Scatter distribution in transmission measurements with positron emission tomography

PET instrumentation: what are the limits?

This report has emphasized the attributes of positron emission tomography (PET) through a discussion of the historical development with attention to limitations or factors that are of importance in using and further developing this technology. As is the case for all nuclear detector developments, the factors that require consideration are spatial resolution, uniformity of resolution, sensitivity, distortions (attenuation), background noise (scatter and randoms), image volume, data acquisition capabilities (count-rate saturation), and limitations based on allowable radiation doses to the subject. Forty years ago, the fact that dual gamma-cameras could not handle the count-rates from the short half-life radionuclides that had clinical applications at that time (ie, 15O, 11C, 13N) precluded their acceptance in nuclear medicine. With the advent of 18F applications particularly with FDG in oncology, this limitations was no longer a barrier. Twenty years ago and until recently, the promise of time-of-flight PET has been stifled by the fact that the appropriately fast scintillator BaF2 had too low an efficiency (low density) to be useful in improving the signal to noise of a time-of-flight tomograph over contemporary systems. With the development of dense scintillators with high light output and high speed such as LSO30 the time-of-flight potentials are now once again worth pursuing. Twenty years ago systems that theoretically would have improved sensitivity by minimal or no septa with spherical geometric arrangements of detectors were ignored because it appeared that scatter backgrounds would lead to a signal to noise less than 1. But in the last 5 years, cylindrical systems without speta have shown that noise effective sensitivity improvements of a factor of 4 can be realized. With time-of-flight additional improvements in sensitivity will be realized. Horizons for detector development include discovery of new scintillators, new methods of registering scintillation light, deployment of larger field of view systems and methods of compensating for scatter, randoms, attenuation, and irregular sampling associated with new geometries which can encircle most of the body. The expected limit for PET is 2 mm isotropic resolution for the head and appendages including joints and breasts. Clinical realization of this resolution for the thorax and abdomen requires compensation for motion and even in this area strategies are underdevelopment which rely on the improvement in sensitivity being realized by 3D systems.

Simultaneous emission and transmission (SET) scanning in neurological PET studies

PURPOSE

We evaluated the impact of simultaneous emission and transmission (SET) measurements of quantification and noise in neurological PET studies.

METHOD

Bias in SET was measured as a function of emission count rate and used to predict distortion in simulated FDG tissue curves and its effect on model parameter estimates. Studies were performed on a brain phantom and a patient to verify predicted bias and examine the effect of SET on noise.

RESULTS

In static imaging, SET underestimated tracer concentration by approximately 2%. In kinetic studies, tracer concentration was overestimated initially and underestimated during the mid to late part of the study, but bias in measurement of glucose metabolic rate was < 5% by simulation and < 10% in the patient study. SET imaging takes 10% longer than the emission part of a conventional scan to achieve comparable statistics.

CONCLUSION

Accurate neurological PET studies can be performed with SET. The relatively small bias can be predicted and potentially corrected.

Grouped-coordinate ascent algorithms for penalized-likelihood transmission image reconstruction

This paper presents a new class of algorithms for penalized-likelihood reconstruction of attenuation maps from low-count transmission scans. We derive the algorithms by applying to the transmission log-likelihood a version of the convexity technique developed by De Pierro for emission tomography. The new class includes the single-coordinate ascent (SCA) algorithm and Lange's convex algorithm for transmission tomography as special cases. The new grouped-coordinate ascent (GCA) algorithms in the class overcome several limitations associated with previous algorithms. 1) Fewer exponentiations are required than in the transmission maximum likelihood-expectation maximization (ML-EM) algorithm or in the SCA algorithm. 2) The algorithms intrinsically accommodate nonnegativity constraints, unlike many gradient-based methods. 3) The algorithms are easily parallelizable, unlike the SCA algorithm and perhaps line-search algorithms. We show that the GCA algorithms converge faster than the SCA algorithm, even on conventional workstations. An example from a low-count positron emission tomography (PET) transmission scan illustrates the method.

