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Head and neck imaging with PET and PET/CT: artefacts from dental metallic implants

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract.

Germanium-68 based attenuation correction (PETGe68) is performed in positron emission tomography (PET) imaging for quantitative measurements. With the recent introduction of combined in-line PET/CT scanners, CT data can be used for attenuation correction. Since dental implants can cause artefacts in CT images, CT-based attenuation correction (PETCT) may induce artefacts in PET images. The purpose of this study was to evaluate the influence of dental metallic artwork on the quality of PET images by comparing non-corrected images and images attenuation corrected by PETGe68 and PETCT. Imaging was performed on a novel in-line PET/CT system using a 40-mAs scan for PETCT in 41 consecutive patients with high suspicion of malignant or inflammatory disease. In 17 patients, additional PETGe68 images were acquired in the same imaging session. Visual analysis of fluorine-18 fluorodeoxyglucose (FDG) distribution in several regions of the head and neck was scored on a 4-point scale in comparison with normal grey matter of the brain in the corresponding PET images. In addition, artefacts adjacent to dental metallic artwork were evaluated. A significant difference in image quality scoring was found only for the lips and the tip of the nose, which appeared darker on non-corrected than on corrected PET images. In 33 patients, artefacts were seen on CT, and in 28 of these patients, artefacts were also seen on PET imaging. In eight patients without implants, artefacts were seen neither on CT nor on PET images. Direct comparison of PETGe68 and PETCT images showed a different appearance of artefacts in 3 of 17 patients. Malignant lesions were equally well visible using both transmission correction methods. Dental implants, non-removable bridgework etc. can cause artefacts in attenuation-corrected images using either a conventional 68Ge transmission source or the CT scan obtained with a combined PET/CT camera. We recommend that the non-attenuation-corrected PET images also be evaluated in patients undergoing PET of the head and neck.

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Received 1 October and in revised form 11 November 2001

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Goerres, G.W., Hany, T.F., Kamel, E. et al. Head and neck imaging with PET and PET/CT: artefacts from dental metallic implants. Eur J Nucl Med 29, 367–370 (2002). https://doi.org/10.1007/s00259-001-0721-1

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  • DOI: https://doi.org/10.1007/s00259-001-0721-1

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