Effectiveness of Detailed Operating Room Quality Care on the Quality of Operating Room Care and Patient Satisfaction.

Objective: The current study was performed to assess the effectiveness of detailed operating room quality care on the quality of operating room care and patient satisfaction. Methods: A total of 102 patients who underwent surgery in Union Hospital, Tongji Medical College, Huazhong University of Science and Technology between October 2020 and April 2022 were recruited and assigned to receive either conventional operating room care (conventional group) or detailed operating room quality care (quality group), with 51 cases in each group. Outcome measures for the evaluation of the detailed quality care included quality of operating room care, safe operation, incidence of errors in instrument preparation, loss of parts, incidence of intraoperative adverse reactions, and patient satisfaction. Results: Patients who received quality care showed higher scores for information acquisition ability, communication ability, standardization of nursing process, and professionalism of nursing service than those who received conventional care (P = .021, .032, .003, .043). Detailed operating room quality care resulted in significantly higher standardization of anesthesia disinfection, promptness of instrument preparation, instrument and equipment management, effectiveness of auxiliary cooperation, and standardization of medical records scores versus conventional care (P = .004, .022, .036, .004, .002). Detailed operating room quality care was associated with a lower incidence of instrument preparation errors, lost parts, and intraoperative adverse reactions than conventional care (P < .05). Patients were more satisfied with quality care (49/51, 96.1%) than with conventional care (39/51, 76.5%) (P = .004). Conclusion: Detailed operating room quality care can significantly improve patient satisfaction, enhance the quality of operating room care and safe operation, and reduce the risk of instrument preparation errors, lost parts, and intraoperative complications in the operating room.

Ubiquitin ligase TRIM15 promotes the progression of pancreatic cancer via the upregulation of the IGF2BP2-TLR4 axis.

BACKGROUND: The tripartite motif family, predominantly characterized by its E3 ubiquitin ligase activities, is involved in various cellular processes including signal transduction, apoptosis and autophagy, protein quality control, immune regulation, and carcinogenesis. Tripartite Motif Containing 15 (TRIM15) plays an important role in melanoma progression through extracellular signal-regulated kinase activation; however, data on its role in pancreatic tumors remain lacking. We previously demonstrated that TRIM15 targeted lipid synthesis and metabolism in pancreatic cancer; however, other specific regulatory mechanisms remain elusive. METHODS: We used transcriptomics and proteomics, conducted a series of phenotypic experiments, and used a mouse orthotopic transplantation model to study the specific mechanism of TRIM15 in pancreatic cancer in vitro and in vivo. RESULTS: TRIM15 overexpression promoted the progression of pancreatic cancer by upregulating the toll-like receptor 4. The TRIM15 binding protein, IGF2BP2, could combine with TLR4 to inhibit its mRNA degradation. Furthermore, the ubiquitin level of IGF2BP2 was positively correlated with TRIM15. CONCLUSIONS: TRIM15 could ubiquitinate IGF2BP2 to enhance the function of phase separation and the maintenance of mRNA stability of TLR4. TRIM15 is a potential therapeutic target against pancreatic cancer.

N-Doped Porous Carbon-Nanofiber-Supported Fe3C/Fe2O3 Nanoparticles as Anode for High-Performance Supercapacitors.

Exploring anode materials with an excellent electrochemical performance is of great significance for supercapacitor applications. In this work, a N-doped-carbon-nanofiber (NCNF)-supported Fe3C/Fe2O3 nanoparticle (NCFCO) composite was synthesized via the facile carbonizing and subsequent annealing of electrospinning nanofibers containing an Fe source. In the hybrid structure, the porous carbon nanofibers used as a substrate could provide fast electron and ion transport for the Faradic reactions of Fe3C/Fe2O3 during charge-discharge cycling. The as-obtained NCFCO yields a high specific capacitance of 590.1 F g-1 at 2 A g-1, superior to that of NCNF-supported Fe3C nanoparticles (NCFC, 261.7 F g-1), and NCNFs/Fe2O3 (NCFO, 398.3 F g-1). The asymmetric supercapacitor, which was assembled using the NCFCO anode and activated carbon cathode, delivered a large energy density of 14.2 Wh kg-1 at 800 W kg-1. Additionally, it demonstrated an impressive capacitance retention of 96.7%, even after 10,000 cycles. The superior electrochemical performance can be ascribed to the synergistic contributions of NCNF and Fe3C/Fe2O3.

