Anthropomorphic Striatal Phantom Research Articles

Evaluation of Collimators in a High-Resolution, Whole-Body SPECT/CT Device with a Dual-Head Cadmium-Zinc-Telluride Detector for 123I-FP-CIT SPECT.

The study aim was to evaluate the adaptation of collimators to 123I-N-fluoropropyl-2b-carbomethoxy-3b-(4-iodophenyl)nortropane (123I-FP-CIT) dopamine transporter SPECT (DAT-SPECT) by a high-resolution whole-body SPECT/CT system with a cadmium-zinc-telluride detector (C-SPECT) in terms of image quality, quantitation, diagnostic performance, and acquisition time. Methods: Using a C-SPECT device equipped with a wide-energy, high-resolution collimator and a medium-energy, high-resolution sensitivity (MEHRS) collimator, we evaluated the image quality and quantification of DAT-SPECT for an anthropomorphic striatal phantom. Ordered-subset expectation maximization iterative reconstruction with resolution recovery, scatter, and attenuation correction was used, and the optimal collimator was determined on the basis of the contrast-to-noise ratio (CNR), percentage contrast, and specific binding ratio. The acquisition time that could be reduced using the optimal collimator was determined. The optimal collimator was used to retrospectively evaluate diagnostic accuracy via receiver-operating-characteristic analysis and specific binding ratios for 41 consecutive patients who underwent DAT-SPECT. Results: When the collimators were compared in the phantom verification, the CNR and percentage contrast were significantly higher for the MEHRS collimator than for the wide-energy high-resolution collimator (P < 0.05). There was no significant difference in the CNR between 30 and 15 min of imaging time using the MEHRS collimator. In the clinical study, the areas under the curve for acquisition times of 30 and 15 min were 0.927 and 0.906, respectively, and the diagnostic accuracies of the DAT-SPECT images did not significantly differ between the 2 times. Conclusion: The MEHRS collimator provided the best results for DAT-SPECT with C-SPECT; shorter acquisition times (<15 min) may be possible with injected activity of 167-186 MBq.

Assessment of different regions of interest-based methods for [99mTc]Tc DAT-SPECT quantification using an anthropomorphic striatal phantom

Background and aimsMolecular imaging of the dopamine transporters (DAT) provides valuable information about neurodegenerative diseases, such as Parkinson’s. This study assessed the accuracy and precision of DAT-SPECT quantification methods.MethodsTwenty-three DAT-SPECT images of a striatal phantom were acquired. The specific (caudate and putamen) and the non-specific (background activity) chambers were filled with [99mTc]Tc. Different specific-to-non-specific activity ratios (10, 9, 8, 7, 6, 5, 4, 3 and 2 to 1) and the specific binding ratio (SBR) were calculated. Five methods using ROIs were assessed: (a) Manual ROIs on SPECT images; (b) TwoBox and (c) ThreeBox methods and Volume of Interest (VOI) using structural images; (d) MRI and (e) CT. Accuracy was evaluated by the concordance correlation coefficient (CCC) and precision by Pearson’s coefficient and linear regression.ResultsThe SBR quantified in the specific and striatal chambers resulted in a CCC increase with a decrease in the nominal values. For lower SBR, MRI and CT showed higher CCCs when caudate (hbox {CCC}_{mathrm{MRI-CA}} = 0.89 e hbox {CCC}_{mathrm{CT-CA}} = 0.84) and putamen (hbox {CCC}_{mathrm{MRI-PU}} = 0.86 e hbox {CCC}_{mathrm{CT-PU}} = 0.82) were evaluated. For striatal assessments, the TwoBox method was the most accurate (hbox {CCC}_{mathrm{TWOBOX-ST}} = 0.95). High Pearson’s coefficients were found in the correlations between all methods.conclusionsAll five methods showed high precision even when applied to images with different activities. MRI and CT were the most accurate for assessing the caudate or putamen. To assess the striatal chamber and in the absence of structural information, the TwoBox method is advisable.

Quantitative Monte Carlo-based brain dopamine transporter SPECT imaging.

