Merence Sibomana

Comparison of regional cerebral blood flow and glucose metabolism in the normal brain: effect of aging

The regional cerebral blood flow (rCBF) and metabolic rate for glucose (rCMRGlc) are associated with functional activity of the neural cells. The present work reports a comparison study between rCBF and rCMRGlc in a normal population as a function of age. 10 young (25.9+/-5.6 years) and 10 old (65.4+/-6.1 years) volunteers were similarly studied at rest. In each subject, rCBF and rCMRGlc were measured in sequence, during the same session. Both rCBF and rCMRGlc values were found to decrease from young (mean rCBF=43.7 ml/100 g per min; mean rCMRGlc=40.6 micromol/100 g per min) to old age (mean rCBF=37.3 ml/100 g per min; mean rCMRGlc=35.2 micromol/100 g per min), resulting in a drop over 40 years of 14.8% (0.37%/year) and 13.3% (0.34%/year), respectively. On a regional basis, the frontal and the visual cortices were observed to have, respectively, the highest and the lowest reduction in rCBF, while, for rCMRGlc, these extremes were observed in striatum and cerebellum. Despite these differences, the ratio of rCBF to rCMRGlc was found to have a similar behavior in all brain regions for young and old subjects as shown by a correlation coefficient of 88%. This comparative study indicates a decline in rCBF and rCMRGlc values and a coupling between CBF and CMRGlc as a function of age.

Quantitation in PET using isotopes emitting prompt single gammas: application to yttrium-86

Several yttrium-90 labelled somatostatin analogues are now available for cancer radiotherapy. After injection, a large amount of the compound is excreted via the urinary tract, while a variable part is trapped in the tumour(s), allowing the curative effect. Unfortunately, the compound may also be trapped in critical tissues such as kidney or bone marrow. As a consequence, a method for assessment of individual biodistribution and pharmacokinetics is required to predict the maximum dose that can be safely injected into patients. However, 90Y, a pure β–particle emitter, cannot be used for quantitative imaging. Yttrium-86 is a positron emitter that allows imaging of tissue uptake using a PET camera. In addition to the positron, 86Y also emits a multitude of prompt single γ-rays, leading to significant overestimation of uptake when using classical reconstruction methods. We propose a patient-dependent correction method based on sinogram tail fitting using an 86Y point spread function library. When applied to abdominal phantom acquisition data, the proposed correction method significantly improved the accuracy of the quantification: the initial overestimation of background activity by 117% was reduced to 9%, while the initial error in respect of kidney uptake by 84% was reduced to 5%. In patient studies, the mean discrepancy between PET total body activity and the activity expected from urinary collections was reduced from 92% to 7%, showing the benefit of the proposed correction method.

Exact rebinning methods for three-dimensional PET

The high computational cost of data processing in volume PET imaging is still hindering the routine application of this successful technique, especially in the case of dynamic studies. This paper describes two new algorithms based on an exact rebinning equation, which can be applied to accelerate the processing of three-dimensional (3-D) PET data. The first algorithm, FOREPROJ, is a fast-forward projection algorithm that allows calculation of the 3-D attenuation correction factors (ACFs) directly from a two dimensional (2-D) transmission scan, without first reconstructing the attenuation map and then performing a 3-D forward projection. The use of FOREPROJ speeds up the estimation of the 3-D ACFs by more than a factor five. The second algorithm, FOREX, is a rebinning algorithm that is also more than five times faster, compared to the standard reprojection algorithm (3DRP) and does not suffer from the image distortions generated by the even faster approximate Fourier rebinning (FORE) method at large axial apertures. However, FOREX is probably not required by most existing scanners, as the axial apertures are not large enough to show improvements over FORE with clinical data. Both algorithms have been implemented and applied to data simulated for a scanner with a large axial aperture (30/spl deg/), and also to data acquired with the ECAT HR and the ECAT HR+ scanners. Results demonstrate the excellent accuracy achieved by these algorithms and the important speedup when the sinogram sizes are powers of two.

