Prospects and Clinical Perspectives of Total-Body PET Imaging Using Plastic Scintillators

Positronium image of the human brain in vivo

Positronium is abundantly produced within the molecular voids of a patient's body during positron emission tomography (PET). Its properties dynamically respond to the submolecular architecture of the tissue and the partial pressure of oxygen. Current PET systems record only two annihilation photons and cannot provide information about the positronium lifetime. This study presents the in vivo images of positronium lifetime in a human, for a patient with a glioblastoma brain tumor, by using the dedicated Jagiellonian PET system enabling simultaneous detection of annihilation photons and prompt gamma emitted by a radionuclide. The prompt gamma provides information on the time of positronium formation. The photons from positronium annihilation are used to reconstruct the place and time of its decay. In the presented case study, the determined positron and positronium lifetimes in glioblastoma cells are shorter than those in salivary glands and those in healthy brain tissues, indicating that positronium imaging could be used to diagnose disease in vivo.

SPLIT: Statistical Positronium Lifetime Image Reconstruction via Time-Thresholding

Positron emission tomography (PET) is a widely utilized medical imaging modality that uses positron-emitting radiotracers to visualize biochemical processes in a living body. The spatiotemporal distribution of a radiotracer is estimated by detecting the coincidence photon pairs generated through positron annihilations. In human tissue, about 40% of the positrons form positroniums prior to the annihilation. The lifetime of these positroniums is influenced by the microenvironment in the tissue and could provide valuable information for better understanding of disease progression and treatment response. Currently, there are few methods available for reconstructing high-resolution lifetime images in practical applications. This paper presents an efficient statistical image reconstruction method for positronium lifetime imaging (PLI). We also analyze the random triple-coincidence events in PLI and propose a correction method for random events, which is essential for real applications. Both simulation and experimental studies demonstrate that the proposed method can produce lifetime images with high numerical accuracy, low variance, and resolution comparable to that of the activity images generated by a PET scanner with currently available time-of-flight resolution.

Towards Clinical Development of Scandium Radioisotope Complexes for Use in Nuclear Medicine: Encouraging Prospects with the Chelator 1,4,7,10-Tetraazacyclododecane-1,4,7,10-tetraacetic Acid (DOTA) and Its Analogues

Scandium (Sc) isotopes have recently attracted significant attention in the search for new radionuclides with potential uses in personalized medicine, especially in the treatment of specific cancer patient categories. In particular, Sc-43 and Sc-44, as positron emitters with a satisfactory half-life (3.9 and 4.0 h, respectively), are ideal for cancer diagnosis via Positron Emission Tomography (PET). On the other hand, Sc-47, as an emitter of beta particles and low gamma radiation, may be used as a therapeutic radionuclide, which also allows Single-Photon Emission Computed Tomography (SPECT) imaging. As these scandium isotopes follow the same biological pathway and chemical reactivity, they appear to fit perfectly into the "theranostic pair" concept. A step-by-step description, initiating from the moment of scandium isotope production and leading up to their preclinical and clinical trial applications, is presented. Recent developments related to the nuclear reactions selected and employed to produce the radionuclides Sc-43, Sc-44, and Sc-47, the chemical processing of these isotopes and the main target recovery methods are also included. Furthermore, the radiolabeling of the leading chelator, 1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid (DOTA), and its structural analogues with scandium is also discussed and the advantages and disadvantages of scandium complexation are evaluated. Finally, a review of the preclinical studies and clinical trials involving scandium, as well as future challenges for its clinical uses and applications, are presented.

Evaluation of lesion contrast in the walk-through long axial FOV PET scanner simulated with XCAT anthropomorphic phantoms

BACKGROUND

This study evaluates the lesion contrast in a cost-effective long axial field of view (FOV) PET scanner, called the walk-through PET (WT-PET). The scanner consists of two flat detector panels covering the entire torso and head, scanning patients in an upright position for increased throughput. High-resolution, depth-of-interaction capable, monolithic detector technology is used to provide good spatial resolution and enable detection of smaller lesions.

METHODS

Monte Carlo GATE simulations are used in conjunction with XCAT anthropomorphic phantoms to evaluate lesion contrast in lung, liver and breast for various lesion diameters (10, 7 and 5 mm), activity concentration ratios (8:1, 4:1 and 2:1) and patient BMIs (18-37). Images were reconstructed iteratively with listmode maximum likelihood expectation maximization, and contrast recovery coefficients (CRCs) were obtained for the reconstructed lesions.

RESULTS

Results shows notable variations in contrast recovery coefficients (CRC) across different lesion sizes and organ locations within the XCAT phantoms. Specifically, our findings reveal that 10 mm lesions consistently exhibit higher CRC compared to 7 mm and 5 mm lesions, with increases of approximately 54% and 330%, respectively, across all investigated organs. Moreover, high contrast recovery is observed in most liver lesions regardless of diameter or activity ratio (average CRC = 42%), as well as in the 10 mm lesions in the lung. Notably, for the 10 mm lesions, the liver demonstrates 42% and 62% higher CRC compared to the lung and breast, respectively. This trend remains consistent across lesion sizes, with the liver consistently exhibiting higher CRC values compared to the lung and breast: 7 mm lesions show an increase of 96% and 41%, while 5 mm lesions exhibit approximately 294% and 302% higher CRC compared to the lung and breast, respectively.

CONCLUSION

A comparison with a conventional pixelated LSO long axial FOV PET shows similar performance, achieved at a reduced cost for the WT-PET due to a reduction in required number of detectors.

Feasibility of the J-PET to monitor the range of therapeutic proton beams

PURPOSE

The aim of this work is to investigate the feasibility of the Jagiellonian Positron Emission Tomography (J-PET) scanner for intra-treatment proton beam range monitoring.

METHODS

The Monte Carlo simulation studies with GATE and PET image reconstruction with CASToR were performed in order to compare six J-PET scanner geometries. We simulated proton irradiation of a PMMA phantom with a Single Pencil Beam (SPB) and Spread-Out Bragg Peak (SOBP) of various ranges. The sensitivity and precision of each scanner were calculated, and considering the setup's cost-effectiveness, we indicated potentially optimal geometries for the J-PET scanner prototype dedicated to the proton beam range assessment.

