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

PET detectors with depth-of-interaction and time-of-flight capabilities

In positron emission tomography (PET), measurements of depth-of-interaction (DOI) information and time-of-flight (TOF) information are important. DOI information reduces the parallax error, and TOF information reduces noise by measuring the arrival time difference of the annihilation photons. Historically, these have been studied independently, and there has been less implementation of both DOI and TOF capabilities because previous DOI detectors did not have good TOF resolution. However, recent improvements in PET detector performance have resulted in commercial PET scanners achieving a coincidence resolving time of around 200 ps, which result in an effect even for small objects. This means that TOF information can now be utilized even for a brain PET scanner, which also requires DOI information. Therefore, various methods have been proposed to obtain better DOI and TOF information. In addition, the cost of PET detectors is also an important factor to consider, since several hundred detectors are used per PET scanner. In this paper, we review the latest DOI-TOF detectors including the history of detector development. When put into practical use, these DOI-TOF detectors are expected to contribute to the improvement of imaging performance in brain PET scanners.

Performance Characteristics of the NeuroEXPLORER, a Next-Generation Human Brain PET/CT Imager

The collaboration of Yale, the University of California, Davis, and United Imaging Healthcare has successfully developed the NeuroEXPLORER, a dedicated human brain PET imager with high spatial resolution, high sensitivity, and a built-in 3-dimensional camera for markerless continuous motion tracking. It has high depth-of-interaction and time-of-flight resolutions, along with a 52.4-cm transverse field of view (FOV) and an extended axial FOV (49.5 cm) to enhance sensitivity. Here, we present the physical characterization, performance evaluation, and first human images of the NeuroEXPLORER. Methods: Measurements of spatial resolution, sensitivity, count rate performance, energy and timing resolution, and image quality were performed adhering to the National Electrical Manufacturers Association (NEMA) NU 2-2018 standard. The system's performance was demonstrated through imaging studies of the Hoffman 3-dimensional brain phantom and the mini-Derenzo phantom. Initial 18F-FDG images from a healthy volunteer are presented. Results: With filtered backprojection reconstruction, the radial and tangential spatial resolutions (full width at half maximum) averaged 1.64, 2.06, and 2.51 mm, with axial resolutions of 2.73, 2.89, and 2.93 mm for radial offsets of 1, 10, and 20 cm, respectively. The average time-of-flight resolution was 236 ps, and the energy resolution was 10.5%. NEMA sensitivities were 46.0 and 47.6 kcps/MBq at the center and 10-cm offset, respectively. A sensitivity of 11.8% was achieved at the FOV center. The peak noise-equivalent count rate was 1.31 Mcps at 58.0 kBq/mL, and the scatter fraction at 5.3 kBq/mL was 36.5%. The maximum count rate error at the peak noise-equivalent count rate was less than 5%. At 3 iterations, the NEMA image-quality contrast recovery coefficients varied from 74.5% (10-mm sphere) to 92.6% (37-mm sphere), and background variability ranged from 3.1% to 1.4% at a contrast of 4.0:1. An example human brain 18F-FDG image exhibited very high resolution, capturing intricate details in the cortex and subcortical structures. Conclusion: The NeuroEXPLORER offers high sensitivity and high spatial resolution. With its long axial length, it also enables high-quality spinal cord imaging and image-derived input functions from the carotid arteries. These performance enhancements will substantially broaden the range of human brain PET paradigms, protocols, and thereby clinical research applications.

Design and characterization of a hybrid PET detector with DOI capability

BACKGROUND

Monolithic or semi-monolithic detectors are attractive for positron emission tomography (PET) scanners with depth-of-interaction (DOI) capability. However, they often require complicated calibrations to determine the interaction positions of gamma photons.

PURPOSE

We introduce a novel hybrid detector design that combines pixelated and semi-monolithic elements to achieve DOI capability while simplifying the calibrations for positioning.

