optimization of reconstruction and quantification of motion-corrected coronary pet-ct

Coronary pet shows promise in the detection of high-risk atherosclerosis, but there remains a need to optimize imaging and reconstruction techniques. we investigated the impact of reconstruction parameters and cardiac motion-correction in 18f sodium fluoride (18f-naf) pet. twenty-two patients underwent 18f-naf pet within 22 days of an acute coronary syndrome. optimal reconstruction parameters were determined in a subgroup of six patients. motion-correction was performed on ecg-gated data of all patients with optimal reconstruction. tracer uptake was quantified in culprit and reference lesions by computing signal-to-noise ratio (snr) in diastolic, summed, and motion-corrected images. reconstruction using 24 subsets, 4 iterations, point-spread-function modelling, time of flight, and 5-mm post-filtering provided the highest median snr (31.5) compared to 4 iterations 0-mm (22.5), 8 iterations 0-mm (21.1), and 8 iterations 5-mm (25.6; all p < .05). motion-correction improved snr of culprit lesions (n = 33) (24.5[19.9-31.5]) compared to diastolic (15.7[12.4-18.1]; p < .001) and summed data (22.1[18.9-29.2]; p < .001). motion-correction increased the snr difference between culprit and reference lesions (10.9[6.3-12.6]) compared to diastolic (6.2[3.6-10.3]; p = .001) and summed data (7.1 [4.8-11.6]; p = .001). the number of iterations and extent of post-filtering has marked effects on coronary 18f-naf pet quantification. cardiac motion-correction improves discrimination between culprit and reference lesions.