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Patient position alters attenuation effects in multipinhole cardiac SPECT

Purpose: Dedicated cardiac cameras offer improved sensitivity over conventional SPECT cameras. Sensitivity gains are obtained by large numbers of detectors and novel collimator arrangements such as an array of multiple pinholes that focus on the heart. Pinholes lead to variable amounts of attenuation as a source is moved within the camera field of view. This study evaluated the effects of this variable attenuation on myocardial SPECT images. Methods: Computer simulations were performed for a set of nine point sources distributed in the left ventricular wall (LV). Sources were placed at the location of the heart in both an anthropomorphic and a water-cylinder computer phantom. Sources were translated in x, y, and z by up to 5 cm from the center. Projections were simulated with and without attenuation and the changes in attenuation were compared. A LV with an inferior wall defect was also simulated in both phantoms over the same range of positions. Real camera data were acquired on a Discovery NM530c camera (GE Healthcare, Haifa, Israel) for five min in list-mode using an anthropomorphic phantom (DataSpectrum, Durham, NC) with 100 MBq of Tc-99m in the LV. Images were taken over the same range of positions as the simulations and were compared based on the summed perfusion score (SPS), defect width, and apparent defect uptake for each position. Results: Point sources in the water phantom showed absolute changes in attenuation of ≤8% over the range of positions and relative changes of ≤5% compared to the apex. In the anthropomorphic computer simulations, absolute change increased to 20%. The changes in relative attenuation caused a change in SPS of <1.5 for the water phantom but up to 4.2 in the anthropomorphic phantom. Changes were larger for axial than for transverse translations. These results were supported by SPS changes of up to six seen in the physical anthropomorphic phantom for axial translations. Defect width was also seen to significantly increase. The position-dependent changes were removed with attenuation correction. Conclusions: Translation of a source relative to a multipinhole camera caused only small changes in homogeneous phantoms with SPS changing <1.5. Inhomogeneous attenuating media cause much larger changes to occur when the source is translated. Changes in SPS of up to six were seen in an anthropomorphic phantom for axial translations. Attenuation correction removes the position-dependent changes in attenuation.

60 APPLIED LIFE SCIENCES↗

Effects of CT-based attenuation correction of rat microSPECT images on relative myocardial perfusion and quantitative tracer uptake

Purpose: Our goal in this work was to investigate the impact of CT-based attenuation correction on measurements of rat myocardial perfusion with {sup 99m}Tc and {sup 201}Tl single photon emission computed tomography (SPECT). Methods: Eight male Sprague-Dawley rats were injected with {sup 99m}Tc-tetrofosmin and scanned in a small animal pinhole SPECT/CT scanner. Scans were repeated weekly over a period of 5 weeks. Eight additional rats were injected with {sup 201}Tl and also scanned following a similar protocol. The images were reconstructed with and without attenuation correction, and the relative perfusion was analyzed with the commercial cardiac analysis software. The absolute uptake of {sup 99m}Tc in the heart was also quantified with and without attenuation correction. Results: For {sup 99m}Tc imaging, relative segmental perfusion changed by up to +2.1%/−1.8% as a result of attenuation correction. Relative changes of +3.6%/−1.0% were observed for the {sup 201}Tl images. Interscan and inter-rat reproducibilities of relative segmental perfusion were 2.7% and 3.9%, respectively, for the uncorrected {sup 99m}Tc scans, and 3.6% and 4.3%, respectively, for the {sup 201}Tl scans, and were not significantly affected by attenuation correction for either tracer. Attenuation correction also significantly increased the measured absolute uptake of tetrofosmin and significantly altered the relationship between the rat weight and tracer uptake. Conclusions: Our results show that attenuation correction has a small but statistically significant impact on the relative perfusion measurements in some segments of the heart and does not adversely affect reproducibility. Attenuation correction had a small but statistically significant impact on measured absolute tracer uptake.

60 APPLIED LIFE SCIENCES↗

Assessment of radiation dose in nuclear cardiovascular imaging using realistic computational models

