Purpose: In this study we evaluate the number of data partitions (gates) needed to sort 4D-PET and 4D-CT data to obtain motion-free images as a function of lesion size and motion displacement.
Methods: Plexiglas spheres of various diameters (8, 10, 15, 20, and 25 mm) were filled with a radioactive solution of water and 18F. A PET/CT study was acquired for each sphere in a rest condition to reconstruct a motion-free image as a reference in terms of radioactivity concentration and spatial distribution. Each sphere was then moved sinusoidally in the superior-inferior direction over different motion displacements (5, 10, 15, 20, and 25 mm) with a periodic motion of 4 s. During motion a 4D-CT scan followed by a 4D-PET scan were acquired. Each set of 4D-CT and 4D-PET data was retrospectively sorted to generate one, two, four, six, eight, ten, and 12 partitions (gates) over the whole cycle of motion. 4D-PET gates were reconstructed by using the corresponding 4D-CT gates for attenuation correction, while PET data acquired, with the sphere in the rest condition were corrected for attenuation by using the corresponding CT image set. For each series of PET images, data analysis was performed by measuring (1) the maximum value of the radioactivity concentration (RACmax) in a VOI encompassing the radioactivity distribution over the volume of motion and (2) the axial-profile of the radioactivity distribution (Ax-p).
Results: The results show that radioactivity concentration is strongly underestimated due to motion in most conditions considered in this study. In particular, the underestimation of RACmax for the smallest sphere varied from -10.6% to -66.3% with motion displacements ranging from 5 to 25 mm. For the largest sphere, errors ranged from -1.4% to -26.7%. The 4D-PET/CT methodology allows motion-free or nearly motion-free images to be obtained. It also permits both radioactivity concentration (RACmax) and Ax-p to be recovered with residual differences with respect to the rest condition, depending on the number of partitions used to process the data. Within the limitation of the regular sinusoidal motion, used to simulate a general breathing condition, a scheme describing the number of partitions needed to obtain nearly motion-free images with Ax-p differences of around 10% with respect to the rest data is presented as a function of the lesion size and motion displacement. Such a scheme is proposed to guide the setup of a 4D-PET/CT acquisition and processing protocol for clinical applications.
Conclusions: By using the 4D-PET/CT acquisition technique, it is possible to compensate for the degradation effect of lesion motion on the reconstructed PET images.