Concept of an upright wearable positron emission tomography imager in humans

The United States Department of Energy and National Institutes of Health Collaboration: Medical Care Advances by Discovery in Radiation Detection

A National Institutes of Health (NIH) and U.S. Department of Energy (DOE) Office of Science virtual workshop on shared general topics was held in July of 2021 and reported on in this publication in January of 2023. Following the inaugural 2021 joint meeting representatives from the DOE Office of Science and NIH met to discuss organizing a second joint workshop that would concentrate on radiation detection to bring together teams from both agencies and their grantee populations to stimulate collaboration and efficiency. To meet this scientific mission within the NIH and DOE radiation detection space, the organizers assembled workshop sessions covering the state-of-the-art in cameras, detectors, and sensors for radiation external and internal (diagnostic and therapeutic) to human, data acquisition and electronics, image reconstruction and processing, and the application of artificial intelligence. NIH and DOE are committed to continuing the process of convening a joint workshop every 12-24 months. This Special Report recaps the findings of this second workshop. Beyond showing only the innovations and areas of success, important gaps in our knowledge were defined and presented. We summarize by defining four areas of greatest opportunity and need that emerged from the unique, dynamic dialogue the in-person workshop provided the attendees.

Real-time motion-enabling positron emission tomography of the brain of upright ambulatory humans

BACKGROUND

Mobile upright PET devices have the potential to enable previously impossible neuroimaging studies. Currently available options are imagers with deep brain coverage that severely limit head/body movements or imagers with upright/motion enabling properties that are limited to only covering the brain surface.

METHODS

In this study, we test the feasibility of an upright, motion-compatible brain imager, our Ambulatory Motion-enabling Positron Emission Tomography (AMPET) helmet prototype, for use as a neuroscience tool by replicating a variant of a published PET/fMRI study of the neurocorrelates of human walking. We validate our AMPET prototype by conducting a walking movement paradigm to determine motion tolerance and assess for appropriate task related activity in motor-related brain regions. Human participants (n = 11 patients) performed a walking-in-place task with simultaneous AMPET imaging, receiving a bolus delivery of F18-Fluorodeoxyglucose.

RESULTS

Here we validate three pre-determined measure criteria, including brain alignment motion artifact of less than <2 mm and functional neuroimaging outcomes consistent with existing walking movement literature.

CONCLUSIONS

The study extends the potential and utility for use of mobile, upright, and motion-tolerant neuroimaging devices in real-world, ecologically-valid paradigms. Our approach accounts for the real-world logistics of an actual human participant study and can be used to inform experimental physicists, engineers and imaging instrumentation developers undertaking similar future studies. The technical advances described herein help set new priorities for facilitating future neuroimaging devices and research of the human brain in health and disease.

Attenuation correction and truncation completion for breast PET/MR imaging using deep learning

Objective. Simultaneous PET/MR scanners combine the high sensitivity of MR imaging with the functional imaging of PET. However, attenuation correction of breast PET/MR imaging is technically challenging. The purpose of this study is to establish a robust attenuation correction algorithm for breast PET/MR images that relies on deep learning (DL) to recreate the missing portions of the patient's anatomy (truncation completion), as well as to provide bone information for attenuation correction from only the PET data.Approach. Data acquired from 23 female subjects with invasive breast cancer scanned with18F-fluorodeoxyglucose PET/CT and PET/MR localized to the breast region were used for this study. Three DL models, U-Net with mean absolute error loss (DLMAE) model, U-Net with mean squared error loss (DLMSE) model, and U-Net with perceptual loss (DLPerceptual) model, were trained to predict synthetic CT images (sCT) for PET attenuation correction (AC) given non-attenuation corrected (NAC) PETPET/MRimages as inputs. The DL and Dixon-based sCT reconstructed PET images were compared against those reconstructed from CT images by calculating the percent error of the standardized uptake value (SUV) and conducting Wilcoxon signed rank statistical tests.Main results. sCT images from the DLMAEmodel, the DLMSEmodel, and the DLPerceptualmodel were similar in mean absolute error (MAE), peak-signal-to-noise ratio, and normalized cross-correlation. No significant difference in SUV was found between the PET images reconstructed using the DLMSEand DLPerceptualsCTs compared to the reference CT for AC in all tissue regions. All DL methods performed better than the Dixon-based method according to SUV analysis.Significance. A 3D U-Net with MSE or perceptual loss model can be implemented into a reconstruction workflow, and the derived sCT images allow successful truncation completion and attenuation correction for breast PET/MR images.