Overexpressed histone acetyltransferase 1 regulates cancer immunity by increasing programmed death-ligand 1 expression in pancreatic cancer.

BACKGROUND: Pancreatic ductal adenocarcinoma is one of the leading causes of cancer-related death worldwide. Immune checkpoint blockade therapy, including anti-PD-1 and anti-PD-L1, is a new therapeutic strategy for cancer treatment but the monotherapy with PD-L1 inhibitors for pancreatic cancer is almost ineffective for pancreatic cancer. Thus, exploring the regulatory mechanism of PD-L1 in cancer cells, especially in pancreatic cancer cells, is one of the key strategies to improving cancer patient response to PD-L1 blockade therapy. Histone acetyltransferase 1(HAT1) is a classic type B histone acetyltransferase and the biological role of HAT1 in pancreatic cancer is unclear. METHODS: The clinical relevance of HAT1 was examined by the GEPIA web tool, Western blotting and immunohistochemistry of pancreatic cancer tissue microarray slides. Tumor cell motility was investigated by MTS assay, colony formation assay and xenografts. The relationship between HAT1 and PD-L1 was examined by Western blot analysis, RT-qPCR and immunohistochemistry. RESULTS: HAT1 was upregulated in PDAC and associated with poor prognosis in PDAC patients. The knockdown of HAT1 decreased the proliferation of pancreatic cancer cells in vivo and in vitro. Strikingly, we showed that HAT1 transcriptionally regulated PD-L1, and this process was mainly mediated by BRD4 in pancreatic cancer. The knockdown of HAT1 improved the efficacy of immune checkpoint blockade by decreasing the PD-L1. CONCLUSIONS: The recognition of HAT1 in regulating tumor cell proliferation and cancer immunity indicated that HAT1 might be employed as a new diagnostic and prognostic marker and a predictive marker for pancreatic cancer therapy, especially in immune checkpoint blockade therapy. Targeting HAT1 highlights a novel therapeutic approach to overcome immune evasion by tumor cells.

Performance evaluation of a new high-sensitivity time-of-flight clinical PET/CT system.

BACKGROUND: PoleStar m660 is a newly developed clinical PET/CT system with time-of-flight (TOF) capability. The aim of this study is to characterize the performance of the new system. Spatial resolution, sensitivity, scatter fraction, and noise equivalent count rate (NECR) were measured on the scanner according to the NEMA NU 2-2012 protocol. The timing resolution was measured using a rotating line source that orbited around the center of field of view (CFOV) at a radius of 20 cm. The image quality phantom was also imaged to quantify the percent contrast, percent background variability, and residual error. The impacts of data acquisition time and bed overlap on the PET image quality were also evaluated using phantom and patient studies. RESULTS: The transverse (axial) spatial resolutions were 3.59 mm (3.67), 4.08 mm (4.65), and 5.32 mm (6.48) full width at half maximum (FWHM) at 1 cm, 10 cm, and 20 cm, respectively, off the CFOV. The measured sensitivity was 10.7 cps/kBq at the CFOV and 10.4 cps/kBq at 10 cm off the CFOV. The peak NECR was 216.7 kcps at an activity concentration of 29.1 kBq/ml, and the scatter fraction was 38.2%. An average of 435 ps FWHM timing resolution was measured. For the image quality phantom, the contrast recovery ratios ranged from 33.9 to 76.4%, while the background variability ranged from 4.7 to 2.0%. In the preliminary clinical study, no noticeable difference in the image quality was observed when the scan time for the whole body and brain was reduced to 1 min/bed and 3 min, respectively. The tested 21% bed overlap showed no significant difference in the image quality compared with the default 38% bed overlap setting. CONCLUSIONS: The physical performances of the PoleStar m660 PET/CT system showed good sensitivity, count rate performance, and timing resolution. The improved performance could help to reduce the acquisition time and bed overlap in the clinical application without detectable compromise in the image quality.

FBP1 loss contributes to BET inhibitors resistance by undermining c-Myc expression in pancreatic ductal adenocarcinoma.

