Reconstrucción de imagen en tomografía por emisión de positrones

Las imágenes de tomografía de emisión se generan mediante un algoritmo de reconstrucción, a partir de un conjunto de proyecciones adquiridas del objeto o paciente bajo examen. El procedimiento clásico de reconstrucción de imagen es la retroproyección filtrada (FBP). Este método es rápido y sencillo, pero no utiliza información estadística. Es un buen método para aplicaciones en las que el número de cuentas es alto (como tomografía de rayos X o CT), pero es peor cuando hay un bajo número de cuentas, como en imágenes de medicina nuclear. Los métodos iterativos de reconstrucción de imagen se han propuesto como alternativas a FBP. Estas técnicas tienen un coste computacional más alto que FBP pero producen imágenes de mejor contraste y relación señal-ruido. Los métodos iterativos eliminan los artefactos de líneas presentes en las imágenes FBP, reduciendo los falsos positivos y los falsos negativos cuando las lesiones están en la proximidad de órganos calientes. Este artículo presenta una visión de conjunto de los principios de la reconstrucción de imágenes para tomografía por emisión de positrones (PET); se introducen brevemente las bases matemáticas del método FBP para seguidamente presentar los métodos estadísticos de reconstrucción iterativa, principalmente los basados en la estimación de la máxima verosimilitud. También se comenta la técnica de subconjuntos ordenados para acelerar su cómputo, así como el uso de probabilidades a priori bayesianas, lo que permite la incorporación de información a priori (tal como restricciones de suavidad o información topológica parcialmente especificada) y así mejorar la calidad de la imagen. Finalmente se muestran ejemplos con fantomas y con estudios de pacientes para comparar los métodos presentadosIn emission tomography images are obtained from a reconstruction process using a set of measured projections of the object or the patient examined. The classical method for image reconstruction is filtered backprojection (FBP). This method is fast and simple, but it does not use any statistical information about the measurements. It is a good method for applications when the number of measured counts is high (e.g., in X-ray computed tomography, CT) but insufficient when applied for low-count projection data in nuclear molecular imaging. Iterative image reconstruction methods have been proposed as alternatives to FBP. Statistical iterative image reconstruction techniques show higher computational cost than FBP but are shown to produce images of better contrast and signalto- noise ratio. The elimination of streak artifacts present in FBP images with the use of iterative methods minimizes false-positive as well as false-negative results, when lesions are situated in the vicinity of hot organs. This paper presents an overview of the principles of image reconstruction for positron emission tomography (PET) and introduces briefly the mathematical background of the FBP method before entering into details of statistical iterative image reconstruction methods,mainly based on maximum likelihood estimation. A discussion is included about the ordered subsets technique for the acceleration of these methods and the Bayesian prior approach, which allows the incorporation of a priori information (such as smoothness constraints or partial specified topological information) and therefore further improves image quality. Some examples are included from phantom and patient studies to compare some of the methods presentedPublicad

Olanzapine-associated neuroleptic malignant syndrome: Is there an overlap with the serotonin syndrome?

BACKGROUND: The neuroleptic malignant syndrome is a rare but serious condition mainly associated with antipsychotic medication. There are controversies as to whether "classical" forms of neuroleptic malignant syndrome can occur in patients given atypical antipsychotics. The serotonin syndrome is caused by drug-induced excess of intrasynaptic 5-hydroxytryptamine. The possible relationship between neuroleptic malignant syndrome and serotonin syndrome is at present in the focus of scientific interest. METHODS: This retrospective phenomenological study aims to examine the seventeen reported olanzapine – induced neuroleptic malignant syndrome cases under the light of possible overlap between neuroleptic malignant syndrome and serotonin syndrome clinical features. RESULTS: The serotonin syndrome clinical features most often reported in cases initially diagnosed as neuroleptic malignant syndrome are: fever (82%), mental status changes (82%) and diaphoresis (47%). Three out of the ten classical serotonin syndrome clinical features were concurrently observed in eleven (65%) patients and four clinical features were observed in seven (41%) patients. CONCLUSION: The results of this study show that the clinical symptoms of olanzapine-induced neuroleptic malignant syndrome and serotonin syndrome are overlapping suggesting similarities in underlying pathophysiological mechanisms

Design of a high resolution small animal octagonal PET scanner: preliminary studies

[Abstract] AMI International Conference 2003, September 21 - 27, Madrid, Spain: "High Resolution Molecular Imaging: from Basic Science to Clinical Applications"We present a preliminary study on the design of a high resolution small animal octagonal positron emission tomography (PET) scanner, based on Monte Carlo simulations. The purpose of this study is to evaluate the impact of several critical design parameters on the reconstructed image quality, as well as the calculation of the system matrix for iterative image reconstruction based on statistical modelsPublicad

