Deconvolution of Tc-99m-Mercaptoacetyltriglycine Renograms with the Concomitant Use of a Sparse Legendre Polynomial Representation and the Moore-Penrose Pseudo-inverse.

OBJECTIVES: This study aimed to introduce an improved deconvolution technique for Tc-99m-mercaptoacetyltriglycine renograms based on the combination of a sparse Legendre polynomial representation and the Moore-Penrose inversion matrix (LG). This method reduces the effect of noise on the measurement of renal retention function transit time (TT). METHODS: The stability and accuracy of the proposed method were tested using a renal database containing Monte Carlo-simulated studies and real adult patient data. Two clinical parameters, namely, split function (SF) and mean TT (meanTT), obtained with LG were compared with values calculated with the established method that combines matrix deconvolution and a three-point linear smoothing (F121) as recommended by the 2008 International Scientific Committee of Radionuclides in Nephrourology consensus on renal TT measurements. RESULTS: For simulated data, the root mean square error (RMSE) between the theoretical non-noisy renal retention curve (RRC) and the results of the deconvolution methods applied to the noisy RRC were up to two times lower with LG (p<0.001). The RMSE of the reconvoluted renogram and the theoretical one was also lower for LG (p<0.001) and showed better preservation of the original signal. The SF was neither improved nor degraded by the proposed method. For patient data, no statistically significant difference was found between the SF for the LG method compared with the database values, and the meanTT better agreed with the physician's diagnosis than the matrix or clinical software (Hermes) outputs. A visual improvement of the RRC was also observed. CONCLUSION: By combining the sparse Legendre representation of the renogram curves and the Moore-Penrose matrix inverse techniques, we obtained improved noise reduction in the deconvoluted data, leading to better elimination of non-physiological signals -as negative values- and the avoidance of the smear effect of conventional smoothing on the vascular peak, which both influenced the meanTT measurement.

In vivo exploration of synaptic projections in frontotemporal dementia.

The purpose of this exploratory research is to provide data on synaptopathy in the behavioral variant of frontotemporal dementia (bvFTD). Twelve patients with probable bvFTD were compared to 12 control participants and 12 patients with Alzheimer's disease (AD). Loss of synaptic projections was assessed with [18F]UCBH-PET. Total distribution volume was obtained with Logan method using carotid artery derived input function. Neuroimages were analyzed with SPM12. Verbal fluency, episodic memory and awareness of cognitive impairment were equally impaired in patients groups. Compared to controls, [18F]UCBH uptake tended to decrease in the right anterior parahippocampal gyrus of bvFTD patients. Loss of synaptic projections was observed in the right hippocampus of AD participants, but there was no significant difference in [18F]UCBH brain uptake between patients groups. Anosognosia for clinical disorder was correlated with synaptic density in the caudate nucleus and the anteromedial prefrontal cortex. This study suggests that synaptopathy in bvFTD targets the temporal social brain and self-referential processes.

A parametric study of occupational radiation dose in interventional radiology by Monte-Carlo simulations.

This paper presents the results of a parametric study on the occupational exposure in interventional radiology to explore the influence of various variables on the staff doses. These variables include the angiography beam settings: x-ray peak voltage (kVp), added copper filtration, field diameter, beam projection and source to detector distance. The study was performed using Monte-Carlo simulations with MCNPX for more than 5600 combinations of parameters that account for different clinical situations. Additionally, the analysis of the results was performed using both multiple and random forest regression to build a predictive model and to quantify the importance of each variable when the variables simultaneously change. Primary and secondary projections were found to have the most effect on the scatter fraction that reaches the operator followed by the effect of changing the x-ray beam quality. The effect of changing the source to image intensifier distance had the lowest effect.

Legendre Polynomials: A Fully Automatic Method for Noise Reduction in 99mTc-Mercaptoacetyltriglycine Renogram Analysis.

