A combined time-of-flight and depth-of-interaction detector for total-body positron emission tomography

High-resolution Imaging Using Virtual-Pinhole PET Concept

Organ-specific PET scanners continues to draw interest for their high-resolution imaging capability that is unmatched by whole-body PET/computed tomography (CT) scanners. The virtual-pinhole PET concept offers new opportunities in PET system design, allowing one to mix and match detectors of different characteristics to achieve the highest performance such as high image resolution, high system sensitivity, and large imaging field-of-view. This novel approach delivers high-resolution PET images previously available only through organ-specific PET scanner while maintaining the imaging field-of-view of a clinical PET/CT scanner to see the entire body.

Performance evaluation of the PennPET explorer with expanded axial coverage

Objective.This work evaluated the updated PennPET Explorer total-body (TB) PET scanner, which was extended to 6 rings with updated readout firmware to achieve a 142 cm axial field of view (AFOV) without 7.6 cm inter-ring axial gaps.Approach.National Electrical Manufacturers Association (NEMA) NU 2-2018 measurements were performed with modifications including longer phantoms for sensitivity and count-rate measurements and additional positions for spatial resolution and image quality. A long uniform phantom and the clinical trials network (CTN) phantom were also used.Main results.The total sensitivity increased to 140 kcps MBq-1for a 70 cm line, a gain of 1.8x compared to the same system with axial gaps; an additional 47% increase in total counts was observed with a 142 cm line at the same activity per cm. The noise equivalent count rate (NECR) increased by 1.8x without axial gaps. The peak NECR is 1550 kcps at 25 kBq cc-1for a 140 cm phantom; due to increased randoms, the NECR is lower than with a 70 cm phantom, for which NECR is 2156 kcps cc-1at 25 kBq cc-1and continues increasing. The time-of-flight resolution is 250 ps, increasing by <10 ps at the highest activity. The axial spatial resolution degrades by 0.6 mm near the center of the AFOV, compared to 4 mm resolution near the end. The NEMA image quality phantom showed consistent contrast recovery throughout the AFOV. A long uniform phantom demonstrated axial uniformity of uptake and noise, and the CTN phantom demonstrated quantitative accuracy for both18F and89Zr.Significance. The performance evaluation of the updated PennPET Explorer demonstrates significant gains compared to conventional scanners and shows where the current NEMA standard needs to be updated for TB-PET systems. The comparisons of systems with and without inter-ring gaps demonstrate the performance trade-offs of a more cost-effective TB-PET system with incomplete detector coverage.

A semi-monolithic detector providing intrinsic DOI-encoding and sub-200 ps CRT TOF-capabilities for clinical PET applications

BACKGROUND

Current clinical positron emission tomography (PET) systems utilize detectors where the scintillator typically contains single elements of 3-6-mm width and about 20-mm height. While providing good time-of-flight performance, this design limits the spatial resolution and causes radial astigmatism as the depth-of-interaction (DOI) remains unknown.

PURPOSE

We propose an alternative, aiming to combine the advantages of current detectors with the DOI capabilities shown for monolithic concepts, based on semi-monolithic scintillators (slabs). Here, the optical photons spread along one dimension enabling DOI-encoding with a still small readout area beneficial for timing performance.

METHODS

An array of eight monolithic LYSO slabs of dimensions 3.9 × 32 × 19 mm³ was read out by a 64-channel photosensor containing digital SiPMs (DPC3200-22-44, Philips Digital Photon Counting). The position estimation in the detector's monolithic and DOI direction was based on a calibration with a fan beam collimator and the machine learning technique gradient tree boosting (GTB).

RESULTS

We achieved a positioning performance in terms of mean absolute error (MAE) of 1.44 mm for the monolithic direction and 2.12 mm for DOI considering a wide energy window of 300-700 keV. The energy resolution was determined to be 11.3%, applying a positional-dependent energy calibration. We established both an analytical and machine-learning-based timing calibration approach and applied them for a first-photon trigger. The analytical timing calibration corrects for electronic and optical time skews leading to 240 ps coincidence resolving time (CRT) for a pair of slab-detectors. The CRT was significantly improved by utilizing GTB to predict the time difference based on specific training data and applied on top of the analytical calibration. We achieved 209 ps for the wide energy window and 198 ps for a narrow selection around the photopeak (411-561 keV). To maintain the detector's sensitivity, no filters were applied to the data during processing.

CONCLUSION

Overall, the semi-monolithic detector provides attractive performance characteristics. Especially, a good CRT can be achieved while introducing DOI capabilities to the detector, making the concept suitable for clinical PET scanners.

High-resolution and high-sensitivity PET for quantitative molecular imaging of the monoaminergic nuclei: A GATE simulation study

PURPOSE

Quantitative in vivo molecular imaging of fine brain structures requires high-spatial resolution and high-sensitivity. Positron emission tomography (PET) is an attractive candidate to introduce molecular imaging into standard clinical care due to its highly targeted and versatile imaging capabilities based on the radiotracer being used. However, PET suffers from relatively poor spatial resolution compared to other clinical imaging modalities, which limits its ability to accurately quantify radiotracer uptake in brain regions and nuclei smaller than 3 mm in diameter. Here we introduce a new practical and cost-effective high-resolution and high-sensitivity brain-dedicated PET scanner, using our depth-encoding Prism-PET detector modules arranged in a conformal decagon geometry, to substantially reduce the partial volume effect and enable accurate radiotracer uptake quantification in small subcortical nuclei.

