Evaluation of SPET quantification of simultaneous emission and transmission imaging of the brain using a multidetector SPET system with the TEW scatter compensation method and fan-beam collimation

A gamma camera system which is able to acquire simultaneous single-photon emission tomographic (SPET) data and gamma ray transmission computed tomography (TCT) data for brain study using external rod sources and fan-beam collimators was developed and evaluated. Since the three external rod sources were located at the focal points of fan-beam collimators, which also happened to be the apexes of the equilateral triangle defined by the three detectors, simultaneous SPET and TCT scan could be performed using a 120° shared scan. Therefore, the proposed system required less than one third of the scanning time of a single-head system. Since the combination of rod sources and fan-beam collimators decreased the scatter component in transmission data without a slit collimator for each rod source, the radioactivity of the rod source was less than one-tenth of the previous investigations. For evaluation, we used two isotopes, thallium-201 for TCT and technetium-99m for SPET. The cross-contamination of transmission and emission was well compensated using the triple energy window (TEW) method. In a separate TCT scan, the measured attenuation coefficient of²⁰¹Tl for water was 0.19±0.01 cm^–1, while in a simultaneous scan, it was 0.20±0.01 cm^–1. The measured attenuation coefficient for water agreed well with the narrow-beam (theoretical) value of 0.187 cm^–1. In SPET images, scatter compensation was also performed using the TEW method and attenuation compensation was done using the measured attenuation map. The results showed the feasibility of simultaneous SPET and TCT scanning using the TEW method to obtain quantitative SPET images.     

Improved tolerance to missing data in myocardial perfusion SPET using OSEM reconstruction

When projection data are incomplete for various technical reasons, artefacts may occur in the reconstructed images. This study examines whether an iterative reconstruction method, the ordered subsets implementation of the EM algorithm (OSEM), can improve reconstruction and minimise the artefacts compared to filtered back-projection (FBP). We varied the number and location of projections removed to investigate when significant artefacts occur, and whether diagnosis is affected. Phantom studies were analysed with sequential orthogonal pairs of projection angles removed (as would typically occur when either data loss or severe motion is detected during acquisition with a right-angled, dual-head cardiac single-photon emission tomography system) and reconstructed with both FBP and OSEM. Twelve normal myocardial perfusion studies were also assessed to study the effect of missing projections on clinical diagnosis. Differences between reconstructions with intact versus missing data were measured. Also, reconstructed images were clinically assessed and scored on a five-point scale based on whether the artefacts would alter clinical interpretation. Although both reconstruction methods showed artefacts, the absolute differences between reconstructed phantom data with intact and missing projection sets were significantly greater (P<0.005) for FBP than for OSEM for all numbers of missing projections. The clinical data showed similar differences between FBP and OSEM reconstructions. The three observers noted superiority of OSEM compared to FBP, with reduced incidence of clinically significant artefacts. However, neither reconstruction method could tolerate six or more missing pairs from 32 projections. There was no significant dependence on the angular location of missing projections. In the absence of any attempt to correct for missing projections, OSEM reduced the influence of artefacts compared to FBP.     

Attenuation correction in whole-body FDG oncological studies: the role of statistical reconstruction

