Flexible mini gamma camera reconstructions of extended sources using step and shoot and list mode.

PURPOSE: Hand- and robot-guided mini gamma cameras have been introduced for the acquisition of single-photon emission computed tomography (SPECT) images. Less cumbersome than whole-body scanners, they allow for a fast acquisition of the radioactivity distribution, for example, to differentiate cancerous from hormonally hyperactive lesions inside the thyroid. This work compares acquisition protocols and reconstruction algorithms in an attempt to identify the most suitable approach for fast acquisition and efficient image reconstruction, suitable for localization of extended sources, such as lesions inside the thyroid. METHODS: Our setup consists of a mini gamma camera with precise tracking information provided by a robotic arm, which also provides reproducible positioning for our experiments. Based on a realistic phantom of the thyroid including hot and cold nodules as well as background radioactivity, the authors compare "step and shoot" (SAS) and continuous data (CD) acquisition protocols in combination with two different statistical reconstruction methods: maximum-likelihood expectation-maximization (ML-EM) for time-integrated count values and list-mode expectation-maximization (LM-EM) for individually detected gamma rays. In addition, the authors simulate lower uptake values by statistically subsampling the experimental data in order to study the behavior of their approach without changing other aspects of the acquired data. RESULTS: All compared methods yield suitable results, resolving the hot nodules and the cold nodule from the background. However, the CD acquisition is twice as fast as the SAS acquisition, while yielding better coverage of the thyroid phantom, resulting in qualitatively more accurate reconstructions of the isthmus between the lobes. For CD acquisitions, the LM-EM reconstruction method is preferable, as it yields comparable image quality to ML-EM at significantly higher speeds, on average by an order of magnitude. CONCLUSIONS: This work identifies CD acquisition protocols combined with LM-EM reconstruction as a prime candidate for the wider introduction of SPECT imaging with flexible mini gamma cameras in the clinical practice.

Towards personalized interventional SPECT-CT imaging.

The development of modern robotics and compact imaging detectors allows the transfer of diagnostic imaging modalities to the operating room, supporting surgeons to perform faster and safer procedures. An intervention that currently suffers from a lack of interventional imaging is radioembolization, a treatment for hepatic carcinoma. Currently, this procedure requires moving the patient from an angiography suite for preliminary catheterization and injection to a whole-body SPECT/CT for leakage detection, necessitating a second catheterization back in the angiography suite for the actual radioembolization. We propose an imaging setup that simplifies this procedure using a robotic approach to directly acquire an interventional SPECT/CT in the angiography suite. Using C-arm CT and a co-calibrated gamma camera mounted on a robotic arm, a personalized trajectory of the gamma camera is generated from the C-arm CT, enabling an interventional SPECT reconstruction that is inherently co-registered to the C-arm CT. In this work we demonstrate the feasibility of this personalized interventional SPECT/CT imaging approach in a liver phantom study.

Mini gamma cameras for intra-operative nuclear tomographic reconstruction.

Nuclear imaging modalities like PET or SPECT are in extensive use in medical diagnostics. In a move towards personalized therapy, we present a flexible nuclear tomographic imaging system to enable intra-operative SPECT-like 3D imaging. The system consists of a miniaturized gamma camera mounted on a robot arm for flexible positioning, while spatio-temporal localization is provided by an optical tracking system. To facilitate statistical tomographic reconstruction of the radiotracer distribution using a maximum likelihood approach, a precise model of the mini gamma camera is generated by measurements. The entire system is evaluated in a series of experiments using a hot spot phantom, with a focus on criteria relevant for the intra-operative workflow, namely the number of required imaging positions as well as the required imaging time. The results show that high quality reconstructed images of simple hot spot configurations with positional errors of less than one millimeter are possible within acquisition times as short as 15s.

Electromagnetic servoing-a new tracking paradigm.