BACKGROUND: Pancreatic ductal adenocarcinoma (PDAC) is one of the most lethal tumor types worldwide. BET inhibitors display anti-tumor activity in pancreatic cancer, however the cells often develop resistance after a long-term treatment and the underlying molecular basis is not fully understood. METHODS: Drug screening assay in Fructose-1, 6-biphosphatase (FBP1) knockdown or overexpressing pancreatic cancer cells was performed. Tumor cell motility, FBP1 protein and mRNA changes were investigated after BET inhibitors treatment. The interaction between TRIM28 and FBP1 after BET inhibitors treatment was examined by Co-immunoprecipitation (IP) and GST pull-down. The relationship between FBP1 and c-Myc was examined by western blot, RT-qPCR and immunohistochemistry (IHC). RESULTS: The expression of FBP1 protein increased the sensitivity of pancreatic cancer cells to JQ1. Furthermore, we showed that JQ1 stabilized FBP1 protein level by disrupting the interaction between FBP1 and TRIM28 in pancreatic cancer cells. Moreover, we demonstrated that FBP1 promoted c-Myc degradation through disrupting the ERK-c-Myc axis. CONCLUSIONS: FBP1 modulates the sensitivity of pancreatic cancer cells to BET inhibitors by decreasing the expression of c-Myc. These findings highlight FBP1 could be used as a therapeutic niche for patient-tailored therapies.

Design and research on reliability-validity for 3S intraoperative risk assessment scale of pressure sore.

The reliability and validity of risk assessment scale (RAS) of pressure sore during 3S surgery were investigated. RAS of pressure sore was designed independently during 3S surgery. Five operating room nursing experts were selected to consult and detect face validity. Convenient and purposive sampling of 707 samples was conducted. Cronbach's alpha was used to measure content reliability and evaluate the internal consistence of RAS. The structural reliability was investigated by exploratory factor analysis method. The results showed that the content validity index was 0.92, and Cronbach's alpha of content reliability was 0.71. Structural validity, detected by Bartlett sphericity test, was 135.3 for 707 samples with the difference being statistically significant (P<0.01). KMO value was 0.729. The accumulative variance contribution ratio of common factor was 64.63%. The exploratory factor analysis showed the factor load of every clause was larger than 0.596. It was concluded that RAS of pressure sore for 3S surgery has better validity and reliability, and it could be used for evaluating and screening the high risk patients with pressure sores during surgery in order to efficiently reduce the occurrence of pressure sore during surgery. RAS of pressure sore for 3S surgery is worth to be popularized.

Improving PET imaging for breast cancer using virtual pinhole PET half-ring insert.

A PET insert with detector having smaller crystals and placed near a region of interest in a conventional PET scanner can improve image resolution locally due to the virtual-pinhole PET (VP-PET) effect. This improvement is from the higher spatial sampling of the imaging area near the detector. We have built a prototype half-ring PET insert for head-and-neck cancer imaging applications. In this paper, we extend the use of the insert to breast imaging and show that such a system provides high resolution images of breast and axillary lymph nodes while maintaining the full imaging field of view capability of a clinical PET scanner. We characterize the resolution and contrast recovery for tumors across the imaging field of view. First, we model the system using Monte Carlo methods to determine its theoretical limit of improvement. Simulations were conducted with hot spherical tumors embedded in background activity at tumor-to-background contrast ranging from 3:1 to 12:1. Tumors are arranged in a Derenzo-like pattern with their diameters ranging from 2 to 12 mm. Experimental studies were performed using a chest phantom with cylindrical breast attachment. Tumors of different sizes arranged in a Derenzo-like pattern with tumor-to-background ratio of 6:1 are inserted into the breast phantom. Imaging capability of mediastinum and axillary lymph nodes is explored. Both Monte Carlo simulations and experiment show clear improvement in image resolution and contrast recovery with VP-PET half-ring insert. The degree of improvement in resolution and contrast recovery depends on location of the tumor. The full field of view imaging capability is shown to be maintained. Minor artifacts are introduced in certain regions.

3-D Spatial Resolution of 350 µm Pitch Pixelated CdZnTe Detectors for Imaging Applications.

