Evaluation of cost-effective system designs for long axial field-of-view PET scanners.

Objective. Current commercial positron emission tomography (PET) scanners have excellent performance and diagnostic image quality primarily due to improvements in scanner sensitivity and time-of-flight (TOF) resolution. Recent years have seen the development of total-body PET scanners with longer axial field-of-view (AFOV) that increase sensitivity for single organ imaging, and also image more of the patient in a single bed position thereby enabling multi-organ dynamic imaging. While studies have shown significant capabilities of these systems, cost will be a major factor in their widespread adoption in the clinic. Here we evaluate alternative designs that achieve many advantages of long AFOV PET while utilizing cost-effective detector hardware.Approach. We utilize Monte Carlo simulations and clinically relevant lesion detectability metric to study the impact of scintillator type lutetium oxyorthosilicate or bismuth germanate (LSO or BGO), scintillator thickness (10-20 mm), and TOF resolution on resultant image quality in a 72 cm long scanner. Detector TOF resolution was varied based on current scanner performance, as well as expected future performance from detector designs that currently hold most promise for scaling into a scanner.Main results. Results indicate that BGO is competitive with LSO (both 20 mm thick) if we assume that it uses TOF (e.g. Cerenkov timing with 450 ps fwhm and Lorentzian distribution) and the LSO scanner has TOF resolution similar to the latest PMT-based scanners (∼500-650 ps). Alternatively, a system using 10 mm thick LSO with 150 ps TOF resolution can also provide similar performance. Both these alternative systems can provide cost savings (25%-33%) relative to a scanner using 20 mm LSO with ∼50% of effective sensitivity, but still 500%-700% higher than a conventional AFOV scanner.Significance. Our results have relevance to the development of long AFOV PET, where reduced cost of these alternative designs can provide wider accessibility for use in situations requiring imaging of multiple organs simultaneously.

Performance evaluation of the PennPET explorer with expanded axial coverage.

Objective.This work evaluated the updated PennPET Explorer total-body (TB) PET scanner, which was extended to 6 rings with updated readout firmware to achieve a 142 cm axial field of view (AFOV) without 7.6 cm inter-ring axial gaps.Approach.National Electrical Manufacturers Association (NEMA) NU 2-2018 measurements were performed with modifications including longer phantoms for sensitivity and count-rate measurements and additional positions for spatial resolution and image quality. A long uniform phantom and the clinical trials network (CTN) phantom were also used.Main results.The total sensitivity increased to 140 kcps MBq-1for a 70 cm line, a gain of 1.8x compared to the same system with axial gaps; an additional 47% increase in total counts was observed with a 142 cm line at the same activity per cm. The noise equivalent count rate (NECR) increased by 1.8x without axial gaps. The peak NECR is 1550 kcps at 25 kBq cc-1for a 140 cm phantom; due to increased randoms, the NECR is lower than with a 70 cm phantom, for which NECR is 2156 kcps cc-1at 25 kBq cc-1and continues increasing. The time-of-flight resolution is 250 ps, increasing by <10 ps at the highest activity. The axial spatial resolution degrades by 0.6 mm near the center of the AFOV, compared to 4 mm resolution near the end. The NEMA image quality phantom showed consistent contrast recovery throughout the AFOV. A long uniform phantom demonstrated axial uniformity of uptake and noise, and the CTN phantom demonstrated quantitative accuracy for both18F and89Zr.Significance. The performance evaluation of the updated PennPET Explorer demonstrates significant gains compared to conventional scanners and shows where the current NEMA standard needs to be updated for TB-PET systems. The comparisons of systems with and without inter-ring gaps demonstrate the performance trade-offs of a more cost-effective TB-PET system with incomplete detector coverage.

Performance Characteristics of Long Axial Field-of-View PET Scanners with Axial Gaps.

