A simplified method to integrate metabolic images in stereotactic procedures using a PET/CT scanner.
We have developed a method that needs only the computed tomography (CT) indicator box to coregister positron emission tomography (PET) images and integrates this information with magnetic resonance imaging. The study was performed using a PET/CT scanner. A standard CT bed adapter was attached to the scanner couch. Then, the patient, with the Leksell G frame fixed, was positioned into the scanner with the CT indicator box. PET images were acquired using either [18F]fluorodeoxyglucose or [11C]choline as radioisotopes. After acquisition, CT and PET images were exported in DICOM 3 standard and transferred to a dedicated workstation via data link. Homemade software was implemented for multimodal image fusion. PET images were overwritten to their corresponding CT point values using a threshold algorithm, maintaining the stereotactic CT markers. The use of a CT indicator simplifies the procedure, because there is no need for a radioactive solution filling the indicator box. This method was tested first using a phantom and then in patients. The localization accuracy of the PET images is limited only by the slice thickness.
Picozzi
Piero
P
Department of Neurosurgery, IRCCS, Ospedale San Raffaele, Vita Salute University, Milan, Italy. picozzi.piero@hsr.it
Rizzo
Giovanna
G
Landoni
Claudio
C
Attuati
Luca
L
Franzin
Alberto
A
Messa
Cristina
C
Ferrari da Passano
Camillo
C
Bettinardi
Valentino
V
Fazio
Ferruccio
F
D000368:Aged; D000465:Algorithms; D001921:Brain / Q000601:surgery; D002250:Carbon Radioisotopes; D002794:Choline; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D016399:Lymphoma, T-Cell / Q000175:diagnosis; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000175:diagnosis; D049268:Positron-Emission Tomography / Q000379:methods*; D016634:Radiosurgery / Q000379:methods; D012984:Software; D013238:Stereotaxic Techniques; D014057:Tomography, X-Ray Computed / Q000379:methods*
D002250:Carbon Radioisotopes; D019788:Fluorodeoxyglucose F18; D002794:Choline