A quantitative assessment of Geant4 for predicting the yield and distribution of positron-emitting fragments in ion beam therapy

PURPOSE

To compare the accuracy with which different hadronic inelastic physics models across ten Geant4 Monte Carlo simulation toolkit versions can predict positron-emitting fragments produced along the beam path during carbon and oxygen ion therapy. Materials and Methods: Phantoms of polyethylene, gelatin or poly(methyl methacrylate) were irradiated with monoenergetic carbon and oxygen ion beams. Post-irradiation, 4D PET images were acquired and parent11C,10C and15O radionuclides contributions in each voxel were determined from the extracted time activity curves. Next, the experimental configurations were simulated in Geant4 Monte Carlo versions 10.0 to 11.1, with three different fragmentation models - binary ion cascade (BIC), quantum molecular dynamics (QMD) and the Liege intranuclear cascade (INCL++) - 30 model-version combinations. Total positron annihilation and parent isotope production yields predicted by each simulation were compared between simulations and experiments using normalised mean squared error and Pearson cross-correlation coefficient. Finally, we compared the depth of maximum positron annihilation yield and the distal point at which positron yield decreases to 50% of peak between each model and the experimental results. Results: Performance varied considerably across versions and models, with no one version/model combination providing the best prediction of all positron-emitting fragments in all evaluated target materials and irradiation conidiations. BIC in Geant4 10.2 provided the best overall agreement with experimental results in the largest number of test cases. QMD consistently provided the best estimates of both the depth of peak positron yield (10.4 and 10.6) and the distal 50%-of-peak point (10.2), while BIC also performed well and INCL generally performed the worst across most Geant4 versions. Conclusions: Best spatial prediction of annihilation yield and positron-emitting fragment production during carbon and oxygen ion therapy was found to be 10.2.p03 with BIC or QMD. These version/model combinations are recommended for future heavy ion therapy research.

Deep learning-based PET image denoising and reconstruction: a review

This review focuses on positron emission tomography (PET) imaging algorithms and traces the evolution of PET image reconstruction methods. First, we provide an overview of conventional PET image reconstruction methods from filtered backprojection through to recent iterative PET image reconstruction algorithms, and then review deep learning methods for PET data up to the latest innovations within three main categories. The first category involves post-processing methods for PET image denoising. The second category comprises direct image reconstruction methods that learn mappings from sinograms to the reconstructed images in an end-to-end manner. The third category comprises iterative reconstruction methods that combine conventional iterative image reconstruction with neural-network enhancement. We discuss future perspectives on PET imaging and deep learning technology.

First experimental demonstration of real-time neutron capture discrimination in helium and carbon ion therapy

This work provides the first experimental proof of an increased neutron capture photon signal following the introduction of boron to a PMMA phantom during helium and carbon ion therapies in Neutron Capture Enhanced Particle Therapy (NCEPT). NCEPT leverages [Formula: see text]B neutron capture, leading to the emission of detectable 478 keV photons. Experiments were performed at the Heavy Ion Medical Accelerator in Chiba, Japan, with two Poly(methyl methacrylate) (PMMA) targets, one bearing a boron insert. The BeNEdiCTE gamma-ray detector measured an increase in the 478 keV signal of 45 ± 7% and 26 ± 2% for carbon and helium ion irradiation, respectively. Our Geant4 Monte Carlo simulation model, developed to investigate photon origins, found less than 30% of detected photons originated from the insert, while boron in the detector's circuit boards contributed over 65%. Further, the model investigated detector sensitivity, establishing its capability to record a 10% increase in 478 keV photon detection at a target [Formula: see text]B concentration of 500 ppm using spectral windowing alone, and 25% when combined with temporal windowing. The linear response extended to concentrations up to 20,000 ppm. The increase in the signal in all evaluated cases confirm the potential of the proposed detector design for neutron capture quantification in NCEPT.

Whole Gamma Imaging: Challenges and Opportunities

Compton imaging has been recognized as a possible nuclear medicine imaging method following the establishment of SPECT and PET. Whole gamma imaging (WGI), a combination of PET and Compton imaging, could be the first practical method to bring out the potential of Compton imaging in nuclear medicine. With the use of such positron emitters as 89Zr and 44Sc, WGI may enable highly sensitive imaging of antibody drugs for early tumor detection and quantitative hypoxia imaging for effective tumor treatment. Some of these concepts have been demonstrated preliminarily in physics experiments and small animal imaging tests with a developed WGI prototype.

Pre-acquired CT-based attenuation correction with automated headrest removal for a brain-dedicated PET system

Attenuation correction (AC) is essential for quantitative positron emission tomography (PET) images. Attenuation coefficient maps (μ-maps) are usually generated from computed tomography (CT) images when PET-CT combined systems are used. If CT has been performed prior to PET imaging, pre-acquired CT can be used for brain PET AC, because the human head is almost rigid. This pre-acquired CT-based AC approach is suitable for stand-alone brain-dedicated PET, such as VRAIN (ATOX Co. Ltd., Tokyo, Japan). However, the headrest of PET is different from the headrest in pre-acquired CT images, which may degrade the PET image quality. In this study, we prepared three different types of μ-maps: (1) based on the pre-acquired CT, where namely the headrest is different from the PET system (μ-map-diffHr); (2) manually removing the headrest from the pre-acquired CT (μ-map-noHr); and (3) artificially replacing the headrest region with the headrest of the PET system (μ-map-sameHr). Phantom images by VRAIN using each μ-map were investigated for uniformity, noise, and quantitative accuracy. Consequently, only the uniformity of the images using μ-map-diffHr was out of the acceptance criteria. We then proposed an automated method for removing the headrest from pre-acquired CT images. In comparisons of standardized uptake values in nine major brain regions from the 18F-fluoro-2-deoxy-D-glucose-PET of 10 healthy volunteers, no significant differences were found between the μ-map-noHr and the μ-map-sameHr. In conclusion, pre-acquired CT-based AC with automated headrest removal is useful for brain-dedicated PET such as VRAIN.

