Tomographic image quality of rotating slat versus parallel hole-collimated SPECT

Parallel and converging hole collimators are most frequently used in nuclear medicine. Less common is the use of rotating slat collimators for single photon emission computed tomography (SPECT). The higher photon collection efficiency, inherent to the geometry of rotating slat collimators, results in much lower noise in the data. However, plane integrals contain spatial information in only one direction, whereas line integrals provide two-dimensional information. It is not a trivial question whether the initial gain in efficiency will compensate for the lower information content in the plane integrals. Therefore, a comparison of the performance of parallel hole and rotating slat collimation is needed. This study compares SPECT with rotating slat and parallel hole collimation in combination with MLEM reconstruction with accurate system modeling and correction for scatter and attenuation. A contrast-to-noise study revealed an improvement of a factor 2-3 for hot lesions and more than a factor of 4 for cold lesion. Furthermore, a clinically relevant case of heart lesion detection is simulated for rotating slat and parallel hole collimators. In this case, rotating slat collimators outperform the traditional parallel hole collimators. We conclude that rotating slat collimators are a valuable alternative for parallel hole collimators

Scatter modelling and compensation in emission tomography

In nuclear medicine, clinical assessment and diagnosis are generally based on qualitative assessment of the distribution pattern of radiotracers used. In addition, emission tomography (SPECT and PET) imaging methods offer the possibility of quantitative assessment of tracer concentration in vivo to quantify relevant parameters in clinical and research settings, provided accurate correction for the physical degrading factors (e.g. attenuation, scatter, partial volume effects) hampering their quantitative accuracy are applied. This review addresses the problem of Compton scattering as the dominant photon interaction phenomenon in emission tomography and discusses its impact on both the quality of reconstructed clinical images and the accuracy of quantitative analysis. After a general introduction, there is a section in which scatter modelling in uniform and non-uniform media is described in detail. This is followed by an overview of scatter compensation techniques and evaluation strategies used for the assessment of these correction methods. In the process, emphasis is placed on the clinical impact of image degradation due to Compton scattering. This, in turn, stresses the need for implementation of more accurate algorithms in software supplied by scanner manufacturers, although the choice of a general-purpose algorithm or algorithms may be difficul

Relevance of accurate Monte Carlo modeling in nuclear medical imaging

Monte Carlo techniques have become popular in different areas of medical physics with advantage of powerful computing systems. In particular, they have been extensively applied to simulate processes involving random behavior and to quantify physical parameters that are difficult or even impossible to calculate by experimental measurements. Recent nuclear medical imaging innovations such as single-photon emission computed tomography (SPECT), positron emission tomography (PET), and multiple emission tomography (MET) are ideal for Monte Carlo modeling techniques because of the stochastic nature of radiation emission, transport and detection processes. Factors which have contributed to the wider use include improved models of radiation transport processes, the practicality of application with the development of acceleration schemes and the improved speed of computers. This paper presents derivation and methodological basis for this approach and critically reviews their areas of application in nuclear imaging. An overview of existing simulation programs is provided and illustrated with examples of some useful features of such sophisticated tools in connection with common computing facilities and more powerful multiple-processor parallel processing systems. Current and future trends in the field are also discussed

Quantification of dopaminergic neurotransmission SPECT studies with 123 l-labelled radioligands

