Can we predict radiation-induced changes in pulmonary function based on the sum of predicted regional dysfunction?

PURPOSE: To determine whether changes in whole-lung pulmonary function test (PFT) values are related to the sum of predicted radiation therapy (RT)-induced changes in regional lung perfusion. PATIENTS AND METHODS: Between 1991 and 1998, 96 patients (61% with lung cancer) who were receiving incidental partial lung irradiation were studied prospectively. The patients were assessed with pre- and post-RT PFTs (forced expiratory volume in one second [FEV1] and diffusion capacity for carbon monoxide [DLCO]) for at least a 6-month follow-up period, and patients were excluded if it was determined that intrathoracic recurrence had an impact on lung function. The maximal declines in PFT values were noted. A dose-response model based on RT-induced reduction in regional perfusion (function) was used to predict regional dysfunction. The predicted decline in pulmonary function was calculated as the weighted sum of the predicted regional injuries: equation [see text] where Vd is the volume of lung irradiated to dose d, and Rd is the reduction in regional perfusion anticipated at dose d. RESULTS: The relationship between the predicted and measured reduction in PFT values was significant for uncorrected DLCO (P = .005) and borderline significant for DLCO (P = .06) and FEV1 (P = .08). However, the correlation coefficients were small (range,.18 to.30). In patients with lung cancer, the correlation coefficients improved as the number of follow-up evaluations increased (range,.43 to.60), especially when patients with hypoperfusion in the lung adjacent to a central mediastinal/hilar thoracic mass were excluded (range,.59 to.91). CONCLUSION: The sum of predicted RT-induced changes in regional perfusion is related to RT-induced changes in pulmonary function. In many patients, however, the percentage of variation explained is small, which renders accurate predictions difficult.

Determination of mechanical and electronic shifts for pinhole SPECT using a single point source.

The effects of uncompensated electronic and mechanical shifts may compromise the resolution of pinhole single photon emission computed tomography. The resolution degradation due to uncompensated shifts is estimated through simulated data. A method for determining the transverse mechanical and axial electronic shifts is described and evaluated. This method assumes that the tilt of the detector and the radius of rotation (ROR) are previously determined using another method. When this assumption is made, it is possible to determine the rest of the calibration parameters using a single point source. A method that determines the electronic and mechanical shifts as well as the tilt has been previously described; this method requires three point sources. It may be reasonable in most circumstances to calibrate tilt much less frequently than the mechanical shifts since the tilt is a property of the scanner whereas the mechanical shift may change every time the collimator is replaced. An alternative method for determining the ROR may also be used. Lastly, we take the view that the transverse electronic shift and the focal length change slowly and find these parameters independently.

Molecular imaging of small animals with a triple-head SPECT system using pinhole collimation.

Pinhole collimation yields high sensitivity when the distance from the object to the aperture is small, as in the case of imaging small animals. Fine-resolution images may be obtained when the magnification is large since this mitigates the effect of detector resolution. Large magnifications in pinhole single-photon emission computed tomography (SPECT) may be obtained by using a collimator whose focal length is many times the radius of rotation. This may be achieved without truncation if the gamma camera is large. We describe a commercially available clinical scanner mated with pinhole collimation and an external linear stage. The pinhole collimation gives high magnification. The linear stage allows for helical pinhole SPECT. We have used the system to image radiolabeled molecules in phantoms and small animals.

The utility of SPECT lung perfusion scans in minimizing and assessing the physiologic consequences of thoracic irradiation.