Modeling the acquisition front-end in high resolution gamma-ray imaging

The availability of synthetic realistic data eases design optimization, algorithm evaluation and verification of any digital system where a significant amount of digital signal processing is performed. The evolution of positron emission tomography cameras towards continuous sampling of individual position-sensitive photomultiplier anodes with processing algorithms implemented on digital programmable logic devices creates a new framework where new approaches to the γ-event detection are possible. We have developed a system model of the acquisition chain, including multi-layer phoswich, photomultiplier, front-end analog electronics, data acquisition and digital processing. This processing includes estimation algorithms for the most relevant event parameters: energy, layer-of-interaction, time picking-off and event location. The selected simulation platform couples gently to digital hardware simulation tools, in such a way that implemented models may generate real-like stimuli for the digital system under development. The modeling of the whole front-end electronics enables deeper understanding and tuning of different system trade-offs and provides a rapid and soft transition between specification and hardware developmentPublicad

Treatment of severe neuroleptic-induced tardive torticollis

BACKGROUND: The aim of this paper is to describe a case of severe neuroleptic-induced tardive torticollis successfully treated with a combination of clozapine, clonazepam and botulinum toxin-A. CASE REPORT: The patient, a 30-year old man with a seven-year history of delusional disorder experienced severe right torticollis with painful tightness of the neck and elevation of the shoulder. At this time he was receiving haloperidol 20 mg, trifluoperazine 5 mg, zuclopenthixol 20 mg and biperidine 4 mg daily. The combination therapy with clozapine and clonazepam and the long-term use of botulinum toxin-A resulted in a complete remission of dystonic movements. CONCLUSIONS: The present observations provide evidence indicating that this combination therapy may be of benefit in patients with severe neuroleptic-induced tardive torticollis

New embedded digital front-end for high resolution PET scanner

This work describes a new digital front-end for a high-resolution low-cost animal PET scanner which is currently under development. The advances in flexibility and size of modern FPGAs together with the release of new tools enable the integration of most of the front-end electronics in a single FPGA. The implemented system includes a small 32-bit RISC processor, several peripherals attached to the internal buses and a special DSP unit closely attached to the processor which is dedicated to the detection of the gamma events. On top of these, a small footprint real time operating system abstracts the underlying hardware, providing the mechanisms to combine on-chip slow control and data streamingThis work was supported in part by the FPU Research Grant from the Spanish Education and Science Ministry, by the Spanish Thematic Network IM3 (PI052204) and project TEC2004-07052-C02-02Publicad

Real-Time Digital Timing in Positron Emission Tomography

Positron emission tomography (PET) requires accurate timing of scintillation events to properly discriminate between coincident and noncoincident pairs. The traditional solution to timing is based on custom application specific integrated circuits (ASIC) designs, whose cost may not be justified in the design of experimental small animal PET scanners. The new generation of PET scanners introduces the idea of continuous sampling of the detected scintillation pulse, replacing event-triggered acquisition front-ends. This approach enables new options to the timing procedure based on digital processing of the sampled pulse signal. This work proposes a time stamping algorithm based on the optically matched filter and compares the potential performance benefits of this approach versus other FIR-based timing algorithms, some of which have been already implemented by different authors. Results show that the coincidence timing resolution may be as low as 1.5 ns without the need of expensive high-speed converters when the proper signal processing is appliedIEEE Nuclear and Plasma Sciences SocietyPublicad

Evaluating Depressive Symptoms in Schizophrenia: A Psychometric Comparison of the Calgary Depression Scale for Schizophrenia and the Hamilton Depression Rating Scale

Background: The aim of this study was to compare two measures of depression in patients with schizophrenia and schizophrenia spectrum disorder, including patients with delusional and schizoaffective disorder, to conclude implications for their application. Sampling and Methods: A total of 278 patients were assessed using the Calgary Depression Scale for Schizophrenia (CDSS) and the Hamilton Depression Rating Scale (HAMD-17). The Positive and Negative Syndrome Scale (PANSS) was also applied. At admission and discharge, a principal component analysis was performed with each depression scale. The two depression rating scales were furthermore compared using correlation and regression analyses. Results: Three factors were revealed for the CDSS and HAMD-17 factor component analysis. A very similar item loading was found for the CDSS at admission and discharge, whereas results of the loadings of the HAMD-17 items were less stable. The first two factors of the CDSS revealed correlations with positive, negative and general psychopathology. In contrast, multiple significant correlations were found for the HAMD-17 factors and the PANSS sub-scores. Multiple regression analyses demonstrated that the HAMD-17 accounted more for the positive and negative symptom domains than the CDSS. Conclusions:The present results suggest that compared to the HAMD-17, the CDSS is a more specific instrument to measure depressive symptoms in schizophrenia and schizophrenia spectrum disorder, especially in acutely ill patients. Copyright (c) 2012 S. Karger AG, Base