Timothy G. Turkington

A Systematic Review of the Factors Affecting Accuracy of SUV Measurements

OBJECTIVE There is growing interest in using PET/CT for evaluating early response to therapy in cancer treatment. Although widely available and convenient to use, standardized uptake value (SUV) measurements can be influenced by a variety of biologic and technologic factors. Many of these factors can be addressed with close attention to detail and appropriate quality control. This article will review factors potentially affecting SUV measurements and provide recommendations on ways to minimize when using serial PET to assess early response to therapy. CONCLUSION Scanner and reconstruction parameters can significantly affect SUV measurements. When using serial SUV measurements to assess early response to therapy, imaging should be performed on the same scanner using the same image acquisition and reconstruction protocols. In addition, attention to detail is required for accurate determination of the administered radiopharmaceutical dose.

Brain morphological changes and early marijuana use: a magnetic resonance and positron emission tomography study.

Abstract Background: The focus of this report is on the possible role that the age of first use of marijuana may play on brain morphology and function. Methods: Magnetic resonance imaging (MRI) and positron emission tomography (PET) were utilized to study 57 subjects. Brain volume measures (whole brain, gray matter, white matter and lateral ventricle volumes), global cerebral blood flow (CBF) and body size were evaluated. Results: There are three primary findings related to age of first use of marijuana. Subjects who started using marijuana before age 17, compared to those who started later, had smaller whole brain and percent cortical gray matter and larger percent white matter volumes. Functionally, males who started using marijuana before 17 had significantly higher CBF than other males. Both males and females who started younger were physically smaller in height and weight, with the effects being greater in males. Conclusions: These findings suggest that the age at which exposure to marijuana begins is important. Early adolescence may be a critical period for effects that are not present when exposure begins later. These results are discussed in light of reported effects of marijuana on gonadal and pituitary hormones.

Bayesian reconstruction and use of anatomical a priori information for emission tomography

A Bayesian method is presented for simultaneously segmenting and reconstructing emission computed tomography (ECT) images and for incorporating high-resolution, anatomical information into those reconstructions. The anatomical information is often available from other imaging modalities such as computed tomography (CT) or magnetic resonance imaging (MRI). The Bayesian procedure models the ECT radiopharmaceutical distribution as consisting of regions, such that radiopharmaceutical activity is similar throughout each region. It estimates the number of regions, the mean activity of each region, and the region classification and mean activity of each voxel. Anatomical information is incorporated by assigning higher prior probabilities to ECT segmentations in which each ECT region stays within a single anatomical region. This approach is effective because anatomical tissue type often strongly influences radiopharmaceutical uptake. The Bayesian procedure is evaluated using physically acquired single-photon emission computed tomography (SPECT) projection data and MRI for the three-dimensional (3-D) Hoffman brain phantom. A clinically realistic count level is used. A cold lesion within the brain phantom is created during the SPECT scan but not during the MRI to demonstrate that the estimation procedure can detect ECT structure that is not present anatomically.

Adult age differences in regional cerebral blood flow during visual word identification: Evidence from H215O PET

We used H215O PET to investigate adult age differences in regional cerebral blood flow (rCBF) during the performance of a visual word identification task. The study participants were 20 healthy, right-handed men: 10 young adults between 18 and 27 years of age, and 10 older adults between 63 and 75 years of age. The word identification task comprised six blocks of test trials representing four task conditions; subjects responded manually. The task conditions varied with regard to whether semantic retrieval was required (e.g., word/nonword discrimination vs simple response to each stimulus) and with regard to the difficulty of visual encoding (e.g., words presented normally vs words with asterisks inserted between adjacent letters). Each subject performed all six trial blocks, concurrently with each of six H215O PET scans. Analyses of quantitative CBF data obtained from the arterial time-activity curve demonstrated a significant age-related decline in global CBF rate. Analyses of the changes in rCBF between task conditions indicated that retrieval of semantic information sufficient to distinguish words from nonwords is mediated by a ventral occipitotemporal cortical pathway. Specific areas within this pathway were also associated with visual encoding processes. Several rCBF activations were significantly greater for young adults than for older adults, indicating an age-related decline in processing efficiency within this ventral occipitotemporal pathway. Although the performance data demonstrated a greater age-related slowing for visual encoding than for semantic retrieval, these age-related performance changes were not associated with corresponding changes in rCBF activation.