METHODS

Two Prism-PET brain scanner setups were proposed based on our 4-to-1 and 9-to-1 coupling of scintillators to readout pixels using1.5 × 1.5 × 20 $1.5 \times 1.5 \times 20$  mm3 and0.987 × 0.987 × 20 $0.987 \times 0.987 \times 20$  mm3 crystal columns, respectively. Monte Carlo simulations of our Prism-PET scanners, Siemens Biograph Vision, and United Imaging EXPLORER were performed using Geant4 application for tomographic emission (GATE). National Electrical Manufacturers Association (NEMA) standard was followed for the evaluation of spatial resolution, sensitivity, and count-rate performance. An ultra-micro hot spot phantom was simulated for assessing image quality. A modified Zubal brain phantom was utilized for radiotracer imaging simulations of 5-HT1A receptors, which are abundant in the raphe nuclei (RN), and norepinephrine transporters, which are highly concentrated in the bilateral locus coeruleus (LC).

RESULTS

The Prism-PET brain scanner with 1.5 mm crystals is superior to that with 1 mm crystals as the former offers better depth-of-interaction (DOI) resolution, which is key to realizing compact and conformal PET scanner geometries. We achieved uniform 1.3 mm full-width-at-half-maximum (FWHM) spatial resolutions across the entire transaxial field-of-view (FOV), a NEMA sensitivity of 52.1 kcps/MBq, and a peak noise equivalent count rate (NECR) of 957.8 kcps at 25.2 kBq/mL using 450-650 keV energy window. Hot spot phantom results demonstrate that our scanner can resolve regions as small as 1.35 mm in diameter at both center and 10 cm away from the center of the transaixal FOV. Both 5-HT1A receptor and norepinephrine transporter brain simulations prove that our Prism-PET scanner enables accurate quantification of radiotracer uptake in small brain regions, with a 1.8-fold and 2.6-fold improvement in the dorsal RN as well as a 3.2-fold and 4.4-fold improvement in the bilateral LC compared to the Biograph Vision and EXPLORER, respectively.

CONCLUSIONS

Based on our simulation results, the proposed high-resolution and high-sensitivity Prism-PET brain scanner is a promising cost-effective candidate to achieve quantitative molecular neuroimaging of small but important brain regions with PET clinically viable.

Performance of Dual-Ended Readout PET Detectors Based on BGO Arrays and BaSO₄ Reflector

In this paper, the performance of two dual-ended readout PET detectors based on 15 × 15 BGO arrays were compared. The crystal elements of one BGO array have polished lateral surfaces, while the crystal elements of the other BGO array have unpolished lateral surfaces. The two ends of the BGO elements are polished. The two BGO arrays both have a pitch size of 1.6 mm and thickness of 20 mm, and BaSO4 with a thickness of 80 μm was used as the reflector. Hamamatsu S14161-0305-08 SiPM arrays were used as photodetectors. All the measurements were performed at a bias voltage of 41.0 V and a temperature of 23.5 °C. The flood histograms show that all the crystal elements in the two BGO arrays were clearly resolved. The detector based on the BGO array with polished lateral surfaces provides an energy resolution of 16.9 ± 1.3%, timing resolution of 3.2 ± 0.2 ns, and DOI resolution of 18.4 ± 2.2 mm. In comparison, the detector based on the BGO array with unpolished lateral surfaces provides an energy resolution of 17.7 ± 2.0%, timing resolution of 3.5 ± 0.3 ns, and DOI resolution of 3.2 ± 0.2 mm.

Multiplexed imaging in oncology

In oncology, technologies for clinical molecular imaging are used to diagnose patients, establish the efficacy of treatments and monitor the recurrence of disease. Multiplexed methods increase the number of disease-specific biomarkers that can be detected simultaneously, such as the overexpression of oncogenic proteins, aberrant metabolite uptake and anomalous blood perfusion. The quantitative localization of each biomarker could considerably increase the specificity and the accuracy of technologies for clinical molecular imaging to facilitate granular diagnoses, patient stratification and earlier assessments of the responses to administered therapeutics. In this Review, we discuss established techniques for multiplexed imaging and the most promising emerging multiplexing technologies applied to the imaging of isolated tissues and cells and to non-invasive whole-body imaging. We also highlight advances in radiology that have been made possible by multiplexed imaging.

Opportunities for Molecular Imaging in Multiple Sclerosis Management: Linking Probe to Treatment

Imaging has been a critical component of multiple sclerosis (MS) management for nearly 40 years. The visual information derived from structural MRI, that is, signs of blood-brain barrier disruption, inflammation and demyelination, and brain and spinal cord atrophy, are the primary metrics used to evaluate therapeutic efficacy in MS. The development of targeted imaging probes has expanded our ability to evaluate and monitor MS and its therapies at the molecular level. Most molecular imaging probes evaluated for MS applications are small molecules initially developed for PET, nearly half of which are derived from U.S. Food and Drug Administration-approved drugs and those currently undergoing clinical trials. Superparamagnetic and fluorinated particles have been used for tracking circulating immune cells (in situ labeling) and immunosuppressive or remyelinating therapeutic stem cells (ex vivo labeling) clinically using proton (hydrogen 1 [¹H]) and preclinically using fluorine 19 MRI. Translocator protein PET and ¹H MR spectroscopy have been demonstrated to complement imaging metrics from structural (gadolinium-enhanced) MRI in nine and six trials for MS disease-modifying therapies, respectively. Still, despite multiple demonstrations of the utility of molecular imaging probes to evaluate the target location and to elucidate the mechanisms of disease-modifying therapies for MS applications, their use has been sparse in both preclinical and clinical settings.

