Low-energy High-resolution Collimator Research Articles

Comparison of low energy and medium energy collimators in the quantitative assessment of 123I-MIBG cardiac sympathetic innervation imaging

Abstract Funding Acknowledgements Type of funding sources: Public hospital(s). Main funding source(s): University Clinic Hospital of Valencia Aim The assessment of cardiac sympathetic innervation by 123I-metayodobenzylguanidine (123I-MIBG) has proved useful in patients with heart failure and neurodegenerative disorders. The standard quantification of global cardiac uptake is to obtain the heart to mediastinum (HM) ratio in planar images, while SPECT images provide better evaluation of regional extent of denervated areas. Although low energy (LE) collimator has been widely used in these patients, septal penetration of high-energy photons of 123I could affect image quality and quantification accuracy. We have compared in the same patients the effect of collimator type on image quality and quantitative assessment of HM ratio. Methods In a group of 14 patients (11 men, 57-77 y/o, 66.4 ± 5.6) submitted for cardiac sympathetic study, we obtained successive planar anterior chest images 4h after the IV administration of 10 mCi of 123I-MIBG with a low-energy-high-resolution (LEHR) and a medium-energy (ME) collimators. Images were obtained with the same gammacamera Brightview Philips for 10 min on 256x256 matrix, with 159 Kev photopeak and unchanged patient position. For quantification of HM ratio, we use in each patient the same manual heart ROI and rectangular upper mediastinum ROI in the two acquired images to obtain the corresponding HM ratio. Results The image quality was better in all the patients with ME collimator acquisition than with LEHR collimator acquisition, and the HM ratio showed higher values with ME: 1.65-2.61 (mean 2.15 ± 0.28) than with LEHR: 1.27-1.85 (mean: 1.51 ± 0.18) with a mean difference of 0.64 ± 0.15 (0.38-0.88) between ME and LEHR and a mean ratio LEHR/ME of 0.70 ± 0.04 (0.64-0.79). In 9 patients with HM ratio ≤ 1.60 obtained from LEHR collimator acquisition, the mean difference with HM ratio obtained with ME collimator was 0.61 ± 0.12 and mean ratio LEHR/ME was 0.69 ± 0.03 and in 5 patients with HM ratio(LEHR) >1.60, mean difference with HM ratio(ME) was 0.69 ± 0.19 and mean ratio LEHR/ME was 0.71 ± 0.02. Conclusion Use of a ME collimator provides better image quality than LEHR collimator in planar images and higher values of HM ratio, providing a more accurate quantification of cardiac uptake in the patients submitted for evaluation of cardiac sympathetic innervation by 123I-MIBG, and could also improve the evaluation of regional impairment and extent of denervated areas by SPECT.

Lessons learned from 15-year of radionuclide bone scan in cancer context at Yaoundé General Hospital (Cameroon) (+ Running poster)

In our setting, patients come lately to cancer treatment centres. The introduction of radionuclide scan in 2004 has had a great contribution to the diagnosis of bone metastases. To take stock of fifteen years of bone exploration in cancer context in our setting. A 15-year retrospective study with 1278 patients who performed each a radionuclide bone scan for different cancers, from 2004 to 2019 in our national reference centre. All 99mTc-MDP bone scans were performed on a Siemens® gamma-camera with a low energy high-resolution collimator. Collected data were analysed using SPSS® software with significant P -value < 0.05. Ages ranged from 15 to 92 years with a mean of 55.9 ± 15.9 and a 1.34 sex ratio. The modal age group was 50 to 70 years (39.36%). The major cancers were prostate (49.68%), breast (31.77%) and cervix (5.16%) cancers. The average duration since the diagnosis of cancer was 25.7 months. Positive bone scans accounted for 40.77% and the presence of bone metastases revealed an unknown cancer in 9.79%. The main affected sites were chest (79.27%), spine (78.31%) and pelvis (71.01%). In 26.49% of positive cases, there was no clinical sign of bone disease. According to Soloway and SWOG's classifications, the prognosis was poor in 70.06% and 66.22%, respectively. Prostate cancer was the most pejorative and cervix cancer was the one with the best prognosis ( P = 0.0014). Bone metastases are present in almost half of cases of cancers, even in absence of clinical signs. Axial bones, mainly chest, spine and pelvis, are the preferential sites. Ten percent of cancers are revealed by bone metastases. In 2/3 of cases, the prognosis is pejorative, especially for prostate cancer. We recommend that clinicians become more aware of the systematic search of bone extension as soon as the cancer is diagnosed.

