Diagnostic accuracy of SPECT and PET myocardial perfusion imaging in patients with left bundle branch block or ventricular-paced rhythm.

BACKGROUND: The difference in diagnostic accuracy of coronary artery disease (CAD) between vasodilator SPECT and PET myocardial perfusion imaging (MPI) in patients with left bundle branch block (LBBB) or ventricular-paced rhythm (VPR) is unknown. METHODS: We identified patients with LBBB or VPR who underwent either vasodilator SPECT or PET MPI and subsequent coronary angiography. LBBB/VPR-related septal and anteroseptal defects were defined as perfusion defects involving those regions in the absence of obstructive CAD in the left anterior descending artery or left main coronary artery. RESULTS: Of the 55 patients who underwent coronary angiography, 38 (69%) underwent SPECT and 17 patients (31%) underwent PET. PET compared to SPECT demonstrated higher sensitivity (88% vs 60%), specificity (56% vs 14%), positive predictive value (64% vs 20%), negative predictive value (83% vs 50%), and overall superior diagnostic accuracy (AUC .72 (95% CI .50-.93) vs .37 (95% CI .20-.54), P = .01) to detect obstructive CAD. LBBB/VPR-related septal and anteroseptal defects were more common with SPECT compared to PET (septal: 72% vs 17%, P = .001; anteroseptal: 47% vs 8%, P = .02). CONCLUSIONS: PET has higher diagnostic accuracy when compared to SPECT for the detection of obstructive CAD in patients with LBBB or VPR.

APJ acts as a dual receptor in cardiac hypertrophy.

Cardiac hypertrophy is initiated as an adaptive response to sustained overload but progresses pathologically as heart failure ensues. Here we report that genetic loss of APJ, a G-protein-coupled receptor, confers resistance to chronic pressure overload by markedly reducing myocardial hypertrophy and heart failure. In contrast, mice lacking apelin (the endogenous APJ ligand) remain sensitive, suggesting an apelin-independent function of APJ. Freshly isolated APJ-null cardiomyocytes exhibit an attenuated response to stretch, indicating that APJ is a mechanosensor. Activation of APJ by stretch increases cardiomyocyte cell size and induces molecular markers of hypertrophy. Whereas apelin stimulates APJ to activate Gαi and elicits a protective response, stretch signals in an APJ-dependent, G-protein-independent fashion to induce hypertrophy. Stretch-mediated hypertrophy is prevented by knockdown of ß-arrestins or by pharmacological doses of apelin acting through Gαi. Taken together, our data indicate that APJ is a bifunctional receptor for both mechanical stretch and the endogenous peptide apelin. By sensing the balance between these stimuli, APJ occupies a pivotal point linking sustained overload to cardiomyocyte hypertrophy.

Direct evaluation of myocardial viability and stem cell engraftment demonstrates salvage of the injured myocardium.

RATIONALE: The mechanism of functional restoration by stem cell therapy remains poorly understood. Novel manganese-enhanced MRI and bioluminescence reporter gene imaging were applied to follow myocardial viability and cell engraftment, respectively. Human-placenta-derived amniotic mesenchymal stem cells (AMCs) demonstrate unique immunoregulatory and precardiac properties. In this study, the restorative effects of 3 AMC-derived subpopulations were examined in a murine myocardial injury model: (1) unselected AMCs, (2) ckit(+)AMCs, and (3) AMC-derived induced pluripotent stem cells (MiPSCs). OBJECTIVE: To determine the differential restorative effects of the AMC-derived subpopulations in the murine myocardial injury model using multimodality imaging. METHODS AND RESULTS: SCID (severe combined immunodeficiency) mice underwent left anterior descending artery ligation and were divided into 4 treatment arms: (1) normal saline control (n=14), (2) unselected AMCs (n=10), (3) ckit(+)AMCs (n=13), and (4) MiPSCs (n=11). Cardiac MRI assessed myocardial viability and left ventricular function, whereas bioluminescence imaging assessed stem cell engraftment during a 4-week period. Immunohistological labeling and reverse transcriptase polymerase chain reaction of the explanted myocardium were performed. The unselected AMC and ckit(+)AMC-treated mice demonstrated transient left ventricular functional improvement. However, the MiPSCs exhibited a significantly greater increase in left ventricular function compared with all the other groups during the entire 4-week period. Left ventricular functional improvement correlated with increased myocardial viability and sustained stem cell engraftment. The MiPSC-treated animals lacked any evidence of de novo cardiac differentiation. CONCLUSION: The functional restoration seen in MiPSCs was characterized by increased myocardial viability and sustained engraftment without de novo cardiac differentiation, indicating salvage of the injured myocardium.

