Variability in PET image quality and quantification measured with a permanently filled 68Ge-phantom: a multi-center study.

BACKGROUND: This study evaluated, as a snapshot, the variability in quantification and image quality (IQ) of the clinically utilized PET [18F]FDG whole-body protocols in Finland using a NEMA/IEC IQ phantom permanently filled with 68Ge. METHODS: The phantom was imaged on 14 PET-CT scanners, including a variety of models from two major vendors. The variability of the recovery coefficients (RCmax, RCmean and RCpeak) of the hot spheres as well as percent background variability (PBV), coefficient of variation of the background (COVBG) and accuracy of corrections (AOC) were studied using images from clinical and standardized protocols with 20 repeated measurements. The ranges of the RCs were also compared to the limits of the EARL 18F standards 2 accreditation (EARL2). The impact of image noise on these parameters was studied using averaged images (AVIs). RESULTS: The largest variability in RC values of the routine protocols was found for the RCmax with a range of 68% and with 10% intra-scanner variability, decreasing to 36% when excluding protocols with suspected cross-calibration failure or without point-spread-function (PSF) correction. The RC ranges of individual hot spheres in routine or standardized protocols or AVIs fulfilled the EARL2 ranges with two minor exceptions, but fulfilling the exact EARL2 limits for all hot spheres was variable. RCpeak was less dependent on averaging and reconstruction parameters than RCmax and RCmean. The PBV, COVBG and AOC varied between 2.3-11.8%, 9.6-17.8% and 4.8-32.0%, respectively, for the routine protocols. The RC ranges, PBV and COVBG were decreased when using AVIs. With AOC, when excluding routine protocols without PSF correction, the maximum value dropped to 15.5%. CONCLUSION: The maximum variability of the RC values for the [18F]FDG whole-body protocols was about 60%. The RC ranges of properly cross-calibrated scanners with PSF correction fitted to the EARL2 RC ranges for individual sphere sizes, but fulfilling the exact RC limits would have needed further optimization. RCpeak was the most robust RC measure. Besides COVBG, also RCs and PVB were sensitive to image noise.

Fast voxel-level dosimetry for (177)Lu labelled peptide treatments.

In peptide receptor radionuclide therapy (PRRT), voxel-level radiation absorbed dose calculations can be performed using several different methods. Each method has it strengths and weaknesses; however, Monte Carlo (MC) simulation is presently considered the most accurate method at providing absorbed dose distributions. Unfortunately MC simulation is time-consuming and often impractical to carry out in a clinical practice. In this work, a fast semi-Monte Carlo (sMC) absorbed dose calculation method for (177)Lu PRRT dosimetry is presented. The sMC method is based on a local electron absorption assumption and fast photon MC simulations. The sMC method is compared against full MC simulation code built on PENELOPE (vxlPen) using digital phantoms to assess the accuracy of these assumptions.Due to the local electron absorption assumption of sMC, the potential errors in cross-fire dose from electrons and photons emitted by (177)Lu were first evaluated using an ellipsoidal kidney model by comparing vxlPen and sMC. The photon cross-fire dose from background to kidney and kidney to background with varying kidney-to-background activity concentration ratios were calculated. In addition, kidney to kidney photon and electron cross-dose with different kidney to kidney distances were studied. Second, extended cardiac-torso (XCAT) phantoms were created with liver lesions and with realistic activity distributions and tissue densities. The XCAT phantoms were used to simulate SPECT projections and 3D activity distribution images were reconstructed using an OSEM algorithm. Image-based dose rate distributions were calculated using vxlPen and sMC. Total doses and dose rate volume histograms (DrVH) produced by the two methods were compared.The photon cross-fire dose from the kidney increased the background's absorbed dose by 5% or more up to 5.8 cm distance with 20 : 1 kidney to background activity concentration ratio. On the other hand, the photon cross-fire dose from the background to the kidney volume was negligible. The vxlPen results showed that the cross fire dose between two similar kidney volumes relative to the source kidney's self-dose were 0.5% and 0.02% for photon and electrons, respectively, when source and target kidneys were modelled next to each other. The photon cross-dose decreased as function of distance, and electron doses were zero at distances larger than 4 mm. The difference between sMC and vxlPen kidney total doses in the XCAT phantom study was -0.4% while the electron dose DrVHs were identical between the methods. There was a systematic 5% difference in photon doses in soft tissue between the codes due to different simulations parameters. However, the photons produced only 4% of the kidney's total dose, thus the difference was not considered significant for total dose calculations.The comparison studies show that the absorbed doses calculated using the sMC differ only slightly from dedicated MC simulator results, while the dose estimates can be obtained in a fraction of the dedicated simulator's calculation time. Results imply that there is no need for electron MC simulation for (177)Lu absorption calculations with current SPECT systems. However, the photon cross-fire dose should be taken into account in healthy tissues, which have a relatively low uptake especially in cases where there are high uptake volumes are nearby.

Acceleration of Monte Carlo-based scatter compensation for cardiac SPECT.

Single proton emission computed tomography (SPECT) images are degraded by photon scatter making scatter compensation essential for accurate reconstruction. Reconstruction-based scatter compensation with Monte Carlo (MC) modelling of scatter shows promise for accurate scatter correction, but it is normally hampered by long computation times. The aim of this work was to accelerate the MC-based scatter compensation using coarse grid and intermittent scatter modelling. The acceleration methods were compared to un-accelerated implementation using MC-simulated projection data of the mathematical cardiac torso (MCAT) phantom modelling (99m)Tc uptake and clinical myocardial perfusion studies. The results showed that when combined the acceleration methods reduced the reconstruction time for 10 ordered subset expectation maximization (OS-EM) iterations from 56 to 11 min without a significant reduction in image quality indicating that the coarse grid and intermittent scatter modelling are suitable for MC-based scatter compensation in cardiac SPECT.

PET imaging using a triple-head gamma camera.

Interest in clinical fluorodeoxyglucose (FDG) imaging with multiple-head gamma cameras is growing. To improve sensitivity, triple-head coincidence imaging has been proposed. We report our initial experiences with a triple-head coincidence gamma camera with 19 mm sodium iodide crystal thickness. Several positron emission tomography-image quality parameters were evaluated using a Carlson and line source phantom. The system sensitivity with two-dimensional axial shields was 830 cps kBq-1 ml-1 and maximum noise equivalent count rate 1900 cps for an 18F-activity of 50 MBq. The imaging resolution was in central axial 7.0 mm and in central transaxial 7.6 mm, respectively. The average scatter fraction in scattered media was 29%. Clinical brain, heart and whole body images studies with [18F]FDG were acquired and they show good correlation with the phantom image quality. As a conclusion, triple-head coincidence gamma camera provides relatively high-count rate imaging with good contrast and resolution.