The joint maximum-likelihood reconstruction of activity and attenuation (MLAA) for emission-based attenuation correction has regained attention since the advent of time-of-flight PET/MR imaging. Recently, we improved the performance of the MLAA algorithm using an MR imaging-constrained gaussian mixture model (GMM). In this study, we compare the performance of our proposed algorithm with standard 4-class MR-based attenuation correction (MRAC) implemented on commercial systems. Methods: Five head and neck 18 F-FDG patients were scanned on PET/MR imaging and PET/CT scanners. Dixon fat and water MR images were registered to CT images. MRAC maps were derived by segmenting the MR images into 4 tissue classes and assigning predefined attenuation coefficients. For MLAA-GMM, MR images were segmented into known tissue classes, including fat, soft tissue, lung, background air, and an unknown MR low-intensity class encompassing cortical bones, air cavities, and metal artifacts. A coregistered bone probability map was also included in the unknown tissue class. Finally, the GMM prior was constrained over known tissue classes of attenuation maps using unimodal gaussians parameterized over a patient population.
Results:The results showed that the MLAA-GMM algorithm outperformed the MRAC method by differentiating bones from air gaps and providing more accurate patient-specific attenuation coefficients of soft tissue and lungs. It was found that the MRAC and MLAA-GMM methods resulted in average standardized uptake value errors of -5.4% and -3.5% in the lungs, -7.4% and -5.0% in soft tissues/lesions, and -18.4% and -10.2% in bones, respectively. Conclusion: The proposed MLAA algorithm is promising for accurate derivation of attenuation maps on time-of-flight PET/MR systems. Hybr id PET/MR imaging systems have provided new opportunities for enhancing the diagnostic confidence of PET and MR imaging findings through the fusion of complementary structural and molecular information (1). The potential of PET/MR imaging in establishing a new multiparametric imaging paradigm has been a driving force for developing innovative solutions to tackle the challenges of these dual-modality systems.Accurate attenuation correction (AC) of PET data is one of the major challenges of quantitative PET/MR imaging (2). In these systems, attenuation maps at 511 keV should ideally be derived from the acquired MR images. However, in contrast to CT, MR imaging signals are not correlated with electron density and photon-attenuating properties of tissues but rather to proton density and magnetic relaxation properties. Therefore, there is no unique global mapping technique to convert MR imaging intensities to attenuation coefficients. In addition, lung tissues and cortical bones, which are 2 important tissue types in attenuation maps, exhibit low signals on images acquired using conventional MR pulse sequences because of their low water content and short transverse relaxation time. Therefore, the lungs, bones, and air pockets, which also produce a low signal, c...