Introduction to neutron stimulated emission computed tomography

In vivo neutron activation assembly design for quantification of trace elements using MCNP

BACKGROUND

Trace and essential elements both play a crucial role in maintaining normal cellular and organ functions in human, while abnormal exposure to some of them are also potentially related to diseases, e.g., manganism. To study the association between elemental intake and health outcomes, accurate assessment of elemental uptake and storage in the human body is essential.

OBJECTIVES

Neutron activation analysis based technology can be used for in vivo measurements of the trace elements given that the measurement system guarantees a low detection limit with an acceptable dose. This study aims to design and optimize a customized and portable deuterium-deuterium (DD) neutron generator-based irradiation assembly for neutron activation analysis of trace elements in vivo, using Monte Carlo simulations.

METHODS

The irradiation assembly includes a moderator, a fast neutron filter (FNF), reflector, and shielding. The human hand equivalent phantoms doped with manganese (Mn) and potassium (K) are used to determine the respective elements' system sensitivity and detection limit.

RESULTS

The calculated detection limit is 0.16 g Mn per gram dry bone (ppm) for Mn and 17 ppm for K, with an equivalent dose of 36 mSv to the hand for a 10 min irradiation.

CONCLUSION

This more sensitive in vivo neutron activation analysis system will detect trace elements in vivo.

Elemental analysis in living human subjects using biomedical devices

Today, patients undergoing dialysis are at low risk for aluminum-induced dementia. Workers are unlikely to experience cadmium-induced emphysema and the public's exposure to lead is an order of magnitude lower than in 1970. The research field of in vivo elemental analysis has played a role in these occupational and environmental health improvements by allowing the effects of people's chronic exposure to elements to be studied using non-invasive, painless, and relatively low-cost technology. From the early 1960s to the present day, researchers have developed radiation-based systems to measure the elemental content of organs at risk or storage organs. This reduces the need for (sometimes painful) biopsy and the risk of infection. Research and development has been undertaken on forty-nine in vivo measurement system designs. Twenty-nine different in vivo elemental analysis systems, measuring 22 different elements, have been successfully taken from design and testing through to human measurement. The majority of these systems employ either neutron activation analysis or x-ray fluorescence analysis as the basis of the measurement. In this review, we discuss eight of the successful systems, explaining the rationale behind their development, the methodology, the health data that has resulted from application of these tools, and provide our opinion on potential future technical developments of these systems. We close by discussing four technologies that may lead to new directions and advances in the whole field.

Scalable gamma-ray camera for wide-area search based on silicon photomultipliers array

Portable coded-aperture imaging systems based on scintillators and semiconductors have found use in a variety of radiological applications. For stand-off detection of weakly emitting materials, large volume detectors can facilitate the rapid localization of emitting materials. We describe a scalable coded-aperture imaging system based on 5.02 × 5.02 cm² CsI(Tl) scintillator modules, each partitioned into 4 × 4 × 20 mm³ pixels that are optically coupled to 12 × 12 pixel silicon photo-multiplier (SiPM) arrays. The 144 pixels per module are read-out with a resistor-based charge-division circuit that reduces the readout outputs from 144 to four signals per module, from which the interaction position and total deposited energy can be extracted. All 144 CsI(Tl) pixels are readily distinguishable with an average energy resolution, at 662 keV, of 13.7% FWHM, a peak-to-valley ratio of 8.2, and a peak-to-Compton ratio of 2.9. The detector module is composed of a SiPM array coupled with a 2 cm thick scintillator and modified uniformly redundant array mask. For the image reconstruction, cross correlation and maximum likelihood expectation maximization methods are used. The system shows a field of view of 45° and an angular resolution of 4.7° FWHM.

New generation non-stationary portable neutron generators for biophysical applications of Neutron Activation Analysis

BACKGROUND

Neutron sources are increasingly employed in a wide range of research fields. For some specific purposes an alternative to existing large-scale neutron scattering facilities, can be offered by the new generation of portable neutron devices.