Whole-body fluorine-18 fluoro-2-d-deoxyglucose positron emission tomography (FDG-PET) is widely used in clinical centres for diagnosis, staging and therapy monitoring in oncology. Images are usually not corrected for attenuation since filtered backprojection (FBP) reconstruction methods require a 10 to 15-min transmission scan per bed position on most current PET devices equipped with germanium-68 rod transmission sources. Such an acquisition protocol would increase the total scanning time beyond acceptable limits. The aim of this work is to validate the use of iterative reconstruction methods, on both transmission and emission scans, in order to obtain a fully corrected whole-body study within a reasonable scanning time of 60 min. Five minute emission and 3-min transmission scans are acquired at each of the seven bed positions. The transmission data are reconstructed with OSEM (ordered subsets expectation maximization) and the last iteration is reprojected to obtain consistent attenuation correction factors (ACFs). The emission image is then also reconstructed with OSEM, using the emission scan corrected for normalization, scatter and decay together with the set of consistent ACFs as inputs. The total processing time is about 35 min, which is acceptable in a clinical environment. The image quality, readability and accuracy of uptake quantification were assessed in 38 patients scanned for various malignancies. The sensitivity for tumour detection was the same for the non-attenuation-corrected (NAC-FBP) and the attenuation-corrected (AC-OSEM) images. The AC-OSEM images were less noisy and easier to interpret. The interobserver reproducibility was significantly increased when compared with non-corrected images (96.1% vs 81.1%, P<0.01). Standardized uptake values (SUVs) measured on images reconstructed with OSEM (AC-OSEM) and filtered backprojection (AC-FBP) were similar in all body regions except in the pelvic area, where SUVs were higher on AC-FBP images (mean increase 7.74%, P<0.01). Our results show that, when statistical reconstruction is applied to both transmission and emission data, high quality quantitative whole-body images are obtained within a reasonable scanning (60 min) and processing time, making it applicable in clinical practice. Received 27 November 1998 and in revised form 31 January 1999     

The role of SPET and PET in monitoring tumour response to therapy

Positron emission tomography (PET) and single-photon emission tomography (SPET) are cross-sectional, quantitative functional imaging modalities in routine use in oncology for the initial staging of cancer, the assessment of patients with recurrent or residual disease and, more recently, for monitoring tumour response to therapy. Both PET and SPET can track tumour biological and metabolic changes caused by therapy or by disease progression, which usually precede the anatomical alterations conventionally detected by anatomical imaging methods. These highly sensitive functional imaging modalities have been used for the early assessment of subclinical tumour response, the evaluation of therapy after its completion and the detection of viable recurrent or relapsing tumour. Timely assessment of response to treatment using PET and SPET may result in modifications in treatment planning and individualisation of therapy and may have prognostic value for the long-term outcome. This review attempts to summarise the current data available on the expanding role of SPET and PET, using a variety of tracers, in monitoring tumour response to therapy in a wide range of malignancies, with emphasis on their clinical impact.     

The effect of filtrating and reconstruction method on the left ventricular ejection fraction derived from GSPET: a statistical comparison of angiography and echocardiography

Objective  There are different protocols of reconstruction in myocardial gated imaging that produce different values of left ventricular ejection fraction (EF). We attempted to determine how the parameters of reconstruction affect the calculated EF. The results were statistically compared with the values obtained from angiography and echocardiography. Methods  In this retrospective study, the data from 23 patients were used. All the patients had the angiographic and the echocardiographic data within 2 weeks before the test. Imaging was performed using a single-head gamma camera using technetium-99 methoxyisobutylisonitrile. The image data were reconstructed using 50 different combinations of the ramp, Hanning, Butterworth, Wiener, and Metz filters. The ordered subset expectation maximization (OSEM) technique was also examined using 12 combinations of iteration and subset. The calculated EF values were analyzed and compared with the echocardiographic and angiographic results. Results  The backprojection technique produced higher values of EF than those derived from echocardiography and angiography. The OSEM on the other hand produced lower values when compared with echocardiography and angiography. On using the backprojection technique, the maximum correlation between the values derived from gated single-photon emission tomography and echocardiography (r = 0.88, P < 0.01) and angiography (r = 0.81, P < 0.01) was observed when using the Metz filter (full width at half maximum = 5 mm and order = 9) and the Gaussian filter (α = 3), respectively. In the case of the OSEM technique, the maximum correlation with both angiography and echocardiography was observed when using the iteration = 2 and the subset = 12. Conclusions  On the average, the backprojection technique produces higher values, and iteration technique produces lower estimation of the EF when compared with angiography and echocardiography.     

