Houston Methodist Academic Institute, Houston Methodist Debakey Heart & Vascular Center, Houston Methodist Hospital, 6550 Fannin Street, Smith Tower - Suite 1801, Houston, TX, 77030, USA.
Weill Cornell Medicine, New York, NY, USA.
Curr Cardiol Rep. 2021 Mar 11;23(5):39. doi: 10.1007/s11886-021-01476-5.
Positron emission tomography (PET) is a leading non-invasive modality for the diagnosis of coronary artery disease due to its diagnostic accuracy and high image quality. With the latest advances in PET systems, clinicians are able to assess for myocardial ischemia and myocardial blood flow while exposing patients to extremely low radiation doses. This review will focus on the basics of acquisition and processing of hybrid PET/CT systems from appropriate patient selection to common artifacts and pitfalls.
The continued development of hybrid PET/CT technology is producing scanners with exquisite sensitivity capable of generating high-quality images while exposing patients to low radiation doses. List mode acquisition is an essential component in all modern PET/CT scanners allowing simultaneous dynamic and ECG-gated imaging without lengthening scan duration. Various PET radiotracers are currently being developed but rubidium-82 and 13N-ammonia remain the most commonly used perfusion radiotracers. The development of mini 13N-ammonia cyclotrons is a promising tool that should increase access to this radiotracer. Misregistration, attenuation from extra-cardiac activity, and patient motion are the most common causes of artifacts during perfusion imaging. Techniques to automatically realign images and correct respiratory or patient motion artifacts continue to evolve. Despite the continuous evolution of PET imaging techniques, basic knowledge of scan parameters, acquisition techniques, and post processing tools remains essential to ensure high-quality images are produced and artifacts are recognized and corrected. Future research should focus on optimizing scanners to allow for shorter scan protocols and lower radiation exposure as well as continue developing techniques to minimize and correct for motion and misregistration artifacts.
正电子发射断层扫描（PET）因其诊断准确性和高图像质量，成为诊断冠状动脉疾病的主要非侵入性手段。随着 PET 系统的最新进展，临床医生能够在暴露于极低辐射剂量的情况下评估心肌缺血和心肌血流。本综述将重点介绍从适当的患者选择到常见伪影和陷阱的混合 PET/CT 系统的采集和处理基础知识。
混合 PET/CT 技术的持续发展正在产生具有极高灵敏度的扫描仪，能够在暴露于低辐射剂量的情况下生成高质量的图像。列表模式采集是所有现代 PET/CT 扫描仪的重要组成部分，允许在不延长扫描时间的情况下同时进行动态和 ECG 门控成像。目前正在开发各种 PET 放射性示踪剂，但铷-82 和 13N-氨仍然是最常用的灌注放射性示踪剂。小型 13N-氨回旋加速器的开发是一种有前途的工具，应该增加这种放射性示踪剂的可及性。配准错误、来自心脏外活动的衰减和患者运动是灌注成像中最常见的伪影原因。自动重新对齐图像和校正呼吸或患者运动伪影的技术仍在不断发展。尽管 PET 成像技术不断发展，但仍需了解扫描参数、采集技术和后处理工具的基础知识，以确保生成高质量的图像，并识别和纠正伪影。未来的研究应侧重于优化扫描仪，以允许更短的扫描方案和更低的辐射暴露，同时继续开发最小化和校正运动和配准伪影的技术。