SCOPE OF REVIEW

This review reports an overview for such recently available neutron generators mainly addressed to biophysics applications with specific reference to portable non-stationary neutron generators applied in Neutron Activation Analysis (NAA).

MAJOR CONCLUSIONS

The review reports a description of a typical portable neutron generator set-up addressed to biophysics applications.

GENERAL SIGNIFICANCE

New generation portable neutron devices, for some specific applications, can constitute an alternative to existing large-scale neutron scattering facilities. Deuterium-Deuterium pulsed neutron sources able to generate 2.5MeV neutrons, with a neutron yield of 1.0×10⁶n/s, a pulse rate of 250Hz to 20kHz and a duty factor varying from 5% to 100%, when combined with solid-state photon detectors, show that this kind of compact devices allow rapid and user-friendly elemental analysis. "This article is part of a Special Issue entitled "Science for Life" Guest Editor: Dr. Austen Angell, Dr. Salvatore Magazù and Dr. Federica Migliardo".

Assessment of individual organ doses in a realistic human phantom from neutron and gamma stimulated spectroscopy of the breast and liver

PURPOSE

Understanding the radiation dose to a patient is essential when considering the use of an ionizing diagnostic imaging test for clinical diagnosis and screening. Using Monte Carlo simulations, the authors estimated the three-dimensional organ-dose distribution from neutron and gamma irradiation of the male liver, female liver, and female breasts for neutron- and gamma-stimulated spectroscopic imaging.

METHODS

Monte Carlo simulations were developed using the Geant4 GATE application and a voxelized XCAT human phantom. A male and a female whole body XCAT phantom was voxelized into 256 × 256 × 600 voxels (3.125 × 3.125 × 3.125 mm(3)). A monoenergetic rectangular beam of 5.0 MeV neutrons or 7.0 MeV photons was made incident on a 2 cm thick slice of the phantom. The beam was rotated at eight different angles around the phantom ranging from 0° to 180°. Absorbed dose was calculated for each individual organ in the body and dose volume histograms were computed to analyze the absolute and relative doses in each organ.

RESULTS

The neutron irradiations of the liver showed the highest organ dose absorption in the liver, with appreciably lower doses in other proximal organs. The dose distribution within the irradiated slice exhibited substantial attenuation with increasing depth along the beam path, attenuating to ~15% of the maximum value at the beam exit side. The gamma irradiation of the liver imparted the highest organ dose to the stomach wall. The dose distribution from the gammas showed a region of dose buildup at the beam entrance, followed by a relatively uniform dose distribution to all of the deep tissue structures, attenuating to ~75% of the maximum value at the beam exit side. For the breast scans, both the neutron and gamma irradiation registered maximum organ doses in the breasts, with all other organs receiving less than 1% of the breast dose. Effective doses ranged from 0.22 to 0.37 mSv for the neutron scans and 41 to 66 mSv for the gamma scans.

CONCLUSIONS

Neutron and gamma irradiation of a primary target organ was found to impart the majority of the total dose to the primary target organ (and other large organs) within the beam plane and considerably lower dose to proximal organs outside of the beam. These results also indicate that despite the use of a highly scattering particle such as a neutron, the dose from neutron stimulated emission computed tomography scans is on par with other clinical imaging techniques such as x-ray computed tomography (x-ray CT). Given the high nonuniformity in the dose across an organ during the neutron scan, care must be taken when computing average doses from neutron irradiations. The effective doses from neutron scanning were found to be comparable to x-ray CT. Further technique modifications are needed to reduce the effective dose levels from the gamma scans.

