Simplified Dynamic Phantom for Pediatric Renography: A Description of Instrument and its Performance.

OBJECTIVES: Renography is used for the diagnostic evaluation of pediatric patients with a suspected obstruction of urinary tract or impaired renal function. The recommended dose for children have been released by the European Association of Nuclear Medicine, Society of Nuclear Medicine and Molecular Imaging, and Japanese Society of Nuclear Medicine. Since acquisition counts in dynamic scintigraphy are affected by the administered doses and sensitivity of the scintillation camera, the scan procedure should be determined independently. In this study, we constructed simplified dynamic phantom imitating pediatric renography and tested its performance. METHODS: Simplified dynamic phantom consisted of three components (i.e., infusion, imitated kidney, and drainage sections). The infusion rates (mL/min) were determined by comparing the time activity curves obtained from patients with normal renal function. The time-points of the maximum counts (Tmax), as well as the two-thirds and one-half of the maximum counts (T2/3 and T1/2) were measured in different doses using the phantom with the best-match infusion rate and duration, and low-energy general-purpose (LEGP) or low-energy high-resolution (LEHR) collimators and applying different attenuations. RESULTS: The best-match infusion rates of the phantom to imitate the time activity curve of the normal renal function were 42.0, 1.0, 0.6, and 0.3 mL/min in the arterial, secretory, early-excretory, and late-excretory phases, respectively. When 30 MBq, LEHR collimator and non-water-equivalent phantom were applied, Tmax, T2/3, and T1/2 were 242±15.3, 220±10.0 and 317±25.2 seconds, respectively. Using LEGP collimator and (3 MBq of activity) 5-cm water-equivalent phantom, Tmax, T2/3, and T1/2 values were estimated as 242±5.8, 213±11.5, and 310±17.3 sec, respectively. CONCLUSION: Our simplified dynamic phantom for pediatric renography could imitate the time activity curves obtained from patients with normal renal function. Tmax, T2/3, and T1/2 could be measured under various settings of dose, collimator, and tissue attenuation.

CT-Based Attenuation Correction in Brain SPECT/CT Can Improve the Lesion Detectability of Voxel-Based Statistical Analyses.

BACKGROUND: Integrated SPECT/CT enables non-uniform attenuation correction (AC) using built-in CT instead of the conventional uniform AC. The effect of CT-based AC on voxel-based statistical analyses of brain SPECT findings has not yet been clarified. Here, we assessed differences in the detectability of regional cerebral blood flow (CBF) reduction using SPECT voxel-based statistical analyses based on the two types of AC methods. SUBJECTS AND METHODS: N-isopropyl-p-[123I]iodoamphetamine (IMP) CBF SPECT images were acquired for all the subjects and were reconstructed using 3D-OSEM with two different AC methods: Chang's method (Chang's AC) and the CT-based AC method. A normal database was constructed for the analysis using SPECT findings obtained for 25 healthy normal volunteers. Voxel-based Z-statistics were also calculated for SPECT findings obtained for 15 patients with chronic cerebral infarctions and 10 normal subjects. We assumed that an analysis with a higher specificity would likely produce a lower mean absolute Z-score for normal brain tissue, and a more sensitive voxel-based statistical analysis would likely produce a higher absolute Z-score for in old infarct lesions, where the CBF was severely decreased. RESULTS: The inter-subject variation in the voxel values in the normal database was lower using CT-based AC, compared with Chang's AC, for most of the brain regions. The absolute Z-score indicating a SPECT count reduction in infarct lesions was also significantly higher in the images reconstructed using CT-based AC, compared with Chang's AC (P = 0.003). The mean absolute value of the Z-score in the 10 intact brains was significantly lower in the images reconstructed using CT-based AC than in those reconstructed using Chang's AC (P = 0.005). CONCLUSIONS: Non-uniform CT-based AC by integrated SPECT/CT significantly improved sensitivity and the specificity of the voxel-based statistical analyses for regional SPECT count reductions, compared with conventional uniform Chang's AC.

Quantitative performance of advanced resolution recovery strategies on SPECT images: evaluation with use of digital phantom models.