A time-based single transmission-line readout with position multiplexing

We developed a time-based single-transmission-line readout method for time-of-flight positron emission tomography (PET) detectors. The 2D position of a silicon photomultiplier (SiPM) array was encoded in the upper and lower widths of a specially prepared L-shaped tag pulse followed by the original scintillation signal. A PET detector setup was configured using a 4 × 4 array of LSO crystals optically coupled one-to-one to a 4 × 4 SiPM array. Two pulse width modulator circuits were employed per SiPM anode signal channel and a total of 32 width-modulated digital pulses were summed and merged with a delayed common-cathode signal. The final output was analyzed using timestamps crossing two-level threshold voltages. All 16 crystals were clearly separated on a positioning map. The average energy and coincidence time resolutions were 15.0 ± 1.1% and 288.7 ± 29.3 ps after proper correction process, respectively. A 3D position decoding capability was also shown by the remarkable discrimination performance in a phoswich PET detector setup (LSO and LGSO), resulting from well-preserved scintillation signals. The proposed method enables a time-based single-channel readout with 3D gamma ray interaction position decoding capability without compromising on detector performance. This method provides gamma ray energy and arrival time information as well as 2D and depthwise interaction positions of the phoswich detectors through one channel readout. Thus, channels can be reduced by at least 4-5 times compared to typically employed charge-sharing-based position multiplexing method; this significantly reduces the burden of data acquisition on the PET system.

Lead-free MCP to improve coincidence time resolution and reduce MCP direct interactions

Achieving direct imaging of the annihilation position of a positron on an event-by-event basis using an ultrafast detector would have a great impact on the field of nuclear medicine. Cherenkov emission is the most attractive physical phenomenon for realizing such an ultrafast timing performance. Moreover, a microchannel-plate photomultiplier tube (MCP-PMT) is one of the most promising photodetectors for fully exploiting the fast timing properties of Cherenkov emission owing to its excellent single photon time resolution of 25 ps full width at half maximum (FWHM). However, as the MCP structure generally contains a lead compound, the gamma rays frequently and directly interact with the MCP, resulting in the degradation of its timing performance and generation of undesirable side peaks in its coincidence timing histogram. To overcome this problem, we have developed a new MCP-PMT based on an MCP consisting of borosilicate glass, thus drastically reducing the probability of the photoelectric effect occurring in the MCP. To evaluate its insensitivity to gamma rays and its timing performance, a coincidence experiment was performed and showed that the probability of direct interactions was reduced by a factor of 3.4. Moreover, a coincidence time resolution of 35.4 ± 0.4 ps FWHM, which is equivalent to a position resolution of 5.31 mm, was obtained without any pulse height/area cut, improving to 28.7 ± 3.0 ps when selecting on the highest amplitude events by careful optimization of the voltage divider circuit of the new MCP-PMT. The timing performance of this new MCP-PMT presents an important step toward making direct imaging possible.

A thick semi-monolithic scintillator detector for clinical PET scanners

Both monolithic and semi-monolithic scintillator positron emission tomography (PET) detectors can measure the depth of interaction with single-ended readout. Usually scintillators with a thickness of 10 mm or less are used since the position resolutions of the detectors degrade as the scintillator thickness increases. In this work, the performance of a 20 mm thick long rectangular semi-monolithic scintillator PET detector was measured by using both single-ended and dual-ended readouts with silicon photomultiplier (SiPM) arrays to provide a high detection efficiency. The semi-monolithic scintillator detector consists of nine lutetium-yttrium oxyorthosilicate slices measuring 1.37 × 51.2 × 20 mm³ with erythrocyte sedimentation rate foils of 0.065 mm thickness in between the slices. The SiPM array at each end of the scintillator detector consists of 16 × 4 SiPMs with a pixel size of 3.0 × 3.0 mm² and a pitch of 3.2 mm. The 64 signals of each SiPM array are processed by using the TOFPET2 application-specific integrated circuit individually. All but the edge slices can be clearly resolved for the detectors with both single-ended and dual-ended readouts. The single-ended readout detector provides an average full width at half maximum (FWHM) Y (continuous direction) position resolution of 2.43 mm, Z (depth direction) position resolution of 4.77 mm, energy resolution of 25.7% and timing resolution of 779 ps. The dual-ended readout detector significantly improves the Y and Z position resolutions, slightly improves the energy and timing resolution at the cost of two photodetectors required for one detector module and provides an average FWHM Y position resolution of 1.97 mm, Z position resolution of 2.60 mm, energy resolution of 21.7% and timing resolution of 718 ps. The energy and timing resolution of the semi-monolithic scintillator detector in this work are worse than those of the segmented scintillator array detector and need to be further improved. The semi-monolithic scintillator detector described in this work reduces costs as compared to the traditional segmented scintillator array detector and reduces the edge effect as compared to the monolithic scintillator detector.

Sub-2 mm depth of interaction localization in PET detectors with prismatoid light guide arrays and single-ended readout using convolutional neural networks

PURPOSE

Depth of interaction (DOI) readout in PET imaging has been researched in efforts to mitigate parallax error, which would enable the development of small diameter, high-resolution PET scanners. However, DOI PET has not yet been commercialized due to the lack of practical, cost-effective, and data efficient DOI readout methods. The rationale for this study was to develop a supervised machine learning algorithm for DOI estimation in PET that can be trained and deployed on unique sets of crystals.

METHODS

Depth collimated flood data was experimentally acquired using a Na-22 source with a depth-encoding single-ended readout Prism-PET module consisting of lutetium yttrium orthosilicate (LYSO) crystals coupled 4-to-1 to 3×3  mm 2 silicon photomultiplier (SiPM) pixels on one end and a segmented prismatoid light guide array on the other end. A convolutional neural network (CNN) was trained to perform DOI estimation on data from center, edge and corner crystals in the Prism-PET module using (a) all non-zero readout pixels and (b) only the 4 highest readout signals per event. CNN testing was performed on data from crystals not included in CNN training.

RESULTS

An average DOI resolution of 1.84 mm full width at half maximum (FWHM) across all crystals was achieved when using all readout signals per event with the CNN compared to 3.04 mm FWHM DOI resolution using classical estimation. When using only the 4 highest signals per event, an average DOI resolution of 1.92 mm FWHM was achieved, representing only a 4% dropoff in CNN performance compared to using all non-zero pixels per event.