RESULTS

The investigations indicate that the double-layer cylindrical and triple-layer double-head configurations are the most promising for clinical application. We found that the scanner sensitivity is of the order of 10-5 coincidences per primary proton, while the precision of the range assessment for both SPB and SOBP irradiation plans was found below 1 mm. Among the scanners with the same number of detector modules, the best results are found for the triple-layer dual-head geometry. The results indicate that the double-layer cylindrical and triple-layer double-head configurations are the most promising for the clinical application, CONCLUSIONS:: We performed simulation studies demonstrating that the feasibility of the J-PET detector for PET-based proton beam therapy range monitoring is possible with reasonable sensitivity and precision enabling its pre-clinical tests in the clinical proton therapy environment. Considering the sensitivity, precision and cost-effectiveness, the double-layer cylindrical and triple-layer dual-head J-PET geometry configurations seem promising for future clinical application.

A simulation study of the system characteristics for a long axial FOV PET design based on monolithic BGO flat panels compared with a pixelated LSO cylindrical design

BACKGROUND

Although a new generation of tomographs with a longer axial field-of-view called total-body PET have been developed, they are not widely utilized due to their high cost compared to conventional scanners. The newly designed walk-through total-body PET scanner is introduced as a high-throughput and cost-efficient alternative to total-body PET scanners, by making use of a flat panel geometry and lower cost, depth-of-interaction capable, monolithic BGO detectors. The main aim of the presented study is to evaluate through Monte Carlo simulation the system characteristics of the walk-through total-body PET scanner by comparing it with a Quadra-like total-body PET of similar attributes to the Siemens Biograph Vision Quadra.

METHODS

The walk-through total-body PET is comprised of two flat detector panels, spaced 50 cm apart. Each panel, 70 [Formula: see text] 106 cm[Formula: see text] in size, consists of 280 BGO-based monolithic detectors. The Quadra-like TB-PET has been simulated based on the characteristics of the Biograph Vision Quadra, one of the most common total-body PET scanners with 106 cm of axial field-of-view, which is constructed with pixelated LSO scintillation crystals. The spatial resolution, sensitivity, count rate performance, scatter fractions, and image quality of both scanners are simulated in the GATE simulation toolkit for comparison.

RESULTS

Due to the DOI-capable detectors used in the walk-through total-body PET, the values of the spatial resolution of this scanner were all below 2 mm along directions parallel to the panels, and reached a maximum of 3.36 mm in the direction perpendicular to the panels. This resolution is a large improvement compared to the values of the Quadra-like TB-PET. The walk-through total-body PET uses its maximum sensitivity (154 cps/kBq) for data acquisition and image reconstruction.

CONCLUSION

Based on the combination of very good spatial resolution and high sensitivity of the walk-through total-body PET, along with a 2.2 times lower scintillation crystal volume and 1.8 times lower SiPM surface, this scanner can be a very cost-efficient alternative for total-body PET scanners in cases where concomitant CT is not required.

Current and Future Use of Long Axial Field-of-View Positron Emission Tomography/Computed Tomography Scanners in Clinical Oncology

The latest technical development in the field of positron emission tomography/computed tomography (PET/CT) imaging has been the extension of the PET axial field-of-view. As a result of the increased number of detectors, the long axial field-of-view (LAFOV) PET systems are not only characterized by a larger anatomical coverage but also by a substantially improved sensitivity, compared with conventional short axial field-of-view PET systems. In clinical practice, this innovation has led to the following optimization: (1) improved overall image quality, (2) decreased duration of PET examinations, (3) decreased amount of radioactivity administered to the patient, or (4) a combination of any of the above. In this review, novel applications of LAFOV PET in oncology are highlighted and future directions are discussed.

Comparative studies of the sensitivities of sparse and full geometries of Total-Body PET scanners built from crystals and plastic scintillators

BACKGROUND

Alongside the benefits of Total-Body imaging modalities, such as higher sensitivity, single-bed position, low dose imaging, etc., their final construction cost prevents worldwide utilization. The main aim of this study is to present a simulation-based comparison of the sensitivities of existing and currently developed tomographs to introduce a cost-efficient solution for constructing a Total-Body PET scanner based on plastic scintillators.

METHODS

For the case of this study, eight tomographs based on the uEXPLORER configuration with different scintillator materials (BGO, LYSO), axial field-of-view (97.4 cm and 194.8 cm), and detector configurations (full and sparse) were simulated. In addition, 8 J-PET scanners with different configurations, such as various axial field-of-view (200 cm and 250 cm), different cross sections of plastic scintillator, and multiple numbers of plastic scintillator layers (2, 3, and 4), based on J-PET technology have been simulated by GATE software. Furthermore, Siemens' Biograph Vision has been simulated to compare the results with standard PET scans. Two types of simulations have been performed. The first one with a centrally located source with a diameter of 1 mm and a length of 250 cm, and the second one with the same source inside a water-filled cylindrical phantom with a diameter of 20 cm and a length of 183 cm.

RESULTS

With regards to sensitivity, among all the proposed scanners, the ones constructed with BGO crystals give the best performance ([Formula: see text] 350 cps/kBq at the center). The utilization of sparse geometry or LYSO crystals significantly lowers the achievable sensitivity of such systems. The J-PET design gives a similar sensitivity to the sparse LYSO crystal-based detectors while having full detector coverage over the body. Moreover, it provides uniform sensitivity over the body with additional gain on its sides and provides the possibility for high-quality brain imaging.

CONCLUSION

Taking into account not only the sensitivity but also the price of Total-Body PET tomographs, which till now was one of the main obstacles in their widespread clinical availability, the J-PET tomography system based on plastic scintillators could be a cost-efficient alternative for Total-Body PET scanners.

A new detector concept based on the prompt gamma radiation analysis for In vivo boron monitoring in BNCT

The problem of boron concentration monitoring during the boron neutron capture therapy (BNCT) therapy is one of the main challenges of this type of radiotherapy and is directly related to the nature of the interaction of neutrons with mater. Among the available in vivo methods of boron monitoring positron emission tomography seems to be very promising but it requires a new boron carrier with a β+ emitter, which is not yet clinically available. An alternative solution may be the prompt gamma radiation analysis (PGRA) based on the secondary radiation emitted in the interaction of neutrons with the patient's tissues. This method requires, however, compact gamma radiation detection systems sustaining high counting rates and characterized by very good energy resolution. In this contribution, we present state-of-the-art solutions for monitoring in BNCT based on PGRA. Moreover, we describe a new concept of such a system based on position-sensitive scintillator detectors equipped with an anti-Compton shield and data analysis supported with modern artificial intelligence algorithms.