Brain dopamine transporter imaging with I-123-labeled radioligands is technically demanding due to the small size of the imaging target relative to the spatial resolution of most SPECT systems. In addition, I-123 has high-energy peaks which can penetrate or scatter in the collimator and be detected in the imaging energy window. The aim of this study was to implement Monte Carlo (MC)-based full collimator-detector response (CDR) compensation algorithm for I-123 into a third-party commercial SPECT reconstruction software package and to evaluate its effect on the quantitative accuracy of dopaminergic-image analysis compared to a method where only the geometric component of the CDR is compensated. In this work, we utilized a full Monte Carlo collimator-detector model and incorporated it into an iterative SPECT reconstruction algorithm. The full Monte Carlo model reconstruction was compared to standard reconstruction using an anthropomorphic striatal phantom filled with different I-123 striatal/cortex uptake ratios and with clinical I-123 Ioflupane DaTScan studies. Reconstruction with the full model yielded higher (13-25%) striatal uptake ratios than the conventional reconstruction, but the uptake ratios were still much lower than the true ratios due to partial volume effect. Visually, images reconstructed with the full Monte Carlo model had better contrast and resolution than the conventional images, with both phantom and patient studies. Reconstruction with full Monte Carlo collimator-detector model yields higher quantitative accuracy than conventional reconstruction. Additional work to reduce the partial volume effect related errors would improve the accuracy further.

Faster Acquisition for Dopamine Transporter Imaging Using Swiftscan Step and Shoot Continuous SPECT Without Impairing Visual and Semiquantitative Analysis.

Aim: Dopamine transporter (DAT) imaging with [123I] FP-CIT (DaTSCAN) is an established diagnostic tool in parkinsonism and dementia. Using a low energy high resolution and sensitivity (LEHRS) collimator and step and shoot continuous scanning mode, Swiftscan single photon emission computed tomography (SPECT) (GE Healthcare) enhances sensitivity and enables time or dose reduction. In this phantom and clinical study, we aim to validate a 25% reduction of the acquisition time using Swiftscan and its lack of effect on visual or quantitative analysis.Methods: Anthropomorphic striatal phantom with fillable striata was used. SPECT data from 30 normals (12 men, 18 women; age range, 39–91 years; mean, 71 years ± 11) and 30 patients with Parkinson disease or other neurodegenerative disease with extra-pyramidal syndrome (16 men, 14 women; age range, 43–84 years; mean, 69 years ± 10) were also included. Both phantom and clinical data were acquired using Swiftscan and reconstructed with full-time and 25%-time reduction. Striatal binding ratios (SBRs) were calculated using DaTQUANT software.Results: Both in phantom experiments and in clinical cases, visual analysis remained stable and SBRs were not significantly different whether using Swiftscan or Swiftscan with 25%-time reduction (p < 0.001). There was an excellent inter-rater agreement and no effect of time reduction on diagnosis or on image quality.Conclusion: Using Swiftscan step and shoot continuous SPECT mode, 25%-time reduction can be applied to DaTSCAN acquisition protocols, without impairing visual or quantitative analysis.

MRI-guided voxel-based automatic semi-quantification of dopamine transporter imaging

PurposeFunctional imaging with 123I-FP-CIT SPECT suffers from poor spatial resolution resulting in partial-volume effect, which affects the subsequent semi-quantification. Definition of regions of interest for semi-quantification is further subject to user's experience and inter-observer variability. The aim of this work has been to develop an automatic method for definition of volumes of interest and partial-volume correction using patient-specific MRI and providing complete contrast recovery in striatal region. MethodThe method consists of spatial pre-processing (image segmentation and multi-modality registration), partial-volume correction (performed by region-based voxel-wise technique), and calculation of uptake indices in striatal structures. Anthropomorphic striatal phantom was used to optimize the method and to assess linearity, accuracy, and reproducibility. The method was tested on 58 patient datasets and compared with clinical assessment and BasGan software. ResultsThe method works automatically. The output is highly linear regarding changing striatal uptake. Complete contrast recovery is achieved using 6.5 mm FWHM. Accuracy is better than 0.15 in terms of RMSE between measured and true uptake indices. Reproducibility is better than 5% for normal uptake ratio. The method outperformed clinical assessment in all measures. With patient data, it provided results closer to BasGan (RMSE 0.9) than to clinical assessment (RMSE 1.9) and fairly correlated with both. ConclusionThe proposed method provides complete recovery of striatal contrast under given acquisition and reconstruction conditions. It reduces intra- and inter-observer variability, accurately defines volumes of interest, and effectively suppresses partial-volume effect. It can be reproduced using publicly available software.