Purpose: Nuclear cardiology plays an important role in clinical assessment and has enormous impact on the management of a variety of cardiovascular diseases. Pediatric patients at different age groups are exposed to a spectrum of radiation dose levels and associated cancer risks different from those of adults in diagnostic nuclear medicine procedures. Therefore, comprehensive radiation dosimetry evaluations for commonly used myocardial perfusion imaging (MPI) and viability radiotracers in target population (children and adults) at different age groups are highly desired. Methods: Using Monte Carlo calculations and biological effects of ionizing radiation VII model, we calculate the S-values for a number of radionuclides (Tl-201, Tc-99m, I-123, C-11, N-13, O-15, F-18, and Rb-82) and estimate the absorbed dose and effective dose for 12 MPI radiotracers in computational models including the newborn, 1-, 5-, 10-, 15-yr-old, and adult male and female computational phantoms. Results: For most organs, {sup 201}Tl produces the highest absorbed dose whereas {sup 82}Rb and {sup 15}O-water produce the lowest absorbed dose. For the newborn baby and adult patient, the effective dose of {sup 82}Rb is 48% and 77% lower than that of {sup 99m}Tc-tetrofosmin (rest), respectively. Conclusions: {sup 82}Rb results in lower effective dose in adults compared to {sup 99m}Tc-labeled tracers. However, this advantage is less apparent in children. The produced dosimetric databases for various radiotracers used in cardiovascular imaging, using new generation of computational models, can be used for risk-benefit assessment of a spectrum of patient population in clinical nuclear cardiology practice.

60 APPLIED LIFE SCIENCES↗

SU-C-201-02: Quantitative Small-Animal SPECT Without Scatter Correction Using High-Purity Germanium Detectors

Purpose: To evaluate the impact of the exceptional energy resolution of germanium detectors for preclinical SPECT in comparison to conventional detectors. Methods: A cylindrical water phantom was created in GATE with a spherical Tc-99m source in the center. Sixty-four projections over 360 degrees using a pinhole collimator were simulated. The same phantom was simulated using air instead of water to establish the true reconstructed voxel intensity without attenuation. Attenuation correction based on the Chang method was performed on MLEM reconstructed images from the water phantom to determine a quantitative measure of the effectiveness of the attenuation correction. Similarly, a NEMA phantom was simulated, and the effectiveness of the attenuation correction was evaluated. Both simulations were carried out using both NaI detectors with an energy resolution of 10% FWHM and Ge detectors with an energy resolution of 1%. Results: Analysis shows that attenuation correction without scatter correction using germanium detectors can reconstruct a small spherical source to within 3.5%. Scatter analysis showed that for standard sized objects in a preclinical scanner, a NaI detector has a scatter-to-primary ratio between 7% and 12.5% compared to between 0.8% and 1.5% for a Ge detector. Preliminary results from line profiles through the NEMA phantom suggest that applying attenuation correction without scatter correction provides acceptable results for the Ge detectors but overestimates the phantom activity using NaI detectors. Due to the decreased scatter, we believe that the spillover ratio for the air and water cylinders in the NEMA phantom will be lower using germanium detectors compared to NaI detectors. Conclusion: This work indicates that the superior energy resolution of germanium detectors allows for less scattered photons to be included within the energy window compared to traditional SPECT detectors. This may allow for quantitative SPECT without implementing scatter correction, reducing uncertainties introduced by scatter correction algorithms. Funding provided by NIH/NIBIB grant R01EB013677; Todd Peterson, Ph.D., has had a research contract with PHDs Co., Knoxville, TN.

07 ISOTOPE AND RADIATION SOURCES↗

SU-C-201-03: Coded Aperture Gamma-Ray Imaging Using Pixelated Semiconductor Detectors

Purpose: Improved localization of gamma-ray emissions from radiotracers is essential to the progress of nuclear medicine. Polaris is a portable, room-temperature operated gamma-ray imaging spectrometer composed of two 3×3 arrays of thick CdZnTe (CZT) detectors, which detect gammas between 30keV and 3MeV with energy resolution of <1% FWHM at 662keV. Compton imaging is used to map out source distributions in 4-pi space; however, is only effective above 300keV where Compton scatter is dominant. This work extends imaging to photoelectric energies (<300keV) using coded aperture imaging (CAI), which is essential for localization of Tc-99m (140keV). Methods: CAI, similar to the pinhole camera, relies on an attenuating mask, with open/closed elements, placed between the source and position-sensitive detectors. Partial attenuation of the source results in a “shadow” or count distribution that closely matches a portion of the mask pattern. Ideally, each source direction corresponds to a unique count distribution. Using backprojection reconstruction, the source direction is determined within the field of view. The knowledge of 3D position of interaction results in improved image quality. Results: Using a single array of detectors, a coded aperture mask, and multiple Co-57 (122keV) point sources, image reconstruction is performed in real-time, on an event-by-event basis, resulting in images with an angular resolution of ∼6 degrees. Although material nonuniformities contribute to image degradation, the superposition of images from individual detectors results in improved SNR. CAI was integrated with Compton imaging for a seamless transition between energy regimes. Conclusion: For the first time, CAI has been applied to thick, 3D position sensitive CZT detectors. Real-time, combined CAI and Compton imaging is performed using two 3×3 detector arrays, resulting in a source distribution in space. This system has been commercialized by H3D, Inc. and is being acquired for various applications worldwide, including proton therapy imaging R&D.