Evaluation of different CT maps for attenuation correction and segmentation in static 99m Tc-MAA SPECT/CT for 90 Y radioembolization treatment planning: A simulation study.

Conventional 99m Tc-macroaggregated albumin (99m Tc-MAA) planar scintigraphy overestimates lung shunt fraction (LSF) compared to SPECT/CT. However, the respiratory motion artifact due to the temporal mismatch between static SPECT and helical CT (HCT) may compromise the SPECT quantitation accuracy by incorrect attenuation correction (AC) and volume-of-interest (VOI) segmentation. This study aims to evaluate AC and VOI segmentation effects systematically and to propose a CT map for LSF and tumor-to-normal liver ratio (TNR) estimation in static 99m Tc-MAA SPECT/CT. The 4D XCAT phantom was used to simulate a phantom population of 120 phantoms, modeling 10 different anatomical variations, nine TNRs (2-13.2), nine tumor sizes (2-6.7cm diameter), eight tumor locations, three axial motion amplitudes of 1, 1.5, and 2 (cm), and four LSFs of 5%, 10%, 15%, and 20%. An analytical projector for low-energy high-resolution parallel-hole collimator was used to simulate 60 noisy projections over 360°, modeling attenuation and geometric collimator-detector response (GCDR). AC and VOI mismatch effects were investigated independently and together, using cine average CT (CACT), HCT at end-inspiration (HCT-IN), mid-respiration (HCT-MID), and end-expiration (HCT-EX) respectively as attenuation and segmentation maps. SPECT images without motion, AC, and VOI errors were also generated as reference. LSF and TNR errors were measured as compared to the ground truth. HCT-MID has slightly better performance for AC effect compared with other CT maps in LSF and TNR estimation, while HCT-EX and HCT-MID perform better for VOI effect. For a respiratory motion amplitude of 1.5cm and a LSF of 5%, the LSF errors are 19.56±4.58%, -6.79±1.74%, 77.29±14.74%, and 111.25±18.29% corresponding to HCT-MID, HCT-EX, HCT-IN, and CACT in static SPECT. The TNR errors are -12.38±6.42%, -20.55±11.25%, -20.89±9.98%, and -22.89±14.38% respectively. HCT-MID has the best performance for LSF estimation for LSF>10% and TNR estimation, followed by HCT-EX, HCT-IN, and CACT. The HCT-MID is recommended for AC and segmentation to alleviate respiratory artifacts and improve quantitation accuracy in 90 Y radioembolization treatment planning. HCT-EX would also be a recommended choice if HCT-MID is not available.

Performance of SwiftScan planar and SPECT technology using low-energy high-resolution and sensitivity collimator compared with Siemens SPECT system.

A new low-energy high-resolution-sensitivity (LEHRS) collimator was developed by General Electric (GE) Healthcare. SwiftScan planar and single photon emission computed tomography (SPECT) systems using LEHRS collimator were developed to achieve the low-dose and/or short-time acquisition. We demonstrated the performance of SwiftScan planar and SPECT system with LEHRS collimator using phantoms. Line source, cylindrical and flat plastic dish phantoms were used to evaluate the performance of planar and SPECT images for four patterns of Siemens LEHR, GE LEHR, GE LEHRS and SwiftScan using two SPECT-CT scanners. Each phantom was filled with 99mTc solution, and the spatial resolution, sensitivity and image uniformity were calculated from the planar and SPECT data. The full-width at half maximum (FWHM) values as a system spatial resolution of Siemens LEHR, GE LEHR and GE LEHRS were approximately 7.4 mm. GE LEHRS showed a lower FWHM value by increasing the blend ratio in Clarity2D processing. The system sensitivity of GE LEHRS increased by approximately 30% compared with that of GE LEHR and was similar to that of Siemens LEHR. The FWHM values of SPECT with an filtered back projection (FBP) method were approximately 10.3 mm. The FWHM values of the ordered subset expectation maximization (OSEM) method were better with an increase in iteration values. The differential uniformities of Siemens LEHR, GE LEHR, GE LEHRS and GE SwiftScan using the FBP method were approximately 15.1%. The differential uniformity of OSEM method was higher with an increase in the iteration value. The SwiftScan planar and SPECT have a high sensitivity while maintaining the spatial resolution compared with the conventional system.