The quest for multifunctional and dedicated PET instrumentation with irregular geometries

We focus on reviewing state-of-the-art developments of dedicated PET scanners with irregular geometries and the potential of different aspects of multifunctional PET imaging. First, we discuss advances in non-conventional PET detector geometries. Then, we present innovative designs of organ-specific dedicated PET scanners for breast, brain, prostate, and cardiac imaging. We will also review challenges and possible artifacts by image reconstruction algorithms for PET scanners with irregular geometries, such as non-cylindrical and partial angular coverage geometries and how they can be addressed. Then, we attempt to address some open issues about cost/benefits analysis of dedicated PET scanners, how far are the theoretical conceptual designs from the market/clinic, and strategies to reduce fabrication cost without compromising performance.

Objective Image Quality Comparison Between Brain-Dedicated PET and PET/CT Scanners

As part of a clinical validation of a new brain-dedicated PET system (CMB), image quality of this scanner has been compared to that of a whole-body PET/CT scanner. To that goal, Hoffman phantom and patient data were obtined with both devices. Since CMB does not use a CT for attenuation correction (AC) which is crucial for PET images quality, this study includes the evaluation of CMB PET images using emission-based or CT-based attenuation maps. PET images were compared using 34 image quality metrics. Moreover, a neural network was used to evaluate the degree of agreement between both devices on the patients diagnosis prediction. Overall, results showed that CMB images have higher contrast and recovery coefficient but higher noise than PET/CT images. Although SUVr values presented statistically significant differences in many brain regions, relative differences were low. An asymmetry between left and right hemispheres, however, was identified. Even so, the variations between the two devices were minor. Finally, there is a greater similarity between PET/CT and CMB CT-based AC PET images than between PET/CT and the CMB emission-based AC PET images.

Marker-less and calibration-less motion correction method for brain PET

Marker-less head motion correction methods have been well-studied; however, no reports discussing potential issues in positional calibration between a PET system and an external sensor remain limited. In this study, we develop a method for positional calibration between the PET system and an external range sensor to achieve practical head motion correction. The basic concept of the developed method involves using the subject's face model as a marker not only for head motion detection but also for the system positional calibration. The face model of the subject, which can be obtained easily using the range sensor, can also be calculated from a computed tomography (CT) image of the same subject. The CT image, which is acquired separately for attenuation correction in PET, has the same coordinates as the PET image because of the appropriate matching algorithm between CT and PET images. The proposed method was implemented in the helmet-type PET and the motion correction accuracy was assessed quantitatively using a mannequin head. The phantom experiments demonstrated the performance of the developed motion correction method; high-resolution images with no trace of the applied motion were obtained as if no motion was provided. Statistical analysis supported the visual assessment results in terms of the spatial resolution, contrast recovery; uniformity, and the results implied that motion with correction slightly improved image quality compared with the motionless case. The tolerance of the developed method against potential tracking errors had a minimum 10% difference in the amplitude of the rotation angle.

Perspectives of brain imaging with PET systems

In this partial review and partial attempt at vision of what may be the future of dedicated brain PET scanners, the key implementations of the PET technique, we postulate that we are still on a development path and there is still a lot to be done in order to develop optimal brain imagers. Optimized for particular imaging tasks and protocols, and also mobile, that can be used outside the PET center, in addition to the expected improvements in sensitivity and resolution. For this multi-application concept to be more practical, flexible, adaptable designs are preferred. This task is greatly facilitated by the improved TOF performance that allows for more open, adjustable, limited angular coverage geometries without creating image artifacts. As achieving uniform very high resolution in the whole body is not practical due to technological limits and high costs, hybrid systems using a moderate-resolution total body scanner (such as J-PET) combined with a very high performing brain imager could be a very attractive approach. As well, as using magnification inserts in the total body or long-axial length imagers to visualize selected targets with higher resolution. In addition, multigamma imagers combining PET with Compton imaging should be developed to enable multitracer imaging.

Comparison of deep learning-based emission-only attenuation correction methods for positron emission tomography

PURPOSE

This study aims to compare two approaches using only emission PET data and a convolution neural network (CNN) to correct the attenuation (μ) of the annihilation photons in PET.