Fully 3D implementation of the end-to-end deep image prior-based PET image reconstruction using block iterative algorithm

Objective. Deep image prior (DIP) has recently attracted attention owing to its unsupervised positron emission tomography (PET) image reconstruction method, which does not require any prior training dataset. In this paper, we present the first attempt to implement an end-to-end DIP-based fully 3D PET image reconstruction method that incorporates a forward-projection model into a loss function.Approach. A practical implementation of a fully 3D PET image reconstruction could not be performed at present because of a graphics processing unit memory limitation. Consequently, we modify the DIP optimization to a block iteration and sequential learning of an ordered sequence of block sinograms. Furthermore, the relative difference penalty (RDP) term is added to the loss function to enhance the quantitative accuracy of the PET image.Main results. We evaluated our proposed method using Monte Carlo simulation with [18F]FDG PET data of a human brain and a preclinical study on monkey-brain [18F]FDG PET data. The proposed method was compared with the maximum-likelihood expectation maximization (EM), maximuma posterioriEM with RDP, and hybrid DIP-based PET reconstruction methods. The simulation results showed that, compared with other algorithms, the proposed method improved the PET image quality by reducing statistical noise and better preserved the contrast of brain structures and inserted tumors. In the preclinical experiment, finer structures and better contrast recovery were obtained with the proposed method.Significance.The results indicated that the proposed method could produce high-quality images without a prior training dataset. Thus, the proposed method could be a key enabling technology for the straightforward and practical implementation of end-to-end DIP-based fully 3D PET image reconstruction.

Optimum selection for multi-interaction events in Compton-PET hybrid reconstruction: a Monte Carlo study

In Compton PET, that has a scatterer inserted inside a PET ring, there are multi-interaction events that can be treated as both PET and Compton events. A PET event from multi-interaction events that include a Compton event and a photoelectric absorption event or two Compton events can be extracted by applying a PET recovery method. In this study, we aimed to establish a method to maximize image quality by utilizing such redundant events. We conducted brain-scale Monte Carlo simulations of a C-shaped Compton-PET geometry and a whole gamma imaging (WGI) geometry. Images were reconstructed by a hybrid image reconstruction method combining both PET and Compton events. The result showed that the spatial resolution was improved when treated as PET events while keeping the noise level. The effect of improvement was more significant in WGI than in C-shaped Compton PET because the number of events recovered as PET events having more accurate spatial information was much larger in WGI. When the PET-recovered multi-interaction events were also included as Compton events in the hybrid reconstruction, we did not observe any improvement in image quality, while the number of used events was largest. The results suggested that treating events as PET events exclusively was better for image quality.

Rice immediately adapts the dynamics of photosynthates translocation to roots in response to changes in soil water environment

Rice is susceptible to abiotic stresses such as drought stress. To enhance drought resistance, elucidating the mechanisms by which rice plants adapt to intermittent drought stress that may occur in the field is an important requirement. Roots are directly exposed to changes in the soil water condition, and their responses to these environmental changes are driven by photosynthates. To visualize the distribution of photosynthates in the root system of rice plants under drought stress and recovery from drought stress, we combined X-ray computed tomography (CT) with open type positron emission tomography (OpenPET) and positron-emitting tracer imaging system (PETIS) with ¹¹C tracer. The short half-life of ¹¹C (20.39 min) allowed us to perform multiple experiments using the same plant, and thus photosynthate translocation was visualized as the same plant was subjected to drought stress and then re-irrigation for recovery. The results revealed that when soil is drier, ¹¹C-photosynthates mainly translocated to the seminal roots, likely to promote elongation of the root with the aim of accessing water stored in the lower soil layers. The photosynthates translocation to seminal roots immediately stopped after rewatering then increased significantly in crown roots. We suggest that when rice plant experiencing drought is re-irrigated from the bottom of pot, the destination of ¹¹C-photosynthates translocation immediately switches from seminal root to crown roots. We reveal that rice roots are responsive to changes in soil water conditions and that rice plants differentially adapts the dynamics of photosynthates translocation to crown roots and seminal roots depending on soil conditions.

Submillimeter resolution positron emission tomography for high-sensitivity mouse brain imaging

Positron emission tomography (PET) is a powerful molecular imaging technique that can provide functional information of living objects. However, the spatial resolution of PET imaging has been limited to around 1 mm which makes it difficult to visualize mouse brain functions in detail. Here we report an ultrahigh resolution small animal PET scanner we developed that can provide a resolution approaching 0.6 mm to visualize the mouse brain functions with unprecedented detail. Methods: The ultrahigh resolution small animal PET scanner had 52.5 mm inner diameter and 51.5 mm axial coverage. The PET scanner consisted of 4 rings each of which had 16 DOI detectors. Each DOI detector consisted of a 3-layer staggered LYSO crystal array with a pitch of 1 mm and 4×4 SiPM array. The physical performance was evaluated in accordance with the NEMA NU4 protocol. The spatial resolution was evaluated with various resolution phantoms. In vivo glucose metabolism imaging of mouse brain was performed. Results: The peak absolute sensitivity was 2.84% with an energy window of 400-600 keV. The 0.55 mm rod structure of a resolution phantom was resolved using the iterative algorithm. The in vivo mouse brain imaging with ¹⁸F-FDG showed clear identification of cortex, thalamus, and hypothalamus which were barely distinguishable in a commercial preclinical PET scanner that we used for imaging comparison. Conclusion: The developed ultrahigh resolution small animal PET scanner is a promising molecular imaging tool for neuroscience research using rodent models.