We are currently investigating the feasibility of using highly pixelated Cadmium Zinc Telluride (CdZnTe) detectors for sub-500 µm resolution PET imaging applications. A 20 mm × 20 mm × 5 mm CdZnTe substrate was fabricated with 350 µm pitch pixels (250 µm anode pixels with 100 µm gap) and coplanar cathode. Charge sharing among the pixels of a 350 µm pitch detector was studied using collimated 122 keV and 511 keV gamma ray sources. For a 350 µm pitch CdZnTe detector, scatter plots of the charge signal of two neighboring pixels clearly show more charge sharing when the collimated beam hits the gap between adjacent pixels. Using collimated Co-57 and Ge-68 sources, we measured the count profiles and estimated the intrinsic spatial resolution of 350 µm pitch detector biased at -1000 V. Depth of interaction was analyzed based on two methods, i.e., cathode/anode ratio and electron drift time, in both 122 keV and 511 keV measurements. For single-pixel photopeak events, a linear correlation between cathode/anode ratio and electron drift time was shown, which would be useful for estimating the DOI information and preserving image resolution in CdZnTe PET imaging applications.

Investigation of the limitations of the highly pixilated CdZnTe detector for PET applications.

We are investigating the feasibility of a high resolution positron emission tomography (PET) insert device based on the CdZnTe detector with 350 µm anode pixel pitch to be integrated into a conventional animal PET scanner to improve its image resolution. In this paper, we have used a simplified version of the multi pixel CdZnTe planar detector, 5 mm thick with 9 anode pixels only. This simplified 9 anode pixel structure makes it possible to carry out experiments without a complete application-specific integrated circuits readout system that is still under development. Special attention was paid to the double pixel (or charge sharing) detections. The following characteristics were obtained in experiment: energy resolution full-width-at-half-maximum (FWHM) is 7% for single pixel and 9% for double pixel photoelectric detections of 511 keV gammas; timing resolution (FWHM) from the anode signals is 30 ns for single pixel and 35 ns for double pixel detections (for photoelectric interactions only the corresponding values are 20 and 25 ns); position resolution is 350 µm in x,y-plane and ∼0.4 mm in depth-of-interaction. The experimental measurements were accompanied by Monte Carlo (MC) simulations to find a limitation imposed by spatial charge distribution. Results from MC simulations suggest the limitation of the intrinsic spatial resolution of the CdZnTe detector for 511 keV photoelectric interactions is 170 µm. The interpixel interpolation cannot recover the resolution beyond the limit mentioned above for photoelectric interactions. However, it is possible to achieve higher spatial resolution using interpolation for Compton scattered events. Energy and timing resolution of the proposed 350 µm anode pixel pitch detector is no better than 0.6% FWHM at 511 keV, and 2 ns FWHM, respectively. These MC results should be used as a guide to understand the performance limits of the pixelated CdZnTe detector due to the underlying detection processes, with the understanding of the inherent limitations of MC methods.

Image reconstruction and system modeling techniques for virtual-pinhole PET insert systems.

Virtual-pinhole PET (VP-PET) imaging is a new technology in which one or more high-resolution detector modules are integrated into a conventional PET scanner with lower resolution detectors. It can locally enhance the spatial resolution and contrast recovery near the add-on detectors, and depending on the configuration, may also increase the sensitivity of the system. This novel scanner geometry makes the reconstruction problem more challenging compared to the reconstruction of data from a stand-alone PET scanner, as new techniques are needed to model and account for the non-standard acquisition. In this paper, we present a general framework for fully 3D modeling of an arbitrary VP-PET insert system. The model components are incorporated into a statistical reconstruction algorithm to estimate an image from the multi-resolution data. For validation, we apply the proposed model and reconstruction approach to one of our custom-built VP-PET systems-a half-ring insert device integrated into a clinical PET/CT scanner. Details regarding the most important implementation issues are provided. We show that the proposed data model is consistent with the measured data, and that our approach can lead to reconstructions with improved spatial resolution and lesion detectability.

A novel phoswich imaging detector for simultaneous beta and coincidence-gamma imaging of plant leaves.