60 APPLIED LIFE SCIENCES↗

SU-C-201-07: Validation of a GATE Gamma Camera Model for the Siemens Symbia

Purpose: To develop a simulation model of a clinical gamma camera/SPECT system and to validate the model using experimental and published measurements from the clinical system. Methods: Geant4 Application for Tomographic Emission (GATE) was used to create a model of the Siemens Symbia gamma camera. A modular model was implemented that allows specifying combinations of crystal thickness (3/8”, 5/8”) and collimator (LEHR, MELP, HE). Shielding, energy resolution, intrinsic resolution, crystal thickness, and collimator properties were set based on manufacturer specifications. Validation of the model was performed by simulating NEMA 2007 gamma camera tests including spatial resolution and sensitivity for Tc99; these were compared with experimental and published data for the scanner. The simulated energy spectra of a Tc99 line source in acrylic blocks was visually compared with the corresponding experimental acquisition. For a 4 cm diameter sphere filled with Tc99, the attenuation maps were generated from simulation data, and the photopeak and scatter window were extracted from GATE output using ROOT to create DICOM files to use in the clinical reconstruction. Results: Simulated spatial resolutions for LEHR 3/8” crystal at 0, 10 cm, 10 cm (with scatter), and 30 cm were 4, 6.7, 7.9, and 14.5 mm FWHM; these were 9% less than published data. For 5/8” crystal the spatial resolutions were 4.5, 7.0, 8.5, and 14.7 mm FWHM; these were 4% to 10% less than published data. Simulated sensitivity was within 3.5% of published data for both LEHR 3/8” and 5/8”. The simulated energy spectra matched the photopeak and scatter window well, but did overestimate the counts below 90 keV. The simulated attenuation map and projection data were successfully reconstructed with the clinical software, and the passed visual inspection. Conclusions: Validation of a specific clinical scanner allows future studies of quantification accuracy for both planar and SPECT imaging. Research reported in this publication was supported by the National Cancer Institute of the National Institutes of Health under Award Number R01CA138986. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

60 APPLIED LIFE SCIENCES↗

SU-E-I-79: Source Geometry Dependence of Gamma Well-Counter Measurements

Purpose: To determine the effect of liquid sample volume and geometry on counting efficiency in a gamma well-counter, and to assess the relative contributions of sample geometry and self-attenuation. Gamma wellcounters are standard equipment in clinical and preclinical studies, for measuring patient blood radioactivity and quantifying animal tissue uptake for tracer development and other purposes. Accurate measurements are crucial. Methods: Count rates were measured for aqueous solutions of 99m- Tc at four liquid volume values in a 1-cm-diam tube and at six volume values in a 2.2-cm-diam vial. Total activity was constant for all volumes, and data were corrected for decay. Count rates from a point source in air, supported by a filter paper, were measured at seven heights between 1.3 and 5.7 cm from the bottom of a tube. Results: Sample volume effects were larger for the tube than for the vial. For the tube, count efficiency relative to a 1-cc volume ranged from 1.05 at 0.05 cc to 0.84 at 3 cc. For the vial, relative count efficiency ranged from 1.02 at 0.05 cc to 0.87 at 15 cc. For the point source, count efficiency relative to 1.3 cm from the tube bottom ranged from 0.98 at 1.8 cm to 0.34 at 5.7 cm. The relative efficiency of a 3-cc liquid sample in a tube compared to a 1-cc sample is 0.84; the average relative efficiency for the solid sample in air between heights in the tube corresponding to the surfaces of those volumes (1.3 and 4.8 cm) is 0.81, implying that the major contribution to efficiency loss is geometry, rather than attenuation. Conclusion: Volume-dependent correction factors should be used for accurate quantitation radioactive of liquid samples. Solid samples should be positioned at the bottom of the tube for maximum count efficiency.

