Low-energy Collimator Research Articles

A 3-Dimensional Mathematic Cylinder Phantom for the Evaluation of the Fundamental Performance of SPECT

Degradation of SPECT images results from various physical factors. The primary aim of this study was the development of a digital phantom for use in the characterization of factors that contribute to image degradation in clinical SPECT studies. A 3-dimensional mathematic cylinder (3D-MAC) phantom was devised and developed. The phantom (200 mm in diameter and 200 mm long) comprised 3 imbedded stacks of five 30-mm-long cylinders (diameters, 4, 10, 20, 40, and 60 mm). In simulations, the 3 stacks and the background were assigned radioisotope concentrations and attenuation coefficients. SPECT projection datasets that included Compton scattering effects, photoelectric effects, and gamma-camera models were generated using the electron gamma-shower Monte Carlo simulation program. Collimator parameters, detector resolution, total photons acquired, number of projections acquired, and radius of rotation were varied in simulations. The projection data were formatted in Digital Imaging and Communications in Medicine (DICOM) and imported to and reconstructed using commercial reconstruction software on clinical SPECT workstations. Using the 3D-MAC phantom, we validated that contrast depended on size of region of interest (ROI) and was overestimated when the ROI was small. The low-energy general-purpose collimator caused a greater partial-volume effect than did the low-energy high-resolution collimator, and contrast in the cold region was higher using the filtered backprojection algorithm than using the ordered-subset expectation maximization algorithm in the SPECT images. We used imported DICOM projection data and reconstructed these data using vendor software; in addition, we validated reconstructed images. The devised and developed 3D-MAC SPECT phantom is useful for the characterization of various physical factors, contrasts, partial-volume effects, reconstruction algorithms, and such, that contribute to image degradation in clinical SPECT studies.

Residual brain viability, evaluated by 99mTc-ECD SPECT, in patients with suspected brain death and with confounding clinical factors

In 1968, the Harvard criteria for brain death diagnosis were introduced in clinical practice. These include no movements or breathing, no reflexes, and flat electroencephalogram in the absence of confounding factors, including hypothermia, drugs, electrolyte, and endocrine disturbances. When confounding factors occur, confirmatory tests documenting the absence of cerebral blood flow, such as cerebral angiogram, transcranial Doppler sonography, computed tomography angiography, and nuclear techniques, are required. The aim of this study was to evaluate the clinical value of single-photon emission computed tomography (SPECT) with technetium-99m (Tc)-ECD in the diagnosis of brain death in a cohort of patients with confounding factors. Fifty-two patients were studied between 1 January 2000 and 23 September 2008. The criteria for the request for Tc-ECD SPECT were sodic thiopental withdrawal after less than 24 h, unreceptivity and unresponsivity of brainstem reflexes, anesthesia in the last 24 h, hypothermia, anamnesis for barbiturate use, electroencephalogram artefacts, toxic state, and pediatric criteria. All patients underwent Tc-ECD SPECT using a dual-headed camera fitted with a high-resolution low-energy collimator. Images were reconstructed and processed according to standard procedures and interpreted qualitatively by two experienced observers. The presence of spots of residual brain viability was observed in 13 patients: 25% of our patient cohort. The patients with residual viability were younger (aged 30.92+/-17.28 years) in comparison with those with no viability (41.91+/-18.77 years, P<0.031). Considering the eligibility for transplantation, there were 12 of 13 patients in the residual viability group and 31 of 39 in the no viability group (P<0.0001). All patients with spots of brain uptake were monitored daily by Tc-ECD SPECT, and all of them reached the condition of empty skull after one or multiple studies. The opposition to organ donation was observed in six of 13 patients with spots of viable brain tissue and in three of 39 with no signs of residual viability (P<0.001). In patients with confounding factors in whom brain death diagnosis is equivocal, Tc-ECD SPECT is a helpful and safe diagnostic approach, allowing a three-dimensional evaluation of cortical and brainstem viability. It guarantees an unequivocal diagnosis of brain death for patients who are potential candidates for organ donation. The persistence of viable spots of brain tissue was found in 25% of our patients and was more frequent in young patients. This affects the opposition to donation.

