Improved Performance of a Multipinhole SPECT for DAT Imaging by Increasing Number of Pinholes at the Expense of Increased Multiplexing

Dopamine Transporter SPECT with 12-Minute Scan Duration Using Multiple-Pinhole Collimators

This study evaluated the potential to reduce the scan duration in dopamine transporter (DAT) SPECT when using a second-generation multiple-pinhole (MPH) collimator designed for brain SPECT with improved count sensitivity and improved spatial resolution compared with parallel-hole and fanbeam collimators. Methods: The retrospective study included 640 consecutive clinical DAT SPECT studies that had been acquired in list mode with a triple-head SPECT system with MPH collimators and a 30-min net scan duration after injection of 181 ± 10 MBq of [123I]FP-CIT. Raw data corresponding to scan durations of 20, 15, 12, 8, 6, and 4 min were obtained by restricting the events to a proportionally reduced time interval of the list-mode data for each projection angle. SPECT images were reconstructed iteratively with the same parameter settings irrespective of scan duration. The resulting 5,120 SPECT images were assessed for a neurodegeneration-typical reduction in striatal signal by visual assessment, conventional specific binding ratio analysis, and a deep convolutional neural network trained on 30-min scans. Results: Regarding visual interpretation, image quality was considered diagnostic for all 640 patients down to a 12-min scan duration. The proportion of discrepant visual interpretations between 30 and 12 min (1.2%) was not larger than the proportion of discrepant visual interpretations between 2 reading sessions of the same reader at a 30-min scan duration (1.5%). Agreement with the putamen specific binding ratio from the 30-min images was better than expected for 5% test-retest variability down to a 10-min scan duration. A relevant change in convolutional neural network-based automatic classification was observed at a 6-min scan duration or less. Conclusion: The triple-head SPECT system with MPH collimators allows reliable DAT SPECT after administration of about 180 MBq of [123I]FP-CIT with a 12-min scan duration.

Multi-pinhole collimator design in different numbers of projections for brain SPECT

Purpose

High resolution and sensitivity brain SPECT is promising for the accurate diagnosis of Alzheimer's disease (AD) and Parkinson's disease (PD). Multi-pinhole (MPH) collimators with a good performance in imaging small field-of-view (FOV) could be better used for brain SPECT. In this study, we aim to evaluate the impact of varying the number of pinholes and the number of projections on the performance of MPH brain SPECT.

Methods

The system design was based on a commercial clinical dual-head SPECT/CT scanner, with target spatial resolutions of 12 mm and 8 mm for AD and PD SPECT, respectively. In total, 1-25 pinholes were modeled for 64, 32, 16, 8, 4, and 2 projections. The 3D NURBS-based HUman Brain (NHUB) phantom was used in the analytical simulation to model 99mTc-HMPAO and 99mTc-TRODAT distributions. The 2D Derenzo hot-rod phantom and star phantom were used in Monte Carlo simulations to evaluate the spatial resolution and angular sampling performance of MPH. The influence of different detector positions was also evaluated for 2, 4, and 6 angular views. The projections were reconstructed using the 3D MPH ML-EM method. Normalized mean square error, coefficient of variation, and image profiles were evaluated.

Results

Along with the decrease in the number of projections, more pinholes are required to achieve the optimum performance. For 32 projections, 9- and 7-pinhole collimators provide the best normalized mean square error (NMSE) to the coefficient of variation (COV) trade-off for 99mTc-HMPAO and 99mTc-TRODAT, respectively. Detector positions substantially affect the image quality for MPH SPECT for 2 and 4 angular views. The smallest rod size for the Derenzo hot-rod phantom, which could be resolved, is 7.9 mm for the MPH general purpose collimator (MPGP) with more than 16 projections and 6.4 mm for MPH high-resolution collimator (MPHR) with more than 8 projections.

Conclusion

The number of pinholes affects the performance of the MPH collimator, especially when the projection views become fewer. More pinholes are required for fewer projections to provide better angular sampling in MPH for complex activity distributions. Detector positions affect the image quality of MPH SPECT for 2 and 4 angular views, where L-mode acquisition is slightly superior to H-mode. MPH collimators exhibited improved spatial resolution and angular sampling compared with both LEHR and single pinhole collimators.

Multiple-pinhole collimators improve intra- and between-rater agreement and the certainty of the visual interpretation in dopamine transporter SPECT

Background

Multiple-pinhole (MPH) collimators improve the resolution–sensitivity trade-off compared to parallel-hole collimators. This study evaluated the impact of MPH collimators on intra- and between-rater agreement, and on the certainty of visual interpretation in dopamine transporter (DAT)-SPECT.