60 APPLIED LIFE SCIENCES↗

SU-E-I-80: Quantification of Respiratory and Cardiac Motion Effect in SPECT Acquisitions Using Anthropomorphic Models: A Monte Carlo Simulation Study

Purpose: The purpose of the present study was to quantify, evaluate the impact of cardiac and respiratory motion on clinical nuclear imaging protocols. Common SPECT and scintigraphic scans are studied using Monte Carlo (MC) simulations, comparing the resulted images with and without motion. Methods: Realistic simulations were executed using the GATE toolkit and the XCAT anthropomorphic phantom as a reference model for human anatomy. Three different radiopharmaceuticals based on 99mTc were studied, namely 99mTc-MDP, 99mTc—N—DBODC and 99mTc—DTPA-aerosol for bone, myocardium and lung scanning respectively. The resolution of the phantom was set to 3.5 mm{sup 3}. The impact of the motion on spatial resolution was quantified using a sphere with 3.5 mm diameter and 10 separate time frames, in the ECAM modeled SPECT scanner. Finally, respiratory motion impact on resolution and imaging of lung lesions was investigated. The MLEM algorithm was used for data reconstruction, while the literature derived biodistributions of the pharmaceuticals were used as activity maps in the simulations. Results: FWHM was extracted for a static and a moving sphere which was ∼23 cm away from the entrance of the SPECT head. The difference in the FWHM was 20% between the two simulations. Profiles in thorax were compared in the case of bone scintigraphy, showing displacement and blurring of the bones when respiratory motion was inserted in the simulation. Large discrepancies were noticed in the case of myocardium imaging when cardiac motion was incorporated during the SPECT acquisition. Finally the borders of the lungs are blurred when respiratory motion is included resulting to a dislocation of ∼2.5 cm. Conclusion: As we move to individualized imaging and therapy procedures, quantitative and qualitative imaging is of high importance in nuclear diagnosis. MC simulations combined with anthropomorphic digital phantoms can provide an accurate tool for applications like motion correction techniques’ optimization. This research has been co-funded by the European Union (European Social Fund) and Greek national resources under the framework of the ‘Archimedes III: Funding of Research Groups in TEI of Athens’ project of the ‘Education & Lifelong Learning’ Operational Programme.

60 APPLIED LIFE SCIENCES↗

SU-E-T-02: 90Y Microspheres Dosimetry Calculation with Voxel-S-Value Method: A Simple Use in the Clinic

Purpose: To present a simple and feasible method of voxel-S-value (VSV) dosimetry calculation for daily clinical use in radioembolization (RE) with {sup 90}Y microspheres. Dose distributions are obtained and visualized over CT images. Methods: Spatial dose distributions and dose in liver and tumor are calculated for RE patients treated with Sirtex Medical miscrospheres at our center. Data obtained from the previous simulation of treatment were the basis for calculations: Tc-99m maggregated albumin SPECT-CT study in a gammacamera (Infinia, General Electric Healthcare.). Attenuation correction and ordered-subsets expectation maximization (OSEM) algorithm were applied.For VSV calculations, both SPECT and CT were exported from the gammacamera workstation and registered with the radiotherapy treatment planning system (Eclipse, Varian Medical systems). Convolution of activity matrix and local dose deposition kernel (S values) was implemented with an in-house developed software based on Python code. The kernel was downloaded from www.medphys.it. Final dose distribution was evaluated with the free software Dicompyler. Results: Liver mean dose is consistent with Partition method calculations (accepted as a good standard). Tumor dose has not been evaluated due to the high dependence on its contouring. Small lesion size, hot spots in health tissue and blurred limits can affect a lot the dose distribution in tumors. Extra work includes: export and import of images and other dicom files, create and calculate a dummy plan of external radiotherapy, convolution calculation and evaluation of the dose distribution with dicompyler. Total time spent is less than 2 hours. Conclusion: VSV calculations do not require any extra appointment or any uncomfortable process for patient. The total process is short enough to carry it out the same day of simulation and to contribute to prescription decisions prior to treatment. Three-dimensional dose knowledge provides much more information than other methods of dose calculation usually applied in the clinic.

60 APPLIED LIFE SCIENCES↗

SU-E-T-507: Internal Dosimetry in Nuclear Medicine Using GATE and XCAT Phantom: A Simulation Study

Purpose Monte Carlo simulations are routinely used for internal dosimetry studies. These studies are conducted with humanoid phantoms such as the XCAT phantom. In this abstract we present the absorbed doses for various pairs of source and target organs using three common radiotracers in nuclear medicine. Methods The GATE software package is used for the Monte Carlo simulations. A typical female XCAT phantom is used as the input. Three radiotracers 153Sm, 131I and 99mTc are studied. The Specific Absorbed Fraction (SAF) for gamma rays (99mTc, 153Sm and 131I) and Specific Fraction (SF) for beta particles (153Sm and 131I) are calculated for all 100 pairs of source target organs including brain, liver, lung, pancreas, kidney, adrenal, spleen, rib bone, bladder and ovaries. Results The source organs themselves gain the highest absorbed dose as compared to other organs. The dose is found to be inversely proportional to distance from the source organ. In SAF results of 153Sm, when the source organ is lung, the rib bone, gain 0.0730 (Kg-1) that is more than lung itself. Conclusion The absorbed dose for various organs was studied in terms of SAF and SF. Such studies hold importance for future therapeutic procedures and optimization of induced radiotracer.

