Seminars in Nuclear Medicine
Volume 38, Issue 3 , Pages 152-166 , May 2008

Positron Emission Tomography/Computed Tomography

  • David W. Townsend, PhD

      Affiliations

    • Corresponding Author InformationAddress reprint requests to David W. Townsend, PhD, Departments of Medicine and Radiology, University of Tennessee Medical Center, 1924 Alcoa Highway, Knoxville, TN 37920-6999.

References 

  1. Levin DN, Pelizzari CA, Chen GT, et al. Retrospective geometric correlation of MR, CT, and PET images. Radiology. 1988;169:817–823
  2. Hawkes DJ, Hill DL, Hallpike L, et al. Coregistration of structural and functional images. In:  Valk P,  Bailey DL,  Townsend DW, et al. editor. Positron Emission Tomography: Basic Science and Clinical Practice. New York: Springer-Verlag; 2003;p. 181–198
  3. Woods RP, Mazziotta JC, Cherry SR. MRI-PET registration with automated algorithm. J Comput Assist Tomogr. 1993;17:536–546
  4. Maes F, Collignon A, Vandermeulen D, et al. Multimodality image registration by maximization of mutual information. IEEE Trans Med Imaging. 1997;16:187–198
  5. Wahl RL, Quint LE, Cieslak RD, et al. “Anatometabolic” tumor imaging: Fusion of FDG PET with CT or MRI to localize foci of increased activity. J Nucl Med. 1993;34:1190–1197
  6. West J, Fitzpatrick JM, Wang MY, et al. Comparison and evaluation of retrospective intermodality brain image registration techniques. J Comput Assist Tomogr. 1997;21:554–566
  7. Hutton BF, Braun M. Software for image registration: Algorithms, accuracy, efficacy. Semin Nucl Med. 2003;33:180–192
  8. Hasegawa BH, Gingold EL, Reilly SM, et al. Description of a simultaneous emission-transmission CT system. Proc SPIE. 1990;1231:50–60
  9. Hasegawa BH, Stebler B, Rutt BK, et al. A prototype high-purity germanium detector system with fast photon-counting circuitry for medical imaging. Med Phys. 1991;18:900–909
  10. Lang TF, Hasegawa BH, Liew SC, et al. Description of a prototype emission-transmission computed tomography imaging system. J Nucl Med. 1992;33:1881–1887
  11. Hasegawa BH, Lang TF, Brown EL, et al. Object specific attenuation correction of SPECT with correlated dual-energy X-ray CT. IEEE Trans Nucl Sci. 1993;NS-40:1242–1252
  12. Blankespoor SC, Wu X, Kalki K, et al. Attenuation correction of SPECT using X-ray CT on an emission-transmission CT system: Myocardial perfusion assessment. IEEE Trans Nucl Sci. 1996;43:2263–2274
  13. Tang HR, Da Silva AJ, Matthay KK, et al. Neuroblastoma imaging using a combined CT scanner-scintillation camera and 131I-MIBG. J Nucl Med. 2001;42:237–247
  14. Beyer T, Kinahan PE, Townsend DW, et al. The use of X-ray CT for attenuation correction of PET data. Nuclear Science Symposium and Medical Imaging Conference, 1994, 1994 IEEE Conference Record. 1994;4:1573–1577vol. 4
  15. Beyer T, Townsend DW, Brun T, et al. A combined PET/CT scanner for clinical oncology. J Nucl Med. 2000;41:1369–1379
  16. Kinahan PE, Townsend DW, Beyer T, et al. Attenuation correction for a combined 3D PET/CT scanner. Med Phys. 1998;25:2046–2053
  17. Charron M, Beyer T, Bohnen NN, et al. Image analysis in patients with cancer studied with a combined PET and CT scanner. Clin Nucl Med. 2000;25:905–910
  18. Kluetz PG, Meltzer CC, Villemagne VL, et al. Combined PET/CT imaging in oncology (Impact on patient management). Clin Positron Imaging. 2000;3:223–230
  19. Meltzer CC, Luketich JD, Friedman D, et al. Whole-body FDG positron emission tomographic imaging for staging esophageal cancer comparison with computed tomography. Clin Nucl Med. 2000;25:882–887
