Impact of reconstruction parameters on quantitative I-131 SPECT.

Radioiodine therapy using I-131 is widely used for treatment of thyroid disease or neuroendocrine tumors. Monitoring treatment by accurate dosimetry requires quantitative imaging. The high energy photons however render quantitative SPECT reconstruction challenging, potentially requiring accurate correction for scatter and collimator effects. The goal of this work is to assess the effectiveness of various correction methods on these effects using phantom studies. A SPECT/CT acquisition of the NEMA IEC body phantom was performed. Images were reconstructed using the following parameters: (1) without scatter correction, (2) with triple energy window (TEW) scatter correction and (3) with Monte Carlo-based scatter correction. For modelling the collimator-detector response (CDR), both (a) geometric Gaussian CDRs as well as (b) Monte Carlo simulated CDRs were compared. Quantitative accuracy, contrast to noise ratios and recovery coefficients were calculated, as well as the background variability and the residual count error in the lung insert. The Monte Carlo scatter corrected reconstruction method was shown to be intrinsically quantitative, requiring no experimentally acquired calibration factor. It resulted in a more accurate quantification of the background compartment activity density compared with TEW or no scatter correction. The quantification error relative to a dose calibrator derived measurement was found to be <1%,-26% and 33%, respectively. The adverse effects of partial volume were significantly smaller with the Monte Carlo simulated CDR correction compared with geometric Gaussian or no CDR modelling. Scatter correction showed a small effect on quantification of small volumes. When using a weighting factor, TEW correction was comparable to Monte Carlo reconstruction in all measured parameters, although this approach is clinically impractical since this factor may be patient dependent. Monte Carlo based scatter correction including accurately simulated CDR modelling is the most robust and reliable method to reconstruct accurate quantitative iodine-131 SPECT images.

Dual-head gamma camera system for intraoperative localization of radioactive seeds.

Breast-conserving surgery is a standard option for the treatment of patients with early-stage breast cancer. This form of surgery may result in incomplete excision of the tumor. Iodine-125 labeled titanium seeds are currently used in clinical practice to reduce the number of incomplete excisions. It seems likely that the number of incomplete excisions can be reduced even further if intraoperative information about the location of the radioactive seed is combined with preoperative information about the extent of the tumor. This can be combined if the location of the radioactive seed is established in a world coordinate system that can be linked to the (preoperative) image coordinate system. With this in mind, we propose a radioactive seed localization system which is composed of two static ceiling-suspended gamma camera heads and two parallel-hole collimators. Physical experiments and computer simulations which mimic realistic clinical situations were performed to estimate the localization accuracy (defined as trueness and precision) of the proposed system with respect to collimator-source distance (ranging between 50 cm and 100 cm) and imaging time (ranging between 1 s and 10 s). The goal of the study was to determine whether or not a trueness of 5 mm can be achieved if a collimator-source distance of 50 cm and imaging time of 5 s are used (these specifications were defined by a group of dedicated breast cancer surgeons). The results from the experiments indicate that the location of the radioactive seed can be established with an accuracy of 1.6 mm ± 0.6 mm if a collimator-source distance of 50 cm and imaging time of 5 s are used (these experiments were performed with a 4.5 cm thick block phantom). Furthermore, the results from the simulations indicate that a trueness of 3.2 mm or less can be achieved if a collimator-source distance of 50 cm and imaging time of 5 s are used (this trueness was achieved for all 14 breast phantoms which were used in this study). Based on these results we conclude that the proposed system can be a valuable tool for (real-time) intraoperative breast cancer localization.