Attenuation correction for rotating multi-segment slant-hole SPECT in breast imaging

Rotating multi-segment slant-hole (RMSSH) SPECT is suitable for detecting small and low-contrast breast lesions since it has much higher detection efficiency compared with parallel-hole SPECT for the same resolution and can image the breast at a closer distance.Our RMSSH SPECT image reconstruction extends a previous rotation-shear transformation based 3D iterative reconstruction method to include non-uniform attenuation compensation. Reconstructed RMSSH SPECT images with attenuation compensation show much improved quantitative accuracy and less image artifacts than without. We conclude that attenuation compensation provides RMSSH SPECT images with improved quality and quantitative accuracy.     

Analysis of a novel offset cone-beam computed mammotomography system geometry for accomodating various breast sizes

We evaluate a newly developed dedicated cone-beam transmission computed mammotomography (CmT) system configuration using an optimized quasi-monochromatic cone beam technique for attenuation correction of SPECT in a planned dual-modality emission and transmission system for pendant, uncompressed breasts. In this study, we perform initial CmT acquisitions using various sized breast phantoms to evaluate an offset cone-beam geometry. This offset geometry provides conjugate projections through a full 360 degree gantry rotation, and thus yields a greatly increased effective field of view, allowing a much wider range of breast sizes to be imaged without truncation in reconstructed images. Using a tungsten X-ray tube and digital flat-panel X-ray detector in a compact geometry, we obtained initial CmT scans without shift and with the offset geometry, using geometrical frequency/resolution phantoms and two different sizes of breast phantoms. Acquired data were reconstructed using an ordered subsets transmission iterative algorithm. Projection images indicate that the larger, 20 cm wide, breast requires use of a half-cone-beam offset scan to eliminate truncation artifacts. Reconstructed image results illustrate elimination of truncation artifacts, and that the novel quasi-monochromatic beam yields reduced beam hardening. The offset geometry CmT system can indeed potentially be used for structural imaging and accurate attenuation correction for the functional dedicated breast SPECT system.     

Nonlinear Dual Reconstruction of SPECT Activity and Attenuation Images

In single photon emission computed tomography (SPECT), accurate attenuation maps are needed to perform essential attenuation compensation for high quality radioactivity estimation. Formulating the SPECT activity and attenuation reconstruction tasks as coupled signal estimation and system parameter identification problems, where the activity distribution and the attenuation parameter are treated as random variables with known prior statistics, we present a nonlinear dual reconstruction scheme based on the unscented Kalman filtering (UKF) principles. In this effort, the dynamic changes of the organ radioactivity distribution are described through state space evolution equations, while the photon-counting SPECT projection data are measured through the observation equations. Activity distribution is then estimated with sub-optimal fixed attenuation parameters, followed by attenuation map reconstruction given these activity estimates. Such coupled estimation processes are iteratively repeated as necessary until convergence. The results obtained from Monte Carlo simulated data, physical phantom, and real SPECT scans demonstrate the improved performance of the proposed method both from visual inspection of the images and a quantitative evaluation, compared to the widely used EM-ML algorithms. The dual estimation framework has the potential to be useful for estimating the attenuation map from emission data only and thus benefit the radioactivity reconstruction.     

Optimization of SPECT-CT Hybrid Imaging Using Iterative Image Reconstruction for Low-Dose CT: A Phantom Study

Background

Hybrid imaging combines nuclear medicine imaging such as single photon emission computed tomography (SPECT) or positron emission tomography (PET) with computed tomography (CT). Through this hybrid design, scanned patients accumulate radiation exposure from both applications. Imaging modalities have been the subject of long-term optimization efforts, focusing on diagnostic applications. It was the aim of this study to investigate the influence of an iterative CT image reconstruction algorithm (ASIR) on the image quality of the low-dose CT images.

Methodology/Principal Findings

Examinations were performed with a SPECT-CT scanner with standardized CT and SPECT-phantom geometries and CT protocols with systematically reduced X-ray tube currents. Analyses included image quality with respect to photon flux. Results were compared to the standard FBP reconstructed images. The general impact of the CT-based attenuation maps used during SPECT reconstruction was examined for two SPECT phantoms. Using ASIR for image reconstructions, image noise was reduced compared to FBP reconstructions for the same X-ray tube current. The Hounsfield unit (HU) values reconstructed by ASIR were correlated to the FBP HU values(R² ≥ 0.88) and the contrast-to-noise ratio (CNR) was improved by ASIR. However, for a phantom with increased attenuation, the HU values shifted for low X-ray tube currents I ≤ 60 mA (p ≤ 0.04). In addition, the shift of the HU values was observed within the attenuation corrected SPECT images for very low X-ray tube currents (I ≤ 20 mA, p ≤ 0.001).

