Hot Contrast Research Articles

Impact of γ factor in the penalty function of Bayesian penalized likelihood reconstruction (Q.Clear) to achieve high-resolution PET images

BackgroundThe Bayesian penalized likelihood PET reconstruction (BPL) algorithm, Q.Clear (GE Healthcare), has recently been clinically applied to clinical image reconstruction. The BPL includes a relative difference penalty (RDP) as a penalty function. The β value that controls the behavior of RDP determines the global strength of noise suppression, whereas the γ factor in RDP controls the degree of edge preservation. The present study aimed to assess the effects of various γ factors in RDP on the ability to detect sub-centimeter lesions.MethodsAll PET data were acquired for 10 min using a Discovery MI PET/CT system (GE Healthcare). We used a NEMA IEC body phantom containing spheres with inner diameters of 10, 13, 17, 22, 28 and 37 mm and 4.0, 5.0, 6.2, 7.9, 10 and 13 mm. The target-to-background ratio of the phantom was 4:1, and the background activity concentration was 5.3 kBq/mL. We also evaluated cold spheres containing only non-radioactive water with the same background activity concentration. All images were reconstructed using BPL + time of flight (TOF). The ranges of β values and γ factors in BPL were 50–600 and 2–20, respectively. We reconstructed PET images using the Duetto toolbox for MATLAB software. We calculated the % hot contrast recovery coefficient (CRChot) of each hot sphere, the cold CRC (CRCcold) of each cold sphere, the background variability (BV) and residual lung error (LE). We measured the full width at half maximum (FWHM) of the micro hollow hot spheres ≤ 13 mm to assess spatial resolution on the reconstructed PET images.ResultsThe CRChot and CRCcold for different β values and γ factors depended on the size of the small spheres. The CRChot, CRCcold and BV increased along with the γ factor. A 6.2-mm hot sphere was obvious in BPL as lower β values and higher γ factors, whereas γ factors ≥ 10 resulted in images with increased background noise. The FWHM became smaller when the γ factor increased.ConclusionHigh and low γ factors, respectively, preserved the edges of reconstructed PET images and promoted image smoothing. The BPL with a γ factor above the default value in Q.Clear (γ factor = 2) generated high-resolution PET images, although image noise slightly diverged. Optimizing the β value and the γ factor in BPL enabled the detection of lesions ≤ 6.2 mm.

Impact of acquisition time on image quality and visibility of Yttrium-90 Positron Emission Tomography: A phantom study

90Y has internal pair production which enables the imaging of this isotope with positron emission tomography (PET). The acquisition time is a crucial factor which strongly influence the image quality due to very small decay branch of this isotope. Hence, the aim of this study was to evaluate the impact of acquisition time on image quality and visibility of 90Y PET. A NEMA IEC body phantom with set of fillable spheres were filled with 90Y to generate a hot lesion to background ratio of 8:1. PET image was acquired by Philips Gemini TF PET/CT scanner with acquisition time per bed varied from 15, 30, 60 and 120 minutes. Image quality was assessed by percentage hot contrast (HC), image noise (CV), signal-to-noise (SNR) ratio and visibility (VS). From a result, hot spheres and their edges were more defined as acquisition time increased. Additionally, SNR and visibility were increased with acquisition time and sphere size as expected but percentage hot contrast was decreased. Thus, this can be explained by the growing of noise at shorter acquisition times and smaller spheres. In conclusion, 90Y PET imaging was feasible but the imaging protocol should be carefully considered particularly in small object.

336. Validation of a methodology for SPECT/CT absolute quantification

Purpose To evaluate the activity quantification performance of our SPECT/CT scanner (SYMBIA T2 – SIEMENS) and to verify a methodology for absolute activity quantification. Methods Quantitative SPECT/CT studies can be performed using the methodology proposed by Zeintl et al. [1] . The instrumentation consists of an uniform cylindrical phantom (5680 mL) and an IEC NEMA torso-phantom with hot sphere inserts. 99mTc was used to prepare the radioactive solutions. Different sphere-to-background ratio (RSB) were used (61:1, 44:1, 33:1, 10:1). Images were reconstructed using the proprietary OSEM 3D algorithm with resolution recovery (FLASH 3D, Siemens Healthcare), CT-based attenuation correction and energy window-based scatter correction. A system calibration factor (S) relating the count rate (cps) and the activity (mCi) contained in a tridimensional volume was determined together with the activity recovery coefficients. The phantom results were extended to 99mTc-MAA patient acquisitions for activity quantification in liver lesions. Lesions contouring was performed using the Volumetric Analysis Software (Siemens Healthcare). Results A calibration factor of 17190 cps/mCi was obtained for 99mTc. Recovery coefficients (Fig. 1) vary from 90% (for volumes ⩾25 mL) to 20% (for volumes up to 0.5 mL). For 128 updates and no post-smoothing filtering we obtain the maximum activity recovery (about 90%) for a volume ⩾25 mL. Hot sphere contrast and activity quantification improve with higher updates while the sphere to background ratio and the background variability increase. A balance between activity recovery and background variability is obtained with 8 iterations, 8subset and no filtering. Applying the phantom results to 7 MAA-99mTc acquisitions, activity accumulated in liver lesions can be determined with an accuracy ⩽10% (Table 1). Conclusions With the proposed methodology spect activity quantification can be reached with an accuracy ⩽10% for 99mTc acquisitions. In the future the method will be tested also with other isotopes used in the clinical practice.