Our purpose was to develop a fully automatic method to deal with the presence of high levels of noise interfering with quantitative analysis of fast, dynamic mercaptoacetyltriglycine renogram images. Methods: A method based on Legendre polynomials to fit and filter time-activity curves was proposed. The method was applied to a renal database that contains Monte Carlo (MC)-simulated studies and real adult patient data. Clinically relevant parameters such as relative function, time to maximum uptake (Tmax), and half-emptying time (T1/2) were obtained with the proposed method, the 1-2-1 filter (F121) method recommended in the 2018 guidelines of the European Association of Nuclear Medicine, and a state-of-the-art commercial software program (Hermes) currently used in routine nuclear medicine. Results: The root mean squared error between reference time-activity curves and the same curves with Poisson noise added was about 2 times lower for the Legendre method than for F121. The left relative function for MC and patient data was statistically equivalent for Hermes, Legendre, and F121 (P < 0.001). For MC studies, the Legendre technique performed better that the Hermes method regarding the known values of Tmax (P < 0.05), and the T1/2 determination was significantly improved (P < 0.05). For patient data, the Legendre and F121 methods were less influenced by noise in the data than the Hermes method, particularly for T1/2. Conclusion: In dynamic nuclear medicine imaging, Legendre polynomials appear to be a promising, fully automatic noise-removal tool that is routinely applicable, accurate, and robust.

Exploring with [18F]UCB-H the in vivo Variations in SV2A Expression through the Kainic Acid Rat Model of Temporal Lobe Epilepsy.

PURPOSE: The main purpose of this study was to understand how the positron emission tomography (PET) measure of the synaptic vesicle 2A (SV2A) protein varies in vivo during the development of temporal lobe epilepsy (TLE) in the kainic acid rat model. PROCEDURES: Twenty Sprague Dawley male rats were administered with multiple systemic doses of saline (control group, n = 5) or kainic acid (5 mg/kg/injection, epileptic group, n = 15). Both groups were scanned at the four phases of TLE (early, latent, transition, and chronic phase) with the [18F]UCB-H PET radiotracer and T2-structural magnetic resonance imaging. At the end of the scans (3 months post-status epilepticus), rats were monitored for 7 days with electroencephalography for the detection of spontaneous electrographic seizures. Finally, the immunofluorescence staining for SV2A expression was performed. RESULTS: Control rats presented a significant increase in [18F]UCB-H binding at the last two scans, compared with the first ones (p < 0.001). This increase existed but was lower in epileptic animals, producing significant group differences in all the phases of the disease (p < 0.028). Furthermore, the quantification of the SV2A expression in vivo with the [18F]UCB-H radiotracer or ex vivo with immunofluorescence led to equivalent results, with a positive correlation between both. CONCLUSIONS: Even if further studies in humans are required, the ability to detect a progressive decrease in SV2A expression during the development of temporal lobe epilepsy supports the use of [18F]UCB-H as a useful tool to differentiate, in vivo, between healthy and epileptic animals along with the development of the epileptic disease.

In vivo imaging of synaptic loss in Alzheimer's disease with [18F]UCB-H positron emission tomography.

PURPOSE: Loss of brain synapses is an early pathological feature of Alzheimer's disease. The current study assessed synaptic loss in vivo with positron emission tomography and an 18F-labelled radiotracer of the synaptic vesicle protein 2A, [18F]UCB-H. METHODS: Twenty-four patients with mild cognitive impairment or Alzheimer's disease and positive [18F]Flutemetamol amyloid-PET were compared to 19 healthy controls. [18F]UCB-H brain uptake was quantified with Logan graphical analysis using an image-derived blood input function. SPM12 and regions-of-interest (ROI) analyses were used for group comparisons of regional brain distribution volumes and for correlation with cognitive measures. RESULTS: A significant decrease of [18F]UCB-H uptake was observed in several cortical areas (11 to 18% difference) and in the thalamus (16% difference), with the largest effect size in the hippocampus (31% difference). Reduced hippocampal uptake was related to patients' cognitive decline (ROI analysis) and unawareness of memory problems (SPM and ROI analyses). CONCLUSIONS: The findings thus highlight predominant synaptic loss in the hippocampus, confirming previous autopsy-based studies and a recent PET study with an 11C-labelled SV2A radiotracer. [18F]UCB-H PET allows to image in vivo synaptic changes in Alzheimer's disease and to relate them to patients' cognitive impairment.