Fully Bayesian estimation of Gibbs hyperparameters for emission computed tomography data

In recent years, many investigators have proposed Gibbs prior models to regularize images reconstructed from emission computed tomography data. Unfortunately, hyperparameters used to specify Gibbs priors can greatly influence the degree of regularity imposed by such priors and, as a result, numerous procedures have been proposed to estimate hyperparameter values, from observed image data. Many of these, procedures attempt to maximize the joint posterior distribution on the image scene. To implement these methods, approximations to the joint posterior densities are required, because the dependence of the Gibbs partition function on the hyperparameter values is unknown. Here, the authors use recent results in Markov chain Monte Carlo (MCMC) sampling to estimate the relative values of Gibbs partition functions and using these values, sample from joint posterior distributions on image scenes. This allows for a fully Bayesian procedure which does not fix the hyperparameters at some estimated or specified value, but enables uncertainty about these values to be propagated through to the estimated intensities. The authors utilize realizations from the posterior distribution for determining credible regions for the intensity of the emission source. The authors consider two different Markov random field (MRF) models-the power model and a line-site model. As applications they estimate the posterior distribution of source intensities from computer simulated data as well as data collected from a physical single photon emission computed tomography (SPECT) phantom.

Marijuana intoxication and brain activation in marijuana smokers.

OBJECTIVE AND METHOD The acute effects of delta9 tetrahydrocannabinol (THC) on cerebral blood flow (CBF) were studied in human subjects. Regional CBF was measured with 15O-water and Positron Emission Tomography (PET) in 32 volunteers with a history of exposure to marijuana. Scans were performed before and after intravenous (I.V.) infusion of either of two doses of THC or a placebo, given under double blind conditions. RESULTS THC but not placebo increased CBF especially in the frontal regions bilaterally, insula and cingulate gyrus and sub-cortical regions with somewhat greater effects in the right hemisphere. While most regions showed significant change at 60 minutes for the lower dose group, the higher dose group had significant change at 30 and 60 minutes. There was a highly significant change in the anterior/posterior ratio for the two THC groups reflecting minimal change in occipital flow but significant increases in frontal flow. Self ratings of THC intoxication showed significant effects, and regression analysis indicated it correlated most markedly with the right frontal region. CONCLUSION Behavioral manifestations of marijuana intoxication may be associated with increased functional activity of the brain especially the frontal cortex, insula and cingulate gyrus.

Simultaneous compensation for attenuation, scatter and detector response for SPECT reconstruction in three dimensions

A three-dimensional reconstruction method for simultaneous compensation of attenuation, scatter and distance-dependent detector response for single photon emission computed tomography is described and tested by experimental studies. The method determines the attenuation factors recursively along each projection ray starting at the intersected source voxel closest to the detector. The method substracts the scatter energy window data from the primary energy window data for scatter compensation. The detector response is modelled to be spatially invariant at a constant distance from the detector. The method convolves source distribution with the modelled response function to compensate for the smoothed by use of a non-uniform entropy prior to searching for the maximum a posteriori probability solution. The method was tested using projections acquired from a chest phantom by a three-headed detector system with parallel hole collimators. An improvement was shown in image noise, recognition of object sizes and shapes, and quantification of concentration ratios.

SPECT/CT physical principles and attenuation correction.

Using nuclear medicine techniques, physiologic activity and processes can be identified in a way that is unique from other modalities. Oftentimes it is helpful to know the exact location of the physiologic uptake that is visualized on a scan. Knowing the exact location can sometimes help to distinguish normal from abnormal physiologic uptake. When an abnormality has been identified, knowing the exact location can then be helpful in treatment planning. The ability to provide precise localization of physiologic data from nuclear medicine studies is now possible with hybrid SPECT/CT systems. Additionally, these systems provide an accurate attenuation correction of the nuclear medicine image data. After reading this article, the technologist will be able to list and describe the inherent problems associated with SPECT image acquisition and reconstruction, briefly explain how data acquired from the CT scanner are used to provide attenuation correction data for SPECT and anatomic information for diagnostic purposes, list and briefly describe the different types of clinical SPECT/CT systems, and discuss the importance of accurate CT and SPECT image registration.

Cerebellar activity and disturbed time sense after THC

Because marijuana continues to be the most commonly used illicit drug, its effects on the brain function are of major interest. We utilized positron emission tomography (PET) and magnetic resonance imaging (MRI) to study the effects of delta-9-tetrahydrocannabinol (THC) infusion on brain blood flow and its behavioral correlates in 46 volunteers. Consistent with previous reports, there was a significant increase in cortical and cerebellar blood flow following THC, but not all subjects showed this effect. Those who showed a decrease in cerebellar CBF also had a significant alteration in time sense. The relationship between decreased cerebellar flow and impaired time sense is of interest because the cerebellum has been linked to an internal timing system.

Regional cerebral blood flow and depersonalization after tetrahydrocannabinol administration

Mathew RJ, Wilson WH, Chiu NY, Turkington TG, Degrado TR, Coleman RE. Regional cerebral blood flow and depersonalization after tetrahydrocannabinol administration.