Clinical validation of time reduction strategy in continuous step-and-shoot mode during SPECT acquisition

BackgroundThe SwiftScan solution (General Electric Healthcare) combines a new low-energy high-resolution sensitivity collimator and a tomographic step-and-shoot continuous (SSC) mode acquisition. The purpose of this study is to determine whether SSC mode can be used in clinical practice with shorter examination times, while preserving image quality and ensuring accurate semi-quantification. Twenty bone scan and 10 lung scan studies were randomly selected over a period of 2 months. Three sets of image datasets were produced: step-and-shoot (SS) acquisition, simulated 25% count reduction using the Poisson resampling method (SimSS), and SimSS continuous acquisition (SimSSC), where SimSS was summed with counts acquired during detector head rotation. Visual assessment (5-point Likert scale, 2 readers) and semi-quantitative evaluation (50 focal uptake from 10 bone studies), assessed by SUVmean, coefficient of variation (COV), and contrast-to-noise ratio (CNR), were performed using t test and Bland-Altman analysis.ResultsIntra-reader agreement was substantial for reader 1 (k = 0.71) and for reader 2 (k = 0.61). Inter-reader agreement was substantial for SS set (k = 0.93) and moderate for SimSSC (k = 0.52). Bland-Altman analysis showed a good interchangeability of SS and SimSSC SUV values. The mean CNR between SS and SimSSC was not significantly different: 42.9 ± 43.7 [23.7–62.1] vs. 43.1 ± 46 [22.9–63.3] (p = 0.46), respectively. COV values, assessing noise level, did not deviate significantly between SS and SimSSC: 0.20 ± 0.08 [0.18–0.23] vs. 0.21 ± 0.08, [0.18–0.23] (p = 0.15), respectively, whereas a significant difference was demonstrated between SS and SimSS: 0.20 ± 0.08 [0.18–0.23] vs. 0.23 ± 0.09 [0.20–0.25] (p < 0.0001), respectively.ConclusionsSSC mode acquisition decreases examination time by approximately 25% in bone and lung SPECT/CT studies compared to SS mode (~ 2 min per single-bed SPECT), without compromising image quality and signal quantification. This SPECT sensitivity improvement also offers the prospect of more comfortable exams, with less motion artifacts, especially in painful or dyspneic patients.

The usefulness of SwiftScan technology for bone scintigraphy using a novel anthropomorphic phantom

The aim of this study was to demonstrate the usefulness of SwiftScan with a low-energy high-resolution and sensitivity (LEHRS) collimator for bone scintigraphy using a novel bone phantom simulating the human body. SwiftScan planar image of lateral view was acquired in clinical condition; thereafter, each planar image of different blend ratio (0–80%) of Crality 2D processing were created. SwiftScan planar images with reduced acquisition time by 25–75% were created by Poisson’s resampling processing. SwiftScan single photon emission computed tomography (SPECT) was acquired with step-and-shoot and continuous mode, and SPECT images were reconstructed using a three-dimensional ordered subset expectation maximization incorporating attenuation, scatter and spatial resolution corrections. SwiftScan planar image showed a high contrast to noise ratio (CNR) and low percent of the coefficient of variance (%CV) compared with conventional planar image. The CNR of the tumor parts in SwiftScan SPECT was higher than that of the conventional SPECT image of step and shoot acquisition, while the %CV showed the lowest value in all systems. In conclusion, SwiftScan planar and SPECT images were able to reduce the image noise compared with planar and SPECT image with a low-energy high-resolution collimator, so that SwiftScan planar and SPECT images could be obtained a high CNR. Furthermore, the SwiftScan planar image was able to reduce the acquisition time by 25% when the blend ratio of Clarity 2D processing set to more than 40%.