CONCLUSIONS

Our CNN-based DOI estimation algorithm provides the best reported DOI resolution in a single-ended readout module and can be readily deployed on crystals not used for model training.

Development and initial characterization of a high-resolution PET detector module with DOI

Organ-dedicated PET scanners are becoming more prevalent because of their advantages in higher sensitivity, improved image quality, and lower cost. Detectors utilized in these scanners have finer pixel size with depth of interaction (DOI) capability. This work presents a LYSO(Ce) detector module with DOI capability which has the potential to be scaled up to a high-resolution small animal or organ-dedicated PET system. For DOI capability, a submodule with one LYSO block detector utilizing PETsys TOFPET2 application-specific integrated circuit (ASIC) was previously developed in our lab. We scaled up the submodule and optimized the configuration to allow for a compact housing of the dual-readout boards in one side of the blocks by designing a high-speed dual-readout cable to maintain the original pin-to-pin relationship between the Samtec connectors. The module size is 53.8 × 57.8 mm2. Each module has 2 × 2 LYSO blocks, each LYSO block consists of 4 × 4 LYSO units, and each LYSO unit contains a 6 × 6 array of 1 × 1 × 20 mm3 LYSO crystals. The four lateral surfaces of LYSO crystal were mechanically ground to W14, and the two end surfaces were polished. Two ends of the LYSO crystal are optically connected to SiPM for DOI measurement. Eight LYSO blocks performance including energy, timing, and DOI resolution is characterized with a single LYSO slab. The in-panel and orthogonal-panel spatial resolution of the two modules with 107.4 mm distance between each other are measured at 9 positions within the field of view (FOV) with a 22Na source. Results show that the average energy, timing, and DOI resolution of all LYSO blocks are 16.13% ± 1.01% at 511 keV, 658.03 ± 15.18 ps, and 2.62 ± 0.06 mm, respectively. The energy and timing resolution of two modules are 16.35% and 0.86 ns, respectively. The in-panel and orthogonal-panel spatial resolution of the two modules at the FOV center are 1.9 and 4.4 mm respectively.

Prismatoid light guide array for enhanced gamma ray localization in PET: a Monte Carlo simulation study of scintillation photon transport

High spatial resolution PET relies on having excellent depth-of-interaction (DOI) resolution and small detector elements. Depth-encoding in PET modules has traditionally been performed using dual-ended readout. In recent years, researchers have explored the feasibility of replacing the second readout array with a light guide at the entrance layer that introduces intercrystal light sharing in order to reduce cost and and make depth-encoding modules more compact. However, single-ended readout depth-encoding modules have suboptimal and non-uniform crystal separation and DOI performance due to the random light sharing patterns of the uniform light guide, resulting in degraded peformance along the edges and corners of the detector arrays. In this paper, we introduce and characterize a segmented light guide composed of an array of prism mirrors which introduce deterministic intercrystal light sharing in single-ended readout PET detectors. We determined the expected spatial performance of our modules with our light guide using optical ray tracing Monte Carlo simulations. We demonstrate that having controlled, deterministic light sharing improves both DOI and crystal identification performance, enabling uniform spatial performance throughout the detector array. Designed specifically for high resolution PET, our prismatoid light guide array can be used to build cost-effective total-body and organ-dedicated PET systems with single-ended readout depth-encoding modules.

Improving depth-of-interaction resolution in pixellated PET detectors using neural networks

Parallax error is a common issue in high-resolution preclinical positron emission tomography (PET) scanners as well as in clinical scanners that have a long axial field of view (FOV), which increases estimation uncertainty of the annihilation position and therefore degrades the spatial resolution. A way to address this issue is depth-of-interaction (DOI) estimation. In this work we propose two machine learning-based algorithms, a dense and a convolutional neural network (NN), as well as a multiple linear regression (MLR)-based method to estimate DOI in depolished PET detector arrays with single-sided readout. The algorithms were tested on an 8× 8 array of 1.53× 1.53× 15 mm³ crystals and a 4× 4 array of 3.1× 3.1× 15 mm³ crystals, both made of Ce:LYSO scintillators and coupled to a 4× 4 array of 3× 3 mm³ silicon photomultipliers (SiPMs). Using the conventional linear DOI estimation method resulted in an average DOI resolution of 3.76 mm and 3.51 mm FWHM for the 8× 8 and the 4× 4 arrays, respectively. Application of MLR outperformed the conventional method with average DOI resolutions of 3.25 mm and 3.33 mm FWHM, respectively. Using the machine learning approaches further improved the DOI resolution, to an average DOI resolution of 2.99 mm and 3.14 mm FWHM, respectively, and additionally improved the uniformity of the DOI resolution in both arrays. Lastly, preliminary results obtained by using only a section of the crystal array for training showed that the NN-based methods could be used to reduce the number of calibration steps required for each detector array.

Depth-of-interaction study of a dual-readout detector based on TOFPET2 application-specific integrated circuit