61 Evaluation and comparison of a new low energy high resolution collimator

Introduction In order to find an optimum compromise between spatial resolution and sensitivity, GEHC designed a new collimator (LEHRS) and combined it to a new acquisition software for planar images (Clarity2D) and to a new tomographic acquisition method: ”step and shoot continuous”. The objective of the study is to evaluate planar and tomographic performances of this new collimator and to compare them to GEHC LEHR and to Siemens LEHR. Methods In planar mode, sensitivity and spatial resolution were measured for the three collimators according to NEMA NU1–2000 [1] . In tomographic mode, volumetric sensitivity and spatial resolution were also evaluated according to NEMA NU1–2000. Image quality was measured according NEMA NU2-2012 (contrast of 8) [2] . Projections were acquired according to routine protocols and the volumes were reconstructed thanks to and independent software taking into account spatial resolution depth dependence and attenuation correction. Results Planar mode. Maximum sensitivity was measured for Siemens LEHR (100 cps/MBq), LEHRS’s was 9% lower and GEHC LEHR’s was 22% lower. The full width at half maximum of the linear spread function, at source contact, is equivalent for both LEHR and 5% higher for LEHRS. Nevertheless thanks to Clarity2D, LSF’s FWHM degradation is less important when collimator distance increases. With 15 cm of diffusing material, LEHRS spatial resolution is 9,2 mm, GEHC LEHR is 10,1 mm and Siemens LEHR is 10,6 mm. Tomographic mode. LEHRS volumetric sensitivity is superior to both LEHR’s (16% for Siemens LEHR and 25% for GEHC LEHR). Spatial resolution is equivalent for the 3 collimators. The biggest hot sphere contrast recovery is equivalent for both GEHC collimators (41% for LEHR and 39,3% for LEHRS) and superior to Siemens LEHR (35,7%). LEHRS provides a better background variability (7,9%) than both LEHR (10,1% for GEC and 9,8% for Siemens). Conclusions In planar mode, LEHRS collimator associated to clarity 2D provides higher quality images than the other collimators since then enough diffusing material is placed between the source and the camera. In tomographic mode, the increase of volumetric sensitivity allows to reduce noise in the images (low background variability) while maintaining equivalent or superior contrast recovery and spatial resolution.

Optimization of PET/CT image quality using the GE 'Sharp IR' point-spread function reconstruction algorithm.

The objective of this study was to quantify any improvement with the GE 'Sharp IR' point-spread function (PSF) reconstruction algorithm in addition to ordered subsets expectation maximum (OSEM) and time-of-flight (TOF) reconstruction algorithms and establish the optimum parameters to be used in clinical studies. We conducted a range of experiments using the National Electrical Manufacturers Association image quality phantom filled with a 4 : 1 signal-to-background ratio. We scanned the phantom using the GE Discovery 690 PET/CT scanner. We varied iteration number and Gaussian filtration. Results were compared for OSEM, OSEM+TOF and OSEM+TOF+PSF reconstructions. A sample of 15 whole-body fluorine-18-fluorodeoxyglucose were reconstructed with OSEM+TOF and OSEM+TOF+PSF using a selection of optimum reconstruction parameters determined in phantom studies. Clinicians qualitatively ranked their preferred images to choose optimum parameters. The addition of PSF improved signal-to-noise ratios (SNRs), contrast, hot contrast recovery coefficients and noise over OSEM and OSEM+TOF reconstruction algorithms. SNRs were the highest at two iterations and with 0 or 2 mm filters with OSEM+TOF+PSF reconstruction in all phantom studies. Clinicians generally favoured OSEM+TOF+PSF reconstruction with three iterations and a 2 mm filter. PSF reconstruction significantly improved image quality for both clinical and phantom studies. We recommended the optimum reconstruction parameters using three iterations, 24 subsets and a 2 mm filter, which improved SNRs by up to 28.8% for small lesions (P<0.05).

