M. A. Flower

Fast accurate iterative reconstruction for low-statistics positron volume imaging

A fast accurate iterative reconstruction (FAIR) method suitable for low-statistics positron volume imaging has been developed. The method, based on the expectation maximization-maximum likelihood (EM-ML) technique, operates on list-mode data rather than histogrammed projection data and can, in just one pass through the data, generate images with the same characteristics as several ML iterations. Use of list-mode data preserves maximum sampling accuracy and implicitly ignores lines of response (LORs) in which no counts were recorded. The method is particularly suited to systems where sampling accuracy can be lost by histogramming events into coarse LOR bins, and also to sparse data situations such as fast whole-body and dynamic imaging where sampling accuracy may be compromised by storage requirements and where reconstruction time can be wasted by including LORs with no counts. The technique can be accelerated by operating on subsets of list-mode data which also allows scope for simultaneous data acquisition and iterative reconstruction. The method is compared with a standard implementation of the EM-ML technique and is shown to offer improved resolution, contrast and noise properties as a direct result of using improved spatial sampling, limited only by hardware specifications.

Measurements of blood-brain barrier permeability in patients undergoing radiotherapy and chemotherapy for primary cerebral lymphoma.

Positron emission tomography (PET) has been used to measure changes in regional blood-brain barrier (BBB) permeability in patients with primary cerebral lymphoma undergoing radiotherapy and chemotherapy. The method employed is to measure the rate of wash-out of a radioactive tracer (68Ga-EDTA) from blood into brain tissue using time-sequence PET imaging. Preliminary studies carried out on patients with more common primary cerebral tumours show that time-activity data are reproducible to approximately 10%. Measurements made in 2 patients with primary cerebral lymphoma treated with initial chemotherapy showed significant changes in permeability in the region of the tumour. Within 5 weeks of the start of treatment, permeability values reached the levels of normal brain. No changes in BBB permeability in normal brain were seen immediately after radiotherapy.

Radiation dose assessment in radioiodine therapy. Dose-response relationships in differentiated thyroid carcinoma using quantitative scanning and PET?

Dose-response charts have been constructed to determine the tumouricidal dose for differentiated thyroid carcinoma metastases and thus enable precise activities of radioiodine to be prescribed in order to maximise tumour kill and minimise morbidity. Tumour and normal residual thyroid absorbed doses from radioiodine-131 have been determined with increased precision using a dual-headed whole-body rectilinear scanner with special high-resolution low-sensitivity collimators. Improved accuracy in the estimation of functioning tumour mass has been achieved using positron emission tomography (PET) with a low-cost large area PET camera. Dose-response data have been obtained for 33 patients. Following near-total thyroidectomy and 3.0 GBq 131I, a mean absorbed dose of 410 Gy achieved complete ablation of thyroid remnants in 75% of patients. Patients who had persistent uptake in the thyroid region on subsequent radioiodine scanning had received a mean dose of only 83 Gy. Cumulative absorbed doses in excess of 100 Gy were found to eradicate cervical node metastases. Patients with bone metastases, who generally have a poor prognosis, were found to have received doses of the order of only 20 Gy to the tumour deposits. The dose-response data explain the spectrum of clinical responses to fixed activities of radioiodine. In future, they will enable precise prescription of radioiodine to achieve tumouricidal doses whilst avoiding the morbidity and expense of ineffective therapy.

The experimental evaluation of a prototype rotating slat collimator for planar gamma camera imaging

A collimator consisting of a series of parallel slats has been constructed and used in conjunction with a conventional gamma camera to collect one-dimensional projections of the radioisotope distribution being imaged. With the camera remaining stationary, the collimator was made to rotate continuously over the face of the detector and the projections acquired were used to reconstruct a planar image by the theory of computed tomography. The propagation of noise on image reconstruction was largely offset by the increased geometric efficiency that resulted from the enlarged solid angle of acceptance afforded by the slat collimator. For a uniform disc of activity the signal to noise ratio (SNR) at a point in an image reconstructed by convolution and backprojection is shown to be given by [formula:see text] and Q1(xi) is the one-dimensional filter function in Fourier space. Improved noise behaviour was observed for images acquired with the slat collimator compared to those acquired with a low-energy high-resolution (LEHR) collimator for small distributions of activity. Spatial resolution with the slat collimator was approximately equal to that obtained with an LEHR collimator and improved contrast was observed in images of small hot regions.