"Scout No Scan" Technique Reduces Patient Radiation Exposure During CT-Guided Spine Biopsy.

OBJECTIVE: The objective of this article is to report our experience with a technique for CT-guided spine biopsies that we refer to as the "scout no scan" technique. CONCLUSION: The scout no scan technique can significantly lower radiation exposure while maintaining high diagnostic yields for CT-guided spinal biopsies.

Fourier rebinning and consistency equations for time-of-flight PET planograms.

Due to the unique geometry, dual-panel PET scanners have many advantages in dedicated breast imaging and on-board imaging applications since the compact scanners can be combined with other imaging and treatment modalities. The major challenges of dual-panel PET imaging are the limited-angle problem and data truncation, which can cause artifacts due to incomplete data sampling. The time-of-flight (TOF) information can be a promising solution to reduce these artifacts. The TOF planogram is the native data format for dual-panel TOF PET scanners, and the non-TOF planogram is the 3D extension of linogram. The TOF planograms is five-dimensional while the objects are three-dimensional, and there are two degrees of redundancy. In this paper, we derive consistency equations and Fourier-based rebinning algorithms to provide a complete understanding of the rich structure of the fully 3D TOF planograms. We first derive two consistency equations and John's equation for 3D TOF planograms. By taking the Fourier transforms, we obtain two Fourier consistency equations and the Fourier-John equation, which are the duals of the consistency equations and John's equation, respectively. We then solve the Fourier consistency equations and Fourier-John equation using the method of characteristics. The two degrees of entangled redundancy of the 3D TOF data can be explicitly elicited and exploited by the solutions along the characteristic curves. As the special cases of the general solutions, we obtain Fourier rebinning and consistency equations (FORCEs), and thus we obtain a complete scheme to convert among different types of PET planograms: 3D TOF, 3D non-TOF, 2D TOF and 2D non-TOF planograms. The FORCEs can be used as Fourier-based rebinning algorithms for TOF-PET data reduction, inverse rebinnings for designing fast projectors, or consistency conditions for estimating missing data. As a byproduct, we show the two consistency equations are necessary and sufficient for 3D TOF planograms. Finally, we give numerical examples of implementation of a fast 2D TOF planogram projector and Fourier-based rebinning for a 2D TOF planograms using the FORCEs to show the efficacy of the Fourier-based solutions.

Multimodality assessment of the coronary microvasculature with TIMI frame count versus perfusion PET highlights coronary changes characteristic of coronary microvascular disease.

Background: The diagnosis of coronary microvascular disease (CMVD) remains challenging. Perfusion PET-derived myocardial blood flow (MBF) reserve (MBFR) can quantify CMVD but is not widely available. Thrombolysis in Myocardial Infarction (TIMI) frame count (TFC) is an angiography-based method that has been proposed as a measure of CMVD. Here, we compare TFC and PET-derived MBF measurements to establish the role of TFC in assessing for CMVD. We use coronary modeling to elucidate the relationship between MBFR and TFC and propose TFC thresholds for identifying CMVD. Methods: In a cohort of 123 individuals (age 58 ± 12.1, 63% women, 41% Caucasian) without obstructive coronary artery disease who had undergone perfusion PET and coronary angiography for clinical indications, we compared TFC and perfusion PET parameters using Pearson correlation (PCC) and linear regression modeling. We used mathematical modeling of the coronary circulation to understand the relationship between these parameters and performed Receiver Operating Curve (ROC) analysis. Results: We found a significant negative correlation between TFC and MBFR. Sex, race and ethnicity, and nitroglycerin administration impact this relationship. Coronary modeling showed an uncoupling between TFC and flow in epicardial vessels. In ROC analysis, TFC performed well in women (AUC 0.84-0.89) and a moderately in men (AUC 0.68-0.78). Conclusions: We established an inverse relationship between TFC and PET-derived MBFR, which is affected by patient selection and procedural factors. TFC represents a measure of the volume of the epicardial coronary compartment, which is increased in patients with CMVD, and performs well in identifying women with CMVD.