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.

Small nuclei identification with a hemispherical brain PET

BACKGROUND

To confirm the performance of the first hemispherical positron emission tomography (PET) for the brain (Vrain) that we developed to visualise the small nuclei in the deep brain area, we compared ¹⁸F-fluorodeoxyglucose (FDG) brain images with whole-body PET images.

METHODS

Ten healthy male volunteers (aged 22-45 years) underwent a representative clinical whole-body PET, followed by Vrain each for 10 min. These two scans were initiated 30 min and 45 min after FDG injection (4.1 ± 0.5 MBq/kg), respectively. First, we visually identified the small nuclei and then compared their standardised uptake values (SUVs) with the participants' age. Next, the SUVs of each brain region, which were determined by applying a volume-of-interest template for anatomically normalised PET images, were compared between the brain images with the Vrain and those with the whole-body PET images.

RESULTS

Small nuclei, such as the inferior colliculus, red nucleus, and substantia nigra, were more clearly visualised in Vrain than in whole-body PET. The anterior nucleus and dorsomedial nucleus in the thalamus and raphe nucleus in the brainstem were identified in Vrain but not in whole-body PET. The SUVs of the inferior colliculus and dentate gyrus in the cerebellum positively correlated with age (Spearman's correlation coefficient r = 0.811, p = 0.004; r = 0.738, p = 0.015, respectively). The SUVs of Vrain were slightly higher in the mesial temporal and medial parietal lobes than those in whole-body PET.

CONCLUSIONS

This was the first time that the raphe nuclei, anterior nuclei, and dorsomedial nuclei were successfully visualised using the first hemispherical brain PET. TRIAL REGISTRATION  : Japan Registry of Clinical Trials, jRCTs032210086, Registered 13 May 2021, https://jrct.niph.go.jp/latest-detail/jRCTs032210086 .

An inception network for positron emission tomography based dose estimation in carbon ion therapy

Objective. We aim to evaluate a method for estimating 1D physical dose deposition profiles in carbon ion therapy via analysis of dynamic PET images using a deep residual learning convolutional neural network (CNN). The method is validated using Monte Carlo simulations of 12C ion spread-out Bragg peak (SOBP) profiles, and demonstrated with an experimental PET image. Approach. A set of dose deposition and positron annihilation profiles for monoenergetic 12C ion pencil beams in PMMA are first generated using Monte Carlo simulations. From these, a set of random polyenergetic dose and positron annihilation profiles are synthesised and used to train the CNN. Performance is evaluated by generating a second set of simulated 12C ion SOBP profiles (one 116 mm SOBP profile and ten 60 mm SOBP profiles), and using the trained neural network to estimate the dose profile deposited by each beam and the position of the distal edge of the SOBP. Next, the same methods are used to evaluate the network using an experimental PET image, obtained after irradiating a PMMA phantom with a 12C ion beam at QST’s Heavy Ion Medical Accelerator in Chiba facility in Chiba, Japan. The performance of the CNN is compared to that of a recently published iterative technique using the same simulated and experimental 12C SOBP profiles. Main results. The CNN estimated the simulated dose profiles with a mean relative error (MRE) of 0.7% ± 1.0% and the distal edge position with an accuracy of 0.1 mm ± 0.2 mm, and estimate the dose delivered by the experimental 12C ion beam with a MRE of 3.7%, and the distal edge with an accuracy of 1.7 mm. Significance. The CNN was able to produce estimates of the dose distribution with comparable or improved accuracy and computational efficiency compared to the iterative method and other similar PET-based direct dose quantification techniques.

Feasibility of triple gamma ray imaging of 10C for range verification in ion therapy

Objective. In carbon ion therapy, the visualization of the range of incident particles in a patient body is important for treatment verification. In-beam positron emission tomography (PET) imaging is one of the methods to verify the treatment in ion therapy due to the high quality of PET images. We have shown the feasibility of in-beam PET imaging of radioactive 15O and 11C ion beams for range verification using our OpenPET system. Recently, we developed a whole gamma imager (WGI) that can simultaneously work as PET, single gamma ray and triple gamma ray imaging. The WGI has high potential to detect the location of 10C, which emits positrons with a simultaneous gamma ray of 718 keV, within the patient’s body during ion therapy. Approach. In this work, we focus on investigating the performance of WGI for 10C imaging and its feasibility for range verification in carbon ion therapy. First, the performance of the WGI was studied to image a 10C point source using the Geant4 toolkit. Then, the feasibility of WGI was investigated for an irradiated polymethyl methacrylate (PMMA) phantom with a 10C ion beam at the carbon therapy facility of the Heavy Ion Medical Accelerator in Chiba. Main results. The average spatial resolution and sensitivity for the simulated 10C point source at the centre of the field of view were 5.5 mm FWHM and 0.010%, respectively. The depth dose of the 10C ion beam was measured, and the triple gamma image of 10C nuclides for an irradiated PMMA phantom was obtained by applying a simple back projection to the detected triple gammas. Significance. The shift between Bragg peak position and position of the peak of the triple gamma image in an irradiated PMMA phantom was 2.8 ± 0.8 mm, which demonstrates the capability of triple gamma imaging using WGI for range verification of 10C ion beams.

Brain PET motion correction using 3D face-shape model: the first clinical study

OBJECTIVE

Head motions during brain PET scan cause degradation of brain images, but head fixation or external-maker attachment become burdensome on patients. Therefore, we have developed a motion correction method that uses a 3D face-shape model generated by a range-sensing camera (Kinect) and by CT images. We have successfully corrected the PET images of a moving mannequin-head phantom containing radioactivity. Here, we conducted a volunteer study to verify the effectiveness of our method for clinical data.