  20. Patton JA, Delbeke D, Sandler MP. Image fusion using an integrated, dual-head coincidence camera with X-ray tube-based attenuation maps. J Nucl Med. 2000;41:1364–1368
  21. Bocher M, Balan A, Krausz Y, et al. Gamma camera-mounted anatomical X-ray tomography: Technology, system characteristics and first images. Eur J Nucl Med. 2000;27:619–627
  22. Surti S, Kuhn A, Werner ME, et al. Performance of philips gemini TF PET/CT scanner with special consideration for its time-of-flight imaging capabilities. J Nucl Med. 2007;48:471–480
  23. Kalender WA, Seissler W, Klotz E, et al. Spiral volumetric CT with single-breath-hold technique, continuous transport, and continuous scanner rotation. Radiology. 1990;176:181–183
  24. Schardt P, Deuringer J, Freudenberger J, et al. New x-ray tube performance in computed tomography by introducing the rotating envelope tube technology. Med Phys. 2004;31:2699–2706
  25. Takagi K, Fukazawa T. Cerium-activated Gd2SiO5 single crystal scintillator. App Phys Lett. 1983;42:43–45
  26. Melcher CL, Schweitzer JS. Cerium-doped lutetium oxyorthosilicate: A fast, efficient new scintillator. IEEE Trans Nucl Sci. 1992;39:502–505
  27. Townsend DW, Isoardi RA, Bendriem B. Volume imaging tomographs. In:  Bendriem B,  Townsend DW editor. The Theory and Practice of 3D PET. Dordrecht: Kluwer Academic Publishers; 1998;p. 111–132
  28. Kemp BJ, Kim C, Williams JJ, et al. National Electrical Manufacturers Association (NEMA): NEMA NU 2-2001 performance measurements of an LYSO-based PET/CT system in 2D and 3D acquisition modes. J Nucl Med. 2006;47:1960–1967
  29. Strobel K, Rudy M, Treyer V, et al. Objective and subjective comparison of standard 2-D and fully 3-D reconstructed data on a PET/CT system. Nucl Med Commun. 2007;28:555–559
  30. Jakoby BW, Bercier Y, Watson CC, et al. Physical performance and clinical workflow of a new LSO HI-REZ PET/CT scanner. Nuclear Science Symposium Conference Record, 2006 IEEE. 2006;5:3130–3134
  31. Townsend DW, Jakoby B, Long MJ, et al. Performance and clinical workflow of a new combined PET/CT scanner. J Nucl Med. 2007;48:437P
  32. Budinger TF. Time-of-flight positron emission tomography: Status relative to conventional PET. J Nucl Med. 1983;24:73–78
  33. Muehllehner G, Karp JS. Positron emission tomography. Phys Med Biol. 2006;51:R117–R137
  34. Kinahan PE, Rodgers JG. Analytic 3D image reconstruction using all detected events. IEEE Trans Nucl Sci. 1989;36:964–968
  35. Defrise M, Kinahan PE, Townsend DW, Michel C, Sibomana M, Newport DF. Exact and approximate rebinning algorithms for 3-D PET data. IEEE Trans Med Imaging. 1997;16:145–158
  36. Hudson H, Larkin R. Accelerated image reconstruction using ordered subsets of projection data. IEEE Trans Med Imaging. 1994;13:601–609
  37. Comtat C, Kinahan PE, Defrise M, et al. Fast reconstruction of 3D PET data with accurate statistical modeling. IEEE Trans Nucl Sci. 1998;45:1083–1089
  38. Comtat C, Bataille F, Michel C, et al. OSEM-3D reconstruction strategies for the ECAT HRRT. Nuclear Science Symposium Conference Record, 2004 IEEE. 2004;6:3492–3496
  39. Liu X, Comtat C, Michel C, et al. Comparison of 3-D reconstruction with 3D-OSEM and with FORE+OSEM for PET. IEEE Trans Med Imaging. 2001;20:804–814
  40. Panin VY, Kehren F, Michel C, et al. Fully 3-D PET reconstruction with system matrix derived from point source measurements. IEEE Trans Med Imaging. 2006;25:907–921
  41. Popescu LM, Matej S, Lewitt RM. Iterative image reconstruction using geometrically ordered subsets with list-mode data. Nuclear Science Symposium Conference Record, 2004 IEEE. 2004;6:3536–3540