Evaluating the In Vivo Specificity of [18F]UCB-H for the SV2A Protein, Compared with SV2B and SV2C in Rats Using microPET.

The synaptic vesicle protein 2 (SV2) is involved in synaptic vesicle trafficking. The SV2A isoform is the most studied and its implication in epilepsy therapy led to the development of the first SV2A PET radiotracer [18F]UCB-H. The objective of this study was to evaluate in vivo, using microPET in rats, the specificity of [18F]UCB-H for SV2 isoform A in comparison with the other two isoforms (B and C) through a blocking assay. Twenty Sprague Dawley rats were pre-treated either with the vehicle, or with specific competitors against SV2A (levetiracetam), SV2B (UCB5203) and SV2C (UCB0949). The distribution volume (Vt, Logan plot, t* 15 min) was obtained with a population-based input function. The Vt analysis for the entire brain showed statistically significant differences between the levetiracetam group and the other groups (p < 0.001), but also between the vehicle and the SV2B group (p < 0.05). An in-depth Vt analysis conducted for eight relevant brain structures confirmed the statistically significant differences between the levetiracetam group and the other groups (p < 0.001) and highlighted the superior and the inferior colliculi along with the cortex as regions also displaying statistically significant differences between the vehicle and SV2B groups (p < 0.05). These results emphasize the in vivo specificity of [18F]UCB-H for SV2A against SV2B and SV2C, confirming that [18F]UCB-H is a suitable radiotracer for in vivo imaging of the SV2A proteins with PET.

Quantification of [18F]UCB-H Binding in the Rat Brain: From Kinetic Modelling to Standardised Uptake Value.

PURPOSE: [18F]UCB-H is a specific positron emission tomography (PET) biomarker for the Synaptic Vesicle protein 2A (SV2A), the binding site of the antiepileptic drug levetiracetam. With a view to optimising acquisition time and simplifying data analysis with this radiotracer, we compared two parameters: the distribution volume (Vt) obtained from Logan graphical analysis using a Population-Based Input Function, and the Standardised Uptake Value (SUV). PROCEDURES: Twelve Sprague Dawley male rats, pre-treated with three different doses of levetiracetam were employed to develop the methodology. Three additional kainic acid (KA) treated rats (temporal lobe epilepsy model) were also used to test the procedure. Image analyses focused on: (i) length of the dynamic acquisition (90 versus 60 min); (ii) correlations between Vt and SUV over 20-min consecutive time-frames; (iii) and (iv) evaluation of differences between groups using the Vt and the SUV; and (v) preliminary evaluation of the methodology in the KA epilepsy model. RESULTS: A large correlation between the Vt issued from 60 to 90-min acquisitions was observed. Further analyses highlighted a large correlation (r > 0.8) between the Vt and the SUV. Equivalent differences between groups were detected for both parameters, especially in the 20-40 and 40-60-min time-frames. The same results were also obtained with the epilepsy model. CONCLUSIONS: Our results enable the acquisition setting to be changed from a 90-min dynamic to a 20-min static PET acquisition. According to a better image quality, the 20-40-min time-frame appears optimal. Due to its equivalence to the Vt, the SUV parameter can be considered in order to quantify [18F]UCB-H uptake in the rat brain. This work, therefore, establishes a starting point for the simplification of SV2A in vivo quantification with [18F]UCB-H, and represents a step forward to the clinical application of this PET radiotracer.

