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Research ArticleContinuing Education

Brain Imaging Techniques: Improving the Quality

Rani M. Noble
Journal of Nuclear Medicine Technology September 2021, 49 (3) 209-214; DOI: https://doi.org/10.2967/jnmt.120.257592
Rani M. Noble
Nuclear Medicine Department, HonorHealth, Phoenix, Arizona
CNMT, RT(N)
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  • FIGURE 1.
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    FIGURE 1.

    Two-dimensional PET sinograms (A and B) and corresponding reconstructed transverse PET images (C and D, respectively) of 18F-filled phantom. Black band in C (suggestive of faulty detector) is virtually undetectable in D (11).

  • FIGURE 2.
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    FIGURE 2.

    (A) Brain 18F-FDG PET/CT images with technologist-caused motion artifact due to misplacing of region-of-interest box on scout images. (B) Transaxial and sagittal lateral radiographs (left), PET images (middle), and PET/CT images (right) of head. Artifact causes false reduction in uptake in left hemicortex and results in part of brain being cut off in final images (12).

  • FIGURE 3.
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    FIGURE 3.

    (A and B) brain MRI (A) and PET (B) scans showing location of caudate nucleus and putamen within brain. These are main focus of 123I-ioflupane scans and need to be fully included in images. (C) PET phantom scans showing how important it is to keep detector radius within 11- to 15-cm range. More distance between patient and detector will increase blurring (9). Arrows in A point to left caudate and left putamen; blue indicates right caudate and red indicates location of right putamen. Scans in A and B are of a patient.

  • FIGURE 4.
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    FIGURE 4.

    (A) Correct positioning of head during brain imaging. Canthomeatal line should be positioned as perpendicularly to imaging table as possible to eliminate head tilt and resulting artifacts. (B) Incorrect head positioning. Patient’s head is tilted and not placed fully in head holder (13).

  • FIGURE 5.
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    FIGURE 5.

    18F-FDG PET brain images showing bilateral hypometabolism in temporal, parietal, and frontal lobes, and maximum-intensity projection (MIP) showing cerebral cortical hypometabolism localization. (B) Semiquantitative (SQ) analysis showing reduction in metabolism in patient’s frontal and temporal lobes and in posterior cingulate cortices and temporoparietal junctions. Semiquantitative analysis, however, does not show hypometabolism in patient’s parietal lobes and undervalues reduction of metabolism in left temporal lobe (12). In B, SQ1 uses NeuroQ software; it presents reduced metabolism in bilateral frontal lobes, posterior cingulate cortices, temporoparietal junctions, bilateral temporal lobes with right being greater than left, and mildly in left basal ganglia. SQ2 uses Hermes BRASS software. This software furnishes greater matching results to visual analysis in cerebral cortex. This does not apply to basal ganglia, however. This program exhibits inferior registration of various parts of brain, which includes caudate heads.

  • FIGURE 6.
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    FIGURE 6.

    Screenshot showing results of DaTQUANT, semiquantitative analysis software used for 123I-ioflupane scans. Scans show how results would be displayed with ROIs placed (14). A = anterior; DB = database; IP2 = type of operating system in Siemens cameras, computer software; IRNC = iterative reconstruction without attenuation correction; LEHR = low-energy high-resolution; NC = normal control; OFOV = operational field of view; OSEM = ordered-subsets expectation maximization; P = posterior; SBR = striatal binding ratio.

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Journal of Nuclear Medicine Technology: 49 (3)
Journal of Nuclear Medicine Technology
Vol. 49, Issue 3
September 1, 2021
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Brain Imaging Techniques: Improving the Quality
Rani M. Noble
Journal of Nuclear Medicine Technology Sep 2021, 49 (3) 209-214; DOI: 10.2967/jnmt.120.257592

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Brain Imaging Techniques: Improving the Quality
Rani M. Noble
Journal of Nuclear Medicine Technology Sep 2021, 49 (3) 209-214; DOI: 10.2967/jnmt.120.257592
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  • Article
    • Abstract
    • DEFINITION OF A QUALITY IMAGE
    • PATIENT PREPARATION
    • MECHANICAL ARTIFACTS
    • TECHNOLOGIST-TRIGGERED ARTIFACTS
    • PATIENT POSITIONING
    • PRECAUTIONS
    • IMAGE INTERPRETATION
    • CONCLUSION
    • ACKNOWLEDGMENT
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Keywords

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