Bassim Aklan

Simultaneous PET/MR imaging: MR-based attenuation correction of local radiofrequency surface coils

PURPOSE In simultaneous positron emission tomography/magnetic resonance (PET/MR) imaging, local receiver surface radiofrequency (RF) coils are positioned in the field-of-view (FOV) of the PET detector during PET/MR data acquisition and potentially attenuate the PET signal. For flexible body RF surface coils placed on top of the patients body, MR-based attenuation correction (AC) is an unsolved problem since the RF coils are not inherently visible in MR images and their individual position in the FOV is patient specific and not knowna priori. The aim of this work was to quantify the effect of local body RF coils used in the Biograph mMR hybrid PET/MR system on PET emission data and to present techniques for MR-based position determination of these specific local RF coils. METHODS Acquisitions of a homogeneous phantom were performed on a whole-body PET/MRI scanner. Two different PET emission scans were performed, with and without the local body matrix RF coil placed on the top of the phantom. For position determination of the coil, two methods were applied. First, cod liver oil capsules were attached to the surface of the coil and second, an ultrashort echo time (UTE) sequence was used. PET images were reconstructed in five different ways: (1) PET reference scan without the coil, (2) PET scan with the coil, but omitting the coil in AC (PET/MR scanning conditions), (3) AC of the coil using a CT scan of the same phantom setup and registration via capsules, (4) same setup as 3, but registration was done using UTE images, neglecting the capsules, and (5) registration using the capsules, but the CT was performed with the coil placed flat on the CT table and the outer regions of the coil were cropped. The activity concentrations were then compared to the reference scan. For clinical evaluation of the concept, the presented methods were also evaluated on a patient. RESULTS The oil capsules were visible in the MR and CT images and image registration was straightforward. The UTE images show only parts of the coils plastic housing and image registration was more difficult. The overall loss of true counts due to the presence of the surface coil is 4.7%. However, a spatially dependent analysis shows larger deviation (10%-15% attenuation) of the activity concentration in the top part of the phantom close to the coil. When accounting for the RF coil for PET AC, attenuation due to the RF coil could mostly be corrected. These results of the phantom studies were confirmed by the patient measurements. CONCLUSIONS Disregarding local coils in PET AC can lead to a bias of the AC PET images that is regional dependent. The closer the analyzed region is located to the coil, the higher the bias. Cod liver oil capsules or the UTE sequence can be used for RF coil position determination. The middle part of the examined RF coil hosting the preamplifiers and electronic components provides the highest attenuating part. Consequently, emphasis should be put on correcting for this portion of the RF coils with the suggested methods.PURPOSE In simultaneous positron emission tomography/magnetic resonance (PET/MR) imaging, local receiver surface radiofrequency (RF) coils are positioned in the field-of-view (FOV) of the PET detector during PET/MR data acquisition and potentially attenuate the PET signal. For flexible body RF surface coils placed on top of the patients body, MR-based attenuation correction (AC) is an unsolved problem since the RF coils are not inherently visible in MR images and their individual position in the FOV is patient specific and not known a priori. The aim of this work was to quantify the effect of local body RF coils used in the Biograph mMR hybrid PET/MR system on PET emission data and to present techniques for MR-based position determination of these specific local RF coils. METHODS Acquisitions of a homogeneous phantom were performed on a whole-body PET/MRI scanner. Two different PET emission scans were performed, with and without the local body matrix RF coil placed on the top of the phantom. For position determination of the coil, two methods were applied. First, cod liver oil capsules were attached to the surface of the coil and second, an ultrashort echo time (UTE) sequence was used. PET images were reconstructed in five different ways: (1) PET reference scan without the coil, (2) PET scan with the coil, but omitting the coil in AC (PET/MR scanning conditions), (3) AC of the coil using a CT scan of the same phantom setup and registration via capsules, (4) same setup as 3, but registration was done using UTE images, neglecting the capsules, and (5) registration using the capsules, but the CT was performed with the coil placed flat on the CT table and the outer regions of the coil were cropped. The activity concentrations were then compared to the reference scan. For clinical evaluation of the concept, the presented methods were also evaluated on a patient. RESULTS The oil capsules were visible in the MR and CT images and image registration was straightforward. The UTE images show only parts of the coils plastic housing and image registration was more difficult. The overall loss of true counts due to the presence of the surface coil is 4.7%. However, a spatially dependent analysis shows larger deviation (10%-15% attenuation) of the activity concentration in the top part of the phantom close to the coil. When accounting for the RF coil for PET AC, attenuation due to the RF coil could mostly be corrected. These results of the phantom studies were confirmed by the patient measurements. CONCLUSIONS Disregarding local coils in PET AC can lead to a bias of the AC PET images that is regional dependent. The closer the analyzed region is located to the coil, the higher the bias. Cod liver oil capsules or the UTE sequence can be used for RF coil position determination. The middle part of the examined RF coil hosting the preamplifiers and electronic components provides the highest attenuating part. Consequently, emphasis should be put on correcting for this portion of the RF coils with the suggested methods.