METHODS

A prototype detector with eight hybrid lutetium-yttrium oxyorthosilicate (LYSO) layers having dimensions of 25.8 × 12.9 × 15 mm3 was constructed. The energy-weighted and energy-squared weighted averages were used for estimating the x- (pixelated direction) and y-positions (non-pixelated direction). Pseudo-pixels were defined as discrete areas on the flood image based on the crystal look-up table (LUT). The intrinsic spatial resolutions in the pixelated and non-pixelated directions were measured. The ratio of the maximum to the sum of the multipixel photon counter (MPPC) signals was used to estimate the DOI positions. The coincidence timing resolution (CTR) was measured using the average and energy-weighted average of the earliest n time stamps. Two energy windows of 250-700 and 400-600 keV were applied for the measurements.

RESULTS

The pattern of the flood images showed discrete event clusters, demonstrating that simple calibrations for determining the x- and y-positions of events could be achieved. Under 400-600 keV energy window, the average intrinsic spatial resolutions were 1.15 and 1.34 mm for the pixelated and non-pixelated directions; the average DOI resolution of the second row of pseudo-pixels was 5.1 mm in full width at half maximum (FWHM); when using the energy-weighted average of the earliest four-time stamps, the best CTR of 350 ps was achieved. Applying a broader energy window of 250-700 keV only slightly degrades the DOI resolution while maintaining the intrinsic resolution; the best CTR degrades to 410 ps.

CONCLUSIONS

The proposed hybrid detector concept was verified, and a prototype detector showed high performance for 3D positioning and timing resolution. The novel detector concept shows promise for preclinical and clinical PET scanners with DOI capability.

Recent developments and challenges in positron emission tomography imaging of gliosis in chronic neuropathic pain

ABSTRACT

Understanding the mechanisms that underpin the transition from acute to chronic pain is critical for the development of more effective and targeted treatments. There is growing interest in the contribution of glial cells to this process, with cross-sectional preclinical studies demonstrating specific changes in these cell types capturing targeted timepoints from the acute phase and the chronic phase. In vivo longitudinal assessment of the development and evolution of these changes in experimental animals and humans has presented a significant challenge. Recent technological advances in preclinical and clinical positron emission tomography, including the development of specific radiotracers for gliosis, offer great promise for the field. These advances now permit tracking of glial changes over time and provide the ability to relate these changes to pain-relevant symptomology, comorbid psychiatric conditions, and treatment outcomes at both a group and an individual level. In this article, we summarize evidence for gliosis in the transition from acute to chronic pain and provide an overview of the specific radiotracers available to measure this process, highlighting their potential, particularly when combined with ex vivo/in vitro techniques, to understand the pathophysiology of chronic neuropathic pain. These complementary investigations can be used to bridge the existing gap in the field concerning the contribution of gliosis to neuropathic pain and identify potential targets for interventions.

Amyloid brain-dedicated PET images can diagnose Alzheimer's pathology with Centiloid Scale

PURPOSE

To evaluate whether the Centiloid Scale may be used to diagnose Alzheimer's Disease (AD) pathology effectively with the only use of amyloid PET imaging modality from a brain-dedicated PET scanner.

METHODS

This study included 26 patients with amyloid PET images with 3 different radiotracers. All patients were acquired both on a PET/CT and a brain-dedicated PET scanner (CareMiBrain, CMB), from which 4 different reconstructions were implemented. A new pipeline was proposed and used for the PET image analysis based on the original Centiloid Scale processing pipeline, but with only PET images. The Youden's Index was employed to calculate the optimal cutoffs for diagnosis and evaluated by the AUC, accuracy, precision, and recall metrics.

RESULTS

The Centiloid Scale (CL) processing pipeline was validated with and without the use of MR images. The CL cutoffs for AD pathology diagnosis on the PET/CT and the 4 CMB reconstructions were 34.4 ± 2.2, 43.5 ± 3.5, 51.9 ± 12.5, 57.5 ± 6.8 and 41.8 ± 1.2 respectively. Overall, for these cutoffs all metrics obtained the maximum score.

CONCLUSION

The Centiloid scale applied to PET images allows for AD pathology diagnosis. The CMB scanner can be used with the Centiloid scale to automatically assist in the diagnosis of AD pathology, relieving the large burden of neurodegenerative diseases on a traditional PET/CT.

