metal artifact reduction strategies for improved attenuation correction in hybrid PET/CT imaging. United States: N. p., 2012. Web. doi:10.1118/1.4709599.
Abdoli, Mehrsima, Dierckx, Rudi A. J. O., Zaidi, Habib, Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospital, CH-1211 Geneva, & Geneva Neuroscience Center, Geneva University, CH-1205 Geneva. Metal artifact reduction strategies for improved attenuation correction in hybrid PET/CT imaging. United States. doi:10.1118/1.4709599.
Abdoli, Mehrsima, Dierckx, Rudi A. J. O., Zaidi, Habib, Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospital, CH-1211 Geneva, and Geneva Neuroscience Center, Geneva University, CH-1205 Geneva. 2012. "Metal artifact reduction strategies for improved attenuation correction in hybrid PET/CT imaging". United States. doi:10.1118/1.4709599.
@article{osti_22100639,
title = {Metal artifact reduction strategies for improved attenuation correction in hybrid PET/CT imaging},
author = {Abdoli, Mehrsima and Dierckx, Rudi A. J. O. and Zaidi, Habib and Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospital, CH-1211 Geneva and Geneva Neuroscience Center, Geneva University, CH-1205 Geneva},
abstractNote = {Metallic implants are known to generate bright and dark streaking artifacts in x-ray computed tomography (CT) images, which in turn propagate to corresponding functional positron emission tomography (PET) images during the CT-based attenuation correction procedure commonly used on hybrid clinical PET/CT scanners. Therefore, visual artifacts and overestimation and/or underestimation of the tracer uptake in regions adjacent to metallic implants are likely to occur and as such, inaccurate quantification of the tracer uptake and potential erroneous clinical interpretation of PET images is expected. Accurate quantification of PET data requires metal artifact reduction (MAR) of the CT images prior to the application of the CT-based attenuation correction procedure. In this review, the origins of metallic artifacts and their impact on clinical PET/CT imaging are discussed. Moreover, a brief overview of proposed MAR methods and their advantages and drawbacks is presented. Although most of the presented MAR methods are mainly developed for diagnostic CT imaging, their potential application in PET/CT imaging is highlighted. The challenges associated with comparative evaluation of these methods in a clinical environment in the absence of a gold standard are also discussed.},
doi = {10.1118/1.4709599},
journal = {Medical Physics},
number = 6,
volume = 39,
place = {United States},
year = 2012,
month = 6
}
  • Purpose: The empirical dual energy calibration (EDEC) method corrects for beam-hardening artifacts, but shows limited performance on metal artifact correction. In this work, we propose an adaptive dual energy calibration (ADEC) method to correct for metal artifacts. Methods: The empirical dual energy calibration (EDEC) method corrects for beam-hardening artifacts, but shows limited performance on metal artifact correction. In this work, we propose an adaptive dual energy calibration (ADEC) method to correct for metal artifacts. Results: Highly attenuating copper rods cause severe streaking artifacts on standard CT images. EDEC improves the image quality, but cannot eliminate the streaking artifacts. Compared tomore » EDEC, the proposed ADEC method further reduces the streaking resulting from metallic inserts and beam-hardening effects and obtains material decomposition images with significantly improved accuracy. Conclusion: We propose an adaptive dual energy calibration method to correct for metal artifacts. ADEC is evaluated with the Shepp-Logan phantom, and shows superior metal artifact correction performance. In the future, we will further evaluate the performance of the proposed method with phantom and patient data.« less
  • Purpose: The overall goal of this work is to improve the computed tomography (CT) image quality for patients with metal implants or fillings by completing the missing kilovoltage (kV) projection data with selectively acquired megavoltage (MV) data that do not suffer from photon starvation. When both of these imaging systems, which are available on current radiotherapy devices, are used, metal streak artifacts are avoided, and the soft-tissue contrast is restored, even for regions in which the kV data cannot contribute any information. Methods: Three image-reconstruction methods, including two filtered back-projection (FBP)-based analytic methods and one iterative method, for combining kVmore » and MV projection data from the two on-board imaging systems of a radiotherapy device are presented in this work. The analytic reconstruction methods modify the MV data based on the information in the projection or image domains and then patch the data onto the kV projections for a FBP reconstruction. In the iterative reconstruction, the authors used dual-energy (DE) penalized weighted least-squares (PWLS) methods to simultaneously combine the kV/MV data and perform the reconstruction. Results: The authors compared kV/MV reconstructions to kV-only reconstructions using a dental phantom with fillings and a hip-implant numerical phantom. Simulation results indicated that dual-energy sinogram patch FBP and the modified dual-energy PWLS method can successfully suppress metal streak artifacts and restore information lost due to photon starvation in the kV projections. The root-mean-square errors of soft-tissue patterns obtained using combined kV/MV data are 10–15 Hounsfield units smaller than those of the kV-only images, and the structural similarity index measure also indicates a 5%–10% improvement in the image quality. The added dose from the MV scan is much less than the dose from the kV scan if a high efficiency MV detector is assumed. Conclusions: The authors have shown that it is possible to improve the image quality of kV CTs for patients with metal implants or fillings by completing the missing kV projection data with selectively acquired MV data that do not suffer from photon starvation. Numerical simulations demonstrated that dual-energy sinogram patch FBP and a modified kV/MV PWLS method can successfully suppress metal streak artifacts and restore information lost due to photon starvation in kV projections. Combined kV/MV images may permit the improved delineation of structures of interest in CT images for patients with metal implants or fillings.« less
