Quantifying the effects of iodine contrast media on standardised uptake values of FDG PET/CT images: an anthropomorphic phantom study

Razak, Hairil Rashmizal Abdul; Nordin, Abdul Jalil; Ackerly, Trevor; Every, Bruce Van; Martín, Ruth Yeste; Geso, Moshi

doi:10.1007/s13246-011-0088-y

Cited by 5 publications

(6 citation statements)

References 20 publications

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“…Using this ROI size, we measured an overestimate of almost 9% with the nominal CT‐based attenuation correction for the phantom configuration in which all tubes contain iodine (“7 iodine inserts”). A similar SUV overestimate was observed in Razak et al 61 and Yau et al 63 Our investigation into the sensitivity of the improved stability on the selected measurement ROI radius

R

revealed that the behavior of mean SUV curves measured with smaller and larger ROIs persisted in both smaller and larger values of

R

(Fig. 6), attesting to the correctness of the ED‐based PET attenuation correction approach which offers the potential of reducing bias due to the presence of iodine.…”

Section: Discussionsupporting

confidence: 85%

“…Antoch et al 38 found contrast‐induced PET artifacts in 13% of patients in a study that included thirty oncology patients who underwent whole‐body PET/CT scans. Razak et al 61 quantified the effect of iodine contrast media on SUV of FDG PET/CT images in a semi‐anthropomorphic phantom and found mean overestimates of about 10%. Kinahan et al 2 performed simulations of an abdomen‐sized object to assess the effect of incorrect LAC mappings of iodinated contrast agents and the ability to correct these errors using spectral information from DECT acquisitions.…”

Section: Discussionmentioning

confidence: 99%

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Quantitative positron emission tomography imaging in the presence of iodinated contrast media using electron density quantifications from dual‐energy computed tomography

et al. 2020

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Purpose As preparation for future positron emission tomography (PET)/dual‐energy computed tomography (DECT)T imaging modality and new possible clinical applications, the study aimed to evaluate the utility of clinically available spectral results from a DECT system for improving attenuation corrections of PET acquisitions in the presence of iodinated contrast media. The dependence of the accuracy of PET quantification values, reconstructed with conventional and spectral‐based attenuation corrections, was examined as a function of the amount of iodine content and x‐ray radiation exposure. Methods Measurements were performed on commercial PET/CT and DECT systems, using a semi‐anthropomorphic phantom with seven centrifuge tubes in its bore. Five different configurations of tube contents were scanned by both PET/CT and DECT. With the aim of mimicking clinically observed concentrations, in all phantom configurations the center tube contained a high concentration of radionuclide while the peripheral tubes contained a lower concentration of radionuclide. Iodine content was incrementally increased between phantom configurations by replacing iodine‐free tubes with tubes that contained the original radionuclide concentration within a 10 mg/ml iodine dilution. DECT‐based attenuation correction maps were generated by scaling electron density spectral results into corresponding 511 keV photon linear attenuation coefficients. Results Mean SUV values obtained from the nominal PET reconstruction, using conventional CT images as input for the attenuation correction, demonstrate a monotonic increase of 8.6% when the water and radionuclide mixtures were replaced by iodine, water, and radionuclide (same level of activity) mixture. Mean SUV values obtained from the DECT‐based reconstruction, in which the attenuation correction utilizes electron density values as input, demonstrate different, more stable behavior across all iodine insert configurations, with a standard deviation to mean ratio of less than 1%. This observed behavior was independent of the area size used for measurement. A minor radiation dose dependency of the electron density values (below 0.5%) was observed. This resulted in consistent (iodine independent) PET quantification behavior, which persisted even at the lowest radiation dose levels tested in our experiment, that is, 25% of the radiation dose utilized for CT acquisition in the clinical PET/CT protocol. Conclusions Utilization of DECT‐generated electron density estimations for attenuation correction benefit PET quantification consistency in the presence of iodine and at nominal and low DECT radiation exposure levels. The ability to correctly account for iodinated contrast media in PET acquisitions will allow the development of new clinical applications that rely on the quantitative capabilities of spectral CT technologies and modern PET systems.

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R

revealed that the behavior of mean SUV curves measured with smaller and larger ROIs persisted in both smaller and larger values of

R

(Fig. 6), attesting to the correctness of the ED‐based PET attenuation correction approach which offers the potential of reducing bias due to the presence of iodine.…”

Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Quantitative positron emission tomography imaging in the presence of iodinated contrast media using electron density quantifications from dual‐energy computed tomography

et al. 2020

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“…This study presents a novel design and 3D printing of an anthropomorphic, population-based, and customisable male and female TKR phantom which can be filled with any bone attenuation equivalent fluids and injected with any appropriate radiopharmaceutical to mimic human TKR PET/CT scans. A range of solutions can be diluted in water and injected into the TKR phantom to simulate either cortical or trabecular bone such as iodinated contrast media or dipotassium hydrogen phosphate (K 2 HPO 4 ) which has been used in previous studies to mimic a range of HU values [ 14 , 22 ]. In our experiment, iodinated contrast media was used as it was easy to source and it allowed the TKR phantoms to be used with adjustable HU values for testing any optimisation method applied to reduce the associated metal artefacts that arise in the PET/CT scans.…”

