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.
Department of Neurosurgery, IRCCS, Ospedale San Raffaele, Vita Salute University, Milan, Italy. picozzi.piero@hsr.it
Piero
P
Picozzi
Giovanna
G
Rizzo
Claudio
C
Landoni
Luca
L
Attuati
Alberto
A
Franzin
Cristina
C
Messa
Camillo
C
Ferrari da Passano
Valentino
V
Bettinardi
Ferruccio
F
Fazio
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