METHODS

Eight healthy men volunteers aged 22-45 years underwent a 10-min head-fixed PET scan as a standard of truth in this study, which was started 45 min after ¹⁸F-fluorodeoxyglucose (285 ± 23 MBq) injection, and followed by a 15-min head-moving PET scan with the developed Kinect based motion-tracking system. First, selecting a motion-less period of the head-moving PET scan provided a reference PET image. Second, CT images separately obtained on the same day were registered to the reference PET image, and create a 3D face-shape model, then, to which Kinect-based 3D face-shape model matched. This matching parameter was used for spatial calibration between the Kinect and the PET system. This calibration parameter and the motion-tracking of the 3D face shape by Kinect comprised our motion correction method. The head-moving PET with motion correction was compared with the head-fixed PET images visually and by standard uptake value ratios (SUVRs) in the seven volume-of-interest regions. To confirm the spatial calibration accuracy, a test-retest experiment was performed by repeating the head-moving PET with motion correction twice where the volunteer's pose and the sensor's position were different.

RESULTS

No difference was identified visually and statistically in SUVRs between the head-moving PET images with motion correction and the head-fixed PET images. One of the small nuclei, the inferior colliculus, was identified in the head-fixed PET images and in the head-moving PET images with motion correction, but not in those without motion correction. In the test-retest experiment, the SUVRs were well correlated (determinant coefficient, r² = 0.995).

CONCLUSION

Our motion correction method provided good accuracy for the volunteer data which suggested it is useable in clinical settings.

Marker-less and calibration-less motion correction method for brain PET

Marker-less head motion correction methods have been well-studied; however, no reports discussing potential issues in positional calibration between a PET system and an external sensor remain limited. In this study, we develop a method for positional calibration between the PET system and an external range sensor to achieve practical head motion correction. The basic concept of the developed method involves using the subject's face model as a marker not only for head motion detection but also for the system positional calibration. The face model of the subject, which can be obtained easily using the range sensor, can also be calculated from a computed tomography (CT) image of the same subject. The CT image, which is acquired separately for attenuation correction in PET, has the same coordinates as the PET image because of the appropriate matching algorithm between CT and PET images. The proposed method was implemented in the helmet-type PET and the motion correction accuracy was assessed quantitatively using a mannequin head. The phantom experiments demonstrated the performance of the developed motion correction method; high-resolution images with no trace of the applied motion were obtained as if no motion was provided. Statistical analysis supported the visual assessment results in terms of the spatial resolution, contrast recovery; uniformity, and the results implied that motion with correction slightly improved image quality compared with the motionless case. The tolerance of the developed method against potential tracking errors had a minimum 10% difference in the amplitude of the rotation angle.

Using inverse Laplace transform in positronium lifetime imaging

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

Initial results of a mouse brain PET insert with a staggered 3-layer DOI detector

Objective.Small animal positron emission tomography (PET) requires a submillimeter resolution for better quantification of radiopharmaceuticals. On the other hand, depth-of-interaction (DOI) information is essential to preserve the spatial resolution while maintaining the sensitivity. Recently, we developed a staggered 3-layer DOI detector with 1 mm crystal pitch and 15 mm total crystal thickness, but we did not demonstrate the imaging performance of the DOI detector with full ring geometry. In this study we present initial imaging results obtained for a mouse brain PET prototype developed with the staggered 3-layer DOI detector.Approach.The prototype had 53 mm inner diameter and 11 mm axial field-of-view. The PET scanner consisted of 16 DOI detectors each of which had a staggered 3-layer LYSO crystal array (4/4/7 mm) coupled to a 4 × 4 silicon photomultiplier array. The physical performance was evaluated in terms of the NEMA NU 4 2008 protocol.Main Results.The measured spatial resolutions at the center and 15 mm radial offset were 0.67 mm and 1.56 mm for filtered-back-projection, respectively. The peak absolute sensitivity of 0.74% was obtained with an energy window of 400-600 keV. The resolution phantom imaging results show the clear identification of a submillimetric rod pattern with the ordered-subset expectation maximization algorithm. The inter-crystal scatter rejection using a narrow energy window could enhance the resolvability of a 0.75 mm rod significantly.Significance.In an animal imaging experiment, the detailed mouse brain structures such as cortex and thalamus were clearly identified with high contrast. In conclusion, we successfully developed the mouse brain PET insert prototype with a staggered 3-layer DOI detector.

Design consideration of compact cardiac TOF-PET systems: a simulation study

Myocardial perfusion imaging (MPI) with PET plays a vital role in the management of coronary artery disease. High sensitivity systems can contribute to maximizing the potential value of PET MPI; therefore, we have proposed two novel detector arrangements, an elliptical geometry and a D-shape geometry, that are more sensitive and more compact than a conventional large-bore cylindrical geometry. Here we investigate two items: the benefits of the proposed geometries for cardiac imaging; and the effects of scatter components on cardiac PET image quality. Using the Geant4 toolkit, we modeled four time-of-flight (TOF) PET systems: an 80-cm-diameter cylinder, a 40-cm-diameter cylinder, a compact ellipse, and a compact D-shape. Spatial resolution and sensitivity were measured using point sources. Noise equivalent count rate (NECR) and image quality were examined using an anthropomorphic digital chest phantom. The proposed geometries showed higher sensitivity and better count rate characteristics with a fewer number of detectors than the conventional large-bore cylindrical geometry. In addition, we found that the increased intensity of the scatter components was a big factor affecting the contrast in defect regions for such a compact geometry. It is important to address the issue of the increased intensity of the scatter components to develop a high-performance compact cardiac TOF PET system.

