Performance characteristics of a new pixelated portable gamma camera.

PURPOSE: To evaluate and characterize the performance of a new commercially available pixelated portable gamma camera Ergo (Digirad, Poway, CA). METHODS: The authors evaluated a pixelated portable gamma camera system, Ergo, that consists of 11 520 elements of 3 × 3 mm(2) CsI(Tl) crystals that are 6-mm thick and are coupled to silicon photodiodes. The detector element has a size of 3.31 × 3.24 mm(2). The gamma camera performance was evaluated for both low-energy all-purpose (LEAP) and low-energy high-resolution (LEHR) collimators. The flood-field uniformity for (99m)Tc and (201)Tl was assessed using fillable uniform flood phantoms. Energy spectra were acquired for (99m)Tc, (111)In, (201)Tl, and (67)Ga to evaluate energy linearity and energy resolution. Spectral fits were performed to calculate the photopeak energies and resolutions. The pixel size and multiwindow spatial registration (MWSR) was evaluated by measuring mixed (99m)Tc and (201)Tl point sources placed at known distances apart. The system's sensitivity was measured according to the National Electrical Manufacturer's Association (NEMA) NU1-2007 standards for both LEAP and LEHR collimators as a function of distance from the collimator surface (5, 10, 15, 20, 25, 30, and 40 cm). The system resolution without scatter was measured for both LEAP and LEHR using (99m)Tc-filled capillary tubes located at 0, 2, 4, 6, 10, and 12 cm away from the surface of the collimator. As a measure of the spatial resolution, the full width at half maximum (FWHM) at a given distance was calculated from the presampling line spread function (LSF), constructed from the line profiles of the capillary tubes at the same distance. As a comparison, the FWHM at 10 cm away from LEHR and LEAP collimators was also calculated from linear interpolation as described by NEMA NU-1 2007 and from fitting the profiles to a Gaussian-plus-constant model. RESULTS: All isotope-collimator pairs demonstrated good flood-field uniformity with an integral uniformity of ≤5% and a differential uniformity of ≤3%. The system demonstrated excellent energy linearity with maximum discrepancy of measured keV from true keV of <1%. The energy resolution of the (99m)Tc 140-keV photopeak was 7.4%. The image pixel size was measured as 3.23 × 3.18 mm(2), and the MWSR was within 0.3 mm (or ~10% of the nominal pixel size). The system sensitivity at 10 cm was 112.6 cps/MBq (249.9 cpm/µCi) for LEAP and 63.1 cps/MBq (140.1 cpm/µCi) for LEHR. The system spatial resolution varied linearly with distance from the collimator and the FWHM were measured to be 7.2 and 8.9 mm at 10 cm for LEHR and LEAP, respectively. CONCLUSIONS: Herein, the authors describe detailed performance evaluation procedures of a new pixelated portable gamma camera system, which can also be applied to evaluate other pixelated gamma camera system. Spatial resolution assessment in near-field imaging condition offers a unique challenge where the measured FWHM is highly dependent on relative position between the capillary tube and the detector element. The evaluations of the Ergo gamma camera suggest suitable clinical imaging performance. This portable gamma camera has a high (LEAP) planar sensitivity, high energy and spatial resolutions that are comparable to other available gamma cameras, and it exhibits superior count rate performance that is linear up to tens of millions count per second. The Ergo imaging performance, however, can still be improved, for example, by optimizing collimator design for near field imaging.

Systematic and random errors of PET-based 90 Y 3D dose quantification.