Improving Generalizability of PET DL Algorithms: List-Mode Reconstructions Improve DOTATATE PET Hepatic Lesion Detection Performance.

Deep learning (DL) algorithms used for DOTATATE PET lesion detection typically require large, well-annotated training datasets. These are difficult to obtain due to low incidence of gastroenteropancreatic neuroendocrine tumors (GEP-NETs) and the high cost of manual annotation. Furthermore, networks trained and tested with data acquired from site specific PET/CT instrumentation, acquisition and processing protocols have reduced performance when tested with offsite data. This lack of generalizability requires even larger, more diverse training datasets. The objective of this study is to investigate the feasibility of improving DL algorithm performance by better matching the background noise in training datasets to higher noise, out-of-domain testing datasets. 68Ga-DOTATATE PET/CT datasets were obtained from two scanners: Scanner1, a state-of-the-art digital PET/CT (GE DMI PET/CT; n = 83 subjects), and Scanner2, an older-generation analog PET/CT (GE STE; n = 123 subjects). Set1, the data set from Scanner1, was reconstructed with standard clinical parameters (5 min; Q.Clear) and list-mode reconstructions (VPFXS 2, 3, 4, and 5-min). Set2, data from Scanner2 representing out-of-domain clinical scans, used standard iterative reconstruction (5 min; OSEM). A deep neural network was trained with each dataset: Network1 for Scanner1 and Network2 for Scanner2. DL performance (Network1) was tested with out-of-domain test data (Set2). To evaluate the effect of training sample size, we tested DL model performance using a fraction (25%, 50% and 75%) of Set1 for training. Scanner1, list-mode 2-min reconstructed data demonstrated the most similar noise level compared that of Set2, resulting in the best performance (F1 = 0.713). This was not significantly different compared to the highest performance, upper-bound limit using in-domain training for Network2 (F1 = 0.755; p-value = 0.103). Regarding sample size, the F1 score significantly increased from 25% training data (F1 = 0.478) to 100% training data (F1 = 0.713; p < 0.001). List-mode data from modern PET scanners can be reconstructed to better match the noise properties of older scanners. Using existing data and their associated annotations dramatically reduces the cost and effort in generating these datasets and significantly improves the performance of existing DL algorithms. List-mode reconstructions can provide an efficient, low-cost method to improve DL algorithm generalizability.

Resolution Enhancement in PET Reconstruction Using Collimation.

Collimation can improve both the spatial resolution and sampling properties compared to the same scanner without collimation. Spatial resolution improves because each original crystal can be conceptually split into two (i.e., doubling the number of in-plane crystals) by masking half the crystal with a high-density attenuator (e.g., tungsten); this reduces coincidence efficiency by 4× since both crystals comprising the line of response (LOR) are masked, but yields 4× as many resolution-enhanced (RE) LORs. All the new RE LORs can be measured by scanning with the collimator in different configurations. In this simulation study, the collimator was assumed to be ideal, neither allowing gamma penetration nor truncating the field of view. Comparisons were made in 2D between an uncollimated small-animal system with 2-mm crystals that were assumed to be perfectly absorbing and the same system with collimation that narrowed the effective crystal size to 1 mm. Digital phantoms included a hot-rod and a single-hot-spot, both in a uniform background with activity ratio of 4:1. In addition to the collimated and uncollimated configurations, angular and spatial wobbling acquisitions of the 2-mm case were also simulated. Similarly, configurations with different combinations of the RE LORs were considered including (i) all LORs, (ii) only those parallel to the 2-mm LORs; and (iii) only cross pairs that are not parallel to the 2-mm LORs. Lastly, quantitative studies were conducted for collimated and uncollimated data using contrast recovery coefficient and mean-squared error (MSE) as metrics. The reconstructions show that for most noise levels there is a substantial improvement in image quality (i.e., visual quality, resolution, and a reduction in artifacts) by using collimation even when there are 4× fewer counts or - in some cases - comparing with the noiseless uncollimated reconstruction. By comparing various configurations of sampling, the results show that it is the matched combination of both improved spatial resolution of each LOR and the increase in the number of LORs that yields improved reconstructions. Further, the quantitative studies show that for low-count scans, the collimated data give better MSE for small lesions and the uncollimated data give better MSE for larger lesions; for high-count studies, the collimated data yield better quantitative values for the entire range of lesion sizes that were evaluated.