Comparison between OSEM and FBP reconstruction algorithms for the qualitative and quantitative interpretation of brain DAT-SPECT using an anthropomorphic striatal phantom: implications for the practice

The aim of this study was to evaluate the effect of ordered subsets maximization expectation (OSEM) and filtered backprojection (FBP) reconstruction algorithms for the qualitative interpretation of DAT-SPECT. Data were acquired using an anthropomorphic striatal phantom and a gamma camera (SPECT/CT). Images were reconstructed using different values of the covariates applied in the OSEM and FBP algorithms (iteration, subsets, order, and cut-off frequency). Image quality was compared according to each set of covariates used in the reconstruction and extracted quantitative parameters of the image quality, such as C, CV RCR, and RSR, as well as the angular coefficients of the edges in regions of interest. Variations in the order from 0 to 10 do not influence the image if a trustworthy cut-off frequency range for FBP (0.9 to 1.6) and OSEM (1.2 to 1.5) are used. For OSEM, the iteration value and the number of subsets that guarantee better quality were those suggested by the developer of the algorithm used (3i8s). For a quality image, it is necessary to use the range of values found for the covariables order and cut-off frequency of the Butterworth filter in the FBP and OSEM reconstruction. OSEM reconstruction shows superiority in the images compared with FBP when the recommended three iterations and eight subsets are used. In the quantitative analyses, the evaluation showed that increasing the number of updates while allowing a better distinction of certain areas, culminates with a degradation image, making it inappropriate for clinical.

Continuous Repetitive Data Acquisition with 123I-FP-CIT SPECT: Effects of Rotation Speed and Rotation Time.

The aim of this study was to evaluate the effects of the acquisition rotation speed and the rotation time for continuous repetitive rotation acquisition (CRRA) on image quality and quantification in 123I-FP-CIT SPECT. Methods: An anthropomorphic striatal phantom filled with 123I solution was acquired with CRRA and the step-and-shoot (SS) mode. The following combinations of acquisition rotation speed and rotation time for CRRA were used: 0.50 rpm by 30 frames, 0.17 rpm by 10 frames, 0.10 rpm by 6 frames, and 0.05 rpm by 3 frames. SPECT images were reconstructed using ordered-subset expectation maximization with resolution recovery, scatter, and CT-based attenuation correction. Two kinds of image processing patterns-image reconstruction after the addition of projection data (the added-projection-data process) and image addition after data reconstruction (the added-reconstructed-image process)-were investigated in this study. The effects of the acquisition parameters and the image processes were evaluated by the full width at half maximum, percentage coefficient of variation (%CV), and specific binding ratio (SBR). Results: With full width at half maximum, there were no clear differences between CRRA images obtained with the various rotation speeds before rotation and the SS mode. Although the combination of a slow rotation speed and a short rotation time improved image uniformity compared with the SS mode, the %CV obtained by CRRA increased as the rotation speed increased. The %CVs were 11.9% ± 0.9% for 0.50 rpm by 30 frames, 6.9% ± 0.9% for 0.05 rpm by 3 frames, and 9.6% ± 0.5% for SS mode. SBRs obtained by CRRA with the added-projection-data process were equal to those obtained by SS mode. However, SBRs obtained with the added-reconstructed-image process were clearly decreased compared with the SS mode. Conclusion: The combination of rotation speed and rotation times affects the image quality and quantification of 123I-FP-CIT SPECT using CRRA. When CRRA is applied in 123I-FP-CIT SPECT, it is necessary to use added-projection-data processes and proper rotation speeds (e.g., 0.10-0.17 rpm rotation speed).

Evaluation of the Reconstruction Parameters of Brain Dopamine Transporter SPECT images Obtained by a Fan Beam Collimator: A Comparison with Parallel-hole Collimators.