First imaging demonstration of a crosshair light-sharing PET detector

The crosshair light-sharing (CLS) PET detector is our original depth-of-interaction (DOI) detector, which is based on a single-ended readout scheme with quadrisected crystals comparable in size to a photo-sensor. In this work, we developed 32 CLS PET detectors, each of which consisted of a multi-pixel photon counter (MPPC) array and gadolinium fine aluminum garnet (GFAG) crystals, and we developed a benchtop prototype of a small animal size PET. Each GFAG crystal was 1.45 × 1.45 × 15 mm³. The MPPC had a surface area of 3.0 × 3.0 mm². The benchtop prototype had two detector rings of 16 detector blocks. The ring diameter and axial field-of-view were 14.2 cm and 4.9 cm, respectively. The data acquisition system used was the PETsys silicon photomultiplier readout system. The continuous DOI information was binned into three DOI layers by applying a look-up-table to a 2D position histogram. Also, energy and timing information was corrected using DOI information. After the calibration procedure, the energy resolution and the coincidence time resolution were 14.6% and 531 ps, respectively. Imaging test results of a small rod phantom obtained by an iterative reconstruction method showed clear separation of 1.6 mm rods with the help of DOI information.

3D Compton image reconstruction method for whole gamma imaging

Compton imaging or Compton camera imaging has been studied well, but its advantages in nuclear medicine and molecular imaging have not been demonstrated yet. Therefore, the aim of this work was to compare Compton imaging with positron emission tomography (PET) by using the same imaging platform of whole gamma imaging (WGI). WGI is a concept that combines PET with Compton imaging by inserting a scatterer ring into a PET ring. This concept utilizes diverse types of gamma rays for 3D tomographic imaging. In this paper, we remodeled our previous WGI prototype for small animal imaging, and we developed an image reconstruction method based on a list-mode ordered subset expectation maximization algorithm incorporating detector response function modeling, random correction and normalization (sensitivity correction) for either PET and Compton imaging. To the best of our knowledge, this is the world's first realization of a full-ring Compton imaging system. We selected ⁸⁹Zr as an imaging target because a ⁸⁹Zr nuclide emits a 909 keV single-gamma ray as well as a positron, and we can directly compare Compton imaging of 909 keV photons with PET, a well-established modality. We measured a cylindrical phantom and a small rod phantom filled with ⁸⁹Zr solutions of 10.3 MBq and 10.2 MBq activity, respectively, for 1 h each. The uniform radioactivity distribution of the cylindrical phantom was reconstructed with normalization in both PET and Compton imaging. Coefficients of variation for region-of-interest values were 4.2% for Compton imaging and 3.3% for PET; the difference might be explained by the difference in the detected count number. The small rod phantom experiment showed that the WGI Compton imaging had spatial resolution better than 3.0 mm at the peripheral region although the center region had lower resolution. PET resolved 2.2 mm rods clearly at any location. We measured a mouse for 1 h, 1 d after injection of 9.8 MBq ⁸⁹Zr oxalate. The ⁸⁹Zr assimilated in the mouse bony structures was clearly depicted, and Compton imaging results agreed well with PET images, especially for the region inside the scatterer ring. In conclusion, we demonstrated the performance of WGI using the developed Compton image reconstruction method. We realized Compton imaging with a quality approaching that of PET, which is supporting a future expectation that Compton imaging outperforms PET.

Whole gamma imaging: a new concept of PET combined with Compton imaging

We proposed a concept of whole gamma imaging (WGI) that utilizes all detectable gamma rays for imaging. An additional detector ring, which is used as the scatterer, is inserted in the field-of-view of a PET ring so that single gamma rays can be detected by the Compton imaging method. In particular, for the non-pure positron emitters which emit an additional gamma ray almost at the same time, triple gamma imaging will be enabled; localization on each line-of-response (LOR) is possible by using the Compton cone of the additional gamma ray. We developed a prototype to show a proof of the WGI concept. The diameters of scatterer ring and PET ring were set as 20 cm and 66 cm, respectively. For Compton imaging of the 662-keV gamma ray from a ¹³⁷Cs point source, spatial resolution obtained by the list-mode OSEM algorithm was 4.4 mm FWHM at the 8 cm off-center position and 13.1 mm FWHM at the center position. For PET imaging of a ²²Na point source, spatial resolution was about 2 mm FWHM at all positions. For the triple gamma imaging, 5.7 mm FWHM (center) and 4.8 mm FWHM (8 cm off-center) were obtained for the ²²Na point source just by plotting the intersecting points between each LOR and each Compton cone of the 1275-keV gamma ray. No image reconstruction was applied. Scandium-44 was produced as a practical candidate of the non-pure positron emitters, and 6.6 mm FWHM (center) and 5.8 mm FWHM (8 cm off-center) were obtained in the same manner. This direct imaging approach which neither requires time-consuming event integration nor iterative image reconstruction may allow in vivo real-time tracking of a tiny amount of activity. Our initial results showed the feasibility of the WGI concept, which is a novel combination of PET and Compton imaging.

Influence of momentum acceptance on range monitoring of 11C and 15O ion beams using in-beam PET