PURPOSE: Three-dimensional single photon emission computed tomography lung perfusion scans (SPECT) provide a unique quantitative 3-dimensional map of the distribution of functioning pulmonary vascular/alveolar subunits, information not provided by other imaging modalities. This report describes our initial experience utilizing these scans to assist in the design of radiation treatment beams and to assess changes in regional lung function following irradiation. METHODS AND MATERIALS: Patients were immobilized and scanned in the treatment position with appropriate fiducial markers. Four millicuries of technetium 99M microaggregated albumin were injected and SPECT images of the lung were generated. Pre-treatment SPECT images were used to help design radiation beams to minimize irradiation of functioning lung. Pre- and post-treatment scans were compared to assess changes in regional function. These changes in function were then correlated with the regional radiation dose. RESULTS: Pre-radiotherapy SPECT scans were obtained in 18 patients (11 with lung cancer). Marked variations in regional function were frequently noted. In patients with primary lung tumors, these variations were not necessarily immediately adjacent to the tumor volume. In general, patients with poor pulmonary function pre-treatment, in whom one would like to spare as much normal lung as possible, had the most non-uniform distribution throughout the lung of functioning vascular/alveolar subunits. In these cases, pre-treatment scans were most useful in designing radiation portals to minimize irradiation of functioning lung. SPECT scans were also used to detect changes in regional lung function secondary to radiotherapy in four patients. With doses in excess of 40 Gy, reductions in regional function were noted 1-6 months following completion of radiotherapy. These reductions were not necessarily accompanied by reductions in conventional pulmonary function tests, which are assessments of whole lung function and may not reflect regional lung injury if the volume affected is small. CONCLUSIONS: SPECT lung scans provide an excellent means of assessing regional lung function, superior to that obtainable with planar images. The functional data provided by the SPECT images is useful in designing "optimal" radiation treatment beams and in assessing the effect of radiotherapy on regional lung functions. Efforts are continuing in our laboratory to develop a dose response curve for regional lung damage using the tools of SPECT scanning and 3-dimensional dose calculations.

The effect of patient-specific factors on radiation-induced regional lung injury.

PURPOSE: To assess the impact of patient-specific factors on radiation (RT)-induced reductions in regional lung perfusion. METHODS: Fifty patients (32 lung carcinoma, 7 Hodgkin's disease, 9 breast carcinoma and 2 other thoracic tumors) had pre-RT and > or = 24-week post-RT single photon emission computed tomography (SPECT) perfusion images to assess the dose dependence of RT-induced reductions in regional lung perfusion. The SPECT data were analyzed using a normalized and non-normalized approach. Furthermore, two different mathematical methods were used to assess the impact of patient-specific factors on the dose-response curve (DRC). First, DRCs for different patient subgroups were generated and compared. Second, in a more formal statistical approach, individual DRCs for regional lung injury for each patient were fit to a linear-quadratic model (reduction = coefficient 1 x dose + coefficient 2 x dose2). Multiple patient-specific factors including tobacco history, pre-RT diffusion capacity to carbon monoxide (DLCO), transforming growth factor-beta (TGF-beta), chemotherapy exposure, disease type, and mean lung dose were explored in a multivariate analysis to assess their impact on the coefficients. RESULTS: None of the variables tested had a consistent impact on the radiation sensitivity of regional lung (i.e., the slope of the DRC). In the formal statistical analysis, there was a suggestion of a slight increase in radiation sensitivity in the dose range >40 Gy for nonsmokers (vs. smokers) and in those receiving chemotherapy (vs. no chemotherapy). However, this finding was very dependent on the specific statistical and normalization method used. CONCLUSION: Patient-specific factors do not have a dramatic effect on RT-induced reduction in regional lung perfusion. Additional studies are underway to better clarify this issue. We continue to postulate that patient-specific factors will impact on how the summation of regional injury translates into whole organ injury. Refinements in our methods to generate and compare SPECT scans are needed.

Quantification of radiation-induced regional lung injury with perfusion imaging.