Methods

The study included 71 patients (62.1 ± 12.7 y). Two SPECT acquisitions were performed in randomized order after a single injection of 182 ± 9 MBq ¹²³I-FP-CIT, one with MPH and one with low-energy–high-resolution–high-sensitivity (LEHRHS) collimators. MPH projections were reconstructed with an iterative 3d Monte Carlo algorithm. LEHRHS projections were reconstructed with filtered backprojection (FBP) or with ordered-subsets expectation–maximization and resolution recovery (OSEM). Images were visually evaluated twice by three independent raters with respect to presence/absence of Parkinson-typical reduction of striatal ¹²³I-FP-CIT uptake using a Likert 6-score (− 3 = clearly normal, …, 3 = clearly reduced). In case of intra-rater discrepancy, an intra-rater consensus was obtained. Intra- and between-rater agreement with respect to the Likert score (6-score and dichotomized score) was characterized by Cohen’s kappa.

Results

Intra-rater kappa of visual scoring of MPH/LEHRHS-OSEM/LEHRHS-FBP images was 0.84 ± 0.12/0.73 ± 0.06/0.73 ± 0.08 (6-score, mean of three raters) and 1.00 ± 0.00/0.96 ± 0.04/0.97 ± 0.03 (dichotomized score). Between-rater kappa of visual scoring (intra-rater consensus) of MPH/LEHRHS-OSEM/LEHRHS-FBP images was 0.70 ± 0.06/0.63 ± 0.08/0.48 ± 0.05 (6-score, mean of three pairs of raters) and 1.00 ± 0.00/0.92 ± 0.04/0.90 ± 0.06 (dichotomized score). There was a decrease of (negative) Likert scores in normal DAT-SPECT by 0.87 ± 0.18 points from the LEHRHS-OSEM to the MPH setting. The (positive) Likert scores of reduced DAT-SPECT did not change on average.

Conclusions

MPH collimators improve intra- and between-rater agreement as well as the certainty of the visual interpretation of DAT-SPECT.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13550-022-00923-w.

Design Study of an Ultrahigh Resolution Brain SPECT System Using a Synthetic Compound-Eye Camera Design With Micro-Slit and Micro-Ring Apertures

In this paper, we discuss the design study for a brain SPECT imaging system, referred to as the HelmetSPECT system, based on a spherical synthetic compound-eye (SCE) gamma camera design. The design utilizes a large number (  ∼ 500 ) of semiconductor detector modules, each coupled to an aperture with a very narrow opening for high-resolution SPECT imaging applications. In this study, we demonstrate that this novel system design could provide an excellent spatial resolution, a very high sensitivity, and a rich angular sampling without scanning motion over a clinically relevant field-of-view (FOV). These properties make the proposed HelmetSPECT system attractive for dynamic imaging of epileptic patients during seizures. In ictal SPECT, there is typically no prior information on where the seizures would happen, and both the imaging resolution and quantitative accuracy of the dynamic SPECT images would provide critical information for staging the seizures outbreak and refining the plans for subsequent surgical intervention.We report the performance evaluation and comparison among similar system geometries using non-conventional apertures, such as micro-ring and micro-slit, and traditional lofthole apertures. We demonstrate that the combination of ultrahigh-resolution imaging detectors, the SCE gamma camera design, and the micro-ring and micro-slit apertures would offer an interesting approach for the future ultrahigh-resolution clinical SPECT imaging systems without sacrificing system sensitivity and FOV.

Cerebral SPECT imaging with different acquisition schemes using varying levels of multiplexing versus sensitivity in an adaptive multi-pinhole brain-dedicated scanner

Application of multi-pinhole collimator in pinhole-based SPECT increases detection sensitivity. The presence of multiplexing in projection images due to the usage of multiple pinholes can further improve the sensitivity at the cost of adding data ambiguity. We are developing a next-generation adaptive brain-dedicated SPECT system -AdaptiSPECT-C. The AdaptiSPECT-C can adapt the multiplexing level and system sensitivity using adaptable pinhole modules. In this study, we investigated the performance of 4 data acquisition schemes with different multiplexing levels and sensitivities on cerebral SPECT imaging. Schemes #1, #2, and #3 have <1%, 67%, and 31% overall multiplexing, respectively, while the 4th scheme without multiplexing is considered as ground truth. The ground-truth and schemes #1-3 have 1.0, 1.7, 5.1, and 4.0 times higher sensitivity, respectively, compared to a dual-headed parallel-hole SPECT system at matched spatial resolution. A customized XCAT brain perfusion digital phantom emulating the distribution of I-123 N-isopropyl iodoamphetamine (IMP) in a 99th percentile size male was used for simulations. Data acquisition for each scheme was performed at two count levels (low-count and high-count relative to the recommended clinical count level). The normalized root-mean-square error (NRMSE) for schemes #1, #2, and #3 with the low-count (high-count) scenario showed 11%, 4%, and 5% (10%, 5%, and 6%) deviation, respectively, from that of the multiplex-free ground truth. For both the low-count and high-count scenarios, scheme #1 resulted in the least accurate activity ratio (AR) for almost all the analyzed gray-matter brain regions. Further schemes #2 or #3 led to the most accurate AR values with both low-count and high-count scenarios for all the analyzed gray-matter regions. It was thus observed that even with this large head size which leads to significant multiplexing levels, the higher sensitivity from multiplexing could to some extent mitigate the data ambiguity and be translated into reconstructed images of higher quality.