In heavy-ion therapy, the stopping position of primary ions in tumours needs to be monitored for effective treatment and to prevent overdose exposure to normal tissues. Positron-emitting ion beams, such as ¹¹C and ¹⁵O, have been suggested for range verification in heavy-ion therapy using in-beam positron emission tomography (PET) imaging, which offers the capability of visualizing the ion stopping position with a high signal-to-noise ratio. We have previously demonstrated the feasibility of in-beam PET imaging for the range verification of ¹¹C and ¹⁵O ion beams and observed a slight shift between the beam stopping position and the dose peak position in simulations, depending on the initial beam energy spread. In this study, we focused on the experimental confirmation of the shift between the Bragg peak position and the position of the maximum detected positron-emitting fragments via a PET system for positron-emitting ion beams of ¹¹C (210 MeV u^-1) and ¹⁵O (312 MeV u^-1) with momentum acceptances of 5% and 0.5%. For this purpose, we measured the depth doses and performed in-beam PET imaging using a polymethyl methacrylate (PMMA) phantom for both beams with different momentum acceptances. The shifts between the Bragg peak position and the PET peak position in an irradiated PMMA phantom for the ¹⁵O ion beams were 1.8 mm and 0.3 mm for momentum acceptances of 5% and 0.5%, respectively. The shifts between the positions of two peaks for the ¹¹C ion beam were 2.1 mm and 0.1 mm for momentum acceptances of 5% and 0.5%, respectively. We observed larger shifts between the Bragg peak and the PET peak positions for a momentum acceptance of 5% for both beams, which is consistent with the simulation results reported in our previous study. The biological doses were also estimated from the calculated relative biological effectiveness (RBE) values using a modified microdosimetric kinetic model (mMKM) and Monte Carlo simulation. Beams with a momentum acceptance of 5% should be used with caution for therapeutic applications to avoid extra dose to normal tissues beyond the tumour when the dose distal fall-off is located beyond the treatment volume.

Design study of a brain-dedicated time-of-flight PET system with a hemispherical detector arrangement

Time-of-flight (TOF) is now a standard technology for positron emission tomography (PET), but its effective use for small diameter PET systems has not been studied well. In this paper, we simulated a brain-dedicated TOF-PET system with a hemispherical detector arrangement. We modeled a Hamamatsu TOF-PET module (C13500-4075LC-12) with 280 ps coincidence resolving time (CRT), in which a 12  ×  12 array of multi pixel photon counters (MPPCs) is connected to a lutetium fine silicate (LFS) crystal array of 4.1  ×  4.1 mm² cross section each, based on one-to-one coupling. On the other hand, spatial resolution degradation due to the parallax error should be carefully addressed for the small diameter PET systems. The ideal PET detector would have both depth-of-interaction (DOI) and TOF capabilities, but typical DOI detectors that are based on light sharing tend to degrade TOF performance. Therefore, in this work, we investigated non-DOI detectors with an appropriate crystal length, which was a compromise between suppressed parallax error and decreased sensitivity. Using GEANT4, we compared two TOF detectors, a 20 mm long non-DOI and a 10 mm long non-DOI, with a non-TOF, 4-layer DOI detector with a total length of 20 mm (i.e. 5  ×  4 mm). We simulated a contrast phantom and evaluated the relationship between the contrast recovery coefficient (CRC) and the noise level (the coefficient of variation, COV) for reconstructed images. The 10 mm long non-DOI, which reduces the parallax error at the cost of sensitivity loss, showed better imaging quality than the 20 mm long non-DOI. For example, the CRC value of a 10 mm hot sphere at COV  =  20% was 72% for the 10 mm long non-DOI, which was 1.2 times higher than that of the 20 mm long non-DOI. The converged CRC values for the 10 mm long non-DOI were almost equivalent to those of the non-TOF 4-layer DOI, and the 10 mm long non-DOI converged faster than the non-TOF 4-layer DOI did. Based on the simulation results, we evaluated a one-pair prototype system of the TOF-PET detectors with 10 mm crystal length, which yielded the CRT of 250  ±  8 ps. In summary, we demonstrated support for feasibility of the brain-dedicated TOF-PET system with the hemispherical detector arrangement.

Simulation Study of High-sensitivity Cardiac-dedicated PET Systems with Different Geometries

Noninvasive quantification of myocardial blood flow with PET is a vital tool for detecting and monitoring of coronary artery disease. However, current standard cylindrical PET scanners are not optimized for cardiac imaging because they are designed mainly for whole-body imaging. In this study, we proposed two compact geometries, the elliptical geometry and the D-shape geometry, for cardiac-dedicated PET systems. We then evaluated their performance compared with a whole-body-size cylindrical geometry by using the Geant4 Monte Carlo simulation toolkit. In the simulation, an elliptical water phantom was scanned for 10-sec, and we calculated the sensitivity and the noise-equivalent count rate (NECR). Subsequently, a digital chest phantom was scanned for 30-sec and the coincidence data were reconstructed by in-house image reconstruction software. We evaluated the image noise in the liver region and the contrast recoveries in the heart region. Even with the limited number of detectors, the proposed compact geometries showed higher sensitivity than the whole-body geometry. The D-shape geometry achieved 47% higher NECR and 44% lower image noise compared with the whole-body cylindrical geometry. However, the contrasts in the hot area obtained by the proposed compact geometries were not as good as that obtained by the whole-body cylindrical geometry. There was no considerable difference in image quality between the elliptical geometry and the D-shape geometry. In conclusion, the compact geometries we have proposed are promising designs for a high-sensitivity and low-cost cardiac-dedicated PET system. A further study using a defect phantom model is required to evaluate the contrast of cold areas.

Modified NEMA NU-2 performance evaluation methods for a brain-dedicated PET system with a hemispherical detector arrangement