Hot and cold contrasts in high-resolution Tc-99m planar scintigraphy: A survey of fifty-two camera heads using the PICKER thyroid phantom

This study was aimed at comparing the sensitivity and hot and cold contrasts obtained when imaging the PICKER thyroid phantom using gamma cameras fitted with either their ultra-high or high-resolution low-energy parallel hole collimator. Seventeen camera models from Elscint, General Electric, Siemens and Sopha Medical Vision were involved in the study for a total of 30 cameras and 52 camera heads. A single operator conducted the study in order to minimize the impact of human factors. The phantom contained about 74 MBq 99mTc and was imaged at 10 cm from the collimator face with the energy window that are recommended by the camera manufacturer. A total of 1 million counts were accumulated. Hot and cold contrasts were in mean of about 0.05 higher when using an ultra-high-resolution than when using a high-resolution low-energy collimator. This higher contrast was obtained at the expense of a mean reduction in sensitivity of 30%. In particular, Elscint cameras demonstrated a 30% lower sensitivity whatever the collimator type. The Sopha Medical Vision DST and DSX cameras and the General Electric Magicam camera offered the lowest contrasts among the cameras with a high-resolution collimator. Although this was accompanied by a higher than the mean sensitivity for the DST and DSX, the Magicam demonstrated sensitivity roughly identical to the mean of all the cameras with a high-resolution collimator.

Collimator optimization in SPECT based on a joint detection and localization task

In SPECT the collimator is a crucial element of the imaging chain and controls the noise-resolution tradeoff of the collected data. Optimizing collimator design has been a long studied topic, with many different criteria used to evaluate the design. One class of criteria is task based, in which the collimator is designed to optimize detection of a signal (lesion). Here we consider a new, more realistic task, the joint detection and localization of a signal. Furthermore, we use an ideal observer—one that attains a theoretically maximum task performance—to optimize collimator design. The ideal observer operates on the sinogram data. We consider a family of parallel-hole low-energy collimators of varying resolution and efficiency and optimize over this set. We observe that for a 2D object characterized by noise due to background variability and a sinogram with photon noise, the optimal collimator tends to be of lower resolution and higher efficiency than equivalent commercial collimators. Furthermore, this optimal design is insensitive to the tolerance radius within which the signal must be localized. So for this scenario, the addition of a localization task does not change the optimal collimator. Optimal collimator resolution gets worse as signal size grows, and improves as the level of background variability noise increases. These latter two trends are also observed when the detection task is signal-known-exactly and background variable.

A new imaging modality in detection of caustic oesophageal injury: Technetium-99m pyrophosphate scintigraphy

Early oesophagoscopy is usually recommended in children after caustic ingestion to assess the severity of the initial digestive lesions. An oesophagoscopic procedure in children always demands to be performed under sedation and bears a certain risk of iatrogenic injury. The purpose of the study is to determine the value and sensitivity of Tc-99m pyrophosphate (99mTc-PYP) scintigraphy for the detection of caustic oesophageal injury. The caustic oesophageal burns were created with 25% NaOH in an experimental rat model. Seventeen rats were divided into two groups. The BURN group (n=9) included caustic oesophageal burning rats. Non-BURN group (n=8) included sham-operated rats. All animals underwent 99mTc-PYP scintigraphy 72 h after the burning experiment. Anterior static and single-photon emission computed tomography images were obtained using a low-energy all-purpose collimator, 2.55 zoom factor, 3h after intravenous injection of 10 mCi 99mTc-PYP. After the imaging, all the oesophagi were explored for external determination of the injury sites and macroautoradiographic scintigraphy as well. Rectangular region of interest were placed in the visually determined lesion of oesophagus (O) as well as non-lesion area (N), and an ON ratio was created. The severity and extension of oesophageal burn were assessed 3 days after burning by histopathologic evaluation. The injuries were graded according to the ulcer depth, ulcer width, thrombus formation, and the development of perivascular fibrinoid necrosis. The oesophageal burning areas were demonstrated by visual evaluation of the Tc-99m PYP scintigraphy on all animals. The mean ON ratio of 99mTc-PYP was 21.61+/-7.01 in the BURN group and in the non-BURN group, was 2.25+/-0.24 (p<0.001). The best cut-off point of the ON ratio for caustic oesophageal injury was 5.45, with sensitivity and specificity of 100%. PYP scan findings were also confirmed by histological evidence of ulcer depth, ulcer width, thrombus formation, and perivascular fibrinoid necrosis in the same areas. The caustic oesophageal injuries have been demonstrated by 99mTc-PYP scintigraphy in burning experiment. 99mTc-PYP scintigraphy is sensitive for detection of caustic oesophageal injury. This new imaging tool is found to be sensitive and specific for the detection of caustic oesophageal injury in the rats.

