PET/CT imaging artifacts

The purpose of this paper is to introduce the principles of PET/CT imaging and describe the artifacts associated with it. PET/CT is a new imaging modality that integrates functional (PET) and structural (CT) information into a single scanning session, allowing excellent fusion of the PET and CT images and thus improving lesion localization and interpretation accuracy. Moreover, the CT data can also be used for attenuation correction, ultimately leading to high patient throughput. These combined advantages have rendered PET/CT a preferred imaging modality over dedicated PET. Although PET/CT imaging offers many advantages, this dual-modality imaging also poses some challenges. CT-based attenuation correction can induce artifacts and quantitative errors that can affect the PET emission images. For instance, the use of contrast medium and the presence of metallic implants can be associated with focal radiotracer uptake. Furthermore, the patient's breathing can introduce mismatches between the CT attenuation map and the PET emission data, and the discrepancy between the CT and PET fields of view can lead to truncation artifacts. After reading this article, the technologist should be able to describe the principles of PET/CT imaging, identify at least 3 types of image artifacts, and describe the differences between PET/CT artifacts of different causes: metallic implants, respiratory motion, contrast medium, and truncation.