Performance of a brain PET camera based on anger-logic gadolinium oxyorthosilicate detectors.

UNLABELLED: A high-sensitivity, high-resolution brain PET scanner ("G-PET") has been developed. This scanner is similar in geometry to a previous brain scanner developed at the University of Pennsylvania, the HEAD Penn-PET, but the detector technology and electronics have been improved to achieve enhanced performance. METHODS: This scanner has a detector ring diameter of 42.0 cm with a patient aperture of 30.0 cm and an axial field of view of 25.6 cm. It comprises a continuous light-guide that couples 18,560 (320 x 58 array) 4 x 4 x 10 mm(3) gadolinium oxyorthosilicate (GSO) crystals to 288 (36 x 8 array) 39-mm photomultiplier tubes in a hexagonal arrangement. The scanner operates only in 3-dimensional (3D) mode because there are no interplane septa. Performance measurements on the G-PET scanner were made following National Electrical Manufacturers Association NU 2-2001 procedures for most measurements, although NU 2-1994 procedures were used when these were considered more appropriate for a brain scanner (e.g., scatter fraction and counting-rate performance measurements). RESULTS: The transverse and axial resolutions near the center are 4.0 and 5.0 mm, respectively. At a radial offset of 10 cm, these numbers deteriorate by approximately 0.5 mm. The absolute sensitivity of this scanner measured with a 70-cm long line source is 4.79 counts per second (cps)/kBq. The scatter fraction measured with a line source in a 20-cm-diameter x 19-cm-long cylinder is 39% (for a lower energy threshold of 410 keV). For the same cylinder, the peak noise equivalent counting rate is 60 kcps at an activity concentration of 7.4 kBq/mL (0.20 micro Ci/mL), whereas the peak true coincidence rate is 132 kcps at an activity concentration of 14 kBq/mL (0.38 micro Ci/mL). Images from the Hoffman brain phantom as well as (18)F-FDG patient scans illustrate the high quality of images acquired on the G-PET scanner. CONCLUSION: The G-PET scanner attains the goal of high performance for brain imaging through the use of an Anger-logic GSO detector design with continuous optical coupling. This detector design leads to good energy resolution, which is needed in 3D imaging to minimize scatter and random coincidences.

PET performance measurements using the NEMA NU 2-2001 standard.

UNLABELLED: The NU 2-1994 standard document for PET performance measurements has recently been updated. The updated document, NU 2-2001, includes revised measurements for spatial resolution, intrinsic scatter fraction, sensitivity, counting rate performance, and accuracy of count loss and randoms corrections. The revised measurements are designed to allow testing of dedicated PET systems in both 2-dimensional and 3-dimensional modes as well as coincidence gamma cameras, conditions not considered in the original NU 2-1994 standard. In addition, the updated measurements strive toward being more representative of clinical studies, in particular, whole-body imaging. METHODS: Performance measurements following the NU 2-1994 and NU 2-2001 standards were performed on several different PET scanners. Differences between the procedures and resulting performance characteristics, as well as the rationale for these changes, were noted. RESULTS: Spatial resolution is measured with a point source in all 3 directions, rather than a line source, as specified previously. For the measurements of intrinsic scatter fraction, sensitivity, and counting rate performance, a 70-cm line source is now specified, instead of a 19-cm-long cylindric phantom. The longer configuration permits measurement of these performance characteristics over the entire axial field of view of all current PET scanners and incorporates the effects of activity outside the scanner. A measurement of image quality has been added in an effort to measure overall image quality under clinically realistic conditions. This measurement replaces the individual measurements of uniformity and of the accuracy of corrections for attenuation and scatter. CONCLUSION: The changes from the NU 2-1994 standard to the NU 2-2001 standard strive toward establishing relevance with clinical studies. The tests in the updated standard also are, in general, simpler and less time-consuming to perform than those in the NU 2-1994 standard.

Positron emission tomography imaging in nonmalignant thoracic disorders.

The role of the fluorodeoxyglucose (FDG) technique positron emission tomography (PET) is well established in the management of patients with lung cancer. Increasingly, it is becoming evident that FDG-PET can be effectively employed to diagnose a variety of benign pulmonary disorders. Knowledge of such applications further expands the domain of this powerful modality and further improves the ability to differentiate benign from malignant diseases of the chest. We describe pertinent technical factors that substantially contribute to optimal imaging of the thoracic structures. Particularly, the complementary role of attenuation correction (AC) to that of non-AC images is emphasized. We further outline the need for and the state of the art for co-registration of PET and anatomic images for diagnostic and therapeutic purposes. We then review patterns of physiologic uptake of FDG in thoracic structures, including the lung, the heart, the aorta and large arteries, esophagus, thymus, trachea, thoracic muscles, bone marrow, and joints and alterations following radiation therapy to the thorax. A great deal of information is provided with regard to differentiating benign from malignant nodules and in particular, we emphasize the role of dual time point imaging and partial volume correction for accurate assessment of such lesions. Following a brief review of the diagnostic issues related to the assessment of mediastinal adenopathies, the role of FDG-PET imaging in environment-induced lung diseases, including pneumoconiosis, smoking, and asthma are described. A large body of information is provided about the role of this technology in the management of patients with suspected infection and inflammation of the lungs such as acquired immunodeficiency syndrome, fever of unknown origin, sarcoidosis, chronic granulomatous disease and monitoring the disease process and response to therapy. Finally, the value of FDG-PET in differentiating benign from malignant diseases of the pleura including asbestosis-related disorders is described at the conclusion of this comprehensive review.

