• The Korean Journal of Nuclear Medicine Technology
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• v.20 no.2
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• pp.21-26
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• 2016

Purpose Because of many advantages, PET-CT Scanners generally use CT Data for attenuation correction. By using CT based attenuation correction, we can get anatomical information, reduce scan time and make more accurate correction of attenuation. However in case metal artifact occurred during CT scan, CT-based attenuation correction can induce artifacts and quantitative errors that can affect the PET images. Therefore this study infers true SUV of metal artifact region from attenuation corrected image count -to- non attenuation corrected image count ratio. Materials and Methods Micro phantom inserted $^{18}F-FDG$ 4mCi was used for phantom test and Biograph mCT S(40) is used for medical test equipment. We generated metal artifact in micro phantom by using metal. Then we acquired both metal artifact region of correction factor and non metal artifact region of correction factor by using attenuation correction image count -to- non attenuation correction image count ratio. In case of clinical image, we reconstructed both attenuation corrected images and non attenuation corrected images of 10 normal patient($66{\pm}15age$) who examined PET-CT scan in SNUH. After that, we standardize several organs of correction factor by using attenuation corrected image count -to- non attenuation corrected count ratio. Then we figured out metal artifact region of correction factor by using metal artifact region of attenuation corrected image count -to- non attenuation corrected count ratio And we compared standard organs correction factor with metal artifact region correction factor. Results according to phantom test results, metal artifact induce overestimation of correction factor so metal artifact region of correction factors are 12% bigger than the non metal artifact region of correction factors. in case of clinical test, correction factor of organs with high CT number(>1000) is $8{\pm}0.5%$, correction factor of organs with CT number similar to soft tissue is $6{\pm}2%$ and correction factor of organs with low CT number(-100>) is $3{\pm}1%$. Also metal artifact correction factors are 20% bigger than soft tissue correction factors which didn't happened metal artifact. Conclusion metal artifact lead to overestimation of attenuation coefficient. because of that, SUV of metal artifact region is overestimated. Thus for more accurate quantitative evaluation, using attenuation correction image count -to-non attenuation correction image count ratio is one of the methods to reduce metal artifact affect.

• Nuclear Medicine and Molecular Imaging
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• v.42 no.2
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• pp.112-117
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• 2008

Artifact corrections including normalization and attenuation correction were important for quantitative analysis in Nuclear Medicine Imaging. Normalization is the process of ensuring that all lines of response joining detectors in coincidence have the same effective sensitivity. Failure to account for variations in LOR sensitivity leads to bias and high-frequency artifacts in the reconstructed images. Attenuation correction is the process of the correction of attenuation phenomenon lies in the natural property that photons emitted by the radiopharmaceutical will interact with tissue and other materials as they pass through the body. In this paper, we will review the several approaches for normalization and attenuation correction strategies.

• The Korean Journal of Nuclear Medicine Technology
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• v.14 no.2
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• pp.110-116
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• 2010

Purpose: The X-ray attenuation coefficient based on CT images is used for attenuation correction in PET/CT. The polychromatic X-ray beam can introduce beam-hardening artifact on CT images. The aims of the study were to evaluate the effect of dental metal prostheses in phantom and patients on apparent tracer activity measured with PET/CT when using CT attenuation correction. Materials and Methods: 40 normal patients (mean age $54{\pm}12$) was scanned between Jan and Feb 2010. NEMA(National Electrical Manufactures Association) PET $Phantom^{TM}$ (NU2-1994) was filled with $^{18}F$-FDG injected into the water that insert implant and metal prostheses dental cast. Region of interest were drawn in non-artifact region, bright steak artifact region and dark streak artifact region on the same transaxial CT and PET slices. Patients and phantom with dental metal prostheses and dental implant were evaluated the change rate of CT Number and $SUV_{mean}$ in PET/CT. A paired t-test was performed to compare the ratio and the difference of the calculated values. Results: In patients with dental metal prostheses, $SUV_{mean}$ was reduced 19.64% (p<0.05) in the non-steak artifact region than the brightstreak artifact region whereas was increased 90.1% (p>0.05) in the non-steak artifact region than the dark streak artifact region. In phantom with dental metal prostheses, $SUV_{mean}$ was reduced 18.1% (p<0.05) in the non-steak artifact region than the bright streak artifact region whereas was increased 18.0% (p>0.05) in the non-steak artifact region than the dark streak artifact region. In patients with dental implant, $SUV_{mean}$ was increased 19.1% (p<0.05) in the non-steak artifact region than the bright streak artifact region whereas was increased 96.62% (p>0.05) in the non-steak artifact region than the dark streak artifact region. In phantom with dental implant, $SUV_{mean}$ was increased 14.4% (p<0.05) in the non-steak artifact region than the bright streak artifact region whereas was increased 7.0% (p>0.05) in the non-steak artifact region than the dark streak artifact region. Conclusion: When CT is used for attenuation correction in patients with dental metal prostheses, 19.1% reduced $SUV_{mean}$ is anticipated in the dark streak artifact region on CT images. The dark streak artifacts of CT by dental metal prostheses may cause false negative finding in PET/CT. We recommend that the non-attenuation corrected PET images also be evaluated for clinical use.