Bayesian reconstruction of PET images: methodology and performance analysis

We describe a practical statistical methodology for the reconstruction of PET images. Our approach is based on a Bayesian formulation of the imaging problem. The data are modelled as independent Poisson random variables and the image is modelled using a Markov random field smoothing prior. We describe a sequence of calibration procedures which are performed before reconstruction: (i) calculation of accurate attenuation correction factors from re-projected Bayesian reconstructions of the transmission image; (ii) estimation of the mean of the randoms component in the data; and (iii) computation of the scatter component in the data using a Klein-Nishina-based scatter estimation method. The Bayesian estimate of the PET image is then reconstructed using a pre-conditioned conjugate gradient method. We performed a quantitation study with a multi-compartment chest phantom in a Siemens/CTI ECAT931 system. Using 40 1 min frames, we computed the ensemble mean and variance over several regions of interest from images reconstructed using the Bayesian and a standard filtered backprojection (FBP) protocol. The values for the region of interest were compared with well counter data for each compartment. These results show that the Bayesian protocol can produce substantial improvements in relative quantitation over the standard FBP protocol, particularly when short transmission scans are used. An example showing the application of the method to a clinical chest study is also given.

Sex differences in patterns of hemispheric cerebral metabolism: a multiple regression/discriminant analysis of positron emission tomographic data

Sex differences in brain hemispheric structure and function have been reported, and sex-related differences in hemispheric interregional correlations were reported in a prior analysis of resting PET glucose metabolic (rCMRglc) data. To explore further the effect of sex on patterns of hemispheric brain functional interactions, we applied a multiple regression/discriminant analysis to resting rCMRglc PET data from young normal men and women to test two hypotheses: (1) women have stronger between-hemisphere functional interactions; (2) men have stronger within-hemisphere functional interactions. Two separate discriminant functions based on these hypotheses distinguished men and women: the first reflected rCMRglc interdependencies between hemispheres and correctly classified all women and 94% of the men; the second reflected rCMRglc interdependencies within the left hemisphere and correctly classified 82% of the women and 88% of the men. Because the discriminant functions successfully distinguished men and women, these results provide support for both hypotheses.

Individual differences in cerebral metabolic patterns during pharmacotherapy in obsessive-compulsive disorder: a multiple regression/discriminant analysis of positron emission tomographic data

A multiple regression/discriminant analysis of positron emission tomographic cerebral metabolic (rCMRglc) data in 10 obsessive-compulsive disorder (OCD) patients before and during pharmacotherapy was carried out to see if rCMRglc interdependencies distinguished OCD patients from controls. Before therapy, a discriminant function reflecting parietal, sensorimotor, and midbrain rCMRglc interdependencies correctly classified eight (80%) of the 10 patients as OCD; after therapy, six (70%) were classified as controls, most of whom were responders. Before therapy, rCMRglc interdependencies involving basal ganglia, thalamus, limbic, and sensory and association cortical regions distinguished 67% of patients who clinically responded to drug (RESP, n = 6) and 75% of patients who did not (NRESP, n = 4) from controls. After therapy, all RESP were classified as controls; classification of NRESP remained unchanged. The results suggest the conjunctive utility of this method to assess individual differences in rCMRglc during pharmacotherapy, and to explore the neurobiology of OCD.

Interregional correlations of resting cerebral glucose metabolism in old and young women

A correlational analysis of normalized (regional to whole-brain) regional cerebral metabolic rates for glucose obtained in the 'resting' state (eyes covered, ears plugged) using [18F]fluorodeoxyglucose, demonstrated differences between old and young women in patterns of functional associations. Fifteen healthy young (age less than 40 years) and 17 healthy old women (age greater than 64 years) were scanned with a Scanditronix PC1024-7B tomograph. The brain was divided into 65 regions of interest. The old women had fewer and less positive correlations between pairs of metabolic ratios in the frontal and parietal cortices. The results suggest an age-related reduction in frontal and parietal functional interactions in the 'resting' state that is consistent with a prior correlation analysis using a low resolution ECAT II scanner on young and old men. Reduced functional interactions may reflect age-related cognitive changes.