SPECT performance evaluation on image of Yttrium 90 - Bremsstrahlung using Monte Carlo simulation

Yttrium-90 (90Y) is one of the most widely used radionuclides in Nuclear Medicine practice. However, characteristic energy of this beta emitter constitutes a difficulty for dose planning using SPECT imaging. This work aimed to study bremsstrahlung X-rays effects produced by 90Y beta particles during SPECT image acquisition using Monte Carlo code MCNPX. Several simulations were carried out to evaluate different aspects that could affect SPECT image quality, such as: collimator type, source-collimator distance and composition of each interacting material. Two configurations of 90Y sources were simulated: a point source in several spheres of different materials (soft tissue, water, articular cartilage, and bone) and dimensions with radius ranging from 1 to 20 mm; and a uniformly distributed source in a Lucite cylindrical phantom filled with water. It was evaluated the bremsstrahlung photon emission generated inside different materials; for this was considered the number photons that passing through every different sphere's surface for each radii and material. In case of cylindrical phantom filled with water, in order to obtain the energy deposited over NaI (Tl) crystal detector; there was considered Median Energy General Purpose (MEGP) and Low Energy High Resolution (LEHR) collimators. Moreover, using TMESH routine available in the MCNPX Monte Carlo code, energy distribution images according to the collimator type and the source-collimator distance were obtained. The simulation was validated by comparing with the spectral distribution of the 90Y bremsstrahlung X-rays obtained experimentally from an acrylic cylindrical phantom. Results corroborated the importance of Monte Carlo simulation method to evaluate a performance of SPECT image acquisition with 90Y. The best resolution was obtained with MEGP collimator independent of source-collimator distance.

Collimator and Energy Window Evaluation in Ga-67 Imaging by Monte Carlo Simulation

Objectives:Gallium-67 (Ga-67) imaging is affected by collimator penetration and scatter components owing to the high-energy (HE) gamma-ray emissions. The characterization of penetration and scatter distribution is essential for the optimization of low-energy high-resolution (LEHR), medium energy (ME), and HE collimators and for the development of an effective correction technique. We compared the image quality that can be achieved by 3 collimators for different energy windows using the SIMIND Monte Carlo code.Methods:Simulation experiments were conducted for LEHR, ME, and HE collimators for Ga-67 point source placed at 12-cm distance from the detector surface using the Monte Carlo SIMIND simulation code. Their spectra point spread functions as well as the original, penetration, scattering, and X-rays curves were drawn and analyzed. The parameters full-width at half maximum and full-width at tenth maximum were also investigated.Results:The original, penetration, and scatter curves within 10% for LEHR were 34.46%, 33.52%, 17.29%, and 14.72%, respectively. Similarly, the original, penetration, scatter, and X-rays within 10% for ME and HE were 83.06%, 10.25%, 6.69%, and 0% and 81.44%, 11.51%, 7.05%, and 0%, respectively. The trade-off between spatial resolution and sensitivity was achieved by using the ME collimator at 185 photopeak of Ga-67.Conclusion:The Monte Carlo simulation outcomes can be applied for optimal collimator designing and for the development of new correction method in Ga-67 imaging.

Agreement between left ventricular ejection fraction assessed in patients with gated IQ-SPECT and conventional imaging

BackgroundThe aim of the study was to assess the agreement between the left ventricular ejection fraction (LVEF) values obtained with IQ-SPECT and those obtained with a conventional gamma camera equipped with low-energy high-resolution (LEHR), considered as the method of reference. MethodsGated-stress MPI using 99mTc-tetrofosmin was performed in 55 consecutive patients. The patients underwent two sequential acquisitions (Method A and B) performed on Symbia-IQ SPECT with different acquisition times and one (Method C) on a Ecam SPECT equipped with LEHR collimators. The values of the different datasets were compared using the Bland-Altman analysis method: the bias and the limits of agreement (LA) were estimated in a head-to-head comparison of the three protocols. ResultsIn the (Method A-Method C) comparison for LVEF, the bias was 3.8% and the LAs ranged from − 9.3% to 16.8%. The agreement was still lower between Method B and C, whilst only slightly improved when Methods A and B were compared. ConclusionsThe wide amplitude in LA intervals of about 30% indicates that IQ and LEHR GSPECT are not interchangeable. The values obtained with IQ-SPECT should only be used with caution when evaluating the functional state of the heart.