METHODS

One of the approaches uses a CNN to generate μ-maps from the non-attenuation-corrected (NAC) PET images (μ-CNN_NAC). In the other method, CNN is used to improve the accuracy of μ-maps generated using maximum likelihood estimation of activity and attenuation (MLAA) reconstruction (μ-CNN_MLAA). We investigated the improvement in the CNN performance by combining the two methods (μ-CNN_MLAA+NAC) and the suitability of μ-CNN_NAC for providing the scatter distribution required for MLAA reconstruction. Image data from ¹⁸F-FDG (n = 100) or ⁶⁸ Ga-DOTATOC (n = 50) PET/CT scans were used for neural network training and testing.

RESULTS

The error of the attenuation correction factors estimated using μ-CT and μ-CNN_NAC was over 7%, but that of scatter estimates was only 2.5%, indicating the validity of the scatter estimation from μ-CNN_NAC. However, CNN_NAC provided less accurate bone structures in the μ-maps, while the best results in recovering the fine bone structures were obtained by applying CNN_MLAA+NAC. Additionally, the μ-values in the lungs were overestimated by CNN_NAC. Activity images (λ) corrected for attenuation using μ-CNN_MLAA and μ-CNN_MLAA+NAC were superior to those corrected using μ-CNN_NAC, in terms of their similarity to λ-CT. However, the improvement in the similarity with λ-CT by combining the CNN_NAC and CNN_MLAA approaches was insignificant (percent error for lung cancer lesions, λ-CNN_NAC = 5.45% ± 7.88%; λ-CNN_MLAA = 1.21% ± 5.74%; λ-CNN_MLAA+NAC = 1.91% ± 4.78%; percent error for bone cancer lesions, λ-CNN_NAC = 1.37% ± 5.16%; λ-CNN_MLAA = 0.23% ± 3.81%; λ-CNN_MLAA+NAC = 0.05% ± 3.49%).

CONCLUSION

The use of CNN_NAC was feasible for scatter estimation to address the chicken-egg dilemma in MLAA reconstruction, but CNN_MLAA outperformed CNN_NAC.

Emerging ethical issues raised by highly portable MRI research in remote and resource-limited international settings

Smaller, more affordable, and more portable MRI brain scanners offer exciting opportunities to address unmet research needs and long-standing health inequities in remote and resource-limited international settings. Field-based neuroimaging research in low- and middle-income countries (LMICs) can improve local capacity to conduct both structural and functional neuroscience studies, expand knowledge of brain injury and neuropsychiatric and neurodevelopmental disorders, and ultimately improve the timeliness and quality of clinical diagnosis and treatment around the globe. Facilitating MRI research in remote settings can also diversify reference databases in neuroscience, improve understanding of brain development and degeneration across the lifespan in diverse populations, and help to create reliable measurements of infant and child development. These deeper understandings can lead to new strategies for collaborating with communities to mitigate and hopefully overcome challenges that negatively impact brain development and quality of life. Despite the potential importance of research using highly portable MRI in remote and resource-limited settings, there is little analysis of the attendant ethical, legal, and social issues (ELSI). To begin addressing this gap, this paper presents findings from the first phase of an envisioned multi-staged and iterative approach for creating ethical and legal guidance in a complex global landscape. Section 1 provides a brief introduction to the emerging technology for field-based MRI research. Section 2 presents our methodology for generating plausible use cases for MRI research in remote and resource-limited settings and identifying associated ELSI issues. Section 3 analyzes core ELSI issues in designing and conducting field-based MRI research in remote, resource-limited settings and offers recommendations. We argue that a guiding principle for field-based MRI research in these contexts should be including local communities and research participants throughout the research process in order to create sustained local value. Section 4 presents a recommended path for the next phase of work that could further adapt these use cases, address ethical and legal issues, and co-develop guidance in partnership with local communities.

Brain connectivity during simulated balance in older adults with and without Parkinson's disease