Gender differences in correlations of cerebral glucose metabolic rates in young normal adults

Correlational analysis of normalized regional cerebral metabolic data obtained by positron emission tomography, in healthy subjects in the 'resting' state (eyes covered, ears plugged) using [18F]2-fluoro-2-deoxy-D-glucose, demonstrated gender differences in patterns of functional associations. Fifteen women and 18 men (less than 40 yr) were scanned with a Scanditronix PC1024-7B tomograph. The brain was divided into 65 regions of interest (ROIs). There were no differences between men and women in global or regional metabolic rates, or in metabolic right-left asymmetries. Although the total number of significant correlations did not differ between men and women, patterns differed: female correlations rF were most positive than male correlations rM more often than rM greater than rF; and most rF greater than rM cases involved left frontal and sensorimotor ROIs, whereas most rM greater than rF cases involved right sensorimotor and occipital ROIs. The findings demonstrate gender differences in the pattern of functional neocortical interactions at the 'resting' state.

Online brain attenuation correction in PET: towards a fully automated data handling in a clinical environment

We have improved the calculation of the brain attenuation correction in positron emission tomography (PET) and set up a procedure which allows the clinician to get a fully corrected image in a single reconstruction step, without human intervention. By using a general object description scheme based on polygonal contour trees we are able to calculate the attenuation correction for brain tissue, bone and head holder. The head contour is generated from the emission sinogram. On a set of 15 adult patients, the emission values obtained using this calculated attenuation compare favorably with those obtained with an attenuation resulting from a transmission measurement. Residual discrepancies are attributed to incomplete scatter compensation between emission and transmission. The robustness of the algorithm has been tested on more than 100 brain fluorodeoxyglucose (18FDG) studies in adult patients, including pathological cases. Its applicability for 18FDG studies in children and for other tracers such as water (H2 15O) and fluoroethylspiperone (18FESP) is also presented.

Image quantification with a large area multiwire proportional chamber positron camera (MUP-PET)

A large area multi wire proportional chamber positron camera system is under evaluation for clinical Nuclear Medicine investigation using isotopes both from the house generators (68Ga) and from remote cyclotrons (18F, 124I, 64Cu and 81Rb). Images are reconstructed using a fully three dimensional (3D) algorithm and exhibit equal resolution in all three orthogonal directions. The axial field of view of 15 cm is large enough to allow coverage of the whole brain. This paper discusses the performance of the MUP-PET system with particular emphasis on quantification and the development of an attenuation correction scheme for a large area detector system. The distribution of scattered and accidental events is investigated and observed to contribute a fairly uniform background to the image. Dead time correction factors are calculated from an analytical expression obtained by considering the various sources of dead time present in the system. Following correction for attenuation, accidentals, scattered events and dead time, reconstructed phantom images show a strong linear correlation (r = 0.998) between count density and regional isotope concentration. The extension of the methods to clinical studies is discussed.

Imaging Performance of a Dynamic Positron Emission Tomograph: Positome IIIp

This paper documents modifications to an older PET system to improve its dead time, scatter fraction, and spatial resolution in high count rate, short duration studies. A new dual-tapered collimator reduces scatter by 33 percent while providing excellent resolution uniformity in all slices. A data encoding scheme produces uniformly sampled parallel projections from the coincidence data in real time while the detector array executes an orbital motion. The image uniformity, scatter compensation and high count-rate performance have been validated up to 40 kBq/cc in a 20 cm flood source. The errors in image quantification due to counting statistics, live time, and random counts are estimated from repeated measurements on a contrast phantom at high count-rates. The effects of two methods of scatter compensation on image contrast are shown in contrast phantoms and a typical glucose utilization study. Blood flow measurements using 0-15 labeled water bolus method, made under different physiological conditions, reflected the changes expected. The true count efficiency of 75 kcps/(uCi/cc) permits these studies to be done with only 500-900 MBq (13-25 mCi) injected activity.