Objective(s):The purpose of this study was to examine the optimal reconstruction parameters for brain dopamine transporter SPECT images obtained with a fan beam collimator and compare the results with those obtained by using parallel-hole collimators. Methods:Data acquisition was performed using two SPECT/CT devices, namely a Symbia T6 and an Infinia Hawkeye 4 (device A and B) equipped with fan-beam (camera A-1 and B-1), low- and medium-energy general-purpose (camera A-2 and B-2), and low-energy high-resolution (camera A-3 and B-3) collimators. The SPECT images were reconstructed using filtered back projection (FBP) with Chang’s attenuation correction. However, the scatter correction was not performed. A pool phantom and a three-dimensional (3D) brain phantom were filled with 123I solution to examine the reconstruction parameters. The optimal attenuation coefficient was based on the visual assessment of the profile curve, coefficient of variation (CV) [%], and summed difference from the reference activity of the pool phantom. The optimal Butterworth filter for the 3D-brain phantom was also determined based on a visual assessment. The anthropomorphic striatal phantom was filled with 123I solution at striatum-to-background radioactivity ratios of 8, 6, 4, and 3. The specific binding ratio (SBR) of the striatum (calculated by the CT method) was used to compare the results with those of the parallel-hole collimators.Results:The optimal attenuation coefficients were 0.09, 0.11, 0.05, 0.05, 0.11, and, 0.10 cm-1 for cameras A-1, A-2, A-3, B-1, B-2, and B-3, respectively. The cutoff frequencies of the Butterworth filter were 0.32, 0.40, and 0.36 cycles/cm for camera A, and 0.46, 0.44, and 0.44 cycles/cm for camera B, respectively. The recovery rates of the SBRmean with camera A were 51.2%, 49.4%, and 45.6%, respectively. The difference was not statistically significant. The recovery rates of the SBR with camera B were 59.2%, 50.7%, and 50.8%, respectively. Camera B-1 showed significantly high SBR values.Conclusion:As the findings indicated, the optimal reconstruction parameters differed according to the devices and collimators. The fan beam collimator was found to provide promising results with each device.

Evaluation of Iterative Reconstruction Method and Attenuation Correction in Brain Dopamine Transporter SPECT Using an Anthropomorphic Striatal Phantom.

Objective(s):The aim of this study was to determine the optimal reconstruction parameters for iterative reconstruction in different devices and collimators for dopamine transporter (DaT) single-photon emission computed tomography (SPECT). The results were compared between filtered back projection (FBP) and different attenuation correction (AC) methods.Methods:An anthropomorphic striatal phantom was filled with 123I solutions at different striatum-to-background radioactivity ratios. Data were acquired using two SPECT/CT devices, equipped with a low-to-medium-energy general-purpose collimator (cameras A-1 and B-1) and a low-energy high-resolution (LEHR) collimator (cameras A-2 and B-2). The SPECT images were once reconstructed by FBP using Chang’s AC and once by ordered subset expectation maximization (OSEM) using both CTAC and Chang’s AC; moreover, scatter correction was performed. OSEM on cameras A-1 and A-2 included resolution recovery (RR). The images were analyzed, using the specific binding ratio (SBR). Regions of interest for the background were placed on both frontal and occipital regions.Results:The optimal number of iterations and subsets was 10i10s on camera A-1, 10i5s on camera A-2, and 7i6s on cameras B-1 and B-2. The optimal full width at half maximum of the Gaussian filter was 2.5 times the pixel size. In the comparison between FBP and OSEM, the quality was superior on OSEM-reconstructed images, although edge artifacts were observed in cameras A-1 and A-2. The SBR recovery of OSEM was higher than that of FBP on cameras A-1 and A-2, while no significant difference was detected on cameras B-1 and B-2. Good linearity of SBR was observed in all cameras. In the comparison between Chang’s AC and CTAC, a significant correlation was observed on all cameras. The difference in the background region influenced SBR differently in Chang’s AC and CTAC on cameras A-1 and B-1.Conclusion:Iterative reconstruction improved image quality on all cameras, although edge artifacts were observed in images captured by cameras with RR. The SBR of OSEM with RR was higher than that of FBP, while the SBR of OSEM without RR was equal to that of FBP. Also, the SBR of Chang’s AC varied with different background regions in cameras A-1 and B-1.

Optimization of iterative reconstruction parameters with 3-dimensional resolution recovery, scatter and attenuation correction in ¹²³I-FP-CIT SPECT.