PURPOSE: To better understand the dose and time dependence of radiation therapy (RT)-induced regional lung dysfunction as assessed by changes in regional lung perfusion. METHODS AND MATERIALS: Patients who were to receive RT for tumors in and around the thorax, wherein portions of healthy lung would be incidentally irradiated, were prospectively studied. Regional function was assessed pre- and post-RT with single photon emission computed tomography (SPECT) lung perfusion scans, obtained following the intravenous administration of approximately 4 mCi of technetium-99m macroaggregated albumin. Pre-RT computed tomography (CT) scans were used to calculate the three-dimensional (3D) dose distribution, reflecting tissue density inhomogeneity corrections. Each SPECT scan was correlated with the pre-RT CT scan, and the 3D dose distribution. Changes in regional lung perfusion were correlated with regional RT dose, at various time intervals following radiation. RESULTS: The data from 20 patients (7 breast cancer, 5 lymphoma, 1 esophagus, 1 sarcoma, and 6 lung cancer) have been analyzed. Patients with gross intrathoracic lung cancers causing obstruction of regional pulmonary arteries were not included. For most patients, there is a statistically significant dose-dependent reduction in regional blood flow at all time points following radiation. While a time dependence is suggested in the high dose range, the limited amount of data prevents meaningful statistical evaluation. CONCLUSIONS: Radiation therapy-induced regional lung dysfunction occurs in a dose-dependent manner and develops within 3-6 months following radiation. In contrast to classical "sigmoid" dose-response curves, described mainly for changes following whole lung irradiation, these data suggest a more gradual relationship between regional dysfunction and RT dose. Retraction of irradiated lung with secondary movement of unirradiated lung into the "3D-defined irradiated volume" may have introduced inaccuracies into this analysis. Additional studies are currently underway to assess this possibility and better refine this dose-response curve. Studies are underway to determine if changes in assessments of whole lung function, such as pulmonary function tests, can be predicted by summing the regional changes observed.

Relating radiation-induced regional lung injury to changes in pulmonary function tests.

PURPOSE: To determine whether the sum of radiotherapy (RT)-induced reductions in regional lung perfusion is quantitatively related to changes in global lung function as assessed by reductions in pulmonary function tests (PFTs). METHODS AND MATERIALS: Two hundred seven patients (70% with lung cancer) who received incidental partial lung irradiation underwent PFTs (forced expiratory volume in 1 s and diffusion capacity for carbon monoxide) before and repeatedly after RT as part of a prospective clinical study. Regional lung function was serially assessed before and after RT by single photon emission computed tomography perfusion scans. Of these, 53 patients had 105 post-RT evaluations of changes in both regional perfusion and PFTs, were without evidence of intrathoracic disease recurrence that might influence regional perfusion and PFT findings, and were not taking steroids. The summation of the regional functional perfusion changes were compared with changes in PFTs using linear regression analysis. RESULTS: Follow-up ranged from 3 to 86 months (median 19). Overall, a significant correlation was found between the sum of changes in regional perfusion and the changes in the PFTs (p = 0.002-0.24, depending on the particular PFT index). However, the correlation coefficients were small (r = 0.16-0.41). CONCLUSIONS: A statistically significant correlation was found between RT-induced changes in regional function (i.e., perfusion) and global function (i.e., PFTs). However, the correlation coefficients are low, making it difficult to relate changes in perfusion to changes in the PFT results. Thus, with our current techniques, the prediction of changes in perfusion alone does not appear to be sufficient to predict the changes in PFTs accurately. Additional studies to clarify the relationship between regional and global lung injury are needed.

Radionuclide emission computed tomography of the head with 99mTc and a scintillation camera.

To investigate the potential application of radionuclide computed tomography (RCT) to nuclear medicine imaging using 99mTc, a tomographic system using a lightweight scintillation camera for brain imaging was constructed, and lesion contrast with RCT and conventional scintigraphy were compared. The detector revolves once around the patient's head at constant angular velocity, requiring approximately 20 min. Nine sections are reconstructed from the data, using either a Fourier transform or a filtered back-projection algorithm. In a phantom simulating the radionuclide distribution observed during brain imaging, quantitative lesion contrast was far superior in the RCT images. In a series of 25 patients with intracranial lesions, the average RCT lesion contrast was superior to that of standard scintigraphy by a factor of more than 2. An RCT image of an experimentally infarcted dog's heart, taken after the injection of 99mTc-MAA into the left atrium, also showed excellent correspondence to the gross anatomic defect. Although problems of photon absorption may occur in imaging larger body areas, RCT imaging in this feasibility study produced surprisingly good results that warrant further investigation of the technique.

Comparison of 180 degrees and 360 degrees data collection in thallium-20 1 imaging using single-photon emission computerized tomography (SPECT): concise communication.