3D melanoma spheroid model for the development of positronium biomarkers

It was recently demonstrated that newly invented positronium imaging may be used for improving cancer diagnostics by providing additional information about tissue pathology with respect to the standardized uptake value currently available in positron emission tomography (PET). Positronium imaging utilizes the properties of positronium atoms, which are built from the electrons and positrons produced in the body during PET examinations. We hypothesized that positronium imaging would be sensitive to the in vitro discrimination of tumor-like three-dimensional structures (spheroids) built of melanoma cell lines with different cancer activities and biological properties. The lifetime of ortho-positronium (o-Ps) was evaluated in melanoma spheroids from two cell lines (WM266-4 and WM115) differing in the stage of malignancy. Additionally, we considered parameters such as the cell number, spheroid size and melanoma malignancy to evaluate their relationship with the o-Ps lifetime. We demonstrate pilot results for o-Ps lifetime measurement in extracellular matrix-free spheroids. With the statistical significance of two standard deviations, we demonstrated that the higher the degree of malignancy and the rate of proliferation of neoplastic cells, the shorter the lifetime of ortho-positronium. In particular, we observed the following indications encouraging further research: (i) WM266-4 spheroids characterized by a higher proliferation rate and malignancy showed a shorter o-Ps lifetime than WM115 spheroids characterized by a lower growth rate. (ii) Both cell lines showed a decrease in the lifetime of o-Ps after spheroid generation on day 8 compared to day 4 in culture, and the mean o-Ps lifetime was longer for spheroids formed from WM115 cells than for those formed from WM266-4 cells, regardless of spheroid age. The results of this study revealed that positronium is a promising biomarker that may be applied in PET diagnostics for the assessment of the degree of cancer malignancy.

Efficiency determination of J-PET: first plastic scintillators-based PET scanner

BACKGROUND

The Jagiellonian Positron Emission Tomograph is the 3-layer prototype of the first scanner based on plastic scintillators, consisting of 192 half-metre-long strips with readouts at both ends. Compared to crystal-based detectors, plastic scintillators are several times cheaper and could be considered as a more economical alternative to crystal scintillators in future PETs. JPET is also a first multi-photon PET prototype. For the development of multi-photon detection, with photon characterized by the continuous energy spectrum, it is important to estimate the efficiency of J-PET as a function of energy deposition. The aim of this work is to determine the registration efficiency of the J-PET tomograph as a function of energy deposition by incident photons and the intrinsic efficiency of the J-PET scanner in detecting photons of different incident energies. In this study, 3-hit events are investigated, where 2-hits are caused by 511 keV photons emitted in [Formula: see text] annihilations, while the third hit is caused by one of the scattered photons. The scattered photon is used to accurately measure the scattering angle and thus the energy deposition. Two hits by a primary and a scattered photon are sufficient to calculate the scattering angle of a photon, while the third hit ensures the precise labeling of the 511 keV photons.

RESULTS

By comparing experimental and simulated energy distribution spectra, the registration efficiency of the J-PET scanner was determined in the energy deposition range of 70-270 keV, where it varies between 20 and 100[Formula: see text]. In addition, the intrinsic efficiency of the J-PET was also determined as a function of the energy of the incident photons.

CONCLUSION

A method for determining registration efficiency as a function of energy deposition and intrinsic efficiency as a function of incident photon energy of the J-PET scanner was demonstrated. This study is crucial for evaluating the performance of the scanner based on plastic scintillators and its applications as a standard and multi-photon PET systems. The method may be also used in the calibration of Compton-cameras developed for the ion-beam therapy monitoring and simultaneous multi-radionuclide imaging in nuclear medicine.

Developing a novel positronium biomarker for cardiac myxoma imaging

PURPOSE

Cardiac myxoma (CM), the most common cardiac tumor in adults, accounts for 50-75% of benign cardiac tumors. The diagnosis of CM is often elusive, especially in young stroke survivors and transthoracic echocardiography (TTE) is the initial technique for the differential diagnostics of CM. Less invasive cardiac computed tomography (CT) and magnetic resonance imaging (MRI) are not available for the majority of cardiac patients. Here, a robust imaging approach, ortho-Positronium (o-Ps) imaging, is presented to determine cardiac myxoma extracted from patients undergoing urgent cardiac surgery due to unexpected atrial masses. We aimed to assess if the o-Ps atom, produced copiously in intramolecular voids during the PET imaging, serves as a biomarker for CM diagnosing.

METHODS

Six perioperative CM and normal (adipose) tissue samples from patients, with primary diagnosis confirmed by the histopathology examination, were examined using positron annihilation lifetime spectroscopy (PALS) and micro-CT. Additionally, cell cultures and confocal microscopy techniques were used to picture cell morphology and origin.

RESULTS

We observed significant shortening in the mean o-Ps lifetime in tumor with compare to normal tissues: an average value of 1.92(02) ns and 2.72(05) ns for CM and the adipose tissue, respectively. Microscopic differences between tumor samples, confirmed in histopathology examination and micro-CT, did not influenced the major positronium imaging results.

CONCLUSIONS

Our findings, combined with o-Ps lifetime analysis, revealed the novel emerging positronium imaging marker (o-PS) for cardiovascular imaging. This method opens the new perspective to facilitate the quantitative in vivo assessment of intracardiac masses on a molecular (nanoscale) level.

Hybrid PET/Compton-camera imaging: an imager for the next generation

Compton cameras can offer advantages over gamma cameras for some applications, since they are well suited for multitracer imaging and for imaging high-energy radiotracers, such as those employed in radionuclide therapy. While in conventional clinical settings state-of-the-art Compton cameras cannot compete with well-established methods such as PET and SPECT, there are specific scenarios in which they can constitute an advantageous alternative. The combination of PET and Compton imaging can benefit from the improved resolution and sensitivity of current PET technology and, at the same time, overcome PET limitations in the use of multiple radiotracers. Such a system can provide simultaneous assessment of different radiotracers under identical conditions and reduce errors associated with physical factors that can change between acquisitions. Advances are being made both in instrumentation developments combining PET and Compton cameras for multimodal or three-gamma imaging systems, and in image reconstruction, addressing the challenges imposed by the combination of the two modalities or the new techniques. This review article summarizes the advances made in Compton cameras for medical imaging and their combination with PET.