The introduction of long (>60 cm) axial field-of-view (LAFOV) PET systems has shown their potential for clinical and research applications. LAFOV scanners are expensive, so there is interest in designing systems with longer axial coverage while mitigating cost by introducing detector gaps. We used measurements on the PennPET Explorer (64-cm AFOV prototype) and simulations of scanners up to 143-cm long to assess scanner performance with axial gaps introduced by varying the number of detector rows in each ring. Removing detectors reduces the total sensitivity and results in a non-uniform axial noise profile. Axial resolution shows small (<0.5 mm) loss from the edge of the AFOV to the center, even for a 143-cm AFOV scanner with an unrestricted acceptance angle. The presence of large axial gaps increases the variability in axial resolution and contrast recovery across the AFOV compared to a system without gaps. More modest axial gaps show less variable behavior. The results suggest that designs where the gap is no larger than one-half of the width of a detector ring may be preferred, although the optimal choice of scanner design with the trade-offs of performance and AFOV will depend on its intended usage.

PennPET Explorer: Design and Preliminary Performance of a Whole-Body Imager.

We report on the development of the PennPET Explorer whole-body imager. Methods: The PennPET Explorer is a multiring system designed with a long axial field of view. The imager is scalable and comprises multiple 22.9-cm-long ring segments, each with 18 detector modules based on a commercial digital silicon photomultiplier. A prototype 3-segment imager has been completed and tested with an active 64-cm axial field of view. Results: The instrument design is described, and its physical performance measurements are presented. These include sensitivity of 55 kcps/MBq, spatial resolution of 4.0 mm, energy resolution of 12%, timing resolution of 256 ps, and a noise-equivalent count rate above 1,000 kcps beyond 30 kBq/mL. After an evaluation of lesion torso phantoms to characterize quantitative accuracy, human studies were performed on healthy volunteers. Conclusion: The physical performance measurements validated the system design and led to high-quality human studies.

Design and performance of a high spatial resolution, time-of-flight PET detector.

This paper describes the design and performance of a high spatial resolution PET detector with time-of-flight capabilities. With an emphasis on high spatial resolution and sensitivity, we initially evaluated the performance of several 1.5 × 1.5 and 2.0 × 2.0 mm2 and 12-15 mm long LYSO crystals read out by several appropriately sized PMTs. Experiments to evaluate the impact of reflector on detector performance were performed and the final detector consisted of a 32 × 32 array of 1.5 × 1.5 × 15 mm3 LYSO crystals packed with a diffuse reflector and read out by a single Hamamatsu 64 channel multi-anode PMT. Such a design made it compact, modular and offered a cost-effective solution to obtaining excellent energy and timing resolution. To minimize the number of readout signals, a compact front-end readout electronics that summed anode signals along each of the orthogonal directions was also developed. Experimental evaluation of detector performance demonstrates clear discrimination of the crystals within the detector. An average energy resolution (FWHM) of 12.7 ± 2.6% and average coincidence timing resolution (FWHM) of 348 ps was measured, demonstrating suitability for use in the development of a high spatial resolution time-of-flight scanner for dedicated breast PET imaging.

Design Optimization of a TOF, Breast PET Scanner.

A dedicated breast positron emission tomography (PET) scanner with limited angle geometry can provide flexibility in detector placement around the patient as well as the ability to combine it with other imaging modalities. A primary challenge of a stationary limited angle scanner is the reduced image quality due to artifacts present in the reconstructed image leading to a loss in quantitative information. Previously it has been shown that using time-of-flight (TOF) information in image reconstruction can help reduce these image artifacts arising due to missing angular projections. Our goal in this work is to optimize the TOF, breast scanner design by performing studies for estimating image uniformity and lesion activity uptake as a function of system timing resolution, scanner angular coverage and shape. Our results show that (i) 1.5 × 1.5 × 15 mm3 lutetium oxy-orthosilicate (LSO) crystals provide a high spatial resolution and system sensitivity relative to clinical scanners, (ii) 2/3 angular coverage scanner design with TOF timing resolution less than 600 ps is appropriate for providing a tomographic image with fewer artifacts and good lesion uptake estimation relative to other partial ring designs studied in this work, (iii) a flat scanner design with 2/3 angular coverage is affected more by larger parallax error than a curved scanner geometry with the same angular coverage, but provides more uniform lesion contrast estimate over the imaging field-of-view (FOV), (iv) 2/3 angular coverage, flat, 300 ps TOF scanner design (for short, practical scan times of ≤ 5 mins per breast) provides similar precision of contrast recovery coefficient (CRC) values to a full curved, non-TOF scanner, and (v) employing depth-of-interaction (DOI) measuring detector and/or implementing resolution modeling (RM) in image reconstruction lead to improved and more uniform spatial resolution and lesion contrast over the whole FOV.

