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.

Technical note: Rapid and high-resolution deep learning-based radiopharmaceutical imaging with 3D-CZT Compton camera and sparse projection data

BACKGROUND

The Compton camera (CC) has great potential in nuclear medicine imaging due to the high detection efficiency and the ability to simultaneously detect multi-energy radioactive sources. However, the finite resolution of the detectors will degrade the images that the real-world CC can obtain. Besides, the CC sometimes can be limited by the detection efficiency, leading to difficulty in using sparse projection data to realize high-resolution reconstruction with short-time measurement, which limits its clinical application for real-time or rapid radiopharmaceutical imaging.

PURPOSE

To overcome the difficulty and promote the usage of the CC in radiopharmaceutical imaging, we present a deep learning (DL)-based CC reconstruction method to realize rapid and high-resolution imaging with short-time measurement.

METHODS

We developed a DL-based algorithm MCBP-CCnet via Monte Carlo sampling-based back projection and a dedicated convolutional neural network, called CC-Net, to realize the rapid and high-resolution reconstruction with sparse projection data. A CC prototype based on a single three-dimensional position-sensitive CdZnTe (3D-CZT) detector was used to demonstrate the feasibility of our proposed method. The simulations and experiments of radiopharmaceutical imaging used the 3D-CZT CC and [¹⁸ F]NaF. A 3D-printing mouse phantom was also further used to evaluate the performance of the proposed method in animal molecular imaging.

RESULTS

The simulation and experimental results showed that the proposed method could realize the images reconstruction within 5 s for list-mode projection data and realized a rapid reconstruction within 35 s for experimental radiopharmaceutical imaging based on the 3D-printing mouse phantom, as well as realized the high-resolution imaging with an accuracy of within 0.78 mm in terms of the sparse projection data that only contained hundreds of events. Besides, the deviations between the reconstructed radiative activities and the exact values were less than 1.51%.

CONCLUSION

The results demonstrated that the proposed method could realize the rapid and high-resolution CC reconstruction with sparse projection data obtained by the 3D-CZT CC and realize the high-resolution radiopharmaceutical imaging. The study in this paper also demonstrated the potential and feasibility of future applications of a 3D-CZT CC for real-time high-resolution radiopharmaceutical imaging with short-time measurement.

Development and Applications of Compton Camera-A Review

The history of Compton cameras began with the detection of radiation sources originally for applications in astronomy. A Compton camera is a promising γ-ray detector that operates in the wide energy range of a few tens of keV to MeV. The γ-ray detection method of a Compton camera is based on Compton scattering kinematics, which is used to determine the direction and energy of the γ-rays without using a mechanical collimator. Although the Compton camera was originally designed for astrophysical applications, it was later applied in medical imaging as well. Moreover, its application in environmental radiation measurements is also under study. Although a few review papers regarding Compton cameras have been published, they either focus very specifically on the detectors used in such cameras or the particular applications of Compton cameras. Thus, the aim of this paper is to review the features and types of Compton cameras and introduce their applications, associated imaging algorithms, improvement scopes, and their future aspects.

Compton imaging for medical applications

Compton imaging exploits inelastic scattering, known as Compton scattering, using a Compton camera consisting of a scatterer detector in the front layer and an absorber detector in the back layer. This method was developed for astronomy, and in recent years, research and development for environmental and medical applications has been actively conducted. Compton imaging can discriminate gamma rays over a wide energy range from several hundred keV to several MeV. Therefore, it is expected to be applied to the simultaneous imaging of multiple nuclides in nuclear medicine and prompt gamma ray imaging for range verification in particle therapy. In addition, multiple gamma coincidence imaging is expected to be realized, which allows the source position to be determined from a single coincidence event using nuclides that emit multiple gamma rays simultaneously, such as nuclides that emit a single gamma ray simultaneously with positron decay. This review introduces various efforts toward the practical application of Compton imaging in the medical field, including in vivo studies, and discusses its prospects.

An accurate probabilistic model with detector resolution and Doppler broadening correction in list-mode MLEM reconstruction for Compton camera

Objective. The Compton cameras have been researched for medical applications and radioactive material detection. It is challenging for the Compton camera to realize high-resolution reconstruction when the incident photon energy is below 200 keV. However, multiple kinds of nuclear medical radionuclides are in this energy range, such as 201Tl, 67Ga, 99mTc, and 123I. In this work, we propose an improved probabilistic model with correction of detector energy resolution, detector spatial resolution, and Doppler broadening effect. The proposed model is used for numerical calculation of the system matrix in the list-mode maximum likelihood expectation maximization (LM-MLEM) algorithm. Approach. The model can improve the imaging resolution of LM-MLEM reconstruction by taking Doppler broadening effect into account. It performs well, especially in the following situations: low-energy photon incidence below 200 keV or (and) small distance between scattering and absorbing positions. Main results. Firstly, three main factors that affect the angular resolution of the Compton camera are theoretically analyzed and quantitatively calculated. The results of the analysis indicate the necessity of including the Doppler broadening effect in the model. Secondly, the details and derivation of the proposed probabilistic model are described. Thirdly, both Monte Carlo (MC) simulations and experiments are carried out to verify the performance of the proposed algorithm. The simulations focus on the low-energy reconstruction in which 201Tl (70 keV) and 99mTc (141 keV) are simulated. And the experiments are based on a single-layer Compton camera composed of a Timepix3 detector. Significance. The results of the simulations and the Timepix3-based experiments are presented to verify the effectiveness of the proposed algorithm. The model improves the Compton imaging resolution when the photon energy is below 200 keV.