Comparing bound entanglement of bell diagonal pairs of qutrits and ququarts

We compare the classification as entangled or separable of Bell diagonal bipartite qudits with positive partial transposition (PPT) and their properties for different dimensions. For dimension [Formula: see text], a form of entanglement exists that is hard to detect and called bound entanglement due to the fact that such entangled states cannot be used for entanglement distillation. Up to this date, no efficient solution is known to differentiate bound entangled from separable states. We address and compare this problem named separability problem for a family of bipartite Bell diagonal qudits with special algebraic and geometric structures and applications in quantum information processing tasks in different dimensions. Extending analytical and numerical methods and results for Bell diagonal qutrits ([Formula: see text]), we successfully classify more than [Formula: see text] of representative Bell diagonal PPT states for [Formula: see text]. Via those representative states we are able to estimate the volumes of separable and bound entangled states among PPT ququarts ([Formula: see text]). We find that at least [Formula: see text] of all PPT states are separable, [Formula: see text] bound entangled and for [Formula: see text] it remains unclear whether they are separable or bound entangled. Comparing the structure of bound entangled states and their detectors, we find considerable differences in the detection capabilities for different dimensions and relate those to differences of the Euclidean geometry for qutrits ([Formula: see text]) and ququarts ([Formula: see text]). Finally, using a detailed visual analysis of the set of separable and bound entangled Bell diagonal states in both dimensions, qualitative observations are made that allow to better distinguish bound entangled from separable states.

Experience and new prospects of PET imaging for ion beam therapy monitoring

Pioneering investigations on the usage of positron-emission-tomography (PET) for the monitoring of ion beam therapy with light (protons, helium) and heavier (stable and radioactive neon, carbon and oxygen) ions started shortly after the first realization of planar and tomographic imaging systems, which were able to visualize the annihilation of positrons resulting from irradiation induced or implanted positron emitting nuclei. And while the first clinical experience was challenged by the utilization of instrumentation directly adapted from nuclear medicine applications, new detectors optimized for this unconventional application of PET imaging are currently entering the phase of (pre)clinical testing for more reliable monitoring of treatment delivery during irradiation. Moreover, recent advances in detector technologies and beam production open several new exciting opportunities which will not only improve the performance of PET imaging under the challenging conditions of in-beam applications in ion beam therapy, but will also likely expand its field of application. In particular, the combination of PET and Compton imaging can enable the most efficient utilization of all possible radiative emissions for both stable and radioactive ion beams, while positronium lifetime imaging may enable probing new features of the underlying tumour and normal tissue environment. Thereby, PET imaging will not only provide means for volumetric reconstruction of the delivered treatment and in-vivo verification of the beam range, but can also shed new insights for biological optimization of the treatment or treatment response assessment.

A new brain dedicated PET scanner with 4D detector information

In this article, we present the geometrical design and preliminary results of a high sensitivity organ-specific Positron Emission Tomography (PET) system dedicated to the study of the human brain. The system, called 4D-PET, will allow accurate imaging of brain studies due to its expected high sensitivity, high 3D spatial resolution and, by including precise photon time of flight (TOF) information, a boosted signal-to-noise ratio (SNR).

The 4D-PET system incorporates an innovative detector design based on crystal slabs (semi-monolithic) that enables accurate 3D photon impact positioning (including photon Depth of Interaction (DOI) measurement), while providing a precise determination of the photon arrival time to the detector. The detector includes a novel readout system that reduces the number of detector signals in a ratio of 4:1 thus, alleviating complexity and cost. The analog output signals are fed to the TOFPET2 ASIC (PETsys) for scalability purposes.

The present manuscript reports the evaluation of the 4D-PET detector, achieving best values 3D resolution values of <1.6 mm (pixelated axis), 2.7±0.5 mm (monolithic axis) and 3.4±1.1 (DOI axis) mm; 359 ± 7 ps coincidence time resolution (CTR); 10.2±1.5 % energy resolution; and sensitivity of 16.2% at the center of the scanner (simulated). Moreover, a comprehensive description of the 4D-PET architecture (that includes 320 detectors), some pictures of its mechanical assembly, and simulations on the expected image quality are provided.

Multi-molecule imaging and inter-molecular imaging in nuclear medicine

Multi-molecule imaging and inter-molecular imaging are not fully implemented yet, however, can become an alternative in nuclear medicine. In this review article, we present arguments demonstrating that the advent of the Compton positron emission tomography (Compton-PET) system and the invention of the quantum chemical sensing method with double photon emission imaging (DPEI) provide realistic perspectives for visualizing inter-molecular and multi-molecule in nuclear medicine with MeV photon. In particular, the pH change of InCl3 solutions can be detected and visualized in a three-dimensional image by combining the hyperfine electric quadrupole interaction sensing and DPEI. Moreover, chemical states, such as chelating, can be detected through angular correlation sensing. We argue that multi-molecule and chemical sensing could be a realistic stream of research in future nuclear medicine.

A double photon coincidence detection method for medical gamma-ray imaging

Cascade nuclides emit two or more gamma rays successively through an intermediate state. The coincidence detection of cascade gamma rays provides several advantages in gamma-ray imaging. In this review article, three applications of the double photon coincidence method are reviewed. Double-photon emission imaging with mechanical collimators and Compton double-photon emission imaging can identify radioactive source positions with their angular-resolving detectors, and reduce the crosstalk between nuclides. In addition, a novel method of coincidence Compton imaging is proposed by taking coincidence detection between a Compton event and a photopeak events. Although this type of coincidence Compton imaging cannot specify the location, it can be useful in multi-nuclide Compton imaging.

Multi-photon time-of-flight MLEM application for the positronium imaging in J-PET

We develop a positronium imaging method for the Jagiellonian PET (J-PET) scanners based on the time-of-flight maximum likelihood expectation maximisation (TOF MLEM). The system matrix elements are calculated on-the-fly for the coincidences comprising two annihilation and one de-excitation photons that originate from the ortho-positronium (o-Ps) decay. Using the Geant4 library, a Monte Carlo simulation was conducted for four cylindrical 22Na sources of β+ decay with diverse o-Ps mean lifetimes, placed symmetrically inside the two JPET prototypes. The estimated time differences between the annihilation and the positron emission were aggregated into histograms (one per voxel), updated by the weights of the activities reconstructed by TOF MLEM. The simulations were restricted to include only the o-Ps decays into back-to-back photons, allowing a linear fitting model to be employed for the estimation of the mean lifetime from each histogram built in the log scale. To suppress the noise, the exclusion of voxels with activity below 2% – 10% of the peak was studied. The estimated o-Ps mean lifetimes were consistent with the simulation and distributed quasi -uniformly at high MLEM iterations. The proposed positronium imaging technique can be further upgraded to include various correction factors, as well as be modified according to realistic o-Ps decay models.

