基于磁共振成像Dixon序列和CT的衰减校正方法在心脏PET中的应用比较
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摘要
目的:探讨基于磁共振成像(MRI)Dixon序列的衰减校正方法对心脏正电子发射断层摄影术(PET)成像诊断的准确性。方法:选取23例心肌显像清晰的正电子发射计算机断层显像-CT(PET/CT)肿瘤筛查患者,PET/CT检查后即行心脏PET/MR扫描。使用Cedars心脏软件对PET/CT和PET/MR图像进行处理,分别得到每例患者左室美国心脏协会(AHA)20节段图中每段心肌18F-氟代脱氧葡萄糖(~(18)F-FDG)代谢占左室心肌代谢最高点的百分比(代谢百分比)。评价PET/CT和PET/MR图像中每段心肌代谢百分比之间差异。Pearson相关分析和Bland-Altman一致性分析用于评价PET/CT和PET/MR图像每段心肌代谢百分比的相关性与一致性。结果:在23例患者的460个节段中PET/CT左室心肌代谢百分比为(61.32±11.84)%,明显低于PET/MR图像的(62.55±11.58)%,其差异有统计学意义(t=4.83,P<0.001),但相关性良好(r=0.891);其95%一致性界限为11.95%～-9.49%,平均值为1.23%。结论:PET/CT和PET/MR左室心肌20个节段的~(18)F-FDG心肌代谢百分比整体上具有很好的相关性和一致性,并且对PET/MR结果低估很小,能够提供可靠的诊断信息。
Objective: To explore the accuracy of MRI-Dixon-based attenuation correction(AC) methods in the image diagnosis of cardiac positron emission tomography(PET). Methods: 23 patients with clear imaging on cardiac muscle who received tumor screening of PET/CT were selected. After they received PET/CT examination, they underwent PET/MR scan. And Cedars cardiac software was used to conduct PET/CT image and PET/MR image, and the percentage of ~(18)F-FDG metabolism(metabolism percentage) of each segment myocardium in 20 segment images of American Heart of Association of each patients at the highest point of metabolism of left ventricle were respectively obtained. And the difference of the percentage of each segment myocardial metabolism between PET/CT and PET/MR was evaluated. Pearson correlation analysis and Bland-Altman(BA) consistency analysis were used to evaluate the correlation and consistency of the percentage of each segment metabolism between PET/CT and PET/MR, respectively.Results: In 460 segments of 23 patients, the percentage of left ventricle myocardial metabolism of PET/CT was(61.32%±11.84), which was significantly lower than that of PET/MR image(62.55%±11.58)(t=4.83, P<0.001).However, the correlation of that between two methods was good(r=0.891). Altman limits of consistency between two methods was from-9.49% to +11.95%, and its mean value was 1.23%. Conclusion: There are well correlation and consistency at percentage of ~(18)F-FDG myocardial metabolism of 20 segments of myocardium of left ventricle between PET/CT and PET/MR. And there is very small underestimation at the results of PET/MR. Therefore, it can provide reliable diagnostic message.
Objective: To explore the accuracy of MRI-Dixon-based attenuation correction(AC) methods in the image diagnosis of cardiac positron emission tomography(PET). Methods: 23 patients with clear imaging on cardiac muscle who received tumor screening of PET/CT were selected. After they received PET/CT examination, they underwent PET/MR scan. And Cedars cardiac software was used to conduct PET/CT image and PET/MR image, and the percentage of ~(18)F-FDG metabolism(metabolism percentage) of each segment myocardium in 20 segment images of American Heart of Association of each patients at the highest point of metabolism of left ventricle were respectively obtained. And the difference of the percentage of each segment myocardial metabolism between PET/CT and PET/MR was evaluated. Pearson correlation analysis and Bland-Altman(BA) consistency analysis were used to evaluate the correlation and consistency of the percentage of each segment metabolism between PET/CT and PET/MR, respectively.Results: In 460 segments of 23 patients, the percentage of left ventricle myocardial metabolism of PET/CT was(61.32%±11.84), which was significantly lower than that of PET/MR image(62.55%±11.58)(t=4.83, P<0.001).However, the correlation of that between two methods was good(r=0.891). Altman limits of consistency between two methods was from-9.49% to +11.95%, and its mean value was 1.23%. Conclusion: There are well correlation and consistency at percentage of ~(18)F-FDG myocardial metabolism of 20 segments of myocardium of left ventricle between PET/CT and PET/MR. And there is very small underestimation at the results of PET/MR. Therefore, it can provide reliable diagnostic message.