  • Purpose: To test the efficacy of a retrospective metal artifact reduction (MAR) reconstruction algorithm for a commercial computed tomography (CT) scanner for radiation therapy purposes. Methods: High Z geometric integrity and artifact reduction analysis was performed with three phantoms using General Electric’s (GE) Discovery CT. The three phantoms included: a Computerized Imaging Reference Systems (CIRS) electron density phantom (Model 062) with a 6.5 mm diameter titanium rod insert, a custom spine phantom using Synthes Spine hardware submerged in water, and a dental phantom with various high Z fillings submerged in water. Each phantom was reconstructed using MAR and compared againstmore » the original scan. Furthermore, each scenario was tested using standard and extended Hounsfield Unit (HU) ranges. High Z geometric integrity was performed using the CIRS phantom, while the artifact reduction was performed using all three phantoms. Results: Geometric integrity of the 6.5 mm diameter rod was slightly overestimated for non-MAR scans for both standard and extended HU. With MAR reconstruction, the rod was underestimated for both standard and extended HU. For artifact reduction, the mean and standard deviation was compared in a volume of interest (VOI) in the surrounding material (water and water equivalent material, ∼0HU). Overall, the mean value of the VOI was closer to 0 HU for the MAR reconstruction compared to the non-MAR scan for most phantoms. Additionally, the standard deviations for all phantoms were greatly reduced using MAR reconstruction. Conclusion: GE’s MAR reconstruction algorithm improves image quality with the presence of high Z material with minimal degradation of its geometric integrity. High Z delineation can be carried out with proper contouring techniques. The effects of beam hardening artifacts are greatly reduced with MAR reconstruction. Tissue corrections due to these artifacts can be eliminated for simple high Z geometries and greatly reduced for more complex geometries.« less
  • Purpose: Solid state flat panel electronic portal imaging devices (EPIDs) are widely used for megavolt (MV) photon imaging applications in radiotherapy. In addition to their original purpose in patient position verification, they are convenient to use in quality assurance and dosimetry to verify beam geometry and dose deposition or to perform linear accelerator (linac) calibration procedures. However, native image frames from amorphous silicon (aSi:H) detectors show a range of artifacts which have to be eliminated by proper correction algorithms. When a panel is operated in free-running frame acquisition mode, moving vertical stripes (periodic synchronization artifacts) are a disturbing feature inmore » image frames. Especially for applications in volumetric intensity modulated arc therapy (VMAT) or motion tracking, the synchronization (sync) artifacts are the limiting factor for potential and accuracy since they become even worse at higher frame rates and at lower dose rates, i.e., linac pulse repetition frequencies (PRFs). Methods: The authors introduced a synchronization correction method which is based on a theoretical model describing the interferences of the panel's readout clocking with the linac's dose pulsing. Depending on the applied PRF, a certain number of dose pulses is captured per frame which is readout columnwise, sequentially. The interference of the PRF with the panel readout is responsible for the period and the different gray value levels of the sync stripes, which can be calculated analytically. Sync artifacts can then be eliminated multiplicatively in precorrected frames without additional information about radiation pulse timing. Results: For the analysis, three aSi:H EPIDs of various types were investigated with 6 and 15 MV photon beams at varying PRFs of 25, 50, 100, 200, and 400 pulses per second. Applying the sync correction at panels with gadolinium oxysulfide scintillators improved single frame flood field image quality drastically [improvement of the signal-to-noise ratio (SNR) up to 66.1 dB for 6 MV and 66.0 dB for 15 MV]. Also for the EPID with a caesium iodide scintillator, the noise for the lower PRFs could be reduced (SNR at 6 MV of up to 56.3 dB and at 15 MV up to 46.7 dB). However, the simplistic readout interference model fails at higher PRFs, where image lag and ghosting effects due to trapped charges in the thin film transistor and scintillator postglowing require additional corrections. Conclusions: The presented free-running sync correction method improves SNR of single frames and enables imaging applications, like low-dose rate imaging at increased image frame rates (e.g., to track moving gold fiducials in the lung). Adaptive image guided radiotherapy protocols become even feasible in VMAT plans. Also simultaneous kilovolt and MV imaging applications can benefit from new possibilities of MV scatter removal in x-ray images.« less
  • Purpose: Computed tomography (CT) artifacts can severely degrade dose calculation accuracy in proton therapy. Prompted by the recently increased popularity of magnetic resonance imaging (MRI) in the radiation therapy clinic, we developed an MRI-based CT artifact correction method for improving the accuracy of proton range calculations. Methods and Materials: The proposed method replaces corrupted CT data by mapping CT Hounsfield units (HU number) from a nearby artifact-free slice, using a coregistered MRI. MRI and CT volumetric images were registered with use of 3-dimensional (3D) deformable image registration (DIR). The registration was fine-tuned on a slice-by-slice basis by using 2D DIR.more » Based on the intensity of paired MRI pixel values and HU from an artifact-free slice, we performed a comprehensive analysis to predict the correct HU for the corrupted region. For a proof-of-concept validation, metal artifacts were simulated on a reference data set. Proton range was calculated using reference, artifactual, and corrected images to quantify the reduction in proton range error. The correction method was applied to 4 unique clinical cases. Results: The correction method resulted in substantial artifact reduction, both quantitatively and qualitatively. On respective simulated brain and head and neck CT images, the mean error was reduced from 495 and 370 HU to 108 and 92 HU after correction. Correspondingly, the absolute mean proton range errors of 2.4 cm and 1.7 cm were reduced to less than 2 mm in both cases. Conclusions: Our MRI-based CT artifact correction method can improve CT image quality and proton range calculation accuracy for patients with severe CT artifacts.« less