The performance of a multiwire proportional chamber positron camera for clinical use

The Rutherford Appleton Laboratory clinical positron camera consists of two opposed multiwire proportional chambers (MWPCS) mounted on a rotating gantry capable of performing routine nuclear medicine studies. The system has operated since the end of 1986 with complete reliability. It has a sensitivity of 37 kcps MBq-1 cm3 per axial cm for a 20 cm diameter uniformly filled cylinder of activity. The best spatial resolution obtainable is about 6 mm, although in practice images are smoothed in order to reduce statistical noise with a corresponding decrease in resolution. Cross-plane rays are utilised during image reconstruction and the resulting three-dimensional images exhibit the same spatial resolution in three orthogonal directions over a large cylindrical field of view 15 cm high by 30 cm in diameter. The maximum data-taking rate is limited to 1.5 to 2 kcps at present due to deadtime in the read-out system. The performance of the system is described with particular reference to the problems of imaging with the large fractions of random and scattered events which are a consequence of using large-area detectors. Images of phantoms and patients are presented and proposed modifications to the camera are described.

Dosimetry of iodine 131 metaiodobenzylguanidine for treatment of resistant neuroblastoma: results of a UK study

In 1987, the United Kingdom Childrens Cancer Study Group (UKCCSG) set up a multi-centre study to investigate the toxicity of iodine 131 metaiodobenzyl-guanidine (mIBG) in the treatment of resistant neuroblastoma. Since December 1987, 25 children suffering from neuroblastoma have been treated with131I-mIBG at six UK centres. All centres followed standardised physics and clinical protocols to provide consistent toxicity and dosimetry data. These protocols describe the methods employed for both the tracer study using131I-mIBG and the subsequent therapy. Whole-body dosimetry calculations were performed on data from the tracer study. The activity administered for therapy was the amount predicted to deliver a predefined whole-body dose. Estimates of doses delivered to various organs during treatment are given in Table 1.

Measurement of radiation dose to the thyroid using positron emission tomography.

Measurements of the functioning volume of thyroid tissue have been made in 22 patients undergoing radioiodine therapy for thyrotoxicosis, using a prototype multiwire proportional counter positron camera. Tomographic images were produced of the distribution of 124I in the thyroid. Functioning volumes were found to be in the range 21-79 cm3 with volume errors of the order of +/- 4% to +/- 14%. Radioiodine uptake varied from 28% to 98%. Using a value of 6 days for the effective half-life of radioiodine in hyperactive thyroids, radiation doses from a standard therapy administration of 75 MBq of 131I varied from 11 to 48 Gy (compared with a recommended 50-70 Gy). In five cases PET imaging showed a non-uniform distribution of radioiodine in thyroids thought to have uniform uptake from conventional pinhole scintigraphy.

Treatment planning for 131I-mIBG radiotherapy of neural crest tumours using 124I-mIBG positron emission tomography

Patients designated to receive 131I-meta-iodobenzylguanadine (mIBG) for the treatment of neural crest tumours have been scanned with 124I-mIBG using the MUP-PET positron camera. Uptake was detected in tumour sites in lung, liver and abdomen. The tomographic images produced have allowed estimates to be made of the concentration of mIBG in both tumour and normal tissue. From these data it is possible to predict the radiation doses that would be achieved using therapy levels (up to 11 GBq) of 131I-mIBG. The levels of tumour uptake are between 0.5 and 2.0 kBq/g indicating that the radiation doses to tumour would be in the range 3 Gy to 7.5 Gy.

Constrained deconvolution of SPECT liver tomograms by direct digital image restoration

Several techniques for performing digital image restoration are reviewed and the problems associated with evaluating image processing are discussed. An application of constrained deconvulution to images of the liver produced by single-photon emission computed tomography is presented. Specific evaluation criteria are suggested and based on these, the choice of conditions best suited for processing liver images is proposed. Typically cold tumor contrast can be improved by a factor of greater than 2 whilst image mottle increases negligibly.

Intercomparison of four reconstruction techniques for positron volume imaging with rotating planar detectors.

Four reconstruction techniques for positron volume imaging have been evaluated for scanners based on rotating planar detectors using measured and simulated data. The four techniques compared are backproject then filter (BPF), the 3D reprojection (3D RP) method for 3D filtered backprojection (FBP), Fourier rebinning (FORE) in conjunction with 2D FBP (FORE + 2D FBP) and 3D ordered subsets expectation maximization (3D OSEM). The comparison was based on image resolution and on the trade-off between contrast and noise. In general FORE + 2D FBP offered a better contrast-noise trade-off than 3D RP, whilst 3D RP offered a better trade-off than BPF. Unlike 3D RP, FORE + 2D FBP did not suffer any contrast degradation effect at the edges of the axial field of view, but was unable to take as much advantage from high-accuracy data as the other methods. 3D OSEM gave the best contrast at the expense of greater image noise. BPF, which demonstrated generally inferior contrast-noise behaviour due to use of only a subset of the data, gave more consistent spatial resolution over the field of view than the projection-data based methods, and was best at taking full advantage of high-accuracy data.