Depth-of-interaction (DOI) capability is important for achieving high spatial resolution and sensitivity in dedicated organ and small animal positron emission tomography (PET) scanners. The dual-ended readout is one of the common methods that can achieve good DOI resolution. The aim of this study is to evaluate a dual-ended readout detector based on silicon photomultiplier (SiPM) and TOFPET2 application-specific integrated circuit (ASIC). The detector is based on 4 [Formula: see text] 4 lutetium-yttrium oxyorthosilicate (LYSO) units, each unit contained 6 [Formula: see text] 6 LYSO crystals, and the crystal size was 1 [Formula: see text] 1 [Formula: see text] 20 mm³. The four lateral surfaces of LYSO crystals were mechanically ground to W14 (surface roughness 10-14 [Formula: see text]m), and the two ended surfaces were polished (surface roughness  <0.5 [Formula: see text]m). The reflector was Toray Lumirror E60, and the packing fraction of the LYSO block was 86.5%. Each LYSO unit was read out from both ends with two Hamamatsu S13361-3050AE-08 SiPM arrays. The analog output signals of SiPM were digitized by PETsys TOFPET2 ASIC and acquired by PETsys SiPM Readout System. The ASIC and SiPM were cooled by a fan and a Peltier element. To investigate the crystal resolvability, different light guide thicknesses including 0.8, 1, 1.2 and 2 mm were tested. The light guide was made of optical glass (H-K9L-Foctek Photoincs), and the size and refractive index were 6.45 [Formula: see text] 6.45 mm² and 1.53 (at 420 nm), respectively. To characterize the detector performance at different depths, another 1 [Formula: see text] 25.8 [Formula: see text] 20 mm³ single LYSO slab was used. Data were acquired at 10 depths (1, 3, …, 19 mm), and each depth had a 10 min acquisition time and about 40 thousand coincidence events. During the experiment, the SiPM temperature was controlled as 27.6 [Formula: see text] 0.4 °C. The results showed that the 1.2 mm light guide offered the best crystal resolvability. The energy, coincidence time, and DOI resolution full-width at half-maximum of the detector were characterized as 15.66% [Formula: see text] 0.66%, 602.98 [Formula: see text] 10.58 ps, and 2.33 [Formula: see text] 0.07 mm, respectively. The good DOI resolution indicates the potential of utilizing the detector for high-resolution PET applications.

A second-generation virtual-pinhole PET device for enhancing contrast recovery and improving lesion detectability of a whole-body PET/CT scanner

PURPOSE

We have developed a second-generation virtual-pinhole (VP) positron emission tomography (PET) device that can position a flat-panel PET detector around a patient's body using a robotic arm to enhance the contrast recovery coefficient (CRC) and detectability of lesions in any region-of-interest using a whole-body PET/computed tomography (CT) scanner.

METHODS

We constructed a flat-panel VP-PET device using 32 high-resolution detectors, each containing a 4  ×  4 MPPC array and 16  ×  16 LYSO crystals of 1.0  ×  1.0  ×  3.0 mm³ each. The flat-panel detectors can be positioned around a patient's body anywhere in the imaging field-of-view (FOV) of a Siemens Biograph 40 PET/CT scanner by a robotic arm. New hardware, firmware and software have been developed to support the additional detector signals without compromising a scanner's native functions. We stepped a ²² Na point source across the axial FOV of the scanner to measure the sensitivity profile of the VP-PET device. We also recorded the coincidence events measured by the scanner detectors and by the VP-PET detectors when imaging phantoms of different sizes. To assess the improvement in the CRC of small lesions, we imaged an elliptical torso phantom measuring 316  ×  228  ×  162 mm³ that contains spherical tumors with diameters ranging from 3.3 to 11.4 mm with and without the VP-PET device. Images were reconstructed using a list mode Maximum-Likelihood Estimation-Maximization algorithm implemented on multiple graphics processing units (GPUs) to support the unconventional geometries enabled by a VP-PET system. The mean and standard deviation of the CRC were calculated for tumors of different sizes. Monte Carlo simulation was also conducted to image clusters of lesions in a torso phantom using a PET/CT scanner alone or the same scanner equipped with VP-PET devices. Receiver operating characteristic (ROC) curves were analyzed for three system configurations to evaluate the improvement in lesion detectability by the VP-PET device over the native PET/CT scanner.

RESULTS

The repeatability in positioning the flat-panel detectors using a robotic arm is better than 0.15 mm in all three directions. Experimental results show that the average CRC of 3.3, 4.3, and 6.0 mm diameter tumors was 0.82%, 2.90%, and 5.25%, respectively, when measured by the native scanner. The corresponding CRC was 2.73%, 6.21% and 10.13% when imaged by the VP-PET insert device with the flat-panel detector under the torso phantom. These values may be further improved to 4.31%, 9.65% and 18.01% by a future dual-panel VP-PET insert device if DOI detectors are employed to triple its detector efficiency. Monte Carlo simulation results show that the tumor detectability can be improved by a VP-PET device that has a single flat-panel detector. The improvement is greater if the VP-PET device employs a dual-panel design.

CONCLUSIONS

We have developed a prototype flat-panel VP-PET device and integrated it with a clinical PET/CT scanner. It significantly enhances the contrast of lesions, especially for those that are borderline detectable by the native scanner, within regions-of-interest specified by users. Simulation demonstrated the enhancement in lesion detectability with the VP-PET device. This technology may become a cost-effective solution for organ-specific imaging tasks.

Feasibility of Using Crystal Geometry for a DOI Scintillation Detector

We have used simulations and measurements to investigate the feasibility of using slanted scintillator crystal geometries as means to provide depth-of-interaction (DOI) information for a pixelated gamma ray imaging detector. The simulations were performed to estimate the fraction of scintillation light detected by the photodetector as a function of interaction location along the height of crystals with different geometries. In addition, physical measurements of the light output for these crystal geometries were obtained from individual crystals coupled to a solid state photodetector (Philips digital-SiPM DPC-3200). In agreement with previous work, we found a change in light output in the slanted region of the crystals compared to the rectangular region. The results from this study indicate the potential of using slanted crystals to gather DOI information based on light output changes as a function of the location of interaction. An examination of the measured energy spectra for the geometries evaluated here, suggests that for BGO crystals somewhere between 2 or 3 DOI bins could be implemented. Based on these results, we conceived a design for a DOI detector module that consists of two slanted crystals, each read-out by separate SiPM pixels.

