Faraz Kalantari

Respiratory motion correction in 4D-PET by simultaneous motion estimation and image reconstruction (SMEIR)

In conventional 4D positron emission tomography (4D-PET), images from different frames are reconstructed individually and aligned by registration methods. Two issues that arise with this approach are as follows: (1) the reconstruction algorithms do not make full use of projection statistics; and (2) the registration between noisy images can result in poor alignment. In this study, we investigated the use of simultaneous motion estimation and image reconstruction (SMEIR) methods for motion estimation/correction in 4D-PET. A modified ordered-subset expectation maximization algorithm coupled with total variation minimization (OSEM-TV) was used to obtain a primary motion-compensated PET (pmc-PET) from all projection data, using Demons derived deformation vector fields (DVFs) as initial motion vectors. A motion model update was performed to obtain an optimal set of DVFs in the pmc-PET and other phases, by matching the forward projection of the deformed pmc-PET with measured projections from other phases. The OSEM-TV image reconstruction was repeated using updated DVFs, and new DVFs were estimated based on updated images. A 4D-XCAT phantom with typical FDG biodistribution was generated to evaluate the performance of the SMEIR algorithm in lung and liver tumors with different contrasts and different diameters (10-40 mm). The image quality of the 4D-PET was greatly improved by the SMEIR algorithm. When all projections were used to reconstruct 3D-PET without motion compensation, motion blurring artifacts were present, leading up to 150% tumor size overestimation and significant quantitative errors, including 50% underestimation of tumor contrast and 59% underestimation of tumor uptake. Errors were reduced to less than 10% in most images by using the SMEIR algorithm, showing its potential in motion estimation/correction in 4D-PET.

Optimized Energy Window Configuration for 201Tl Imaging

A poor signal-to-noise ratio attributable to a low injected dose of thallium and the presence of scattered photons are the major impediments in the use of thallium as an imaging agent. Thallium decays in a complicated way and emits photons in a wide range of energies (68–82 keV). To increase the ratios of primary photons to scatter photons (primary-to-scatter ratios) and possibly increase system sensitivity, a new energy window for thallium was investigated. Methods: The NCAT phantom was used to simulate the distribution of activity and the attenuation coefficient in a typical patient torso. The phantom was imaged with a SPECT simulator in different energy window configurations. The energy spectra for primary photons and scatter photons were generated, and the most suitable energy windows were investigated. To evaluate the results of the simulation study, a physical phantom was imaged in different energy windows with a SPECT system. The images of the physical phantom were analyzed for the best-quality image and the corresponding window setting. To evaluate the windows determined in the simulation and phantom studies, SPECT images of 7 patients who had angiographically confirmed myocardial defects were acquired in different energy windows. The images were quantitatively compared on the basis of the calculated contrast, scatter-to-noise ratio, and sensitivity. The images were also qualitatively evaluated independently by 4 nuclear medicine specialists. Results: The simulation study showed that the conventional window setting (68 ± 10% keV) is not the most suitable window configuration for 201Tl imaging and that the optimum energy window is 77 ± 15% keV. The images acquired in the latter window configuration yielded higher primary-to-scatter ratios, higher sensitivity (total counts), and better contrast than the images acquired in the conventional window configuration. The phantom study confirmed the results of the simulation study. In the clinical study, the images acquired in the suggested window showed a considerable increase in myocardium-to-defect contrast (1.541 ± 0.368) and myocardium-to-cavity contrast (1.171 ± 0.099) than those acquired in the conventional window configuration. Conclusion: The energy window configuration of 77 ± 15% keV yields higher-quality images than the conventional window configuration.

Impact of anatomical noise on model observers for prostate SPECT

Scanning observers have been proposed for detection-localization tasks in medical imaging, but handling anatomical noise with these observers can be challenging. We have introduced visual-search (VS) observers as an alternative. The VS observer is a two-step process which mimics human perception through an initial search before a more detailed candidate analysis. Both the scanning and VS observers often outperform humans. In this paper, we analyze the performance of a VS observer with various inefficiency models as a means of matching human-observer performance. The observers were applied to prostate SPECT (single photon emission computed tomography) images. Prostate imaging protocols with In-111 and medium energy, parallel hole (MEPH) collimators were simulated. This was followed by a detailed localization receiver operator characteristic (LROC) study with human and model observers. Area under the LROC curve was used for observer performance evaluation. Results indicate that the VS observer applied with a combination of perceptual inefficiencies can quantitatively match human performance.