60 APPLIED LIFE SCIENCES↗

MO-F-CAMPUS-I-05: Radiation Dosimetry of 99mTc-IDA-D-[c(RGDfK)]2, a SPECT Agent for Angiogenesis Imaging

Purpose: Tc-99m labeled IDA-D-[c(RGDfK){sub 2} ( {sup 99m}Tc-RGD) is a recently developed radiotracer for gamma camera or single photon emission computed tomography (SPECT) imaging and promising agent for the visualization of angiogenesis. In this study, we investigated the internal radiation dosimetry of {sup 99m}Tc-RGD in humans. Methods: Six normal controls (F:M=4:2; 68.3±3.2 years; 56.5±10.7 kg) were participated in this study. Simultaneous anterior and posterior scans of whole-body were performed using dual head gamma camera system. Before the emission scan, transmission scan was performed just before injection of {sup 99m}Tc-RGD using Co-57 flood source. After an intravenous injection of 388.7±29.3 MBq of {sup 99m}Tc-RGD, six serial emission scans were performed at 0, 1, 2, 4, 8 and 24 hours post-injection. The anterior and posterior images were geometrically averaged and attenuation correction was applied using transmission scan image. Regions of interest (ROIs) were drawn on liver, gallbladder, kidneys, urinary bladder, spleen, brain, and large intestine. Time activity curves were obtained from serial emission scan and ROIs. The number of disintegrations per unit activity administered (residence time) were calculated from the area under the curve of time activity curves and injected dose of each patient. Finally, the radiation dose for each organ and effective doses were obtained using OLINDA/EXM 1.1 software and residence time. Results: High radiation doses were reported on renal and biliary excretion tracks such as urinary bladder wall, upper large intestine, kidneys, liver and gallbladder wall and their doses were 19.15±6.84, 19.28±4.78, 15.67±0.90, 9.13±1.71 and 9.09±2.03 µGy/MBq, respectively. The effective dose and effective dose equivalent were 5.08±0.53 and 7.11±0.58 µSv/MBq, respectively. Conclusion: We evaluated the radiation dose of 99mTc-RGD, which has an acceptable effective radiation dose compare to the other Tc-99m labeled radio-tracers.

60 APPLIED LIFE SCIENCES↗

TU-EF-204-04: Feasibility Study of a Novel Stationary Spectral CT Scanner

Purpose: To evaluate a cadmium zinc telluride (CZT) detector module and to develop a proof-of-concept bench-top system to examine the concept and feasibility of a stationary spectral scanner that would consist of a CZT detector ring and a distributed source for rotationless imaging. Methods: The bench-top system employs a double-rotation set-up with two concentric but independent rotating stages, one for turning the object at sparse angles to mimic the imaging from a sequentially activated source distributed on a ring, while the other for translating the detector module to simulate a projection arc along a virtual detector ring. A source of 30-degree fan is used in the set-up, and the ring is designed to be 85cm in diameter in order to provide a 22cm field-of-view that is large enough for an average human head. The CZT detector module has 16×16 0.5mm pixels and eight global energy thresholds, and is attached to an experimental data acquisition board from the same vendor (Nova R&D). Its pixel gain is first calibrated using radioisotope Tc-99m to align the photo-peaks. Count rate performance is assessed using the X-ray source. Air and offset corrections are done prior to each CT scan. A 10cm acrylic phantom with 5 different inserts is imaged at 100kVp, 2mA, with an effective exposure window of 150ms per projection. Reconstruction is done using a total variation-type iterative method. Results: The detector module exhibited large gain variations among pixels. Average count rate was over 1Mcps per pixel. Parallax effect was observed along the arcs but was corrected. Reconstructed images from two energy bins demonstrated good contrast, spatial resolution and image uniformity, with little artifacts. Conclusion: The CZT detector tested is suitable for imaging relatively small objects. A stationary spectral CT appears feasible should we have enough buttable modules and a distributed source. This work was supported by Ministry of Science and Technology of China through grants 11YQ040082 and 2012BAI13B04.