Thallium-201 imaging using SPECT is being done with 180 degrees (RAO to LPO) data collection in some centers with single-gamma camera systems. Using our SPECT system with two gamma cameras, we have compared the effects of 180 degrees data collection without attenuation correction against 360 degrees collection with attenuation correction, using phantoms and patients. With a heart phantom in a chest phantom, TI-201 activities simulating "normal myocardium," "ischemia," "infarction," and "background" were placed in object contrast ratios (with respect to background) of 5.0, 2.0, and -1.0, respectively. The 180 degrees data gave image contrast ratios of 1.6, 0.2, and -0.8, and the 260 degrees data gave ratios of 1.5, 0.8, and -0.3, respectively. Uniform activity throughout the heart gave similar image contrast with both data-collection methods, but there was more variability with the 180 degrees collection than with 360 degrees collection. Since attenuation correction is available with the 260 degrees collection, the effects of attenuation are seen only on the 180 degrees collection images. In eight patients the image contrasts from the 180 degrees and 260 degrees collections are similar. For our two-camera SPECT system, the 360 degrees collection permits attenuation correction, has less variability in counting statistics, and gives contrast ratios like those of 180 degrees collection.

SPECT using a specially designed cone beam collimator.

A specially designed high resolution converging collimator having a focal length of 50 cm has been evaluated for cone beam single photon emission computed tomography (SPECT). The focal region was investigated by imaging a point source placed at the expected focal point and along the central ray of the collimator in front of and behind the focal point. Technetium-99m point source sensitivities measured in air at 5, 10, 15, and 20 cm from the collimator surface are 4.2, 5.5, 7.3, and 10.5 cts.sec-1.microCi-1 when used with a single camera SPECT system. A commercially available parallel hole collimator, with similar resolution characteristics has a measured sensitivity of 3.3 cts.sec-1.microCi-1. Volume sensitivities of 9,780 and 4,945 (cts.sec-1)/(microCi.ml-1) were measured for the cone beam and parallel hole collimators, respectively, using a 17-cm-diameter spherical source. Reconstructed spatial resolution (FWHM) on the axis-of-rotation ranged between 10 and 11 mm for both collimators when the radius of rotation was equal to 15 cm. Using equal acquisition times SPECT images of phantoms scanned with the cone beam collimator were visually improved compared with images acquired using the parallel hole collimator. These results demonstrate that a factor of 2 improvement in volume sensitivity can be demonstrated with a cone beam collimator compared with a commercially available parallel hole collimator. Further improvements are possible using shorter focal lengths, astigmatic focusing, and larger field of view cameras.

Cardiac phantom evaluation of simultaneously acquired dual-isotope rest thallium-201/stress technetium-99m SPECT images.

Simultaneously acquired dual-isotope 201Tl/99mTc SPECT studies were performed using cardiac and thoracic phantoms to evaluate the dual-isotope myocardial perfusion technique. Cardiac phantom images representing infarction, viable myocardium and various levels of ischemia were analyzed. Studies with and without attenuating media were performed, and myocardium-to-defect count ratios and defect sizes from dual-isotope SPECT images were compared to myocardium-to-defect count ratios and defect sizes from single-isotope (201Tl and 99mTc) SPECT images. Dual-isotope studies also were interpreted qualitatively. Studies with background activity simulating clinical conditions were performed and interpreted qualitatively. Myocardium-to-defect count ratios from both 99mTc and 201Tl were similar in single-isotope and dual-isotope SPECT images. Thallium-201 and 99mTc defect sizes were decreased slightly (mean +/- s.d., 1.0 +/- 1.7 cc for 201Tl and 0.7 +/- 1.0 cc for 99mTc) on dual studies when compared to single studies but were not statistically significant. Dual-isotope image simulations of normal, ischemic and infarcted and viable myocardium were correctly identified by experienced clinicians in 95% of the cases (21/22). Simultaneous dual-isotope 201Tl/99mTc SPECT imaging of cardiac phantoms produced images that had similar myocardium-to-defect count ratios to those produced using single-isotope techniques and were correctly evaluated on qualitative analysis. Changes in defect size related to dual-isotope imaging were minimal and not qualitatively important.