Fast iterative image reconstruction of 3D PET data

For count-limited PET imaging protocols, two different approaches to reducing statistical noise are volume, or 3D, imaging to increase sensitivity, and statistical reconstruction methods to reduce noise propagation. These two approaches have largely been developed independently, likely due to the perception of the large computational demands of iterative 3D reconstruction methods. The authors present results of combining the sensitivity of 3D PET imaging with the noise reduction and reconstruction speed of 2D iterative image reconstruction methods. This combination is made possible by using the recently-developed Fourier rebinning technique (FORE), which accurately and noiselessly rebins 3D PET data into a 2D data set. The resulting 2D sinograms are then reconstructed independently by the ordered-subset EM (OSEM) iterative reconstruction method, although any other 2D reconstruction algorithm could be used. The authors demonstrate significant improvements in image quality for whole-body 3D PET scans by using the FORE+OSEM approach compared with the standard 3D Reprojection (3DRP) algorithm. In addition, the FORE+OSEM approach involves only 2D reconstruction and it therefore requires considerably less reconstruction time than the 3DRP algorithm, or any fully 3D statistical reconstruction algorithm.

Spatial resolution of the HRRT PET scanner using 3D-OSEM PSF reconstruction

In this paper, the resolution of the Siemens high resolution research tomograph (HRRT) was centrally (r < 60 mm) homogenous with a FWHM of 1.4 mm for 18F-FDG in air. This was where the main part of the brain is located if the patient has been positioned correctly. The 1.4 mm resolution was obtained using the newly develop 3D-OSEM PSF reconstruction algorithm, which was a significant improvement over 3D-OSEM reconstruction without PSF. The algorithm uses a simple PSF model that was the same for all the pixels in the FOV and does not regulate for the circular/octagonal scanner geometry. This supports that the FWHM of the radial axis is increasing with the distance from the center for r > 60mm.

Evolution of brain glucose metabolism with age in epileptic infants, children and adolescents.

During the first years of life, the human brain undergoes repetitive modifications in its anatomical, functional, and synaptic construction to reach the complex functional organization of the adult central nervous system. As an attempt to gain further insight in those maturation processes, the evolution of cerebral metabolic activity was investigated as a function of age in epileptic infants, children and adolescents. The regional cerebral metabolic rates for glucose (rCMRGlc) were measured with positron emission tomography (PET) in 60 patients aged from 6 weeks to 19 years, who were affected by complex partial epilepsy. They were scanned at rest, without premedication, in similar conditions to 20 epileptic adults and in 49 adult controls. The distribution of brain metabolic activity successively extended from sensorimotor areas and thalamus in epileptic newborns to temporo-parietal and frontal cortices and reached the adult pattern after 1 year of age. The measured rCMRGlc in the cerebral cortex, excluding the epileptic lesions, increased from low values in infants to a maximum between 4 and 12 years, before it declined to stabilize at the end of the second decade of life. Similar age-related changes in glucose metabolic rates were not observed in the adult groups. Despite the use of medications, the observed variations of rCMRGlc with age in young epileptic humans confirm those previously described in pediatric subjects. These metabolic changes are in full agreement with the current knowledge of the synaptic density evolution in the human brain.

Methods for Motion Correction Evaluation Using 18F-FDG Human Brain Scans on a High-Resolution PET Scanner

Many authors have reported the importance of motion correction (MC) for PET. Patient motion during scanning disturbs kinetic analysis and degrades resolution. In addition, using misaligned transmission for attenuation and scatter correction may produce regional quantification bias in the reconstructed emission images. The purpose of this work was the development of quality control (QC) methods for MC procedures based on external motion tracking (EMT) for human scanning using an optical motion tracking system. Methods: Two scans with minor motion and 5 with major motion (as reported by the optical motion tracking system) were selected from 18F-FDG scans acquired on a PET scanner. The motion was measured as the maximum displacement of the markers attached to the subjects head and was considered to be major if larger than 4 mm and minor if less than 2 mm. After allowing a 40- to 60-min uptake time after tracer injection, we acquired a 6-min transmission scan, followed by a 40-min emission list-mode scan. Each emission list-mode dataset was divided into 8 frames of 5 min. The reconstructed time-framed images were aligned to a selected reference frame using either EMT or the AIR (automated image registration) software. The following 3 QC methods were used to evaluate the EMT and AIR MC: a method using the ratio between 2 regions of interest with gray matter voxels (GM) and white matter voxels (WM), called GM/WM; mutual information; and cross correlation. Results: The results of the 3 QC methods were in agreement with one another and with a visual subjective inspection of the image data. Before MC, the QC method measures varied significantly in scans with major motion and displayed limited variations on scans with minor motion. The variation was significantly reduced and measures improved after MC with AIR, whereas EMT MC performed less well. Conclusion: The 3 presented QC methods produced similar results and are useful for evaluating tracer-independent external-tracking motion-correction methods for human brain scans.