Carbon range verification with 718 keV Compton imaging

Carbon ion radiotherapy is a sophisticated radiation treatment modality because of its superiority in achieving precise dosage distribution and high biological effectiveness. However, there exist beam range uncertainties that affect treatment efficiency. This problem can be resolved if the clinical beam could be monitored precisely in real-time, such as by imaging the prompt gamma emission from the target. In this study, we performed real-time detection and imaging of 718 keV prompt gamma emissions using a Si/CdTe Compton camera. We conducted experiments on graphite phantoms using clinical carbon ion beams of 290 MeV/u energy. Compton images were reconstructed using simple back-projection methods from the energy events of 718 keV prompt gamma emissions. The peak intensity position in reconstructed 718 keV prompt gamma images was few millimeters below the Bragg peak position. Moreover, the dual- and triple-energy window images for all positions of phantoms were not affected by scattered gammas, and their peak intensity positions were approximately similar to those observed in the reconstructed 718 keV prompt gamma images. In conclusion, the findings of the current study demonstrate the feasibility of using our Compton camera for real-time beam monitoring of carbon ion beams under clinical beam intensity.

Use of a Si/CdTe Compton Camera for In vivo Real-Time Monitoring of Annihilation Gamma Rays Generated by Carbon Ion Beam Irradiation

The application of annihilation gamma-ray monitoring to the adaptive therapy of carbon ion radiotherapy (C-ion RT) requires identification of the peak intensity position and confirmation of activated elements with annihilation gamma-rays generated at the C-ion-irradiated site from those transported to unirradiated sites. Real-time monitoring of C-ion-induced annihilation gamma-rays was implemented using a Compton camera in a mouse model. An adult C57BL/6 mouse was anesthetized, and C-ion beams were directed into the abdomen at 1 × 10⁹ particles/s for 20 s. The 511 keV annihilation gamma-rays, generated by the interaction between the irradiated C-ion beam and the target mouse, were detected using a silicon/cadmium telluride (Si/CdTe) Compton camera for 20 min immediately after irradiation. The irradiated site and the peak intensity position of 511 keV gamma emissions due to C-ion beam irradiation on a mouse were observed at the abdomen of the mouse by developing Compton images. Moreover, the positron emitter transport was observed by evaluating the range of gamma-ray emission after the C-ion beam irradiation on the mouse. Our data suggest that by confirming the peak intensity and beam range of C-ion RT with Si/CdTe-based Compton camera, it would be possible to reduce the intra-fractional and inter-fractional dose distribution degradation. Therefore, the results of this study would contribute to the future development of adaptive therapy with C-ion RT for humans.

Improved iterative reconstruction method for Compton imaging using median filter

A Compton camera is a device for imaging a radio-source distribution without using a mechanical collimator. Ordered-subset expectation-maximization (OS-EM) is widely used to reconstruct Compton images. However, the OS-EM algorithm tends to over-concentrate and amplify noise in the reconstructed image. It is, thus, necessary to optimize the number of iterations to develop high-quality images, but this has not yet been achieved. In this paper, we apply a median filter to an OS-EM algorithm and introduce a median root prior expectation-maximization (MRP-EM) algorithm to overcome this problem. In MRP-EM, the median filter is used to update the image in each iteration. We evaluated the quality of images reconstructed by our proposed method and compared them with those reconstructed by conventional algorithms using mathematical phantoms. The spatial resolution was estimated using the images of two point sources. Reproducibility was evaluated on an ellipsoidal phantom by calculating the residual sum of squares, zero-mean normalized cross-correlation, and mutual information. In addition, we evaluated the semi-quantitative performance and uniformity on the ellipsoidal phantom. MRP-EM reduces the generated noise and is robust with respect to the number of iterations. An evaluation of the reconstructed image quality using some statistical indices shows that our proposed method delivers better results than conventional techniques.