Evaluation of monolithic crystal detector with dual-ended readout utilizing multiplexing method

Objective.Monolithic crystal detectors are increasingly being applied in positron emission tomography (PET) devices owing to their excellent depth-of-interaction (DOI) resolution capabilities and high detection efficiency. In this study, we constructed and evaluated a dual-ended readout monolithic crystal detector based on a multiplexing method.Approach.We employed two 12 × 12 silicon photomultiplier (SiPM) arrays for readout, and the signals from the 12 × 12 array were merged into 12 X and 12 Y channels using channel multiplexing. In 2D reconstruction, three methods based on the centre of gravity (COG) were compared, and the concept of thresholds was introduced. Furthermore, a light convolutional neural network (CNN) was employed for testing. To enhance depth localization resolution, we proposed a method by utilizing the mutual information from both ends of the SiPMs. The source width and collimation effect were simulated using GEANT4, and the intrinsic spatial resolution was separated from the measured values.Main results.At an operational voltage of 29 V for the SiPM, an energy resolution of approximately 12.5 % was achieved. By subtracting a 0.8 % threshold from the total energy in every channel, a 2D spatial resolution of approximately 0.90 mm full width at half maximum (FWHM) can be obtained. Furthermore, a higher level of resolution, approximately 0.80 mm FWHM, was achieved using a CNN, with some alleviation of edge effects. With the proposed DOI method, a significant 1.36 mm FWHM average DOI resolution can be achieved. Additionally, it was found that polishing and black coating on the crystal surface yielded smaller edge effects compared to a rough surface with a black coating.Significance.The introduction of a threshold in COG method and a dual-ended readout scheme can lead to excellent spatial resolution for monolithic crystal detectors, which can help to develop PET systems with both high sensitivity and high spatial resolution.

Dynamic Human Brain Imaging with a Portable PET Camera: Comparison to a Standard Scanner

Portable, cost-effective PET cameras can radically expand the applicability of PET. We present here a within-participant comparison of fully quantified [18F]FDG dynamic scans in healthy volunteers using the standard Biograph mCT scanner and portable CerePET scanner. Methods: Each of 20 healthy volunteers underwent dynamic [18F]FDG imaging with both scanners (1-154 d apart) and concurrent arterial blood sampling. Tracer SUV, net influx rate (Ki), and the corresponding cerebral metabolic rate of glucose (CMRglu) were quantified at regional and voxel levels. Results: At the regional level, CerePET outcome measure estimates within participants robustly correlated with Biograph mCT estimates in the neocortex, wherein the average Pearson correlation coefficients across participants ± SD were 0.83 ± 0.07 (SUV) and 0.85 ± 0.08 (Ki and CMRglu). There was also strong agreement between CerePET and Biograph mCT estimates, wherein the average regression slopes across participants were 0.84 ± 0.17 (SUV), 0.83 ± 0.17 (Ki), and 0.85 ± 0.18 (CMRglu). There was similar bias across participants but higher correlation and less variability in subcortical regions than in cortical regions. Pearson correlation coefficients for subcortical regions equaled 0.97 ± 0.02 (SUV) and 0.97 ± 0.03 (Ki and CMRglu), and average regression slopes equaled 0.79 ± 0.14 (SUV), 0.83 ± 0.11 (Ki), and 0.86 ± 0.11 (CMRglu). In voxelwise assessment, CerePET and Biograph mCT estimates across outcome measures were significantly different only in a cluster of left frontal white matter. Conclusion: Our results indicate robust correlation and agreement between semi- and fully quantitative brain glucose metabolism measurements from portable CerePET and standard Biograph mCT scanners. The results obtained with a portable PET scanner in this comparison in humans require follow-up but lend confidence to the feasibility of more flexible and portable brain imaging with PET.

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.

New Horizons in Brain PET Instrumentation

Dedicated brain PET scanners are optimized to provide high sensitivity and high spatial resolution compared with existing whole-body PET systems, and they can be much cheaper to produce and install in various clinical and research settings. Advancements in detector technology over the past few years have placed several standalone PET, PET/computed tomography, and PET/MR systems on or near the commercial market; the features and capabilities of these systems will be reviewed here.

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.