Weighted schemes applied to 3D-OSEM reconstruction in PET

In order to better preserve the Poisson characteristics of PET data when using 3D OSEM iterative reconstruction, the authors have compared images reconstructed by various data weighting schemes: unweighted, attenuation weighted, attenuation and normalization weighted OSEM 3D, FORE+unweighted and attenuation weighted OSEM 2D using 3DRP and FORE+FBP images as reference. Due to better noise modeling, 3D weighted OSEM schemes are expected to produce better images (i.e. noise-bias trade-off) especially at low statistics, in short frames of dynamic studies and when bed overlap is suboptimal, as in 3D wholebody studies. These reconstruction methods were implemented on the ECAT Exact HR and quantification was validated on clinical data. Their influence on physiological parameter measurements was examined on a dynamic brain receptor study with /sup 11/C-Flumazenil and a whole-body study with /sup 18/FDG. The 3D weighted OSEM schemes provide unbiased results in volume of interests. The resulting noise reduction may lead to more accurate registration, acquisition of shorter frames and generation of parametric images.

Investigation of motion induced errors in scatter correction for the HRRT brain scanner

Patient motion during PET scans introduces errors in the attenuation correction and image blurring leading to false changes in regional radioactivity concentrations. However, the potential effect that motion has on simulation-based scatter correction is not fully appreciated. Specifically for tracers with high uptake close to the edge of head (e.g. scalp and nose) as observed with [11C]Verapamil, mismatches between transmission and emission data can lead to significant quantification errors and image artefacts due to over scatter correction. These errors are linked with unusually high values in the scatter scaling factors (SSF) returned during the single scatter simulation process implemented in the HRRT image reconstruction. Reconstruction of μ-map with TXTV (an alternative μ-map reconstruction using non-linear filtering rather than brain segmentation and scatter correction of the transmission data) was found to improve the scatter simulation results for [11C]Verapamil and [18F]FDG. The errors from patient motion were characterised and quantified through simulations by applying realistic transformations to the attenuation map (μ-map). This generated inconsistencies between the emission and transmission data, and introduced large over-corrections of scatter similar to some cases observed with [11C]Verapamil. Automated Image Registration (AIR) based motion correction was also implemented, and found to remove the artifact and recover quantification in dynamic studies after aligning all the PET images to a common reference space.

A standardized blood sampling scheme in quantitative FDG-PET studies

Quantitative estimation of brain glucose metabolism (rCMRGlc) with positron emission tomography and fluorodeoxyglucose involves arterial blood sampling to estimate the delivery of radioactivity to the brain. Usually, for an intravenous injection of 30 s duration, an accurate input curve requires a frequency of one sample every 5 s or less to determine the peak activity in arterial plasma during the first 2 min after injection. In this work, 13 standardized sampling times were shown to be sufficient to accurately define the input curve. This standardized input curve was subsequently fitted by a polynomial function for its rising part and by spectral analysis for its decreasing part. Using the measured, the standardized, and the fitted input curves, rCMRGlc was estimated in 32 cerebral regions of interest in 20 normal volunteers. Comparison of rCMRGlc values obtained with the measured and the fitted input curves showed that both procedures gave consistent results, with a maximal relative error in mean rCMRGlc of 1% when using the autoradiographic method and 2% using kinetic analysis of dynamic data. This input-curve-fitting technique, which is not dependent on the peak time occurrence, allows an accurate determination of the input-curve shape from reduced sampling schemes.