• Nuclear Engineering and Technology
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• v.55 no.8
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• pp.2854-2863
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• 2023

Objective: To present a hybrid approach that incorporates a constrained beam-hardening estimator (CBHE) and deep learning (DL)-based post-refinement for metal artifact reduction in dental cone-beam computed tomography (CBCT). Methods: Constrained beam-hardening estimator (CBHE) is derived from a polychromatic X-ray attenuation model with respect to X-ray transmission length, which calculates associated parameters numerically. Deep-learning-based post-refinement with an artifact disentanglement network (ADN) is performed to mitigate the remaining dark shading regions around a metal. Artifact disentanglement network (ADN) supports an unsupervised learning approach, in which no paired CBCT images are required. The network consists of an encoder that separates artifacts and content and a decoder for the content. Additionally, ADN with data normalization replaces metal regions with values from bone or soft tissue regions. Finally, the metal regions obtained from the CBHE are blended into reconstructed images. The proposed approach is systematically assessed using a dental phantom with two types of metal objects for qualitative and quantitative comparisons. Results: The proposed hybrid scheme provides improved image quality in areas surrounding the metal while preserving native structures. Conclusion: This study may significantly improve the detection of areas of interest in many dentomaxillofacial applications.

• Journal of the Korean Society for Industrial and Applied Mathematics
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• v.18 no.2
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• pp.157-166
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• 2014

If there are metals located in the X-ray scanned object, a point outside the metals has its range of projection angle at which projections passing through the point are disturbed by the metals. Roughly speaking, this implies that attenuation information at the point is missing in the blocked projection range. So conventional projection completion MAR algorithms to use the undisturbed projection data on the boundary of the metaltrace is less efficient in reconstructing the attenuation coefficient in detailed parts, in particular, near the metal region. In order to overcome this problem, we propose the algebraic correction technique (ACT) to utilize a pre-reconstructed interim image of the attenuation coefficient outside the metal region which is obtained by solving a linear system designed to reduce computational costs. The reconstructed interim image of the attenuation coefficient is used as prior information for MAR. Numerical simulations support that the proposed correction technique shows better performance than conventional inpainting techniques such as the total variation and the harmonic inpainting.

• The Korean Journal of Nuclear Medicine Technology
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• v.18 no.2
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• pp.3-7
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• 2014

Purpose SPECT/CT scan to be performed attenuation correction on the basis of CT induce an overestimation of the site due to the beam hardening artifact by metal cover and reduce the images quality. Therefore, this study using a phantom that has been inserted artificial hip joint investigated that effect on the SPECT/CT image causing by metal artifact for varying the parameters of the Attenuation Map. Materials and Methods Siemens Symbia T16 SPECT/CT equipment was used. Artificial hip joint was inserted to SPECT/PET phantom, 17 mm sphere of Bright Streak area in CT image was filled with Tc-99m so that the radiation activity was 8 times compared to background. And then Hot and Background was measured in varying Wide Beam Coefficient on Attenuation Map and RBR (Region to Background Ratio) of Metal and Non-Metal was calculated and analyzed depending on the presence or absence of the hip joint. Results It tended to hot count of Non-Metal and Metal to increase as the value of the manual mode is increased, hot count ratio with the group of both manual mode 0.5 and 0.4 is the best match. Also, in automatic mode, the ratio of RBRNon-Metal and RBRMetal was 1.135, statistically significant difference was not observed in the manual mode 0.5 and 0.4. Conclusion In the automatic mode of Wide Beam Coefficient in attenuation correction map, it was found that it is over-correction by 13.52%, it was possible to minimize the over-correction by the artifact in 0.5 and 0.4 of manual mode. Further studies should be performed in order to apply to a patient with the help of this and it is considered possible to reduce the over-correction by the metal artifact of an artificial hip joint for Hip-Resurfacing Arthroplasty patients, and to improve the diagnostic performance.