Electromagnetic (EM) tracking is highly relevant for many computer assisted interventions. This is in particular due to the fact that the scientific community has not yet developed a general solution for tracking of flexible instruments within the human body. Electromagnetic tracking solutions are highly attractive for minimally invasive procedures, since they do not require line of sight. However, a major problem with EM tracking solutions is that they do not provide uniform accuracy throughout the tracking volume and the desired, highest accuracy is often only achieved close to the center of tracking volume. In this paper, we present a solution to the tracking problem, by mounting an EM field generator onto a robot arm. Proposing a new tracking paradigm, we take advantage of the electromagnetic tracking to detect the sensor within a specific sub-volume, with known and optimal accuracy. We then use the more accurate and robust robot positioning for obtaining uniform accuracy throughout the tracking volume. Such an EM servoing methodology guarantees optimal and uniform accuracy, by allowing us to always keep the tracked sensor close to the center of the tracking volume. In this paper, both dynamic accuracy and accuracy distribution within the tracking volume are evaluated using optical tracking as ground truth. In repeated evaluations, the proposed method was able to reduce the overall error from 6.64±7.86 mm to a significantly improved accuracy of 3.83±6.43 mm. In addition, the combined system provides a larger tracking volume, which is only limited by the reach of the robot and not the much smaller tracking volume defined by the magnetic field generator.

Trajectory optimization for intra-operative nuclear tomographic imaging.

Diagnostic nuclear imaging modalities like SPECT typically employ gantries to ensure a densely sampled geometry of detectors in order to keep the inverse problem of tomographic reconstruction as well-posed as possible. In an intra-operative setting with mobile freehand detectors the situation changes significantly, and having an optimal detector trajectory during acquisition becomes critical. In this paper we propose an incremental optimization method based on the numerical condition of the system matrix of the underlying iterative reconstruction method to calculate optimal detector positions during acquisition in real-time. The performance of this approach is evaluated using simulations. A first experiment on a phantom using a robot-controlled intra-operative SPECT-like setup demonstrates the feasibility of the approach.

First use of mini gamma cameras for intra-operative robotic SPECT reconstruction.

Different types of nuclear imaging systems have been used in the past, starting with pre-operative gantry-based SPECT systems and gamma cameras for 2D imaging of radioactive distributions. The main applications are concentrated on diagnostic imaging, since traditional SPECT systems and gamma cameras are bulky and heavy. With the development of compact gamma cameras with good resolution and high sensitivity, it is now possible to use them without a fixed imaging gantry. Mounting the camera onto a robot arm solves the weight issue, while also providing a highly repeatable and reliable acquisition platform. In this work we introduce a novel robotic setup performing scans with a mini gamma camera, along with the required calibration steps, and show the first SPECT reconstructions. The results are extremely promising, both in terms of image quality as well as reproducibility. In our experiments, the novel setup outperformed a commercial fhSPECT system, reaching accuracies comparable to state-of-the-art SPECT systems.

Optimization of acquisition geometry for intra-operative tomographic imaging.

Acquisition geometries for tomographic reconstruction are usually densely sampled in order to keep the underlying linear system used in iterative reconstruction as well-posed as possible. While this objective is easily enforced in imaging systems with gantries, this issue is more critical for intra-operative setups using freehand-guided data sensing. This paper investigates an incremental method to monitor the numerical condition of the system based on the singular value decomposition of the system matrix, and presents an approach to find optimal detector positions via a randomized optimization scheme. The feasibility of this approach is demonstrated using simulations of an intra-operative functional imaging setup and actual robot-controlled phantom experiments.

Reconstruction of 3-D histology images by simultaneous deformable registration.

The reconstruction of histology sections into a 3-D volume receives increased attention due to its various applications in modern medical image analysis. To guarantee a geometrically coherent reconstruction, we propose a new way to register histological sections simuItaneously to previously acquired reference images and to neighboring slices in the stack. To this end, we formulate two potential functions and associate them to the same Markov random field through which we can efficiently find an optimal solution. Due to our simultaneous formulation and the absence of any segmentation step during the reconstruction we can dramatically reduce error propagation effects. This is illustrated by experiments on carefully created synthetic as well as real data sets.