Halo artifacts of indwelling urinary catheter by inaccurate scatter correction in 18F-FDG PET/CT imaging: incidence, mechanism, and solutions.

Halo artifacts from urinary catheters can occur due to inaccurate scatter correction, and the artifacts affect the tumor visibility in 18F-FDG PET/CT images. We investigated the incidence rate and the mechanisms of halo-artifact generation and explored several scatter correction techniques to prevent artifacts.

We conducted patient and phantom studies. (1) We retrospectively reviewed the cases of patients who had undergone 18F-FDG PET/CT scans. To determine the frequency of halo-artifact generation, we used the patients' PET images with a standard scatter correction based on a tail-fitted single-scatter simulation (TF-SSS) using 4-mm voxel μ-maps (TFS 4-mm). (2) We performed phantom studies to evaluate the effects of a urine catheter and two scatter correction techniques, i.e., TF-SSS with 2-mm voxel μ-maps (TFS 2-mm) and a Monte Carlo-based single-scatter simulation (MC-SSS) using 4-mm voxel μ-maps (MCS 4-mm). The average standardized uptake values (SUVs) were measured for axial PET images. (3) Using the patients' data, we investigated whether TFS 2-mm and MCS 4-mm can eliminate the artifacts in the clinical images.

(1) There were 61 patients with urinary catheters; in five (8.2%), halo artifacts were observed in the TFS 4-mm PET images. (2) The phantom study clearly reproduced the halo artifacts in the TFS 4-mm PET images. The halo artifacts were generated when urine moved in the interval between the CT and PET imaging, and when the urinary catheter was placed in a circular shape. The SUVs for the TFS 4-mm and TFS-2mm PET images were underestimated at the halo-artifact regions, whereas the SUVs for the MCS 4-mm PET images were close to the true values. (3) The halo artifacts disappeared in the TFS 2-mm PET images in 4/5 patients but not 1/5 patient, whereas the halo artifacts were completely absent in the MCS 4-mm PET images in 5/5 patients.

These data suggest that halo artifacts are caused if the PET images do not correspond to the physical material in the μ-maps, which induces the scatter correction error. With the MC-SSS, it was possible to accurately estimate the scatter without generating halo artifacts.

EJNMMI physics. 2020 Nov 13*** epublish ***

Keiichi Magota, Naoto Numata, Daiki Shinyama, Junya Katahata, Yamato Munakata, Piotr J Maniawski, Kentaro Kobayashi, Osamu Manabe, Kenji Hirata, Ukihide Tateishi, Kohsuke Kudo, Tohru Shiga

Division of Medical Imaging and Technology, Hokkaido University Hospital, Sapporo, Japan., Philips Japan, Tokyo, Japan., Philips Healthcare, Cleveland, Ohio, USA., Department of Diagnostic Imaging, Hokkaido University Graduate School of Medicine, Kita 15 Nishi 7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan., Department of Diagnostic Radiology and Nuclear Medicine, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan., Department of Diagnostic Imaging, Hokkaido University Graduate School of Medicine, Kita 15 Nishi 7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan. .