Performance Characteristics of the Whole-Body Discovery IQ PET/CT System.

The aim of this study was to assess the physical performance of a new PET/CT system, the Discovery IQ with 5-ring detector blocks. Methods: Performance was measured using the National Electrical Manufacturers Association NU2-2012 methodology. Image quality was extended by accounting for different acquisition parameters (lesion-to-background ratios [8:1, 4:1, and 2:1] and acquisition times) and reconstruction algorithms (VUE-point HD [VPHD], VPHD with point-spread-function modeling [VPHD-S], and Q.Clear). Tomographic reconstruction was also assessed using a Jaszczak phantom. Additionally, 30 patient lesions were analyzed to account for differences in lesion volume and SUV quantification between reconstruction algorithms. Results: Spatial resolution ranged from 4.2 mm at 1 cm to 8.5 mm at 20 cm. Sensitivity measured at the center and at 10 cm was 22.8 and 20.4 kps/kBq, respectively. The noise-equivalent counting rate peak was 124 kcps at 9.1 kBq/cm3 The scatter fraction was 36.2%. The accuracy of correction for count losses and randoms was 3.9%. In the image quality test, contrast recovery for VPHD, VPHD-S, and Q.Clear ranged from 18%, 18%, and 13%, respectively (hot contrast; 10-mm sphere diameter; ratio, 2:1), to 68%, 67%, and 81%, respectively (cold contrast; 37-mm sphere diameter; ratio, 8:1). Background variability ranged from 3.4%, 3.0%, and 2.1%, respectively (ratio, 2:1), to 5.5%, 4.8%, and 3.7%, respectively (ratio, 8:1). On Q.Clear reconstruction, the decrease in the penalty term (β) increased the contrast recovery coefficients and background variability. With the Jaszczak phantom, image quality increased overall when a reconstruction algorithm modeling the point-spread function was used, and use of Q.Clear increased the signal-to-noise ratio. Lesions analyzed using VPHD-S and Q.Clear had an SUVmean of 6.5 ± 3 and 7 ± 3, respectively (P < 0.01), and an SUVmax of 11 ± 4.8 and 12 ± 4, respectively (P < 0.01). No significant difference in mean lesion volume was found between algorithms. Conclusion: Among the various Discovery bismuth germanium oxide-based PET/CT scanners, the IQ with 5-ring detector blocks has the highest overall performance, with improved sensitivity and counting rate performance. Q.Clear reconstruction improves the PET image quality, with higher recovery coefficients and lower background variability.

Quantitative comparison of PET performance-Siemens Biograph mCT and mMR.

BackgroundIntegrated clinical whole-body PET/MR systems were introduced in 2010. In order to bring this technology into clinical usage, it is of great importance to compare the performance with the well-established PET/CT. The aim of this study was to evaluate PET performance, with focus on image quality, on Siemens Biograph mMR (PET/MR) and Siemens Biograph mCT (PET/CT).MethodsA direct quantitative comparison of the performance characteristics between the mMR and mCT system was performed according to National Electrical Manufacturers Association (NEMA) NU 2-2007 protocol. Spatial resolution, sensitivity, count rate and image quality were evaluated. The evaluation was supplemented with additional standardized uptake value (SUV) measurements.ResultsThe spatial resolution was similar for the two systems. Average sensitivity was higher for the mMR (13.3 kcps/MBq) compared to the mCT system (10.0 kcps/MBq). Peak noise equivalent count rate (NECR) was slightly higher for the mMR (196 kcps @ 24.4 kBq/mL) compared to the mCT (186 kcps @ 30.1 kBq/mL). Scatter fractions in the clinical activity concentration range yielded lower values for the mCT (34.9 %) compared to those for the mMR (37.0 %). Best image quality of the systems resulted in approximately the same mean hot sphere contrast and a difference of 19 percentage points (pp) in mean cold contrast, in favour of the mCT. In general, point spread function (PSF) increased hot contrast and time of flight (TOF) increased both hot and cold contrast. Highest hot contrast for the smallest sphere (10 mm) was achieved with the combination of TOF and PSF on the mCT. Lung residual error was higher for the mMR (22 %) than that for the mCT (17 %), with no effect of PSF. With TOF, lung residual error was reduced to 8 % (mCT). SUV was accurate for both systems, but PSF caused overestimations for the 13-, 17- and 22-mm spheres.ConclusionsBoth systems proved good performance characteristics, and the PET image quality of the mMR was close to that of the mCT. Differences between the systems were mainly due to the TOF possibility on the mCT, which resulted in an overall better image quality, especially for the most challenging settings with higher background activity and small uptake volumes.

Phantom Validation of Tc-99m Absolute Quantification in a SPECT/CT Commercial Device.