A conformal TOF-DOI Prism-PET prototype scanner for high-resolution quantitative neuroimaging

BACKGROUND

Positron emission tomography (PET) has had a transformative impact on oncological and neurological applications. However, still much of PET's potential remains untapped with limitations primarily driven by low spatial resolution, which severely hampers accurate quantitative PET imaging via the partial volume effect (PVE).

PURPOSE

We present experimental results of a practical and cost-effective ultra-high resolution brain-dedicated PET scanner, using our depth-encoding Prism-PET detectors arranged along a compact and conformal gantry, showing substantial reduction in PVE and accurate radiotracer uptake quantification in small regions.

METHODS

The decagon-shaped prototype scanner has a long diameter of 38.5 cm, a short diameter of 29.1 cm, and an axial field-of-view (FOV) of 25.5 mm with a single ring of 40 Prism-PET detector modules. Each module comprises a 16 × 16 array of 1.5 × 1.5 × 20-mm3 lutetium yttrium oxyorthosillicate (LYSO) scintillator crystals coupled 4-to-1 to an 8 × 8 array of silicon photomultiplier (SiPM) pixels on one end and to a prismatoid light guide array on the opposite end. The scanner's performance was evaluated by measuring depth-of-interaction (DOI) resolution, energy resolution, timing resolution, spatial resolution, sensitivity, and image quality of ultra-micro Derenzo and three-dimensional (3D) Hoffman brain phantoms.

RESULTS

The full width at half maximum (FWHM) DOI, energy, and timing resolutions of the scanner are 2.85 mm, 12.6%, and 271 ps, respectively. Not considering artifacts due to mechanical misalignment of detector blocks, the intrinsic spatial resolution is 0.89-mm FWHM. Point source images reconstructed with 3D filtered back-projection (FBP) show an average spatial resolution of 1.53-mm FWHM across the entire FOV. The peak absolute sensitivity is 1.2% for an energy window of 400-650 keV. The ultra-micro Derenzo phantom study demonstrates the highest reported spatial resolution performance for a human brain PET scanner with perfect reconstruction of 1.00-mm diameter hot-rods. Reconstructed images of customized Hoffman brain phantoms prove that Prism-PET enables accurate radiotracer uptake quantification in small brain regions (2-3 mm).

CONCLUSIONS

Prism-PET will substantially strengthen the utility of quantitative PET in neurology for early diagnosis of neurodegenerative diseases, and in neuro-oncology for improved management of both primary and metastatic brain tumors.

Technical opportunities and challenges in developing total-body PET scanners for mice and rats

Positron emission tomography (PET) is the most sensitive in vivo molecular imaging technique available. Small animal PET has been widely used in studying pharmaceutical biodistribution and disease progression over time by imaging a wide range of biological processes. However, it remains true that almost all small animal PET studies using mouse or rat as preclinical models are either limited by the spatial resolution or the sensitivity (especially for dynamic studies), or both, reducing the quantitative accuracy and quantitative precision of the results. Total-body small animal PET scanners, which have axial lengths longer than the nose-to-anus length of the mouse/rat and can provide high sensitivity across the entire body of mouse/rat, can realize new opportunities for small animal PET. This article aims to discuss the technical opportunities and challenges in developing total-body small animal PET scanners for mice and rats.

Evaluation of the performance of a high-resolution time-of-flight PET system dedicated to the head and breast according to NEMA NU 2-2012 standard

BACKGROUND

This study evaluated the physical performance of a positron emission tomography (PET) system dedicated to the head and breast according to the National Electrical Manufacturers Association (NEMA) NU2-2012 standard.

METHODS

The spatial resolution, sensitivity, scatter fraction, count rate characteristics, corrections for count losses and randoms, and image quality of the system were determined. All measurements were performed according to the NEMA NU2-2012 acquisition protocols, but image quality was assessed using a brain-sized phantom. Furthermore, scans of the three-dimensional (3D) Hoffmann brain phantom and mini-Derenzo phantom were acquired to allow visual evaluation of the imaging performance for small structures.