Individuals with Parkinson's disease often experience postural instability, a debilitating and largely treatment-resistant symptom. A better understanding of the neural substrates contributing to postural instability could lead to more effective treatments. Constraints of current functional neuroimaging techniques, such as the horizontal orientation of most MRI scanners (forcing participants to lie supine), complicates investigating cortical and subcortical activation patterns and connectivity networks involved in healthy and parkinsonian balance control. In this cross-sectional study, we utilized a newly-validated MRI-compatible balance simulator (based on an inverted pendulum) that enabled participants to perform balance-relevant tasks while supine in the scanner. We utilized functional MRI to explore effective connectivity underlying static and dynamic balance control in healthy older adults (n = 17) and individuals with Parkinson's disease while on medication (n = 17). Participants performed four tasks within the scanner with eyes closed: resting, proprioceptive tracking of passive ankle movement, static balancing of the simulator, and dynamic responses to random perturbations of the simulator. All analyses were done in the participant's native space without spatial transformation to a common template. Effective connectivity between 57 regions of interest was computed using a Bayesian Network learning approach with false discovery rate set to 5%. The first 12 principal components of the connection weights, binomial logistic regression, and cross-validation were used to create 4 separate models: contrasting static balancing vs {rest, proprioception} and dynamic balancing vs {rest, proprioception} for both controls and individuals with Parkinson's disease. In order to directly compare relevant connections between controls and individuals with Parkinson's disease, we used connections relevant for predicting a task in either controls or individuals with Parkinson's disease in logistic regression with Least Absolute Shrinkage and Selection Operator regularization. During dynamic balancing, we observed decreased connectivity between different motor areas and increased connectivity from the brainstem to several cortical and subcortical areas in controls, while individuals with Parkinson's disease showed increased connectivity associated with motor and parietal areas, and decreased connectivity from brainstem to other subcortical areas. No significant models were found for static balancing in either group. Our results support the notion that dynamic balance control in individuals with Parkinson's disease relies more on cortical motor areas compared to healthy older adults, who show a preference of subcortical control during dynamic balancing.

A layered single-side readout depth of interaction time-of-flight-PET detector

We are exploring a scintillator-based PET detector with potential of high sensitivity, depth of interaction (DOI) capability, and timing resolution, with single-side readout. Our design combines two previous concepts: (1) multiple scintillator arrays stacked with relative offset, yielding inherent DOI information, but good timing performance has not been demonstrated with conventional light sharing readout. (2) Single crystal array with one-to-one coupling to the photodetector, showing superior timing performance compared to its light sharing counterparts, but lacks DOI. The combination, where the first layer of a staggered design is coupled one-to-one to a photodetector array, may provide both DOI and timing resolution and this concept is here evaluated through light transport simulations. Results show that: (1) unpolished crystal pixels in the staggered configuration yield better performance across all metrics compared to polished pixels, regardless of readout scheme. (2) One-to-one readout of the first layer allows for accurate DOI extraction using a single threshold. The number of multi pixel photon counter (MPPC) pixels with signal amplitudes exceeding the threshold corresponds to the interaction layer. This approach was not possible with conventional light sharing readout. (3) With a threshold of 2 optical photons, the layered approach with one-to-one coupled first layer improves timing close to the MPPC compared to the conventional one-to-one coupling non-DOI detector, due to effectively reduced crystal thickness. Single detector timing resolution values of 91, 127, 151 and 164 ps were observed per layer in the 4-layer design, to be compared to 148 ps for the single array with one-to-one coupling. (4) For the layered design with light sharing readout, timing improves with increased MPPC pixel size due to higher signal per channel. In conclusion, the combination of straightforward DOI determination, good timing performance, and relatively simple design makes the proposed concept promising for DOI-Time-of-Flight PET detectors.

Increased prefrontal oxygenation prior to and at the onset of over-ground locomotion in humans

We found using wireless near-infrared spectroscopy that prefrontal oxygenation increased before the onset of arbitrary over-ground walking, whereas the preexercise increase was absent when walking was suddenly started by cue. The difference in prefrontal oxygenation between start modes (considered related to central command) preceded heart rate response variances and demonstrated a positive relationship with the difference in heart rate. The central command-related prefrontal activity may contribute to cardiac adjustment, synchronized with the beginning of over-ground walking.

Development and initial characterization of a high-resolution PET detector module with DOI

Organ-dedicated PET scanners are becoming more prevalent because of their advantages in higher sensitivity, improved image quality, and lower cost. Detectors utilized in these scanners have finer pixel size with depth of interaction (DOI) capability. This work presents a LYSO(Ce) detector module with DOI capability which has the potential to be scaled up to a high-resolution small animal or organ-dedicated PET system. For DOI capability, a submodule with one LYSO block detector utilizing PETsys TOFPET2 application-specific integrated circuit (ASIC) was previously developed in our lab. We scaled up the submodule and optimized the configuration to allow for a compact housing of the dual-readout boards in one side of the blocks by designing a high-speed dual-readout cable to maintain the original pin-to-pin relationship between the Samtec connectors. The module size is 53.8 × 57.8 mm2. Each module has 2 × 2 LYSO blocks, each LYSO block consists of 4 × 4 LYSO units, and each LYSO unit contains a 6 × 6 array of 1 × 1 × 20 mm3 LYSO crystals. The four lateral surfaces of LYSO crystal were mechanically ground to W14, and the two end surfaces were polished. Two ends of the LYSO crystal are optically connected to SiPM for DOI measurement. Eight LYSO blocks performance including energy, timing, and DOI resolution is characterized with a single LYSO slab. The in-panel and orthogonal-panel spatial resolution of the two modules with 107.4 mm distance between each other are measured at 9 positions within the field of view (FOV) with a 22Na source. Results show that the average energy, timing, and DOI resolution of all LYSO blocks are 16.13% ± 1.01% at 511 keV, 658.03 ± 15.18 ps, and 2.62 ± 0.06 mm, respectively. The energy and timing resolution of two modules are 16.35% and 0.86 ns, respectively. The in-panel and orthogonal-panel spatial resolution of the two modules at the FOV center are 1.9 and 4.4 mm respectively.