シールド装着状態のシリンジ製剤を用いたエネルギースペクトル収集法の検討

I previously reported on a spectrum sampling method with shielded syringes before use, although the report included only data obtained using technetium-99m. In this study, we sampled the energy spectrum in a similar manner using thallium-201, iodine-123, and gallium-67. In spectrum sampling, a radioisotopic source in a cylindrical shield is located midway between two opposed gamma-camera detectors equipped with collimators. An unshielded syringe before use emits excessive radiation and makes count rates too high to obtain accurate photopeak values. With a shielded syringe, we can sample the spectrum of radiation leaked from the needle side of the syringe and the unshielded part of its plunger side. Consequently, the detectors are exposed to lower-dose gamma rays and probably offer count rates appropriate to measure accurate photopeak values. The study results show the general validity of spectrum sampling and photopeak acquisition in our method. However, a syringe should be located accurately perpendicular to each detector; otherwise, gamma rays did not reach the detectors in some cases, resulting in measurement failures. In addition, when low-energy collimators are used for sampling from (123)I sources, photopeak values depend on penetration. More accurate measurements require the use of high-energy collimators.

Standardization of the heart-to-mediastinum ratio of 123I-labelled-metaiodobenzylguanidine uptake using the dual energy window method: feasibility of correction with different camera–collimator combinations

Although the heart-to-mediastinum (H/M) ratio in a planar image has been used for practical quantification in (123)I-metaiodobenzylguanidine (MIBG) imaging, standardization of the parameter is not yet established. We hypothesized that the value of the H/M ratio could be standardized to the various camera-collimator combinations. Standard phantoms consisting of the heart and mediastinum were made. A low-energy high-resolution (LEHR) collimator and a medium-energy (ME) collimator were used. We examined multi-window correction methods with (123)I- dual-window (IDW) acquisition, and planar images were obtained with IDW correction and the LEHR collimator. The images were obtained using the following gamma camera systems: GCA 9300A (Toshiba, Tokyo), E.CAM Signature (Toshiba/Siemens, Tokyo) and Varicam (GE, Tokyo). Cardiac phantom studies demonstrated that contamination of the H/M count ratio was greater with the LEHR collimator and least with the ME collimator. The corrected H/M ratio with the LEHR collimator was similar to that with ME collimators. The uncorrected H/M ratio with the ME collimator was linearly related to the H/M ratio with IDW correction with the LEHR collimator. The relationship between the uncorrected H/M ratios determined with the LEHR (E.CAM) and the ME collimators was y = 0.56x + 0.49, where y = H/M ratio with the E.CAM and x = H/M ratio with the ME collimator. The average normal values for the low-energy collimator (n=18) were 2.2+/-0.2 (initial H/M ratio) and 2.42+/-0.2 (delayed H/M ratio), and for the low/medium-energy (LME) collimator (n=14) were 2.63+/-0.25 (initial H/M ratio) and 2.87+/-0.19 (delayed H/M ratio). H/M ratios in previous clinical studies using LEHR collimators are comparable to those with ME collimators. The IDW-corrected H/M ratios determined with the LEHR collimator were similar to those determined with the ME collimator. This finding could make it possible to standardize the H/M ratio in planar imaging among various collimators in the clinical setting.