引文
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[13]Aznar MC,Sersar R,Saabye J,et al.Whole-body PET/MRI:the effect of bone attenuation during MR-based attenuation correction in oncology imaging[J].Eur J Radiol,2014,83(7):1177-1183.
[14]Hofmann M,Bezrukov I,Mantlik F,et al.MRI-Based Attenuation Correction for Whole-Body PET/MRI:Quantitative Evaluation of Segmentation-and Atlas-Based Methods[J].J Nucl Med,2011,52(9):1392-1399.
[15]Lassen ML,Rasul S,Beitzke D,et al.Assessment of attenuation correction for myocardial PET imaging using combined PET/MRI[J].J Nucl Cardiol,2017,22:1-12.
[2]Roy S,Wang WT,Carass A,et al.PET attenuation correction using synthetic CT from ultrashort echo-time MR imaging[J].J Nucl Med,2014,55(12):2071-2077.
[3]Zaidi H,Montandon ML,Alavi A.Advances in Attenuation Correction Techniques in PET[J].PET Clin,2007,2(2):191-217.
[4]Martinez-M?ller A,Souvatzoglou M,Delso G,et al.Tissue classification as a potential approach for attenuation correction in whole-body PET/MRI:evaluation with PET/CT data[J].J Nucl Med,2009,50(4):520-526.
[5]Eiber M,Martinez-M?ller A,Souvatzoglou M,et al.Value of a Dixon-based MR/PET attenuation correction sequence for the localization and evaluation of PET-positive lesions[J].Eur J Nucl Med Mol Imaging,2011.38(9):1691-1701.
[6]Schulz V,Torres-Espallardo I,Renisch S,et al.Automatic,three-segment,MR-based attenuation correction for whole-body PET/MR data[J].Eur J Nucl Med Mol Imaging,2011,38(1):138-152.
[7]Lau JMC,Laforest R,Sotoudeh H,et al.Evaluation of attenuation correction in cardiac PET using PET/MR[J].J Nucl Cardiol,2017,24(3):839-846.
[8]Paulus DH,Quick HH,Geppert C,et al.Whole-Body PET/MR Imaging:Quantitative Evaluation of a Novel Model-Based MR Attenuation Correction Method Including Bone[J].J Nucl Med,2015,56(7):1061-1066.
[9]Huang YQ.Whole-Body MR/PET hybrid imaging:technical considerations,clinical workflow,and initial results[J].Chinese Journal of Magnetic Resonance Imaging,2011,6:53-62.
[10]刘家金,富丽萍,尹大一,等.PET/MR一体机安装、调试及临床初步应用[J].中国医疗器械信息,2013(10):15-20.
[11]Delso G,Fürst S,Jakoby B,et al.Performance measurements of the Siemens mMR integrated whole-body PET/MR scanner[J].J Nucl Med,2011,52(12):1914-1922.
[12]Nensa F,Poeppel TD,Beiderwellen K,et al.Hybrid PET/MR imaging of the heart:feasibility and initial results[J].Radiology,2013,268(2):366-373.
[13]Aznar MC,Sersar R,Saabye J,et al.Whole-body PET/MRI:the effect of bone attenuation during MR-based attenuation correction in oncology imaging[J].Eur J Radiol,2014,83(7):1177-1183.
[14]Hofmann M,Bezrukov I,Mantlik F,et al.MRI-Based Attenuation Correction for Whole-Body PET/MRI:Quantitative Evaluation of Segmentation-and Atlas-Based Methods[J].J Nucl Med,2011,52(9):1392-1399.
[15]Lassen ML,Rasul S,Beitzke D,et al.Assessment of attenuation correction for myocardial PET imaging using combined PET/MRI[J].J Nucl Cardiol,2017,22:1-12.