The aim of this study was to determine the optimal reconstruction parameters on ordered-subset expectation maximization iterative reconstruction with resolution recovery, scatter and attenuation correction (OSEM(RRSCAC)) on (123)I-FP-CIT SPECT in terms of the image quality, quantification and diagnostic ability. We evaluated the quality and quantification in (123)I-FP-CIT SPECT images obtained by different reconstruction parameters using the anthropomorphic striatal phantom. The phantom images were acquired using a SPECT/CT system equipped with a low- and medium-energy general-purpose collimator and then were reconstructed using OSEM(RRSCAC) with various update numbers and the full width at half maximum (FWHM) of the Gaussian filter. The count ratio of the striatum, the coefficient of variation (CV) on the background and the specific binding ratio (SBR) were calculated to determine the optimal reconstruction parameters. Then, 42 consecutive patients who underwent (123)I-FP-CIT SPECT were selected for clinical study. The patients were grouped into potentially decreasing group (20 with Parkinson's disease, 5 with parkinsonian syndrome and 5 with dementia with Lewy bodies) and potentially normal binding group (4 with Alzheimer disease and 8 with essential tremor). Clinical images were reconstructed using OSEM(RRSCAC) and FBP with Chang's AC (FBP(AC)). The performance of OSEM(RRSCAC) with the optimal reconstruction parameters was evaluated according to the receiver operating characteristic analysis and visual assessment. The count ratio increased with an increasing update number and converged uniformly with an update number over 90. The CV continuously increased with the update number. The SBR also increased with an increasing update number and converged uniformly with an update number of 90 or larger. The FWHM of the Gaussian filter influenced the image quality and quantification. In the clinical study, the area under curve (AUC) for the OSEM(RRSCAC) and FBP(AC) were 0.9812 and 0.9759, respectively. The quality of the SPECT images of OSEM(RRSCAC) (3.8 ± 0.8) was significantly superior to that of FBP(AC) (2.2 ± 0.7). We determined that the optimal reconstruction parameter for OSEM(RRSCAC) was 90 update numbers with 6.6 mm FWHM of the Gaussian filter. Our results suggested that the optimal reconstruction parameters have a potential to improve the performance and the image quality of (123)I-FP-CIT SPECT in comparison with the FBP reconstruction.

An anthropomorphic phantom study of brain dopamine transporter SPECT images obtained using different SPECT/CT devices and collimators.

The aim of this study was to evaluate differences in dopamine transporter SPECT images among different SPECT/CT devices and to determine the most appropriate region of interest (ROI) for semiquantitative evaluation. An anthropomorphic striatal phantom was filled with (123)I solutions of different striatum-to-background radioactivity ratios. Data were acquired using 2 SPECT/CT devices equipped with low- to medium-energy general-purpose and low-energy high-resolution (LEHR) collimators. The SPECT images were reconstructed by filtered backprojection with both attenuation and scatter correction and then were analyzed using specific binding ratio (SBR). The most appropriate of 7 ROI types was determined, and we then compared the linearity and recovery of SBR among the different SPECT/CT devices and collimators. The linearity of SBR was excellent for all types of ROIs. The ROI contouring the striatum based on the CT images showed the best recovery of SBR using mean activity in the striatal ROI (SBRmean) (47.8%). For this ROI, the recovery of SBRmean for SPECT/CT with a LEHR collimator with thick septa and a long hole length was 61.6%-significantly higher than that of other devices. The ROI contouring the striatum based on CT images was considered appropriate for evaluating dopamine transporter SPECT/CT. Among the different SPECT/CT devices, an LEHR collimator designed for (123I)I imaging is recommended.

Weighted registration of 123I‐FP‐CIT SPECT images improves accuracy of binding potential estimates in pathologically low striatal uptake

To test whether the use of a striatum weighted image may improve registration accuracy and diagnostic outcome in patients with parkinsonian syndromes (PS), weighted images were generated by increasing signal intensity of striatal voxels and used as intermediate dataset for co-registering the brain image onto template. Experimental validation was performed using an anthropomorphic striatal phantom. (123)I-FP-CIT SPECT binding ratios were manually determined in 67 PS subjects and compared to those obtained using unsupervised standard (UWR) and weighted registered (WR) approach. Normalized cost function was used to evaluate the accuracy of phantom and subjects registered images to the template. Reproducibility between unsupervised and manual ratios was assessed by using intra-class correlation coefficient (ICC) and Bland and Altman analysis. Correlation coefficient was used to assess the dependence of semi-quantitative ratios on clinical findings. Weighted method improves accuracy of brain registration onto template as determined by cost function in phantom (0.86 ± 0.06 vs. 0.98 ± 0.02; Student's t-test, P = 0.04) and in subject scans (0.69 ± 0.06 vs. 0.53 ± 0.06; Student's t-test, P < 0.0001). Agreement between manual and unsupervised derived binding ratios as measured by ICC was significantly higher on WR as compared to UWR images (0.91 vs. 0.76). Motor UPDRS score was significantly correlated with manual and unsupervised derived binding potential. In phantom, as well as in subjects studies, correlations were more significant using the WR method (BPm: R(2) = 0.36, P = 0.0001; BPwr: R(2) = 0.368, P = 0.0001; BPuwr: R(2) = 0.300, P = 0.0008). Weighted registration improves accuracy of binding potential estimates and may be a promising approach to enhance the diagnostic outcome of SPECT imaging, correlation with disease severity, and for monitoring disease progression in Parkinsonian syndromes.