Fast implementation of the single scatter simulation algorithm and its use in iterative image reconstruction of PET data.

In positron emission tomography (PET), scatter correction is usually performed prior to image reconstruction using a more or less exact model of the scatter processes. These models require estimates of the true activity and object density distributions of the imaged object. The problem is that these estimates are computed from measured data and, therefore, already contain scattered events. The purpose of this work was to overcome this problem by incorporating scatter characteristics directly into the process of iterative image reconstruction. This could be achieved by an optimized implementation of the single scatter simulation (SSS) algorithm, which results in a significant speed-up of the scatter estimation procedure. The scatter simulation was then included in the forward projection step of maximum likelihood image reconstruction. The results demonstrate that this approach leads to a more exact estimation of the scatter component which cannot be obtained by a simple sequential data processing strategy.

Optimization of a fully 3D single scatter simulation algorithm for 3D PET.

We describe a new implementation of a single scatter simulation (SSS) algorithm for the prediction and correction of scatter in 3D PET. In this implementation, out of field of view (FoV) scatter and activity, side shields and oblique tilts are explicitly modelled. Comparison of SSS predictions with Monte Carlo simulations and experimental data from uniform, line and cold-bar phantoms showed that the code is accurate for uniform as well as asymmetric objects and can model different energy resolution crystals and low level discriminator (LLD) settings. Absolute quantitation studies show that for most applications, the code provides a better scatter estimate than the tail-fitting scatter correction method currently in use at our institution. Several parameters such as the density of scatter points, the number of scatter distribution sampling points and the axial extent of the FoV were optimized to minimize execution time, with particular emphasis on patient studies. Development and optimization were carried out in the case of GSO-based scanners, which enjoy relatively good energy resolution. SSS estimates for scanners with lower energy resolution may result in different agreement, especially because of a higher fraction of multiple scatter events. The algorithm was applied to a brain phantom as well as to clinical whole-body studies. It proved robust in the case of large patients, where the scatter fraction increases. The execution time, inclusive of interpolation, is typically under 5 min for a whole-body study (axial FoV: 81 cm) of a 100 kg patient.

Use of a corrected standardized uptake value based on the lesion size on CT permits accurate characterization of lung nodules on FDG-PET.

The purpose of this study was to determine the actual standardized uptake value (SUV) by using the lesion size from computer tomography (CT) scan to correct for resolution and partial volume effects in positron emission tomography (PET) imaging. This retrospective study included 47 patients with lung lesions seen on CT scan whose diagnoses were confirmed by biopsy or by follow up CT scan when the PET result was considered negative for malignancy. Each lesion's FDG uptake was quantified by the SUV using two methods: by measuring the maximum voxel SUV (maxSUV) and by using the lesion's size on CT to calculate the actual SUV (corSUV). Among small lesions (2.0 cm or smaller on CT scan), ten were benign and 17 were malignant. The average maxSUV was 1.43+/-0.77 and 3.02+/-1.74 for benign and malignant lesions respectively. When using an SUV of 2.0 as the cutoff to differentiate benignity and malignancy, the sensitivity, specificity, and accuracy were 65%, 70%, and 67% respectively. When an SUV of 2.5 was used for cutoff, the sensitivity, specificity, and accuracy were 47%, 80%, and 59% respectively. The average corSUV was 1.65+/-1.09 and 5.28+/-2.71 for benign and malignant lesions respectively. Whether an SUV of either 2.0 or 2.5 was used for cutoff, the sensitivity, specificity, and accuracy remained 94%, 70%, and 85% respectively. The only malignant lesion that was falsely considered benign with both methods was a bronchioalveolar carcinoma which did not reveal any elevated uptake of fluorine-18 fluorodeoxyglucose (FDG). Of the large lesions (more than 2.0 cm and less than 6.0 cm), one was benign and 19 were malignant and the corSUV technique did not significantly change the accuracy. It is concluded that measuring the SUV by using the CT size to correct for resolution and partial volume effects offers potential value in differentiating malignant from benign lesions in this population. This approach appears to improve the accuracy of FDG-PET for optimal characterization of small lung nodules.