ABSTRACT
In single photon emission computed tomography (SPECT), the collimator is a crucial element of the imaging chain and controls the noise resolution tradeoff of the collected data. The current study is an evaluation of the effects of different thicknesses of a low-energy high-resolution (LEHR) collimator on tomographic spatial resolution in SPECT. In the present study, the SIMIND Monte Carlo program was used to simulate a SPECT equipped with an LEHR collimator. A point source of (99m)Tc and an acrylic cylindrical Jaszczak phantom, with cold spheres and rods, and a human anthropomorphic torso phantom (4D-NCAT phantom) were used. Simulated planar images and reconstructed tomographic images were evaluated both qualitatively and quantitatively. According to the tabulated calculated detector parameters, contribution of Compton scattering, photoelectric reactions, and also peak to Compton (P/C) area in the obtained energy spectrums (from scanning of the sources with 11 collimator thicknesses, ranging from 2.400 to 2.410 cm), we concluded the thickness of 2.405 cm as the proper LEHR parallel hole collimator thickness. The image quality analyses by structural similarity index (SSIM) algorithm and also by visual inspection showed suitable quality images obtained with a collimator thickness of 2.405 cm. There was a suitable quality and also performance parameters' analysis results for the projections and reconstructed images prepared with a 2.405 cm LEHR collimator thickness compared with the other collimator thicknesses.
ABSTRACT
AIM: Hepatobiliary scintigraphy is an integral part in the diagnostic work-up of the neonatal cholestasis syndrome. However, less than optimal specificity is its major disadvantage. Differentiation between biliary atresia and neonatal hepatitis is nearly impossible in some cases with poor hepatocellular function. 99mTc sestamibi (MIBI) is a cationic lipophilic agent which is a substrate of P-glycoprotein. This glycoprotein is normally expressed in biliary canalicular surfaces of hepatocytes. This property provides a hepatic excretory mechanism which is different from bilirubin excretion. In this study we evaluated the value of 99mTc MIBI in differential diagnosis of neonatal cholestasis. PATIENTS, METHODS: 20 infants with a mean age of 2.41 months (range, 0.1-5 months) were included in the study. Ten infants turned out to have extrahepatic biliary atresia and the other ten had neonatal hepatitis. Hepatobiliary (with 99mTc BrIDA) and 99mTc MIBI scintigraphy were performed for all the patients. RESULTS: 99mTc MIBI scintigraphy has shown bowel activity in all patients, including the patients with biliary atresia. Hepatobiliary scintigraphy revealed bowel activity only in five patients with neonatal hepatitis. CONCLUSION: Bowel visualization with 99mTc MIBI may be seen in patients with biliary atresia and 99mTc MIBI has limited value in differential diagnosis of neonatal cholestasis.