  42. Daube-Witherspoon ME, Matej S, Karp JS, et al. Application of the row action maximum likelihood algorithm with spherical basis functions to clinical PET imaging. IEEE Trans Nucl Sci. 2001;48:24–30
  43. Kinahan PE, Hasegawa BH, Beyer T. X-ray-based attenuation correction for positron emission tomography/computed tomography scanners. Semin Nucl Med. 2003;33:166–179
  44. Watson CC, Townsend DW, Bendriem B. PET/CT systems. In:  Wernick M,  Aarsvold J editor. Emission Tomography. London: Elsevier Science; 2004;p. 195–212
  45. Burger C, Goerres G, Schoenes S, et al. PET attenuation coefficients from CT images: Experimental evaluation of the transformation of CT into PET 511-keV attenuation coefficients. Eur J Nucl Med Mol Imaging. 2002;29:922–927
  46. Watson CC, Rappoport V, Faul D, et al. A method for calibrating the CT-based attenuation correction of PET in human tissue. IEEE Trans Nucl Sci. 2006;53:102–107
  47. Carney JP, Townsend DW, Rappoport V, et al. Method for transforming CT images for attenuation correction in PET/CT imaging. Med Phys. 2006;33:976–983
  48. Cohade C, Wahl RL. Applications of positron emission tomography/computed tomography image fusion in clinical positron emission tomography-clinical use, interpretation methods, diagnostic improvements. Semin Nucl Med. 2003;33:228–237
  49. Bockisch A, Beyer T, Antoch G, et al. Positron emission tomography/computed tomography–imaging protocols, artifacts, and pitfalls. Mol Imaging Biol. 2004;6:188–199
  50. Nakamoto Y, Chin BB, Cohade C, et al. PET/CT: Artifacts caused by bowel motion. Nucl Med Commun. 2004;25:221–225
  51. Cohade C, Osman M, Marshall L, et al. Metallic object artifacts on PET-CT: Clinical and phantom studies. J Nucl Med. 2002;43:308P
  52. Goerres GW, Ziegler SI, Burger C, et al. Artifacts at PET and PET/CT caused by metallic hip prosthetic material. Radiology. 2003;226:577–584
  53. Kamel EM, Burger C, Buck A, et al. Impact of metallic dental implants on CT-based attenuation correction in a combined PET/CT scanner. Eur Radiol. 2003;13:724–728
  54. Yau YY, Coel M, Chan WS, et al. Application of IV contrast in PET-CT: Does it really produce attenuation correction error. J Nucl Med. 2003;44:272P
  55. Antoch G, Freudenberg LS, Beyer T, et al. To enhance or not to enhance? (18F-FDG and CT contrast agents in dual-modality 18F-FDG PET/CT). J Nucl Med. 2004;45(suppl 1):56S–65S
  56. Carney JP, Beyer T, Brasse D, et al. Clinical PET/CT scanning using oral CT contrast agents. J Nucl Med. 2002;45:57P
  57. Cohade C, Osman M, Nakamoto Y, et al. Initial experience with oral contrast in PET/CT: Phantom and clinical studies. J Nucl Med. 2003;44:412–416
  58. Schafers KP, Raupach R, Beyer T. Combined 18F-FDG-PET/CT imaging of the head and neck (An approach to metal artifact correction). Nuklearmedizin. 2006;45:219–222
  59. Lemmens C, Nuyts J, Faul D, et al. Suppression of metal streak artifacts in CT using a MAP reconstruction procedure. IEEE MIC Conference Record. 2006;6:3431–3437
  60. Mirzaei S, Guerchaft M, Bonnier C, et al. Use of segmented CT transmission map to avoid metal artifacts in PET images by a PET-CT device. BMC Nucl Med. 2005;5:3
  61. Sarikaya I, Yeung HW, Erdi Y, et al. Respiratory artefact causing malpositioning of liver dome lesion in right lower lung. Clin Nucl Med. 2003;28:943–944
  62. Romer W, Chung M, Chan A, et al. Single-detector helical CT in PET-CT: Assessment of image quality. AJR Am J Roentgenol. 2004;182:1571–1577