Assessment of alveolar epithelial permeability in Behçet’s disease with 99mTc-DTPA aerosol scintigraphy

Behçet's disease (BD) is a multisystem disorder characterized by vasculitis, and consists of a triad of recurrent ulcers of the oral and genital mucosa with relapsing uveitis. The prevalance of pulmonary involvement varies in the range of 1-10% in various studies and its complications are severe and life threatening. In this study, we investigated the changes of pulmonary epithelial permeability of patients with BD using technetium-99m diethylene triamine penta-acetic acid ((99m)Tc-DTPA) aerosol scintigraphy, so as to begin the therapy regimen as soon as possible. Twenty-one nonsmoking patients with BD (8 women, 13 men; mean age 38.67 +/- 8.86 years) and 15 healthy volunteer nonsmoking controls (8 women, 7 men; mean age 50.87 +/- 12.45 years) underwent (99m)Tc-DTPA aerosol inhalation scintigraphy and pulmonary function tests (PFTs). Subjects inhaled 1480 MBq of (99m)Tc-DTPA for 4 min in the supine position. Scintigraphic data were recorded dynamically (1 frame/min) in the posterior projection on a 64 x 64 matrix for a 30-min period using a double-headed gamma camera (Infinia, GE, Tirat Hacarmel, Israel) equipped with a low-energy all-purpose parallel hole collimator. Half time of (99m)Tc-DTPA clearance (T (1/2)) was calculated by placing a mono-exponential fit on the curves. Penetration index (PI) was also calculated by dividing the peripheral total counts by the sum of the peripheral and central total counts on the first minute image, in order to quantify the distribution of the inhaled aerosol. The clearance half time of (99m)Tc-DTPA radioaerosols in the BD patients (24.81 +/- 6.22 min) was faster than in the normal control group (46.53 +/- 22.41 min) (P = 0.004). There was also a significant difference between PI of the patients with BD (0.15 +/- 0.03) and that of the controls (0.21 +/- 0.06) (P = 0.002). No correlation was found between the mean T (1/2) values of (99m)Tc-DTPA clearance or the spirometric measurements in the BD patients. Penetration indices were not correlated with PFT in the BD patients. Lung epithelial permeability of the patients with BD was significantly higher than that of the normal subjects. The results of this study demonstrated that the assessment of lung epithelial permeability using (99m)Tc-DTPA aerosol scintigraphy could predict the presence of lung involvement in the early stages of BD.

Evaluation of collimator choice and scatter correction on 123I SPECT images

Aim To compare the performance of low-energy (LE) and medium-energy (ME) collimators and the use of scatter correction on 123I SPECT images as assessed by visual inspection and semi-quantitative analysis. Materials and methods Both brain and heart/thorax phantoms were used to evaluate the effects of collimator selection and correction methods on brain and cardiac 123I imaging. Experiments were performed to measure the target-to-background ratio for calculation of object contrast. The projection data were corrected using X-ray-based attenuation maps for attenuation correction (AC) and dual-energy window method for scatter correction (SC). Reconstructed images using different methods were compared, which included FBP (filtered backprojection), and OSEM (ordered subsets expectation maximization) without any correction, with AC, with SC, and with AC and SC. Results In both phantom studies, the image contrasts provided by the ME collimator were better than that of the LE collimator. The OSEM with simple dual-energy window SC method improved image contrast and visual image quality as compared to the FBP method. The use of AC improved the visual image quality but did not improve image contrast, if SC method was not implemented at the same time. Conclusions This study demonstrates the importance of SC and ME collimator in 123I SPECT imaging. If image contrast is the figure of merit, then SC should be performed and the use of the ME collimator appears to be preferable in semi-quantitative 123I SEPCT studies.

25 Quantitative analysis of a cardiac I-123??? MIBG scan must use a scatter correction when using a low-energy collimator

Fletcher, A.M.1; Motherwell, D.W.2; McCurrach, G.1; Small, A.D.1; Martin, W.1; Cobbe, S.M.2 Author Information

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Downscatter correction and choice of collimator in 123I imaging

123I imaging is increasingly used in nuclear medicine but downscatter from high (>300 keV) energy emissions degrades the image and introduces variation in sensitivity with depth when imaging with a low energy collimator. A dual windowing technique using a matched window immediately above the principle window to correct for the effects of downscatter is described. The technique is shown to correct for the variation in sensitivity with depth and to reduce outlying scatter. Quantitative imaging of 123I using a low energy collimator should always employ downscatter correction.