Practical Nuclear Medicine and Utility of Phantoms for Internal Dosimetry: XCAT Compared with Zubal

Purpose The absorbed doses for two radioisotopes, 99mTc and 131I, between previously validated Zubal phantom and the recently developed XCAT phantom were compared. Materials and methods GATE Monte Carlo code was used to simulate the statistical process of radiation. A XCAT phantom with voxel and matrix sizes similar to a standard Zubal phantom was generated. According to Medical International Radiation Dose formalism, specific absorbed fraction (SAF) values for photons and S-factors for beta particles were tabulated. The amounts of absorbed doses were calculated and compared in different organs. Results The differences of gamma radiation doses, SAFs, between Zubal and XCAT are >50% in adrenal from adrenal, pancreas from pancreas and thyroid from thyroid, in lung from kidney, kidneys from lungs and in kidneys from thyroid and thyroid from kidneys. The beta radiation doses differences between Zubal and XCAT are >50% in thyroid from thyroid, bladder from bladder, kidney from kidney, liver from bladder, thyroid from bladder and kidney from thyroid. The size and distances of the organs were different between XCAT and Zubal phantoms. Denoted differences of SAF and S-factors correspond to the different organ geometries in phantoms. Conclusion The results of absorbed doses in Zubal and XCAT phantoms are different. The variations prohibit easy comparison or interchangeability of dosimetry between these phantoms.

SU-E-T-507: Internal Dosimetry in Nuclear Medicine Using GATE and XCAT Phantom: A Simulation Study

Purpose Monte Carlo simulations are routinely used for internal dosimetry studies. These studies are conducted with humanoid phantoms such as the XCAT phantom. In this abstract we present the absorbed doses for various pairs of source and target organs using three common radiotracers in nuclear medicine. Methods The GATE software package is used for the Monte Carlo simulations. A typical female XCAT phantom is used as the input. Three radiotracers 153Sm, 131I and 99mTc are studied. The Specific Absorbed Fraction (SAF) for gamma rays (99mTc, 153Sm and 131I) and Specific Fraction (SF) for beta particles (153Sm and 131I) are calculated for all 100 pairs of source target organs including brain, liver, lung, pancreas, kidney, adrenal, spleen, rib bone, bladder and ovaries. Results The source organs themselves gain the highest absorbed dose as compared to other organs. The dose is found to be inversely proportional to distance from the source organ. In SAF results of 153Sm, when the source organ is lung, the rib bone, gain 0.0730 (Kg-1) that is more than lung itself. Conclusion The absorbed dose for various organs was studied in terms of SAF and SF. Such studies hold importance for future therapeutic procedures and optimization of induced radiotracer.

The influence of resolution recovery by using collimator detector response during 3D OSEM image reconstruction on 99m Tc-ECD brain SPET images

Partial volume effect, due to the poor spatial resolution of single photon emission tomography (SPET), significantly restricts the absolute quantification of the regional brain uptake and limits the accuracy of the absolute measurement of blood flow. In this study the importance of compensation for the collimator-detector response (CDR) in the technetium-99m ethyl cysteinate dimer ((99m)Tc-ECD) brain SPET was assessed, by incorporating system response in the ordered-subsets expectation maximization (OSEM) reconstruction algorithm. By placing a point source of (99m)Tc at different distances from the face of the collimator, CDR were found and modeled using Gaussian functions. A fillable slice of the brain phantom was designed and filled by (99m)Tc. Projections acquired from the phantom and also 4 patients who underwent the (99m)Tc-ECD brain SPET were used in this study. To reconstruct the images, 3D OSEM algorithm was used. System blurring functions were modeled, during the reconstruction in both projection and backprojection steps. Our results were compared with the conventional resolution recovery using Metz filter in filtered backprojection (FBP). Visual inspection of the images was performed by six nuclear medicine specialists. Quantitative analysis was also studied by calculating the contrast and the count density of the reconstructed images. For the phantom images, background counts and noise were decreased by 3D OSEM compared to the FBP-Metz method. Quantitatively, the ratio of the counts of the occupied hot region to that of the cold region of the reconstructed by FBP-Metz images was 1.14. This value was decreased from 1.12 to 0.86 for 3D OSEM of 2 and 30 iterations respectively. The reference value was 0.85 for the planar image. For clinical images, hot to cold regions (grey to white matter), the count ratio was increased from 1.44 in FBP-Metz to 3.2 and 4 in 3D OSEM with 10 and 20 iterations respectively. Based on the interpretability of images, the best scores (3.79±0.51) by the physicians were given to the images reconstructed by 3D OSEM and 10 iterations. This value was 0.63±0.77 for FBP-Metz images. In conclusion, by incorporating the distance dependent CDR during 3D OSEM, it was possible to reconstruct the brain images with much higher resolution and contrast as compared to the conventional resolution recovery method, which used FBP-Metz. It was however important to make a trade-off between noise and resolution by determining an optimum iterations number.