Conclusion/Significance

In general, the decrease in X-ray tube current up to 30 mA in combination with ASIR led to a reduction of CT-related radiation exposure without a significant decrease in image quality.     

CT-SPECT fusion for analysis of radiolabeled antibodies: Applications in gastrointestinal and lung carcinoma

Fusing or image registration improves the information obtained by correlating images from various imaging modalities. We “fused” radiolabeled antibody SPECT with CT in patients with colorectal or lung cancer. We identified corresponding landmarks on cross-sectional images and used standard graphics algorithms for untilting to match planes of reconstruction and for two-dimensional warping or ransformation of images or regions of interest. Fusing localizes activity on SPECT to specific anatomic structures and decreases SPECT false positives and CT false negatives.     

Magnetic resonace-based attenuation correction for micro-single-photon emission computed tomography

Attenuation correction is necessary for quantification in micro-single-photon emission computed tomography (micro-SPECT). In general, this is done based on micro-computed tomographic (micro-CT) images. Derivation of the attenuation map from magnetic resonance (MR) images is difficult because bone and lung are invisible in conventional MR images and hence indistinguishable from air. An ultrashort echo time (UTE) sequence yields signal in bone and lungs. Micro-SPECT, micro-CT, and MR images of 18 rats were acquired. Different tracers were used: hexamethylpropyleneamine oxime (brain), dimercaptosuccinic acid (kidney), colloids (liver and spleen), and macroaggregated albumin (lung). The micro-SPECT images were reconstructed without attenuation correction, with micro-CT-based attenuation maps, and with three MR-based attenuation maps: uniform, non-UTE-MR based (air, soft tissue), and UTE-MR based (air, lung, soft tissue, bone). The average difference with the micro-CT-based reconstruction was calculated. The UTE-MR-based attenuation correction performed best, with average errors ≤ 8% in the brain scans and ≤ 3% in the body scans. It yields nonsignificant differences for the body scans. The uniform map yields errors of ≤ 6% in the body scans. No attenuation correction yields errors ≥ 15% in the brain scans and ≥ 25% in the body scans. Attenuation correction should always be performed for quantification. The feasibility of MR-based attenuation correction was shown. When accurate quantification is necessary, a UTE-MR-based attenuation correction should be used.     

An APD-based iterative reconstruction method for simultaneous technetium-99m/iodine-123 SPECT imaging

Dual-isotope SPECT (DI-SPECT) studies offer significant advantages over sequential scans, foremost among them faster acquisition and perfect image registration. However, reconstructed images may be affected by substantial cross-talk contamination rendering them inadequate for diagnosis. This effect is especially strong for isotopes with close photopeak energies, such as ^99mTc (140 keV) and ¹²³I (159 keV). In this paper we present an iterative DI-SPECT reconstruction method which includes accurate, analytically computed scatter corrections provided by the APD (analytical photon distribution) algorithm. This algorithm calculates first and second order Compton scatter (based on the Klein–Nishina formula) and first order Rayleigh scatter. Both self-scatter and cross-talk between the two isotopes are evaluated using patient specific attenuation maps and an initial activity distribution estimate. To validate our method we performed experiments using the Data Spectrum, Inc. thorax phantom and a SPECT/CT camera system. Reconstructed images demonstrate significant improvement in data quantitation. Their quantitative accuracy increases up to a factor of two, even for activity ratios which strongly enhance cross-talk effects and seriously degrade projections.     