Myocardial infarction in rats: high-resolution single-photon emission tomographic imaging with a pinhole collimator

The purpose of this study was to evaluate the accuracy of myocardial imaging by means of high-resolution single-photon emission tomography (SPET) with a pinhole collimator in rats with experimental infarction. Myocardial infarctions were induced in male Wistar rats by ligation of the left coronary artery for 30 min, followed by reperfusion. Two days after the reperfusion, pinhole SPET was performed after the intravenous administration of 111 MBq of thallium-201 chloride, using a rotating gamma camera equipped with a pinhole insert (2.0-mm aperture) in a low-energy pinhole collimator. SPET projection data were collected at 6° increments over 360° using a 4-cm radius of rotation to reconstruct the short- and long-axis images. Projection data were acquired in 15 or 30 s, the SPET imaging being accomplished within 40 min after the injection of²⁰¹T1. After SPET, the rats were sacrificed to remove the hearts for autoradiography (ARG) and nitroblue tetrazolium (NBT) staining as a visual correlative study. Quantitative correlative studies between pinhole SPET and ARG were performed with linear regression analysis for infarct size and distribution properties (relative counts on SPET images and relative density on autoradiographs) on the short-axis sections. All infarcts (4 mm in minimum diameter) in seven rats were detected by pinhole SPET. The SPET images in rats with or without myocardial infarction were consistent with the findings of ARG and NBT staining. There were significant correlations between pinhole SPET and ARG with respect to the infarct size (r=0.933,P <0.001;n=15) and the relative radiotracer distribution (r=0.931,P <0.001; n=68). This study therefore confirmed the accuracy of myocardial pinhole SPET imaging in rats with myocardial infarction. This method may partially substitute for ARG and prove useful for assessing new myocardial imaging agents in vivo in small laboratory animals.     

Application of statistical parametric mapping to SPET in the assessment of intractable childhood epilepsy

Statistical parametric mapping (SPM) quantification and analysis has been successfully applied to functional imaging studies of partial epilepsy syndromes in adults. The present study evaluated whether localisation of the epileptogenic zone (determined by SPM) improves upon visually examined single-photon emission tomography (SPET) imaging in presurgical assessment of children with temporal lobe epilepsy (TLE) and frontal lobe epilepsy (FLE). The patient sample consisted of 24 children (15 males) aged 2.1–17.8 years (9.8±4.3 years; mean±SD) with intractable TLE or FLE. SPET imaging was acquired routinely in presurgical evaluation. All patient images were transformed into the standard stereotactic space of the adult SPM SPET template prior to SPM statistical analysis. Individual patient images were contrasted with an adult control group of 22 healthy adult females. Resultant statistical parametric maps were rendered over the SPM canonical magnetic resonance imaging (MRI). Two corresponding sets of ictal and interictal SPM and SPET images were then generated for each patient. Experienced clinicians independently reviewed the image sets, blinded to clinical details. Concordance of the reports between SPM and SPET images, syndrome classification and MRI abnormality was studied. A fair level of inter-rater reliability (kappa=0.73) was evident for SPM localisation. SPM was concordant with SPET in 71% of all patients, the majority of the discordance being from the FLE group. SPM and SPET localisation were concordant with epilepsy syndrome in 80% of the TLE cases. Concordant localisation to syndrome was worse for both SPM (33%) and SPET (44%) in the FLE group. Data from a small sample of patients with varied focal structural pathologies suggested that SPM performed poorly relative to SPET in these cases. Concordance of SPM and SPET with syndrome was lower in patients younger than 6 years than in those aged 6 years and above. SPM is effective in localising the potential epileptogenic zone but does not provide additional benefit beyond SPET in presurgical assessment of children with intractable epilepsy. The impact of different pathologies on the efficacy of SPM warrants further study.     