Performance evaluation of resolution and sensitivity of C-SPECT's variable slat-stack collimator.

BACKGROUND: Myocardial perfusion imaging is commonly performed using SPECT, where both general-purpose and dedicated scanners are available. A limitation with general-purpose systems has been the inability to image dynamically since different projections are obtained far apart in time due to scanner rotation. Dedicated systems can have this capability since they acquire completely sampled projections (i.e., those with enough angular views for reconstruction) with short time frames. C-SPECT, does not need any scanner or patient motion to obtain complete projections, allowing fast dynamics. When imaging fast dynamics, the optimal collimator settings are not necessarily the same as for static imaging, where longer acquisitions can be utilized. Thus, C-SPECT offers adaptive collimation in the transverse and axial directions. PURPOSE: The performance of adaptation in the axial direction was characterized herein. METHODS: The ratio of the resolution metric in high-sensitivity mode to that in the high-resolution mode, termed resolution boost factor, was determined. Analogously, the sensitivity boost factor was also determined. Comparisons were made with theory and simulations. RESULTS: The boost factors for resolution and sensitivity, averaged over the 14 modules of the system, were determined to be 1.72 and 1.75, respectively. CONCLUSIONS: The boost factors, which ideally would be two, were between 10% and 15% below optimal values and tracked each other, suggesting mechanical challenges in the apparatus, such as incomplete closure of adjacent slats, but show reasonably successful adaptation between modes.

Modeling contrast-to-noise ratio from list mode reconstructions of 68Ga DOTATATE PET/CT: predicting detectability of hepatic metastases in shorter acquisition PET reconstructions.

BACKGROUND: Deep learning (DL) algorithms have shown promise in identifying and quantifying lesions in PET/CT. However, the accuracy and generalizability of these algorithms relies on large, diverse datasets which are time and labor intensive to curate. Modern PET/CT scanners may acquire data in list mode, allowing for multiple reconstructions of the same datasets with different parameters and imaging times. These reconstructions may provide a wide range of image characteristics to increase the size and diversity of datasets. Training algorithms with shorter imaging times and higher noise properties requires that lesions remain detectable. The purpose of this study is to model and predict the contrast-to-noise ratio (CNR) for shorter imaging times based on CNR from longer duration, lower noise images for 68Ga DOTATATE PET hepatic lesions and identify a threshold above which lesions remain detectable. METHODS: 68Ga DOTATATE subjects (n=20) with hepatic lesions were divided into two subgroups. The "Model" group (n=4 subjects; n=9 lesions; n=36 datapoints) was used to identify the relationship between CNR and imaging time. The "Test" group (n=16 subjects; n=44 lesions; n=176 datapoints) was used to evaluate the prediction provided by the model. RESULTS: CNR plotted as a function of imaging time for a subset of identified subjects was very well fit with a quadratic model. For the remaining subjects, the measured CNR showed a very high linear correlation with the predicted CNR for these lesions (R2 > 0.97) for all imaging durations. From the model, a threshold CNR=6.9 at 5-minutes predicted CNR > 5 at 2-minutes. Visual inspection of lesions in 2-minute images with CNR above the threshold in 5-minute images were assessed and rated as a 4 or 5 (probably positive or definitely positive) confirming 100% lesion detectability on the shorter 2-minute PET images. CONCLUSIONS: CNR for shorter DOTATATE PET imaging times may be accurately predicted using list mode reconstructions of longer acquisitions. A threshold CNR may be applied to longer duration images to ensure lesion detectability of shorter duration reconstructions. This method can aid in the selection of lesions to include in novel data augmentation techniques for deep learning.

Finding Optimized Conditions of Slit-Slat and Multislit-Slat Collimation for Breast Imaging.