Development and application of a multimodal contrast agent for SPECT/CT hybrid imaging

Hybrid or multimodality imaging is often applied in order to take advantage of the unique and complementary strengths of individual imaging modalities. This hybrid noninvasive imaging approach can provide critical information about anatomical structure in combination with physiological function or targeted molecular signals. While recent advances in software image fusion techniques and hybrid imaging systems have enabled efficient multimodal imaging, accessing the full potential of this technique requires development of a new toolbox of multimodal contrast agents that enhance the imaging process. Toward that goal, we report the development of a hybrid probe for both single photon emission computed tomography (SPECT) and X-ray computed tomography (CT) imaging that facilitates high-sensitivity SPECT and high spatial resolution CT imaging. In this work, we report the synthesis and evaluation of a novel intravascular, multimodal dendrimer-based contrast agent for use in preclinical SPECT/CT hybrid imaging systems. This multimodal agent offers a long intravascular residence time (t(1/2) = 43 min) and sufficient contrast-to-noise for effective serial intravascular and blood pool imaging with both SPECT and CT. The colocalization of the dendritic nuclear and X-ray contrasts offers the potential to facilitate image analysis and quantification by enabling correction for SPECT attenuation and partial volume errors at specified times with the higher resolution anatomic information provided by the circulating CT contrast. This may allow absolute quantification of intramyocardial blood volume and blood flow and may enable the ability to visualize active molecular targeting following clearance from the blood.     

Imagerie hybride : principe,dosimétrie et contrôle de qualité

The recent introduction of hybrid systems combining a SPECT and a CT in nuclear medicine, greatly improved the diagnostic accuracy for particular clinical indications, due to the possible attenuation and/or scatter correction of the SPECT functional images and the availability of helpful anatomic information. Although the gamma cameras performances are noticeably comparable, the associated CT furnished by the manufacturer are relatively different from each other. Whatever the system is, the introduction of CT in the nuclear diagnostic process results in a significant increase of the patient dose. This dose increase should be justified and optimized considering both the clinical question and the CT settings available on these systems. The installation of a hybrid system must be accompanied by the management of a documentary quality insurance program, jointly developed by the technologists, physicists and physicians, both covering its clinical use and the associated dosimetry issues as monitoring its performances. Particular quality control procedures have to be defined because of the coupling between the two devices.     

采用Evolution CDR补偿重建技术提高骨断层图像质量方法学研究

目的应用Evolution CDR补偿技术对骨断层图像质量的改善进行评价。方法随机选择32例骨断层显像,分别进行全时采集OSEM迭代处理,1／2时采集OSEM处理以及1／2时采集Evolution处理和全时采集Evolution处理。通过盲法读片,对三种不同图像采集处理技术获得图像进行图像质量评分。结果1／2时采集Evolution重建图像质量与全时采集OS-EM重建图像质量相当;而全时采集Evolution重建的图像质量明显优于全时采集OSEM重建。结论Evolution重建技术通过对CDR补偿,能降低图像噪声,明显改善图像质量,或者在得到与全时采集OSEM迭代重建相当的图像质量的情况下,可以大女降低采键时间．     

Generation of clinical 177Lu SPECT/CT images based on Monte Carlo simulation with GATE

PurposePatient-specific dosimetry in MRT relies on quantitative imaging, pharmacokinetic assessment and absorbed dose calculation. The DosiTest project was initiated to evaluate the uncertainties associated with each step of the clinical dosimetry workflow through a virtual multicentric clinical trial. This work presents the generation of simulated clinical SPECT datasets based on GATE Monte Carlo modelling with its corresponding experimental CT image, which can subsequently be processed by commercial image workstations.MethodsThis study considers a therapy cycle of 6.85 GBq ¹⁷⁷Lu-labelled DOTATATE derived from an IAEA-Coordinated Research Project (E23005) on “Dosimetry in Radiopharmaceutical therapy for personalised patient treatment”. Patient images were acquired on a GE Infinia-Hawkeye 4 gamma camera using a medium energy (ME) collimator. Simulated SPECT projections were generated based on experimental time points and validated against experimental SPECT projections using flattened profiles and gamma index. The simulated projections were then incorporated into the patient SPECT/CT DICOM envelopes for processing and their reconstruction within a commercial image workstation.ResultsGamma index passing rate (2% − 1 pixel criteria) between 95 and 98% and average gamma between 0.28 and 0.35 among different time points revealed high similarity between simulated and experimental images. Image reconstruction of the simulated projections was successful on HERMES and Xeleris workstations, a major step forward for the initiation of a multicentric virtual clinical dosimetry trial based on simulated SPECT/CT images.ConclusionsRealistic ¹⁷⁷Lu patient SPECT projections were generated in GATE. These modelled datasets will be circulated to different clinical departments to perform dosimetry in order to assess the uncertainties in the entire dosimetric chain.     