Measuring brain synaptic vesicle protein 2A with positron emission tomography and [18F]UCB-H.

INTRODUCTION: Brain distribution of synaptic vesicle protein 2A was measured with fluorine-18 UCB-H ([18F]UCB-H) and positron emission tomography (PET). METHODS: Images of synaptic density were acquired in healthy volunteers (two young participants and two seniors). Input function was measured by arterial blood sampling (arterial input function) and derived from PET images using carotid activity (image-derived input function). Logan graphical analysis was used to estimate regional synaptic vesicle protein 2A distribution volume. RESULTS: [18F]UCB-H uptake was ubiquitous in cortical and subcortical gray matter. Arterial input function and image-derived input function provided regional distribution volume with a high linear relationship. DISCUSSION: The cerebral distribution of [18F]UCB-H is similar to that recently observed with carbon-11 UCB-J ([11C]UCB-J). An accurate [18F]UCB-H quantification can be performed without invasive arterial blood sampling when no suitable reference region is available, using dynamic PET carotid activity. Brain synaptic density can be studied in vivo in normal and pathological aging.

Monte Carlo simulations of the dose from imaging with GE eXplore 120 micro-CT using GATE.

PURPOSE: Small animals are increasingly used as translational models in preclinical imaging studies involving microCT, during which the subjects can be exposed to large amounts of radiation. While the radiation levels are generally sublethal, studies have shown that low-level radiation can change physiological parameters in mice. In order to rule out any influence of radiation on the outcome of such experiments, or resulting deterministic effects in the subjects, the levels of radiation involved need to be addressed. The aim of this study was to investigate the radiation dose delivered by the GE eXplore 120 microCT non-invasively using Monte Carlo simulations in GATE and to compare results to previously obtained experimental values. METHODS: Tungsten X-ray spectra were simulated at 70, 80, and 97 kVp using an analytical tool and their half-value layers were simulated for spectra validation against experimentally measured values of the physical X-ray tube. A Monte Carlo model of the microCT system was set up and four protocols that are regularly applied to live animal scanning were implemented. The computed tomography dose index (CTDI) inside a PMMA phantom was derived and multiple field of view acquisitions were simulated using the PMMA phantom, a representative mouse and rat. RESULTS: Simulated half-value layers agreed with experimentally obtained results within a 7% error window. The CTDI ranged from 20 to 56 mGy and closely matched experimental values. Derived organ doses in mice reached 459 mGy in bones and up to 200 mGy in soft tissue organs using the highest energy protocol. Dose levels in rats were lower due to the increased mass of the animal compared to mice. The uncertainty of all dose simulations was below 14%. CONCLUSIONS: Monte Carlo simulations proved a valuable tool to investigate the 3D dose distribution in animals from microCT. Small animals, especially mice (due to their small volume), receive large amounts of radiation from the GE eXplore 120 microCT, which might alter physiological parameters in a longitudinal study setup.

Evaluation of 18F-UCB-H as a novel PET tracer for synaptic vesicle protein 2A in the brain.

UNLABELLED: Synaptic vesicle protein 2 isoforms are critical for proper nervous system function and are involved in vesicle trafficking. The synaptic vesicle protein 2A (SV2A) isoform has been identified as the binding site of the antiepileptic levetiracetam (LEV), making it an interesting therapeutic target for epilepsy. (18)F-UCB-H is a novel PET imaging agent with a nanomolar affinity for human SV2A. METHODS: Preclinical PET studies were performed with isoflurane-anesthetized rats. The arterial input function was measured with an arteriovenous shunt and a ß-microprobe system. (18)F-UCB-H was injected intravenously (bolus of 140 ± 20 MBq). RESULTS: Brain uptake of (18)F-UCB-H was high, matching the expected homogeneous distribution of SV2A. The distribution volume (Vt) for (18)F-UCB-H was calculated with Logan graphic analysis, and the effect of LEV pretreatment on Vt was measured. In control animals the whole-brain Vt was 9.76 ± 0.52 mL/cm(3) (mean ± SD; n = 4; test-retest), and the reproducibility in test-retest studies was 10.4% ± 6.5% (mean ± SD). The uptake of (18)F-UCB-H was dose dependently blocked by pretreatment with LEV (0.1-100 mg/kg intravenously). CONCLUSION: Our results indicated that (18)F-UCB-H is a suitable radiotracer for the imaging of SV2A in vivo. To our knowledge, this is the first PET tracer for the in vivo quantification of SV2A. The necessary steps for the implementation of (18)F-UCB-H production under good manufacturing practice conditions and the first human studies are being planned.