In order to develop a breast-imaging system for Single Photon Emission Computed Tomography (SPECT) using slit-slat and multislit-slat collimators, we searched for optimized geometric parameters of the collimators. For this study, we employed two independent metrics to validate each result: 1) Signal to Noise Ratio (SNR) based on the Cramer-Rao lower Bound (CRB) and 2) contrast at the same noise level from an ensemble. We calculated SNR values using forward-projection data of an anthropomorphic digital phantom containing two lesions in the breast (one at the chest wall and the other at the center) with a simulated slit-slat collimator as a function of the collimator's geometric parameters. We also calculated contrast values from reconstructed images with noise. Based on the results from the slit-slat case, we investigated angular range, SNR, and contrast for the multislit-slat. We saw similar trends of the two metrics. One interesting property of the multislit-slat is that the imaging performance depends on the orientation of the field of view (FOV) of the side slits. When we compared the metric values for the slit-slat and multislit-slat, improvement was seen only when the lesion was in the FOV of the side slits. Therefore, tuning the parameters of the multislit-slat to optimally detect lesions at the chest wall might be a sensible option since the slit-slat already provides good image quality for center and superficial lesions.

A Novel Mouse Model of Radiation-Induced Cardiac Injury Reveals Biological and Radiological Biomarkers of Cardiac Dysfunction with Potential Clinical Relevance.

PURPOSE: Radiation-induced cardiotoxicity is a significant concern in thoracic oncology patients. However, the basis for this disease pathology is not well characterized. We developed a novel mouse model of radiation-induced cardiotoxicity to investigate pathophysiologic mechanisms and identify clinically targetable biomarkers of cardiac injury. EXPERIMENTAL DESIGN: Single radiation doses of 20, 40, or 60 Gy were delivered to the cardiac apex of female C57BL/6 mice ages 9-11 weeks, with or without adjacent lung tissue, using conformal radiotherapy. Cardiac tissue was harvested up to 24 weeks post-radiotherapy for histologic analysis. Echocardiography and Technetium-99m sestamibi single photon emission computed tomography (SPECT) at 8 and 16 weeks post-radiotherapy were implemented to evaluate myocardial function and perfusion. Mouse cardiac tissue and mouse and human plasma were harvested for biochemical studies. RESULTS: Histopathologically, radiotherapy resulted in perivascular fibrosis 8 and 24 (P < 0.05) weeks post-radiotherapy. Apical perfusion deficits on SPECT and systolic and diastolic dysfunction on echocardiography 8 and 16 weeks post-radiotherapy were also observed (P < 0.05). Irradiated cardiac tissue and plasma showed significant increases in placental growth factor (PlGF), IL6, and TNFα compared with nonradiated matched controls, with greater increases in cardiac cytokine levels when radiotherapy involved lung. Human plasma showed increased PlGF (P = 0.021) and TNFα (P = 0.036) levels after thoracic radiotherapy. PlGF levels demonstrated a strong correlation (r = 0.89, P = 0.0001) with mean heart dose. CONCLUSIONS: We developed and characterized a pathophysiologically relevant mouse model of radiation-induced cardiotoxicity involving in situ irradiation of the cardiac apex. The model can be used to integrate radiomic and biochemical markers of cardiotoxicity to inform early therapeutic intervention and human translational studies.

Vasoactive agents alter the biomechanical properties of aortic heart valve leaflets in a time-dependent manner.

BACKGROUND AND AIM OF THE STUDY: Although the vasoactive agents, angiotensin II (Ang II) and 5-hydroxytryptamine (5-HT) are implicated in aortic heart valve disease, it is unclear how these compounds alter the biomechanical properties of valve leaflet tissue. The study aim was to characterize temporal changes in the elastic modulus of tissues incubated with these compounds. METHODS: Valve leaflets were excised from fresh porcine aortic heart valves. Leaflet tissue was incubated with 10(-6) M 5-HT, or 10(-6) M Ang II. The stress and elongation of the tissue in the circumferential and radial directions was measured using a stepper motor-driven micromechanical testing machine at 0.5, 6, and 24 h, followed by calculations of strain and elastic modulus of each sample. RESULTS: Tissue samples incubated with Ang II showed a significant increase in stiffness with time in the radial direction, but not in the circumferential direction. Regression analysis showed a correlation between time and elastic modulus for the tissue (R2 = 0.84). Conversely, leaflets incubated in 5-HT did not show any significant change in elastic modulus over time in the radial direction; however, significant increases in stiffness were observed after 24 h in the circumferential direction. A strong correlation between the elastic modulus in the circumferential direction and time was also noted (R2 = 0.99). CONCLUSION: The study results showed that vasoactive agents are capable of increasing the elastic modulus of aortic valve tissue in a time-dependent manner. Furthermore, the biomechanical changes induced by vasoactive agents are direction-specific, indicating different modes of action.