The "third" dimension in craniofacial surgery

A new method for reconstruction of a three-dimensional surface from a sequence of high-resolution axial CT scans has been developed. This algorithm is realized as a set of computer programs that can operate on commercially available CT scanners or evaluation consoles. The program is both efficient and easy to implement. No operator intervention is required. The images produced simulate photographs of the skull. Frontal, lateral, oblique, bird's eye, worm's eye, and rear views are generated. As with photographs and conventional radiographs, each of these projections uniquely displays specific anatomic details. This method of osseous surface reconstruction is now routinely applied to all patients evaluated for major craniofacial reconstruction at our institution. The images are useful in defining aberrant anatomy, planning surgical procedures, and evaluating the results of such operations. This method replaces an inexact concept in the surgeon's imagination with a three-dimensional image of the craniofacial skeleton.     

TEMP/TDM : les preuves de l’efficacité pour les pathologies inflammatoires et infectieuses profondes ; localisation des foyers ectopiques

The disposal of SPECT/CT hybrid cameras offers the nuclear physicians a great evolution in their daily practice. The indications in cardiology have been known for several years and the search for correcting the attenuation is at the origin of the technology. Rapidly, this method pairing the optimisation of the sensibility – due to the attenuation correction – and the localization, has been used to increase the performance of most of the scintigaphic exams. The contribution in the osteoarticular and oncological indications is already well accepted. The purpose of this paper is to point-out the contribution of this technology in the difficult task to identify the infectious and inflammatory seats in the deep organs. The improvement of the ratio of signal to noise achieved in SPECT/CT becomes a precious tool. Likewise the accurate localization offers the clinician a significant orientation for the diagnosis. Today, the SPECT/CT exams are the most efficient of all the imaging technologies, to detect, digestive inflammatory pathologies or exsudative enteropathies, as well as the identification of a vascular infectious seat. Moreover, the ectopic seat acute localization becomes a precious pre-operating tool for these fragile patients as it gives important data to the surgical team.     

Physiological imaging of the lung: single-photon-emission computed tomography (SPECT).

Emission tomography provides three-dimensional, quantitative images of the distribution of radiotracers used to mark physiological, metabolic, or pathological processes. Quantitative single photon emission computed tomography (SPECT) requires correction for the image-degrading effects due to photon attenuation and scatter. Phantom experiments have shown that radioactive concentrations can be assessed within some percentage of the true value when relevant corrections are applied. SPECT is widely spread, and radiotracers are available that are easy to use and comparably inexpensive. Compared with other methods, SPECT suffers from a lower spatial resolution, and the time required for image acquisition is longer than for some alternative methods. In contrast to some other methods, SPECT allows simultaneous imaging of more than one process, e.g., both regional blood flow and ventilation, for the whole lung. SPECT has been used to explore the influence of posture and clinical interventions on the spatial distribution of lung blood flow and ventilation. Lung blood flow is typically imaged using macroaggregates of albumin. Both radioactive gases and particulate aerosols labeled with radioactivity have been used for imaging of regional ventilation. However, all radiotracers are not equally suited for quantitative measurements; all have specific advantages and limitations. With SPECT, both blood flow and ventilation can be marked with radiotracers that remain fixed in the lung tissue, which allows tracer administration during conditions different from those at image registration. All SPECT methods have specific features that result from the used radiotracer, the manner in which it is administered, and how images are registered and analyzed.     

Secure Similar Image Search and Copyright Protection over Encrypted Medical Image Databases

The recent advances in digital medical imaging and storage in cloud are bringing about more demands for efficient and secure image retrieval and management. Typically, medical images are very sensitive to changes where any modifications in its content may bring about an erroneous medical diagnosis. Therefore, securing medical images is a very essential process and the major task is, the medical image must maintain their sensitive contents at the time of reconstruction. The proposed methodology executes a secure image encryption and search of medical images proficiently over encrypted image database without leaking any sensitive data. It also ensures medical data integrity by introducing an efficient recovery mechanism on ROI of the image. The proposed scheme obtains recovery information about the image from the ROI of the medical data and embeds it in the RONI region using IWT transform which act as a reversible watermarking. If any alterations or tampers are caused to ROI at the third-party end, then it can be identified and recovered from the obtained recovery data. Besides, the model also executes a Copyright protection scheme to locate the authorized users, who illegally duplicate and distribute the retrieved image to unauthorized entities.     