Dopaminergic neurotransmission SPECT studies with 123I-labelled radioligands can help in the diagnosis of neurological and psychiatric disorders such as Parkinson¿s disease and schizophrenia. Nowadays, interpretation of SPECT images is based mainly on visual assessment by experienced observers. However, a quantitative evaluation of the images is recommended in current clinical guidelines. Quantitative information can help diagnose the disease at the early pre-clinical stages, follow its progression and assess the effects of treatment strategies. SPECT images are affected by a number of effects that are inherent in the image formation: attenuation and scattering of photons, system response and partial volume effect. These effects degrade the contrast and resolution of the images and, as a consequence, the real activity distribution of the radiotracer is distorted. Whilst the photon emission of 123I is dominated by a low-energy line of 159 keV, it also emits several high-energy lines. When 123I-labelled radioligands are used, a non-negligible fraction of high-energy photons undergoes backscattering in the detector and the gantry and reaches the detector within the energy window. In this work, a complete methodology for the compensation of all the degrading effects involved in dopaminergic neurotransmission SPECT imaging with 123I is presented. The proposed method uses Monte Carlo simulation to estimate the scattered photons detected in the projections. For this purpose, the SimSET Monte Carlo code was modified so as to adapt it to the more complex simulation of high-energy photons emitted by 123I. Once validated, the modified SimSET code was used to simulate 123I SPECT studies of an anthropomorphic striatal phantom using different imaging systems. The projections obtained showed that scatter is strongly dependent on the imaging system and comprises at least 40% of the detected photons. Applying the new methodology demonstrated that absolute quantification can be achieved when the method includes accurate compensations for all the degrading effects. When the method did not include correction for all degradations, calculated values depended on the imaging system, although a linear relationship was found between calculated and true values. It was also found that partial volume effect and scatter corrections play a major role in the recovery of nominal values. Despite the advantages of absolute quantification, the computational and methodological requirements needed severely limit the possibility of application in clinical routine. Thus, for the time being, absolute quantification is limited to academic studies and research trials. In a clinical context, reliable, simple and rapid methods are needed, thus, semi-quantitative methods are used. Diagnosis also requires the establishment of robust reference values for healthy controls. These values are usually derived from a large data pool obtained in multicentre clinical trials. The comparison between the semi-quantitative values obtained from a patient and the reference is only feasible if the quantitative values have been previously standardised, i.e. they are independent of the gamma camera, acquisition protocol, reconstruction parameters and quantification procedure applied. Thus, standardisation requires that the calculated values are compensated somehow for all the image-degrading phenomena. In this thesis dissertation, a methodology for the standardisation of the quantitative values extracted from dopaminergic neurotransmission SPECT studies with 123I is evaluated using Monte Carlo simulation. This methodology is based on the linear relationship found between calculated and true values for a group of studies corresponding to different subjects with non-negligible anatomical and tracer uptake differences. Reconstruction and quantification methods were found to have a high impact on the linearity of the relationship and on the accuracy of the standardised results

Comparative evaluation of scatter correction techniques in 3D positron emission tomography

Much research and development has been concentrated on the scatter compensation required for quantitative 3D PET. Increasingly sophisticated scatter correction procedures are under investigation, particularly those based on accurate scatter models, and iterative reconstruction-based scatter compensation approaches. The main difference among the correction methods is the way in which the scatter component in the selected energy window is estimated. Monte Carlo methods give further insight and might in themselves offer a possible correction procedure. Methods: Five scatter correction methods are compared in this paper where applicable. The dual-energy window (DEW) technique, the convolution-subtraction (CVS) method, two variants of the Monte Carlo-based scatter correction technique (MCBSC1 and MCBSC2) and our newly developed statistical reconstruction-based scatter correction (SRBSC) method. These scatter correction techniques are evaluated using Monte Carlo simulation studies, experimental phantom measurements, and clinical studies. Accurate Monte Carlo modelling is still the gold standard since it allows to separate scattered and unscattered events and compare the estimated and true unscattered component. Results: In this study, our modified version of Monte Carlo-based scatter correction (MCBSC2) seems to provide a good contrast recovery on the simulated Utah phantom, while the DEW method was found to be clearly superior for the experimental phantom studies in terms of quantitative accuracy at the expense of a significant deterioration of the signal-to-noise ratio. On the other hand, the immunity to noise in emission data of statistical reconstruction-based scatter correction methods make them particularly applicable to low-count emission studies. All scatter correction methods give very good activity recovery values for the simulated 3D Hoffman brain phantom which average within 3%. The CVS and MCBSC1 techniques tend to overcorrect while SRBSC undercorrects for scatter in most regions of this phantom. Conclusion: It was concluded that all correction methods significantly improved the image quality and contrast compared to the case where no correction is applied. Generally, it was shown that the differences in the estimated scatter distributions did not have a significant impact on the final quantitative results. The DEW method showed the best compromise between ease of implementation and quantitative accuracy, but significantly deteriorates the signal-noise ratio

Phantom and clinical evaluation of the effect of full Monte Carlo collimator modelling in post-SIRT yttrium-90 Bremsstrahlung SPECT imaging