60 APPLIED LIFE SCIENCES↗

WE-AB-204-12: Dosimetry at the Sub-Cellular Scale of Auger-Electron Emitter 99m-Tc in a Mouse Single Thyroid Follicle Model

Purpose: To perform a dosimetry study at the sub-cellular scale of Auger-electron emitter 99m-Tc using a mouse single thyroid cellular model to investigate the contribution of the 99m-Tc Auger-electrons to the absorbed dose and possible link to the thyroid stunning in in vivo experiments in mice, recently reported in literature. Methods: The simulation of S-values for Auger-electron emitting radionuclides was performed using both the recent MCNP6 software and the Geant4-DNA extension of the Geant4 toolkit. The dosimetric calculations were validated through comparison with results from literature, using a simple model of a single cell consisting of two concentric spheres of unit density water and for six Auger-electron emitting radionuclides. Furthermore, the S-values were calculated using a single thyroid follicle model for uniformly distributed 123-I and 125-I radionuclides and compared with published S-values. After validation, the simulation of the S-values was performed for the 99m-Tc radionuclide within the several mouse thyroid follicle cellular compartments, considering the radiative and non-radiative transitions of the 99m-Tc radiation spectrum. Results: The calculated S-values using MCNP6 are in good agreement with the results from literature, validating its use for the 99m-Tc S-values calculations. The most significant absorbed dose corresponds to the case where the radionuclide is uniformly distributed in the follicular cell’s nucleus, with a S-value of 7.8 mGy/disintegration, due mainly to the absorbed Auger-electrons. The results show that, at a sub-cellular scale, the emitted X-rays and gamma particles do not contribute significantly to the absorbed dose. Conclusion: In this work, MCNP6 was validated for dosimetric studies at the sub-cellular scale. It was shown that the contribution of the Auger-electrons to the absorbed dose is important at this scale compared to the emitted photons’ contribution and can’t be neglected. The obtained S-values of Auger-electron emitting 99m-Tc radionuclide will be presented and discussed.

60 APPLIED LIFE SCIENCES↗

WE-D-204-07: Development of An ImageJ Plugin for Renal Function Quantification: RenalQuant

Purpose: Commercial workstations usually have their own software to calculate dynamic renal functions. However, usually they have low flexibility and subjectivity on delimiting kidney and background areas. The aim of this paper is to present a public domain software, called RenalQuant, capable to semi-automatically draw regions of interest on dynamic renal scintigraphies, extracting data and generating renal function quantification parameters. Methods: The software was developed in Java and written as an ImageJ-based plugin. The preprocessing and segmentation steps include the user’s selection of one time frame with higher activity in kidney’s region, compared with background, and low activity in the liver. Next, the chosen time frame is smoothed using a Gaussian low pass spatial filter (σ = 3) for noise reduction and better delimitation of kidneys. The maximum entropy thresholding method is used for segmentation. A background area is automatically placed below each kidney, and the user confirms if these regions are correctly segmented and positioned. Quantitative data are extracted and each renogram and relative renal function (RRF) value is calculated and displayed. Results: RenalQuant plugin was validated using retrospective 20 patients’ 99mTc-DTPA exams, and compared with results produced by commercial workstation software, referred as reference. The renograms intraclass correlation coefficients (ICC) were calculated and false-negative and false-positive RRF values were analyzed. The results showed that ICC values between RenalQuant plugin and reference software for both kidneys’ renograms were higher than 0.75, showing excellent reliability. Conclusion: Our results indicated RenalQuant plugin can be trustingly used to generate renograms, using DICOM dynamic renal scintigraphy exams as input. It is user friendly and user’s interaction occurs at a minimum level. Further studies have to investigate how to increase RRF accuracy and explore how to solve limitations in the segmentation step, mainly when background region has higher activity compared to kidneys. Financial support by CAPES.

60 APPLIED LIFE SCIENCES↗

Reduced dose measurement of absolute myocardial blood flow using dynamic SPECT imaging in a porcine model

Purpose: Absolute myocardial blood flow (MBF) and myocardial flow reserve (MFR) measurements provide important additional information over traditional relative perfusion imaging. Recent advances in camera technology have made this possible with single-photon emission tomography (SPECT). Low dose protocols are desirable to reduce the patient radiation risk; however, increased noise may reduce the accuracy of MBF measurements. The authors studied the effect of reducing dose on the accuracy of dynamic SPECT MBF measurements. Methods: Nineteen 30–40 kg pigs were injected with 370 + 1110 MBq of Tc-99m sestamibi or tetrofosmin or 37 + 111 MBq of Tl-201 at rest + stress. Microspheres were injected simultaneously to measure MBF. The pigs were imaged in list-mode for 11 min starting at the time of injection using a Discovery NM 530c camera (GE Healthcare). Each list file was modified so that 3/4, 1/2, 1/4, 1/8, 1/16, and 1/32 of the original counts were included in the projections. Modified projections were reconstructed with CT-based attenuation correction and an energy window-based scatter correction and analyzed with FlowQuant kinetic modeling software using a 1-compartment model. A modified Renkin-Crone extraction function was used to convert the tracer uptake rate K1 to MBF values. The SPECT results were compared to those from microspheres. Results: Correlation between SPECT and microsphere MBF values for the full injected activity was r ≥ 0.75 for all 3 tracers and did not significantly degrade over all count levels. The mean MBF and MFR and the standard errors in the estimates were not significantly worse than the full-count data at 1/4-counts (Tc99m-tracers) and 1/2-counts (Tl-201). Conclusions: Dynamic SPECT measurement of MBF and MFR in pigs can be performed with 1/4 (Tc99m-tracers) or 1/2 (Tl-201) of the standard injected activity without significantly reducing accuracy and precision.