Design study of fully wearable high-performance brain PETs for neuroimaging in free movement

A practical wearable brain PET scanner capable of dynamic neuroimaging during free bodily movement will enable potential breakthrough basic neuroscience studies and help develop imaging-based neurological diagnoses and treatments. Weight, brain coverage, and sensitivity are three fundamental technical obstacles in the development of Fully Wearable High-Performance (FWHP) brain PET scanners. The purpose of this study is to investigate the feasibility of building a FWHP brain PET using a limited volume of lutetium-yttrium oxyorthosilicate (LYSO) scintillator crystals. Six scanners, consisted of the same volume (2.66 kg) of LYSO scintillators with combinations of 2 different crystal pitches (3 mm and 1.5 mm) and 3 different crystal lengths (20 mm, 10 mm, and 5 mm), were simulated. The performances of the six scanners were assessed and compared with Siemen's HRRT brain PET and mCT whole-body PET, in terms of aperture, axial field of views (AFOV), sensitivity, spatial resolution, count rates, and image noise property. The time-of-flight (TOF) information was included in the image reconstruction to improve the effective sensitivity. The effects of the TOF was assessed by scanning a Jaszczak phantom and reconstructing images with the maximum likelihood expectation maximization (MLEM) algorithm with different timing settings (non-TOF, 500 ps, 200 ps, 100 ps and 50 ps Coincidence Time Resolution, CTR). The signal-noise ratio (SNR) of the images were assessed and compared with those of the HRRT scanner and mCT scanner. The results show that it is possible to construct a FWHP brain PET with better spatial resolution than the dedicated HRRT brain PET, comparable effective sensitivity (with 50 ∼ 100 ps CTR), and whole-brain coverage (23.7 cm inner diameter and 13.4 cm axial field of view) using 2.66 kg of LYSO.

Design study of a dedicated head and neck cancer PET system

The tumor-involved regions of head and neck cancer (HNC) have complex anatomical structures and vital physiological roles. As a consequence, there is a need for high sensitivity and high spatial resolution dedicated HNC PET scanner. The purpose of this study is to evaluate and optimize system design that includes detecting materials and geometries. For the detecting material, two scanners with the same two-panel geometry based on CZT and LYSO were evaluated. For the system geometry, four CZT scanners with two-panel, lengthened two-panel, four-panel, and full-ring geometries were evaluated. A cylinder phantom with sphere lesions and an XCAT phantom in the head and neck region were simulated. The results showed that the sensitivity of the 40-mm thickness CZT system and the 20-mm thickness LYSO system were comparable. However, the multiple interaction photon events recovery accuracy of the CZT system was about 20% higher. The in-panel and orthogonal-panel spatial resolutions of CZT are 0.58 and 0.74 mm, while those of LYSO are 0.70 and 1.40 mm. For system geometry, the four-panel and full-ring scanners have a higher contrast recovery coefficient (CRC) and contrast-to-noise ratio (CNR) than the two-panel and lengthened two-panel scanners. However, a 5-mm lesion in the XCAT phantom was visualized within 6 min in the two-panel system.