Quantitative SPECT reconstruction of iodine-123 data.

Many clinical and research studies in nuclear medicine require quantitation of iodine-123 (123I) distribution for the determination of kinetics or localization. The objective of this study was to implement several reconstruction methods designed for single-photon emission computed tomography (SPECT) using 123I and to evaluate their performance in terms of quantitative accuracy, image artifacts, and noise. The methods consisted of four attenuation and scatter compensation schemes incorporated into both the filtered backprojection/Chang (FBP) and maximum likelihood-expectation maximization (ML-EM) reconstruction algorithms. The methods were evaluated on data acquired of a phantom containing a hot sphere of 123I activity in a lower level background 123I distribution and nonuniform density media. For both reconstruction algorithms, nonuniform attenuation compensation combined with either scatter subtraction or Metz filtering produced images that were quantitatively accurate to within 15% of the true value. The ML-EM algorithm demonstrated quantitative accuracy comparable to FBP and smaller relative noise magnitude for all compensation schemes.

Volume and activity quantitation with iodine-123 SPECT.

UNLABELLED: The goals of this study were to investigate the effect of septal penetration on 123I SPECT activity quantitation using low-energy, high-resolution collimators, and to evaluate a semi-automatic method for measuring volume and activity of 123I distribution with SPECT. METHODS: Data were acquired from experimental phantoms containing spheres filled with a high-purity 123I solution. The penetration study compared the reconstructed activity of a 3.4-cm diameter sphere with and without the presence of surrounding activity. In the study of volume and activity quantitation, three different size spheres (diameters of 1.8 cm, 2.8 cm and 3.4 cm) were imaged in three different sphere-to-background (S:B) 123I concentration ratios (2.5, 5 and 10) with low-energy collimators. The filtered backprojection reconstruction method was used with compensation for scatter, attenuation and detector response. Volume and activity measurements were obtained from the SPECT image using a semiautomatic gradient technique which estimates the location of the sphere/boundary in three dimensions. RESULTS: With the low-energy collimator, there was only a small (< 2%) increase in the measured activity of the sphere when surrounding activity was present. The measured volume for the two largest spheres was within 5% of the true volume for all S:B ratios. The activity measurement of these spheres was consistently underestimated by 20%-25% but suggested that the accuracy could be improved with calibration. For the smallest sphere, the volume was grossly overestimated and only at the 10 S:B ratio was the activity measured reasonably accurately (< 20%). CONCLUSIONS: The low-energy collimators used in this study are suitable for quantitative 123I SPECT. Accurate SPECT volume and activity quantitation of 123I distribution can be achieved by semiautomatic means at clinical count densities for objects as small as 2.8 cm in diameter and reasonable activity quantitation is possible for smaller objects with an S:B ratio of at least 10.

Inverse Monte Carlo as a unified reconstruction algorithm for ECT.

Tomographic reconstruction for single photon emission computed tomography (SPECT) with simultaneous compensation for attenuation, scatter, and distance dependent collimator resolution is provided by an Inverse Monte Carlo (IMOC) reconstruction algorithm. A detection probability matrix is formed by Monte Carlo solution to the photon transport equation for SPECT acquisition from a unit source activity in each reconstruction source voxel. The measured projection vector will equal the product of this detection probability matrix with the unknown source distribution vector. The resulting large, nonsparse system of equations is solved for the source distribution using an iterative Maximum Likelihood EM estimator. Reconstruction of experimentally acquired projections from phantoms shows quantitative compensation for scatter and attenuation. Comparison with filtered backprojection (FBP) reconstruction shows an improvement in resolution recovery, contrast, and signal-to-noise for the IMOC algorithm. Reconstruction of clinical studies shows improved contrast, structural resolution, and noise characteristics.

Deconvolution of Compton scatter in SPECT.