直线加速器二级准直器在乳腺癌根治术后调强放疗计划中的应用

目的 探讨乳腺癌根治术后调强放疗（IMRT）计划中固定二级准直器位置对靶区剂量分布和危及器官受照剂量的影响,为临床治疗技术的选择提供依据。方法 选取定位影像资料完整的10例左侧乳腺癌根治术后患者,分别设计两种四野逆向IMRT计划。IMRT-1：采用0°、40°以及两个切线野方向射野,二级准直器的位置不做限制;IMRT-2：保持射野方向和优化参数与IMRT-1相同,0°、40°野二级准直器位置固定在锁骨上区的下界。比较两种IMRT计划的靶区剂量分布、危及器官受照剂量及所需机器跳数（MU）。结果 IMRT-1和IMRT-2的适形指数（CI）分别为0.79和0.73（Z=-2.316,P<0.05）;均匀性指数（HI）两组计划之间差异无统计学意义（P>0.05）;IMRT-2患侧肺V₅、V₁₀、D_mean均低于IMRT-1,差异有统计学意义（Z=-2.805、-2.812、-2.521,P<0.05）;健侧肺平均剂量、心脏平均剂量和健侧乳腺平均剂量IMRT-2均低于IMRT-1,差异有统计学意义（Z=-2.666、-2.701、-2.310,P<0.05）;患侧肺V₂₀、V₃₀和心脏V₃₀在两种计划之间差异均无统计学意义（P>0.05）。结论 在乳腺癌根治术后IMRT计划中,在保证靶区剂量均匀性的情况下,适当固定二级准直器的位置能明显降低危及器官受照的低剂量区,能更好地保护危及器官。     

Application of reduced-encoding imaging with generalized-series reconstruction (RIGR) in dynamic MR imaging

Dynamic MRI has proven to be an important tool in studies of transient physiologic changes in animals and humans. High sensitivity and temporal resolution in such measurements are critical for accurate estimation of dynamic information. Fast imaging, often involving expensive hardware, has evolved for use in such cases. We demonstrate herein the possibility of accelerated data acquisition schemes on conventional machines using standard pulse sequences for dynamic studies. This is achieved by combining reduced-encoded dynamic data (typically 30 to 40 phase encodings) with a priori high-resolution data via a novel constrained image reconstruction algorithm. Such an approach reduces image acquisition time significantly (by a factor of 3 to 4 in the examples described here) without loss in the accuracy of information.     

Comparison of thallium-201 SPET and CT/MRI in the detection of residual/recurrent squamous cell carcinoma of the oral cavity

This study was designed to compare the effectiveness of thallium-201 single-photon emission tomography (SPET) and conventional imaging, comprising computed tomography (CT) and magnetic resonance imaging (MRI), in the detection of residual/recurrent squamous cell carcinoma (SCC) of the oral cavity. Thirty-two patients with clinically suspected recurrent SCC of the oral cavity were recruited. All patients underwent ²⁰¹Tl SPET and CT or MRI within 2 weeks. The final diagnoses were based on the histology of the biopsy specimen. ²⁰¹Tl SPET and CT/MRI both accurately detected 17 of 18 residual/recurrent tumours. CT/MRI yielded eight false-positive studies, whereas ²⁰¹Tl SPET successfully excluded all tumours. The sensitivity, specificity, positive and negative predictive values and accuracy of ²⁰¹Tl SPET for the detection of recurrent oral SCC were 94%, 100%, 100%, 93% and 97%, respectively. The sensitivity, specificity, positive and negative predictive values and accuracy of CT/MRI for the detection of recurrent oral SCC were 94%, 43%, 68%, 86% and 72%, respectively. Thallium-201 SPET is more accurate than conventional imaging (CT or MRI) in differentiating residual/recurrent oral SCC from post-therapy changes.     

An efficient gridding reconstruction method for multishot non‐Cartesian imaging with correction of off‐resonance artifacts

An efficient iterative gridding reconstruction method with correction of off‐resonance artifacts was developed, which is especially tailored for multiple‐shot non‐Cartesian imaging. The novelty of the method lies in that the transformation matrix for gridding (T) was constructed as the convolution of two sparse matrices, among which the former is determined by the sampling interval and the spatial distribution of the off‐resonance frequencies and the latter by the sampling trajectory and the target grid in the Cartesian space. The resulting T matrix is also sparse and can be solved efficiently with the iterative conjugate gradient algorithm. It was shown that, with the proposed method, the reconstruction speed in multiple‐shot non‐Cartesian imaging can be improved significantly while retaining high reconstruction fidelity. More important, the method proposed allows tradeoff between the accuracy and the computation time of reconstruction, making customization of the use of such a method in different applications possible. The performance of the proposed method was demonstrated by numerical simulation and multiple‐shot spiral imaging on rat brain at 4.7 T. Magn Reson Med, 2010. © 2010 Wiley‐Liss, Inc.     