Compton imaging with 99mTc for human imaging

We have been developing a medical imaging system using a Compton camera and demonstrated the imaging ability of Compton camera for ^99mTc-DMSA accumulated in rat kidneys. In this study, we performed imaging experiments using a human body phantom to confirm its applicability to human imaging. Preliminary simulations were conducted using a digital phantom with varying activity ratios between the kidney and body trunk regions. Gamma rays (141 keV) were generated and detected by a Compton camera based on a silicon and cadmium telluride (Si/CdTe) detector. Compton images were reconstructed with the list mode median root prior expectation maximization method. The appropriate number of iterations of the condition was confirmed through simulations. The reconstructed Compton images revealed two bright points in the kidney regions. Furthermore, the numerical value calculated by integrating pixel values inside the region of interest correlated well with the activity of the kidney regions. Finally, experimental studies were conducted to ascertain whether the results of the simulation studies could be reproduced. The kidneys could be successfully visualised. In conclusion, considering that the conditions in this study agree with those of typical human bodies and imaginable experimental setup, the Si/CdTe Compton camera has a high probability of success in human imaging. In addition, our results indicate the capability of (semi-) quantitative analysis using Compton images.

Annihilation gamma imaging for carbon ion beam range monitoring using Si/CdTe Compton camera

In this study, we performed on-beam monitoring of 511 keV annihilation gamma emissions using a Compton camera. Beam monitoring experiments were conducted using carbon ion beams of 290 MeV/u irradiated on a polymethyl methacrylate (PMMA) phantom. The intensity of the beams was 3  ×  10⁹ particles per pulse, with 20 pulses per minute. A Compton camera based on a silicon/cadmium telluride (Si/CdTe) detector was used to monitor the annihilation gamma rays emitted from the phantom. We successfully reconstructed the energy events of 511 keV annihilation gamma rays and developed Compton images using a simple back-projection method. The distribution of the annihilation gamma ray generation traced the beam trajectory and the peak intensity position was a few millimeters shorter than the Bragg peak position. Moreover, the effect of the beam range shifter with 30, 60, and 90 mm water equivalent thickness (WET) was clearly visualized in the reconstructed Compton images. The experimentally measured values of the corresponding range shifts in the PMMA phantom (28.70 mm, 52.49 mm, and 76.77 mm, respectively) were consistent with the shifts of the Bragg peak position (25.50 mm, 51.30 mm and 76.70 mm, respectively) evaluated by Monte Carlo simulation. The results show that the Si/CdTe Compton camera has strong potential for on-beam monitoring of annihilation gamma rays in particle therapy in clinical situations.

In vivo simultaneous imaging with 99mTc and 18F using a Compton camera

We have been developing a medical imaging technique using a Compton camera. This study evaluates the feasibility of clear imaging with ^99mTc and ¹⁸F simultaneously, and demonstrates in vivo imaging with ^99mTc and/or ¹⁸F. We used a Compton camera with silicon and cadmium telluride (Si/CdTe) semiconductors. We estimated the imaging performance of the Compton camera for 141 keV and 511 keV gamma rays from ^99mTc and ²²Na, respectively. Next, we simultaneously imaged ^99mTc and ¹⁸F point sources to evaluate the cross-talk artifacts produced by a higher energy gamma-ray background. Then, in the in vivo experiments, three rats were injected with ^99mTc-dimercaptosuccinic acid and/or ¹⁸F-fluorodeoxyglucose and imaged. The Compton images were compared with PET images. The rats were euthanized, and the activities in their organs were measured using a well counter. The energy resolution and spatial resolution were measured for the sources. No apparent cross-talk artifacts were observed in the practical-activity ratio (^99mTc:¹⁸F  =  1:16). We succeeded in imaging the distributions of ^99mTc and ¹⁸F simultaneously, and the results were consistent with the PET images and well counter measurements. Our Si/CdTe Compton camera can thus work as a multi-tracer imager, covering various SPECT and PET probes, with less cross-talk artifacts in comparison to the conventional Anger cameras using a collimator. Our findings suggest the possibility of human trials.

First demonstration of multi-color 3-D in vivo imaging using ultra-compact Compton camera

In the field of nuclear medicine, single photon emission tomography and positron emission tomography are the two most common techniques in molecular imaging, but the available radioactive tracers have been limited either by energy range or difficulties in production and delivery. Thus, the use of a Compton camera, which features gamma-ray imaging of arbitrary energies from a few hundred keV to more than MeV, is eagerly awaited along with potential new tracers which have never been used in current modalities. In this paper, we developed an ultra-compact Compton camera that weighs only 580 g. The camera consists of fine-pixelized Ce-doped Gd₃Al₂Ga₃O₁₂ scintillators coupled with multi-pixel photon counter arrays. We first investigated the 3-D imaging capability of our camera system for a diffuse source of a planar geometry, and then conducted small animal imaging as pre-clinical evaluation. For the first time, we successfully carried out the 3-D color imaging of a live mouse in just 2 h. By using tri-color gamma-ray fusion images, we confirmed that ¹³¹I, ⁸⁵Sr, and ⁶⁵Zn can be new tracers that concentrate in each target organ.