PURPOSE: The objective was to characterize both systematic and random errors in Positron Emission Tomography (PET)-based 90 Y three-dimensional (3D) dose quantification. METHODS: A modified NEMA-IEC phantom was used to emulate 90 Y-microsphere PET imaging conditions: sphere activity concentrations of 1.6 and 4.8 MBq/cc, sphere-to-background ratios of 4 and 13, and sphere diameters of 13, 17, and 37 mm. PET data were acquired using a GE D690 PET/CT scanner for 300 min on days 0-11. The data were downsampled to 60-5 min for multiple realizations to evaluate the count starvation effect. The image reconstruction algorithm was 3D-OSEM with PSF + TOF modeling; the parameters were optimized for dose-volume histogram (DVH), as a 90 Y 3D dose quantification. 90 Y-PET images were converted to dose maps using the local deposition method, then the sphere DVHs were calculated. The ground truth for the DVH was calculated using convolution method. Dose linearity was evaluated in decaying 90 Y activity (reduced count rate and total count) and decreasing acquisition durations (reduced total count only). Finally, the impacts of the low 32-ppm positron yield on PET-based 3D 90 Y-dose quantification were evaluated; the bias and variability of resulting DVHs were characterized. RESULTS: We observed nonlinear errors that depended on the 90 Y activity (count rate) and not on the total true prompt counts. These nonlinear errors in mean dose underestimated the measured mean dose by> 20% for a measured dose range of 40-230 Gy; although the shapes of the DVH were not altered. Compensation based on empirical models reduced the nonlinearity errors to be within 5% for measured dose range of 40-230 Gy. In contrast, the errors due to nonuniformity introduced by image noise dominated the systematic errors in the DVH and stretched the DVH on both tails. For the 37-mm sphere, the magnitude of errors in D80 increased from -25% to -36% when acquisition duration was decreased from 300 to 10 min. The effect of image noise on DVH was more extensive in smaller spheres; for the 17-mm sphere, the magnitude of errors in D80 increased from -29% to -45% acquisition duration was decreased from 300 to 10 min. For the 37-mm sphere, the errors in D20 increased from +3.5% to only +10.5% when the acquisition duration was decreased from 300 to 10 min; in the 17-mm sphere, the errors in D20 were 6.5% for both 300- and 10-min sphere images. CONCLUSIONS: Count-starved 90 Y-PET data introduce both systematic and random errors. The systematic error increases the apparent nonuniformity of the DVH, while the random error increases the uncertainty in the DVH. The systematic errors were larger than the random errors. Lower count rate of 90 Y-PET also introduces systematic bias, which is scanner specific. The errors of bias-compensated mean tumor dose were <10% when 90 Y-PET scan time was >15 min/bed for tumors >37 mm. Dmedian and Dmean were the most stable dose metrics. An acquisition duration of 30 min is recommended to keep the random errors < 10% for a typical tumor with sphere equivalent diameter >17 mm and average tumor dose >40 Gy.

Effects of image noise, respiratory motion, and motion compensation on 3D activity quantification in count-limited PET images.

The aims of this study were to evaluate the effects of noise, motion blur, and motion compensation using quiescent-period gating (QPG) on the activity concentration (AC) distribution-quantified using the cumulative AC volume histogram (ACVH)-in count-limited studies such as 90Y-PET/CT. An International Electrotechnical Commission phantom filled with low 18F activity was used to simulate clinical 90Y-PET images. PET data were acquired using a GE-D690 when the phantom was static and subject to 1-4 cm periodic 1D motion. The static data were down-sampled into shorter durations to determine the effect of noise on ACVH. Motion-degraded PET data were sorted into multiple gates to assess the effect of motion and QPG on ACVH. Errors in ACVH at AC90 (minimum AC that covers 90% of the volume of interest (VOI)), AC80, and ACmean (average AC in the VOI) were characterized as a function of noise and amplitude before and after QPG. Scan-time reduction increased the apparent non-uniformity of sphere doses and the dispersion of ACVH. These effects were more pronounced in smaller spheres. Noise-related errors in ACVH at AC20 to AC70 were smaller (<15%) compared to the errors between AC80 to AC90 (>15%). The accuracy of ACmean was largely independent of the total count. Motion decreased the observed AC and skewed the ACVH toward lower values; the severity of this effect depended on motion amplitude and tumor diameter. The errors in AC20 to AC80 for the 17 mm sphere were -25% and -55% for motion amplitudes of 2 cm and 4 cm, respectively. With QPG, the errors in AC20 to AC80 of the 17 mm sphere were reduced to -15% for motion amplitudes <4 cm. For spheres with motion amplitude to diameter ratio >0.5, QPG was effective at reducing errors in ACVH despite increases in image non-uniformity due to increased noise. ACVH is believed to be more relevant than mean or maximum AC to calculate tumor control and normal tissue complication probability. However, caution needs to be exercised when using ACVH in post-therapy 90Y imaging because of its susceptibility to image degradation from both image noise and respiratory motion.