Towards high sensitivity and high-resolution PET scanners: imaging-guided proton therapy and total body imaging

Quantitative imaging (i.e., providing not just an image but also the related data) guidance in proton radiation therapy to achieve and monitor the precision of planned radiation energy deposition field in-vivo (a.k.a. proton range verification) is one of the most under-invested aspects of radiation cancer treatment despite that it may dramatically enhance the treatment accuracy and lower the exposure related toxicity improving the entire outcome of cancer therapy. In this article, we briefly describe the effort of the TPPT Consortium (a collaborative effort of groups from the University of Texas and Portugal) on building a time-of-flight positron-emission-tomography (PET) scanner to be used in pre-clinical studies for proton therapy at MD Anderson Proton Center in Houston. We also discuss some related ideas towards improving and expanding the use of PET detectors, including the total body imaging.

Radiovesicolomics-new approach in medical imaging

This review introduce extracellular vesicles (EVs) to a molecular imaging field. The idea of modern analyses based on the use of omics studies, using high-throughput methods to characterize the molecular content of a single biological system, vesicolomics seems to be the new approach to collect molecular data about EV content, to find novel biomarkers or therapeutic targets. The use of various imaging techniques, including those based on radionuclides as positron emission tomography (PET) or single photon emission computed tomography (SPECT), combining molecular data on EVs, opens up the new space for radiovesicolomics—a new approach to be used in theranostics.

Positronium Lifetime Image Reconstruction for TOF PET

Positron emission tomography is widely used in clinical and preclinical applications. Positronium lifetime carries information about the tissue microenvironment where positrons are emitted, but such information has not been captured because of two technical challenges. One challenge is the low sensitivity in detecting triple coincidence events. This problem has been mitigated by the recent developments of PET scanners with long (1-2 m) axial field of view. The other challenge is the low spatial resolution of the positronium lifetime images formed by existing methods that is determined by the time-of-flight (TOF) resolution (200-500 ps) of existing PET scanners. This paper solves the second challenge by developing a new image reconstruction method to generate high-resolution positronium lifetime images using existing TOF PET. Simulation studies demonstrate that the proposed method can reconstruct positronium lifetime images at much better spatial resolution than the limit set by the TOF resolution of the PET scanner. The proposed method opens up the possibility of performing positronium lifetime imaging using existing TOF PET scanners. The lifetime information can be used to understand the tissue microenvironment in vivo which could facilitate the study of disease mechanism and selection of proper treatments.

ProTheRaMon - a GATE simulation framework for proton therapy range monitoring using PET imaging

OBJECTIVE

This paper reports on the implementation and shows examples of the use of the ProTheRaMon framework for simulating the delivery of proton therapy treatment plans and range monitoring using positron emission tomography (PET). ProTheRaMon offers complete processing of proton therapy treatment plans, patient CT geometries, and intra-treatment PET imaging, taking into account therapy and imaging coordinate systems and activity decay during the PET imaging protocol specific to a given proton therapy facility. We present the ProTheRaMon framework and illustrate its potential use case and data processing steps for a patient treated at the Cyclotron Centre Bronowice (CCB) proton therapy center in Krakow, Poland.

APPROACH

The ProTheRaMon framework is based on GATE Monte Carlo software, the CASToR reconstruction package and in-house developed Python and bash scripts. The framework consists of five separated simulation and data processing steps, that can be further optimized according to the user's needs and specific settings of a given proton therapy facility and PET scanner design.

MAIN RESULTS

ProTheRaMon is presented using example data from a patient treated at CCB and the J-PET scanner to demonstrate the application of the framework for proton therapy range monitoring. The output of each simulation and data processing stage is described and visualized.

SIGNIFICANCE

We demonstrate that the ProTheRaMon simulation platform is a high-performance tool, capable of running on a computational cluster and suitable for multi-parameter studies, with databases consisting of large number of patients, as well as different PET scanner geometries and settings for range monitoring in a clinical environment. Due to its modular structure, the ProTheRaMon framework can be adjusted for different proton therapy centers and/or different PET detector geometries. It is available to the community via github.

The OpenGATE ecosystem for Monte Carlo simulation in medical physics

This paper reviews the ecosystem of GATE, an open-source Monte Carlo toolkit for medical physics. Based on the shoulders of Geant4, the principal modules (geometry, physics, scorers) are described with brief descriptions of some key concepts (Volume, Actors, Digitizer). The main source code repositories are detailed together with the automated compilation and tests processes (Continuous Integration). We then described how the OpenGATE collaboration managed the collaborative development of about one hundred developers during almost 20 years. The impact of GATE on medical physics and cancer research is then summarized, and examples of a few key applications are given. Finally, future development perspectives are indicated.

Almost complete solution for the NP-hard separability problem of Bell diagonal qutrits

With a probability of success of 95% we solve the separability problem for Bell diagonal qutrit states with positive partial transposition (PPT). The separability problem, i.e. distinguishing separable and entangled states, generally lacks an efficient solution due to the existence of bound entangled states. In contrast to free entangled states that can be used for entanglement distillation via local operations and classical communication, these states cannot be detected by the Peres-Horodecki criterion or PPT criterion. We analyze a large family of bipartite qutrit states that can be separable, free entangled or bound entangled. Leveraging a geometrical representation of these states in Euclidean space, novel methods are presented that allow the classification of separable and bound entangled Bell diagonal states in an efficient way. Moreover, the classification allows the precise determination of relative volumes of the classes of separable, free and bound entangled states. In detail, out of all Bell diagonal PPT states [Formula: see text] are determined to be separable while [Formula: see text] are bound entangled and only [Formula: see text] remain unclassified. Moreover, our applied criteria are compared for their effectiveness and relation as detectors of bound entanglement, which reveals that not a single criterion is capable to detect all bound entangled states.