Comparison of list-mode and DIRECT approaches for time-of-flight PET reconstruction.

Early clinical results with time-of-flight (TOF) positron emission tomography (PET) systems have demonstrated the advantages of TOF information in PET reconstruction. Reconstruction approaches in TOF-PET systems include list-mode and binned iterative algorithms as well as confidence-weighted analytic methods. List-mode iterative TOF reconstruction retains the resolutions of the data in the spatial and temporal domains without any binning approximations but is computationally intensive. We have developed an approach [DIRECT (direct image reconstruction for TOF)] to speed up TOF-PET reconstruction that takes advantage of the reduced angular sampling requirement of TOF data by grouping list-mode data into a small number of azimuthal views and co-polar tilts and depositing the grouped events into histo-images, arrays with the sampling and geometry of the final image. All physical effects are included in the system model and deposited in the same histo-image structure. Using histo-images allows efficient computation during reconstruction without ray-tracing or interpolation operations. The DIRECT approach was compared with 3-D list-mode TOF ordered subsets expectation maximization (OSEM) reconstruction for phantom and patient data taken on the University of Pennsylvania research LaBr (3) TOF-PET scanner. The total processing and reconstruction time for these studies with DIRECT without attention to code optimization is approximately 25%-30% that of list-mode TOF-OSEM to achieve comparable image quality. Furthermore, the reconstruction time for DIRECT is independent of the number of events and/or sizes of the spatial and TOF kernels, while the time for list-mode TOF-OSEM increases with more events or larger kernels. The DIRECT approach is able to reproduce the image quality of list-mode iterative TOF reconstruction both qualitatively and quantitatively in measured data with a reduced time.

Imaging studies for evaluating impact of position sampling techniques in PET scanners.

Previously we have evaluated two crystal calibration techniques that can be applied to pixelated detector designs to improve system spatial resolution without detector motion. The inter-crystal positioning technique utilizes sub-sampling in the crystal flood map to better sample the Compton scatter events in the detector. The Compton scatter rejection technique, on the other hand, rejects those events that are located further from individual crystal centers in the flood map. Here we performed imaging studies with a Mini Deluxe hot rod phantom and a hot sphere phantom (sphere diameters of 4.95 and 7.86-mm with 6:1 uptake relative to background) using the standard crystal calibration technique, as well as the inter-crystal and Compton rejection calibration techniques. Our results show improved separation of 1.6-mm diameter hot rods with the two new crystal calibration techniques that is consistent with improved spatial resolution. For the hot sphere phantom the contrast recovery is improved with both the inter-crystal and Compton rejection calibration techniques over the standard calibration technique. The only drawback of the inter-crystal calibration technique is the increase in the number of possible lines-of-response (LORs) (factor of 16) that may slow image reconstruction. With the Compton rejection calibration technique, loss of counts leads to increased noise in the images.

Improved spatial resolution in PET scanners using sampling techniques.

Increased focus towards improved detector spatial resolution in PET has led to the use of smaller crystals in some form of light sharing detector design. In this work we evaluate two sampling techniques that can be applied during calibrations for pixelated detector designs in order to improve the reconstructed spatial resolution. The inter-crystal positioning technique utilizes sub-sampling in the crystal flood map to better sample the Compton scatter events in the detector. The Compton scatter rejection technique, on the other hand, rejects those events that are located further from individual crystal centers in the flood map. We performed Monte Carlo simulations followed by measurements on two whole-body scanners for point source data. The simulations and measurements were performed for scanners using scintillators with Z(eff) ranging from 46.9 to 63 for LaBr(3) and LYSO, respectively. Our results show that near the center of the scanner, inter-crystal positioning technique leads to a gain of about 0.5-mm in reconstructed spatial resolution (FWHM) for both scanner designs. In a small animal LYSO scanner the resolution improves from 1.9-mm to 1.6-mm with the inter-crystal technique. The Compton scatter rejection technique shows higher gains in spatial resolution but at the cost of reduction in scanner sensitivity. The inter-crystal positioning technique represents a modest acquisition software modification for an improvement in spatial resolution, but at a cost of potentially longer data correction and reconstruction times. The Compton scatter rejection technique, while also requiring a modest acquisition software change with no increased data correction and reconstruction times, will be useful in applications where the scanner sensitivity is very high and larger improvements in spatial resolution are desirable.