Practical reconstruction protocol for quantitative (90)Y bremsstrahlung SPECT/CT.

PURPOSE: To develop a practical background compensation (BC) technique to improve quantitative (90)Y-bremsstrahlung single-photon emission computed tomography (SPECT)/computed tomography (CT) using a commercially available imaging system. METHODS: All images were acquired using medium-energy collimation in six energy windows (EWs), ranging from 70 to 410 keV. The EWs were determined based on the signal-to-background ratio in planar images of an acrylic phantom of different thicknesses (2-16 cm) positioned below a (90)Y source and set at different distances (15-35 cm) from a gamma camera. The authors adapted the widely used EW-based scatter-correction technique by modeling the BC as scaled images. The BC EW was determined empirically in SPECT/CT studies using an IEC phantom based on the sphere activity recovery and residual activity in the cold lung insert. The scaling factor was calculated from 20 clinical planar (90)Y images. Reconstruction parameters were optimized in the same SPECT images for improved image quantification and contrast. A count-to-activity calibration factor was calculated from 30 clinical (90)Y images. RESULTS: The authors found that the most appropriate imaging EW range was 90-125 keV. BC was modeled as 0.53× images in the EW of 310-410 keV. The background-compensated clinical images had higher image contrast than uncompensated images. The maximum deviation of their SPECT calibration in clinical studies was lowest (<10%) for SPECT with attenuation correction (AC) and SPECT with AC + BC. Using the proposed SPECT-with-AC + BC reconstruction protocol, the authors found that the recovery coefficient of a 37-mm sphere (in a 10-mm volume of interest) increased from 39% to 90% and that the residual activity in the lung insert decreased from 44% to 14% over that of SPECT images with AC alone. CONCLUSIONS: The proposed EW-based BC model was developed for (90)Y bremsstrahlung imaging. SPECT with AC + BC gave improved lesion detectability and activity quantification compared to SPECT with AC only. The proposed methodology can readily be used to tailor (90)Y SPECT/CT acquisition and reconstruction protocols with different SPECT/CT systems for quantification and improved image quality in clinical settings.

A revised monitor source method for practical deadtime count loss compensation in clinical planar and SPECT studies.

The aim of the study is to verify the fundamental assumption in the monitor source method, i.e. uniform fractional count loss across the field of view (FOV), and to introduce a revised monitor source method for SPECT deadtime correction that minimally interferes with the clinical protocol. SPECT images of non-uniform phantoms (4GBq (99m)Tc) with and without monitor sources (2 × 20MBq (99m)Tc) attached to each detector were acquired nine times over 48 h in the photopeak energy window and the scatter energy window. Fractional count loss uniformity across the FOV was evaluated by correlating count rates in different regions of interest on projection images at different deadtime loss levels. The correction factors were calculated as the ratios of monitor source count rates with and without the phantom. Such factors were applied to the phantom images acquired without the monitor sources. The counting efficiency (count rate per unit activity) of the camera was calculated as a function of activity in the FOV both prior to and after the deadtime count-loss correction. The deadtime correction effectiveness was assessed by the independence of the efficiency on the activity in the FOV. Methods to interpolate the projection deadtime loss, based on limited projections, were also investigated. The fractional deadtime count loss was uniform across the FOV (r > 0.99). After the deadtime correction, the efficiency was largely independent of the activity in the FOV. The median and maximum absolute errors after the deadtime count loss correction were ≤1% and ~2%, respectively. Measured deadtime loss from five views per detector can be used to estimate deadtime count loss with errors ≤1% for all SPECT projections. The revised monitor source method can effectively correct planar and SPECT deadtime loss. Sparse sampling of the projection deadtime loss allows the acquisition of high monitor source counts with minimal time added while preserving the entire useful FOV.