Background: Post-therapy SPECT/CT imaging of Y-90 microspheres delivered to hepatic malignancies is difficult, owing to the continuous, high-energy Bremsstrahlung spectrum emitted by Y-90. This study aimed to evaluate the utility of a commercially available software package (HybridRecon, Hermes Medical Solutions AB) which incorporates full Monte Carlo collimator modelling. Analysis of image quality was performed on both phantom and clinical images in order to ultimately provide a recommendation of an optimum reconstruction for post-therapy Y-90 microsphere SPECT/CT imaging. A 3D-printed anthropomorphic liver phantom was filled with Y-90 with a sphere-to-background ratio of 4:1 and imaged on a GE Discovery 670 SPECT/CT camera. Datasets were reconstructed using ordered-subsets expectation maximization (OSEM) 1-7 iterations in order to identify the optimal OSEM reconstruction (5 iterations, 15 subsets). Quantitative analysis was subsequently carried out on phantom datasets obtained using four reconstruction algorithms: the default OSEM protocol (2 iterations, 10 subsets) and the optimised OSEM protocol, both with and without full Monte Carlo collimator modelling. The quantitative metrics contrast recovery (CR) and background variability (BV) were calculated. The four algorithms were then used to retrospectively reconstruct 10 selective internal radiation therapy (SIRT) patient datasets which were subsequently blind scored for image quality by a consultant radiologist. Results: The optimised OSEM reconstruction (5 iterations, 15 subsets with full MC collimator modelling) increased the CR by 42% (p <0.001) compared to the default OSEM protocol (2 iterations, 10 subsets). The use of full Monte Carlo collimator modelling was shown to further improve CR by 14% (30 mm sphere, CR = 90%, p <0.05). The consultant radiologist had a significant preference for the optimised OSEM over the default OSEM protocol (p <0. 001), with the optimised OSEM being the favoured reconstruction in every one of the 10 clinical cases presented. Conclusions: OSEM (5 iterations, 15 subsets) with full Monte Carlo collimator modelling is quantitatively the optimal image reconstruction for post-SIRT 90Y Bremsstrahlung SPECT/CT imaging. The use of full Monte Carlo collimator modelling for correction of image-degrading effects significantly increases contrast recovery without degrading clinical image quality.Peer reviewe

Multi-Isotope Multi-Pinhole SPECT Bildgebung in kleinen Labortieren: Experimentelle Messungen und Monte Carlo Simulationen

Single photon emission computed tomography (SPECT) in small laboratory animals has become an integral part of translational medicine. It enables non-invasive validation of drug targeting, safety and efficacy in living organisms, which is progressively gaining importance in pharmaceutical industry. The increasing demand for efficiency in pharmaceutical research could be addressed by novel multitracer study designs. Multi-isotope multi-pinhole sampling allows validation of multiple tracers in a single experiment and consolidation of consecutive research trials. Due to physical and technical limitations, however, image quality and quantification can be substantially reduced. Advanced corrective procedures are required to establish multi-isotope multi-pinhole SPECT as a reliable and quantitative imaging technique for widespread use. For this purpose, the present work aimed to investigate the technical capabilities and physical limitations of multi-isotope multi-pinhole SPECT imaging in small laboratory animals. Based on experimental measurements and Monte Carlo simulations, specific error sources have been identified and procedures for quantitative image correction have been developed. A Monte Carlo simulation model of a state-of-the art SPECT/CT system has been established to provide a generalized framework for in-silico optimization of imaging hardware, acquisition protocols and reconstruction algorithms. The findings of this work can be used to improve image quality and quantification of SPECT in-vivo data for multi-isotope applications. They guide through the laborious process of multi-isotope protocol optimization and support the 3R welfare initiative that aims to replace, reduce and refine animal experimentation.Die Einzelphotonen-Emissionscomputertomographie (SPECT) in kleinen Labortieren hat sich als wichtiger Bestandteil der translationalen Medizin etabliert. Sie ermöglicht die nicht-invasive Validierung der Zielgenauigkeit, Wirksamkeit und Sicherheit von Wirkstoffen in lebenden Organismen und gewinnt zunehmend an Bedeutung in der pharmazeutischen Industrie. Die Forderung nach mehr Effizienz in der pharmazeutischen Forschung könnte durch neuartige Multitracer-Studien adressiert werden. Die Multi-Isotopen Akquisition mit Multi-Pinhole Kollimatoren ermöglicht die Validierung mehrerer Tracer in einem einzelnen Experiment und die Konsolidierung konsekutiver Bildgebungsstudien. Aufgrund physikalischer und technischer Limitationen ist die Bildqualität und Quantifizierbarkeit bei diesem Verfahren jedoch häufig reduziert. Um die Multi-Isotopen SPECT als zuverlässige und quantitative Bildgebungsmethode für den breiten Einsatz zu etablieren sind komplexe Korrekturverfahren erforderlich. Ziel der vorliegenden Arbeit war daher, die technischen Möglichkeiten und physikalischen Limitationen der Multi-Isotopen SPECT-Bildgebung in kleinen Labortieren systematisch zu untersuchen. Mithilfe von experimentellen Messungen und Monte Carlo Simulationen wurden spezifische Fehlerquellen identifiziert und Verfahren zur quantitativen Bildkorrektur entwickelt. Zudem wurde das Monte-Carlo Modell eines neuartigen SPECT/CT-Systems etabliert, um eine Plattform für die in-silico Optimierung von Bildgebungshardware, Aufnahmeprotokollen und Rekonstruktionsalgorithmen zu schaffen. Die Ergebnisse dieser Arbeit können die Bildqualität und Quantifizierbarkeit von SPECT in-vivo Daten für Multi-Isotopen Anwendungen verbessern. Sie führen beispielhaft durch den Prozess der Multi-Isotopen Protokolloptimierung und unterstützen die 3R-Initiative mit dem Ziel, experimentelle Tierversuche zu vermeiden (Replace), zu vermindern (Reduce) und zu verbessern (Refine)

