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This study evaluated the usefulness of an “Enhanced AC” (EAC) reconstruction method designed to reduce RMA. Consecutive FDG-PET/CT cases (July–August 2024) were assessed by multiple radiologists using a 5-point misalignment score before and after EAC adaptation, with lower scores across all evaluators.",{"@graph":69,"@context":126},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/enhanced-attenuation-correction-in-fdg-petct-with-respiratory-mismatch-correction/405806/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/enhanced-attenuation-correction-in-fdg-petct-with-respiratory-mismatch-correction/405806.png","ImageObject",300,407,{"name":92,"@type":93},"Rowan","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-29","2026-09-28",true,{"@type":102,"interactionType":103,"userInteractionCount":29},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118,122],{"name":109,"@type":110,"acceptedAnswer":111},"What is the main problem addressed in this study?","Question",{"text":112,"@type":113},"The study addresses respiratory motion–induced misalignment artifacts (RMA) in FDG-PET/CT caused by mismatch between PET image reconstruction and CT-based attenuation correction.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How were misaligned cases and EAC comparisons performed?",{"text":117,"@type":113},"Two radiologists independently identified misaligned cases using a deviation assessment, forming a misalignment group. Radiologists then compared pre-EAC images with EAC-reconstructed images using a 5-point misalignment score.",{"name":119,"@type":110,"acceptedAnswer":120},"What were the key findings on misalignment scores after EAC?",{"text":121,"@type":113},"Across five radiologists, average misalignment scores were significantly lower for EAC images than for pre-EAC images (p \u003C 0.01 for all evaluators).",{"name":123,"@type":110,"acceptedAnswer":124},"Why is EAC considered suitable for routine diagnostics?",{"text":125,"@type":113},"EAC is described as effective and practical for selected cases and can be tailored to individual patients without requiring a large deep-learning dataset.","https://schema.org",{"og:url":83,"og:type":128,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":130,"canonical":83},"index,follow",{"doc_id":132,"site_id":62},405806,1791580653,{"code":4,"msg":5,"data":135},{"doc_id":132,"user_id":136,"nickname":92,"user_avatar":137,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":138,"file_id":139,"file_url":140,"file_type":141,"file_size":142,"view_count":29,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":52,"language":143,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":144,"faqs":145,"seo_title":146,"seo_description":67,"update_tm":147,"read_time":148,"preview_page_count":4},1099514067415,"https://ap-avatar.wpscdn.com/avatar/100002539d78ffe74a7?x-image-process=image/resize,m_fixed,w_180,h_180&k=1779092875211072502","Kitamura et al. EJNMMI Reports (2025) 9:43 [https://doi.org/10.1186/s41824-025-00279-z](https://doi.org/10.1186/s41824-025-00279-z)  \nEJNMMI Reports  \nORIGINAL ARTICLE Open Access  \nEnhanced attenuation correction in FDG-PET/   CT with respiratory mismatch correction  \nYoshiyuki Kitamura 1*, Takuro Isoda 1, Motohiro Sando 1, Masaoki Kusunoki 1, Kazufumi Kikuchi 1, Shingo Baba2 and Kousei Ishigami 1  \n*Correspondence: Yoshiyuki Kitamura kitamura.yoshiyuki. 524@m. [kyushu-u.ac.jp](kyushu-u.ac.jp)  \n1Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka-shi, Japan 2Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka-shi, Japan  \nAbstract  \nBackground In positron emission tomography/computed tomography (PET/CT), CT is typically used for attenuation correction during the creation and reconstruction of PET images. Respiratory motion can cause artifacts due to misalignment of PET images, known as respiratory misalignment artifacts (RMA), which occur in up to 30% of lesion-based evaluations, often necessitating rescans of both PET and CT. A new method for reconstructing PET/CT artifacts caused by respiratory motion, termed‘Enhanced AC’ (EAC) (GE HealthCare, USA), was developed to improve RMA. To evaluate the effectiveness of EAC, radiologists’ visual assessment using a misalignment score is appropriate regardless of the presence or absence of target lesions. This study aimed to assess the usefulness of EAC based on radiologist evaluations.  \nMethods Consecutive F-18 fluorodeoxyglucose (FDG) PET/CT cases imaged  \nat our hospital between July and August 2024 were included. Two radiologists independently assessed the deviation of FDG-PET/CT images from all cases imaged conventionally. Cases identified by either radiologist as misaligned were designated asthe misalignment case group and used for evaluating EAC. A 5-point scoring system was established for the misalignment score. To evaluate the effect of EAC, PET coronal section images from the misalignment case group before EAC adaptation (pre-images) and the EAC-reconstructed images (EAC images) were displayed side by side. Five radiologists independently evaluated both images using a misalignment score.  \nResults Fifty-four patients (male/female = 36/18, average age 64.1 ± 15.0 years, median 66.5 years) were identified as the misalignment case group. The average misalignment scores from the five radiologists for the pre-images were 3 . 5, 3 .4, 3 . 3, 3 . 1, and 3. 1, respectively, whereas the scores for the EAC images were significantly lower (p \u003C 0. 01) across all radiologists: 2 . 1, 2 .4, 2 . 5, 2 . 2, and 1. 9, respectively.  \nConclusions EAC is an effective and practical method for reducing RMA in selected cases. This method can be easily tailored to individual patients and does not require a large, deep-learning dataset, making it suitable for routine diagnostics.  \nKeywords Positron emission tomography/computed tomography (PET/CT), Respiratory misalignment artifacts (RMA), PET image reconstruction  \n© The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain p","cbCaihe95MxXRgBi","https://ap.wps.com/l/cbCaihe95MxXRgBi","pdf",1473975,"English","# Abstract\n## Background\n## Methods\n## Results\n## Conclusions","[{\"question\":\"What is the main problem addressed in this study?\",\"answer\":\"The study addresses respiratory motion–induced misalignment artifacts (RMA) in FDG-PET/CT caused by mismatch between PET image reconstruction and CT-based attenuation correction.\"},{\"question\":\"How were misaligned cases and EAC comparisons performed?\",\"answer\":\"Two radiologists independently identified misaligned cases using a deviation assessment, forming a misalignment group. Radiologists then compared pre-EAC images with EAC-reconstructed images using a 5-point misalignment score.\"},{\"question\":\"What were the key findings on misalignment scores after EAC?\",\"answer\":\"Across five radiologists, average misalignment scores were significantly lower for EAC images than for pre-EAC images (p \\u003c 0.01 for all evaluators).\"},{\"question\":\"Why is EAC considered suitable for routine diagnostics?\",\"answer\":\"EAC is described as effective and practical for selected cases and can be tailored to individual patients without requiring a large deep-learning dataset.\"}]","Enhanced attenuation correction in FDG-PET/CT with respiratory mismatch correction | PDF",1790561911,25]