In vivo PET/CT in a human glioblastoma chicken chorioallantoic membrane model: a new tool for oncology and radiotracer development.

UNLABELLED: For many years the laboratory mouse has been used as the standard model for in vivo oncology research, particularly in the development of novel PET tracers, but the growth of tumors on chicken chorioallantoic membrane (CAM) provides a more rapid, low cost, and ethically sustainable alternative. For the first time, to our knowledge, we demonstrate the feasibility of in vivo PET and CT imaging in a U87 glioblastoma tumor model on chicken CAM, with the aim of applying this model for screening of novel PET tracers. METHODS: U87 glioblastoma cells were implanted on the CAM at day 11 after fertilization and imaged at day 18. A small-animal imaging cell was used to maintain incubation and allow anesthesia using isoflurane. Radiotracers were injected directly into the exposed CAM vasculature. Sodium (18)F-fluoride was used to validate the imaging protocol, demonstrating that image-degrading motion can be removed with anesthesia. Tumor glucose metabolism was imaged using (18)F-FDG, and tumor protein synthesis was imaged using 2-(18)F-fluoro-l-tyrosine. Anatomic images were obtained by contrast-enhanced CT, facilitating clear delineation of the tumor, delineation of tracer uptake in tumor versus embryo, and accurate volume measurements. RESULTS: PET imaging of tumor glucose metabolism and protein synthesis was successfully demonstrated in the CAM U87 glioblastoma model. Catheterization of CAM blood vessels facilitated dynamic imaging of glucose metabolism with (18)F-FDG and demonstrated the ability to study PET tracer uptake over time in individual tumors, and CT imaging improved the accuracy of tumor volume measurements. CONCLUSION: We describe the novel application of PET/CT in the CAM tumor model, with optimization of typical imaging protocols. PET imaging in this valuable tumor model could prove particularly useful for rapid, high-throughput screening of novel radiotracers.

Preclinical radiation dosimetry for the novel SV2A radiotracer [18F]UCB-H.

BACKGROUND: [18F]UCB-H was developed as a novel radiotracer with a high affinity for synaptic vesicle protein 2A, the binding site for the antiepileptic levetiracetam. The objectives of this study were to evaluate the radiation dosimetry of [18F]UCB-H in a preclinical trial and to determine the maximum injectable dose according to guidelines for human biomedical research. The radiation dosimetry was derived by organ harvesting and dynamic micro positron emission tomography (PET) imaging in mice, and the results of both methods were compared. METHODS: Twenty-four male C57BL-6 mice were injected with 6.96 ± 0.81 MBq of [18F]UCB-H, and the biodistribution was determined by organ harvesting at 2, 5, 10, 30, 60, and 120 min (n = 4 for each time point). Dynamic microPET imaging was performed on five male C57BL-6 mice after the injection of 9.19 ± 3.40 MBq of [18F]UCB-H. A theoretical dynamic bladder model was applied to simulate urinary excretion. Human radiation dose estimates were derived from animal data using the International Commission on Radiological Protection 103 tissue weighting factors. RESULTS: Based on organ harvesting, the urinary bladder wall, liver and brain received the highest radiation dose with a resulting effective dose of 1.88E-02 mSv/MBq. Based on dynamic imaging an effective dose of 1.86E-02 mSv/MBq was calculated, with the urinary bladder wall and liver (brain was not in the imaging field of view) receiving the highest radiation. CONCLUSIONS: This first preclinical dosimetry study of [18F]UCB-H showed that the tracer meets the standard criteria for radiation exposure in clinical studies. The dose-limiting organ based on US Food and Drug Administration (FDA) and European guidelines was the urinary bladder wall for FDA and the effective dose for Europe with a maximum injectable single dose of approximately 325 MBq was calculated. Although microPET imaging showed significant deviations from organ harvesting, the Pearson's correlation coefficient between radiation dosimetry derived by either method was 0.9666.