• The Korean Journal of Nuclear Medicine Technology
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• v.16 no.2
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• pp.35-43
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• 2012

Purpose : PET/CT performed CT-based attenuation correction generates the beam hardening artifact by metallic implant. The attenuation correction causes over or underestimate of the area adjacent to metallic hip prosthetic material and change of $^{18}F$-FDG uptake. Also, the image quality and the diagnosability on genitourinary disease are reduced. Therefore, this study will evaluate the usefulness of MAR (Metal Artifact Reduction) algorithm method to improve the image quality on PET/CT. Materials and Methods : PET/CT was performed by fixing hip prosthesis in SPECT/PET phantom. In PET images with and Without MAR algorithm, the Bright streak, Dark streak, Metal region and Background area that appeared on CT were confirmed, and the change of each SUV (standardized uptake value) was analyzed. Also, in 15 patients who underwent total hip arthroplasty, each MAR algorithm and Without MAR algorithm and non attenuation correction was evaluated. Results : In PET image Without MAR algorithm, SUV of Bright streak region was $0.98{\pm}0.48$ g/ml; Dark streak region was $0.88{\pm}0.02$ g/ml; Metal region was $0.24{\pm}0.16$ g/ml, Background area was $0.91{\pm}0.18$ g/ml. In SUV of PET image with MAR algorithm, Bright streak region was $0.88{\pm}0.49$ g/ml, Dark streak region was $0.63{\pm}0.21$ g/ml, Metal region was $0.06{\pm}0.07$ g/ml, Background was $0.90{\pm}0.02$ g/ml. SUV generally decreased when applying MAR algorithm. In PET image Without MAR algorithm, SUVs of Bright region were higher than those measured in the Background, and it was false positive uptake. But, in PET image with MAR algorithm, SUVs of Bright region were similar to the Background, and false positive uptake disappeared. Conclusion : MAR algorithm could reduce an increase of $^{18}F$-FDG uptake due to attenuation correction in the hip surrounding tissue. However, decrease of SUV in Dark streak region should be considered in the future. Therefore, this study propose that the diagnostic accuracy can be improved in genitourinary diseases adjacent to metallic hip prosthesis, if provided PET images with and Without MAR algorithm, and non attenuation correction images at the same time.

• Nuclear Medicine and Molecular Imaging
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• v.41 no.1
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• pp.68-69
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• 2007

A 44-year-old female underwent three-phase bone scintigraphy for an evaluation of right hip joint pain. The blood-flow and blood-pool images show a pelvic blush with a photopenic center (doughnut) prior to bladder filling. On the three hour delayed image, the pelvic uptake disappeared. The scintigraphic findings indicated the possibility of an early pregnancy. However, plain radiography demonstrated an intrauterine device. A uterine doughnut developed as a result of photon attenuation of intrauterine device.

• The Korean Journal of Nuclear Medicine Technology
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• v.28 no.1
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• pp.35-40
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• 2024

Purpose: To improve the image quality in positron emission tomography (PET), the attenuation correction technique based on the computed tomography (CT) data is important process. However, the artifact is caused by metal material during PET/CT scan, and the image quality is degraded. Therefore, the purpose of this study was to evaluate image quality according to with and without iterative metal artifact reduction (iMAR) algorithm using customized 3D printing phantom. Materials and Methods: The Hoffman and Derenzo phantoms were designed. To protect the gamma ray transmission and express the metal portion, lead substance was located to the surface. The SiPM based PET/CT was used for acquisition of PET images according to application with and without iMAR algorithm. The quantitative methods were used by signal to noise ratio (SNR), coefficient of variation (COV), and contrast to noise ratio (CNR). Results and Discussion: The results shows that the image quality applying iMAR algorithm was higher 1.15, 1.19, and 1.11 times than image quality without iMAR algorithm for SNR, COV, and CNR. Conclusion: In conclusion, the iMAR algorithm was useful for improvement of image quality by reducing the metal artifact lesion.

• The Journal of Korean Society for Radiation Therapy
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• v.17 no.1
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• pp.45-55
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• 2005

Purpose : To evaluate the usefulness of the handmade patient immobilization device and to report the clinical results of it. Materials and methods : We made two fusion images and analyzed those images. One image is made with diagnostic MR image and CT image, the other with therapeutic planning MR image and CT image. With open head holder, we measured the skin dose and attenuation dose. Also, we made the planning CT couch plate with acrylic plate and styrofoam and compared artifact. Results : We could get more accurate fusion image when we use MR head holder(within 2mm error). The skin dose was reduced 2 times and the attenuation dose was reduced more than $20\%$ when open head holder used. The planning CT couch plate was more convenient than conventional board and reduced artifact remarkably. Conclusion : We could verify the localization point in the MR image which is taken with MR head holder. So we could fuse the image more accurately. The same method could be applied to PET and US image, if the alike immobilization device used. With open head holder, the skin dose and the attenuation dose was reduced. And those above devices could substitute for expensive foreign device, if those are manufactured adequately.