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Effect of tomographic operator inaccuracies and respiratory motion on PET/CT lung nodule images smearing

Daouk, Joël; Bailly, Pascal; Bouzerar, Roger; Meyer, Marc-Étienne

Nuclear Medicine Communications: February 2017 - Volume 38 - Issue 2 - p 178–184
doi: 10.1097/MNM.0000000000000624

Background In thoracic PET/computed tomography (CT) imaging, uptake foci usually appear smeared because of postreconstruction smoothing and respiratory motion.

Objective The aim of the present study was to assess the respective contributions of the reconstruction process and respiratory motion on PET/CT images.

Materials and methods Thirty-one pulmonary lesions were studied. Free-breathing PET/CT acquisitions were followed by a 10-min respiratory-gated PET/CT acquisition. Four different reconstructions were performed by combining two different tomographic operators (TOs) (i.e. the geometric clinical system matrix or a system matrix including the detector response) and taking account (or not) of respiratory motion using a previously developed ‘CT-based’ technique. For each reconstruction method, lesion segmentation was performed with an adaptive threshold. Next, we computed the volume differences between each reconstruction. Finally, we applied a multiple linear model to compute the relative contributions of TO-based and CT-based respiratory compensation to lesion volume.

Results The three groups, combining the reconstruction methods and the respiratory compensation (or not), differed significantly in terms of the volume differences. For all lesions, the full linear model yielded a regression coefficient R2 of 76.10%. The partial R2 values were 65.58 and 10.52% for the detector response operator and the CT-based method, respectively. For lesions in the upper/middle lobes, blurring was mainly because of TO (partial R2=78.53%), whereas, for lower lobe lesions, smearing was mainly because of respiratory motion (partial R2=56.76%).

Conclusion Our results showed that image reconstruction, by TO accuracy, was the main explanatory factor for lesion smearing when considering the chest as a whole. Respiration had a major impact on the lower lobes.

aBioflow Image Unit, Jules Verne University of Picardie

bDepartment of Nuclear Medicine and Image Processing, Amiens University Medical Center, Amiens, France

Correspondence to Pascal Bailly, MSc, Nuclear Medicine Department, Amiens University Medical Center, CHU d’Amiens, Avenue René Laennec, F-80054 Amiens cedex, France Tel: +33 322 455 967; fax: +33 322 456 011; e-mail:

Received September 20, 2016

Received in revised form November 2, 2016

Accepted November 3, 2016

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