NEMA Performance Evaluation of CareMiBrain dedicated brain PET and Comparison with the whole-body and dedicated brain PET systems

This article presents system performance studies of the CareMiBrain dedicated brain PET according to NEMA NU 2-2012 (for whole-body PETs) and NU 4-2008 (for preclinical PETs). This scanner is based on monolithic LYSO crystals coupled to silicon photomultipliers. The results obtained for both protocols are compared with current commercial whole body PETs and dedicated brain PETs found in the literature. Spatial resolution, sensitivity, NECR and scatter-fraction are characterized with NEMA standards, as well as an image quality study. A customized image quality phantom is proposed as NEMA phantoms do not fulfil the necessities of dedicated brain PETs. The full-width half maximum of the radial/tangential/axial spatial resolution of CareMiBrain reconstructed with FBP at 10 and 100 mm from the system center were, respectively, 1.87/1.68/1.39 mm and 1.86/1.91/1.40 mm (NU 2-2012) and 1.58/1.45/1.40 mm and 1.64/1.66/1.44 mm (NU 4-2008). Peak NECR was 49 kcps@287 MBq with a scatter fraction of 48% using NU 2-2012 phantom. The sensitivity was 13.82 cps/kBq at the center of the FOV (NU 2-2012) and 10% (NU 4-2008). Contrast recovery coefficients for customizing image quality phantom were 0.73/0.78/1.14/1.01 for the 4.5/6/9/12 mm diameter rods. The performance characteristics of CareMiBrain are at the top of the current technologies for PET systems. Dedicated brain PET systems significantly improve spatial resolution and sensitivity, but present worse results in count rate measurements and scatter-fraction tests. As for the comparison of preclinical and clinical standards, the results obtained for solid and liquid sources were similar.

Ambulatory Microdose PET: A Wearable PET Scanner for Neurologic Imaging

The ambulatory microdose PET scanner is an innovative machine that is advancing the field of nuclear medicine neurologic imaging. This scanner is a wearable helmet that allows neurologic PET imaging to be done while a subject is sitting upright or ambulating. It has the potential to tell researchers and physicians more about how the brain and movement are connected and give more insight on the deeper structures. The evolving design of the helmet has grown to show improvement in image quality and the ability to image the brain with useful information on different neurologic disorders and diseases. When the ambulatory microdose PET scanner is compared with a conventional PET scanner, it not only provides higher-resolution images and increased sensitivity while allowing the patient to have a greater range of motion but also allows for the introduction of newer radiotracers and lower radiation doses.

Seated versus supine: consideration of the optimum measurement posture for brain-dedicated PET

Some recently developed brain-dedicated positron emission tomography (PET) scanners measure subjects in a sitting position. Sitting enables PET scanning under more natural conditions for the subjects and also helps with making the scanners smaller. It is unclear, however, how much the degree of head motion when sitting differs from the supine posture commonly employed in clinical PET. In this report, we describe development of a markerless and contactless head motion tracking system and a study of healthy volunteers in several different postures to determine the optimum posture for brain PET. We used Kinect^® (Microsoft) and developed software that can measure head motion with about 1 mm (translation) and less than 1° (rotation) accuracy. In the volunteer study, we measured the amount of head motion, with and without head fixation, in supine, normal sitting, and reclining postures. The results indicated that the normal sitting posture without head fixation had the largest head movement, and that the reclining and supine postures were similarly effective for minimizing head movement (average head movement of about 0.5 mm during 1 min). We also visualized the influence that head motion had on images for each pose by simulating the actual motions obtained from the volunteer study using a digital Hoffman phantom. Comparisons with the original image showed that the extent to which motion was reduced in the reclining and supine postures were quantitatively equivalent. The head motions of the volunteer studies were also reproduced using a mannequin head on a motorized stage to assess how well the proposed motion measurement system worked when used for motion correction. The results indicated that even though the system improved image quality for all postures, the reclining and supine postures could provide better image quality than the normal sitting posture.

Development of Dedicated Brain PET Imaging Devices: Recent Advances and Future Perspectives

Whole-body PET scanners are not optimized for imaging small structures in the human brain. Several PET devices specifically designed for this task have been proposed either for stand-alone operation or as MR-compatible inserts. The main distinctive features of some of the most recent concepts and their performance characteristics, with a focus on spatial resolution and sensitivity, are reviewed. The trade-offs between the various performance characteristics, desired capabilities, and cost that need to be considered when designing a dedicated brain scanner are presented. Finally, the aspirational goals for future-generation scanners, some of the factors that have contributed to the current status, and how recent advances may affect future developments in dedicated brain PET instrumentation are briefly discussed.