Section: Discussionmentioning

confidence: 99%

Optimising total knee replacement imaging: a novel 3D printed PET/CT anthropomorphic phantom for metal artefact simulation

Assiri,

Knapp,

Fulford

et al. 2024

EJNMMI Phys

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Purpose Arthroplasty phantoms, including total knee replacement (TKR) phantoms, have been frequently used to test metal artefact reduction methods applied to positron emission tomography/computed tomography (PET/CT) images. These phantoms generally simulate either simple anatomical features or simple activity distribution around the metal inserts in the PET/CT scans. 3D printing has been used recently to fabricate fillable anthropomorphic phantoms that accurately simulate volume and geometry. This study aims to describe the process of image segmentation, phantom modelling, 3D printing and validation of a population-based fillable TKR phantom that simulates human TKR PET/CT metal artefacts. Methods 10 participants (5 male and 5 female) were scanned using 3T MRI and the images were segmented to create average male and average female 3D knee models, inversely with void cortical and porous trabecular compartments for 3D printing and contrast media. Virtual total knee replacement (TKR) surgery was implemented on these models to prepare the insertion locations for knee prosthetic implants. Subsequently, TKR models were printed using a 3D photopolymer resin printer and then injected with normal saline to test the phantoms for any leaks. Subsequently, diluted iodinated contrast media was injected into the cortical compartment and saline with 18F-FDG was injected into the trabecular compartment and the phantom was scanned with PET/CT. The images were then evaluated and compared to the human knee radiographic features reported in the literature. Results Phantoms were shown to be fluid-tight with distinct compartments. They showed comparable volume and geometry to the segmented human MRI knees. The phantoms demonstrated similar values for x-ray attenuation and Hounsfield units (HU) to the literature for both cortical and trabecular compartments. The phantoms displayed a uniform distribution for the radioactive tracer, resembling that seen in human trabecular bone PET. TKR phantom PET/CT images with metal inserts replicated the clinical metal artefacts seen clinically in the periprosthetic area. Conclusion This novel, 3D-printed, and customisable phantom effectively mimics the geometric, radiographic and radiotracer distribution features of real TKRs. Importantly, it simulates TKR image metal artefacts, making it suitable for repeatable and comprehensive evaluation of various metal artefact reduction methods in future research.

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“…On anthropomorphic phantom with and without Iodine Contrast Media (ICM), the study conducted by Razac et al revealed a marginal absolute difference ΔSUV max and ΔSUV mean , of 0.2 and 0.4, respectively ( 18 ). This disparity was more pronounced in the most metabolically active simulated lesion (ΔSUV = 1.5 for a SUV max of 22).…”

Section: Physical Impact On Standardized Uptake Valuementioning

confidence: 99%

Comprehensive literature review of oral and intravenous contrast-enhanced PET/CT: a step forward?

Metrard,

Cohen,

Bailly

2024

Front. Med.

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The integration of diagnostic CT scans into PET/CT facilitates a comprehensive single examination, presenting potential advantages for patients seeking a thorough one-shot check-up. The introduction of iodinated contrast media during PET scanning raises theoretical concerns about potential interference with uptake quantification, due to the modification of tissue density on CT. Nevertheless, this impact appears generally insignificant for clinical use, compared to the intrinsic variability of standardized uptake values. On the other hand, with the growing indications of PET, especially 18F-FDG PET, contrast enhancement increases the diagnostic performances of the exam, and provides additional information. This improvement in performance achieved through contrast-enhanced PET/CT must be carefully evaluated considering the associated risks and side-effects stemming from the administration of iodinated contrast media. Within this article, we present a comprehensive literature review of contrast enhanced PET/CT, examining the potential impact of iodinated contrast media on quantification, additional side-effects and the pivotal clinically demonstrated benefits of an all-encompassing examination for patients. In conclusion, the clinical benefits of iodinated contrast media are mainly validated by the large diffusion in PET protocols. Contrary to positive oral contrast, which does not appear to offer any major advantage in patient management, intravenous iodine contrast media provides clinical benefits without significant artifact on images or quantification. However, studies on the benefit–risk balance for patients are still lacking.

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Quantifying the effects of iodine contrast media on standardised uptake values of FDG PET/CT images: an anthropomorphic phantom study

Cited by 5 publications

References 20 publications

Quantitative positron emission tomography imaging in the presence of iodinated contrast media using electron density quantifications from dual‐energy computed tomography

Quantitative positron emission tomography imaging in the presence of iodinated contrast media using electron density quantifications from dual‐energy computed tomography

Optimising total knee replacement imaging: a novel 3D printed PET/CT anthropomorphic phantom for metal artefact simulation

Comprehensive literature review of oral and intravenous contrast-enhanced PET/CT: a step forward?

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