Integrated PET/MR imaging: automatic attenuation correction of flexible RF coils.

PURPOSE Flexible radiofrequency (RF) surface coils used in simultaneous PET/MR imaging are currently disregarded in PET attenuation correction (AC) since their position and individual geometry are unknown in whole-body patient scans. The attenuation of PET emission data due to the presence of RF surface coils has been investigated by several research groups but so far no automatic approach for the incorporation of RF surface coils into PET AC has been described. In this work, an algorithm is presented and evaluated which automatically determines the position of multiple RF surface coils and corrects for their attenuation of the PET emission data. METHODS The presented algorithm nonrigidly registers pre-acquired CT-based three-dimensional attenuation templates of RF surface coils into attenuation maps used for PET AC. Transformation parameters are obtained by nonrigid B-spline landmark registration of marker positions in the CT-based attenuation templates of the RF surface coils to marker positions in the current MR images of the patient. The use of different marker patterns enables the registration algorithm to distinguish multiple partly overlapping RF surface coils. To evaluate the registration algorithm, two different PET emission scans of a NEMA standard body phantom with six active lesions and of a large rectangular body phantom were performed on an integrated whole-body PET/MR scanner. The phantoms were scanned with and without one (NEMA phantom scan) or three (large body phantom scan) flexible six-channel RF surface coils placed on top. Additionally, the accuracy and performance of the algorithm were evaluated on volunteer scans (n=5) and on a patient scan using a typical clinical setup of three RF surface coils. RESULTS Overall loss of true counts due to the presence of the RF surface coils was 5.1% for the NEMA phantom, 3.6% for the large body phantom, and 2.1% for the patient scan. Considerable local underestimation of measured activity concentration up to 15.4% in the top part of the phantoms and 15.5% for a lesion near the body surface of the patient was measured close to the high attenuating hardware components of the RF coils. The attenuation maps generated by the registration algorithm reduced the quantification errors due to the RF surface coils to values ranging from -3.9% to 4.3%. Concerning the volunteer examinations, the attenuation templates of the three RF surface coils were registered to their correct positions with an overall accuracy of about 3 mm. CONCLUSIONS The presence of flexible RF surface coils leads to considerable local errors in the simultaneously measured PET activity concentration up to 15.5% especially in regions close to the coils. The presented automatic algorithm accurately and reliably reduces the PET quantification errors caused by multiple partly overlapping flexible RF surface coils to values of 4.3% or better.

Toward simultaneous PET/MR breast imaging: Systematic evaluation and integration of a radiofrequency breast coil