Brain PET imaging has important roles in neurology, neuro-oncology and molecular imaging research. We have developed a helmet-type PET prototype and have shown that the proposed hemispherical geometry had high potential for realizing high-sensitivity and low-cost brain imaging. However, there is no standard performance evaluation method for helmet-type PET, which would be a bottleneck to its commercialization. Therefore, we investigated appropriate performance evaluation methods for a helmet-type PET based on the NEMA NU 2-2018 standards. For those measurement methods that are not applicable to the helmet-type PET, we changed them while keeping the basic concept of the original NEMA standards. We measured spatial resolution, sensitivity, scatter fraction, count rate characteristics, accuracy of corrections for count losses and randoms, and image quality. We partially changed the measurement methods by making brain-size phantoms and by optimizing the length or the position of radioactive sources. The spatial resolution was 2.8 mm at 1-cm offset position by the filtered back-projection method. Sensitivities measured by the NEMA original setup and the proposed setup were 13.4 and 57.1 kcps/MBq. The respective values measured with our developed brain-size scatter phantom and with the conventional whole-body-size scatter phantom were: scatter fractions of 35% and 35%; peak NECRs of 25.1 kcps at 3.2 kBq/ml and 19.8 kcps at 2.6 kBq/ml ; and maximum absolute biases of 5.5% and 16.0%. The image quality was evaluated with the developed brain-size phantom, and good image quality was obtained. The helmet-type PET prototype showed high-sensitivity even with the small number of 54 detectors. The spatial resolution was better than 4.0 mm over the field-of-view. In conclusion, we proposed the performance evaluation methods for a brain-dedicated PET system with a hemispherical geometry. The proposed method could facilitate evaluation of performance characteristics of brain-dedicated PET scanners and optimization of its scanning and reconstruction parameters.

Comparative study of alternative Geant4 hadronic ion inelastic physics models for prediction of positron-emitting radionuclide production in carbon and oxygen ion therapy

The distribution of fragmentation products predicted by Monte Carlo simulations of heavy ion therapy depend on the hadronic physics model chosen in the simulation. This work aims to evaluate three alternative hadronic inelastic fragmentation physics options available in the Geant4 Monte Carlo radiation physics simulation framework to determine which model most accurately predicts the production of positron-emitting fragmentation products observable using in-beam PET imaging. Fragment distributions obtained with the BIC, QMD, and INCL + + physics models in Geant4 version 10.2.p03 are compared to experimental data obtained at the HIMAC heavy-ion treatment facility at NIRS in Chiba, Japan. For both simulations and experiments, monoenergetic beams are applied to three different block phantoms composed of gelatin, poly(methyl methacrylate) and polyethylene. The yields of the positron-emitting nuclei ¹¹C, ¹⁰C and ¹⁵O obtained from simulations conducted with each model are compared to the experimental yields estimated by fitting a multi-exponential radioactive decay model to dynamic PET images using the normalised mean square error metric in the entrance, build up/Bragg peak and tail regions. Significant differences in positron-emitting fragment yield are observed among the three physics models with the best overall fit to experimental ¹²C and ¹⁶O beam measurements obtained with the BIC physics model.

Range verification of radioactive ion beams of 11C and 15O using in-beam PET imaging

In advanced ion therapy, the visualization of the range of incident ions in a patient's body is important for exploiting the advantages of this type of therapy. It is ideal to use radioactive ion beams for in-beam positron emission tomography (PET) imaging in particle therapy due to the high quality of PET images caused by the high signal-to-noise ratio. We have shown the feasibility of this idea through an in-beam PET study for ¹¹C and ¹⁵O ion beams using the dedicated OpenPET system. In this work, we investigate the potential difference between the Bragg peak position and the position of the maximum detected positron-emitting fragments by a PET system for the radioactive beams of ¹¹C and ¹⁵O. For this purpose, we measured the depth dose in a water phantom and performed PET scans of an irradiated PMMA phantom for the available beams of ¹¹C and ¹⁵O at the Heavy Ion Medical Accelerator in Chiba (HIMAC). Then, we simulated the depth dose profiles in the water phantom and the yield of the positron-emitting fragments in a PMMA phantom for both available beams using the Monte Carlo code PHITS. The positions of the Bragg peak and maximum positron-emitting fragments from the measurements were well reproduced by simulation. The effect of beam energy broadening on the positional differences between two peaks was studied by simulating an irradiated PMMA phantom. The differences in position between the Bragg peak and the maximum positron-emitting fragments increased when the beam energy spread was broadened, although the differences were zero for the ideal mono-energetic beams. Greater differences were observed for ¹¹C ion beams compared to ¹⁵O ion beams, although both beams had the same range in water, and the higher energy corresponded to a larger difference. For the known energy spread of the beams, the predicted differences between two peaks from the simulation were consistent with the measured data within submillimetre agreement.

Seated versus supine: consideration of the optimum measurement posture for brain-dedicated PET

Some recently developed brain-dedicated positron emission tomography (PET) scanners measure subjects in a sitting position. Sitting enables PET scanning under more natural conditions for the subjects and also helps with making the scanners smaller. It is unclear, however, how much the degree of head motion when sitting differs from the supine posture commonly employed in clinical PET. In this report, we describe development of a markerless and contactless head motion tracking system and a study of healthy volunteers in several different postures to determine the optimum posture for brain PET. We used Kinect^® (Microsoft) and developed software that can measure head motion with about 1 mm (translation) and less than 1° (rotation) accuracy. In the volunteer study, we measured the amount of head motion, with and without head fixation, in supine, normal sitting, and reclining postures. The results indicated that the normal sitting posture without head fixation had the largest head movement, and that the reclining and supine postures were similarly effective for minimizing head movement (average head movement of about 0.5 mm during 1 min). We also visualized the influence that head motion had on images for each pose by simulating the actual motions obtained from the volunteer study using a digital Hoffman phantom. Comparisons with the original image showed that the extent to which motion was reduced in the reclining and supine postures were quantitatively equivalent. The head motions of the volunteer studies were also reproduced using a mannequin head on a motorized stage to assess how well the proposed motion measurement system worked when used for motion correction. The results indicated that even though the system improved image quality for all postures, the reclining and supine postures could provide better image quality than the normal sitting posture.