Iterative reconstruction with boundary detection for carbon ion computed tomography

In heavy ion radiation therapy, improving the accuracy in range prediction of the ions inside the patients body has become essential. Accurate localization of the Bragg peak provides greater conformity of the tumor while sparing healthy tissues. We investigated the use of carbon ions directly for computed tomography (carbon CT) to create the relative stopping power map of a patients body. The Geant4 toolkit was used to perform a Monte Carlo simulation of the carbon ion trajectories, to study their lateral and angular deflections and the most likely paths, using a water phantom. Geant4 was used to create carbonCT projections of a contrast and spatial resolution phantom, with a cone beam of 430 MeV/u carbon ions. The contrast phantom consisted of cranial bone, lung material, and PMMA inserts while the spatial resolution phantom contained bone and lung material inserts with line pair (lp) densities ranging from 1.67 lp cm-1 through 5 lp cm-1. First, the positions of each carbon ion on the rear and front trackers were used for an approximate reconstruction of the phantom. The phantom boundary was extracted from this approximate reconstruction, by using the position as well as angle information from the four tracking detectors, resulting in the entry and exit locations of the individual ions on the phantom surface. Subsequent reconstruction was performed by the iterative algebraic reconstruction technique coupled with total variation minimization (ART-TV) assuming straight line trajectories for the ions inside the phantom. The influence of number of projections was studied with reconstruction from five different sets of projections: 15, 30, 45, 60 and 90. Additionally, the effect of number of ions on the image quality was investigated by reducing the number of ions/projection while keeping the total number of projections at 60. An estimation of carbon ion range using the carbonCT image resulted in improved range prediction compared to the range calculated using a calibration curve.

Evaluation of normal lung tissue complication probability in gated and conventional radiotherapy using the 4D XCAT digital phantom

PURPOSE The present study was conducted to investigate normal lung tissue complication probability in gated and conventional radiotherapy (RT) as a function of diaphragm motion, lesion size, and its location using 4D-XCAT digital phantom in a simulation study. MATERIALS AND METHODS Different time series of 3D-CT images were generated using the 4D-XCAT digital phantom. The binary data obtained from this phantom were then converted to the digital imaging and communication in medicine (DICOM) format using an in-house MATLAB-based program to be compatible with our treatment planning system (TPS). The 3D-TPS with superposition computational algorithm was used to generate conventional and gated plans. Treatment plans were generated for 36 different XCAT phantom configurations. These included four diaphragm motions of 20, 25, 30 and 35 mm, three lesion sizes of 3, 4, and 5 cm in diameter and each tumor was placed in four different lung locations (right lower lobe, right upper lobe, left lower lobe and left upper lobe). The complication of normal lung tissue was assessed in terms of mean lung dose (MLD), the lung volume receiving ≥20 Gy (V20), and normal tissue complication probability (NTCP). RESULTS The results showed that the gated RT yields superior outcomes in terms of normal tissue complication compared to the conventional RT. For all cases, the gated radiation therapy technique reduced the mean dose, V20, and NTCP of lung tissue by up to 5.53 Gy, 13.38%, and 23.89%, respectively. CONCLUSIONS The results of this study showed that the gated RT provides significant advantages in terms of the normal lung tissue complication, compared to the conventional RT, especially for the lesions near the diaphragm.