Aim. Similar to PET, absolute quantitative imaging is becoming available in commercial SPECT/CT devices. This study's goal was to assess quantitative accuracy of activity recovery as a function of image reconstruction parameters and count statistics in a variety of phantoms. Materials and Methods. We performed quantitative 99mTc-SPECT/CT acquisitions (Siemens Symbia Intevo, Erlangen, Germany) of a uniform cylindrical, NEMA/IEC, and an anthropomorphic abdominal phantom. Background activity concentrations tested ranged: 2–80 kBq/mL. SPECT acquisitions used 120 projections (20 s/projection). Reconstructions were performed with the proprietary iterative conjugate gradient algorithm. NEMA phantom reconstructions were obtained as a function of the iteration number (range: 4–48). Recovery coefficients, hot contrast, relative lung error (NEMA phantom), and image noise were assessed. Results. In all cases, absolute activity and activity concentration were measured within 10% of the expected value. Recovery coefficients and hot contrast in hot inserts did not vary appreciably with count statistics. RC converged at 16 iterations for insert size > 22 mm. Relative lung errors were comparable to PET levels indicating the efficient integration of attenuation and scatter corrections with adequate detector modeling. Conclusions. The tested device provided accurate activity recovery within 10% of correct values; these performances are comparable to current generation PET/CT systems.

Effects of point spread function-based image reconstruction on neuroreceptor binding in positron emission tomography study with [(11)C]FLB 457.

The ordered subset expectation maximization with a point spread function (OSEM-PSF) was developed to improve the spatial resolution of reconstructed positron emission tomography (PET) images and has been reported to improve the contrast of hot spots in PET studies for oncology. However, in neuroreceptor imaging, the regional radioactivity concentration changes dynamically during the scan, and the effects of the PSF may differ among various radioligands or quantification methods. In this study, we investigated the effects of the PSF on quantification in PET studies with [(11)C]FLB 457 of dopamine D2 receptors, using both phantom and human data acquired by the Siemens Biograph 16 imaging platform. In the phantom studies, we evaluated the hot contrast recovery coefficient (HCRC) for variously sized hot spheres and the linearity between the measured and true radioactivities in OSEM-PSF images. Next, in the human studies with [(11)C]FLB 457, radioactivity concentrations and binding potentials for the cerebral cortex and thalamus were compared between images reconstructed with and without PSF. In the phantom studies, the OSEM-PSF images showed a better HCRC compared to images without PSF, and they showed a good linear correlation with true radioactivity. In the human studies, the radioactivity concentration increased especially in small regions with high accumulation of [(11)C]FLB 457 when the PSF was included. However, little difference in the binding potentials was observed for the target regions between both types of reconstructed images. In conclusion, PSF-based reconstruction reduced the spill-over phenomena in small hot regions; however, it caused no increase in the binding potentials in the [(11)C]FLB 457 studies.

The impact of reconstruction algorithms and time of flight information on PET/CT image quality.

BackgroundThe aim of the study was to explore the influence of various time-of-flight (TOF) and non-TOF reconstruction algorithms on positron emission tomography/computer tomography (PET/CT) image quality.Materials and methods.Measurements were performed with a triple line source phantom, consisting of capillaries with internal diameter of ∼ 1 mm and standard Jaszczak phantom. Each of the data sets was reconstructed using analytical filtered back projection (FBP) algorithm, iterative ordered subsets expectation maximization (OSEM) algorithm (4 iterations, 24 subsets) and iterative True-X algorithm incorporating a specific point spread function (PSF) correction (4 iterations, 21 subsets). Baseline OSEM (2 iterations, 8 subsets) was included for comparison. Procedures were undertaken following the National Electrical Manufacturers Association (NEMA) NU-2-2001 protocol.ResultsMeasurement of spatial resolution in full width at half maximum (FWHM) was 5.2 mm, 4.5 mm and 2.9 mm for FBP, OSEM and True-X; and 5.1 mm, 4.5 mm and 2.9 mm for FBP+TOF, OSEM+TOF and True-X+TOF respectively. Assessment of reconstructed Jaszczak images at different concentration ratios showed that incorporation of TOF information improves cold contrast, while hot contrast only slightly, however the most prominent improvement could be seen in background variability - noise reduction.ConclusionsOn the basis of the results of investigation we concluded, that incorporation of TOF information in reconstruction algorithm mostly affects reduction of the background variability (levels of noise in the image), while the improvement of spatial resolution due to incorporation of TOF information is negligible. Comparison of traditional and modern reconstruction algorithms showed that analytical FBP yields comparable results in some parameter measurements, such as cold contrast and relative count error. Iterative methods show highest levels of hot contrast, when TOF and PSF corrections were applied simultaneously.