  63. Osman MM, Cohade C, Nakamoto Y, et al. Clinically significant inaccurate localization of lesions with PET/CT: Frequency in 300 patients. J Nucl Med. 2003;44:240–243
  64. Carney JP, Townsend DW. CT-based attenuation correction for PET/CT scanners. In:  von Schulthess GK editors. Molecular Anatomic Imaging: PET-CT and SPECT-CT Integrated Modality Imaging. Lippincott: Williams and Wilkins; 2006;p. 54–62
  65. Antoch G, Freudenberg LS, Egelhof T, et al. Focal tracer uptake: A potential artifact in contrast-enhanced dual-modality PET/CT scans. J Nucl Med. 2002;43:1339–1342
  66. Berthelsen AK, Holm S, Loft A, et al. PET/CT with intravenous contrast can be used for PET attenuation correction in cancer patients. Eur J Nucl Med Mol Imaging. 2005;32:1167–1175
  67. Mawlawi O, Erasmus JJ, Munden RF, et al. Quantifying the effect of IV contrast media on integrated PET/CT: Clinical evaluation. AJR Am J Roentgenol. 2006;186:308–319
  68. Brechtel K, Klein M, Vogel M, et al. Optimized contrast-enhanced CT protocols for diagnostic whole-body 18F-FDG PET/CT: Technical aspects of single-phase versus multiphase CT imaging. J Nucl Med. 2006;47:470–476
  69. Gollub MJ, Hong R, Sarasohn DM, et al. Limitations of CT during PET/CT. J Nucl Med. 2007;48:1583–1591
  70. Otsuka H, Graham MM, Kubo A, et al. The effect of oral contrast on large bowel activity in FDG-PET/CT. Ann Nucl Med. 2005;19:101–108
  71. Antoch G, Kuehl H, Kanja J, et al. Dual-modality PET/CT scanning with negative oral contrast agent to avoid artifacts: Introduction and evaluation. Radiology. 2004;230:879–885
  72. Kaneta T, Takanami K, Wakayama Y, et al. High-density materials do not always induce artifacts on PET/CT: What is responsible for the difference?. Nucl Med Commun. 2007;28:495–499
  73. Beyer T, Antoch G, Blodgett T, et al. Dual-modality PET/CT imaging: The effect of respiratory motion on combined image quality in clinical oncology. Eur J Nucl Med Mol Imaging. 2003;30:588–596
  74. Osman MM, Cohade C, Nakamoto Y, et al. Respiratory motion artifacts on PET emission images obtained using CT attenuation correction on PET-CT. Eur J Nucl Med Mol Imaging. 2003;30:603–606
  75. Papathanassiou D, Becker S, Amir R, et al. Respiratory motion artefact in the liver dome on FDG PET/CT: Comparison of attenuation correction with CT and a caesium external source. Eur J Nucl Med Mol Imaging. 2005;32:1422–1428
  76. Bacharach SL. PET/CT attenuation correction: Breathing lessons. J Nucl Med. 2007;48:677–679
  77. Beyer T, Rosenbaum S, Veit P, et al. Respiration artifacts in whole-body (18)F-FDG PET/CT studies with combined PET/CT tomographs employing spiral CT technology with 1 to 16 detector rows. Eur J Nucl Med Mol Imaging. 2005;32:1429–1439
  78. Pan T, Mawlawi O, Nehmeh SA, et al. Attenuation correction of PET images with respiration-averaged CT images in PET/CT. J Nucl Med. 2005;46:1481–1487
  79. Chi PC, Mawlawi O, Nehmeh SA, et al. Design of respiration averaged CT for attenuation correction of the PET data from PET/CT. Med Phys. 2007;34:2039–2047
  80. Alessio AM, Kohlmyer S, Branch K, et al. Cine CT for attenuation correction in cardiac PET/CT. J Nucl Med. 2007;48:794–801
  81. Pan T, Lee TY, Rietzel E, et al. 4D-CT imaging of a volume influenced by respiratory motion on multi-slice CT. Med Phys. 2004;31:333–340
  82. Meirelles GS, Erdi YE, Nehmeh SA, et al. Deep-inspiration breath-hold PET/CT: Clinical findings with a new technique for detection and characterization of thoracic lesions. J Nucl Med. 2007;48:712–719
