A non-negative fast multiplicative algorithm in 3D scatter-compensated SPET reconstruction

Expectation maximization (EM) algorithms using polar symmetries for computed tomography (CT) image reconstruction

We suggest a symmetric-polar pixellation scheme which makes possible a reduction of the computational cost for expectation maximization (EM) iterative algorithms. The proposed symmetric-polar pixellation allows us to deal with 3D images as a whole problem without dividing the 3D problem into 2D slices approach. Performance evaluation of each approach in terms of stability and image quality is presented. Exhaustive comparisons between all approaches were conducted in a 2D based image reconstruction model. From these 2D approaches, that showing the best performances were finally implemented and evaluated in a 3D based image reconstruction model. Comparison to 3D images reconstructed with FBP is also presented. Although the algorithm is presented in the context of computed tomography (CT) image reconstruction, it can be applied to any other tomographic technique as well, due to the fact that the only requirement is a scanning geometry involving measurements of an object under different projection angles. Real data have been acquired with a small animal (CT) scanner to verify the proposed mathematical description of the CT system.

A comparison of a Monte Carlo-based detection probability matrix with analytical probability matrix for small animal PET scanners

Positron Emission Tomography (PET) offers the possibility to quantitatively measure the radiotracer distribution in tissues. In order to obtain images of these tissues, the detection probability matrix (DPM) must be accurately determined. Usually, DPM is analytically calculated. However, this approach does not take into account the whole probabilistic interactions of the photons. On the other hand, Monte Carlo simulations (MC) are more accurate to calculate the DPM as they selectively consider diverse photon interactions. In this work, MC DPM (MCDPM) and analytically calculated DPM (ACDPM) were compared in terms of image quality. The results showed that the images obtained from the MCDPM were qualitatively better resolved and provided a significant improvement of the signal-to-noise ratio (SNR). The MCDPM yielded to an increase of up to 40% in SNR and up to 25% in contrast in comparison with ACDPM. On the other hands, MCDPM enhanced the counts distribution by more than 12% with respect to ACDPM.

Experimental facts supporting a red marrow uptake due to radiometal transchelation in 90Y-DOTATOC therapy and relationship to the decrease of platelet counts

PURPOSE

The aim of this study was to retrospectively evaluate whether the red marrow (RM) takes up (111)In-diethylenetriaminepentaacetic acid (DTPA)-D-Phe(1)-octreotide and (86)Y-DOTATOC and to assess the correlation between the RM absorbed doses and platelet count reduction as a biological dose estimate.

METHODS

Data from 12 patients who underwent at 24 h p.i. high statistics (111)In single photon emission computed tomography (SPECT) and (86)Y positron emission tomography (PET) acquisitions of the chest were analysed. Uptake was measured on >7 cm spine length and converted to total RM uptake using standard RM distribution in man. RM absorbed doses were calculated assuming specific RM uptake and using the plasma and remainder of the body models. RM doses were correlated with the platelet count reduction at 4 weeks. In vitro experiments explored the metabolism of (111)In-DTPA-D-Phe(1)-octreotide and (90)Y-DOTATOC in plasma.

RESULTS

The correlation between the uptake of both tracers was excellent (R = 0.80), indicating that RM uptake of (86)Y-DOTATOC reflects a real physiological process and not reconstruction artefacts. The kinetics of (86)Y-DOTATOC RM activity was different than that in blood and tumours, with no activity at 4 h p.i. indicating that the uptake is not somatostatin receptor dependent. In vitro experiments showed a transchelation of both radiometals to free transferrin that could explain the RM uptake. In patients without chemotherapy and with a normal platelet count recovery, a good correlation (R = 0.96) was found between the RM doses and the platelet count reduction at the nadir.

CONCLUSION

These experimental facts support the existence of a true RM uptake likely related to transchelation of the radiometal to transferrin. RM uptake correlates well with the observed acute RM toxicity.

Therapy using labelled somatostatin analogues: comparison of the absorbed doses with 111In-DTPA-D-Phe1-octreotide and yttrium-labelled DOTA-D-Phe1-Tyr3-octreotide

OBJECTIVE

We estimated the absorbed doses for (111)In-DTPA-D-Phe(1)-octreotide and (90)Y-DOTA-D-Phe(1)-Tyr(3)-octreotide in the same patients in order to compare the potential effectiveness (tumour dose) and safety (kidney and red marrow dose) of these drugs for peptide-targeted radiotherapy of somatostatin receptor positive tumours.

METHODS

Six patients with neuroendocrine tumours underwent quantitative (111)In-DTPA-D-Phe(1)-octreotide SPECT and (86)Y-DOTA-D-Phe(1)-Tyr(3)-octreotide PET scan at intervals of 1 week. All studies were performed with a co-infusion of amino acids for renal protection. PET and SPECT were reconstructed using iterative algorithms, incorporating attenuation and scatter corrections. Tissue uptakes (IA%) were measured and used to calculate residence times. Absorbed doses to tissues were estimated and the maximal allowed activity, defined as either the activity delivering 23 Gy to the kidneys (MAA(K)) or 2 Gy to the red marrow (MAA(RM)), was calculated and the resulting tumour absorbed doses were computed.