Performance of Philips Gemini TF PET/CT scanner with special consideration for its time-of-flight imaging capabilities.

UNLABELLED: Results from a new PET/CT scanner using lutetium-yttrium oxyorthosilicate (LYSO) crystals for the PET component are presented. This scanner, which operates in a fully 3-dimensional mode, has a diameter of 90 cm and an axial field of view of 18 cm. It uses 4 x 4 x 22 mm(3) LYSO crystals arranged in a pixelated Anger-logic detector design. This scanner was designed to perform as a high-performance conventional PET scanner as well as provide good timing resolution to operate as a time-of-flight (TOF) PET scanner. METHODS: Performance measurements on the scanner were made using the National Electrical Manufacturers Association (NEMA) NU2-2001 procedures to benchmark its conventional imaging capabilities. The scatter fraction and noise equivalent count (NEC) measurements with the NEMA cylinder (20-cm diameter) were repeated for 2 larger cylinders (27-cm and 35-cm diameter), which better represent average and heavy patients. New measurements were designed to characterize its intrinsic timing resolution capability, which defines its TOF performance. Additional measurements to study the impact of pulse pileup at high counting rates on timing, as well as energy and spatial, resolution were also performed. Finally, to characterize the effect of TOF reconstruction on lesion contrast and noise, the standard NEMA/International Electrotechnical Commission torso phantom as well as a large 35-cm-diameter phantom with both hot and cold spheres were imaged for varying scan times. RESULTS: The transverse and axial resolution near the center is 4.8 mm. The absolute sensitivity of this scanner measured with a 70-cm-long line source is 6.6 cps/kBq, whereas scatter fraction is 27% measured with a 70-cm-long line source in a 20-cm-diameter cylinder. For the same line source cylinder, the peak NEC rate is measured to be 125 kcps at an activity concentration of 17.4 kBq/mL (0.47 microCi/mL). The 2 larger cylinders showed a decrease in the peak NEC due to increased attenuation, scatter, and random coincidences, and the peak occurs at lower activity concentrations. The system coincidence timing resolution was measured to be 585 ps. The timing resolution changes as a function of the singles rate due to pulse pileup and could impact TOF image reconstruction. Image-quality measurements with the torso phantom show that very high quality images can be obtained with short scan times (1-2 min per bed position). However, the benefit of TOF is more apparent with the large 35-cm-diameter phantom, where small spheres are detectable only with TOF information for short scan times. CONCLUSION: The Gemini TF whole-body scanner represents the first commercially available fully 3-dimensional PET scanner that achieves TOF capability as well as conventional imaging capabilities. The timing resolution is also stable over a long duration, indicating the practicality of this device. Excellent image quality is achieved for whole-body studies in 10-30 min, depending on patient size. The most significant improvement with TOF is seen for the heaviest patients.

Optimization of a fully 3D single scatter simulation algorithm for 3D PET.

We describe a new implementation of a single scatter simulation (SSS) algorithm for the prediction and correction of scatter in 3D PET. In this implementation, out of field of view (FoV) scatter and activity, side shields and oblique tilts are explicitly modelled. Comparison of SSS predictions with Monte Carlo simulations and experimental data from uniform, line and cold-bar phantoms showed that the code is accurate for uniform as well as asymmetric objects and can model different energy resolution crystals and low level discriminator (LLD) settings. Absolute quantitation studies show that for most applications, the code provides a better scatter estimate than the tail-fitting scatter correction method currently in use at our institution. Several parameters such as the density of scatter points, the number of scatter distribution sampling points and the axial extent of the FoV were optimized to minimize execution time, with particular emphasis on patient studies. Development and optimization were carried out in the case of GSO-based scanners, which enjoy relatively good energy resolution. SSS estimates for scanners with lower energy resolution may result in different agreement, especially because of a higher fraction of multiple scatter events. The algorithm was applied to a brain phantom as well as to clinical whole-body studies. It proved robust in the case of large patients, where the scatter fraction increases. The execution time, inclusive of interpolation, is typically under 5 min for a whole-body study (axial FoV: 81 cm) of a 100 kg patient.