1
|
Krishnamoorthy S, Surti S. Advances in Breast PET Instrumentation. PET Clin 2024; 19:37-47. [PMID: 37949606 DOI: 10.1016/j.cpet.2023.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Abstract
Dedicated breast PET scanners currently have a spatial resolution in the 1.5 to 2 mm range, and the ability to provide tomographic images and quantitative data. They are also commercially available from a few vendors. A review of past and recent advances in the development and performance of dedicated breast PET scanners is summarized.
Collapse
Affiliation(s)
- Srilalan Krishnamoorthy
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA.
| | - Suleman Surti
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| |
Collapse
|
2
|
Chaudhari AJ, Badawi RD. Application-specific nuclear medical in vivoimaging devices. Phys Med Biol 2021; 66. [PMID: 33770765 DOI: 10.1088/1361-6560/abf275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 03/26/2021] [Indexed: 11/11/2022]
Abstract
Nuclear medical imaging devices, such as those enabling photon emission imaging (gamma camera, single photon emission computed tomography, or positron emission imaging), that are typically used in today's clinics are optimized for assessing large portions of the human body, and are classified as whole-body imaging systems. These systems have known limitations for organ imaging, therefore application-specific devices have been designed, constructed and evaluated. These devices, given their compact nature and superior technical characteristics, such as their higher detection sensitivity and spatial resolution for organ imaging compared to whole-body imaging systems, have shown promise for niche applications. Several of these devices have further been integrated with complementary anatomical imaging devices. The objectives of this review article are to (1) provide an overview of such application-specific nuclear imaging devices that were developed over the past two decades (in the twenty-first century), with emphasis on brain, cardiac, breast, and prostate imaging; and (2) discuss the rationale, advantages and challenges associated with the translation of these devices for routine clinical imaging. Finally, a perspective on the future prospects for application-specific devices is provided, which is that sustained effort is required both to overcome design limitations which impact their utility (where these exist) and to collect the data required to define their clinical value.
Collapse
Affiliation(s)
- Abhijit J Chaudhari
- Department of Radiology, University of California Davis, Sacramento, CA 95817, United States of America.,Center for Molecular and Genomic Imaging, University of California Davis, Davis, CA 95616, United States of America
| | - Ramsey D Badawi
- Department of Radiology, University of California Davis, Sacramento, CA 95817, United States of America.,Department of Biomedical Engineering, University of California Davis, Davis, CA 95616, United States of America
| |
Collapse
|
3
|
Krishnamoorthy S, Vent T, Barufaldi B, Maidment ADA, Karp JS, Surti S. Evaluating attenuation correction strategies in a dedicated, single-gantry breast PET-tomosynthesis scanner. Phys Med Biol 2020; 65:235028. [PMID: 33113520 PMCID: PMC7870546 DOI: 10.1088/1361-6560/abc5a8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
We are developing a dedicated, combined breast positron emission tomography (PET)-tomosynthesis scanner. Both the PET and digital breast tomosynthesis (DBT) scanners are integrated in a single gantry to provide spatially co-registered 3D PET-tomosynthesis images. The DBT image will be used to identify the breast boundary and breast density to improve the quantitative accuracy of the PET image. This paper explores PET attenuation correction (AC) strategies that can be performed with the combined breast PET-DBT scanner to obtain more accurate, quantitative high-resolution 3D PET images. The PET detector is comprised of a 32 × 32 array of 1.5 × 1.5 × 15 mm3 LYSO crystals. The PET scanner utilizes two detector heads separated by either 9 or 11 cm, with each detector head having a 4 × 2 arrangement of PET detectors. GEANT4 Application for Tomographic Emission simulations were performed using an anthropomorphic breast phantom with heterogeneous attenuation under clinical DBT-compression. FDG-avid lesions, each 5 mm in diameter with 8:1 uptake, were simulated at four locations within the breast. Simulations were performed with a scan time of 2 min. PET AC was performed using the actual breast simulation model as well as DBT reconstructed volumetric images to derive the breast outline. In addition to using the known breast density as defined by the breast model, we also modeled it as uniform patient-independent soft-tissue, and as a uniform patient-specific material derived from breast tissue composition. Measured absolute lesion uptake was used to evaluate the quantitative accuracy of performing AC using the various strategies. This study demonstrates that AC is necessary to obtain a closer estimate of the true lesion uptake and background activity in the breast. The DBT image dataset assists in measuring lesion uptake with low bias by facilitating accurate breast delineation as well as providing accurate information related to the breast tissue composition. While both the uniform soft-tissue and patient-specific material approaches provides a close estimate to the ground truth, <5% bias can be achieved by using a uniform patient-specific material to define the attenuation map.