Quantitative capabilities of four state-of-the-art SPECT-CT cameras.

BACKGROUND: Four state-of-the-art single-photon emission computed tomography-computed tomography (SPECT-CT) systems, namely Philips Brightview, General Electric Discovery NM/CT 670 and Infinia Hawkeye 4, and Siemens Symbia T6, were investigated in terms of accuracy of attenuation and scatter correction, contrast recovery for small hot and cold structures, and quantitative capabilities when using their dedicated three-dimensional iterative reconstruction with attenuation and scatter corrections and resolution recovery. METHODS: The National Electrical Manufacturers Association (NEMA) NU-2 1994 phantom with cold air, water, and Teflon inserts, and a homemade contrast phantom with hot and cold rods were filled with 99mTc and scanned. The acquisition parameters were chosen to provide adequate linear and angular sampling and high count statistics. The data were reconstructed using Philips Astonish, General Electric Evolution for Bone, or Siemens Flash3D, eight subsets, and a varying number of iterations. A procedure similar to the one used in positron emission tomography (PET) allowed us to obtain the factor to convert counts per pixel into activity per unit volume. RESULTS: Edge and oscillation artifacts were observed with all phantoms and all systems. At 30 iterations, the residual fraction in the inserts of the NEMA phantom fell below 3.5%. Contrast recovery increased with the number of iterations but became almost saturated at 24 iterations onwards. In the uniform part of the NEMA and contrast phantoms, a quantification error below 10% was achieved. CONCLUSIONS: In objects whose dimensions exceeded the SPECT spatial resolution by several times, quantification seemed to be feasible within 10% error limits. A partial volume effect correction strategy remains necessary for the smallest structures. The reconstruction artifacts nevertheless remain a handicap on the road towards accurate quantification in SPECT and should be the focus of further works in reconstruction tomography.

Use of a beta microprobe system to measure arterial input function in PET via an arteriovenous shunt in rats.

BACKGROUND: Kinetic modeling of physiological function using imaging techniques requires the accurate measurement of the time-activity curve of the tracer in plasma, known as the arterial input function (IF). The measurement of IF can be achieved through manual blood sampling, the use of small counting systems such as beta microprobes, or by derivation from PET images. Previous studies using beta microprobe systems to continuously measure IF have suffered from high background counts. METHODS: In the present study, a light-insensitive beta microprobe with a temporal resolution of up to 1 s was used in combination with a pump-driven femoral arteriovenous shunt to measure IF in rats. The shunt apparatus was designed such that the placement of the beta microprobe was highly reproducible. The probe-derived IF was compared to that obtained from manual sampling at 5-s intervals and IF derived from a left ventricle VOI in a dynamic PET image of the heart. RESULTS: Probe-derived IFs were very well matched to that obtained by "gold standard" manual blood sampling, but with an increased temporal resolution of up to 1 s. The area under the curve (AUC) ratio between probe- and manually derived IFs was 1.07 ± 0.05 with a coefficient of variation of 0.04. However, image-derived IFs were significantly underestimated compared to the manually sampled IFs, with an AUC ratio of 0.76 ± 0.24 with a coefficient of variation of 0.32. CONCLUSIONS: IF derived from the beta microprobe accurately represented the IF as measured by blood sampling, was reproducible, and was more accurate than an image-derived technique. The use of the shunt removed problems of tissue-background activity, and the use of a light-tight probe with minimal gamma sensitivity refined the system. The probe/shunt apparatus can be used in both microprobe and PET studies.