Innovations in Instrumentation for Positron Emission Tomography

PET scanners are sophisticated and highly sensitive biomedical imaging devices that can produce highly quantitative images showing the 3-dimensional distribution of radiotracers inside the body. PET scanners are commonly integrated with x-ray CT or MRI scanners in hybrid devices that can provide both molecular imaging (PET) and anatomical imaging (CT or MRI). Despite decades of development, significant opportunities still exist to make major improvements in the performance of PET systems for a variety of clinical and research tasks. These opportunities stem from new ideas and concepts, as well as a range of enabling technologies and methodologies. In this paper, we review current state of the art in PET instrumentation, detectors and systems, describe the major limitations in PET as currently practiced, and offer our own personal insights into some of the recent and emerging technological innovations that we believe will impact the field. Our focus is on the technical aspects of PET imaging, specifically detectors and system design, and the opportunity and necessity to move closer to PET systems for diagnostic patient use and in vivo biomedical research that truly approach the physical performance limits while remaining mindful of imaging time, radiation dose, and cost. However, other key endeavors, which are not covered here, including innovations in reconstruction and modeling methodology, radiotracer development, and expanding the range of clinical and research applications, also will play an equally important, if not more important, role in defining the future of the field.

Performance of a new accelerating-electrode-equipped fast-time-response PMT coupled with fast LGSO

In this study, we measured the performance of a newly developed Hamamatsu Photonics R13478 photomultiplier tube (PMT) and compared the results with those of an existing R9800 PMT. In R13478, an accelerating electrode is placed between the focusing electrode and first dynode for time resolution improvement through reduced transit time jitter. We investigated the time resolution dependence on the supply voltage and time pickoff method for R13478 and R9800 PMTs, each coupled with a 2.9  ×  2.9  ×  20 mm³ fast LGSO:Ce (0.025 mol%) crystal. In addition, we measured the PMT time resolutions coupled with the crystals in edge and laid positions to determine the effects of the reduced position dependence of transit time in R13478. R13478 exhibited a better time performance than R9800 in various ways. The rise time of R13478 for our experimental setup was 1.54 ns, 100 ps shorter than that of R9800 because of the reduced transit time. Further, R13478 achieved a 169 ps single time resolution at the recommended supply voltage, while this value was 187 ps for R9800. The time resolution of R13478 was also significantly better for a low time pickoff threshold level and a high supplied voltage, which are conditions vulnerable to transit time jitter and noise, respectively. A considerable difference in time resolution was observed for the laid position (R13478: 144 ps; R9800: 167 ps), indicating that the accelerating electrode reduced spatial transit time difference. Overall, we showed the effects of the differentiated characteristics of R13478 PMT compared with R9800 and confirmed its excellent time performance. We suggest use of this device as a photodetector effective for fast timing applications such as time-of-flight positron emission tomography.

A depth-encoding PET detector that uses light sharing and single-ended readout with silicon photomultipliers

Detectors with depth-encoding capability and good timing resolution are required to develop high-performance whole-body or total-body PET scanners. In this work, depth-encoding PET detectors that use light sharing between two discrete crystals and single-ended readout with silicon photomultipliers (SiPMs) were manufactured and evaluated. The detectors consisted of two unpolished 3  ×  3  ×  20 mm³ LYSO crystals with different coupling materials between them and were read out by Hamamatsu 3  ×  3 mm² SiPMs with one-to-one coupling. The ratio of the energy of one SiPM to the total energy of two SiPMs was used to measure the depth of interaction (DOI). Detectors with different coupling materials in-between the crystals were measured in the singles mode in an effort to obtain detectors that can provide good DOI resolution. The DOI resolution and energy resolution of three types of detector were measured and the timing resolution was measured for the detector with the best DOI and energy resolution. The optimum detector, with 5 mm optical glue, a 9 mm triangular ESR and a 6 mm rectangular ESR in-between the unpolished crystals, provides a DOI resolution of 2.65 mm, an energy resolution of 10.0% and a timing resolution of 427 ps for events of E  >  400 keV. The detectors simultaneously provide good DOI and timing resolution, and show great promise for the development of high-performance whole-body and total-body PET scanners.

Development and Evaluation of mini-EXPLORER: A Long Axial Field-of-View PET Scanner for Nonhuman Primate Imaging

We describe a long axial field-of-view (FOV) PET scanner for high-sensitivity and total-body imaging of nonhuman primates and present the physical performance and first phantom and animal imaging results. Methods: The mini-EXPLORER PET scanner was built using the components of a clinical scanner reconfigured with a detector ring diameter of 43.5 cm and an axial length of 45.7 cm. National Electrical Manufacturers Association (NEMA) NU-2 and NU-4 phantoms were used to measure sensitivity and count rate performance. Reconstructed spatial resolution was investigated by imaging a radially stepped point source and a Derenzo phantom. The effect of the wide acceptance angle was investigated by comparing performance with maximum acceptance angles of 14°-46°. Lastly, an initial assessment of the in vivo performance of the mini-EXPLORER was undertaken with a dynamic ¹⁸F-FDG nonhuman primate (rhesus monkey) imaging study. Results: The NU-2 total sensitivity was 5.0%, and the peak noise-equivalent count rate measured with the NU-4 monkey scatter phantom was 1,741 kcps, both obtained using the maximum acceptance angle (46°). The NU-4 scatter fraction was 16.5%, less than 1% higher than with a 14° acceptance angle. The reconstructed spatial resolution was approximately 3.0 mm at the center of the FOV, with a minor loss in axial spatial resolution (0.5 mm) when the acceptance angle increased from 14° to 46°. The rhesus monkey ¹⁸F-FDG study demonstrated the benefit of the high sensitivity of the mini-EXPLORER, including fast imaging (1-s early frames), excellent image quality (30-s and 5-min frames), and late-time-point imaging (18 h after injection), all obtained at a single bed position that captured the major organs of the rhesus monkey. Conclusion: This study demonstrated the physical performance and imaging capabilities of a long axial FOV PET scanner designed for high-sensitivity imaging of nonhuman primates. Further, the results of this study suggest that a wide acceptance angle can be used with a long axial FOV scanner to maximize sensitivity while introducing only minor trade-offs such as a small increase in scatter fraction and slightly degraded axial spatial resolution.

