The Aberdeen Mark II single-photon-emission tomographic scanner: specification and some clinical applications

Neuro-SPECT: On the development and function of brain emission tomography in the Copenhagen area

This review describes the development of single-photon emission tomography (SPECT) in the Copenhagen area under the leadership of the internationally renown scientist, Niels A. Lassen, and the history leading up to construction of the tomograph. Measurements of global cerebral blood flow (CBF) in the 1940s and 1950s were performed by Kety & Schmidt and Lassen & Munck. Determination of regional cerebral blood flow (rCBF) by intra-arterial injection of ¹³³ Xe and measurement with a 254-multicrystal scintillation detector and a computer system was a major step forward in the study of physiology and pathophysiology of cortical cerebral blood flow. Tomography with radioisotope ligands, including non-invasive administration, was advanced in different centres during the 1970s. An emission tomograph, the Tomomatic 64, was developed as a result of a multidisciplinary Danish and international collaboration. It was the first emission tomograph to provide dynamic data that could produce cross-sectional rCBF images. The present description of the construction and function of the Tomomatic 64 includes comparison with other contemporary and later brain-dedicated SPECT systems. Basic and clinical application of the Tomomatic 64 in Copenhagen resulted in several hundred important scientific publications and improved diagnostics for patients with a variety of neurological disorders. It is concluded that the development of the Tomomatic 64 was a major step forward in the study and examination of rCBF and brain function related to several brain disorders, in addition to vascular diseases.

Magnetic resonance imaging-the Aberdeen perspective on developments in the early years

From the beginnings of medical imaging with radioactivity, an account is given of the development in Aberdeen of CT scanners in nuclear medicine, and their clinical value, leading to the present-day gamma-cameras. Early animal work with electron magnetic resonance is described, which developed into a programme towards nuclear magnetic resonance of water in body tissues. The 1974 NMR image of a mouse, using the nuclear medicine experience, led to a quest to build the first clinically useful whole-body MRI. The work of other teams is outlined, and the steps which led to successful diagnostic images being made with the Aberdeen machine in 1980. The welcome from the medical fraternity, and the output of the multinational medical imaging companies, has led to the present-day, worldwide use of the MRI technique.

Comparison between planar and tomographic radionuclide ventriculography for detecting inferior wall motion abnormalities

Gated planar radionuclide ventriculography is routinely used for the detection of regional wall motion abnormalities of the left ventricle. However, for inferior wall motion abnormalities, sensitivity is known to be low in the left anterior oblique 'best septal' projection, although improved if a left posterior oblique (LPO) view is also acquired. Gated tomography of the cardiac blood pool is now available. This study compared the sensitivity of planar 'best septal' projection, LPO and tomographic radionuclide ventriculography in the detection of inferior wall motion abnormalities. Thirty-two patients consisting of 18 with previous inferior myocardial infarction and 14 normal controls were studied. All patients underwent equilibrium planar 'best septal', planar LPO and then tomographic radionuclide ventriculography. Inferior wall motion abnormality was detected in 'best septal' in eight (44%) patients, LPO in 12 (67%) and tomography in 17 (94%) patients, respectively. Tomographic radionuclide ventriculography was best at detecting inferior wall motion abnormality while planar LPO projection is better than 'best septal' projection.

Study of left and right ventricular function in Romano-Ward syndrome

OBJECTIVE

To examine left and right ventricular contraction in Romano-Ward syndrome: does abnormal myocardium affect the predisposition to arrhythmia?

DESIGN

Tomographic radionuclide ventriculography was performed after the red blood cells were labelled conventionally with stannous pyrophosphate and technetium-99m.

SETTING

Department of Nuclear Medicine, Aberdeen Royal Infirmary.

PATIENTS

Eight subjects from two families known to have Romano-Ward syndrome, four of whom (two from each family) had had symptoms.

RESULTS

The five subjects from family 1 had normal left ventricular contraction; two had subtle abnormalities of right ventricular phase. in family 2 all three subjects had abnormal left ventricular contraction (reduced amplitude in three, abnormal phase in two). All had subtle abnormalities of right ventricular phase.

CONCLUSION

Abnormal right or left ventricular myocardium may be partly or wholly responsible for the repolarisation changes seen on the electrocardiogram of these families or may act as an ectopic focus to start ventricular tachycardias in a susceptible heart.

A transputer based three-dimensional dynamic cardiac imaging system

In Aberdeen, a single-section transverse emission scanner has been adapted to trigger off patient ECG signals, allowing for the acquisition of gated blood pool tomograms at a number of slice levels through the patient's heart. This paper describes a system for the routine generation and display of surface rendered images derived from this data using a transputer based hardware system. Surface rendering algorithms have been implemented to provide an indication of the distribution of the cardiac blood pool in three dimensions, whilst the additional use of colour and/or cine sequences provide a succinct method of representing the extra information provided by gated acquisition. The transputer provides sufficient computing power to produce rendered views at a rate of about 1 frame per second, thus putting view selection fully under operator control. The success of the system described is reflected in its routine use in a busy clinical department.

Simulated annealing image reconstruction method for a pinhole aperture single photon emission computed tomograph (SPECT)

A series of computer experiments was performed to determine the relative performance of simulated annealing, quenched annealing, and a least-squares iterative technique for image reconstruction for single photon emission computed tomography (SPECT). The simulated SPECT geometry was of the pinhole aperture type, with 32 pinholes and 128 or 512 detectors. To test the robustness of the reconstruction techniques upon arbitrary geometries, a 360-detector geometry with a random pixel-detector-factor matrix was tested. Eight computer-simulated, 10-cm-diameter planar phantoms were used with 1961 2-mm(2) reconstruction bins and a range of 3000 to 50,000,000 detected photon counts. Reconstruction quality was measured by a normalized, squared error picture distance measure. Over a wide range of noise, the simulated annealing method had slightly better reconstruction quality than the iterative method, although requiring greater reconstruction time. Quenched annealing was faster than simulated annealing, with comparable reconstruction quality. Methods of efficiently controlling the simulated annealing algorithm are presented.

Gated cardiac tomography

An ECG gated tomographic system is described and its application to routine diagnosis of cardiac wall dyskinesis discussed. The tomographic sections are gathered by a single section scanning system (Aberdeen Section Scanner). Technetium labelled red blood cells are used as the imaging agent. The time of the occurrence of the ECG R-wave is superimposed on the tomographic projection data stream and the gated images produced subsequently. The average patient study requires 15 min. Images at 8 phases of the cardiac cycle are generated at each of 5 levels, 16 mm apart, covering the length of the left ventricle. The images are stored as a three dimensional matrix and may be analysed in sections at any orientation. Fourier analysis of computer generated short axis sections are used to generate a set of coefficients describing the contraction of the left ventricle. The coefficients for each patient study are displayed as a series of two dimensional polar images, schematically displaying the spatial distribution of the coefficient over the left ventricle. These polar images are further analysed by comparison with distributions obtained from normal patient studies. The calculated deviations from the normal are then used to diagnose the magnitude and position of any dyskinesis. Initial results show that the tomographic system is capable of routinely detecting inferior cardiac wall dyskinesis, showing an advantage over non tomographic techniques.