Hot and cold contrasts in high-resolution Tc-99m planar scintigraphy: a survey of fifty-two camera heads using the PICKER thyroid phantom.

This study was aimed at comparing the sensitivity and hot and cold contrasts obtained when imaging the PICKER thyroid phantom using gamma cameras fitted with either their ultra-high or high-resolution low-energy parallel hole collimator. Seventeen camera models from Elscint, General Electric, Siemens and Sopha Medical Vision were involved in the study for a total of 30 cameras and 52 camera heads. A single operator conducted the study in order to minimize the impact of human factors. The phantom contained about 74MBq (99m)Tc and was imaged at 10cm from the collimator face with the energy window that are recommended by the camera manufacturer. A total of 1 million counts were accumulated. Hot and cold contrasts were in mean of about 0.05 higher when using an ultra-high-resolution than when using a high-resolution low-energy collimator. This higher contrast was obtained at the expense of a mean reduction in sensitivity of 30%. In particular, Elscint cameras demonstrated a 30% lower sensitivity whatever the collimator type. The Sopha Medical Vision DST and DSX cameras and the General Electric Magicam camera offered the lowest contrasts among the cameras with a high-resolution collimator. Although this was accompanied by a higher than the mean sensitivity for the DST and DSX, the Magicam demonstrated sensitivity roughly identical to the mean of all the cameras with a high-resolution collimator.

Comparison of different types of commercial filtered backprojection and ordered-subset expectation maximization SPECT reconstruction software.

UNLABELLED: The aim of this study was to compare the performance of filtered backprojection (FBP) and ordered-subset expectation maximization (OSEM) reconstruction algorithms available in several types of commercial SPECT software. METHODS: Numeric simulations of SPECT acquisitions of 2 phantoms were used: the National Electrical Manufacturers Association line phantom used for the assessment of SPECT resolution and a phantom with uniform, hot-rod, and cold-rod compartments. For FBP, no filtering and filtering of the projections with either a Butterworth filter (order 3 or 6) or a Hanning filter at various cutoff frequencies were considered. For OSEM, the number of subsets was 1, 4, 8, or 16, and the number of iterations was chosen to obtain a product number of iterations times the number of subsets equal to 16, 32, 48, or 64. The line phantom enabled us to obtain the reconstructed central, radial, and tangential full width at half maximum. The uniform compartment of the second phantom delivered the reconstructed mean pixel counts and SDs from which the coefficients of variation were calculated. Hot contrast and cold contrast were obtained from its rod compartments. RESULTS: For FBP, the full width at half maximum, mean pixel count, coefficient of variation, and contrast were almost software independent. The only exceptions were a smaller (by 0.5 mm) full width at half maximum for one of the software types, higher mean pixel counts for 2 of the software types, and better contrast for 2 of the software types under some filtering conditions. For OSEM, the full width at half maximum differed by 0.1-2.5 mm with the different types of software but was almost independent of the number of subsets or iterations. There was a marked dependence of the mean pixel count on the type of software used, and there was a moderate dependence of the coefficient of variation. Contrast was almost software independent. The mean pixel count varied greatly with the number of iterations for 2 of the software types, and the coefficient of variation increased with the number of iterations for all types of software. The mean pixel count, coefficient of variation, and contrast were almost constant for a fixed product number of iterations times the number of subsets, whatever the number of subsets or iterations. CONCLUSION: Most of the types of software were equivalent for FBP or OSEM reconstruction. However, a few differences were observed with some types of software and should be considered when they are used.

NEMA NU4-2008 image quality performance report for the microPET focus 120 and for various transmission and reconstruction methods.