Development of simple processing for deleting undershooting artifact using the FBP method ─evaluation of simulation data─

The undershooting artifact occurs using the filtered back projection (FBP) method. This artifact is influenced by a ramp filter. Thereby, the fall of the target accumulation and a deficit arise and it becomes a clinical problem. We developed a new image reconstruction method based on the FBP method to delete the undershooting artifact of FBP. The image quality of the FBP method is equivalent to that obtained by an evaluation using a digital phantom. The two segmentation and ordinary FBP methods were evaluated in terms of hot contrast, cold contrast, coefficient of variation (%CV), and root mean square uncertainty (%RSMU). The two segmentation FBP method showed equivalent values of hot contrast, % CV, and% RSMU compared with those of the ordinary FBP method. With a threshold level value, cold contrast sharply changed. However, when the threshold level of the two segmentation FBP method was set as the proper value, 90% contrast was obtained. It is necessary to set a threshold level as a proper value using the two segmentation FBP methods. I thought that it can delete an artifact in a simple way, without impairing the image quality. However, it is an examination of only a digital phantom this time. Before using it clinically, one has to use and verify a real phantom.

Endoluminal occlusion devices: technology update.

Endoluminal occlusion has been performed since the early beginning of interventional radiology. Over recent decades, major technological advances have improved the techniques used and different devices have been developed for changing conditions. Most of these occlusion devices have been implemented in the vascular territory. Early embolization materials included glass particles, hot contrast, paraffin, fibrin, and tissue fragments such as muscle fibers and blood clots; today, occlusion materials include metallic devices, particles, and liquid materials, which can be indicated for proximal or distal occlusion, high-flow and low-flow situations, and in large-caliber and small-caliber vessels, based on need. Technological progress has led to a decreased size of delivery catheters, and an increase in safety due to release systems that permit the withdrawing and replacement of embolization material. Furthermore, bioactive embolization materials have been developed to increase the efficacy of embolization or the biological effect of medication. Finally, materials have been modified for changing indications. Intravascular stents were initially developed to keep an artery open; however, by adding a covering membrane, these stents can be used to occlude the wall of a vessel or other endoluminal structures. This article gives an overview of the devices most utilized for occlusion of endoluminal structures, as well as their major purpose in the endovascular territory.

Performance evaluation of small-animal multipinhole μSPECT scanners for mouse imaging

We compared the performance of three commercial small-animal μSPECT scanners equipped with multipinhole general purpose (GP) and multipinhole high-resolution (HR) collimators designed for imaging mice. Spatial resolution, image uniformity, point source sensitivity and contrast recovery were determined for the U-SPECT-II (MILabs), the NanoSPECT-NSO (BioScan) and the X-SPECT (GE) scanners. The pinhole diameters of the HR collimator were 0.35 mm, 0.6 mm and 0.5 mm for these three systems respectively. A pinhole diameter of 1 mm was used for the GP collimator. To cover a broad field of imaging applications three isotopes were used with various photon energies: (99m)Tc (140 keV), (111)In (171 and 245 keV) and (125)I (27 keV). Spatial resolution and reconstructed image uniformity were evaluated in both HR and a GP mode with hot rod phantoms, line sources and a uniform phantom. Point source sensitivity and contrast recovery measures were additionally obtained in the GP mode with a novel contrast recovery phantom developed in-house containing hot and cold submillimetre capillaries on a warm background. In hot rod phantom images, capillaries as small as 0.4 mm with the U-SPECT-II, 0.75 mm with the X-SPECT and 0.6 mm with the NanoSPECT-NSO could be resolved with the HR collimators for (99m)Tc. The NanoSPECT-NSO achieved this resolution in a smaller field-of-view (FOV) and line source measurements showed that this device had a lower axial than transaxial resolution. For all systems, the degradation in image resolution was only minor when acquiring the more challenging isotopes (111)In and (125)I. The point source sensitivity with (99m)Tc and GP collimators was 3,984 cps/MBq for the U-SPECT-II, 620 cps/MBq for the X-SPECT and 751 cps/MBq for the NanoSPECT-NSO. The effects of volume sensitivity over a larger object were evaluated by measuring the contrast recovery phantom in a realistic FOV and acquisition time. For 1.5-mm rods at a noise level of 8 %, the contrast recovery coefficient (CRC) was 42 %, 37 % and 34 % for the U-SPECT-II, X-SPECT and NanoSPECT-NSO, respectively. At maximal noise levels of 10 %, a CRCcold of 70 %, 52 % and 42 % were obtained for the U-SPECT-II, X-SPECT and NanoSPECT-NSO, respectively. When acquiring (99m)Tc with the GP collimators, the integral/differential uniformity values were 30 %/14 % for the U-SPECT-II, 50 %/30 % for the X-SPECT and 38 %/25 % for the NanoSPECT-NSO. When using the HR collimators, these uniformity values remained similar for U-SPECT-II and X-SPECT, but not for the NanoSPECT-NSO for which the uniformity deteriorated with larger volumes. We compared three μSPECT systems by acquiring and analysing mouse-sized phantoms including a contrast recovery phantom built in-house offering the ability to measure the hot contrast on a warm background in the submillimetre resolution range. We believe our evaluation addressed the differences in imaging potential for each system to realistically image tracer distributions in mouse-sized objects.