Recent results on the positronium decay studies with the J-PET detector

Positronium, as a bound state of electron and positron and the lightest matter-antimatter system and at the same time an eigenstate of the C and P operators is a unique probe to search for possible violation of combined charge, parity, and time-reversal symmetries (CPT). The test is performed by a measurement of angular correlations in the annihilations of the lightest leptonic bound system. The J-PET detector is the only device which enables the determination of the polarization of photons from positronium annihilation together with the positronium spin axis on an event-by-event basis. This allows to explore a new class of discrete symmetry odd operators that were not investigated before. The first test of CPT symmetry at J-PET is presented together with preliminary results of CP, P and T symmetry test.

Using inverse Laplace transform in positronium lifetime imaging

Positronium (Ps) lifetime imaging is gaining attention to bring out additional biomedical information from positron emission tomography (PET). The lifetime of Psin vivocan change depending on the physical and chemical environments related to some diseases. Due to the limited sensitivity, Ps lifetime imaging may require merging some voxels for statistical accuracy. This paper presents a method for separating the lifetime components in the voxel to avoid information loss due to averaging. The mathematics for this separation is the inverse Laplace transform (ILT), and the authors examined an iterative numerical ILT algorithm using Tikhonov regularization, namely CONTIN, to discriminate a small lifetime difference due to oxygen saturation. The separability makes it possible to merge voxels without missing critical information on whether they contain abnormally long or short lifetime components. The authors conclude that ILT can compensate for the weaknesses of Ps lifetime imaging and extract the maximum amount of information.

Positronium as a biomarker of hypoxia

In this review article, we present arguments demonstrating that the advent of high sensitivity total-body PET systems and the invention of the method of positronium imaging, open realistic perspectives for the application of positronium as a biomarker for in-vivo assessment of the degree of hypoxia. Hypoxia is a state or condition, in which the availability of oxygen is not sufficient to support physiological processes in tissue and organs. Positronium is a metastable atom formed from electron and positron which is copiously produced in the intramolecular spaces in the living organisms undergoing positron emission tomography (PET). Properties of positronium, such as e.g., lifetime, depend on the size of intramolecular spaces and the concentration in them of oxygen molecules. Therefore, information on the partial pressure of oxygen (pO2) in the tissue may be derived from the positronium lifetime measurement. The partial pressure of oxygen differs between healthy and cancer tissues in the range from 10 to 50 mmHg. Such differences of pO2 result in the change of ortho-positronium lifetime e.g., in water by about 2–7 ps. Thus, the application of positronium as a biomarker of hypoxia requires the determination of the mean positronium lifetime with the resolution in the order of 2 ps. We argue that such resolution is in principle achievable for organ-wise positronium imaging with the total-body PET systems.

Theranostics – present and future

Theragnostics in nuclear medicine constitute an essential element of precision medicine. This notion integrates radionuclide diagnostics procedures and radionuclide therapies using appropriate radiopharmaceutics and treatment targeting specific biological pathways or receptors. The term theragnostics should also include another aspect of treatment: not only whether a given radioisotopic drug can be used, but also in what dose it ought to be used. Theragnostic procedures also allow predicting the effects of treatment based on the assessment of specific receptor density or the metabolic profile of neoplastic cells. The future of theragnostics depends not only on the use of new radiopharmaceuticals, but also on new gamma cameras. Modern theragnostics already require unambiguous pharmacokinetic and pharmacodynamic measurements based on absolute values. Only dynamic studies provide such a possibility. The introduction of the dynamic total-body PET-CT will enable this type of measurements characterizing metabolic processes and receptor expression on the basis of Patlak plot.

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.

Novel biomarker and drug delivery systems for theranostics – extracellular vesicles

Extracellular vesicles (EVs) are nano- and micro-sized double-layered membrane entities derived from most cell types and released into biological fluids. Biological properties (cell-uptake, biocompatibility), and chemical (composition, structure) or physical (size, density) characteristics make EVs a good candidate for drug delivery systems (DDS). Recent advances in the field of EVs (e.g., scaling-up production, purification) and developments of new imaging methods (total-body positron emission tomography [PET]) revealed benefits of radiolabeled EVs in diagnostic and interventional medicine as a potential DDs in theranostics.

Progress and perspectives in total body PET systems instrumentation

Total body positron emission tomography (PET) systems are being developed by different groups worldwide. These systems have potential to change the number of applications in which molecular imaging is used. The change from a short axial field of view (FOV) to a longer one is however associated with a linear increase in the cost of these systems. This may limit their application to a small number of centers (capable of obtaining sufficient research funding). Therefore it remains interesting to see if lower cost systems can be developed and bring total body PET to the clinic for an acceptable budget. The wider availability of this low cost system can also enable more researchers to further optimize and explore the full potential of total body PET.

Unparalleled and revolutionary impact of PET imaging on research and day to day practice of medicine

Positron emission tomography (PET) imaging is the most quantitative modality for assessing disease activity at the molecular and cellular levels, and therefore, it allows monitoring its course and determining the efficacy of various therapeutic interventions. In this scientific communication, we describe the unparalleled and revolutionary impact of PET imaging on research and day to day practice of medicine. We emphasize the critical importance of the development and synthesis of novel radiotracers (starting from the enormous impact of F-Fluorodeouxyglucose (FDG) introduced by investigators at the University of Pennsylvania (PENN)) and PET instrumentation. These innovations have led to the total-body PET systems enabling dynamic and parametric molecular imaging of all organs in the body simultaneously. We also present our perspectives for future development of molecular imaging by multiphoton PET systems that will enable users to extract substantial information (owing to the evolving role of positronium imaging) about the related molecular and biological bases of various disorders, which are unachievable by the current PET imaging techniques.

New Radionuclides and Technological Advances in SPECT and PET Scanners

Simple Summary

Advances in nuclear medicine are made by technological and radionuclide improvements. Throughout nuclear medicine’s history, these advances were often intertwined and complementary based on different clinical questions, availability and need. This paper covers some of these developments in radionuclides and instrumentation.