To meet the growing demand for functional imaging technology for use in studying plant biology, we are developing a novel technique that permits simultaneous imaging of escaped positrons and coincidence gammas from annihilation of positrons within an intake leaf. The multi-modality imaging system will include two planar detectors: one is a typical PET detector array and the other is a phoswich imaging detector that detects both beta and gamma. The novel phoswich detector is made of a plastic scintillator, a lutetium oxyorthosilicate (LSO) array, and a position sensitive photomultiplier tube (PS-PMT). The plastic scintillator serves as a beta detector, while the LSO array serves as a gamma detector and light guide that couples scintillation light from the plastic detector to the PMT. In our prototype, the PMT signal was fed into the Siemens QuickSilver electronics to achieve shaping and waveform sampling. Pulse-shape discrimination based on the detectors' decay times (2.1 ns for plastic and 40 ns for LSO) was used to differentiate beta and gamma events using the common PMT signals. Using our prototype phoswich detector, we simultaneously measured a beta image and gamma events (in single mode). The beta image showed a resolution of 1.6 mm full-width-at-half-maximum using F-18 line sources. Because this shows promise for plant-scale imaging, our future plans include development of a fully functional simultaneous beta-and-coincidence-gamma imager with sub-millimeter resolution imaging capability for both modalities.

Parallel Beam Approximation for Calculation of Detection Efficiency of Crystals in PET Detector Arrays.

In this work we propose a parallel beam approximation for the computation of the detection efficiency of crystals in a PET detector array. In this approximation the detection efficiency of a crystal is estimated using the distance between source and the crystal and the pre-calculated detection cross section of the crystal in a crystal array which is calculated for a uniform parallel beam of gammas. The pre-calculated detection cross sections for a few representative incident angles and gamma energies can be used to create a look-up table to be used in simulation studies or practical implementation of scatter or random correction algorithms. Utilizing the symmetries of the square crystal array, the pre-calculated look-up tables can be relatively small. The detection cross sections can be measured experimentally, calculated analytically or simulated using a Monte Carlo (MC) approach. In this work we used a MC simulation that takes into account the energy windowing, Compton scattering and factors in the "block effect". The parallel beam approximation was validated by a separate MC simulation using point sources located at different positions around a crystal array. Experimentally measured detection efficiencies were compared with Monte Carlo simulated detection efficiencies. Results suggest that the parallel beam approximation provides an efficient and accurate way to compute the crystal detection efficiency, which can be used for estimation of random and scatter coincidences for PET data corrections.

A sub-millimeter resolution PET detector module using a multi-pixel photon counter array.

A PET block detector module using an array of sub-millimeter lutetium oxyorthosilicate (LSO) crystals read out by an array of surface-mount, semiconductor photosensors has been developed. The detector consists of a LSO array, a custom acrylic light guide, a 3 x 3 multi-pixel photon counter (MPPC) array (S10362-11-050P, Hamamatsu Photonics, Japan) and a readout board with a charge division resistor network. The LSO array consists of 100 crystals, each measuring 0.8 x 0.8 x 3 mm(3) and arranged in 0.86 mm pitches. A Monte Carlo simulation was used to aid the design and fabrication of a custom light guide to control distribution of scintillation light over the surface of the MPPC array. The output signals of the nine MPPC are multiplexed by a charge division resistor network to generate four position-encoded analog outputs. Flood image, energy resolution and timing resolution measurements were performed using standard NIM electronics. The linearity of the detector response was investigated using gamma-ray sources of different energies. The 10 x 10 array of 0.8 mm LSO crystals was clearly resolved in the flood image. The average energy resolution and standard deviation were 20.0% full-width at half-maximum (FWHM) and +/-5.0%, respectively, at 511 keV. The timing resolution of a single MPPC coupled to a LSO crystal was found to be 857 ps FWHM, and the value for the central region of detector module was 1182 ps FWHM when +/-10% energy window was applied. The nonlinear response of a single MPPC when used to read out a single LSO was observed among the corner crystals of the proposed detector module. However, the central region of the detector module exhibits significantly less nonlinearity (6.5% for 511 keV). These results demonstrate that (1) a charge-sharing resistor network can effectively multiplex MPPC signals and reduce the number of output signals without significantly degrading the performance of a PET detector and (2) a custom light guide to permit light sharing among multiple MPPC and to diffuse and direct scintillation light can reduce the nonlinearity of the detector response within the limited dynamic range of a typical MPPC. As a result, the proposed PET detector module has the potential to be refined for use in high-resolution PET insert applications.

Compton Scattering in Clinical PET/CT With High Resolution Half Ring PET Insert Device.