RESULTS

The tangential, radial, and axial full width at half maximum (FWHM) at a 10-mm offset in half the axial field of view were measured as 2.3, 2.5, and 2.9 mm, respectively. The average system sensitivity at the center of the field of view and at a 10-cm radial offset was 7.18 and 8.65 cps/kBq, respectively. The peak noise-equivalent counting rate was 35.2 kcps at 4.8 kBq/ml. The corresponding scatter fraction at the peak noise-equivalent counting rate was 46.8%. The peak true rate and scatter fraction at 8.6 kBq/ml were 127.8 kcps and 54.3%, respectively. The percent contrast value for a 10-mm sphere was approximately 50%. On the 3D Hoffman brain phantom image, the structures of the thin layers composing the phantom were visualized on the sagittal and coronal images. On the mini-Derenzo phantom, each of the 1.6-mm rods was clearly visualized.

CONCLUSION

Taken together, these results indicate that the head- and breast-dedicated PET system has high resolution and is well suited for clinical PET imaging.

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.

Performance evaluation of VRAIN: a brain-dedicated PET with a hemispherical detector arrangement

Objective.For PET imaging systems, a smaller detector ring enables less intrinsic spatial resolution loss due to the photon non-collinearity effect as well as better balance between production cost and sensitivity, and a hemispherical detector arrangement is more appropriate for brain imaging than a conventional cylindrical arrangement. Therefore, we have developed a brain-dedicated PET system with a hemispherical detector arrangement, which has been commercialized in Japan under the product name of VRAIN^TM. In this study, we evaluated imaging performance of VRAIN.Approach.The VRAIN used 54 detectors to form the main hemispherical unit and an additional half-ring behind the neck. Each detector was composed of a 12 × 12 array of lutetium fine silicate crystals (4.1 × 4.1 × 10 mm³) and a 12 × 12 array of silicon photomultipliers (4 × 4 mm²active area) with the one-to-one coupling. We evaluated the physical performance of VRAIN according to the NEMA NU 2-2018 standards. Some measurements were modified so as to fit the hemispherical geometry. In addition, we performed¹⁸F-FDG imaging in a healthy volunteer.Main results.In the phantom study, the VRAIN showed high resolution for separating 2.2 mm rods, 229 ps TOF resolution and 19% scatter fraction. With the TOF gain for a 20 cm diameter object (an assumed head diameter), the peak noise-equivalent count rate was 144 kcps at 9.8 kBq ml^-1and the sensitivity was 25 kcps MBq^-1. Overall, the VRAIN provided excellent image quality in phantom and human studies. In the human FDG images, small brain nuclei and gray matter structures were clearly visualized with high contrast and low noise.Significance.We demonstrated the excellent imaging performance of VRAIN, which supported the advantages of the hemispherical detector arrangement.

Evaluation of a High-Sensitivity Organ-Targeted PET Camera

The aim of this study is to evaluate the performance of the Radialis organ-targeted positron emission tomography (PET) Camera with standardized tests and through assessment of clinical-imaging results. Sensitivity, count-rate performance, and spatial resolution were evaluated according to the National Electrical Manufacturers Association (NEMA) NU-4 standards, with necessary modifications to accommodate the planar detector design. The detectability of small objects was shown with micro hotspot phantom images. The clinical performance of the camera was also demonstrated through breast cancer images acquired with varying injected doses of 2-[fluorine-18]-fluoro-2-deoxy-D-glucose (¹⁸F-FDG) and qualitatively compared with sample digital full-field mammography, magnetic resonance imaging (MRI), and whole-body (WB) PET images. Micro hotspot phantom sources were visualized down to 1.35 mm-diameter rods. Spatial resolution was calculated to be 2.3 ± 0.1 mm for the in-plane resolution and 6.8 ± 0.1 mm for the cross-plane resolution using maximum likelihood expectation maximization (MLEM) reconstruction. The system peak noise equivalent count rate was 17.8 kcps at a ¹⁸F-FDG concentration of 10.5 kBq/mL. System scatter fraction was 24%. The overall efficiency at the peak noise equivalent count rate was 5400 cps/MBq. The maximum axial sensitivity achieved was 3.5%, with an average system sensitivity of 2.4%. Selected results from clinical trials demonstrate capability of imaging lesions at the chest wall and identifying false-negative X-ray findings and false-positive MRI findings, even at up to a 10-fold dose reduction in comparison with standard ¹⁸F-FDG doses (i.e., at 37 MBq or 1 mCi). The evaluation of the organ-targeted Radialis PET Camera indicates that it is a promising technology for high-image-quality, low-dose PET imaging. High-efficiency radiotracer detection also opens an opportunity to reduce administered doses of radiopharmaceuticals and, therefore, patient exposure to radiation.