Abstract

Developments throughout the history of nuclear medicine have involved improvements in both instrumentation and radionuclides, which have been intertwined. Instrumentation developments always occurred during the search to improving devices’ sensitivity and included advances in detector technology (with the introduction of cadmium zinc telluride and digital Positron Emission Tomography—PET-devices with silicon photomultipliers), design (total body PET) and configuration (ring-shaped, Single-Photon Emission Computed Tomography (SPECT), Compton camera). In the field of radionuclide development, we observed the continual changing of clinically used radionuclides, which is sometimes influenced by instrumentation technology but also driven by availability, patient safety and clinical questions. Some areas, such as tumour imaging, have faced challenges when changing radionuclides based on availability, when this produced undesirable clinical findings with the introduction of unclear focal uptakes and unspecific uptakes. On the other end of spectrum, further developments of PET technology have seen a resurgence in its use in nuclear cardiology, with rubidium-82 from strontium-82/rubidium-82 generators being the radionuclide of choice, moving away from SPECT nuclides thallium-201 and technetium-99m. These continuing improvements in both instrumentation and radionuclide development have helped the growth of nuclear medicine and its importance in the ever-evolving range of patient care options.

Combined BNCT and PET for theranostics

This short review summarizes the issue of boron distribution monitoring in boron neutron capture therapy (BNCT), which remains a serious drawback of this powerful oncological treatment. Here we present the monitoring methods that are presently used with particular emphasis on the positron emission tomography (PET) which has the highest potential to be used for the real-time monitoring of boron biodistribution. We discuss the possibility of using present PET scanners to determine the boron uptake in vivo before the BNCT treatment with the use of p-boronphenylalanine (BPA) labeled with 18F isotope. Several examples of preclinical studies and clinical trials performed with the use of [18F]FBPA are shown. We also discuss shortly the perspectives of using other radiotracers and boron carriers which may significantly improve the boron imaging with the use of the state-of-the-art Total-Body PET scanners providing a theranostic approach in the BNCT.

Prospects for the production of radioisotopes and radiobioconjugates for theranostics

The development of diagnostic methods in medicine as well as the progress in the synthesis of biologically active compounds allows the use of selected radioisotopes for the simultaneous diagnosis and treatment of diseases, especially cancerous ones, in patients. This approach is called theranostic. This review article includes chemical and physical characterization of chosen theranostic radioisotopes and their compounds that are or could be useful in nuclear medicine.

History of positron emission tomography (PET) in Poland

In this short chronological review, we showed the development of positron emission tomography (PET) starting from research on first isotopes through the concepts and prototype of PET machine to the current clinical practice and technological and clinical research. Particular emphasis was placed on a clear description of the milestones of PET development in Poland.

Positronium imaging with the novel multiphoton PET scanner

In vivo assessment of cancer and precise location of altered tissues at initial stages of molecular disorders are important diagnostic challenges. Positronium is copiously formed in the free molecular spaces in the patient’s body during positron emission tomography (PET). The positronium properties vary according to the size of inter- and intramolecular voids and the concentration of molecules in them such as, e.g., molecular oxygen, O₂; therefore, positronium imaging may provide information about disease progression during the initial stages of molecular alterations. Current PET systems do not allow acquisition of positronium images. This study presents a new method that enables positronium imaging by simultaneous registration of annihilation photons and deexcitation photons from pharmaceuticals labeled with radionuclides. The first positronium imaging of a phantom built from cardiac myxoma and adipose tissue is demonstrated. It is anticipated that positronium imaging will substantially enhance the specificity of PET diagnostics.

Free versus bound entanglement, a NP-hard problem tackled by machine learning

Entanglement detection in high dimensional systems is a NP-hard problem since it is lacking an efficient way. Given a bipartite quantum state of interest free entanglement can be detected efficiently by the PPT-criterion (Peres-Horodecki criterion), in contrast to detecting bound entanglement, i.e. a curious form of entanglement that can also not be distilled into maximally (free) entangled states. Only a few bound entangled states have been found, typically by constructing dedicated entanglement witnesses, so naturally the question arises how large is the volume of those states. We define a large family of magically symmetric states of bipartite qutrits for which we find [Formula: see text] to be free entangled, [Formula: see text] to be certainly separable and as much as [Formula: see text] to be bound entangled, which shows that this kind of entanglement is not rare. Via various machine learning algorithms we can confirm that the remaining [Formula: see text] of states are more likely to belonging to the set of separable states than bound entangled states. Most important we find via dimension reduction algorithms that there is a strong two-dimensional (linear) sub-structure in the set of bound entangled states. This revealed structure opens a novel path to find and characterize bound entanglement towards solving the long-standing problem of what the existence of bound entanglement is implying.

Testing CPT symmetry in ortho-positronium decays with positronium annihilation tomography

Charged lepton system symmetry under combined charge, parity, and time-reversal transformation (CPT) remains scarcely tested. Despite stringent quantum-electrodynamic limits, discrepancies in predictions for the electron–positron bound state (positronium atom) motivate further investigation, including fundamental symmetry tests. While CPT noninvariance effects could be manifested in non-vanishing angular correlations between final-state photons and spin of annihilating positronium, measurements were previously limited by knowledge of the latter. Here, we demonstrate tomographic reconstruction techniques applied to three-photon annihilations of ortho-positronium atoms to estimate their spin polarisation without magnetic field or polarised positronium source. We use a plastic-scintillator-based positron-emission-tomography scanner to record ortho-positronium (o-Ps) annihilations with single-event estimation of o-Ps spin and determine the complete spectrum of an angular correlation operator sensitive to CPT-violating effects. We find no violation at the precision level of 10⁻⁴, with an over threefold improvement on the previous measurement.

CPT violation could manifest itself in annihilating positronium events, but searching for this effect would require to know the spin of the annihilating system. Here, the authors do this using a positron-emission tomography scanner, finding no violation with a statistical precision of 10⁻⁴.

Blue-emitting polystyrene scintillators for plastic scintillation dosimetry

Objectives

Purpose of this research was to find the best blue-emitting fluorescent substance for plastic scintillator used for gamma radiation dosimetry. Scintillator should convert gamma radiation into blue light with high efficiency.

Methods

Plastic scintillators with fixed concentration of various fluorescent additives, called wavelength shifters, absorbing ultraviolet light and emitting blue light were manufactured by radical bulk polymerization of styrene. Light output were measured and compared to the light output of commercial plastic scintillator.

Results

Performed measurements of charge Compton spectra confirmed usefulness of majority of researched substances as wavelength shifters in plastic scintillators with emission maximum at blue range of visible light.

Conclusions

Plastic scintillation dosimeter may be constructed from manufactured polystyrene-based scintillators. Performance of synthesized scintillators is close to commercial polystyrene scintillators.