Quantitative 90Y image reconstruction in PET

Positron emission tomography (PET) imaging is increasingly used to confirm localization of (90)Y microspheres in the treatment of liver cancer. The aim of this work was to evaluate the quantification of (90)Y PET data on a current generation time-of-flight extended axial field-of-view PET∕CT camera. The International Electrotechnical Commission (IEC) body phantom was used to image six spheres of varying diameters containing a high concentration of (90)Y solution in a lower concentration background. Multiple PET studies were acquired of the phantom over a number of days during decay. The effect of reconstruction parameters in OSEM was evaluated both qualitatively and quantitatively. Expected values of total phantom activity, hot-sphere, and background concentration were compared to measured values from the reconstructed data as well as misplaced events in a cold insert. The partial volume effect was measured and the effects of time-of-flight during reconstruction on hot contrast recovery and background variability were evaluated according to NEMA-NU2-2007 protocol, and compared to that for (18)F. The method was applied to a patient study following radioembolization to estimate actual implanted radioactivity. Increasing the number of OSEM iterations visually deteriorated image data and resulted in a larger overall difference of hot concentration measures when considering both count high and count poor data. The average difference between measured and true total activity and background concentration was found to be +5% and +5%, respectively. Measured hot-sphere concentration was linear across all datasets, and while estimated to be within error of expected values, was consistently underestimated by an average of 23%, 12%, and 8%, when using a CT-derived, 50% threshold-derived, and 70% threshold-derived volume of interest, respectively. Partial volume effects were evident in all but the largest sphere, following an expected relationship between object size and recovery coefficient, inferior to that of (18)F. Time-of-flight improved contrast of hot-spheres but resulted in a deterioration of background variability, following a similar trend to that seen with (18)F. The patient data estimated a total implanted activity of 1643 MBq, compared to the intended dose of 1780 MBq, with a difference most likely due to residual and error in the initial dose calibration. Quantitative (90)Y PET with a state-of-the-art PET∕CT scanner with time-of-flight and standard corrections for photon interactions demonstrates consistent and acceptable measures of total activity and radionuclide concentration across a range of realistic count statistics. The method is suitable for measuring the radioactivity delivered at the time of (90)Y therapy with the potential for absorbed dose calculation.

Varicocele Retrograde Embolization with Boiling Contrast Medium and Gelatin Sponges in Adolescent Subjects: A Clinically Effective Therapeutic Alternative

Purpose Varicoceles occur in approximately 15% of adolescent male subjects and may impair future fertility. The present study describes a varicocele treatment technique involving percutaneous retrograde embolization with boiling hot contrast medium and gelatin sponge pledgets. Materials and Methods A retrospective review of medical records and imaging of all patients who underwent percutaneous retrograde varicocele embolization from 2005 to 2010 was performed. Pre- and postembolization symptoms, physical findings, and ultrasound findings were documented. Fifteen patients (16 embolizations) were identified, with an average age of 15.9 years (range, 12–18 y). Nine were referred because of persistent varicocele after surgical ligation. Three had grade 2 and nine had grade 3 varicoceles. Two had grade 1 varicoceles; one was painful and one was associated with poor semen quality. One varicocele was not clinically evident, but was associated with persistently decreased testicular size. Nine patients had pain or discomfort, and six had no discomfort. Clinical resolution was defined by a combination of symptom resolution and a lack of physical examination findings of varicocele or findings of treated varicocele. Results Fifteen of the 16 embolizations (94%) were technically successful. Clinical resolution was documented in 14 of 15 patients (95%); one patient experienced a recurrence at 30 months, which was successfully reembolized. One patient experienced temporary paresthesia of the left thigh. There were no major postprocedural complications. Mean follow-up duration was 11 months. Conclusions Retrograde embolization of varicoceles in adolescent subjects with the use of boiling hot contrast medium and gelatin sponges is a promising technique that appears effective.