Evaluation of STIR Library Adapted for PET Scanners with Non-Cylindrical Geometry

Software for Tomographic Image Reconstruction (STIR) is an open source C++ library used to reconstruct single photon emission tomography and positron emission tomography (PET) data. STIR has an experimental scanner geometry modelling feature to accurately model detector placement. In this study, we test and improve this new feature using several types of data: Monte Carlo simulations and measured phantom data acquired from a dedicated brain PET prototype scanner. The results show that the new geometry class applied to non-cylindrical PET scanners improved spatial resolution, uniformity, and image contrast. These are directly observed in the reconstructions of small features in the test quality phantom. Overall, we conclude that the revised "BlocksOnCylindrical" class will be a valuable addition to the next STIR software release with adjustments of existing features (Single Scatter Simulation, forward projection, attenuation corrections) to "BlocksOnCylindrical".

Performance evaluation of dedicated brain PET scanner with motion correction system

OBJECTIVE

Various motion correction (MC) algorithms for positron emission tomography (PET) have been proposed to accelerate the diagnostic performance and research in brain activity and neurology. We have incorporated MC system-based optical motion tracking into the brain-dedicated time-of-flight PET scanner. In this study, we evaluate the performance characteristics of the developed PET scanner when performing MC in accordance with the standards and guidelines for the brain PET scanner.

METHODS

We evaluate the spatial resolution, scatter fraction, count rate characteristics, sensitivity, and image quality of PET images. The MC evaluation is measured in terms of the spatial resolution and image quality that affect movement.

RESULTS

In the basic performance evaluation, the average spatial resolution by iterative reconstruction was 2.2 mm at 10 mm offset position. The measured peak noise equivalent count rate was 38.0 kcps at 16.7 kBq/mL. The scatter fraction and system sensitivity were 43.9% and 22.4 cps/(Bq/mL), respectively. The image contrast recovery was between 43.2% (10 mm sphere) and 72.0% (37 mm sphere). In the MC performance evaluation, the average spatial resolution was 2.7 mm at 10 mm offset position, when the phantom stage with the point source translates to ± 15 mm along the y-axis. The image contrast recovery was between 34.2 % (10 mm sphere) and 66.8 % (37 mm sphere).

CONCLUSIONS

The reconstructed images using MC were restored to their nearly identical state as those at rest. Therefore, it is concluded that this scanner can observe more natural brain activity.

Relating18F-FDG image signal-to-noise ratio to time-of-flight noise-equivalent count rate in total-body PET using the uEXPLORER scanner

Objective.This work assessed the relationship between image signal-to-noise ratio (SNR) and total-body noise-equivalent count rate (NECR)-for both non-time-of-flight (TOF) NECR and TOF-NECR-in a long uniform water cylinder and 14 healthy human subjects using the uEXPLORER total-body PET/CT scanner.Approach.A TOF-NEC expression was modified for list-mode PET data, and both the non-TOF NECR and TOF-NECR were compared using datasets from a long uniform water cylinder and 14 human subjects scanned up to 12 h after radiotracer injection.Main results.The TOF-NECR for the uniform water cylinder was found to be linearly proportional to the TOF-reconstructed image SNR²in the range of radioactivity concentrations studied, but not for non-TOF NECR as indicated by the reducedR²value. The results suggest that the use of TOF-NECR to estimate the count rate performance of TOF-enabled PET systems may be more appropriate for predicting the SNR of TOF-reconstructed images.Significance.Image quality in PET is commonly characterized by image SNR and, correspondingly, the NECR. While the use of NECR for predicting image quality in conventional PET systems is well-studied, the relationship between SNR and NECR has not been examined in detail in long axial field-of-view total-body PET systems, especially for human subjects. Furthermore, the current NEMA NU 2-2018 standard does not account for count rate performance gains due to TOF in the NECR evaluation. The relationship between image SNR and total-body NECR in long axial FOV PET was assessed for the first time using the uEXPLORER total-body PET/CT scanner.