OSEM子集及迭代次数对PET图像质量的影响

目的 :探讨有序子集最大期望重建算法 (OSEM )中子集及迭代次数对PET图像质量的影响。材料和方法 :圆柱模型 (长 18.5cm ,直径 2 1.5cm)内灌注比活度为 1.2 5kBq/ml18F 水溶液形成本底 ,平行内置的 7个不同直径空心小圆柱内灌注18F 水溶液 (比活度 12 5kBq/ml)形成热灶 ,以 2D方式采集数据、OSEM算法重建图像 ,子集水平 3 2、16,迭代次数 1～10。在图像横断面对应外围 7个热灶画与其同大小的ROI及本底ROI ,由此计算CV等参数。结果 :相同条件下 3 2子集重建图像的热灶活度比 16子集更接近真实值。变异系数CV ,在较小热灶及背景区中 3 2子集的大于 16子集 ,较大的热灶中 3 2子集的则小于 16子集。结论 :OSEM重建方式选择 3 2子集 2～ 3次迭代 ,或 16子集 3～ 4次迭代的图像质量较好。     

Performance characteristics of a 511-keV collimator for imaging positron emitters with a standard gamma-camera

Line-source experiments were conducted to assess the performance of a gamma-camera equipped with a specially designed 511-keV collimator for the planar imaging of positron emitters. The results were compared with the camera performance with routinely used collimators and radionuclides (thallium-201, technetium-99m and gallium-67). With positron emitters, scatter contributed less to the widening of the line spread function than with radionuclides emitting lower photon energies. These observations can be explained by the relative deterioration in the discrimination power of the gamma-camera to reject scattered radiation at low energies. Planar 511-keV imaging may provide relevant clinical information, as we showed by fluorodeoxyglucose studies in a patient with a myocardial infarction and in a patient with a malignant lymphoma. It is concluded that positron emitters can be effectively applied for planar imaging with the generally available gamma-cameras. This study implies that radiotracers developed for positron emission tomography may find a place in the practice of conventional nuclear medicine. Offprint requests to: A. van Lingen     

Effects of photon attenuation on the determination of cardiac volumes from reconstructed counts in gated blood pool SPET

In gated cardiac blood pool single-photon emission tomography (SPET), the volume of a ventricle may be determined by a method that exploits the proportionality between that volume and the total reconstructed counts within a larger volume of interest that includes the actual ventricle. The present work was carried out to determine how the attenuation of photons modifies the reconstructed counts obtained with this technique, and how this affects the accuracy of volume determination. Furthermore, we wanted to investigate how count-based determination of ventricle volumes is affected by the total SPET rotation angle and by different arm positions. We used µ-maps derived from computed tomography (CT) series of nine arbitrarily chosen patients to calculate a volume correction factor for each cardiac volume manually drawn on the CT images. An anthropomorphic chest phantom was used to confirm the calculation of correction factors. For the regions of the ventricles contained within a CT slice through the central part of the heart, the left to right volume ratio needed to be corrected by factors of 1.21 and 1.12 for 180° and 360° rotation, respectively. When all voxels within the left and right ventricles were included, the required volume ratio correction factor was close to 1. However, the variation among patients was larger for a 180° (range 0.97–1.08) than for a 360° rotation arc (range 1.0–1.03).     

Analysis and correction of motion artifacts in diffusion weighted imaging

For diffusion-weighted magnetic resonance imaging and under circumstances where patient movement can be modeled as rigid body motion, it is shown both theoretically and experimentally that translations and rotations produce phase errors which are zero- and first-order, respectively, in position. Whlile a navigator echo can be used to correct the imaging data for arbitrary translations, only when the diffusion gradient is applied in the phase encode direction is there sufficient information to correct for rotations around all axes, and therefore for general rigid body motion. Experiments in test objects and human brain imaging confirm theoretical predictions and demonstrate that appropriate corrections dramatically improve image quality in vivo.     