Caméras hybrides TEMP-TDM et semi-quantification du 123I-FPCIT : évaluation de l’apport de la TDM

Objectives Tomoscintigraphy of dopamine transporters with 123I-FP-CIT is nowadays essential to visualise impairment of nigro-striatal system for the diagnosis of parkinsonism and for the differential diagnosis of dementia. With the development of hybrid cameras (SPECT-CT), the CT contribution in nuclear neurology needs to be assessed in diagnostic and semi-quantification performances. The main purpose of our study is to compare attenuation correction using CT to attenuation correction using the linear algorithm of Chang. SPECT-CT with parallel collimation results were also weighed against fan beam collimation and the contribution of partial volume effect correction was studied in secondary objective. Materials and methods We used a trilinear phantom to define spatial resolution and an anthropomorphic striatal phantom to quantify the activity in striatal cavities. We compared the impact of attenuation and scatter correction on spatial resolution and semi-quantification in striatum. We performed the partial volume effect correction on reconstructed images according to the method of Rousset. Results Attenuation correction by CT did not improve significantly spatial resolution compared to the algorithm of Chang. The semi-quantification of 123I-FPCIT in striata was not significantly different according to the various CA, but was significantly improved with CT attenuation and scatter correction. Partial volume effect correction improved the quantification from 40 to 60% in the striatal structures, when the activity was superior in at least twice the background noise. Conclusion SPECT-CT hybrid cameras increase spatial resolution and improve semi-quantification of 123I-FPCIT because of CT attenuation and scatter correction. Another use of CT is the possibility of calibrating anatomic segmentation of striata for partial volume effect correction. Partial volume effect correction improves quantification and is essential for early diagnosis of nigro-striatal disease.

Fully automated 3D basal ganglia activity measurement in dopamine transporter scintigraphy (Spectalyzer)

Semiquantitative evaluation of tracer uptake in basal ganglia is superior to visual assessment of images in dopamine transporter (DAT) scintigraphy especially in follow-up of the patients. Manual drawing of regions of interest (ROIs) in two-dimensional (2D) transaxial slices of the single photon emission computed tomography (SPECT) datasets leads to a large inter- and intra-reader variability, while being time consuming. Our aim was to investigate a technique that extracts 3D ROIs in a fully automated fashion and thus might provide reproducible user-independent results allowing better follow-up control and large-scale clinical studies. The highest activity of 123IFP-CIT is expected in the basal ganglia. The proposed method (Spectalyzer) uses the following steps to localize this maximum and extract the ROIs in 3D: (1) Dithers the SPECT volume to obtain a 3D volume with binary only. (2) Models the obtained point distributions as two multivariate Gaussian distributions and estimated their parameters using the expectation maximization algorithm. (3) Using the original SPECT activity values, thresholding is performed using a fixed percentage of maximum activity as a parameter to obtain the 3D ROIs. (4) A reference volume in the occipital region is automatically found based on the location of the two ROIs. (5) From the 3D ROIs, statistical information like mean and median activity and the volume is extracted, relative to the activity in the reference region. The resulting values are compared with values from manual 2D ROIs. Further validation is performed by means of an anthropomorphic striatal phantom. The method was evaluated on 12 SPECT volumes including anthropomorphic striatal phantoms. In all cases the two basal-ganglia were successfully localized and the 3D ROIs estimated, with perfect reproducibility. The obtained values for the mean activity showed the same trend with the values obtained manually and also with the results of the 2D semiautomatic software, but without the substantial inter- and intra-reader variations. The proposed method is successful in finding the 3D ROIs and performing the subsequent measurements automatically. It is proposed as an automatic reproducible approach for semiquantitative analysis of DAT scintigraphy.