RESULTS

For the MAA(K) the mean absorbed dose to the red marrow was lower for (90)Y-DOTA-D-Phe(1)-Tyr(3)-octreotide than for (111)In-DTPA-D-Phe(1)-octreotide (1.8+/-0.9 Gy vs. 6.4+/-1.6 Gy; P<0.001). The median absorbed dose to tumours for the MAA(K) was two-fold higher for (90)Y-DOTA-D-Phe(1)-Tyr(3)-octreotide as compared to (111)In-DTPA-D-Phe(1)-octreotide (30.1 vs. 12.6 Gy; P<0.05). The median absorbed dose to tumours estimated for the MAA(RM) was 10-fold higher for (90)Y-DOTA-D-Phe(1)-Tyr(3)-octreotide than for (111)In-DTPA-D-Phe(1)-octreotide (35.1 Gy vs. 3.9 Gy; P<0.05).

CONCLUSIONS

This direct intra-patient comparison confirms that the use of (90)Y-DOTA-D-Phe(1)-Tyr(3)-octreotide is more appropriate for therapy of somatostatin receptor bearing tumours. When using (111)In-DTPA-D-Phe(1)-octreotide, the red marrow represents the major critical organ; this can result in significant toxicity if high activities have to be administered to obtain efficient tumour irradiation.

Attenuation-corrected 99mTc-MIBI SPECT in overweight patients with chronic ischaemic dysfunction: a comparison to NH3 PET and implications for the diagnosis of myocardial viability

OBJECTIVE

We determined the value of attenuation correction (AC) of myocardial perfusion estimation with (99m)Tc-MIBI SPECT in overweight patients by comparison of uncorrected (filtered back-projection (FBP) and corrected (an iterative algorithm with a measured attenuation coefficients map (FL-AC)) (99m)Tc-MIBI relative uptake to perfusion data obtained in the same patients with NH3 PET. In addition, the impact of attenuation correction for the assessment of myocardial viability with (99m)Tc-MIBI SPECT was determined using FDG PET as the reference method.

METHODS

Thirty consecutive overweight patients (BMI=28+/-4) with left ventricular dysfunction underwent a resting (99m)Tc-MIBI SPECT and a PET study (NH3 and FDG). (99m)Tc-MIBI SPECT scans were reconstructed without attenuation correction (FBP) and with attenuation correction (FL-AC). The left ventricle was divided into 16 segments, in which the relative uptake was quantified using circumferential profiles. A relative uptake > or = 60% was considered consistent with viable myocardium for FDG and MIBI.

RESULTS

The absolute difference between (99m)Tc-MIBI SPECT and NH3 PET uptakes was less pronounced in the inferior (12+/-10% vs. 17+/-12%, P<0.001), anteroseptal (12+/-11% vs. 16+/-12%, P=0.009) and septal (15+/-12% vs. 18+/-14%, P=0.003) regions (FL-AC vs. FBP, respectively). The sensitivity of MIBI for diagnosing myocardial viability increased from 83 to 100% (P=0.034), without loss in specificity.

CONCLUSION

Attenuation correction improves myocardial perfusion estimation by (99m)Tc-MIBI SPECT in the inferior, anteroseptal and septal regions and increases its sensitivity for the diagnosis of myocardial viability.

Diagnostic and therapeutic potential of amyloid-reactive IgG antibodies contained in human sera

Passive immunotherapy using fibril-reactive mAbs has been shown experimentally to reduce amyloid formation and also accelerate amyloidolysis. We now report that human sera, as well as various sources of pooled human IgG, including pharmacologic formulations of immune globulin i.v. (IGIV), contain Abs that specifically recognize fibrils formed from light chains and other amyloidogenic precursor proteins, including serum amyloid A, transthyretin, islet amyloid polypeptide, and amyloid beta 1-40 peptide, but notably, do not react with these molecules in their native nonfibrillar forms. After isolation of the Abs from IGIV via fibril-conjugated affinity column chromatography, the EC50-binding value for light chains and amyloid beta 1-40 peptide fibrils was approximately 15 nM-a magnitude approximately 200 and 70 times less than that of the unbound fraction and unfractionated product, respectively. Comparable reactivity was found in the case of those formed from serum amyloid A, transthyretin, and islet amyloid polypeptide. The purified Abs immunostained human amyloid tissue deposits and could inhibit fibrillogenesis, as shown in fibril formation and extension assays. Most importantly, in vivo reactivity was evidenced in a murine model when the enriched Abs were used to image amyloid, as well as expedite its removal. These promising experimental results suggest that fibril affinity-purified IGIV has potential as a diagnostic and therapeutic agent for patients with amyloid-associated disease.

Evaluation of a cross-validation stopping rule in MLE SPECT reconstruction

One of the problems in the routine use of the maximum-likelihood estimator method-expectation maximization (MLE-EM) algorithm is to decide when the iterative process should be stopped. We studied a cross-validation stopping rule to assess its usefulness in SPECT. We tested this stopping rule criterion in the MLE-EM algorithm without acceleration as well as in two accelerating algorithms, the successive substitutions algorithm (SSA) and the additive algorithm (AA). Different values of an acceleration factor were tested in SSA and AA. Our results from numerical and physical phantoms show that the stopping rule based on the cross-validation ratio (CVR) takes into account the similarity of the reconstructed image to the ideal image, noise and the contrast of the image. CVR yields reconstructed images with balanced values of the figures of merit (FOM) employed to assess the image quality. The CVR criterion can be used in the original MLE-EM algorithm as well as in SSA and AA. The reconstructed images obtained with SSA and AA showed FOM values that were very similar. These results were justified by considering AA to be an approximate form of SSA. The range of validity for the acceleration factor in SSA and AA was found to be [1, 2]. In this range, an inverse function connects the acceleration factor to the number of iterations needed to attain prefixed values of FOMs.