UNLABELLED: This work aimed to evaluate the image quality and accuracy of attenuation and scatter corrections provided with the microPET Focus 120 scanner using the National Electrical Manufacturers Association NU4-2008 image quality phantom. METHODS: Attenuation correction was obtained from transmission measurements using either a (68)Ge or a (57)Co point source. Fully corrected emission images were reconstructed using Fourier rebinning (FORE) and filtered backprojection (FBP). For attenuation data obtained with the (57)Co source, fully corrected emission images were also reconstructed using FORE and 2-dimensional (2D) ordered-subset expectation maximization (OSEM), 3-dimensional (3D) filtered backprojection (3DRP), 3D OSEM, and 3D maximum a posteriori methods. The mean activity, the coefficients of variation (COVs) of the uniform slices, the recovery coefficients (RCs) for hot rods, and the spillover ratio (SOR) for nonemitting water and air compartments were measured. RESULTS: For (57)Co-based attenuation correction, the mean activity value differed by less than 3% from the true activity. Measuring the attenuation with (68)Ge resulted in lower reconstructed activity and higher COV. On the basis of (57)Co measurements, the SORs for air and water nonemitting compartments were the closest to zero for attenuation correction. The RC measured on emission images corrected for attenuation but not for scatter did not show any significant difference linked to the transmission method. However, higher RCs were noted for transmission measurement with (68)Ge in coincidence with windowing when emission data were corrected for attenuation and scatter. This resulted from a lower mean value in the uniform area. 2D and 3DRP reconstruction methods showed little effect on the mean activity value, whereas iterative 3D methods gave 7% higher values. Higher RCs were found with iterative reconstruction than with FBP and 3DRP. However, the SOR seemed to be optimal with FBP. SORs were higher with iterative methods and decreased with the number of iterations. CONCLUSION: For studies of small rodents with the Focus 120, (57)Co transmission seems to be the most suitable method for attenuation correction. FORE and 2D reconstruction methods appear to be a good compromise between overall image quality and reconstruction time: OSEM provides the largest contrasts, but FBP provides superior attenuation and scatter correction.

99mTc-MIBI pinhole SPECT in primary hyperparathyroidism: comparison with conventional SPECT, planar scintigraphy and ultrasonography.

PURPOSE: A pinhole collimator is routinely used to increase the resolution of scintigraphy. This prospective study was conducted to determine the interest of (99m)Tc-MIBI pinhole single-photon emission computed tomography (SPECT) for the preoperative localisation of parathyroid lesions in primary hyperparathyroidism. METHODS: All patients underwent a neck ultrasonography (US), (99m)TcO4- and (99m)Tc-MIBI planar images and two consecutive SPECT with a parallel (C-SPECT) and a pinhole collimator (P-SPECT). P-SPECT was performed with a tilted detector equipped with a pinhole collimator and reconstructed with a dedicated OSEM algorithm. A diagnostic confidence score (CS) was assigned to each procedure considering intensity and extra-thyroidal location of suspected lesions: 0 = negative, 1 = doubtful, 2 = moderately positive, 3 = positive. The results of these preoperative localisation studies were compared with surgical, pathological and 6-month biological findings. RESULTS: Fifty-one patients cured after surgery were included. Surgery revealed 55 lesions (median weight 0.5 g, 11 in ectopy). Sensitivities of US, planar imaging, C-SPECT and P-SPECT were, respectively, 51, 76, 82 and 87%. Nine glands were only detected by tomography and five glands only by P-SPECT. 99mTc-MIBI/99mTcO4- planar scans and P-SPECT were complementary and, when combined together, showed the highest sensitivity (93%). Compared with planar imaging and C-SPECT, P-SPECT increased CS for 42 and 53% of lesions, respectively, and contributed to markedly reduce the number of uncertain results. CONCLUSIONS: A combination of planar 99mTc-MIBI/99mTcO4- scintigraphy and P-SPECT appears to be a highly accurate preoperative imaging procedure in primary hyperparathyroidism.