The integration of a high resolution PET insert into a conventional PET system can significantly improve the resolution and the contrast of its images within a reduced imaging field of view. For the rest of the scanner imaging field of view, the insert is a highly attenuating and scattering media. In order to use all available coincidence events (including coincidences between 2 detectors in the original scanner, namely the scanner-scanner coincidences), appropriate scatter and attenuation corrections have to be implemented. In this work, we conducted a series of Monte Carlo simulations to estimate the composition of the scattering background and the importance of the scatter correction. We implemented and tested the Single Scatter Simulation (SSS) algorithm for a hypothetical system and show good agreement between the estimated scatter using SSS and Monte Carlo simulated scatter contribution. We further applied the SSS to estimate scatter contribution from an existing prototype PET insert for a clinical PET/CT scanner. The results demonstrated the applicability of SSS to estimate the scatter contribution within a clinical PET/CT system even when there is a high resolution half ring PET insert device in its imaging field of view.

Micro insert: a prototype full-ring PET device for improving the image resolution of a small-animal PET scanner.

UNLABELLED: A full-ring PET insert device should be able to enhance the image resolution of existing small-animal PET scanners. METHODS: The device consists of 18 high-resolution PET detectors in a cylindric enclosure. Each detector contains a cerium-doped lutetium oxyorthosilicate array (12 x 12 crystals, 0.72 x 1.51 x 3.75 mm each) coupled to a position-sensitive photomultiplier tube via an optical fiber bundle made of 8 x 16 square multiclad fibers. Signals from the insert detectors are connected to the scanner through the electronics of the disabled first ring of detectors, which permits coincidence detection between the 2 systems. Energy resolution of a detector was measured using a (68)Ge point source, and a calibrated (68)Ge point source stepped across the axial field of view (FOV) provided the sensitivity profile of the system. A (22)Na point source imaged at different offsets from the center characterized the in-plane resolution of the insert system. Imaging was then performed with a Derenzo phantom filled with 19.5 MBq of (18)F-fluoride and imaged for 2 h; a 24.3-g mouse injected with 129.5 MBq of (18)F-fluoride and imaged in 5 bed positions at 3.5 h after injection; and a 22.8-g mouse injected with 14.3 MBq of (18)F-FDG and imaged for 2 h with electrocardiogram gating. RESULTS: The energy resolution of a typical detector module at 511 keV is 19.0% +/- 3.1%. The peak sensitivity of the system is approximately 2.67%. The image resolution of the system ranges from 1.0- to 1.8-mm full width at half maximum near the center of the FOV, depending on the type of coincidence events used for image reconstruction. Derenzo phantom and mouse bone images showed significant improvement in transaxial image resolution using the insert device. Mouse heart images demonstrated the gated imaging capability of the device. CONCLUSION: We have built a prototype full-ring insert device for a small-animal PET scanner to provide higher-resolution PET images within a reduced imaging FOV. Development of additional correction techniques are needed to achieve quantitative imaging with such an insert.

Virtual-pinhole PET.

UNLABELLED: We proposed and tested a novel geometry for PET system design analogous to pinhole SPECT called the virtual-pinhole PET (VP-PET) geometry to determine whether it could provide high-resolution images. METHODS: We analyzed the effects of photon acolinearity and detector sizes on system resolution and extended the empiric formula for reconstructed image resolution of conventional PET proposed earlier to predict the resolutions of VP-PET. To measure the system resolution of VP-PET, we recorded coincidence events as a (22)Na point source was stepped across the coincidence line of response between 2 detectors made from identical arrays of 12 x 12 lutetium oxyorthosilicate crystals (each measuring 1.51 x 1.51 x 10 mm(3)) separated by 565 mm. To measure reconstructed image resolution, we built 4 VP-PET systems using 4 types of detectors (width, 1.51-6.4 mm) and imaged 4 point sources of (64)Cu (half-life = 12.7 h to allow a long acquisition time). Tangential and radial resolutions were measured and averaged for each source and each system. We then imaged a polystyrene plastic phantom representing a 2.5-cm-thick cross-section of isolated breast volume. The phantom was filled with an aqueous solution of (64)Cu (713 kBq/mL) in which the following were imbedded: 4 spheric tumors ranging from 1.8 to 12.6 mm in inner diameter (ID), 6 micropipettes (0.7- or 1.1-mm ID filled with (64)Cu at 5x, 20x, or 50x background), and a 10.0-mm outer-diameter cold lesion. RESULTS: The shape and measured full width at half maximum of the line spread functions agree well with the predicted values. Measured reconstructed image resolution (2.40-3.24 mm) was +/-6% of the predicted value for 3 of the 4 systems. In one case, the difference was 12.6%, possibly due to underestimation of the block effect from the low-resolution detector. In phantom experiments, all spheric tumors were detected. Small line sources were detected if the activity concentration is at least 20x background. CONCLUSION: We have developed and characterized a novel geometry for PET. A PET system following the VP-PET geometry provides high-resolution images for objects near the system's high-resolution detectors. This geometry may lead to the development of special-purpose PET systems or resolution-enhancing insert devices for conventional PET scanners.

