A nonlinear spatially variant object-dependent system model for prediction of partial volume effects and scatter in PET

Quantitative SPECT/CT-Technique and Clinical Applications

The continuous development of SPECT over the past 50 years has led to improved image quality and increased diagnostic confidence. The most influential developments include the realization of hybrid SPECT/CT devices, as well as the implementation of attenuation correction and iterative image reconstruction techniques. These developments have led to a preference for SPECT/CT devices over SPECT-only systems and to the widespread adoption of the former, strengthening the role of SPECT/CT as the workhorse of Nuclear Medicine imaging. New trends in the ongoing development of SPECT/CT are diverse. For example, whole-body SPECT/CT images, consisting of acquisitions from multiple consecutive bed positions in the manner of PET/CT, are increasingly performed. Additionally, in recent years, some interesting approaches in detector technology have found their way into commercial products. For example, some SPECT cameras dedicated to specific organs employ semiconductor detectors made of cadmium telluride or cadmium zinc telluride, which have been shown to increase the obtainable image quality by offering a higher sensitivity and energy resolution. However, the advent of quantitative SPECT/CT which, like PET, can quantify the amount of tracer in terms of Bq/mL or as a standardized uptake value could be regarded as most important development. It is a major innovation that will lead to increased diagnostic accuracy and confidence, especially in longitudinal studies and in the monitoring of treatment response. The current work comprises two main aspects. At first, physical and technical fundamentals of SPECT image formation are described and necessary prerequisites of quantitative SPECT/CT are reviewed. Additionally, the typically achievable quantitative accuracy based on reports from the literature is given. Second, an extensive list of studies reporting on clinical applications of quantitative SPECT/CT is provided and reviewed.

Quantitative SPECT/CT

Conventional nuclear medical imaging uses radiopharmaceuticals labeled by single-photon emitters such as Tc-99m, I-123, or I-131 in vivo. Classical clinical examples are the study of bone metabolism by bone scintigraphy with the Tc-99m-labeled polyphosphonates or of iodine transport into the thyroid gland using Tc-99m-pertechnetate. With single-photon emission-computed tomography (SPECT), the distribution of these radiopharmaceuticals within the human body is three-dimensionally visualized. Contrary to positron emission tomography (PET), current SPECT technology does not allow the quantification of regional values of radioactivity tissue concentration as SPECT images are grossly compromised by artifacts caused by photon scatter and attenuation. With the advent of hybrid imaging systems combining a SPECT camera with an X-ray computerized (CT) scanner in one gantry, reliable corrections for these artifacts seem possible, allowing truly quantitative SPECT.

An MR image-guided, voxel-based partial volume correction method for PET images

PURPOSE

Partial volume effect in positron emission tomography (PET) can cause incorrect quantification of radiopharmaceutical uptake in functional imaging. A PET partial volume correction method is presented to attenuate partial volume blurring and to yield voxel-based corrected PET images.

METHODS

By modeling partial volume effect as a convolution of point spread function of the PET scanner, the reconstructed PET images are corrected by iterative deconvolution with an edge-preserving smoothness constraint. The constraint is constructed to restore discontinuities extracted from coregistered MR images but maintains the smoothness in radioactivity distribution. The correction is implemented in a Bayesian deconvolution framework and is solved by a conjugate gradient method. The performance of the method was compared with the geometric transfer matrix (GTM) method on a simulated dataset. The method was evaluated on synthesized brain FDG-PET data and phantom MRI-PET experiments.

RESULTS

The true PET activity of objects with a size of greater than the full-width at half maximum of the point spread function has been effectively restored in the simulated data. The partial volume correction method is quantitatively comparable to the GTM method. For synthesized FDG-PET with true activity 0 μci/cc for cerebrospinal fluid (CSF), 228 μci/cc for white matter (WM), and 621 μci/cc for gray matter (GM), the method has improved the radioactivity quantification from 186 ± 16 μci/cc to 30 ± 7 μci/cc in CSF, 317 ± 15 μci/cc to 236 ± 10 μci/cc for WM, 438 ± 4 μci/cc to 592 ± 5 μci/cc for GM. Both visual and quantitative assessments show improvement of partial volume correction in the synthesized and phantom experiments.

CONCLUSIONS

The partial volume correction method improves the quantification of PET images. The method is comparable to the GTM method but does not need MR image segmentation or prior tracer distribution information. The voxel-based method can be particularly useful for combined PET/MRI studies.