Collapse
Affiliation(s)
- Srilalan Krishnamoorthy
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Trevor Vent
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Bruno Barufaldi
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Andrew D A Maidment
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Joel S Karp
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, United States of America
- Department of Physics and Astronomy, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Suleman Surti
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, United States of America
| |
Collapse
|
4
|
Jiang J, Samanta S, Li K, Siegel SB, Mintzer RA, Cho S, Conti M, Schmand M, O'Sullivan J, Tai YC. Augmented Whole-Body Scanning via Magnifying PET. IEEE TRANSACTIONS ON MEDICAL IMAGING 2020; 39:3268-3277. [PMID: 31899415 PMCID: PMC7673659 DOI: 10.1109/tmi.2019.2962623] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
A novel technique, called augmented whole-body scanning via magnifying PET (AWSM-PET), that improves the sensitivity and lesion detectability of a PET scanner for whole-body imaging is proposed and evaluated. A Siemens Biograph Vision PET/CT scanner equipped with one or two high-resolution panel-detectors was simulated to study the effectiveness of AWSM-PET technology. The detector panels are located immediately outside the scanner's axial field-of-view (FOV). A detector panel contains 2 ×8 detector modules each consisting of 32 ×64 LSO crystals ( 1.0 ×1.0 ×10.0 mm3 each). A 22Na point source was stepped across the scanner's FOV axially to measure sensitivity profiles at different locations. An elliptical torso phantom containing 7×9 spherical lesions was imaged at different axial locations to mimic a multi-bed-position whole-body imaging protocol. Receiver operating characteristic (ROC) curves were analyzed to evaluate the improvement in lesion detectability by the AWSM-PET technology. Experimental validation was conducted using an existing flat-panel detector integrated with a Siemens Biograph 40 PET/CT scanner to image a torso phantom containing spherical lesions with diameters ranging from 3.3 to 11.4 mm. The contrast-recovery-coefficient (CRC) of the lesions was evaluated for the scanner with or without the AWSM-PET technology. Monte Carlo simulation shows 36%-42% improvement in system sensitivity by a dual-panel AWSM-PET device. The area under the ROC curve is 0.962 by a native scanner for the detection of 4 mm diameter lesions with 5:1 tumor-to-background activity concentration. It was improved to 0.977 and 0.991 with a single- and dual-panel AWSM-PET system, respectively. Experimental studies showed that the average CRC of 3.3 mm and 4.3 mm diameter tumors were improved from 2.8% and 4.2% to 7.9% and 11.0%, respectively, by a single-panel AWSM-PET device. With a high-sensitivity dual-panel device, the corresponding CRC can be further improved to 11.0% and 15.9%, respectively. The principle of the AWSM-PET technology has been developed and validated. Enhanced system sensitivity, CRC and tumor detectability were demonstrated by Monte Carlo simulations and imaging experiments. This technology may offer a cost-effective path to realize high-resolution whole-body PET imaging clinically.