Analytic Derivation and Monte Carlo Validation of a Sensitivity Formula for Slit-Slit Collimation With Penetration.

A slit-slit collimator consists of two orthogonal slits and can be conceptualized as a generalized pinhole. Since the two slits are independent of each other, there can be independent axial and transaxial acceptance angles. A small axial acceptance angle may help mitigate axial blurring with circular orbits, allowing multiple copies axially. In addition, since the two slit planes can be placed at different distances with respect to the source, a better detector usage can be achieved, especially in the case of detectors and imaged objects with different aspect ratios. In this paper an analytical expression is derived for the sensitivity of slit-slit collimation including effective slit widths for photon penetration. An analytical expression for sensitivity is necessary in order to accurately model the system response. This expression could also be useful for comparing the slit-slit's sensitivity performance with others. When the effective slit width is used instead of the geometric slit width, the derived analytical expression accurately accounts for photon penetration of the aperture. The derived expression for the sensitivity was validated by Monte Carlo simulation for both geometric and penetrative cases.

Slit-Slat and Multislit-Slat Collimator Design and Experimentally Acquired Phantom Images from a Rotating Prototype.

We have previously found and validated expressions for slit-slat (SS) geometric efficiency and resolution. These expressions have suggested that SS may be a good choice for imaging mid-size objects or objects that are long axially since (i) the geometric efficiency increases near the slit as h(-1) (instead of h(-2) for pinhole (PIN) and either decreases near the collimator for fan-beam (FB) or remains constant for parallel-beam (PB)), where h is the distance from a point to the slit plane; (ii) the transverse resolution is comparable to that of PIN, which is better than that of FB and PB for small objects; (iii) the axial resolution is worse than that of PIN since there is no axial magnification; (iv) there is a large axial FOV, unlike PIN, which is likely to be useful when imaging mid-size or long objects; and (v) there is no need for 3D orbits (e.g., helical) since each slice is complete (like PB and FB).We have developed a rotating prototype SS collimator that is capable of single-slit or multi-slit acquisition of data. The focal length (FL) is shorter than that of a typical PIN since increasing the FL requires taller slats to maintain resolution; taller slats reduce geometric efficiency. A lead rectangular box was used to provide support and shielding around the slit-slat collimator. Lead slats, spaced with Rohacell foam, were mounted in an assembly with 3 mm pitch.We have performed preliminary characterization with point sources and acquired micro hot- and cold-rod phantoms and a Deluxe Jaszczak phantom. The projections have been reconstructed using an MLEM algorithm and show good resolution.Comparisons indicate that SS is more sensitive than PB and FB for the same resolution for smaller-diameter objects. The advantage of SS over PB and FB increases as the desired resolution improves. SS can also be used in configurations that yield projections that have non-isotropic resolution; it is possible for SS to achieve transverse resolutions that are unreachable by PB, since PB does not magnify, and by FB, since its magnification factor for small objects is much smaller than that of SS. Experimental results show that the resolution of the reconstructed phantoms is consistent with theoretical expectations.

Special Section Guest Editorial: Three-Dimensional Image Reconstruction in Radiology and Nuclear Medicine.

Guest editors Scott D. Metzler, Samuel Matej, and J. Webster Stayman provide an introduction to the Special Section on Three-Dimensional Image Reconstruction in Nuclear Medicine, PET, and CT.

Analytic Determination of Rectangular-Pinhole Sensitivity With Penetration.

Modern small-animal SPECT systems use multiple pinhole collimators per detector to increase sensitivity while still maintaining high resolution. This resolution is a combination of aperture resolution combined with detector resolution, which is mitigated by magnification. Higher magnification results in better resolution, but fewer apertures per detector. When multiple pinhole collimators project onto the same detector, those with a rectangular field of view (FOV) can be packed more tightly than those with a circular FOV. In addition, a rectangular aperture can be used to obtain different resolution-sensitivity tradeoffs in the two orthogonal directions. Thus, these rectangular-pinhole collimators can have independent FOVs and independent resolution values in the two directions of the rectangular aperture. Previous work has determined the amount of penetration for circular pinholes (i.e., circular apertures with circular FOVs), where the pinhole walls were modeled as cones. In this work, a formula for the penetrative sensitivity for rectangular apertures with a rectangular FOV is determined. The formula was validated using numerical calculations for various combinations of acceptance angles, aperture sizes, linear attenuation coefficients, and incidence angles.

