Patient motion effects on the quantification of regional myocardial blood flow with dynamic PET imaging

Abstract

Patient body motion can produce MBF estimation errors up to 500%. To reduce these errors, new motion correction algorithms must be effective in identifying motion in the left/right direction, and in the mid-to-late time-frames, since these conditions produce the largest errors in MBF, particularly for high resolution PET imaging. Ideally, motion correction should be done before or during image reconstruction to eliminate PET-CTAC misalignment artifacts.

Clinical Quantification of Myocardial Blood Flow Using PET: Joint Position Paper of the SNMMI Cardiovascular Council and the ASNC

“…However, patient motion during the first-pass transit can produce inconsistent alignment of the dynamic image series, leading to attenuation artifacts and severe bias in MBF. 24 Differences in reconstruction methods may have a substantial impact on measured MBF, 58 and standardization is critical. Iterative reconstruction per manufacturer recommendations is preferred for dynamic image series.…”

“…Assessment and correction of patient motion between the first-pass transit phase and the late-phase myocardial retention images are essential, as this can otherwise introduce a large bias in the estimated MBF values. 24 The peak height of blood pool time-activity curves at rest and stress should be comparable (or slightly lower at stress) if similar radiotracer activities are injected. If there are substantial differences, extravasation or incomplete delivery of tracer may have occurred and may result in inaccurate MBF estimates ( Figure 5).…”

Assessment of attenuation correction for myocardial PET imaging using combined PET/MRI

“…16 The impact of these artifacts is expected to be significant for the calculation of the myocardial perfusion, given the non-linear nature of kinetic modeling. 31 The misalignment artifacts may be corrected for through acquisitions of the DIXON-sequence in several respiratory phases, 32,33 or by a subsequent DIXONacquisition at the end of the examination.…”

The Status and Future of PET Myocardial Blood Flow Quantification Software

“…of datasets with majority 45% in the axial direction and it affects mean estimates of MBF up to 250% (27). The models conventionally used are compartmental models.…”