PURPOSE With the recent introduction of integrated whole-body hybrid positron emission tomography/magnetic resonance (PET/MR) scanners, simultaneous PET/MR breast imaging appears to be a potentially attractive new clinical application. In this study, the technical groundwork toward performing simultaneous PET/MR breast imaging was developed and systematically evaluated in phantom experiments and breast cancer patient hybrid imaging. METHODS Measurements were performed on a state-of-the-art whole-body simultaneous PET/MR system (Biograph mMR, Siemens AG, Erlangen, Germany). The PET signal attenuating effects of a MR-only four-channel radiofrequency (RF) breast coil that is present in the PET field-of-view (FoV) during a simultaneous PET/MR data acquisition has been investigated and quantified. For this purpose, a dedicated PET/MR visible breast phantom featuring four modular inserts with various structures (no insert, MR insert, PET insert, and PET/MR insert) was developed. In addition to a systematic evaluation of MR-only image quality, the following phantom scans were performed using (18)F radio tracer: (1) PET emission scan with only the homogeneous breast phantom; (2) PET emission scan additionally with the RF breast coil in the PET FoV. Attenuation correction (AC) of PET data was performed with CT-based three-dimensional (3D) hardware attenuation maps (μ-maps) of the RF coil and breast phantom. Finally, a simultaneous PET/MR breast imaging was performed in two breast cancer patients. RESULTS The modular breast phantom allowed for systematic evaluation of various MR, PET, and PET/MR image quality parameters. The RF breast coil provided MR images of good image quality, unaffected by PET imaging. The global attenuation of the RF breast coil on the PET emission data was approximately 11%. This hardware attributed PET signal attenuation was successfully corrected by using an appropriate CT-based 3D μ-map of the RF breast coil. Imaging of two breast cancer patients confirmed the successful integration of the RF breast coil into the concept of simultaneous PET/MR breast imaging. CONCLUSIONS The successful integration of a four-channel RF breast coil with a defined table position together with the CT-based μ-maps provides a technical basis for future clinical PET/MR breast imaging applications.

Impact of Point-Spread Function Modeling on PET Image Quality in Integrated PET/MR Hybrid Imaging

The aim of this study was to systematically assess the quantitative and qualitative impact of including point-spread function (PSF) modeling into the process of iterative PET image reconstruction in integrated PET/MR imaging. Methods: All measurements were performed on an integrated whole-body PET/MR system. Three substudies were performed: an 18F-filled Jaszczak phantom was measured, and the impact of including PSF modeling in ordinary Poisson ordered-subset expectation maximization reconstruction on quantitative accuracy and image noise was evaluated for a range of radial phantom positions, iteration numbers, and postreconstruction smoothing settings; 5 representative datasets from a patient population (total n = 20, all oncologic 18F-FDG PET/MR) were selected, and the impact of PSF on lesion activity concentration and image noise for various iteration numbers and postsmoothing settings was evaluated; and for all 20 patients, the influence of PSF modeling was investigated on visual image quality and number of detected lesions, both assessed by clinical experts. Additionally, the influence on objective metrics such as changes in SUVmean, SUVpeak, SUVmax, and lesion volume was assessed using the manufacturer-recommended reconstruction settings. Results: In the phantom study, PSF modeling significantly improved activity recovery and reduced the image noise at all radial positions. This effect was measurable only at a high number of iterations (>10 iterations, 21 subsets). In the patient study, again, PSF increased the detected activity in the patient’s lesions at concurrently reduced image noise. Contrary to the phantom results, the effect was notable already at a lower number of iterations (>1 iteration, 21 subsets). Lastly, for all 20 patients, when PSF and no-PSF reconstructions were compared, an identical number of congruent lesions was found. The overall image quality of the PSF reconstructions was rated better when compared with no-PSF data. The SUVs of the detected lesions with PSF were substantially increased in the range of 6%–75%, 5%–131%, and 5%–148% for SUVmean, SUVpeak, and SUVmax, respectively. A regression analysis showed that the relative increase in SUVmean/peak/max decreases with increasing lesion size, whereas it increases with the distance from the center of the PET field of view. Conclusion: In whole-body PET/MR hybrid imaging, PSF-based PET reconstructions can improve activity recovery and image noise, especially at lateral positions of the PET field of view. This has been demonstrated quantitatively in phantom experiments as well as in patient imaging, for which additionally an improvement of image quality could be observed.

GATE Monte Carlo simulations for variations of an integrated PET/MR hybrid imaging system based on the Biograph mMR model.