3D element imaging using NSECT for the detection of renal cancer: a simulation study in MCNP

This work describes a simulation study investigating the application of neutron stimulated emission computed tomography (NSECT) for noninvasive 3D imaging of renal cancer in vivo. Using MCNP5 simulations, we describe a method of diagnosing renal cancer in the body by mapping the 3D distribution of elements present in tumors using the NSECT technique. A human phantom containing the kidneys and other major organs was modeled in MCNP5. The element composition of each organ was based on values reported in literature. The two kidneys were modeled to contain elements reported in renal cell carcinoma (RCC) and healthy kidney tissue. Simulated NSECT scans were executed to determine the 3D element distribution of the phantom body. Elements specific to RCC and healthy kidney tissue were then analyzed to identify the locations of the diseased and healthy kidneys and generate tomographic images of the tumor. The extent of the RCC lesion inside the kidney was determined using 3D volume rendering. A similar procedure was used to generate images of each individual organ in the body. Six isotopes were studied in this work - (32)S, (12)C, (23)Na, (14)N, (31)P and (39)K. The results demonstrated that through a single NSECT scan performed in vivo, it is possible to identify the location of the kidneys and other organs within the body, determine the extent of the tumor within the organ, and to quantify the differences between cancer and healthy tissue-related isotopes with p ≤ 0.05. All of the images demonstrated appropriate concentration changes between the organs, with some discrepancy observed in (31)P, (39)K and (23)Na. The discrepancies were likely due to the low concentration of the elements in the tissue that were below the current detection sensitivity of the NSECT technique.

Quantitative assessment of lesion detection accuracy, resolution, and reconstruction algorithms in neutron stimulated emission computed tomography

We present a quantitative analysis of the image quality obtained using filtered back-projection (FBP) with Ram-Lak filtering and maximum likelihood-expectation maximization (ML-EM)-with no post-reconstruction filtering in either case-in neutron stimulated emission computed tomography (NSECT) imaging using Monte Carlo simulations in the context of clinically relevant models of liver iron overload. The ratios of pixel intensities for several regions of interest and lesion shape detection using an active-contours segmentation algorithm are assessed for accuracy across different scanning configurations and reconstruction algorithms. The modulation transfer functions (MTFs) are also computed for the cases under study and are applied to determine a minimum detectable lesion spacing as a form of sensitivity analysis. The accuracy of NSECT imaging in measuring relative tissue concentration is presented for simulated clinical liver cases. When using the 15th iteration, ML-EM provides at least 25% better resolution than FBP and proves to be highly robust under low-signal high-noise conditions prevalent in NSECT. However, FBP gives more accurate lesion pixel intensity ratios and size estimates in some cases; due to advantages provided by both reconstruction algorithms, it is worth exploring the development of an algorithm that is a hybrid of the two. We also show that NSECT imaging can be used to accurately detect 3-cm lesions in backgrounds that are a significant fraction (one-quarter) of the concentration of the lesion, down to a 4-cm spacing between lesions.

Prompt gamma-ray emission from biological tissues during proton irradiation: a preliminary study

In this paper, we present the results of a preliminary study of secondary 'prompt' gamma-ray emission produced by proton-nuclear interactions within tissue during proton radiotherapy. Monte Carlo simulations were performed for mono-energetic proton beams, ranging from 2.5 MeV to 250 MeV, irradiating elemental and tissue targets. Calculations of the emission spectra from different biological tissues and their elemental components were made. Also, prompt gamma rays emitted during delivery of a clinical proton spread-out Bragg peak (SOBP) in a homogeneous water phantom and a water phantom containing heterogeneous tissue inserts were calculated to study the correlation between prompt gamma-ray production and proton dose delivery. The results show that the prompt gamma-ray spectra differ significantly for each type of tissue studied. The relative intensity of the characteristic gamma rays emitted from a given tissue was shown to be proportional to the concentration of each element in that tissue. A strong correlation was found between the delivered SOBP dose distribution and the characteristic prompt gamma-ray production. Based on these results, we discuss the potential use of prompt gamma-ray emission as a method to verify the accuracy and efficacy of doses delivered with proton radiotherapy.