Simulating NEMA characteristics of the modular total-body J-PET scanner-an economic total-body PET from plastic scintillators

The purpose of the presented research is estimation of the performance characteristics of the economic total-body Jagiellonian-PET system (TB-J-PET) constructed from plastic scintillators. The characteristics are estimated according to the NEMA NU-2-2018 standards utilizing the GATE package. The simulated detector consists of 24 modules, each built out of 32 plastic scintillator strips (each with cross section of 6 mm times 30 mm and length of 140 or 200 cm) arranged in two layers in regular 24-sided polygon circumscribing a circle with the diameter of 78.6 cm. For the TB-J-PET with an axial field-of-view (AFOV) of 200 cm, a spatial resolutions (SRs) of 3.7 mm (transversal) and 4.9 mm (axial) are achieved. The noise equivalent count rate (NECR) peak of 630 kcps is expected at 30 kBq cc^-1. Activity concentration and the sensitivity at the center amounts to 38 cps kBq^-1. The scatter fraction (SF) is estimated to 36.2 %. The values of SF and SR are comparable to those obtained for the state-of-the-art clinical PET scanners and the first total-body tomographs: uExplorer and PennPET. With respect to the standard PET systems with AFOV in the range from 16 to 26 cm, the TB-J-PET is characterized by an increase in NECR approximately by factor of 4 and by the increase of the whole-body sensitivity by factor of 12.6 to 38. The time-of-flight resolution for the TB-J-PET is expected to be at the level of CRT = 240 ps full width at half maximum. For the TB-J-PET with an AFOV of 140 cm, an image quality of the reconstructed images of a NEMA IEC phantom was presented with a contrast recovery coefficient and a background variability parameters. The increase of the whole-body sensitivity and NECR estimated for the TB-J-PET with respect to current commercial PET systems makes the TB-J-PET a promising cost-effective solution for the broad clinical applications of total-body PET scanners. TB-J-PET may constitute an economic alternative for the crystal TB-PET scanners, since plastic scintillators are much cheaper than BGO or LYSO crystals and axial arrangement of the strips significantly reduces the costs of readout electronics and SiPMs.

Computational modeling for the evaluation of suppressed scintillation yields in plastic scintillators using Geant4

The yield of scintillation photons emitted from scintillators is considered to be proportional to the LET (linear energy transfer) which is energy distribution per unit length, in the low-LET domain, but not proportional in the high LET domain due to the suppression yield from the so-called quenching effect. Ogawa et al. proposed a computational method to estimate scintillation yield using Monte Carlo simulations considering the principle of the FRET (fluorescence resonance energy transfer) process, which is a phenomenon of energy transfer between fluorescent molecules. In their study, the track structure simulations could reproduce measured yields of scintillation. However, Ogawa et al.'s model was not suitable for estimating the scintillation yields when the particle energy was low when using condensed history simulations. Therefore, we propose a new method for estimating scintillation yields more accurately using Geant4 to improve the model calculations based on condensed history simulations. We simulated the local energy deposition pattern in a NE102A plastic scintillator to calculate the number of excitors in the microscopic volume for various nuclides (helium to argon ions). The suppressed scintillation yields were estimated using the model calculations of sequential FRET processes while considering the inactivation of the excitors selected as donors of the FRET process. The model calculations successfully reproduced the experimental scintillation yields within 10% error for the lighter ions up to neon. However, when the analysis was repeated for silicon and argon, the maximum error in the scintillation yields increased up to 27%. The proposed computational model for the evaluation of the suppressed scintillation yields emitted from NE102A scintillator irradiated with heavy ions using sequential FRET calculations with condensed history method returned simulated scintillation yields.

Optimisation of the event-based TOF filtered back-projection for online imaging in total-body J-PET

We perform a parametric study of the newly developed time-of-flight (TOF) image reconstruction algorithm, proposed for the real-time imaging in total-body Jagiellonian PET (J-PET) scanners. The asymmetric 3D filtering kernel is applied at each most likely position of electron-positron annihilation, estimated from the emissions of back-to-back γ-photons. The optimisation of its parameters is studied using Monte Carlo simulations of a 1-mm spherical source, NEMA IEC and XCAT phantoms inside the ideal J-PET scanner. The combination of high-pass filters which included the TOF filtered back-projection (FBP), resulted in spatial resolution, 1.5 times higher in the axial direction than for the conventional 3D FBP. For realistic 10-minute scans of NEMA IEC and XCAT, which require a trade-off between the noise and spatial resolution, the need for Gaussian TOF kernel components, coupled with median post-filtering, is demonstrated. The best sets of 3D filter parameters were obtained by the Nelder-Mead minimisation of the mean squared error between the resulting and reference images. The approach allows training the reconstruction algorithm for custom scans, using the IEC phantom, when the temporal resolution is below 50 ps. The image quality parameters, estimated for the best outcomes, were systematically better than for the non-TOF FBP.

Advanced Monte Carlo simulations of emission tomography imaging systems with GATE

Built on top of the Geant4 toolkit, GATE is collaboratively developed for more than 15 years to design Monte Carlo simulations of nuclear-based imaging systems. It is, in particular, used by researchers and industrials to design, optimize, understand and create innovative emission tomography systems. In this paper, we reviewed the recent developments that have been proposed to simulate modern detectors and provide a comprehensive report on imaging systems that have been simulated and evaluated in GATE. Additionally, some methodological developments that are not specific for imaging but that can improve detector modeling and provide computation time gains, such as Variance Reduction Techniques and Artificial Intelligence integration, are described and discussed.

Sensitivity of Discrete Symmetry Tests in the Positronium System with the J-PET Detector

Study of certain angular correlations in the three-photon annihilations of the triplet state of positronium, the electron–positron bound state, may be used as a probe of potential CP and CPT-violating effects in the leptonic sector. We present the perspectives of CP and CPT tests using this process recorded with a novel detection system for photons in the positron annihilation energy range, the Jagiellonian Positron Emission Tomography (J-PET). We demonstrate the capability of this system to register three-photon annihilations with an unprecedented range of kinematical configurations and to measure the CPT-odd correlation between positronium spin and annihilation plane orientation with a precision improved by at least an order of magnitude with respect to present results. We also discuss the means to control and reduce detector asymmetries in order to allow J-PET to set the first measurement of the correlation between positronium spin and momentum of the most energetic annihilation photon which has never been studied to date.