The basal ganglia matching tools package for striatal uptake semi-quantification: description and validation

To design a novel algorithm (BasGan) for automatic segmentation of striatal (123)I-FP-CIT SPECT. The BasGan algorithm is based on a high-definition, three-dimensional (3D) striatal template, derived from Talairach's atlas. A blurred template, obtained by convolving the former with a 3D Gaussian kernel (FWHM = 10 mm), approximates striatal activity distribution. The algorithm performs translations and scale transformation on the bicommissural aligned image to set the striatal templates with standard size in an appropriate initial position. An optimization protocol automatically performs fine adjustments in the positioning of blurred templates to best match the radioactive counts, and locates an occipital ROI for background evaluation. Partial volume effect correction is included in the process of uptake computation of caudate, putamen and background. Experimental validation was carried out by means of six acquisitions of an anthropomorphic striatal phantom. The BasGan software was applied to a first set of patients with Parkinson's disease (PD) versus patients affected by essential tremor. A highly significant correlation was achieved between true binding potential and measured (123)I activity from the phantom. (123)I-FP-CIT uptake was significantly lower in all basal ganglia in the PD group versus controls with both BasGan and a conventional ROI method used for comparison, but particularly with the former. Correlations with the motor UPDRS score were far more significant with the BasGan. The novel BasGan algorithm automatically performs the 3D segmentation of striata. Because co-registered MRI is not needed, it can be used by all nuclear medicine departments, since it is freely available on the Web.

Assessment of errors caused by X-ray scatter and use of contrast medium when using CT-based attenuation correction in PET

Quantitative image reconstruction in positron emission tomography (PET) requires an accurate attenuation map of the object under study for the purpose of attenuation correction. Current dual-modality PET/CT systems offer significant advantages over stand-alone PET, including decreased overall scanning time and increased accuracy in lesion localisation and detectability. However, the contamination of CT data with scattered radiation and misclassification of contrast medium with high-density bone in CT-based attenuation correction (CTAC) are known to generate artefacts in the attenuation map and thus the resulting PET images. The purpose of this work was to quantitatively measure the impact of scattered radiation and contrast medium on the accuracy of CTAC. Our recently developed MCNP4C-based Monte Carlo X-ray CT simulator for modelling both fan- and cone-beam CT scanners and the Eidolon dedicated 3D PET Monte Carlo simulator were used to generate realigned PET/CT data sets. The impact of X-ray scattered radiation on the accuracy of CTAC was investigated through simulation of a uniform cylindrical water phantom for both a commercial fan-beam multi-slice and a prototype cone-beam flat panel detector-based CT scanner. The influence of contrast medium was studied by simulation of a cylindrical phantom containing different concentrations of contrast medium. Moreover, an experimental study using an anthropomorphic striatal phantom was conducted for quantitative evaluation of errors arising from the presence of contrast medium by calculating the apparent recovery coefficient (ARC) in the presence of different concentrations of contrast medium. The analysis of attenuation correction factors (ACFs) for the simulated cylindrical water phantom in both fan- and cone-beam CT scanners showed that the contamination of CT data with scattered radiation in the absence of scatter removal causes underestimation of the true ACFs, namely by 7.3% and 28.2% in the centre for the two geometries, respectively. The ARC was 190.7% for a cylindrical volume of interest located in the main chamber of the striatal phantom containing contrast medium corresponding to 2,000 Hounsfield units, whereas the ARC was overestimated by less than 5% for the main chamber and by approximately 2% for the left/right putamen and caudate nucleus compared with the absence of contrast medium. Without X-ray scatter compensation, the visual artefacts and quantitative errors in flat panel detector-based cone-beam geometry are substantial and propagate cupping artefacts to PET images during CTAC. Likewise, contrast-enhanced CT images may create considerable artefacts during CTAC in regions containing high concentrations of contrast medium.

Computed tomography-based attenuation correction in neurological positron emission tomography: evaluation of the effect of the X-ray tube voltage on quantitative analysis