Effect of four sedative and anesthetic protocols on quantitative thyroid scintigraphy in euthyroid cats

To determine the effect of sedation and anesthesia on thyroid and salivary gland uptake of technetium Tc 99m pertechnetate ((99m)TcO(4)) in euthyroid cats. 6 euthyroid cats. Thyroid scintigraphy was performed by use of a high-resolution low-energy parallel-hole collimator after IV injection of 117 to 133 MBq (3.16 to 3.59 mCi) of (99m)TcO(4)(-). The procedure was performed 4 times on each cat during different sedative and anesthetic protocols in a rotating schedule as follows: propofol, ketamine-midazolam-atropine, ketaminemidazolam, and medetomidine. Regions of interest were drawn around thyroid and salivary glands and counts corrected for background and decay. Percentage of (99m)TcO(4)(-) uptake in salivary and thyroid glands and thyroid-to-salivary gland (99m)TcO(4)(-) uptake ratio were calculated at 20 and 40 minutes. Relative effects of anesthesia and sedation on salivary and thyroid gland (99m)TcO(4)(-) uptake were compared. Significant differences among sedativeanesthetic protocols were found for thyroid gland (99m)TcO(4)(-) uptake, salivary gland (99m)TcO(4)(-) uptake, and thyroid-to-salivary gland (99m)TcO(4)(-) uptake ratio. Thyroid gland (99m)TcO(4)(-) uptake for the ketamine-midazolam protocol at 20 and 40 minutes after (99m)TcO(4)(-) administration was significantly higher than for the propofol protocol. A significant difference in salivary gland(99m) TcO(4)(-) uptake was found between ketamine-midazolam and ketamine-midazolam-atropine protocols at 40 minutes. The thyroid-to-salivary gland (99m)TcO(4)(-) uptake ratio for the ketamine-midazolam protocol was significantly higher at 40 minutes than for propofol or ketamine-midazolam-atropine protocols. Sedation and anesthesia have a significant effect on thyroid and salivary gland (99m)TcO(4) uptake in euthyroid cats that may interfere with thyroid scintigraphic image interpretation.

THYROID TO SALIVARY RATIOS DETERMINED BY TECHNETIUM‐99MPERTECHNETATE IMAGING IN THIRTY‐TWO EUTHYROID CATS

Thyroid to salivary (TS) ratio is the most commonly used scintigraphic parameter for differentiating euthyroid and hyperthyroid cats. Studies to determine the normal TS ratio have been performed in small cat populations. In this study, the TS ratio was determined in 32 cats between 8 and 13 years of age. The study population was documented to be euthyroid based on normal initial and 6-week follow-up serum thyroid concentrations and normal T3 suppression tests. All images were obtained with a low-energy all-purpose collimator between 20 and 40 min after the injection of approximately 111 MBq (3.0 mCi) pertechnetate. Manual regions of interest (ROI) were made of the thyroid and salivary glands of the ventral image A 95% prediction interval based on the natural log of the TS ratio was computed to provide a normal range of 0.48-1.66. This range is similar to previous studies, but suggests a slightly higher upper limit than previously reported.

The Radiosynthesis of [2- 18F] Fluorodeoxyglucose Using a Resin Bound Precursor

cluding most recently 8 female ApcMin/ mice. Anesthetized mice were scanned for up to 60 days post injection in a modified Bioscan AR2000 radio-TLC scanner and an ImTek microCT scanner for anatomic comparison and image fusion analysis. Anesthetized rats, on the other hand, were imaged on a mobile clinical gamma camera equipped with a with low energy collimator. At sacrifice, tissues were imaged ex vivo, lesions were excised, weighed, and radioactivity quantitated. Lesion samples were submitted for histologic classification.

Sentinel node detection in patients with breast cancer: low-energy all-purpose collimator or medium-energy collimator?