A deconvolution algorithm has been developed which compensates for Compton scattering in SPECT images. Compton scatter is modeled as a convolution of the nonscattered projection data with an exponential function. Deconvolution of the total (scatter + nonscatter) projection data yields compensated true projection. Using Monte Carlo methods, the scattered and nonscattered components of a SPECT image are simulated thus allowing a comparison of scatter compensated results with direct nonscatter results. The quality of the compensation is evaluated by comparing the ratio of total to direct counts with the ratio of compensated to direct counts. This deconvolution technique has been developed and evaluated for experimentally acquired SPECT data as well as for simulated data.

Quantitative imaging of iodine-131 distributions in brain tumors with pinhole SPECT: a phantom study.

UNLABELLED: A method of quantitatively imaging 131I distributions in brain tumors from intratumoral administration of activity was developed and investigated using pinhole SPECT of brain tumor phantoms. METHODS: Pinhole SPECT sensitivity and resolution were characterized using 131I point-source acquisitions with high-resolution lead (1.4-mm diameter aperture) and tungsten (1.0-mm diameter aperture) pinhole inserts. SPECT scans were obtained from brain tumor phantoms in a water-filled cylinder. The tumor phantoms consisted of spheres filled with an 131I solution to model intratumoral administration of radiolabeled monoclonal antibodies. Two spheres were 20.5 and 97 ml, and two other concentric spheres modeled a tumor with a high-activity shell (71.5 ml) and a low-activity core (21 ml). The collimator focal length was 16 cm and the distance from the pinhole to the center of rotation was 13 cm. The filtered backprojection reconstruction algorithm incorporated scatter and attenuation compensation. SPECT tumor activities and concentrations were estimated using scaling factors from reference point-source scans. RESULTS: System sensitivities for point sources at the center of rotation were 28.4 cts/sec(-1) MBq(-1) (lead insert) and 13.6 cts/sec(-1) MBq(-1) (tungsten insert). SPECT resolutions (FWHM) at the center of rotation were 8.1-11.9 mm (lead) and 6.7-10.3 mm (tungsten). Total tumor activity estimates from SPECT were within 17% of the true activities. SPECT activity concentration estimates in small regions of interest (ROIs) averaged -20% for the 20.5-ml sphere, -11% for the 97-ml sphere, -39% for the shell and +20% for the core of the shell-core phantom. Activity spillover due to limited spatial resolution and the tails of the system response functions biased the estimates. The shell-to-core activity concentration ratio of 4.1 was better estimated with the tungsten insert (2.3) than with the lead insert (1.9) due to better resolution. CONCLUSION: Pinhole SPECT is a promising technique for imaging and quantifying total 131I activity in regions the size of brain tumors. Relative errors were greater for activity concentration estimates in small ROIs than for total activity estimates.

Transmission imaging for nonuniform attenuation correction using a three-headed SPECT camera.

UNLABELLED: Our objective was to build and test a new system for transmission CT (TCT) imaging on a three-headed SPECT camera. The TCT images are intended for use in nonuniform attenuation correction of cardiac SPECT data. METHODS: The system consists of a transmission line source mounted to the camera gantry at the focal line of a long focal length, asymmetric fanbeam collimator. The focal line is 114 cm from the collimator surface and shifted 20 cm from the detector midline. This asymmetric fanbeam geometry is used to reduce truncation artifacts in the reconstructed TCT image. The line source fixture accommodates a 25-cm long source and contains removable, variable thickness attenuator plates (copper or lead) to modulate the photon flux density and a slat collimator to collimate the TCT source beam in the axial direction. For the TCT reconstruction, an iterative maximum likelihood-expectation maximization algorithm is used that models the asymmetric fanbeam geometry. Our initial studies with this system used a 1850 MBq (50 mCi) 123mTe line source. The evaluation included TCT scans of a resolution phantom, an anthropomorphic thorax phantom and a human subject. For the thorax phantom and human subject, short (2-min) and long (14-min) scans were performed. The SPECT imaging performance of the fanbeam collimator was also characterized. RESULTS: For both phantom and human data, high quality TCT reconstructions were obtained with linear attenuation coefficients closely matching narrow beam values. In the images of the resolution phantom, the smallest rods (4.8-mm diam) were resolved. The long scan images of the thorax phantom and human subject demonstrated the high resolution nature of the system and contained no evidence of truncation artifacts. With smoothing to control noise, the short scan images generally retained the attenuation features of the lung and of soft tissue and may provide a practical approach for clinical application. The fanbeam collimator demonstrated high resolution SPECT performance. CONCLUSION: These results suggest this system may provide an effective and practical approach to TCT imaging for nonuniform attenuation correction on a three-headed SPECT camera.