60 APPLIED LIFE SCIENCES↗

Scatter and crosstalk corrections for {sup 99m}Tc/{sup 123}I dual-radionuclide imaging using a CZT SPECT system with pinhole collimators

Purpose: The energy spectrum for a cadmium zinc telluride (CZT) detector has a low energy tail due to incomplete charge collection and intercrystal scattering. Due to these solid-state detector effects, scatter would be overestimated if the conventional triple-energy window (TEW) method is used for scatter and crosstalk corrections in CZT-based imaging systems. The objective of this work is to develop a scatter and crosstalk correction method for {sup 99m}Tc/{sup 123}I dual-radionuclide imaging for a CZT-based dedicated cardiac SPECT system with pinhole collimators (GE Discovery NM 530c/570c). Methods: A tailing model was developed to account for the low energy tail effects of the CZT detector. The parameters of the model were obtained using {sup 99m}Tc and {sup 123}I point source measurements. A scatter model was defined to characterize the relationship between down-scatter and self-scatter projections. The parameters for this model were obtained from Monte Carlo simulation using SIMIND. The tailing and scatter models were further incorporated into a projection count model, and the primary and self-scatter projections of each radionuclide were determined with a maximum likelihood expectation maximization (MLEM) iterative estimation approach. The extracted scatter and crosstalk projections were then incorporated into MLEM image reconstruction as an additive term in forward projection to obtain scatter- and crosstalk-corrected images. The proposed method was validated using Monte Carlo simulation, line source experiment, anthropomorphic torso phantom studies, and patient studies. The performance of the proposed method was also compared to that obtained with the conventional TEW method. Results: Monte Carlo simulations and line source experiment demonstrated that the TEW method overestimated scatter while their proposed method provided more accurate scatter estimation by considering the low energy tail effect. In the phantom study, improved defect contrasts were observed with both correction methods compared to no correction, especially for the images of {sup 99m}Tc in dual-radionuclide imaging where there is heavy contamination from {sup 123}I. In this case, the nontransmural defect contrast was improved from 0.39 to 0.47 with the TEW method and to 0.51 with their proposed method and the transmural defect contrast was improved from 0.62 to 0.74 with the TEW method and to 0.73 with their proposed method. In the patient study, the proposed method provided higher myocardium-to-blood pool contrast than that of the TEW method. Similar to the phantom experiment, the improvement was the most substantial for the images of {sup 99m}Tc in dual-radionuclide imaging. In this case, the myocardium-to-blood pool ratio was improved from 7.0 to 38.3 with the TEW method and to 63.6 with their proposed method. Compared to the TEW method, the proposed method also provided higher count levels in the reconstructed images in both phantom and patient studies, indicating reduced overestimation of scatter. Using the proposed method, consistent reconstruction results were obtained for both single-radionuclide data with scatter correction and dual-radionuclide data with scatter and crosstalk corrections, in both phantom and human studies. Conclusions: The authors demonstrate that the TEW method leads to overestimation in scatter and crosstalk for the CZT-based imaging system while the proposed scatter and crosstalk correction method can provide more accurate self-scatter and down-scatter estimations for quantitative single-radionuclide and dual-radionuclide imaging.

60 APPLIED LIFE SCIENCES↗

Quantitatively accurate activity measurements with a dedicated cardiac SPECT camera: Physical phantom experiments