Sentinel node detection in patients with breast cancer: low-energy all-purpose collimator or medium-energy collimator?

Sentinel node detection in patients with breast cancer: low-energy all-purpose collimator or medium-energy collimator?

Sentinel node detection in patients with breast cancer: low-energy all-purpose collimator or medium-energy collimator?

Transmission imaging with a moving point source: influence of crystal thickness and collimator type

Nonuniform patient attenuation maps can be acquired using an axially moving point source of a high energy isotope that emits a fanbeam of photons. We simulated the Beacon attenuation correction tool attached to multiheaded Single Photon Emission Computed Tomography (SPECT) cameras which uses this approach. We investigated the scatter order of the photons reaching the detector, and the scatter contributions from the different detector components were evaluated for different energy windows. In case of simultaneous emission and transmission scanning the spatial signals are electronically windowed to allow differentiation between photons from the attenuation and from the emission source. However, an additional correction needs to be applied for cross-contamination. When applying the Beacon device in hybrid mode [gammacamera-Positron Emission Tomography (PET)] there are no degrees of freedom for crystal and collimator. The inter-window contamination was thus examined in detail to derive possible protocol optimizations for that dedicated setup. For the case of applying Beacon-SPECT, we performed multiple types of simulations including different crystal thicknesses and different collimators to evaluate the inter-window contamination. The main conclusion of this work is that a thick crystal detector coupled to a Low Energy High Resolution (LEHR) collimator is the best solution for acquiring attenuation maps in low energy applications. For medium energy studies attenuation maps have to be rescaled to account for the low sensitivity near the center of the patient. Fully Monte Carlo simulating the system matrix for medium energy studies on low energy collimators in order to replace the Medium Energy General Purpose (MEGP) collimators by the LEHR variants appeared to be a more valuable approach. This last method is penalized by a computational burden but results in an improved image quality after reconstruction.

Gastroesophageal scintigraphy in children: A comparison of posterior and anterior imaging

The purpose of this study was to compare the posterior dynamic imaging with the anterior imaging in the evaluation of children with gastroesophageal reflux (GER). Sixty-eight children (26 female, 42 male; age range 4 months to 7 years, median 21 months) were studied. After 4-hour fasting, all the subjects underwent gastroesophageal scintigraphy. Synchronous dynamic imaging in the anterior and posterior projections was performed with the subject in the supine position with a dual-head gamma camera equipped with low-energy general-purpose collimators at a rate of 30 s/frame for 40 min. The anterior and posterior images were visually evaluated for the presence of gastroesophageal reflux by two nuclear medicine physicians. The anterior and posterior images were correlated by Pearson correlation analysis, and inter-observer variability was evaluated by paired t-test and kappa value. There was a good correlation between the two projections with r-values of 0.906-0.990. The inter-observer agreement for interpretation of the anterior and posterior imaging was excellent (k: 0.83). In conclusion, anterior and posterior dynamic imaging showed excellent correlation in detection of GER in children. Posterior imaging is superior to anterior imaging in that it is more comfortable, and it reduces motion artifacts, especially for infants and anxious children; thus, it may be preferred over anterior imaging.

Planar image quality comparison between a CdZnTe prototype and a standard NaI(Tl) gamma camera

A CdZnTe prototype was evaluated along with a standard NaI(Tl) gamma camera for planar imaging performance. A 12×20cm2 CdZnTe gamma camera comprised of 15 Imarad modules and a 3/8-in. thick NaI(Tl) gamma camera were used. A 2D brain slice phantom filled with 110MBq of 99mTc pertechnetate was imaged at varying count densities (1kCt–1MCt) and distances (0–20cm) on both camera systems. An ultra-high resolution, low-energy collimator was used for both cameras. A 15% energy window was centered on 140keV. CdZnTe count sensitivity was 71% of NaI(Tl) in the 15% energy window. Qualitatively, the CdZnTe images have superior spatial resolution and contrast. The advantage in intrinsic resolution of CdZnTe, combined with the ultra-high resolution collimator, gives the new detector a superior line spread function which accounts for the observed image quality improvement over NaI(Tl) for this planar imaging application.