The Phenomenology of Habits: Integrating First-Person and Neuropsychological Studies of Memory

There is an ongoing debate how one can integrate the subjective (first-person) dimension of experiences more thoroughly into neuropsychological research. In cognitive experimental memory research, for instance, cognitive psychology begins by separating the act of recollection from the context where recollections occur, so as to make memory research suitable for study in the experimental conditions of the laboratory. It is the claim of this article that the challenge for memory research consists not merely in the (possible) loss of meaning entailed by transforming embedded recollected experiences into operationalized cognitive functions. Rather, from the outset, the first-person experiential basis of the entire research procedure is often insufficiently elaborated and hence risks neglecting or misrepresenting significant dimensions of the phenomena it studies. I demonstrate this with regard to habits understood as procedural memories. Research based on the paradigm of embodied cognition and phenomenology has shown that procedural memory-based skills and habits are not necessarily confined to sub-personal (unconscious) processing mechanisms. This paradigm states that some cognitive processes involve not only the brain but also the pre-reflectively experienced lived-body. The key idea is that we have experiential access to bodily processes that are not yet conceptualized or reflexively mediated. In the final part of my paper, I delineate how such experiences can be integrated into the neuropsychological study of habits via the method of ‘front-loaded phenomenology.’

Innovations in Instrumentation for Positron Emission Tomography

PET scanners are sophisticated and highly sensitive biomedical imaging devices that can produce highly quantitative images showing the 3-dimensional distribution of radiotracers inside the body. PET scanners are commonly integrated with x-ray CT or MRI scanners in hybrid devices that can provide both molecular imaging (PET) and anatomical imaging (CT or MRI). Despite decades of development, significant opportunities still exist to make major improvements in the performance of PET systems for a variety of clinical and research tasks. These opportunities stem from new ideas and concepts, as well as a range of enabling technologies and methodologies. In this paper, we review current state of the art in PET instrumentation, detectors and systems, describe the major limitations in PET as currently practiced, and offer our own personal insights into some of the recent and emerging technological innovations that we believe will impact the field. Our focus is on the technical aspects of PET imaging, specifically detectors and system design, and the opportunity and necessity to move closer to PET systems for diagnostic patient use and in vivo biomedical research that truly approach the physical performance limits while remaining mindful of imaging time, radiation dose, and cost. However, other key endeavors, which are not covered here, including innovations in reconstruction and modeling methodology, radiotracer development, and expanding the range of clinical and research applications, also will play an equally important, if not more important, role in defining the future of the field.

The State of the NIH BRAIN Initiative

The BRAIN Initiative arose from a grand challenge to "accelerate the development and application of new technologies that will enable researchers to produce dynamic pictures of the brain that show how individual brain cells and complex neural circuits interact at the speed of thought." The BRAIN Initiative is a public-private effort focused on the development and use of powerful tools for acquiring fundamental insights about how information processing occurs in the central nervous system (CNS). As the Initiative enters its fifth year, NIH has supported >500 principal investigators, who have answered the Initiative's challenge via hundreds of publications describing novel tools, methods, and discoveries that address the Initiative's seven scientific priorities. We describe scientific advances produced by individual laboratories, multi-investigator teams, and entire consortia that, over the coming decades, will produce more comprehensive and dynamic maps of the brain, deepen our understanding of how circuit activity can produce a rich tapestry of behaviors, and lay the foundation for understanding how its circuitry is disrupted in brain disorders. Much more work remains to bring this vision to fruition, and the National Institutes of Health continues to look to the diverse scientific community, from mathematics, to physics, chemistry, engineering, neuroethics, and neuroscience, to ensure that the greatest scientific benefit arises from this unique research Initiative.

Auditory object perception: A neurobiological model and prospective review

Interaction with the world is a multisensory experience, but most of what is known about the neural correlates of perception comes from studying vision. Auditory inputs enter cortex with its own set of unique qualities, and leads to use in oral communication, speech, music, and the understanding of emotional and intentional states of others, all of which are central to the human experience. To better understand how the auditory system develops, recovers after injury, and how it may have transitioned in its functions over the course of hominin evolution, advances are needed in models of how the human brain is organized to process real-world natural sounds and "auditory objects". This review presents a simple fundamental neurobiological model of hearing perception at a category level that incorporates principles of bottom-up signal processing together with top-down constraints of grounded cognition theories of knowledge representation. Though mostly derived from human neuroimaging literature, this theoretical framework highlights rudimentary principles of real-world sound processing that may apply to most if not all mammalian species with hearing and acoustic communication abilities. The model encompasses three basic categories of sound-source: (1) action sounds (non-vocalizations) produced by 'living things', with human (conspecific) and non-human animal sources representing two subcategories; (2) action sounds produced by 'non-living things', including environmental sources and human-made machinery; and (3) vocalizations ('living things'), with human versus non-human animals as two subcategories therein. The model is presented in the context of cognitive architectures relating to multisensory, sensory-motor, and spoken language organizations. The models' predictive values are further discussed in the context of anthropological theories of oral communication evolution and the neurodevelopment of spoken language proto-networks in infants/toddlers. These phylogenetic and ontogenetic frameworks both entail cortical network maturations that are proposed to at least in part be organized around a number of universal acoustic-semantic signal attributes of natural sounds, which are addressed herein.