Development of a dual-ended readout detector with segmented crystal bars made using a subsurface laser engraving technique

Depth of interaction (DOI) information is indispensable to improving the sensitivity and spatial resolution of positron emission tomography (PET) systems, especially for small field-of-view PET such as small animal PET and human brain PET. We have already developed a series of X'tal cube detectors for isotropic spatial resolution and we obtained the best isotropic resolution of 0.77 mm for detectors with six-sided readout. However, it is still challenging to apply the detector for PET systems due to the high cost of six-sided readout electronics and carrying out segmentation of a monolithic cubic scintillator in three dimensions using the subsurface laser engraving (SSLE) technique. In this work, we propose a more practical X'tal cube with a two-sided readout detector, which is made of crystal bars segmented in the height direction only by using the SSLE technique. We developed two types of prototype detectors with a 3 mm cubic segment and a 1.5 mm cubic segment by using 3  ×  3  ×  20 mm³ and 1.5  ×  1.5  ×  20 mm³ crystal bars segmented into 7 and 13 DOI segments, respectively, using the SSLE technique. First, the performance of the detector, composed of one crystal bar with different DOI segments and two thorough silicon via (TSV) multi-pixel photon counters (MPPCs) as readout at both ends of the crystal bar, were evaluated in order to demonstrate the capability of the segmented crystal bars as a DOI detector. Then, performance evaluation was carried out for a 4  ×  4 crystal array of 3  ×  3  ×  20 mm³ with 7 DOI segments and an 8  ×  8 crystal array of 1.5  ×  1.5  ×  20 mm³ with 13 DOI segments. Each readout included a 4  ×  4 channel of the 3  ×  3 mm² active area of the TSV MPPCs. The three-dimensional position maps of the detectors were obtained by the Anger-type calculation. All the segments in the 4  ×  4 array were identified very clearly when there was air between the crystal bars, as each crystal bar was coupled to one channel of the MPPCs; however, it was necessary to optimize optical conditions between crystal bars for the 8  ×  8 array because of light sharing between crystal bars coupled to one channel of the MPPCs. The optimization was performed for the 8  ×  8 array by inserting reflectors fully or partially between the crystal bars and the best crystal identification performance was obtained with the partial reflectors between the crystal bars. The mean energy resolutions at the 511 keV photo peak for the 4  ×  4 array with air between the crystal bars and for the 8  ×  8 array with partial reflectors between the crystal bars were 10.1%  ±  0.3% and 10.8%  ±  0.8%, respectively. Timing resolutions of 783  ±  36 ps and 1.14  ±  0.22 ns were obtained for the detectors composed of the 4  ×  4 array and the 8  ×  8 array with partial reflectors, respectively. These values correspond to single photon timing resolutions. Practical X'tal cubes with 3 mm and 1.5 mm DOI resolutions and two-sided readout were developed.

Multiplexed imaging for diagnosis and therapy

Complex molecular and metabolic phenotypes depict cancers as a constellation of different diseases with common themes. Precision imaging of such phenotypes requires flexible and tunable modalities capable of identifying phenotypic fingerprints by using a restricted number of parameters while ensuring sensitivity to dynamic biological regulation. Common phenotypes can be detected by in vivo imaging technologies, and effectively define the emerging standards for disease classification and patient stratification in radiology. However, for the imaging data to accurately represent a complex fingerprint, the individual imaging parameters need to be measured and analysed in relation to their wider spatial and molecular context. In this respect, targeted palettes of molecular imaging probes facilitate the detection of heterogeneity in oncogene-driven alterations and their response to treatment, and lead to the expansion of rational-design elements for the combination of imaging experiments. In this Review, we evaluate criteria for conducting multiplexed imaging, and discuss its opportunities for improving patient diagnosis and the monitoring of therapy.

Depth of interaction determination in monolithic scintillator with double side SiPM readout

Background

Monolithic scintillators read out by arrays of photodetectors represent a promising solution to obtain high spatial resolution and the depth of interaction (DOI) of the annihilation photon. We have recently investigated a detector geometry composed of a monolithic scintillator readout on two sides by silicon photomultiplier (SiPM) arrays, and we have proposed two parameters for the DOI determination: the difference in the number of triggered SiPMs on the two sides of the detector and the difference in the maximum collected signal on a single SiPM on each side. This work is focused on the DOI calibration and on the determination of the capability of our detector. For the DOI calibration, we studied a method which can be implemented also in detectors mounted in a full PET scanner. We used a PET detector module composed of a monolithic 20 × 20 × 10 mm³ LYSO scintillator crystal coupled on two opposite faces to two arrays of SiPMs. On each side, the scintillator was coupled to 6 × 6 SiPMs. In this paper, the two parameters previously proposed for the DOI determination were calibrated with two different methods. The first used a lateral scan of the detector with a collimated 511 keV pencil beam at steps of 0.5 mm to study the detector DOI capability, while the second used the background radiation of the ¹⁷⁶Lu in the scintillator. The DOI determination capability was tested on different regions of the detector using each parameter and the combination of the two.

Results

With both parameters for the DOI determination, in the lateral scan, the bias between the mean reconstructed DOI and the real beam position was lower than 0.3 mm, and the DOI distribution had a standard deviation of about 1.5 mm. When using the calibration with the radioactivity of the LYSO, the mean bias increased of about 0.2 mm but with no degradation of the standard deviation of the DOI distribution.

Conclusions

The two parameters allow to achieve a DOI resolution comparable with the state of the art, giving a continuous information about the three-dimensional interaction position of the scintillation. These results were obtained by using simple estimators and a detector scalable to a whole PET system. The DOI calibration obtained using lutetium natural radioactivity gives results comparable to the other standard method but appears more readily applicable to detectors mounted in a full PET scanner.