Comparison of yttrium-90 quantitative imaging by TOF and non-TOF PET in a phantom of liver selective internal radiotherapy

The aim of this study is to determine the feasibility of achieving quantitative measurement in 90Y-microspheres liver selective internal radiotherapy (SIRT) by imaging 90Y with a conventional non-time of flight (TOF) PET device. Instead of the bremsstrahlung x-rays of the β-decay, the low branch of e−– e+ pair production in the 90Y-decay was used. The activity distribution in a phantom-simulated liver SIRT was obtained by direct 90Y-PET imaging. We tested a LYSO TOF PET and two GSO and BGO non-TOF PET scanners using a 3.6-l cylindrical phantom filled with the 90Y solution containing two sets of hot and cold spheres. The best hot contrast was obtained with the LYSO TOF. It was close to the expected value and remained constant, even for short acquisition times. The LYSO non-TOF was about 10% lower. The GSO performed similarly but degraded for shorter times whilst the BGO was the worst with 40% loss. For the cold spheres, the LYSO TOF and the GSO provided the best results, while the LYSO non-TOF and the BGO were the worst. 90Y PET imaging in liver SIRT is achievable with LYSO TOF. Conventional LYSO and GSO show a loss of contrast and require longer acquisition times. BGO imaging is not feasible for dosimetry calculation.

Physical Performance of the new hybrid PET/CT Discovery-690

The aim of this work was the assessment of the physical performance of the new hybrid PET∕CT system: Discovery-690. The Discovery-690 combines a lutetium-yttrium-orthosilicate (LYSO) block detector designed PET tomograph with a 64-slice CT scanner. The system is further characterized by a dedicated powerful computing platform implementing fully 3D-PET iterative reconstruction algorithms. These algorithms can account for time of flight (TOF) information and∕or a 3D model of the PET point spread function (PSF). PET physical performance was measured following NEMA NU-2-2007 procedures. Furthermore, specific tests were used: (i) to measure the energy and timing resolution of the PET system and (ii) to evaluate image quality, by using phantoms representing different clinical conditions (e.g., brain and whole body). Data processing and reconstructions were performed as required by standard procedures. Further reconstructions were carried out to evaluate the performance of the new reconstruction algorithms. In particular, four algorithms were considered for the reconstruction of the PET data: (i) HD = standard configuration, without TOF and PSF, (ii) TOF = HD + TOF, (iii) PSF = HD + PSF, and (iv) TOFPSF = HD + TOF + PSF. The transverse (axial) spatial resolution values were 4.70 (4.74) mm and 5.06 (5.55) mm at 1 cm and 10 cm off axis, respectively. Sensitivity (average between 0 and 10 cm) was 7.5 cps∕kBq. The noise equivalent count rate (NECR) peak was 139.1 kcps at 29.0 kBq∕ml. The scatter fraction at the NECR peak was 37%. The correction accuracy for the dead time losses and random event counts had a maximum absolute error below the NECR peak of 2.09%. The average energy and timing resolution were 12.4% and 544.3 ps, respectively. PET image quality was evaluated with the NEMA IEC Body phantom by using four reconstruction algorithms (HD, TOF, PSF, and TOFPSF), as previously described. The hot contrast (after 3 iterations and for a lesion∕background activity ratio of 4:1) for the spheres of 10, 13, 17, and 22 mm was (HD) 29.8, 45.4, 55.4, and 68.1%; (TOF) 39.9, 53.5, 62.7, and 72.2%; (PSF) 28.3, 47.3, 60.4, and 71.8%; (TOFPSF) 43.8, 62.9, 70.6, and 76.4%. The cold contrast for the spheres of 28 and 37 mm was (HD) 62.4 and 65.2%; (TOF) 77.1 and 81.4%; (PSF) 62.0 and 65.2%; (TOFPSF) 77.3 and 81.6%. Similar hot and cold contrast trends were found during the analyses of other phantoms representing different clinical conditions (brain and whole body). Nevertheless, the authors observed a predominant role of either TOF or PSF, depending on the specific characteristics and dimensions of the phantoms. Discovery-690 shows very good PET physical performance for all the standard NEMA NU-2-2007 measurements. Furthermore, the new reconstruction algorithms available for PET data (TOF and PSF) allow further improvements of the D-690 image quality performance both qualitatively and quantitatively.