Performance Characteristics of a Dual-Sided Position-Sensitive Sparse-Sensor Detector for Gamma-ray Imaging

Purpose

We characterize the performance of a dualsided position-sensitive sparse sensor (DS-PS3) array detector for positron emission tomography (PET). The DS-PS3 detector is designed as a high performance, cost effective PET detector for organ-specific imaging systems (e.g., brain, breast, etc.).

Methods

Two sparse 4-by-4 arrays of silicon photomultipliers (18.5% SiPM fill-factor) coupled through segmented light guide are used to readout a 15-by-15 array of 2-mm-pitch, 20-mm-long LSYO crystals. Uniform flood data were used for crystal identification, depth determination, and position-dependent energy resolution. Intrinsic-spatial and depth-of-interaction (DOI) resolutions were determined by stepping a collimated gamma-ray source over the front and side, respectively.

Results

We measured an average intrinsic spatial resolution of 2.14 ± 0.07 mm full width at half maximum (FWHM). DOI FWHM resolution varied from 2.2 mm for crystals over sensors to 5.3 mm for crystals between sensors. Average DOI resolution was 3.6 ± 0.8 mm FHWM. Average energy resolution for the detector module was 16.6% with a range of 11.3% to 25.8%.

Conclusions

We have demonstrated use of a dual-sided sparse sensor arrays to enable low-cost high-performance decoding of three-dimensional positioning within a PET detector using an 18.5% sensor fill-factor.

Monte Carlo Characterization of the Trimage Brain PET System

The TRIMAGE project aims to develop a brain-dedicated PET/MR/EEG (Positron Emission Tomography/Magnetic Resonance/Electroencephalogram) system that is able to perform simultaneous PET, MR and EEG acquisitions. The PET component consists of a full ring with 18 sectors. Each sector includes three square detector modules based on dual sstaggered LYSO:Ce matrices read out by SiPMs. Using Monte Carlo simulations and following NEMA (National Electrical Manufacturers Association) guidelines, image quality procedures have been applied to evaluate the performance of the PET component of the system. The performance are reported in terms of spatial resolution, uniformity, recovery coefficient, spill over ratio, noise equivalent count rate (NECR) and scatter fraction. The results show that the TRIMAGE system is at the top of the current brain PET technologies.

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.

Validation technique and improvements introduced in a new dedicated brain positron emission tomograph (CareMiBrain)

The goal of developing a PET dedicated to the brain (CareMiBrain) has evolved from its initial approach to diagnosis and monitoring of dementias, to the more ambitious of creating a revolutionary clinical pathway for the knowledge and personalized treatment of multiple neurological diseases. The main innovative feature of CareMiBrain is the use of detectors with continuous crystals, which allow a high resolution determination of the depth of annihilation photons interaction within the thickness of the scintillation crystal. The technical validation phase of the equipment consisted of a pilot, prospective and observational study whose objective was to obtain the first images (40 patients), analyze them and make adjustments in the acquisition, reconstruction and correction parameters, comparing the image quality of the CareMiBrain equipment with that of the whole-body PET-CT. Thanks to the team meetings and the joint analysis of the images, it was possible to detect its weak points and some of its causes. The calibration, acquisition and processing processes, as well as the reconstruction, were optimized, the number of iterations was set to achieve the best signal-to-noise ratio, the random correction was optimized and a post-processing algorithm was included in the reconstruction algorithm. The main technical improvements implemented in this phase of technical validation carried out through collaboration of the Services of Nuclear Medicine and Neurology of the Hospital Clínico San Carlos with the Spanish company Oncovision will be exposed in a project financed with funds from the European Union (Horizon 2020 innovation program, 713323).