Establishment of a clinical SPECT/CT protocol for imaging of 161Tb

BackgroundIt has been proposed, and preclinically demonstrated, that 161Tb is a better alternative to 177Lu for the treatment of small prostate cancer lesions due to its high emission of low-energy electrons. 161Tb also emits photons suitable for single-photon emission computed tomography (SPECT) imaging. This study aims to establish a SPECT protocol for 161Tb imaging in the clinic.Materials and methodsOptimal settings using various γ-camera collimators and energy windows were explored by imaging a Jaszczak phantom, including hollow-sphere inserts, filled with 161Tb. The collimators examined were extended low-energy general purpose (ELEGP), medium-energy general purpose (MEGP), and low-energy high resolution (LEHR), respectively. In addition, three ordered subset expectation maximization (OSEM) algorithms were investigated: attenuation-corrected OSEM (A-OSEM); attenuation and dual- or triple-energy window scatter-corrected OSEM (AS-OSEM); and attenuation, scatter, and collimator-detector response-corrected OSEM (ASC-OSEM), where the latter utilized Monte Carlo-based reconstruction. Uniformity corrections, using intrinsic and extrinsic correction maps, were also investigated. Image quality was assessed by estimated recovery coefficients (RC), noise, and signal-to-noise ratio (SNR). Sensitivity was determined using a circular flat phantom.ResultsThe best RC and SNR were obtained at an energy window between 67.1 and 82.1 keV. Ring artifacts, caused by non-uniformity, were removed with extrinsic uniformity correction for the energy window between 67.1 and 82.1 keV, but not with intrinsic correction. Analyzing the lower energy window between 48.9 and 62.9 keV, the ring artifacts remained after uniformity corrections. The recovery was similar for the different collimators when using a specific OSEM reconstruction. Recovery and SNR were highest for ASC-OSEM, followed by AS-OSEM and A-OSEM. When using the optimized parameter setting, the resolution of 161Tb was higher than for 177Lu (8.4 ± 0.7 vs. 10.4 ± 0.6 mm, respectively). The sensitivities for 161Tb and 177Lu were 7.41 and 8.46 cps/MBq, respectively.ConclusionSPECT with high resolution is feasible with 161Tb; however, extrinsic uniformity correction is recommended to avoid ring artifacts. The LEHR collimator was the best choice of the three tested to obtain a high-resolution image. Due to the complex emission spectrum of low-energy photons, window-based scatter correction had a minor impact on the image quality compared to using attenuation correction only. On the other hand, performing attenuation, scatter, and collimator-detector correction clearly improved image quality. Based on these data, SPECT-based dosimetry for 161Tb-labeled radiopharmaceuticals is feasible.

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.

Impact of Collimator on DaT-SPECT Imaging: Monte Carlo Simulation Study

Aim: The purpose of this study was to assess the impact of the collimator in viewing the dopamine transporter, using 123I ioflupane single-photon emission computed tomography (DaT-SPECT) images utilizing a Monte Carlo simulation. Methods: For the purpose of this study, the Monte Carlo simulation of electrons and photons (MCEP)- SPECT was used. A numerical phantom was created from a real basal ganglia phantom and installed within the code. The specific binding ratios (SBRs) were 5.03 and 2.01 for the background concentration of 7.44 kBq/mL or 7.04 and 3.03 for a background concentration of 5.56 kBq/mL. The simulated images were evaluated using a recovery coefficient (RC). Initially, we simulated the performance of 14 collimators without resolution correction to investigate the impact of the collimator dimension. The effects of two resolution correction methods (collimator broad correction (CBC) and three-dimensional frequency– distance relationship (3D-FDR)) on two reconstruction methods (Ordered-Subsets Expectation Maximization (OSEM) and Filtered back projection (FBP)) was assessed for collimators that demonstrated a better RC value. Results: Five low-energy high-resolution (LEHR) collimators and one medium-energy general-purpose (MEGP) collimator demonstrated superior RC values. These collimators had a high aspect ratio (holelength/hole-diameter). The maximum RC value without resolution correction was 64.9% when the image was reconstructed with OSEM. The RC value improved to 79.7% when the resolution correction of CBC was applied. When the resolution collection was applied, the RCs improved by approximately 1.2 times when compared against those without the resolution correction. In terms of the reconstruction method, the RC obtained using OSEM was statistically insignificant when compared to the RC using FBP. The difference in the RC value with collimators decreased according to resolution correction. Conclusion: The LEHR collimator with a high aspect ratio, and the OSEM with spatial resolution correction were confirmed to be appropriate for DaT-SPECT imaging. In terms of the reconstruction method, CBC was more favourable than FDR.