A simulation toolkit, GATE (Geant4 Application for Tomographic Emission), was used to develop an accurate Monte Carlo (MC) simulation of a fully integrated 3T PET/MR hybrid imaging system (Siemens Biograph mMR). The PET/MR components of the Biograph mMR were simulated in order to allow a detailed study of variations of the system design on the PET performance, which are not easy to access and measure on a real PET/MR system. The 3T static magnetic field of the MR system was taken into account in all Monte Carlo simulations. The validation of the MC model was carried out against actual measurements performed on the PET/MR system by following the NEMA (National Electrical Manufacturers Association) NU 2-2007 standard. The comparison of simulated and experimental performance measurements included spatial resolution, sensitivity, scatter fraction, and count rate capability. The validated system model was then used for two different applications. The first application focused on investigating the effect of an extension of the PET field-of-view on the PET performance of the PET/MR system. The second application deals with simulating a modified system timing resolution and coincidence time window of the PET detector electronics in order to simulate time-of-flight (TOF) PET detection. A dedicated phantom was modeled to investigate the impact of TOF on overall PET image quality. Simulation results showed that the overall divergence between simulated and measured data was found to be less than 10%. Varying the detector geometry showed that the system sensitivity and noise equivalent count rate of the PET/MR system increased progressively with an increasing number of axial detector block rings, as to be expected. TOF-based PET reconstructions of the modeled phantom showed an improvement in signal-to-noise ratio and image contrast to the conventional non-TOF PET reconstructions. In conclusion, the validated MC simulation model of an integrated PET/MR system with an overall accuracy error of less than 10% can now be used for further MC simulation applications such as development of hardware components as well as for testing of new PET/MR software algorithms, such as assessment of point-spread function-based reconstruction algorithms.

X-Ray I O Monitor Device for Primary Intensity Measurement in Computed Tomography (CT) Scanner

For a Computed Tomography (CT) Scanner used as a Non Destructive Testing (NDT) machine, 3D volume is reconstructed mathematically using un-attenuated (primary IO) and attenuated (secondary I) intensities. Primary intensity (IO) values are acquired from area of the imaging detector that is not covered by the object being tested. This procedure is prone to errors due to detector artifacts, nonlinear detector behavior, and scattered radiations detection as primary intensities, etc. This study is an attempt to make this procedure efficient and unimpeachable in which an X-ray IO monitor device is designed and validated that permit precise detection of the primary intensity to obtain better normalization and consequently higher quality image. Using TSL235 photodiode from Texas Instrument the X-ray intensity measured in current is directly converted into frequency which provides high resolution and precise X-ray detection. The device is designed to be easily integrate with an existing CT machine and could be interfaced and read out with a standard Personal Computer (PC) without any need of additional hardware. Furthermore, this device could also be used for other applications, like direct measurement of scattered radiations to apply correction to data set of scan obtained.

Regional deep hyperthermia: impact of observer variability in CT-based manual tissue segmentation on simulated temperature distribution

The aim of this study was to systematically investigate the influence of inter- and intra-observer segmentation variation of tumor and organs at risk on the simulated temperature coverage of the target. CT scans of six patients with tumors in the pelvic region acquired for radiotherapy treatment planning were used for the hyperthermia treatment planning. To study the effect of inter-observer variation, three observers manually segmented in the CT images of each patient the following structures: fat, muscle, bone and bladder. The gross tumor volumes (GTV) were contoured by three radiation oncology residents and used as hyperthermia target volume. For the intra-observer variation, one of the observers of each group contoured the structures of each patient three times with a time span of one week between the segmentations. Moreover, the impact of segmentation variations in organs at risk (OARs) between the three inter-observers was investigated on simulated temperature distributions using only one GTV. The spatial overlap between individual segmentations was assessed by the Dice similarity coefficient (DSC) and the mean surface distance (MSD). Additionally, the temperatures T90/T10 delivered to 90%/10% of the GTV, respectively were assessed for each combination observer combination. The results of the segmentation similarity evaluation showed that the DSC of inter-observer variation of fat, muscle, bladder, bone and target was 0.68±0.12, 0.88±0.05, 0.73±0.14, 0.91±0.04 and 0.64±0.11, respectively. Similar results were found for the intra-observer variation. The MSD gave results like DSC for both observer variations. A statistically significant difference (p<0.05) was found for T90 and T10 in the predicted target temperature due to the observer variability. The conclusion is that intra- and inter-observer variations have a significant impact on the temperature coverage of the target. Furthermore, the organs at risk, such as bone and bladder, may essentially influence the homogeneity of the simulated target temperature distribution.The aim of this study was to systematically investigate the influence of the inter- and intra-observer segmentation variation of tumors and organs at risk on the simulated temperature coverage of the target. CT scans of six patients with tumors in the pelvic region acquired for radiotherapy treatment planning were used for hyperthermia treatment planning. To study the effect of inter-observer variation, three observers manually segmented in the CT images of each patient the following structures: fat, muscle, bone and the bladder. The gross tumor volumes (GTV) were contoured by three radiation oncology residents and used as the hyperthermia target volumes. For intra-observer variation, one of the observers of each group contoured the structures of each patient three times with a time span of one week between the segmentations. Moreover, the impact of segmentation variations in organs at risk (OARs) between the three inter-observers was investigated on simulated temperature distributions using only one GTV. The spatial overlap between individual segmentations was assessed by the Dice similarity coefficient (DSC) and the mean surface distance (MSD). Additionally, the temperatures T90/T10 delivered to 90%/10% of the GTV, respectively, were assessed for each observer combination. The results of the segmentation similarity evaluation showed that the DSC of the inter-observer variation of fat, muscle, the bladder, bone and the target was 0.68  ±  0.12, 0.88  ±  0.05, 0.73  ±  0.14, 0.91  ±  0.04 and 0.64  ±  0.11, respectively. Similar results were found for the intra-observer variation. The MSD results were similar to the DSCs for both observer variations. A statistically significant difference (p  <  0.05) was found for T90 and T10 in the predicted target temperature due to the observer variability. The conclusion is that intra- and inter-observer variations have a significant impact on the temperature coverage of the target. Furthermore, OARs, such as bone and the bladder, may essentially influence the homogeneity of the simulated target temperature distribution.