Validation technique and improvements introduced in a new dedicated brain positron emission tomograph (CareMiBrain)

The goal of developing a PET dedicated to the brain (CareMiBrain) has evolved from its initial approach to diagnosis and monitoring of dementias, to the more ambitious of creating a revolutionary clinical pathway for the knowledge and personalized treatment of multiple neurological diseases. The main innovative feature of CareMiBrain is the use of detectors with continuous crystals, which allow a high resolution determination of the depth of annihilation photons interaction within the thickness of the scintillation crystal. The technical validation phase of the equipment consisted of a pilot, prospective and observational study whose objective was to obtain the first images (40 patients), analyze them and make adjustments in the acquisition, reconstruction and correction parameters, comparing the image quality of the CareMiBrain equipment with that of the whole-body PET/CT. Thanks to the team meetings and the joint analysis of the images, it was possible to detect its weak points and some of its causes. The calibration, acquisition and processing processes, as well as the reconstruction, were optimized, the number of iterations was set to achieve the best signal-to-noise ratio, the random correction was optimized and a post-processing algorithm was included in the reconstruction algorithm. The main technical improvements implemented in this phase of technical validation carried out through collaboration of the Services of Nuclear Medicine and Neurology of the Hospital Clínico San Carlos with the Spanish company Oncovision will be exposed in a project financed with funds from the European Union (Horizon 2020 innovation program, 713323).

Simulation study of a coincidence detection system for non-invasive determination of arterial blood time-activity curve measurements

Background

Arterial sampling in PET studies for the purposes of kinetic modeling remains an invasive, time-intensive, and expensive procedure. Alternatives to derive the blood time-activity curve (BTAC) non-invasively are either reliant on large vessels in the field of view or are laborious to implement and analyze as well as being prone to many processing errors. An alternative method is proposed in this work by the simulation of a non-invasive coincidence detection unit.

Results

We utilized GATE simulations of a human forearm phantom with a blood flow model, as well as a model for dynamic radioactive bolus activity concentration based on clinical measurements. A fixed configuration of 14 and, also separately, 8 detectors were employed around the phantom, and simulations were performed to investigate signal detection parameters. Bismuth germanate (BGO) crystals proved to show the highest count rate capability and sensitivity to a simulated BTAC with a maximum coincidence rate of 575 cps. Repeatable location of the blood vessels in the forearm allowed a half-ring design with only 8 detectors. Using this configuration, maximum coincident rates of 250 cps and 42 cps were achieved with simulation of activity concentration determined from ¹⁵O and ¹⁸F arterial blood sampling. NECR simulated in a water phantom at 3 different vertical positions inside the 8-detector system (Y = − 1 cm, Y = − 2 cm, and Y = −3 cm) was 8360 cps, 13,041 cps, and 20,476 cps at an activity of 3.5 MBq. Addition of extra axial detection rings to the half-ring configuration provided increases in system sensitivity by a factor of approximately 10.

Conclusions

Initial simulations demonstrated that the configuration of a single half-ring 8 detector of monolithic BGO crystals could describe the simulated BTAC in a clinically relevant forearm phantom with good signal properties, and an increased number of axial detection rings can provide increased sensitivity of the system. The system would find use in the derivation of the BTAC for use in the application of kinetic models without physical arterial sampling or reliance on image-based techniques.

Simulation Study for Designing a Dedicated Cardiac TOF-PET System

The development of dedicated positron emission tomography scanners is an active area of research, especially aiming at the improvement of lesion detection and in support of cancer treatment and management. Recently, dedicated Positron Emission Tomography (PET) systems with different configurations for specific organs have been developed for improving detection effectiveness. Open geometries are always subject to distortion and artifacts in the reconstructed images. Therefore, the aim of this work is to determine the optimal geometry for a novel cardiac PET system that will be developed by our team, and determine the time resolution needed to achieve reasonable image quality for the chosen geometry. The proposed geometries consist of 36 modules. These modules are arranged in two sets of two plates, each one with different configurations. We performed Monte Carlo simulations with different TOF resolutions, in order to test the image quality improvement in each case. Our results show, as expected, that increasing TOF resolution reduces distortion and artifact effects. We can conclude that a TOF resolution of the order of 200 ps is needed to reduce the artifacts, to acceptable levels, generated in the simulated cardiac-PET open geometries.