Quantification of defect contrast in microSPECT imaging of a myocardial phantom.

Ischemic heart disease remains a significant public health concern, accentuating the importance of basic research and therapeutic studies of small animals in which myocardial changes can be reproducibly detected and quantified. Few or no studies have investigated the performance of microSPECT in quantifying myocardial lesions. We utilized three versions of a multi-compartment phantom containing two left ventricular myocardial compartments (one uniform and one with a transmural 'cold' defect), a ventricular blood pool, and a background compartment, where each version had a different myocardial wall thickness (0.75, 1.0 and 1.25 mm). Each compartment was imaged separately while acquiring list-mode data. The separate compartment data were manipulated into a single data set with a known defect contrast, blood-pool and background activity. Data were processed with background-free defect-contrast values of 0 (no defect), -0.25, -0.5, -0.75, and -1.0 (all defect), three ratios of blood-pool to myocardial activity, 0 (no blood pool activity), 0.1, and 0.2 (20% of the activity in the healthy myocardial compartment), and three ratios of uniform background 0 (no background activity), 0.1 and 0.2, relative to the healthy myocardial compartment. For each wall thickness, defect contrast, blood-pool, and background activity combination, 25 list-mode noise realizations were generated and reconstructed. Volumes of interest were drawn and used to determine mean contrast recovery coefficients (CRCs) over the noise ensembles. We developed a slope-analysis procedure to estimate a single CRC over all contrast levels, with resulting CRC values (for no blood-pool and no background) of 0.848, 0.946, and 0.834 for the 0.75, 1.0, and 1.25 mm wall thicknesses, respectively. We also determined and validated a reprocessing method to calculate an ideal CRC. This work demonstrates the quantitative abilities of microSPECT for myocardial-defect imaging utilizing CRC and establishes a framework for evaluating defect-imaging capabilities in other systems.

Combination of converging collimators for high-sensitivity brain SPECT.

UNLABELLED: The objective of this study, which is related to human brain SPECT, was to increase the sensitivity of a triple-camera SPECT system and reduce statistical noise in reconstructed images using a combination of converging collimators. The reason for combining collimators is to ensure both high sensitivity and sufficient sampling without trading off spatial resolution. METHODS: A high-sensitivity half-cone-beam (HCB) collimator, designed specifically for brain imaging, was combined with other collimators and compared with conventional parallel-beam and fanbeam circular orbit acquisitions. For comparison, previously studied HCB collimation with a circle-and-helix data acquisition trajectory was also included in this study. Simulations of the Hoffman 3-dimensional brain phantom were performed to calculate the efficiencies of collimators and their combinations and to quantitatively evaluate reconstruction bias, statistical noise, and signal-to-noise ratios in the reconstructed images. Experimental brain phantom data were also acquired and compared for different acquisition types. Finally, a patient brain scan was obtained with a combination of HCB and fanbeam collimators and compared with a triple-fanbeam circular orbit acquisition. RESULTS: A combination of 2 HCB collimators and 1 fanbeam collimator, compared with a triple-fanbeam collimator, can increase the photon detection efficiency by 27% and by more than a factor of 2, compared with triple-parallel-hole collimation, with equal spatial resolution measured on the axis of rotation. Quantitative analysis of reconstruction bias and visual analysis of the images showed no signs of sampling artifacts. Reconstructed images in the simulations, experimental brain phantom, and patient brain scans showed improved quality with this collimator combination due to increased sensitivity and reduced noise. Lesion visibility was also improved, as confirmed by signal-to-noise ratios. Alternatively, triple-HCB circle-and-helix acquisition has also shown competitive results, with a slight disadvantage in axial sampling and implementation procedure. CONCLUSION: Combined HCB and fanbeam collimation is a promising approach for high-sensitivity brain SPECT.