Optimization of Scatter Correction Method in Samarium-153 Single-photon Emission Computed Tomography using Triple-Energy Window: A Monte Carlo Simulation Study.

Purpose:In single-photon emission computed tomography imaging, the presence of scatter degrades image quality. The goal of this study is to optimize the main- and sub-energy windows for triple-energy window (TEW) method using Monte Carlo SImulating Medical Imaging Nuclear Detectors (SIMIND) code for samarium-153 (Sm-153) imaging.Materials and Methods:The comparison is based on the Monte Carlo simulation data with the results estimated using TEW method. Siemens Symbia gamma-camera equipped with low-energy high-resolution collimator was simulated for Sm-153 point source located in seven positions in water cylindrical phantom. Three different main-energy window widths (10%, 15%, and 20%) and three different sub-energy window widths (2, 4, and 6 keV) were evaluated. We compared the true scatter fraction determined by SIMIND and scatter fraction estimated using TEW scatter correction method at each position. In order to evaluate the image quality, we used the full width at half maximum (FWHM) computed on the PSF and image contrast using Jaszczak phantom.Results:The scatter fraction using TEW method is similar to the true scatter fraction for 20% of the main-energy window and 6 keV sub-energy windows. For these windows, the results show that the resolution and contrast were improved.Conclusion:TEW method could be a useful scatter correction method to remove the scatter event in the image for Sm-153 imaging.

Energy Window and Collimator Optimization in Lutetium-177 Single-photon Emission Computed Tomography Imaging using Monte Carlo Simulation.

Introduction:In lutetium-177 (Lu-177) single-photon emission computed tomography (SPECT) imaging, the accuracy of activity quantification is degraded by penetrated and scattered photons. We assessed the scattered photon fractions in order to determine the optimal situation and development of correction method. This study proposes to compare the image quality that can be achieved by three collimators.Materials and Methods:Siemens Medical System Symbia fitted with high-energy (HE), medium-energy (ME), and low-energy high-resolution collimators was simulated using the SIMIND Monte Carlo code simulation code. Counts were collected in three different main-energy window widths (20%, 15%, and 10%) for Lu-177 point source. Primary and scattered point spread functions and also geometric, penetration, scattering were drawn and analyzed.Results:In Lu-177 imaging, a 20% of main-energy window and ME collimator were found to be optimal. HE collimator can be used when the resolution is not required.Conclusion:These results provide the optimal energy window and collimator in Lu-177 SPECT imaging and will help the quantification of Lu-177.

Comparison of acquisition protocols for ventilation/perfusion SPECT—a Monte Carlo study

One of the most commonly used imaging techniques for diagnosing pulmonary embolism (PE) is ventilation/perfusion (V/P) scintigraphy. The aim of this study was to evaluate the performance of the currently used imaging protocols for V/P single photon emission computed tomography (V/P SPECT) at two nuclear medicine department sites and to investigate the effect of altering important protocol parameters.The Monte Carlo technique was used to simulate 4D digital phantoms with perfusion defects. Six imaging protocols were included in the study and a total of 72 digital patients were simulated. Six dually trained radiologists/nuclear medicine physicians reviewed the images and reported all perfusion mismatch findings. The radiologists also visually graded the image quality.No statistically significant differences in diagnostic performance were found between the studied protocols, but visual grading analysis pointed out one protocol as significantly superior to four of the other protocols. Considering the study results, we have decided to harmonize our clinical protocols for imaging patients with suspected PE. The administered Technegas and macro aggregated albumin activities have been altered, a low energy all purpose collimator is used instead of a low energy high resolution collimator and the acquisition times have been lowered.