The brain during free movement - What can we learn from the animal model

Animals, just like humans, can freely move. They do so for various important reasons, such as finding food and escaping predators. Observing these behaviors can inform us about the underlying cognitive processes. In addition, while humans can convey complicated information easily through speaking, animals need to move their bodies to communicate. This has prompted many creative solutions by animal neuroscientists to enable studying the brain during movement. In this review, we first summarize how animal researchers record from the brain while an animal is moving, by describing the most common neural recording techniques in animals and how they were adapted to record during movement. We further discuss the challenge of controlling or monitoring sensory input during free movement. However, not only is free movement a necessity to reflect the outcome of certain internal cognitive processes in animals, it is also a fascinating field of research since certain crucial behavioral patterns can only be observed and studied during free movement. Therefore, in a second part of the review, we focus on some key findings in animal research that specifically address the interaction between free movement and brain activity. First, focusing on walking as a fundamental form of free movement, we discuss how important such intentional movements are for understanding processes as diverse as spatial navigation, active sensing, and complex motor planning. Second, we propose the idea of regarding free movement as the expression of a behavioral state. This view can help to understand the general influence of movement on brain function. Together, the technological advancements towards recording from the brain during movement, and the scientific questions asked about the brain engaged in movement, make animal research highly valuable to research into the human "moving brain".

Development and Design of Next-Generation Head-Mounted Ambulatory Microdose Positron-Emission Tomography (AM-PET) System

Several applications exist for a whole brain positron-emission tomography (PET) brain imager designed as a portable unit that can be worn on a patient’s head. Enabled by improvements in detector technology, a lightweight, high performance device would allow PET brain imaging in different environments and during behavioral tasks. Such a wearable system that allows the subjects to move their heads and walk—the Ambulatory Microdose PET (AM-PET)—is currently under development. This imager will be helpful for testing subjects performing selected activities such as gestures, virtual reality activities and walking. The need for this type of lightweight mobile device has led to the construction of a proof of concept portable head-worn unit that uses twelve silicon photomultiplier (SiPM) PET module sensors built into a small ring which fits around the head. This paper is focused on the engineering design of mechanical support aspects of the AM-PET project, both of the current device as well as of the coming next-generation devices. The goal of this work is to optimize design of the scanner and its mechanics to improve comfort for the subject by reducing the effect of weight, and to enable diversification of its applications amongst different research activities.

Concept of an upright wearable positron emission tomography imager in humans

BACKGROUND

Positron Emission Tomography (PET) is traditionally used to image patients in restrictive positions, with few devices allowing for upright, brain-dedicated imaging. Our team has explored the concept of wearable PET imagers which could provide functional brain imaging of freely moving subjects. To test feasibility and determine future considerations for development, we built a rudimentary proof-of-concept prototype (Helmet_PET) and conducted tests in phantoms and four human volunteers.

METHODS

Twelve Silicon Photomultiplier-based detectors were assembled in a ring with exterior weight support and an interior mechanism that could be adjustably fitted to the head. We conducted brain phantom tests as well as scanned four patients scheduled for diagnostic F(18-) FDG PET/CT imaging. For human subjects the imager was angled such that field of view included basal ganglia and visual cortex to test for typical resting-state pattern. Imaging in two subjects was performed ~4 hr after PET/CT imaging to simulate lower injected F(18-) FDG dose by taking advantage of the natural radioactive decay of the tracer (F(18) half-life of 110 min), with an estimated imaging dosage of 25% of the standard.

RESULTS

We found that imaging with a simple lightweight ring of detectors was feasible using a fraction of the standard radioligand dose. Activity levels in the human participants were quantitatively similar to standard PET in a set of anatomical ROIs. Typical resting-state brain pattern activation was demonstrated even in a 1 min scan of active head rotation.

CONCLUSION

To our knowledge, this is the first demonstration of imaging a human subject with a novel wearable PET imager that moves with robust head movements. We discuss potential research and clinical applications that will drive the design of a fully functional device. Designs will need to consider trade-offs between a low weight device with high mobility and a heavier device with greater sensitivity and larger field of view.