Performance evaluation of a whole-body prototype PET scanner with four-layer DOI detectors

Parallax error caused by the detector crystal thickness degrades spatial resolution at the peripheral regions of the field-of-view (FOV) of a scanner. To resolve this issue, depth-of-interaction (DOI) measurement is a promising solution to improve the spatial resolution and its uniformity over the entire FOV. Even though DOI detectors have been used in dedicated systems with a small ring diameter such as for the human brain, breast and small animals, the use of DOI detectors for a large bore whole-body PET system has not been demonstrated yet. We have developed a four-layered DOI detector, and its potential for a brain dedicated system has been proven in our previous development. In the present work, we investigated the use of the four-layer DOI detector for a large bore PET system by developing the world's first whole-body prototype. We evaluated its performance characteristics in accordance with the NEMA NU 2 standard. Furthermore, the impact of incorporating DOI information was evaluated with the NEMA NU 4 image quality phantom. Point source images were reconstructed with a filtered back projection (FBP), and an average spatial resolution of 5.2  ±  0.7 mm was obtained. For the FBP image, the four-layer DOI information improved the radial spatial resolution by 48% at the 20 cm offset position. The peak noise-equivalent count rate (NECR) was 22.9 kcps at 7.4 kBq ml^-1 and the scatter fraction was 44%. The system sensitivity was 5.9 kcps MBq^-1. For the NEMA NU 2 image quality phantom, the 10 mm sphere was clearly visualized without any artifacts. For the NEMA NU 4 image quality phantom, we measured the phantom at 0, 10 and 20 cm offset positions. As a result, we found the image with four-layer DOI could visualize the 2 mm-diameter hot cylinder although it could not be recognized on the image without DOI. The average improvements in the recovery coefficients for the five hot rods (1-5 mm) were 0.3%, 4.4% and 26.3% at the 0, 10 and 20 cm offset positions, respectively (except for the 1 mm-diameter rod at the 20 cm offset position). Although several practical issues (such as adding end-shields) remain to be addressed before the scanner is ready for clinical use, we showed that the four-layer DOI technology provided higher and more uniform spatial resolution over the FOV and improved contrast for small uptake regions located at the peripheral FOV, which could improve detectability of small and distal lesions such as nodal metastases, especially in obese patients.

Experimental validation of the FLUKA Monte Carlo code for dose and [Formula: see text]-emitter predictions of radioactive ion beams

In the context of hadrontherapy, whilst ions are capable of effectively destroying radio resistant, deep seated tumors, their treatment localization must be well assessed to ensure the sparing of surrounding healthy tissue and treatment effectiveness. Thus, range verification techniques, such as online positron-emission-tomography (PET) imaging, hold great potential in clinical practice, providing information on the in vivo beam range and consequent tumor targeting. Furthermore, [Formula: see text] emitting radioactive ions can be an asset in online PET imaging, depending on their half-life, compared to their stable counterparts. It is expected that using these radioactive ions the signal obtained by a PET apparatus during beam delivery will be greatly increased, and exhibit a better correlation to the Bragg Peak. To this end, FLUKA Monte Carlo particle transport and interaction code was used to evaluate, in terms of annihilation events at rest and dose, the figure of merit in using [Formula: see text] emitter, radioactive ion beams (RI [Formula: see text]). For this purpose, the simulation results were compared with experimental data obtained with an openPET prototype in various online PET acquisitions at the Heavy Ion Medical Accelerator in Chiba (HIMAC), in collaboration with colleagues from the National Institute of Radiological Sciences' (NIRS) Imaging Physics Team. The dosimetry performance evaluation with FLUKA benefits from its recent developments in fragmentation production models. The present work estimated that irradiations with RI [Formula: see text], produced via projectile fragmentation and their signal acquisition with state-of-the-art PET scanner, lead to nearly a factor of two more accurate definition of the signals' peak position. In addition to its more advantageous distribution shape, it was observed at least an order magnitude higher signal acquired from ¹¹C and ¹⁵O irradiations, with respect to their stable counterparts.

[State-of-the-Art Technologies in Nuclear Medicine Imaging]

Nuclear medicine imaging is an important tool for cancer diagnosis, brain research, molecular imaging research and so on. Therefore, various imaging techniques and methods are being developed and investigated in nuclear medicine physics. In this report, we introduce state-of-the-art techniques, such as Compton camera imaging, time-of-flight positron emission tomography, semiconductor detectors for medical applications, image reconstruction and deep learning, which were reported in the 2017 IEEE Nuclear Science Symposium & Medical Imaging Conference.

Integrated treatment using intraperitoneal radioimmunotherapy and positron emission tomography-guided surgery with 64Cu-labeled cetuximab to treat early- and late-phase peritoneal dissemination in human gastrointestinal cancer xenografts

Peritoneal dissemination is a common cause of death from gastrointestinal cancers and is difficult to treat using current therapeutic options, particularly late-phase disease. Here, we investigated the feasibility of integrated therapy using ⁶⁴Cu-intraperitoneal radioimmunotherapy (ipRIT), alone or in combination with positron emission tomography (PET)-guided surgery using a theranostic agent (⁶⁴Cu-labeled anti-epidermal growth factor receptor antibody cetuximab) to treat early- and late-phase peritoneal dissemination in mouse models. In this study, we utilized the OpenPET system, which has open space for conducting surgery while monitoring objects at high resolution in real time, as a novel approach to make PET-guided surgery feasible. ⁶⁴Cu-ipRIT with cetuximab inhibited tumor growth and prolonged survival with little toxicity in mice with early-phase peritoneal dissemination of small lesions. For late-phase peritoneal dissemination, a combination of ⁶⁴Cu-ipRIT for down-staging and subsequent OpenPET-guided surgery for resecting large tumor masses effectively prolonged survival. OpenPET clearly detected tumors (≥3 mm in size) behind other organs in the peritoneal cavity and was useful for confirming the presence or absence of residual tumors during an operation. These findings suggest that integrated ⁶⁴Cu therapy can serve as a novel treatment strategy for peritoneal dissemination.