The advent of dual-modality positron emission tomography/computed tomography (PET/CT) imaging has revolutionized the practice of clinical oncology by improving lesion localization and facilitating treatment planning for radiation therapy. In addition, the use of CT images for CT-based attenuation correction (CTAC) allows the overall scanning time to be decreased and a noise-free attenuation map (micromap) to be created. The most common procedure requires a piecewise linear calibration curve acquired under standard imaging conditions to convert the patient's CT image from low effective CT energy into an attenuation map at 511 keV. To evaluate the effect of the tube voltage on the accuracy of CTAC. As different tube voltages are employed in current PET/CT scanning protocols, depending on the size of the patient and the region under study, the impact of using a single calibration curve on the accuracy of CTAC for images acquired at different tube voltages was investigated through quantitative analysis of the created micromaps, generated attenuation correction factors and reconstructed neurological PET data using anthropomorphic experimental phantom and clinical studies. For CT images acquired at 80 and 140 kVp, average relative differences of -2.9% and 0.7%, respectively, from the images acquired at 120 kVp were observed for the absolute activity concentrations in five regions of the anthropomorphic striatal phantom when CT images were converted using a single calibration curve derived at 120 kVp. Likewise, average relative differences of 1.9% and -0.6% were observed when CT images were acquired at 120 kVp and CTAC used calibration curves derived at 80 and 140 kVp, respectively. The use of a single calibration curve acquired under standard imaging conditions does not affect, to a visible or measurable extent, neurological PET images reconstructed using CTAC when CT images are acquired in different conditions.

Iterative three‐dimensional expectation maximization restoration of single photon emission computed tomography images: Application in striatal imaging

Single photon emission computed tomography imaging suffers from poor spatial resolution and high statistical noise. Consequently, the contrast of small structures is reduced, the visual detection of defects is limited and precise quantification is difficult. To improve the contrast, it is possible to include the spatially variant point spread function of the detection system into the iterative reconstruction algorithm. This kind of method is well known to be effective, but time consuming. We have developed a faster method to account for the spatial resolution loss in three dimensions, based on a postreconstruction restoration method. The method uses two steps. First, a noncorrected iterative ordered subsets expectation maximization (OSEM) reconstruction is performed and, in the second step, a three-dimensional (3D) iterative maximum likelihood expectation maximization (ML-EM) a posteriori spatial restoration of the reconstructed volume is done. In this paper, we compare to the standard OSEM-3D method, in three studies (two in simulation and one from experimental data). In the two first studies, contrast, noise, and visual detection of defects are studied. In the third study, a quantitative analysis is performed from data obtained with an anthropomorphic striatal phantom filled with 123-I. From the simulations, we demonstrate that contrast as a function of noise and lesion detectability are very similar for both OSEM-3D and OSEM-R methods. In the experimental study, we obtained very similar values of activity-quantification ratios for different regions in the brain. The advantage of OSEM-R compared to OSEM-3D is a substantial gain of processing time. This gain depends on several factors. In a typical situation, for a 128 x 128 acquisition of 120 projections, OSEM-R is 13 or 25 times faster than OSEM-3D, depending on the calculation method used in the iterative restoration. In this paper, the OSEM-R method is tested with the approximation of depth independent resolution. For the striatum this approximation is appropriate, but for other clinical situations we will need to include a spatially varying response. Such a response is already included in OSEM-3D.

Optimization of acquisition energy windows in simultaneous /sup 99m/Tc//sup 123/I brain SPECT

Simultaneous acquisition SPECT brain imaging using a /sup 99m/Tc labeled perfusion agent and an /sup 123/I labeled neurotransmitter agent has potential applications in diagnosis of neurodegenerative diseases. However, the close proximity of the photopeaks of the two isotopes results in significant crosstalk. We have previously optimized the acquisition parameters for /sup 201/Tl//sup 99m/Tc dual isotope imaging based on an ideal observer signal-to-noise ratio (SNR). In this work, we determined the optimal energy window, i.e., the one providing the optimal tradeoff between minimizing the crosstalk and maximizing the detection efficiency for /sup 99m/Tc//sup 123/I simultaneous acquisition brain SPECT. High-count listmode projections of an anthropomorphic striatal brain phantom were acquired. Projection images with different sets of energy window centers and widths were derived from the listmode data. Those projections were then weighted and summed appropriately to represent various /sup 99m/Tc//sup 123/I activity concentration ratios. The values of a no-low-frequency ideal observer SNR were calculated for a lesion detection task using /sup 99m/Tc only, /sup 123/I only and the simultaneous projection data. The maximum ideal observer SNR values were used as the metric to select the optimal acquisition parameters. For a /sup 99m/Tc only acquisition, the optimal energy window was 30 keV wide centered at 144 keV, and for an /sup 123/I only acquisition the optimal window was 30 keV wide centered at 161 keV. For simultaneous acquisition, the /sup 123/I window tended to be higher and narrower and the /sup 99m/Tc window tended to be lower and narrower than for the separate-isotope acquisition. Use of the projection images acquired with optimal parameters will provide improved data from which to perform simultaneous SPECT reconstructions.