Influence of patient mispositioning on SAR distribution and simulated temperature in regional deep hyperthermia

Patient positioning plays an important role in regional deep hyperthermia to obtain a successful hyperthermia treatment. In this study, the influence of possible patient mispositioning was systematically assessed on specific absorption rate (SAR) and temperature distribution. With a finite difference time domain approach, the SAR and temperature distributions were predicted for six patients at 312 positions. Patient displacements and rotations as well as the combination of both were considered inside the Sigma-Eye applicator. Position sensitivity is assessed for hyperthermia treatment planning -guided steering, which relies on model-based optimization of the SAR and temperature distribution. The evaluation of the patient mispositioning was done with and without optimization. The evaluation without optimization was made by creating a treatment plan for the patient reference position in the center of the applicator and applied for all other positions, while the evaluation with optimization was based on creating an individual plan for each position. The parameter T90 was used for the temperature evaluation, which was defined as the temperature that covers 90% of the gross tumor volume (GTV). Furthermore, the hotspot tumor quotient (HTQ) was used as a goal function to assess the quality of the SAR and temperature distribution. The T90 was shown considerably dependent on the position within the applicator. Without optimization, the T90 was clearly decreased below 40 °C by patient shifts and the combination of shifts and rotations. However, the application of optimization for each positon led to an increase of T90 in the GTV. Position inaccuracies of less than 1 cm in the X-and Y-directions and 2 cm in the Z-direction, resulted in an increase of HTQ of less than 5%, which does not significantly affect the SAR and temperature distribution. Current positioning precision is sufficient in the X (right-left)-direction, but position accuracy is required in the Y-and Z-directions.

Scheelite Coupled Photodiode X-Ray Sensor Designing and Characterization

Efficient detection of un-attenuated and attenuated x-rays intensities is crucial to reconstruct 3D volume in a Computed Tomography (CT) machine employed for Non-Destructive Testing. In this study, an x-ray sensor is developed and characterized to be used with an existing X-ray Io device by evaluating its linearity and operating range. The sensor is developed by using Photodiode BPX61 from Siemens coupled with Sheelite (Calcium Tungstate [CaWO4]) scintillator. Sheelite illuminate by exposure of x-rays and BPX61 converts illuminated light into relative current signal. The current signal is amplified and for further processing transmitted to x-ray Io device virtual instrument which consist of a PIC microcontroller and a Personal Computer (PC). As the x-ray intensity depend upon x-ray tube voltage and current, the linearity and operating range of developed sensor is evaluated by performing special experiments in which the two quantities (tube voltage and current) are accreting one at a time while keeping the other constant. Using normalized values obtained from Oscilloscope and HyperTerminal measurements, the conversion time error is observed and reduced thus increasing linear and operating regions.