Several resolution recovery (RR) methods have been developed. This study was aimed to validate the following performance of the advanced RR methods: Evolution, Astonish, Flash3D, and 3D-OSEM. We compared the advanced RR method with filtered back projection (FBP) and standard order-subset expectation maximization (OSEM) using resolution (RES), cylinder/sphere (CYS), and myocardial (MYD) digital phantoms. The RES phantom was placed in three spheres. Sixteen spheres (hot and cold) were then placed in a concentric configuration (diameter: 96-9.6 mm) inside the CYS phantom. The MYD phantom was created by computer simulation with the use of an electron γ-shower 4 (EGS4) and it included two left ventricular defects in the myocardium. The performance was evaluated at source-to-detector distances (R-distance) of 166, 200, and 250 mm with reconstruction parameters (product of subset and iteration: SI) with use of the resolution recovery factor, count recovery, normalized mean square error (NMSE), and %CV. According to increased SI updates, the value of the FWHM decreased, and the effect was more obvious as the R-distance increased. The spatial resolution of the advanced RR method was 20 % better than that of FBP and OSEM. The resolution recovery ratio was 80 %, and the count recovery was maintained only in objects with a diameter of >30 mm in the advanced RR method. The NMSE and %CV was 50 and 30 % improved over FBP and OSEM, respectively. The advanced RR method caused overestimation due to Gibbs's phenomenon in the marginal region when the diameter of the sphere was 16-28.8 mm.

Optimization of [11C]methionine PET study: appropriate scan timing and effect of plasma amino acid concentrations on the SUV.

BACKGROUND: [11C]methionine (MET) has been used to monitor amino acid metabolism in tumors, the pancreas, liver, and myocardium. The aim of the present study was to standardize [11C]MET positron emission tomography (PET) by optimizing the timing of initiation of the scan and applying correction to the plasma concentrations of neutral amino acids (NAAs), where necessary. METHODS: Sequential whole-body MET PET/computed tomography (CT) was performed in 11 normal adults after they had fasted for at least 4 h. After whole-body CT for attenuation correction and intravenous bolus injection of MET, the subjects were scanned from the parietal to the groin. The scanning was repeated six to seven times. Decay of radioactivity during the PET scan was corrected to the time of initiation of the first scan. The standardized uptake values (SUVs) were evaluated in various organs by setting regions of interest on the tomographic images. Plasma concentrations of NAAs were examined in relation to the SUV values. RESULTS: The SUVs in the pancreas reached their plateau from 6.5 to 11 min after the MET injection, and in the brain, lung, and myocardium, they reached their plateau from 19.6 to 24.1 min. The MET uptake in the spleen and kidney peaked early after the injection and steadily decreased thereafter. The SUVs in the liver and stomach wall rapidly increased during the first 0 to 4.5 min and gradually elevated thereafter during the scan period. Urinary radioactivity in the bladder reached its plateau from 26.1 to 30.6 min after the MET injection. There were no correlations between the plasma concentrations of NAAs and the maximal SUV in any organs. CONCLUSIONS: The present study revealed the times taken to reach the plateau of MET uptake in various important organs, and little effects of the plasma neutral amino acid concentrations on the SUVs in PET studies conducted after the patients had fasted for at least 4 h. In the MET PET study, 4 h fasting period before MET administration and the scan initiation 20 min after MET administration provide the SUV values independent of scan initiation time and the plasma neutral amino acid concentrations.

[Evaluation of commercial resolution recovery techniques in four state-of-the-art single photon emission computed tomography systems using a digital phantom model].

PURPOSE: This study aims to evaluate the fundamental performance of four leading advanced resolution recovery methods. METHOD: To evaluate the performance of the resolution recovery algorithm, we carried out the computer simulation with the cone/sphere digital phantoms. These phantoms were used to investigate the basic properties of those algorithms. The software of four packages (advance) were also tested, specifically Astonish(TM) (AST), Evolution(TM) (EVL), Flash-3D(TM) (FL3), and 3D-OSEM (3DOS). The performance was evaluated in the collimator systems (LEHR) reconstruction conditions using the full width at half maxi am (FWHM), aspect ratio (ASR), and artifacts of conical part. RESULT: In the "without BG," FWHM of the advance method indicated a true-FWHM with SI (subset×iteration)=20, 40. As SI increased, FWHM was composed with over estimate. Each advances of FWHM indicated only 5% of improvement as compared with reference FWHM in the "with BG." The ASR increased 20% to AST, FL3, and ASR of 3DOS remained in 10% in the outside. As for the reproducibility of the conical part, an artifact was caused by the FL3, EVL, and AST methods. This artifact did not occur in 3DOS. DISCUSSIONS: An SI needs more than 150 to obtain an accurate compensation effect. As for the advance method, the major compensation effect was not demonstrated very much as compared with the OS-EM. The EVL, FL3, and AST overestimated values due to a Gibb's oscillation in the artifacts of the conical part.