Comparison of Different Types of Commercial Filtered Backprojection and Ordered-Subset Expectation Maximization SPECT Reconstruction Software

The aim of this study was to compare the performance of filtered backprojection (FBP) and ordered-subset expectation maximization (OSEM) reconstruction algorithms available in several types of commercial SPECT software. Numeric simulations of SPECT acquisitions of 2 phantoms were used: the National Electrical Manufacturers Association line phantom used for the assessment of SPECT resolution and a phantom with uniform, hot-rod, and cold-rod compartments. For FBP, no filtering and filtering of the projections with either a Butterworth filter (order 3 or 6) or a Hanning filter at various cutoff frequencies were considered. For OSEM, the number of subsets was 1, 4, 8, or 16, and the number of iterations was chosen to obtain a product number of iterations times the number of subsets equal to 16, 32, 48, or 64. The line phantom enabled us to obtain the reconstructed central, radial, and tangential full width at half maximum. The uniform compartment of the second phantom delivered the reconstructed mean pixel counts and SDs from which the coefficients of variation were calculated. Hot contrast and cold contrast were obtained from its rod compartments. For FBP, the full width at half maximum, mean pixel count, coefficient of variation, and contrast were almost software independent. The only exceptions were a smaller (by 0.5 mm) full width at half maximum for one of the software types, higher mean pixel counts for 2 of the software types, and better contrast for 2 of the software types under some filtering conditions. For OSEM, the full width at half maximum differed by 0.1-2.5 mm with the different types of software but was almost independent of the number of subsets or iterations. There was a marked dependence of the mean pixel count on the type of software used, and there was a moderate dependence of the coefficient of variation. Contrast was almost software independent. The mean pixel count varied greatly with the number of iterations for 2 of the software types, and the coefficient of variation increased with the number of iterations for all types of software. The mean pixel count, coefficient of variation, and contrast were almost constant for a fixed product number of iterations times the number of subsets, whatever the number of subsets or iterations. Most of the types of software were equivalent for FBP or OSEM reconstruction. However, a few differences were observed with some types of software and should be considered when they are used.

SPECT imaging of high energy isotopes and isotopes with high energy contaminants with rotating slat collimators

Quantitative SPECT imaging is limited by many factors, including penetration of high energy photons through the collimator. Even small peaks of high energy yield extensive contamination in the photopeak energy window. Rotating slat collimators typically offer a 40- to 50-fold increase in geometric detection efficiency compared to parallel hole collimators, while the amount of high-energy contamination is expected to remain the same. The aim of this study is to show that SPECT for isotopes with high energy peaks benefits from the use of a rotating slat collimator by significantly reducing the effect of high energy contamination. Monte Carlo simulations were performed for I-123 and I-131. The simulation of a single point source in a scattering medium was used to investigate the history of each detected photon both for the rotating slat and the parallel hole collimator. Next, realistic simulations of an image quality phantom in combination with iterative image reconstruction enabled us to study the gain in image quality which can be expected for the rotating slat collimator. The results show that the rotating slat collimator is able to reduce the contribution of high energy photons from about 60% to about 8% of all the detected photons in the photopeak energy window. This results in a recovered contrast gain of about 25%. For I-131, there was a reduction in contamination from 65% to 49% when using a rotating slat instead of a parallel hole collimator. This resulted in an average hot contrast improvement of 12% and average cold contrast improvement of 8% for tomographic images. Rotating slat collimators have an additional advantage regarding image quality for isotopes with high energy emissions, especially if the contamination arises from photons with energies higher than the main emission energy, due to the relatively lower number of measured collimator-penetrating photons with respect to geometrically collimated photons.

Optimization of time-of-flight reconstruction on Philips GEMINI TF

The aim of this study is to optimize different parameters in the time-of-flight (TOF) reconstruction for the Philips GEMINI TF. The use of TOF in iterative reconstruction introduces additional variables to be optimized compared to conventional PET reconstruction. The different parameters studied are the TOF kernel width, the kernel truncation (used to reduce reconstruction time) and the scatter correction method. These parameters are optimized using measured phantom studies. All phantom studies were acquired with a very high number of counts to limit the effects of noise. A high number of iterations (33 subsets and 3 iterations) was used to reach convergence. The figures of merit are the uniformity in the background, the cold spot recovery and the hot spot contrast. As reference results we used the non-TOF reconstruction of the same data sets. It is shown that contrast recovery loss can only be avoided if the kernel is extended to more than 3 standard deviations. To obtain uniform reconstructions the recommended scatter correction is TOF single scatter simulation (SSS). This also leads to improved cold spot recovery and hot spot contrast. While the daily measurements of the system show a timing resolution in the range of 590–600 ps, the optimal reconstructions are obtained with a TOF kernel full-width at half-maximum (FWHM) of 650–700 ps. The optimal kernel width seems to be less critical for the recovered contrast but has an important effect on the background uniformity. Using smaller or wider kernels results in a less uniform background and reduced hot and cold contrast recovery. The different parameters studied have a large effect on the quantitative accuracy of the reconstructed images. The optimal settings from this study can be used as a guideline to make an objective comparison of the gains obtained with TOF PET versus PET reconstruction.