  83. Nehmeh SA, Erdi YE, Meirelles GS, et al. Deep-inspiration breath-hold PET/CT of the thorax. J Nucl Med. 2007;48:22–26
  84. Dawood M, Buther F, Lang N, et al. Respiratory gating in positron emission tomography: A quantitative comparison of different gating schemes. Med Phys. 2007;34:3067
  85. Martinez-Moller A, Zikic D, Botnar RM, et al. Dual cardiac-respiratory gated PET: Implementation and results from a feasibility study. Eur J Nucl Med Mol Imaging. 2007;34:1447–1454
  86. Nagel CC, Bosmans G, Dekker AL, et al. Phased attenuation correction in respiration correlated computed tomography/positron emitted tomography. Med Phys. 2006;33:1840–1847
  87. Allen-Auerbach M, Yeom K, Park J, et al. Standard PET/CT of the chest during shallow breathing is inadequate for comprehensive staging of lung cancer. J Nucl Med. 2006;47:298–301
  88. Beyer T, Bockisch A, Kuhl H, et al. Whole-body 18F-FDG PET/CT in the presence of truncation artifacts. J Nucl Med. 2006;47:91–99
  89. Carney JP, Townsend DW, Kinahan PE, et al. CT-based attenuation correction: The effects of imaging with the arms in the field of view [abstract]. J Nucl Med Soc Nucl Med. 2001;42S:56P–57P
  90. Mawlawi O, Pan T, Cody DD, et al. Evaluation of a new CT truncation correction algorithm for accurate quantification of PET/CT images [abstract]. J Nucl Med. 2004;45S:413P
  91. Zaidi H. Is radionuclide transmission scanning obsolete for dual-modality PET/CT systems?. Eur J Nucl Med Mol Imaging. 2007;34:815–818
  92. Nakamoto Y, Osman M, Cohade C, et al. PET/CT: Comparison of quantitative tracer uptake between germanium and CT transmission attenuation-corrected images. J Nucl Med. 2002;43:1137–1143
  93. van Dalen JA, Visser EP, Vogel WV, et al. Impact of ge-68/Ga-68-based versus CT-based attenuation correction on PET. Med Phys. 2007;34:889–897
  94. Brix G, Beyer T. PET/CT: Dose-escalated image fusion?. Nuklearmedizin. 2005;44(suppl 1):S51–S57
  95. ICRP 87. Managing Patient Dose in Computed Tomography. Oxford, New York: Published for the International Commission on Radiological Protection by Pergamon; 2000;
  96. Brix G, Lechel U, Glatting G, et al. Radiation exposure of patients undergoing whole-body dual-modality 18F-FDG PET/CT examinations. J Nucl Med. 2005;46:608–613
  97. Kalender WA, Wolf H, Suess C, et al. Dose reduction in CT by on-line tube current control: Principles and validation on phantoms and cadavers. Eur Radiol. 1999;9:323–328
  98. Kachelriess M, Watzke O, Kalender WA. Generalized multi-dimensional adaptive filtering for conventional and spiral single-slice, multi-slice, and cone-beam CT. Med Phys. 2001;28:475–490
  99. ICRP 53. Radiation Dose to Patients from Radiopharmaceuticals: Addendum 2 to ICRP Publication 53. Oxford, New York: Published for the International Commission on Radiological Protection by Pergamon; 1999;
  100. Deloar HM, Fujiwara T, Shidahara M, et al. Estimation of absorbed dose for 2-[F-18]fluoro-2-deoxy-D-glucose using whole-body positron emission tomography and magnetic resonance imaging. Eur J Nucl Med. 1998;25:565–574
  101. Hays MT, Watson EE, Thomas SR, et al. MIRD dose estimate report no. 19: Radiation absorbed dose estimates from (18)F-FDG. J Nucl Med. 2002;43:210–214
  102. Czernin J, Auerbach MA. Clinical PET/CT imaging: Promises and misconceptions. Nuklearmedizin. 2005;44(suppl 1):S18–S23
  103. Czernin J, Allen-Auerbach M, Schelbert HR. Improvements in cancer staging with PET/CT: Literature-based evidence as of september 2006. J Nucl Med. 2007;48(suppl 1):78S–88S
