Metal artifact reduction of CT scans to improve PET/CT

Charlotte S. Van Der Vos, Anne I.J. Arens, James J. Hamill, Christian Hofmann, Vladimir Y. Panin, Antoi P.W. Meeuwis, Eric P. Visser, Lioe Fee De Geus-Oei

Research output: Contribution to journalArticleAcademicpeer-review

6 Citations (Scopus)

Abstract

In recent years, different metal artifact reduction methods have been developed for CT. These methods have only recently been introduced for PET/CT even though they could be beneficial for interpretation, segmentation, and quantification of the PET/CT images. In this study, phantom and patient scans were analyzed visually and quantitatively to measure the effect on PET images of iterative metal artifact reduction (iMAR) of CT data. Methods: The phantom consisted of 2 types of hip prostheses in a solution of 18F-FDG and water. 18F-FDG PET/CT scans of 14 patients with metal implants (either dental implants, hip prostheses, shoulder prostheses, or pedicle screws) and 68Ga-labeled prostate-specific membrane antigen (68Ga-PSMA) PET/CT scans of 7 patients with hip prostheses were scored by 2 experienced nuclear medicine physicians to analyze clinical relevance. For all patients, a lesion was located in the field of view of the metal implant. Phantom and patients were scanned in a PET/CT scanner. The standard low-dose CT scans were processed with the iMAR algorithm. The PET data were reconstructed using attenuation correction provided by both standard CT and iMAR-processed CT. Results: For the phantom scans, cold artifacts were visible on the PET image. There was a 30% deficit in 18F-FDG concentration, which was restored by iMAR processing, indicating that metal artifacts on CT images induce quantification errors in PET data. The iMAR algorithm was useful for most patients. When iMAR was used, the confidence in interpretation increased or stayed the same, with an average improvement of 28% 6 20% (scored on a scale of 0%–100% confidence). The SUV increase or decrease depended on the type of metal artifact. The mean difference in absolute values of SUVmean of the lesions was 3.5% 6 3.3%. Conclusion: The iMAR algorithm increases the confidence of the interpretation of the PET/CT scan and influences the SUV. The added value of iMAR depends on the indication for the PET/CT scan, location and size/type of the prosthesis, and location and extent of the disease.

Original languageEnglish
Pages (from-to)1867-1872
Number of pages6
JournalJournal of nuclear medicine
Volume58
Issue number11
DOIs
Publication statusPublished - 1 Nov 2017

Fingerprint

Artifacts
Metals
Hip Prosthesis
Fluorodeoxyglucose F18
Dental Implants
Nuclear Medicine
Prostheses and Implants
Physicians

Keywords

  • 18F-FDG
  • 68Ga-PSMA
  • Iterative metal artifact reduction
  • PET/CT
  • TOF-MLACF

Cite this

Van Der Vos, C. S., Arens, A. I. J., Hamill, J. J., Hofmann, C., Panin, V. Y., Meeuwis, A. P. W., ... De Geus-Oei, L. F. (2017). Metal artifact reduction of CT scans to improve PET/CT. Journal of nuclear medicine, 58(11), 1867-1872. https://doi.org/10.2967/jnumed.117.191171
Van Der Vos, Charlotte S. ; Arens, Anne I.J. ; Hamill, James J. ; Hofmann, Christian ; Panin, Vladimir Y. ; Meeuwis, Antoi P.W. ; Visser, Eric P. ; De Geus-Oei, Lioe Fee. / Metal artifact reduction of CT scans to improve PET/CT. In: Journal of nuclear medicine. 2017 ; Vol. 58, No. 11. pp. 1867-1872.
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abstract = "In recent years, different metal artifact reduction methods have been developed for CT. These methods have only recently been introduced for PET/CT even though they could be beneficial for interpretation, segmentation, and quantification of the PET/CT images. In this study, phantom and patient scans were analyzed visually and quantitatively to measure the effect on PET images of iterative metal artifact reduction (iMAR) of CT data. Methods: The phantom consisted of 2 types of hip prostheses in a solution of 18F-FDG and water. 18F-FDG PET/CT scans of 14 patients with metal implants (either dental implants, hip prostheses, shoulder prostheses, or pedicle screws) and 68Ga-labeled prostate-specific membrane antigen (68Ga-PSMA) PET/CT scans of 7 patients with hip prostheses were scored by 2 experienced nuclear medicine physicians to analyze clinical relevance. For all patients, a lesion was located in the field of view of the metal implant. Phantom and patients were scanned in a PET/CT scanner. The standard low-dose CT scans were processed with the iMAR algorithm. The PET data were reconstructed using attenuation correction provided by both standard CT and iMAR-processed CT. Results: For the phantom scans, cold artifacts were visible on the PET image. There was a 30{\%} deficit in 18F-FDG concentration, which was restored by iMAR processing, indicating that metal artifacts on CT images induce quantification errors in PET data. The iMAR algorithm was useful for most patients. When iMAR was used, the confidence in interpretation increased or stayed the same, with an average improvement of 28{\%} 6 20{\%} (scored on a scale of 0{\%}–100{\%} confidence). The SUV increase or decrease depended on the type of metal artifact. The mean difference in absolute values of SUVmean of the lesions was 3.5{\%} 6 3.3{\%}. Conclusion: The iMAR algorithm increases the confidence of the interpretation of the PET/CT scan and influences the SUV. The added value of iMAR depends on the indication for the PET/CT scan, location and size/type of the prosthesis, and location and extent of the disease.",
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Van Der Vos, CS, Arens, AIJ, Hamill, JJ, Hofmann, C, Panin, VY, Meeuwis, APW, Visser, EP & De Geus-Oei, LF 2017, 'Metal artifact reduction of CT scans to improve PET/CT' Journal of nuclear medicine, vol. 58, no. 11, pp. 1867-1872. https://doi.org/10.2967/jnumed.117.191171