Collapse
|
5
|
MacDonald LR, Lo JY, Sturgeon GM, Zeng C, Harrison RL, Kinahan PE, Segars WP. Impact of Using Uniform Attenuation Coefficients for Heterogeneously Dense Breasts in a Dedicated Breast PET/X-ray Scanner. IEEE TRANSACTIONS ON RADIATION AND PLASMA MEDICAL SCIENCES 2020; 4:585-593. [PMID: 33163753 DOI: 10.1109/trpms.2020.2991120] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
We investigated PET image quantification when using a uniform attenuation coefficient (μ) for attenuation correction (AC) of anthropomorphic density phantoms derived from high-resolution breast CT scans. A breast PET system was modeled with perfect data corrections except for AC. Using uniform μ for AC resulted in quantitative errors roughly proportional to the difference between μ used in AC (μ AC) and local μ, yielding approximately ± 5% bias, corresponding to the variation of μ for 511 keV photons in breast tissue. Global bias was lowest when uniform μ AC was equal to the phantom mean μ (μ mean). Local bias in 10-mm spheres increased as the sphere μ deviated from μ mean, but remained only 2-3% when the μ sphere was 6.5% higher than μ mean. Bias varied linearly with and was roughly proportional to local μ mismatch. Minimizing local bias, e.g., in a small sphere, required the use of a uniform μ value between the local μ and the μ mean. Thus, biases from using uniform-μ AC are low when local μ sphere is close to μ mean. As the μ sphere increasingly differs from the phantom μ mean, bias increases, and the optimal uniform μ is less predictable, having a value between μ sphere and the phantom μ mean.
Collapse
Affiliation(s)
| | - Joseph Y Lo
- Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology, Duke University Medical Center, Durham, NC 27705
| | - Gregory M Sturgeon
- Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology, Duke University Medical Center, Durham, NC 27705
| | - Chengeng Zeng
- University of Washington Radiology Department, Seattle, WA 98195
| | | | - Paul E Kinahan
- University of Washington Radiology Department, Seattle, WA 98195
| | - William Paul Segars
- Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology, Duke University Medical Center, Durham, NC 27705
| |
Collapse
|
6
|
Raylman RR, Van Kampen W, Stolin AV, Gong W, Jaliparthi G, Martone PF, Smith MF, Sarment D, Clinthorne NH, Perna M. A dedicated breast-PET/CT scanner: Evaluation of basic performance characteristics. Med Phys 2018; 45:1603-1613. [PMID: 29389017 DOI: 10.1002/mp.12780] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 01/05/2018] [Accepted: 01/05/2018] [Indexed: 12/29/2022] Open
Abstract
PURPOSE Application of advanced imaging techniques, such as PET and x ray CT, can potentially improve detection of breast cancer. Unfortunately, both modalities have challenges in the detection of some lesions. The combination of the two techniques, however, could potentially lead to an overall improvement in diagnostic breast imaging. The purpose of this investigation is to test the basic performance of a new dedicated breast-PET/CT. METHODS The PET component consists of a rotating pair of detectors. Its performance was evaluated using the NEMA NU4-2008 protocols. The CT component utilizes a pulsed x ray source and flat panel detector mounted on the same gantry as the PET scanner. Its performance was assessed using specialized phantoms. The radiation dose to a breast during CT imaging was explored by the measurement of free-in-air kerma and air kerma measured at the center of a 16 cm-diameter PMMA cylinder. Finally, the combined capabilities of the system were demonstrated by imaging of a micro-hot-rod phantom. RESULTS Overall, performance of the PET component is comparable to many pre-clinical and other dedicated breast-PET scanners. Its spatial resolution is 2.2 mm, 5 mm from the center of the scanner using images created with the single-sliced-filtered-backprojection algorithm. Peak NECR is 24.6 kcps; peak sensitivity is 1.36%; the scatter fraction is 27%. Spatial resolution of the CT scanner is 1.1 lp/mm at 10% MTF. The free-in-air kerma is 2.33 mGy, while the PMMA-air kerma is 1.24 mGy. Finally, combined imaging of a micro-hot-rod phantom illustrated the potential utility of the dual-modality images produced by the system. CONCLUSION The basic performance characteristics of a new dedicated breast-PET/CT scanner are good, demonstrating that its performance is similar to current dedicated PET and CT scanners. The potential value of this system is the capability to produce combined duality-modality images that could improve detection of breast disease. The next stage in development of this system is testing with more advanced phantoms and human subjects.