Half-cone beam collimation for triple-camera SPECT systems.

UNLABELLED: Cone-beam collimators provide increased sensitivity at similar resolution compared to other collimators. The use of cone-beam collimators for brain imaging with triple-camera SPECT systems, however, results in truncation of the base of the brain because of clearance of the shoulders. A half-cone beam collimator does not have the problem of truncation. The objective of this study was to compare the performance characteristics of half-cone beam with parallel-beam and fan-beam collimators with similar resolution characteristics for SPECT imaging of the brain. METHODS: A half-cone beam collimator with the focal point located towards the base of the brain was built for a triple-camera SPECT system. Spatial resolutions and sensitivities of three collimators were measured. RESULTS: When 10-cm from the collimator surface, the planar spatial resolutions FWHM in mm (point source sensitivities in cps-MBq) for half-cone beam, fan-beam and parallel-beam collimators were 5.2 (85.6), 5.1 (55.6) and 5.9 (39.7), respectively. Image quality was evaluated using a three-dimensional Hoffman brain phantom and patient data. The deeper gray matter were more clearly visualized in the half-cone beam scans. CONCLUSION: Half-cone beam collimation provides higher sensitivity and offers the potential for improved brain imaging compared with parallel-beam and fan-beam collimation when used with a triple-camera SPECT system.

Factors affecting ventricular volumes determined by a count-based equilibrium method.

Using a 99mTc-filled source ("ventricle") in an elliptical torso phantom, we analyzed the effect of source depth, region of interest (ROI) size, background concentration and source shape on volumes determined by an attenuation-corrected count-based equilibrium method. The calculated volume of a 96 cc sphere decreased linearly from 103 to 82 cc with increasing depth from 4 to 18 cm [vol = -1.48 X depth (cm) + 109, r = 0.99]. The calculated volume of the same sphere imaged at a depth of 9 cm increased from 98 to 117 cc with ROI sizes increasing from 161 to 1,369 pixels (1 pixel = 0.17 cm2). With increasing background concentration from 0-2 microCi/ml calculated volumes decreased from 95 to 85 cc (vol = -5.3 X background concentration (microCi/ml) + 95, r = 0.97). However, with correction for over-subtraction of background, increasing background activity caused no decrease in calculated volume (mean = 95 cc, s.d. = 1). Calculated volumes for the sphere and various cylinders were accurate, while those for cones were up to 37% lower for actual volumes ranging from 56-608 cc. This study demonstrates that multiple factors produce variability in count-based determination of phantom volumes. A careful consideration of the interaction of these factors with the edge-detection and computational algorithms is required.

Lesion detection with single-photon emission computed tomography (SPECT) compared with conventional imaging.

We have evaluated analytically and experimentally the effectiveness of both conventional nuclear medicine imaging and single-photon emission computed tomography (SPECT) imaging to detect small photon-deficient areas (approximately the size of the system's resolution) with a relatively uniform background. The experimental model is based on the Tc-99m sulfur colloid study of the liver. The experimental data were obtained from a liver phantom containing two small photon deficient areas, nominally 1 and 1.5 cm in diameter. The liver phantom was placed in a water-filled Alderson body phantom and scanned with the cold defects located both centrally and peripherally. Lesion image contrast for both conventional and SPECT imaging is proportional to the lesion uptake ratio and is degraded by the system's finite spatial resolution and Compton-scattered photons. However, for conventional imaging the contrast is significantly degraded by the effect of radionuclide superposition (as modified by attenuation), while for SPECT imaging the contrast is essentially independent of these effects. This results in a significant increase in lesion-to-background contrast with SPECT as compared with conventional imaging. The measured SPECT image contrasts for the 1- and 1.5-cm areas of low uptake averaged more than five times the measured image contrasts for the conventional system.