  104. Israel O, Kuten A. Early detection of cancer recurrence: 18F-FDG PET/CT can make a difference in diagnosis and patient care. J Nucl Med. 2007;48(suppl 1):28S–35S
  105. Chen YK, Su CT, Ding HJ, et al. Clinical usefulness of fused PET/CT compared with PET alone or CT alone in nasopharyngeal carcinoma patients. Anticancer Res. 2006;26:1471–1477
  106. Palmedo H, Bucerius J, Joe A, et al. Integrated PET/CT in differentiated thyroid cancer: Diagnostic accuracy and impact on patient management. J Nucl Med. 2006;47:616–624
  107. Osman MM, Cohade C, Leal J, et al. Direct comparison of FDG-PET and PET-CT imaging in staging and re-staging patients with lung cancer. J Nucl Med. 2002;43:151P
  108. Lardinois D, Weder W, Hany TF, et al. Staging of non-small-cell lung cancer with integrated positron-emission tomography and computed tomography. N Engl J Med. 2003;348:2500–2507
  109. Cerfolio RJ, Bryant AS, Ojha B. Restaging patients with N2 (stage IIIa) non-small cell lung cancer after neoadjuvant chemoradiotherapy: A prospective study. J Thorac Cardiovasc Surg. 2006;131:1229–1235
  110. Fueger BJ, Weber WA, Quon A, et al. Performance of 2-deoxy-2-[F-18]fluoro-D-glucose positron emission tomography and integrated PET/CT in restaged breast cancer patients. Mol Imaging Biol. 2005;7:369–376
  111. Tatsumi M, Cohade C, Mourtzikos KA, et al. Initial experience with FDG-PET/CT in the evaluation of breast cancer. Eur J Nucl Med Mol Imaging. 2006;33:254–262
  112. Bar-Shalom R, Guralnik L, Tsalic M, et al. The additional value of PET/CT over PET in FDG imaging of oesophageal cancer. Eur J Nucl Med Mol Imaging. 2005;32:918–924
  113. Guo H, Zhu H, Xi Y, et al. Diagnostic and prognostic value of 18F-FDG PET/CT for patients with suspected recurrence from squamous cell carcinoma of the esophagus. J Nucl Med. 2007;48:1251–1258
  114. Cohade C, Osman M, Leal J, Wahl RL. Direct comparison of (18)F-FDG PET and PET/CT in patients with colorectal carcinoma. J Nucl Med. 2003;44:1797–1803
  115. Kim JH, Czernin J, Allen-Auerbach MS, et al. Comparison between 18F-FDG PET, in-line PET/CT, and software fusion for restaging of recurrent colorectal cancer. J Nucl Med. 2005;46:587–595
  116. Reinhardt MJ, Joe AY, Jaeger U, et al. Diagnostic performance of whole body dual modality 18F-FDG PET/CT imaging for N- and M-staging of malignant melanoma: Experience with 250 consecutive patients. J Clin Oncol. 2006;24:1178–1187
  117. Freudenberg LS, Antoch G, Schutt P, et al. FDG-PET/CT in re-staging of patients with lymphoma. Eur J Nucl Med Mol Imaging. 2004;31:325–329
  118. Yi CA, Lee KS, Kim BT, et al. Tissue characterization of solitary pulmonary nodule: Comparative study between helical dynamic CT and integrated PET/CT. J Nucl Med. 2006;47:443–450
  119. Kim SK, Allen-Auerbach M, Goldin J, et al. Accuracy of PET/CT in characterization of solitary pulmonary lesions. J Nucl Med. 2007;48:214–220
  120. Alavi A, Mavi A, Basu S, Fischman A. Is PET-CT the only option?. Eur J Nucl Med Mol Imaging. 2007;34:819–821
  121. Coleman RE, Delbeke D, Guiberteau MJ, et al. Concurrent PET/CT with an integrated imaging system: Intersociety dialogue from the joint working group of the American college of radiology, the society of nuclear medicine, and the society of computed body tomography and magnetic resonance. J Nucl Med. 2005;46:1225–1239

 Financial support for the original PET/CT development was provided by NCI Grant CA 65856.

PII: S0001-2998(08)00022-6

doi: 10.1053/j.semnuclmed.2008.01.003

Seminars in Nuclear Medicine
Volume 38, Issue 3 , Pages 152-166 , May 2008

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