Collapse
Affiliation(s)
- Raymond R Raylman
- Center for Advanced Imaging, Department of Radiology, 1 Medical Center Dr., West Virginia University, Morgantown, WV, 26506, USA
| | - Will Van Kampen
- Xoran Technologies Inc., 5210 S State Rd., Ann Arbor, MI, 48108, USA
| | - Alexander V Stolin
- Center for Advanced Imaging, Department of Radiology, 1 Medical Center Dr., West Virginia University, Morgantown, WV, 26506, USA
| | - Wenbo Gong
- Xoran Technologies Inc., 5210 S State Rd., Ann Arbor, MI, 48108, USA
| | - Gangadhar Jaliparthi
- Center for Advanced Imaging, Department of Radiology, 1 Medical Center Dr., West Virginia University, Morgantown, WV, 26506, USA
| | - Peter F Martone
- Center for Advanced Imaging, Department of Radiology, 1 Medical Center Dr., West Virginia University, Morgantown, WV, 26506, USA
| | - Mark F Smith
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, 655 W. Baltimore Street, Baltimore, MD, 21201, USA
| | - David Sarment
- Xoran Technologies Inc., 5210 S State Rd., Ann Arbor, MI, 48108, USA
| | | | - Mark Perna
- Perna Health Physics, Inc., 705 Augusta Dr, Bridgeville, PA, 15017, USA
| |
Collapse
|
7
|
Zeng C, Kinahan PE, Qian H, Harrison RL, Champley KM, MacDonald LR. Simulation study of quantitative precision of the PET/X dedicated breast PET scanner. J Med Imaging (Bellingham) 2017; 4:045502. [PMID: 29134188 PMCID: PMC5661484 DOI: 10.1117/1.jmi.4.4.045502] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Accepted: 09/27/2017] [Indexed: 11/14/2022] Open
Abstract
The goal for positron emission tomography (PET)/X is measuring changes in radiotracer uptake for early assessment of response to breast cancer therapy. Upper bounds for detecting such changes were investigated using simulation and two image reconstruction algorithms customized to the PET/X rectangular geometry. Analytical reconstruction was used to study spatial resolution, comparing results with the distance of the closest approach (DCA) resolution surrogate that is independent of the reconstruction method. An iterative reconstruction algorithm was used to characterize contrast recovery in small targets. Resolution averaged [Formula: see text] full width at half maximum when using depth-of-interaction (DOI) information. Without DOI, resolution ranged from [Formula: see text] to [Formula: see text] for scanner crystal thickness between 5 and 15 mm. The DCA resolution surrogate was highly correlated to image-based FWHM. Receiver-operating characteristic analysis showed specificity and sensitivity over 95% for detecting contrast change from 5:1 to 4:1 (area under curve [Formula: see text]). For PET/X parameters modeled here, the ability to measure contrast changes benefited from higher photon absorption efficiency of thicker crystals while being largely unaffected by degraded resolution obtained with thicker crystals; DOI provided marginal improvements. These results assumed perfect data corrections and other idealizations, and thus represent an upper bound for detecting changes in small lesion radiotracer uptake of clinical interest using the PET/X system.