Absolute quantification in SPECT

Single-photon emission computed tomography (SPECT) allows the three-dimensional visualization of radioactivity within the human body and is widely used for clinical purposes. In SPECT, image quality is compromised by several factors including photon attenuation, photon scatter, the partial volume effect, and motion artefacts. These variables also confound the capacity of SPECT to quantify the concentration of radioactivity within given volumes of interest in absolute units, e.g. as kilobecquerels per cubic centimetre. In the last decade, considerable technical progress has been achieved in SPECT image reconstruction, involving, in particular, the development of iterative image reconstruction techniques. Furthermore, hybrid cameras integrating a SPECT camera with an X-ray CT scanner have become commercially available. These systems allow the acquisition of SPECT and CT datasets registered to each other with a high anatomical accuracy. First studies have shown that iterative SPECT image reconstruction techniques incorporating information from SPECT/CT image datasets greatly increase the accuracy of SPECT in quantifying radioactivity concentrations in phantoms and also in humans. This new potential of SPECT may improve not only diagnostic accuracy, but also dosimetry for internal radiotherapy.

A method for partial volume correction of PET-imaged tumor heterogeneity using expectation maximization with a spatially varying point spread function

Tumor heterogeneities observed in positron emission tomography (PET) imaging are frequently compromised by partial volume effects which may affect treatment prognosis, assessment or future implementations such as biologically optimized treatment planning (dose painting). This paper presents a method for partial volume correction of PET-imaged heterogeneous tumors. A point source was scanned on a GE Discovery LS at positions of increasing radii from the scanner's center to obtain the spatially varying point spread function (PSF). PSF images were fit in three dimensions to Gaussian distributions using least squares optimization. Continuous expressions were devised for each Gaussian width as a function of radial distance, allowing for generation of the system PSF at any position in space. A spatially varying partial volume correction (SV-PVC) technique was developed using expectation maximization (EM) and a stopping criterion based on the method's correction matrix generated for each iteration. The SV-PVC was validated using a standard tumor phantom and a tumor heterogeneity phantom and was applied to a heterogeneous patient tumor. SV-PVC results were compared to results obtained from spatially invariant partial volume correction (SINV-PVC), which used directionally uniform three-dimensional kernels. SV-PVC of the standard tumor phantom increased the maximum observed sphere activity by 55 and 40% for 10 and 13 mm diameter spheres, respectively. Tumor heterogeneity phantom results demonstrated that as net changes in the EM correction matrix decreased below 35%, further iterations improved overall quantitative accuracy by less than 1%. SV-PVC of clinically observed tumors frequently exhibited changes of +/-30% in regions of heterogeneity. The SV-PVC method implemented spatially varying kernel widths and automatically determined the number of iterations for optimal restoration, parameters which are arbitrarily chosen in SINV-PVC. Comparing SV-PVC to SINV-PVC demonstrated that similar results could be reached using both methods, but large differences result for the arbitrary selection of SINV-PVC parameters. The presented SV-PVC method was performed without user intervention, requiring only a tumor mask as input. Research involving PET-imaged tumor heterogeneity should include correcting for partial volume effects to improve the quantitative accuracy of results.

Optimized protocols in terms of equalizing the true and accidental coincidences of each bed position in static multiple bed position carbon-11 PET studies and a target single bed position study

Quantitative carbon-11 (11C) positron emission tomography (PET) is gaining more attention in oncological applications. In addition, it was discovered that accidental coincidences (randoms) can play an important role in studies such as partial volume effects correction without needing to use anatomical information. However, because of the short half-life of 11C, a homogeneous multiple bed position 11C image is hard to obtain. This study aimed to determine whether innovative pseudogating, optimized pseudogating and optimized double-up methods could match the true counts and randoms to each bed position and to a target single bed position study. A long cylindrical phantom filled with [11C]acetate was scanned by a dedicated PET scanner using six protocols: whole body, frame-duration-compensated whole body, double-up, optimized double-up, pseudogating, and optimized pseudogating. The differences between the protocols are in the initial activity, frame duration and frame number for each bed position. The parameters for pseudogating were determined according to the theory that true counts and randoms are proportional to the radioactivity and its square, respectively. The results show that the stated goals could only be achieved by pseudogating and optimized pseudogating. We conclude that pseudogating or optimized pseudogating must be applied for a critical quantitative study. However, optimized double-up and double-up methods are good alternatives for semi-quantitative and qualitative studies, respectively.

A method to correct for scatter, spillover, and partial volume effects in region of interest analysis in PET

Scatter and spatial resolution effects degrade the accuracy of radioactivity concentration estimates obtained from positron emission tomography (PET) data. We present and evaluate a methodology for region quantification which accounts for these degradations. The method is based on analysis of sinogram data and does not require dynamic data sequences to be reconstructed. Moreover, estimates of region variance are also produced which may be used to define weights for model analyses that use weighted least squares minimization in order to obtain unbiased parameter estimates. We evaluate the method using both simulation and measured data and find that, with an appropriate model of scatter and spatial resolution effects, it is unbiased and capable of quantifying myocardial concentration with no more than a 5% error in accuracy for myocardium as thin as 10 mm.