Optimization of reconstruction and quantification of motion-corrected coronary PET-CT

J Nucl Cardiol. 2020 Apr;27(2):494-504. doi: 10.1007/s12350-018-1317-5. Epub 2018 Jun 11.


Background: Coronary PET shows promise in the detection of high-risk atherosclerosis, but there remains a need to optimize imaging and reconstruction techniques. We investigated the impact of reconstruction parameters and cardiac motion-correction in 18F Sodium Fluoride (18F-NaF) PET.

Methods: Twenty-two patients underwent 18F-NaF PET within 22 days of an acute coronary syndrome. Optimal reconstruction parameters were determined in a subgroup of six patients. Motion-correction was performed on ECG-gated data of all patients with optimal reconstruction. Tracer uptake was quantified in culprit and reference lesions by computing signal-to-noise ratio (SNR) in diastolic, summed, and motion-corrected images.

Results: Reconstruction using 24 subsets, 4 iterations, point-spread-function modelling, time of flight, and 5-mm post-filtering provided the highest median SNR (31.5) compared to 4 iterations 0-mm (22.5), 8 iterations 0-mm (21.1), and 8 iterations 5-mm (25.6; all P < .05). Motion-correction improved SNR of culprit lesions (n = 33) (24.5[19.9-31.5]) compared to diastolic (15.7[12.4-18.1]; P < .001) and summed data (22.1[18.9-29.2]; P < .001). Motion-correction increased the SNR difference between culprit and reference lesions (10.9[6.3-12.6]) compared to diastolic (6.2[3.6-10.3]; P = .001) and summed data (7.1 [4.8-11.6]; P = .001).

Conclusions: The number of iterations and extent of post-filtering has marked effects on coronary 18F-NaF PET quantification. Cardiac motion-correction improves discrimination between culprit and reference lesions.

Keywords: Atherosclerosis; Cardiac motion; Computed tomography; Positron emission tomography.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Atherosclerosis / diagnostic imaging*
  • Diastole
  • Electrocardiography / methods
  • Female
  • Fluorine Radioisotopes
  • Fluorodeoxyglucose F18
  • Heart / physiopathology
  • Humans
  • Image Processing, Computer-Assisted*
  • Male
  • Middle Aged
  • Motion*
  • Positron Emission Tomography Computed Tomography / methods*
  • Positron-Emission Tomography / methods*
  • Radiopharmaceuticals
  • Reproducibility of Results
  • Signal-To-Noise Ratio


  • Fluorine Radioisotopes
  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18