Collapse
Affiliation(s)
- Chengeng Zeng
- University of Washington, Radiology Department, Seattle, Washington, United States
| | - Paul E. Kinahan
- University of Washington, Radiology Department, Seattle, Washington, United States
| | - Hua Qian
- GE Global Research Center, Niskayuna, New York, United States
| | - Robert L. Harrison
- University of Washington, Radiology Department, Seattle, Washington, United States
| | - Kyle M. Champley
- Lawrence Livermore National Laboratory, Livermore, California, United States
| | | |
Collapse
|
8
|
Chaudhari AJ, Ferrero A, Godinez F, Yang K, Shelton DK, Hunter JC, Naguwa SM, Boone JM, Raychaudhuri SP, Badawi RD. High-resolution (18)F-FDG PET/CT for assessing disease activity in rheumatoid and psoriatic arthritis: findings of a prospective pilot study. Br J Radiol 2016; 89:20160138. [PMID: 27109738 PMCID: PMC5257326 DOI: 10.1259/bjr.20160138] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 04/05/2016] [Accepted: 04/20/2016] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE Rheumatoid arthritis (RA) and psoriatic arthritis (PsA) commonly affect the small joints of the wrist and hand. We evaluated the performance of a new, high-resolution extremity positron emission tomography (PET)/CT scanner for characterizing and quantifying pathologies associated with the two arthritides in the wrist and hand joints. METHODS Patients with RA or PsA underwent fluorine-18 fludeoxyglucose ((18)F-FDG) PET/CT wrist and hand imaging, respectively, on the high-resolution scanner. Calibrated CT images and co-registered PET images were reconstructed. PET/CT was derived for the radiocarpal and pisiform-triquetral compartments, joints with erosive changes, sites of synovitis or tenosynovitis and the nail bed and were correlated with clinical and MRI findings. RESULTS Significantly elevated (18)F-FDG uptake was measured for the radiocarpal and pisiform-triquetral compartments and at sites of bone erosion, synovitis, pannus and oedema, compared with unaffected joints (p < 0.05) in patients with RA, consistent with their clinical findings. In patients with PsA, significantly elevated (18)F-FDG uptake was measured for joints with synovitis compared with unaffected joints (p < 0.05), with patterns of (18)F-FDG uptake along the tendons, at the enthesis and in the nail bed, consistent with tenosynovitis, enthesitis and nail dystrophy, respectively. CONCLUSION High-resolution (18)F-FDG PET/CT imaging of the wrist and hand is feasible in an RA or PsA patient cohort and is capable of providing quantifiable measures of disease activity (synovitis, enthesitis, oedema and bone destruction). ADVANCES IN KNOWLEDGE High-resolution PET/CT imaging shows promise as a tool for understanding the pathogenesis of the arthritic process and for non-invasive, objective assessment of RA or PsA severity and therapy selection.
Collapse
Affiliation(s)
- Abhijit J Chaudhari
- Department of Radiology, University of California Davis, Sacramento, CA, USA
| | - Andrea Ferrero
- Department of Radiology, University of California Davis, Sacramento, CA, USA
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Felipe Godinez
- Department of Radiology, University of California Davis, Sacramento, CA, USA
| | - Kai Yang
- Department of Radiology, University of California Davis, Sacramento, CA, USA
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - David K Shelton
- Department of Radiology, University of California Davis, Sacramento, CA, USA
| | - John C Hunter
- Department of Radiology, University of California Davis, Sacramento, CA, USA
| | - Stanley M Naguwa
- Department of Internal Medicine, University of California Davis, Sacramento, CA, USA
| | - John M Boone
- Department of Radiology, University of California Davis, Sacramento, CA, USA
| | - Siba P Raychaudhuri
- Department of Internal Medicine, University of California Davis, Sacramento, CA, USA
- Sacramento Veterans Affairs Medical Center, Rancho Cordova, CA, USA
| | - Ramsey D Badawi
- Department of Radiology, University of California Davis, Sacramento, CA, USA
| |
Collapse
|
9
|
Abstract
Breast-dedicated radionuclide imaging systems show promise for increasing clinical sensitivity for breast cancer while minimizing patient dose and cost. We present several breast-dedicated coincidence-photon and single-photon camera designs that have been described in the literature and examine their intrinsic performance, clinical relevance, and impact. Recent tracer development is mentioned, results from recent clinical tests are summarized, and potential areas for improvement are highlighted.
Collapse
Affiliation(s)
- David F C Hsu
- Department of Electrical Engineering, Stanford University, Stanford, California; and
| | - David L Freese
- Department of Electrical Engineering, Stanford University, Stanford, California; and
| | - Craig S Levin
- Department of Electrical Engineering, Stanford University, Stanford, California; and Departments of Radiology, Bioengineering, and Physics, Stanford University, Stanford, California
| |
Collapse
|