Purpose: Recently, there has been increased interest in dedicated cardiac single photon emission computed tomography (SPECT) scanners with pinhole collimation and improved detector technology due to their improved count sensitivity and resolution over traditional parallel-hole cameras. With traditional cameras, energy-based approaches are often used in the clinic for scatter compensation because they are fast and easily implemented. Some of the cardiac cameras use cadmium-zinc-telluride (CZT) detectors which can complicate the use of energy-based scatter correction (SC) due to the low-energy tail—an increased number of unscattered photons detected with reduced energy. Modified energy-based scatter correction methods can be implemented, but their level of accuracy is unclear. In this study, the authors validated by physical phantom experiments the quantitative accuracy and reproducibility of easily implemented correction techniques applied to {sup 99m}Tc myocardial imaging with a CZT-detector-based gamma camera with multiple heads, each with a single-pinhole collimator. Methods: Activity in the cardiac compartment of an Anthropomorphic Torso phantom (Data Spectrum Corporation) was measured through 15 {sup 99m}Tc-SPECT acquisitions. The ratio of activity concentrations in organ compartments resembled a clinical {sup 99m}Tc-sestamibi scan and was kept consistent across all experiments (1.2:1 heart to liver and 1.5:1 heart to lung). Two background activity levels were considered: no activity (cold) and an activity concentration 1/10th of the heart (hot). A plastic “lesion” was placed inside of the septal wall of the myocardial insert to simulate the presence of a region without tracer uptake and contrast in this lesion was calculated for all images. The true net activity in each compartment was measured with a dose calibrator (CRC-25R, Capintec, Inc.). A 10 min SPECT image was acquired using a dedicated cardiac camera with CZT detectors (Discovery NM530c, GE Healthcare), followed by a CT scan for attenuation correction (AC). For each experiment, separate images were created including reconstruction with no corrections (NC), with AC, with attenuation and dual-energy window (DEW) scatter correction (ACSC), with attenuation and partial volume correction (PVC) applied (ACPVC), and with attenuation, scatter, and PVC applied (ACSCPVC). The DEW SC method used was modified to account for the presence of the low-energy tail. Results: T-tests showed that the mean error in absolute activity measurement was reduced significantly for AC and ACSC compared to NC for both (hot and cold) datasets (p < 0.001) and that ACSC, ACPVC, and ACSCPVC show significant reductions in mean differences compared to AC (p ≤ 0.001) without increasing the uncertainty (p > 0.4). The effect of SC and PVC was significant in reducing errors over AC in both datasets (p < 0.001 and p < 0.01, respectively), resulting in a mean error of 5% ± 4%. Conclusions: Quantitative measurements of cardiac {sup 99m}Tc activity are achievable using attenuation and scatter corrections, with the authors’ dedicated cardiac SPECT camera. Partial volume corrections offer improvements in measurement accuracy in AC images and ACSC images with elevated background activity; however, these improvements are not significant in ACSC images with low background activity.

61 RADIATION PROTECTION AND DOSIMETRY↗

The impact of system matrix dimension on small FOV SPECT reconstruction with truncated projections

Purpose: A dedicated cardiac hybrid single photon emission computed tomography (SPECT)/CT scanner that uses cadmium zinc telluride detectors and multiple pinhole collimators for stationary acquisition offers many advantages. However, the impact of the reconstruction system matrix (SM) dimension on the reconstructed image quality from truncated projections and 19 angular samples acquired on this scanner has not been extensively investigated. In this study, the authors aimed to investigate the impact of the dimensions of SM and the use of body contour derived from adjunctive CT imaging as an object support in reconstruction on this scanner, in relation to background extracardiac activity. Methods: The authors first simulated a generic SPECT/CT system to image four NCAT phantoms with various levels of extracardiac activity and compared the reconstructions using SM in different dimensions and with/without body contour as a support for quantitative evaluations. The authors then compared the reconstructions of 18 patient studies, which were acquired on a GE Discovery NM570c scanner following injection of different radiotracers, including {sup 99m}Tc-Tetrofosmin and {sup 123}I-mIBG, comparing the scanner’s default SM that incompletely covers the body with a large SM that incorporates a patient specific full body contour. Results: The simulation studies showed that the reconstructions using a SM that only partially covers the body yielded artifacts on the edge of the field of view (FOV), overestimation of activity and increased nonuniformity in the blood pool for the phantoms with higher relative levels of extracardiac activity. However, the impact on the quantitative accuracy in the high activity region, such as the myocardium, was subtle. On the other hand, an excessively large SM that enclosed the entire body alleviated the artifacts and reduced overestimation in the blood pool, but yielded slight underestimation in myocardium and defect regions. The reconstruction using the larger SM with body contour yielded the most quantitatively accurate results in all the regions of interest for a range of uptake levels in the extracardiac regions. In patient studies, the SM incorporating patient specific body contour minimized extracardiac artifacts, yielded similar myocardial activity, lower blood pool activity, and subsequently improved myocardium-to-blood pool contrast (p < 0.0001) by an average of 7% (range 0%–18%) across all the patients, compared to the reconstructions using the scanner’s default SM. Conclusions: Their results demonstrate that using a large SM that incorporates a CT derived body contour in the reconstruction could improve quantitative accuracy within the FOV for clinical studies with high extracardiac activity.

61 RADIATION PROTECTION AND DOSIMETRY↗