Diffusion tensor imaging of the brain: effects of distortion correction with correspondence to numbers of encoding directions

Purpose  The aim of the study was to estimate the effect of distortion correction with correspondence to numbers of encoding directions to acquire diffusion tensor imaging (DTI) of improved quality. Materials and methods  Ten volunteers underwent DTI of the head using echo planar imaging with 6, 13, 27, and 55 encoding directions. Fractional anisotropy (FA) maps and apparent diffusion coefficient (ADC) maps were created before and after distortion correction. Regions of interest were placed in the corpus callosum on each map, and standard deviations of FA and ADC were calculated. FA maps were also evaluated visually by experienced neuroradiologists. Results  Dispersion of standard deviations tended to be reduced after distortion correction, with significant differences found in FA maps with 6 encoding directions, ADC maps with 6 directions, and ADC maps with 13 directions (P < 0.001, P < 0.005, and P < 0.05, respectively). Visual image quality was improved after distortion correction (P < 0.01 for all of the visual comparisons). Conclusion  Distortion correction is effective in providing DTI of enhanced quality, notwithstanding the number of encoding directions. This article was presented at a Japan Radiological Society meeting in 2002     

Effects of image reconstruction algorithm on neurotransmission PET studies in humans: Comparison between filtered backprojection and ordered subsets expectation maximization

OBJECTIVES: Both reconstruction algorithms, filtered backprojection (FBP) and ordered subsets expectation maximization (OSEM), are widely used in clinical positron emission tomography (PET) studies. Image reconstruction for most neurotransmission PET scan data is performed by FBP, while image reconstruction for whole-body [18F]FDG scan data is usually performed by OSEM. Although several investigators have compared FBP and OSEM in terms of the quantification of regional radioactivity and physiological parameters calculated from PET data, only a few studies have compared the two reconstruction algorithms in PET studies that estimate neurotransmission, i.e., neuroreceptor and neurotransporter binding. In this study we compared mean regional radioactivity concentration in the late phase and binding potential (BP) between FBP and OSEM algorithms in neurotransmission PET studies for [11C]raclopride and [11C]DASB. METHODS: Dynamic PET scans with [11C]raclopride in 3-dimensional mode were performed on seven healthy subjects. Dynamic PET scans with [11C]DASB in 2-dimensional mode were performed on another seven subjects. OSEM images were post-filtered so that its transverse spatial resolution became similar to that of FBP with the same Hanning filter (Kernel FWHM 6 mm). In both PET studies we calculated the BP of [11C]raclopride and [11C]DASB by a reference tissue model for each ROI (region of interest). RESULTS: There was no significant difference in mean regional radioactivity concentration between FBP and OSEM for [11C]raclopride and [11C]DASB. Only +2.4 - +3.2%, but still a significant difference in BP of [11C]raclopride between FBP and OSEM was observed in the striatum. There was no significant difference in BP between FBP and OSEM in other than the striatum for [11C]raclopride and in all regions for [11C]DASB. In addition, there was no significant difference in root mean square error between FBP and OSEM when BP was calculated. CONCLUSIONS: The BP values were similar between FBP and OSEM algorithms with [11C]raclopride and [11C]DASB. This study indicates that OSEM can be used for human neurotransmission PET studies for calculating BP although OSEM was not necessarily superior to FBP in the present study.     

k-space correction of eddy-current-induced distortions in diffusion-weighted echo-planar imaging.

This paper describes a method for correcting eddy-current (EC)-induced distortions in diffusion-weighted echo-planar imaging (DW-EPI). First, reference measurements of EC fields within the EPI acquisition window are performed for DW gradient pulses applied separately along each physical axis of the gradient set and for a range of gradient amplitudes. EC fields caused by the DW gradients of the DW-MRI protocol are then calculated using the reference EC measurements. Finally, these calculated fields are used to correct the respective DW-EPI raw (k-space) data during image reconstruction. The technique was implemented in a small-bore MRI scanner with no digital preemphasis. It corrected EC-induced image distortions in both phantom and in vivo brain diffusion tensor imaging (DTI) data more effectively than commonly used image-based techniques. The method did not increase imaging time, since the same reference EC measurements were used to correct data acquired from different phantoms, subjects, and DTI protocols. Because of the simplicity of the reference EC measurements, the method can easily be implemented in clinical scanners.