Monte Carlo assessment of coded aperture tool for breast imaging: a Mura-mask case study

The main purpose of this work was to perform a rigorous computational study on scintimammography with a Mura-mask based on Monte Carlo simulation of voxelized breast phantoms. Three main objectives were addressed: (1) verification of Geant4 version 10.4, (2) optimization of the imaging setup, and (3) small tumor detection and localization. We successfully verified the Geant4-based imaging of a commonly used phantom in the field. We used a Mura-mask with a $$41\times 41$$ array pattern with adjustable thickness, material, and hole shape (box and cylinder); a low-energy high-resolution collimator with different hole shapes (cylinder and hexagon); and a voxelized breast phantom with different sizes (small, medium, and large) and glandularity percentages (low, medium, and high). We also compared the detector crystal outputs of CdZnTe and NaI(Tl). The simulation was followed by a deconvolution procedure, and the data (images) were statistically emphasized. Statistical metrics indicate that the Mura-mask (W material with 1.5 mm thickness and box holes) combined with a CdZnTe detector leads to the optimum point spread function. Finally, a preliminary study on small-sized tumor detection and localization was conducted with different tumor-to-background ratios (from 2 to 12). Tumors with diameters of 5 and 8 mm could be detected, while those of 2 mm were undetectable. Nevertheless, this study enhances our understanding of the early detection of tumors in the field of scintimammography.

Comparison of Image Quality of Different Radionuclides Technetium-99m, Samarium-153, and Iodine-123.

Introduction:The choice of the radionuclide has a key role in nuclear medicine which appearing the lowest scatter fraction. In addition, the presence of penetrated and scattered photons from collimator in single-photon emission computed tomography images degrades resolution and contrast. Thus, image quality depends on sensitivity and resolution of the collimator–detector system. The goal of this study was to compare the image quality that can be achieved by three radionuclides: technetium-99 m (Tc-99 m), iodine-123 (I-123), and samarium-153 (Sm-153).Materials and Methods:Tc-99 m and Sm-153 were imaged with low-energy high resolution (LEHR) collimator, while I-123 was imaged with medium-energy (ME) collimator. We modeled the Siemens Symbia Medical system using Monte Carlo simulation code SIMIND. The imaging characteristics of each radionuclide were investigated by simulated data: point spread function, sensitivity (Cps/MBq) and geometric, penetration and scattering distribution.Results:Tc-99 m and Sm-153 give best and results with LEHR collimator for spatial resolution (full width at half maximum [FWHM] = 3.19 mm; full width at tenth maximum [FWTM] = 6.73 mm) and (FWHM = 3.22 mm; FWTM = 7.39 mm), respectively. Whereas, I-123 provided with ME collimator a lower resolution (FWHM = 4.89 mm; FWTM = 9.89 mm). The sensitivity recorded by Tc-99 m, Sm-153, and I-153 were (31.21 Cps/MBq), (10.16 Cps/MBq), and (51.22 Cps/MBq), respectively.Conclusion:Tc-99 m and Sm-153 give the best and generally similar imaging properties with LEHR. For I-123, the ME collimator helps lowering the influence of high-energy gamma rays.

Comparison of automatic depth correction versus manual depth correction in the calculation of glomerular filtration rate in gates renal processing of diethylenetriaminepentaacetic acid renogram in prospective renal donors

Aim: The aim of the study was to compare the glomerular filtration rate (GFR) obtained by gates method of renal processing using automated system generated method (ASGM) of depth correction with manual depth correction method (MDCM), in prospective renal donors using 99m-Tc diethylenetriaminepentaacetic acid (DTPA) scintigraphy. Materials and Methods: Prospective interventional study involving 20 voluntary renal donors of age 26–65 years were included. 99m-Tc DTPA renograms were acquired by dynamic acquisition for 30 min. Presyringe and postsyringe counts, prevoid and postvoid images, and both sides of lateral images (for manual depth correction) were acquired. GFR was calculated by Gates renal processing with the depth correction both by ASGM and MDCM methods. Results: The mean depth of right and left kidneys calculated by MDCM and ASGM were 7.2 ± 1.1 and 6.4 ± 1.1 and 7.0 ± 1.2 and 6 ± 1.2, respectively. The mean total GFR calculated by Gate's Method using MDCM and ASGM was 96.2 ± 15.4 and 82.0 ± 11.5. There was a statistically significant difference in the depth correction of both kidneys and improvement in total GFR values by MDCM methods compared to the ASGM method. Conclusion: There was a significant difference in depth and GFR values, calculated from MDCM compared to ASGM. Hence, the MDCM is better in calculating GFR for renal donors, especially when using low-energy high-resolution collimators, as full-width half-maximum varies considerably for every centimeter of the distance of the source from the collimator.