Intérêt de l’imagerie hybride TEMP/TDM pour la scintigraphie des récepteurs de la somatostatine dans le bilan des tumeurs endocrines gastro-entéro-pancréatiques

In this work, we have evaluated the potential of image fusion and attenuation correction (AC) of SPECT-CT imaging for the assessment of gastro-entero-pancreatic endocrine tumors by somatostatin receptor scintigraphy (SRS).MethodAfter optimisation of acquisition and reconstruction parameters, we have evaluated, in a prospective study, SRS performed over a period of one year. We have compared visual interpretations of planar and tomographic images versus SPECT/CT images to determine if anatomical localisation and diagnostic contributions are improved. In a semi-quantitative analysis of pathological foci, we have measured maximal intensity values (T_max), tumour to background ratios (T/B) and tumour contrasts (Ct) with and without AC.ResultsIn 25 SRS, visual analysis has shown anatomical localisation improvements in 60% of cases (CI95%, 39–79) and diagnostic improvements in 64% of cases (CI95%, 43–82). Doubtful foci proportion changed from 44 to 11%. In the semi-quantitative analysis of 41 pathological foci, Wilcoxon matched-pairs tests showed significantly higher T_max, T/B and Ct values after AC.ConclusionSPECT/CT imaging improves diagnostic quality of SRS thanks to a better foci localisation and a better lesional contrast in the image.     

Les examens cardiaques en tomographie par émission de positons

Cardiac positron emission tomography (PET) is yet considered as a reference imaging technique but remains poorly used in clinical practice. At the present time, the advantages of cardiac PET investigations are far to be evident, when compared with conventional tomoscintigraphy (SPECT), except for perfusion imaging in the obese and for viability assessment in case of very severe cardiac dysfunction. However, this situation might quickly move because of an enhanced availability of PET imaging, dramatic technical progresses and promising new tracers. In particular, the last-generation PET-cameras allow reaching spatial resolutions and detection sensitivities, which are now spectacularly higher than those from conventional SPECT imaging. In addition, the list mode recording allows the subsequent images reconstruction to be synchronized to cardiac cycle but also to respiratory cycle; and the quantifications of myocardial perfusion flow and of coronary flow reserve are now available in clinical routine. Furthermore, new tracers labelled with fluorine-18 are under development, especially for perfusion investigations, and kinetics properties of these new tracers are dramatically enhanced when compared with current perfusion SPECT tracers.     

UCSF tomography: an integrated software suite for real-time electron microscopic tomographic data collection, alignment, and reconstruction

A real-time alignment and reconstruction scheme for electron microscopic tomography (EMT) has been developed and integrated within our UCSF tomography data collection software. This newly integrated software suite provides full automation from data collection to real-time reconstruction by which the three-dimensional (3D) reconstructed volume is immediately made available at the end of each data collection. Real-time reconstruction is achieved by calculating a weighted back-projection on a small Linux cluster (five dual-processor compute nodes) concurrently with the UCSF tomography data collection running on the microscope's computer, and using the fiducial-marker free alignment data generated during the data collection process. The real-time reconstructed 3D volume provides users with immediate feedback to fully asses all aspects of the experiment ranging from sample choice, ice thickness, experimental parameters to the quality of specimen preparation. This information can be used to guide subsequent data collections. Access to the reconstruction is especially useful in low-dose cryo EMT where such information is very difficult to obtain due to extraordinary low signal to noise ratio in each 2D image. In our environment, we generally collect 2048 x 2048 pixel images which are subsequently computationally binned four-fold for the on-line reconstruction. Based upon experiments performed with thick and cryo specimens at various CCD magnifications (50000x-80000x), alignment accuracy is sufficient to support this reduced resolution but should be refined before calculating a full resolution reconstruction. The reduced resolution has proven to be quite adequate to assess sample quality, or to screen for the best data set for full-resolution reconstruction, significantly improving both productivity and efficiency of system resources. The total time from start of data collection to a final reconstructed volume (512 x 512 x 256 pixels) is about 50 min for a +/-70 degrees 2k x 2k pixel tilt series acquired at every 1 degrees.     

L’apport de la fusion scintigraphie myocardique–scanner coronaire

The purpose is to assess the added information provided by the fusion from the SPECT and the CT coronary angiography, in the identification of the coronary artery – related ischemia (reversible defects) and the coronary artery-related infarction (fixed defects). Compared with the sole analyse of SPECT; addition of fused SPECT/CT images appears to enhance the ability to identify the ischemia – related artery. This might be particularly useful for determining the optimal revascularisation procedure in patients with multivessel disease.