Near-Field High-Energy Spectroscopic Gamma Imaging Using a Rotation Modulation Collimator

Certain trace elements are vital to the body and elemental imbalances can be indicators of certain diseases including cancer and liver diseases. Neutron Stimulated Emission Computed Tomography (NSECT) is being developed as spectroscopic imaging technique to non-invasively and non-destructively measure and image elemental concentrations within the body. A region of interest is illuminated via a high-energy beam of neutrons that scatter inelastically with elemental nuclei within the body. The excited nuclei then relax by emitting characteristic gamma rays. Acquiring the gamma spectrum in a tomographic manner allows not only the identification of elements, but also the formation of images representing spatial distributions of specific elements. We are developing a high-energy position-sensitive gamma camera that allows full illumination of the entire region of interest. Because current scintillation crystal based position-sensitive gamma cameras operate in too low of an energy range, we are adapting high-energy gamma imaging techniques used in space-based imaging. A High Purity Germanium (HPGe) detector provides high-resolution energy spectra while a rotating modulation collimator (RMC) placed in front of the detector modulates the incoming signal to provide spatial information. The purpose of this manuscript is to describe the near-field RMC geometry, which varies greatly from the infinite-focus space-based applications, and how it modulates the incident gamma flux. A simple geometric model is presented and then used to reconstruct two-dimensional planar images of both simulated point sources and extended sources.

Experimental detection of iron overload in liver through neutron stimulated emission spectroscopy

Iron overload disorders have been the focus of several quantification studies involving non-invasive imaging modalities. Neutron spectroscopic techniques have demonstrated great potential in detecting iron concentrations within biological tissue. We are developing a neutron spectroscopic technique called neutron stimulated emission computed tomography (NSECT), which has the potential to diagnose iron overload in the liver at clinically acceptable patient dose levels through a non-invasive scan. The technique uses inelastic scatter interactions between atomic nuclei in the sample and incoming fast neutrons to non-invasively determine the concentration of elements in the sample. This paper discusses a non-tomographic application of NSECT investigating the feasibility of detecting elevated iron concentrations in the liver. A model of iron overload in the human body was created using bovine liver tissue housed inside a human torso phantom and was scanned with a 5 MeV pulsed beam using single-position spectroscopy. Spectra were reconstructed and analyzed with algorithms designed specifically for NSECT. Results from spectroscopic quantification indicate that NSECT can currently detect liver iron concentrations of 6 mg g(-1) or higher and has the potential to detect lower concentrations by optimizing the acquisition geometry to scan a larger volume of tissue. The experiment described in this paper has two important outcomes: (i) it demonstrates that NSECT has the potential to detect clinically relevant concentrations of iron in the human body through a non-invasive scan and (ii) it provides a comparative standard to guide the design of iron overload phantoms for future NSECT liver iron quantification studies.

Breast cancer detection using neutron stimulated emission computed tomography: prominent elements and dose requirements

Neutron stimulated emission computed tomography (NSECT) is being developed to noninvasively determine concentrations of trace elements in biological tissue. Studies have shown prominent differences in the trace element concentration of normal and malignant breast tissue. NSECT has the potential to detect these differences and diagnose malignancy with high accuracy with dose comparable to that of a single mammogram. In this study, NSECT imaging was simulated for normal and malignant human breast tissue samples to determine the significance of individual elements in determining malignancy. The normal and malignant models were designed with different elemental compositions, and each was scanned spectroscopically using a simulated 2.5 MeV neutron beam. The number of incident neutrons was varied from 0.5 million to 10 million neutrons. The resulting gamma spectra were evaluated through receiver operating characteristic (ROC) analysis to determine which trace elements were prominent enough to be considered markers for breast cancer detection. Four elemental isotopes (133Cs, 81Br, 79Br, and 87Rb) at five energy levels were shown to be promising features for breast cancer detection with an area under the ROC curve (A(Z)) above 0.85. One of these elements--87Rb at 1338 keV--achieved perfect classification at 10 million incident neutrons and could be detected with as low as 3 million incident neutrons. Patient dose was calculated for each gamma spectrum obtained and was found to range from between 0.05 and 0.112 mSv depending on the number of neutrons. This simulation demonstrates that NSECT has the potential to noninvasively detect breast cancer through five prominent trace element energy levels, at dose levels comparable to other breast cancer screening techniques.