The use of a CT attenuation correction (CTAC) map for the reconstruction of PET image can introduce attenuation artifacts due to the potential misregistration between the PET and CT data. This misregistration is mainly caused by patient motion and physiological movement of organs during the acquisition of the PET and CT scans. In cardiac exams, the motion of the patient may not be significant but the diaphragm movement during the respiratory cycle can displace the heart by up to 2 cm along the long axis of the body. This shift can project the PET heart onto the lungs in the CT image, thereby producing an underestimated value for the attenuation. In brain studies, patients undergoing a PET scan are often not able to follow instructions to keep their head in a still position, resulting in misregistered PET and CT image datasets. The head movement is quite significant in many cases despite the use of head restraints. This misaligns the PET and CT data, thus creating an erroneous CT attenuation correction map. In such cases, bone or air attenuation coefficients may be projected onto the brain which causes an overestimation or an underestimation of the resulting CTAC values. To avoid misregistration artifacts and potential diagnostic misinterpretation, automated software for PET/CT registration has been developed that works for both cardiac and brain datasets. This software segments the PET and CT data, extracts the brain or the heart surface information from both datasets, and compensates for the translational and rotational misalignment between the two scans. The PET data are reconstructed using the aligned CTAC, and the results are analyzed and compared with the original dataset. This procedure has been evaluated on 100 cardiac and brain PET/CT data sets, and the results show that the artifacts due to the misregistration between the two modalities are eliminated after the PET and CT images are aligned.
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