Time-over-threshold for pulse shape discrimination in a time-of-flight phoswich PET detector

It is well known that a PET detector capable of measuring both photon time-of-flight (TOF) and depth-of-interaction (DOI) improves the image quality and accuracy. Phoswich designs have been realized in PET detectors to measure DOI for more than a decade. However, PET detectors based on phoswich designs put great demand on the readout circuits, which have to differentiate the pulse shape produced by different crystal layers. A simple pulse shape discrimination approach is required to realize the phoswich designs in a clinical PET scanner, which consists of thousands of scintillation crystal elements. In this work, we studied time-over-threshold (ToT) as a pulse shape parameter for DOI. The energy, timing and DOI performance were evaluated for a phoswich detector design comprising [Formula: see text] mm LYSO:Ce crystal optically coupled to [Formula: see text] mm calcium co-doped LSO:Ce,Ca(0.4%) crystal read out by a silicon photomultiplier (SiPM). A DOI accuracy of 97.2% has been achieved for photopeak events using the proposed time-over-threshold (ToT) processing. The energy resolution without correction for SiPM non-linearity was [Formula: see text]% and [Formula: see text]% FWHM at 511 keV for LYSO and LSO crystal layers, respectively. The coincidence time resolution for photopeak events ranges from 164.6 ps to 183.1 ps FWHM, depending on the layer combinations. The coincidence time resolution for inter-crystal scatter events ranges from 214.6 ps to 418.3 ps FWHM, depending on the energy windows applied. These results show great promises of using ToT for pulse shape discrimination in a TOF phoswich detector since a ToT measurement can be easily implemented in readout electronics.

Reaching 200-ps timing resolution in a time-of-flight and depth-of-interaction positron emission tomography detector using phosphor-coated crystals and high-density silicon photomultipliers

Current research in the field of positron emission tomography (PET) focuses on improving the sensitivity of the scanner with thicker detectors, extended axial field-of-view, and time-of-flight (TOF) capability. These create the need for depth-of-interaction (DOI) encoding to correct parallax errors. We have proposed a method to encode DOI using phosphor-coated crystals. Our initial work using photomultiplier tubes (PMTs) demonstrated the possibilities of the proposed method, however, a major limitation of PMTs for this application is poor quantum efficiency in yellow light, corresponding to the wavelengths of the converted light by the phosphor coating. In contrast, the red-green-blue-high-density (RGB-HD) silicon photomultipliers (SiPMs) have a high photon detection efficiency across the visible spectrum. Excellent coincidence resolving time (CRT; [Formula: see text]) was obtained by coupling RGB-HD SiPMs and [Formula: see text] lutetium fine silicate crystals coated on a third of one of their lateral sides. Events were classified in three DOI bins ([Formula: see text] width) with an average sensitivity of 83.1%. A CRT of [Formula: see text] combined with robust DOI encoding is a marked improvement in the phosphor-coated approach that we pioneered. For the first time, we read out these crystals with SiPMs and clearly demonstrated the potential of the RGB-HD SiPMs for this TOF-DOI PET detector.

Parallax error in long-axial field-of-view PET scanners-a simulation study

There is a growing interest in the design and construction of a PET scanner with a very long axial extent. One critical design challenge is the impact of the long axial extent on the scanner spatial resolution properties. In this work, we characterize the effect of parallax error in PET system designs having an axial field-of-view (FOV) of 198 cm (total-body PET scanner) using fully-3D Monte Carlo simulations. Two different scintillation materials were studied: LSO and LaBr₃. The crystal size in both cases was 4  ×  4  ×  20 mm³. Several different depth-of-interaction (DOI) encoding techniques were investigated to characterize the improvement in spatial resolution when using a DOI capable detector. To measure spatial resolution we simulated point sources in a warm background in the center of the imaging FOV, where the effects of axial parallax are largest, and at several positions radially offset from the center. Using a line-of-response based ordered-subset expectation maximization reconstruction algorithm we found that the axial resolution in an LSO scanner degrades from 4.8 mm to 5.7 mm (full width at half max) at the center of the imaging FOV when extending the axial acceptance angle (α) from  ±12° (corresponding to an axial FOV of 18 cm) to the maximum of  ±67°-a similar result was obtained with LaBr₃, in which the axial resolution degraded from 5.3 mm to 6.1 mm. For comparison we also measured the degradation due to radial parallax error in the transverse imaging FOV; the transverse resolution, averaging radial and tangential directions, of an LSO scanner was degraded from 4.9 mm to 7.7 mm, for a measurement at the center of the scanner compared to a measurement with a radial offset of 23 cm. Simulations of a DOI detector design improved the spatial resolution in all dimensions. The axial resolution in the LSO-based scanner, with α  =  ± 67°, was improved from 5.7 mm to 5.0 mm by incorporating a two-layer DOI detector. These results characterize the maximum axial blurring for a fully open 2 m long PET scanner and demonstrate that large sensitivity gains are possible with a modest reduction in resolution when using current clinical detector technology with no DOI capability.

A new method for depth of interaction determination in PET detectors

A new method for obtaining depth of interaction (DOI) information in PET detectors is presented in this study, based on sharing and redirection of scintillation light among multiple detectors, together with attenuation of light over the length of the crystals. The aim is to obtain continuous DOI encoding with single side readout, and at the same time without the need for one-to-one coupling between scintillators and detectors, allowing the development of a PET scanner with good spatial, energy and timing resolutions while keeping the complexity of the system low. A prototype module has been produced and characterized to test the proposed method, coupling a LYSO scintillator matrix to a commercial SiPMs array. Excellent crystal separation is obtained for all the scintillators in the array, light loss due to depolishing is found to be negligible, energy resolution is shown to be on average 12.7% FWHM. The mean DOI resolution achieved is 4.1 mm FWHM on a 15 mm long crystal and preliminary coincidence time resolution was estimated in 353 ps FWHM.