Attenuation correction in SPECT images using attenuation map estimation with its emission data

Photon attenuation during SPECT imaging significantly degrades the diagnostic outcome and the quantitative accuracy of final reconstructed images. It is well known that attenuation correction can be done by using iterative reconstruction methods if we access to attenuation map. Two methods have been used to calculate the attenuation map: transmission-based and transmissionless techniques. In this phantom study, we evaluated the importance of attenuation correction by quantitative evaluation of errors associated with each method. For transmissionless approach, the attenuation map was estimated from the emission data only. An EM algorithm with attenuation model was developed and used for attenuation correction during image reconstruction. Finally, a comparison was done between reconstructed images using our OSEM code and analytical FBP method before and after attenuation correction. The results of measurements showed that: our programs are capable to reconstruct SPECT images and correct the attenuation effects. Moreover, to evaluate reconstructed image quality before and after attenuation correction we applied a novel approach using Image Quality Index. Attenuation correction increases the quality and quantitative accuracy in both methods. This increase is independent of activity in quantity factor and decreases with activity in quality factor. In EM algorithm, it is necessary to use regularization to obtain true distribution of attenuation coefficients.

Attenuation correction in 4D‐PET using a single‐phase attenuation map and rigidity‐adaptive deformable registration

Purpose: Four‐dimensional positron emission tomography (4D‐PET) imaging is a potential solution to the respiratory motion effect in the thoracic region. Computed tomography (CT)‐based attenuation correction (AC) is an essential step toward quantitative imaging for PET. However, due to the temporal difference between 4D‐PET and a single attenuation map from CT, typically available in routine clinical scanning, motion artifacts are observed in the attenuation‐corrected PET images, leading to errors in tumor shape and uptake. We introduced a practical method to align single‐phase CT with all other 4D‐PET phases for AC. Methods: A penalized non‐rigid Demons registration between individual 4D‐PET frames without AC provides the motion vectors to be used for warping single‐phase attenuation map. The non‐rigid Demons registration was used to derive deformation vector fields (DVFs) between PET matched with the CT phase and other 4D‐PET images. While attenuated PET images provide useful data for organ borders such as those of the lung and the liver, tumors cannot be distinguished from the background due to loss of contrast. To preserve the tumor shape in different phases, an ROI‐covering tumor was excluded from nonrigid transformation. Instead the mean DVF of the central region of the tumor was assigned to all voxels in the ROI. This process mimics a rigid transformation of the tumor along with a nonrigid transformation of other organs. A 4D‐XCAT phantom with spherical lung tumors, with diameters ranging from 10 to 40 mm, was used to evaluate the algorithm. The performance of the proposed hybrid method for attenuation map estimation was compared to (a) the Demons nonrigid registration only and (b) a single attenuation map based on quantitative parameters in individual PET frames. Results: Motion‐related artifacts were significantly reduced in the attenuation‐corrected 4D‐PET images. When a single attenuation map was used for all individual PET frames, the normalized root‐mean‐square error (NRMSE) values in tumor region were 49.3% (STD: 8.3%), 50.5% (STD: 9.3%), 51.8% (STD: 10.8%) and 51.5% (STD: 12.1%) for 10‐mm, 20‐mm, 30‐mm, and 40‐mm tumors, respectively. These errors were reduced to 11.9% (STD: 2.9%), 13.6% (STD: 3.9%), 13.8% (STD: 4.8%), and 16.7% (STD: 9.3%) by our proposed method for deforming the attenuation map. The relative errors in total lesion glycolysis (TLG) values were −0.25% (STD: 2.87%) and 3.19% (STD: 2.35%) for 30‐mm and 40‐mm tumors, respectively, in proposed method. The corresponding values for Demons method were 25.22% (STD: 14.79%) and 18.42% (STD: 7.06%). Our proposed hybrid method outperforms the Demons method especially for larger tumors. For tumors smaller than 20 mm, nonrigid transformation could also provide quantitative results. Conclusion: Although non‐AC 4D‐PET frames include insignificant anatomical information, they are still useful to estimate the DVFs to align the attenuation map for accurate AC. The proposed hybrid method can recover the AC‐related artifacts and provide quantitative AC‐PET images.