Simplified Dynamic Phantom for Pediatric Renography: A Description of Instrument and its Performance.

Objective(s):Renography is used for the diagnostic evaluation of pediatric patients with a suspected obstruction of urinary tract or impaired renal function. The recommended dose for children have been released by the European Association of Nuclear Medicine, Society of Nuclear Medicine and Molecular Imaging, and Japanese Society of Nuclear Medicine. Since acquisition counts in dynamic scintigraphy are affected by the administered doses and sensitivity of the scintillation camera, the scan procedure should be determined independently. In this study, we constructed simplified dynamic phantom imitating pediatric renography and tested its performance.Methods: Simplified dynamic phantom consisted of three components (i.e., infusion, imitated kidney, and drainage sections). The infusion rates (mL/min) were determined by comparing the time activity curves obtained from patients with normal renal function. The time-points of the maximum counts (Tmax), as well as the two-thirds and one-half of the maximum counts (T2/3 and T1/2) were measured in different doses using the phantom with the best-match infusion rate and duration, and low-energy general-purpose (LEGP) or low-energy high-resolution (LEHR) collimators and applying different attenuations.Results:The best-match infusion rates of the phantom to imitate the time activity curve of the normal renal function were 42.0, 1.0, 0.6, and 0.3 mL/min in the arterial, secretory, early-excretory, and late-excretory phases, respectively. When 30 MBq, LEHR collimator and non-water-equivalent phantom were applied, Tmax, T2/3, and T1/2 were 242±15.3, 220±10.0 and 317±25.2 seconds, respectively. Using LEGP collimator and (3 MBq of activity) 5-cm water-equivalent phantom, Tmax, T2/3, and T1/2 values were estimated as 242±5.8, 213±11.5, and 310±17.3 sec, respectively.Conclusion:Our simplified dynamic phantom for pediatric renography could imitate the time activity curves obtained from patients with normal renal function. Tmax, T2/3, and T1/2 could be measured under various settings of dose, collimator, and tissue attenuation.

Impact of Novel Incorporation of CT-based Segment Mapping into a Conjugated Gradient Algorithm on Bone SPECT Imaging: Fundamental Characteristics of a Context-specific Reconstruction Method.

Objective(s):The latest single-photon emission computed tomography (SPECT)/computed tomography (CT) reconstruction system, referred to as xSPECT Bone™, is a context-specific reconstruction system utilizing tissue segmentation information from CT data, which is called a zone map. The aim of this study was to evaluate the effects of zone-map enhancement incorporated into the ordered-subset conjugated gradient minimization (OSCGM) reconstruction method on SPECT images.Methods: Image quality with zone-map enhanced OSCGM (OSCGMz) and non-enhanced OSCGM methods was compared using various reconstruction parameters. The compartment phantom had 3 radioactive sections with CT values of about 1000, 250, and 0 HU. SPECT data were acquired using a low-energy high-resolution (LEHR) collimator, with a 256×256 matrix and 2.4-mm pixel size. The performances of the 2 reconstruction methods (OSCGM vs. OSCGMz) were evaluated on the basis of %error, coefficient of variation (%CV), and normalized mean squared error (NMSE), and adequate iterative update numbers were determined. The relative CV representing the ratio of smoothed images to non-smoothed images was calculated to evaluate the effects of the Gaussian filter on each section set with different CT values.Results:On comparing the OSCGM and OSCGMz methods, it was found that the %error of the OSCGMz method tended to show convergence with fewer updates, especially in the high CT value section mimicking bone absorption. In the water section, the %CV of the OSCGMz method was lower than that of the OSCGM method. The NMSE minimum values for the OSCGM and OSCGMz methods were obtained at 30 and 20 updates, respectively. The relative CV for the OSCGMz method in the water section decreased remarkably according to the size of the full width at half maximum (FWHM) of the Gaussian filter.Conclusion:The zone-map enhancement contributed to SPECT reconstruction for the reproduction of radioactive concentrations in bone tissues, using a low number of OSCGM updates. Our findings indicated that the incorporation of zone maps into SPECT reconstruction might improve image quality.