A feasibility study of a prototype PET insert device to convert a general-purpose animal PET scanner to higher resolution.

UNLABELLED: We developed a prototype system to evaluate the feasibility of using a PET insert device to achieve higher resolution from a general-purpose animal PET scanner. METHODS: The system consists of a high-resolution PET detector, a computer-controlled rotation stage, and a custom mounting plate. The detector consists of a cerium-doped lutetium oxyorthosilicate array (12 x 12 crystals, 0.8 x 1.66 x 3.75 mm(3) each) directly coupled to a position-sensitive photomultiplier tube (PS-PMT). The detector signals were fed into the scanner electronics to establish coincidences between the 2 systems. The detector was mounted to a rotation stage that is attached to the scanner via the custom mounting plate after removing the transmission source holder. The rotation stage was concentric with the center of the scanner. The angular offset of the insert detector was calibrated via optimizing point-source images. In all imaging experiments, coincidence data were collected from 9 angles to provide 180 degrees sampling. A (22)Na point source was imaged at different offsets from the center to characterize the in-plane resolution of the insert system. A (68)Ge point source was stepped across the axial field of view to measure the sensitivity of the system. A 23.2-g mouse was injected with 38.5 MBq of (18)F-fluoride and imaged at 3 h after injection for 2 h. RESULTS: The transverse image resolution of the PET insert device ranges from 1.1- to 1.4-mm full width at half maximum (FWHM) without correction for the point-source dimension. This corresponds to approximately 33% improvement over the resolution of the original scanner (1.7- to 1.8-mm FWHM) in 2 of the 3 directions. The sensitivity of the device is 0.064% at the center of the field, 46-fold lower than the sensitivity of an existing animal PET scanner. The mouse bone scan had improved image resolution using the PET insert device over that of the existing animal PET scanner alone. CONCLUSION: We have demonstrated the feasibility of using a high-resolution insert device in an existing PET scanner to provide high-resolution PET. A PET insert device with more detector modules will improve sensitivity and may become an alternative to special-purpose PET systems for high-resolution PET.

2D linear and iterative reconstruction algorithms for a PET-insert scanner.

We are developing novel insert devices for existing whole body PET scanners to achieve better resolution in selected regions of interest such as the head, neck, breast or abdomen. The insert considered here is a full ring of high resolution detectors, which can be placed around the object of interest. Adding the insert inside the scanner leads to three different types of coincidences: insert-insert, insert-scanner and scanner-scanner. The insert-insert and scanner-scanner coincidences are similar to the coincidences obtained in a traditional PET system. The insert-scanner coincidences have an inherent fan-beam geometry for which a spatially variant system matrix is proposed. The system matrix is computed using the intersection of a fan beam with a pixel. A filtered back-projection (FBP) algorithm for the insert-scanner geometry is presented. This FBP algorithm yields images with significantly reduced artifacts compared to FBP reconstructions on insert-scanner data rebinned into parallel beams. This is demonstrated using simulated point source data acquired using SimSET. It is proposed to use a penalized ML-EM (PML-EM) algorithm using a log-cosh roughness penalty function to reconstruct a single activity distribution from all three data sets. This is demonstrated qualitatively using simulated point source data. A quantitative comparison of PML-EM and FBP was performed on data acquired from insert-scanner coincidences using a phantom with hot and cold tumors imaged in an experimental setup. The quantitative studies demonstrate that the resolution/noise tradeoff of PML-EM is improved relative to FBP.