Metal artifact reduction of CT scans to improve PET/CT. / Van Der Vos, Charlotte S.; Arens, Anne I.J.; Hamill, James J.; Hofmann, Christian; Panin, Vladimir Y.; Meeuwis, Antoi P.W.; Visser, Eric P.; De Geus-Oei, Lioe Fee.

In: Journal of nuclear medicine, Vol. 58, No. 11, 01.11.2017, p. 1867-1872.

Research output: Contribution to journalArticleAcademicpeer-review

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T1 - Metal artifact reduction of CT scans to improve PET/CT

AU - Van Der Vos, Charlotte S.

AU - Arens, Anne I.J.

AU - Hamill, James J.

AU - Hofmann, Christian

AU - Panin, Vladimir Y.

AU - Meeuwis, Antoi P.W.

AU - Visser, Eric P.

AU - De Geus-Oei, Lioe Fee

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AB - In recent years, different metal artifact reduction methods have been developed for CT. These methods have only recently been introduced for PET/CT even though they could be beneficial for interpretation, segmentation, and quantification of the PET/CT images. In this study, phantom and patient scans were analyzed visually and quantitatively to measure the effect on PET images of iterative metal artifact reduction (iMAR) of CT data. Methods: The phantom consisted of 2 types of hip prostheses in a solution of 18F-FDG and water. 18F-FDG PET/CT scans of 14 patients with metal implants (either dental implants, hip prostheses, shoulder prostheses, or pedicle screws) and 68Ga-labeled prostate-specific membrane antigen (68Ga-PSMA) PET/CT scans of 7 patients with hip prostheses were scored by 2 experienced nuclear medicine physicians to analyze clinical relevance. For all patients, a lesion was located in the field of view of the metal implant. Phantom and patients were scanned in a PET/CT scanner. The standard low-dose CT scans were processed with the iMAR algorithm. The PET data were reconstructed using attenuation correction provided by both standard CT and iMAR-processed CT. Results: For the phantom scans, cold artifacts were visible on the PET image. There was a 30% deficit in 18F-FDG concentration, which was restored by iMAR processing, indicating that metal artifacts on CT images induce quantification errors in PET data. The iMAR algorithm was useful for most patients. When iMAR was used, the confidence in interpretation increased or stayed the same, with an average improvement of 28% 6 20% (scored on a scale of 0%–100% confidence). The SUV increase or decrease depended on the type of metal artifact. The mean difference in absolute values of SUVmean of the lesions was 3.5% 6 3.3%. Conclusion: The iMAR algorithm increases the confidence of the interpretation of the PET/CT scan and influences the SUV. The added value of iMAR depends on the indication for the PET/CT scan, location and size/type of the prosthesis, and location and extent of the disease.

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Van Der Vos CS, Arens AIJ, Hamill JJ, Hofmann C, Panin VY, Meeuwis APW et al. Metal artifact reduction of CT scans to improve PET/CT. Journal of nuclear medicine. 2017 Nov 1;58(11):1867-1872. https://doi.org/10.2967/jnumed.117.191171