Impact of SPECT corrections on 3D-dosimetry for TARE

Purpose: Many centers aim to plan liver transarterial radioembolization (TARE) with dosimetry, even without CT-based attenuation correction (AC), or with unoptimized scatter correction (SC) methods. This work investigates the impact of presence vs absence of such corrections, and limited spatial resolution, on 3D dosimetry for TARE. Methods: Three voxelized phantoms were derived from CT images of real patients with different body sizes. Simulations of 99mTc-SPECT projections were performed with the SIMIND code, assuming three activity distributions in the liver: uniform, inside a "liver's segment," or distributing multiple uptaking nodules ("nonuniform liver"), with a tumoral liver/healthy parenchyma ratio of 5:1. Projection data were reconstructed by a commercial workstation, with OSEM protocol not specifically optimized for dosimetry (spatial resolution of 12.6 mm), with/without SC (optimized, or with parameters predefined by the manufacturer; dual energy window), and with/without AC. Activity in voxels was calculated by a relative calibration, assuming identical microspheres and 99mTc-SPECT counts spatial distribution. 3D dose distributions were calculated by convolution with 90Y voxel S-values, assuming permanent trapping of microspheres. Cumulative dose-volume histograms in lesions and healthy parenchyma from different reconstructions were compared with those obtained from the reference biodistribution (the "gold standard," GS), assessing differences for D95%, D70%, and D50% (i.e., minimum value of the absorbed dose to a percentage of the irradiated volume). γ tool analysis with tolerance of 3%/13 mm was used to evaluate the agreement between GS and simulated cases. The influence of deep-breathing was studied, blurring the reference biodistributions with a 3D anisotropic gaussian kernel, and performing the simulations once again. Results: Differences of the dosimetric indicators were noticeable in some cases, always negative for lesions and distributed around zero for parenchyma. Application of AC and SC reduced systematically the differences for lesions by 5%–14% for a liver segment, and by 7%–12% for a nonuniform liver. For parenchyma, the data trend was less clear, but the overall range of variability passed from −10%/40% for a liver segment, and −10%/20% for a nonuniform liver, to −13%/6% in both cases. Applying AC, SC with preset parameters gave similar results to optimized SC, as confirmed by γ tool analysis. Moreover, γ analysis confirmed that solely AC and SC are not sufficient to obtain accurate 3D dose distribution. With breathing, the accuracy worsened severely for all dosimetric indicators, above all for lesions: with AC and optimized SC, −38%/−13% in liver's segment, −61%/−40% in the nonuniform liver. For parenchyma, D50% resulted always less sensitive to breathing and sub-optimal correction methods (difference overall range: −7%/13%). Conclusions: Reconstruction protocol optimization, AC, SC, PVE and respiratory motion corrections should be implemented to obtain the best possible dosimetric accuracy. On the other side, thanks to the relative calibration, D50% inaccuracy for the healthy parenchyma from absence of AC was less than expected, while the optimization of SC was scarcely influent. The relative calibration therefore allows to perform TARE planning, basing on D50% for the healthy parenchyma, even without AC or with suboptimal corrections, rather than rely on nondosimetric methods

Quantitative imaging for targeted radionuclide therapy dosimetry : technical review

Targeted radionuclide therapy (TRT) is a promising technique for cancer therapy. However, in order to deliver the required dose to the tumor, minimize potential toxicity in normal organs, as well as monitor therapeutic effects, it is important to assess the individualized internal dosimetry based on patient-specific data. Advanced imaging techniques, especially radionuclide imaging, can be used to determine the spatial distribution of administered tracers for calculating the organ-absorbed dose. While planar scintigraphy is still the mainstream imaging method, SPECT, PET and bremsstrahlung imaging have promising properties to improve accuracy in quantification. This article reviews the basic principles of TRT and discusses the latest development in radionuclide imaging techniques for different theranostic agents, with emphasis on their potential to improve personalized TRT dosimetry