Margaret E. Daube-Witherspoon

UNLABELLED: Significant improvements have made it possible to add the technology of time-of-flight (TOF) to improve PET, particularly for oncology applications. The goals of this work were to investigate the benefits of TOF in experimental phantoms and to determine how these benefits translate into improved performance for patient imaging. METHODS: In this study we used a fully 3-dimensional scanner with the scintillator lutetium-yttrium oxyorthosilicate and a system timing resolution of approximately 600 ps. The data are acquired in list-mode and reconstructed with a maximum-likelihood expectation maximization algorithm; the system model includes the TOF kernel and corrections for attenuation, detector normalization, randoms, and scatter. The scatter correction is an extension of the model-based single-scatter simulation to include the time domain. Phantom measurements to study the benefit of TOF include 27-cm- and 35-cm-diameter distributions with spheres ranging in size from 10 to 37 mm. To assess the benefit of TOF PET for clinical imaging, patient studies are quantitatively analyzed. RESULTS: The lesion phantom studies demonstrate the improved contrast of the smallest spheres with TOF compared with non-TOF and also confirm the faster convergence of contrast with TOF. These gains are evident from visual inspection of the images as well as a quantitative evaluation of contrast recovery of the spheres and noise in the background. The gains with TOF are higher for larger objects. These results correlate with patient studies in which lesions are seen more clearly and with higher uptake at comparable noise for TOF than with non-TOF. CONCLUSION: TOF leads to a better contrast-versus-noise trade-off than non-TOF but one that is difficult to quantify in terms of a simple sensitivity gain improvement: A single gain factor for TOF improvement does not include the increased rate of convergence with TOF nor does it consider that TOF may converge to a different contrast than non-TOF. The experimental phantom results agree with those of prior simulations and help explain the improved image quality with TOF for patient oncology studies.

Improved axial spatial resolution in positron emission tomography (PET) scanners will lead to reduced sensitivity unless the axial acceptance angle for the coincidences is kept constant. A large acceptance angle, however, violates assumptions made in most reconstruction algorithms, which reconstruct parallel independent slices, rather than a three-dimensional volume. Two methods of treating the axial information from a volume PET scanner are presented. Qualitative and quantitative errors introduced by the approximations are examined for simulated objects with sharp boundaries and for a more anatomically realistic distribution with smooth activity gradients.

The trend in the design of scanners for positron emission computed tomography has traditionally been to improve the transverse spatial resolution to several millimeters while maintaining relatively coarse axial resolution (1-2 cm). Several scanners are being built with fine sampling in the axial as well as transverse directions, leading to the possibility of the true volume imaging. The number of possible coincidence pairs in these scanners is quite large. The usual methods of image reconstruction cannot handle these data without making approximations. It is computationally most efficient to reduce the size of this large, sparsely populated array by back-projecting the coincidence data prior to reconstruction. While analytic reconstruction techniques exist for back-projected data, an iterative algorithm may be necessary for those cases where the point spread function is spatially variant. A modification of the maximum likelihood algorithm is proposed to reconstruct these back-projected data. The method, the iterative image space reconstruction algorithm (ISRA), is able to reconstruct data from a scanner with a spatially variant point spread function in less time than other proposed algorithms. Results are presented for single-slice data, simulated and actual, from the PENN-PET scanner.

The PENN-PET scanner consists of six hexagonally arranged position-sensitive Nal(TI) detectors. This design offers high spatial resolution in all three dimensions, high sampling density along all three axes without scanner motion, a large axial acceptance angle, good energy resolution, and good timing resolution. This results in three-dimensional imaging capability with high sensitivity and low scatter and random backgrounds. The spatial resolution is 5.5 mm (FWHM) in all directions near the center. The true sensitivity, for a brain-sized object, is a maximum of 85 kcps/microCi/ml and the scatter fraction is a minimum of 10%, both depending on the lower level energy threshold. The scanner can handle up to 5 mCi in the field of view, at which point the randoms equal the true coincidences and the detectors reach their count rate limit. We have so far acquired [18F]FDG brain studies and cardiac studies, which show the applicability of our scanner for both brain and whole-body imaging. With the results to date, we feel that this design results in a simple yet high performance scanner which is applicable to many types of static and dynamic clinical studies.

UNLABELLED: The NU 2-1994 standard document for PET performance measurements has recently been updated. The updated document, NU 2-2001, includes revised measurements for spatial resolution, intrinsic scatter fraction, sensitivity, counting rate performance, and accuracy of count loss and randoms corrections. The revised measurements are designed to allow testing of dedicated PET systems in both 2-dimensional and 3-dimensional modes as well as coincidence gamma cameras, conditions not considered in the original NU 2-1994 standard. In addition, the updated measurements strive toward being more representative of clinical studies, in particular, whole-body imaging. METHODS: Performance measurements following the NU 2-1994 and NU 2-2001 standards were performed on several different PET scanners. Differences between the procedures and resulting performance characteristics, as well as the rationale for these changes, were noted. RESULTS: Spatial resolution is measured with a point source in all 3 directions, rather than a line source, as specified previously. For the measurements of intrinsic scatter fraction, sensitivity, and counting rate performance, a 70-cm line source is now specified, instead of a 19-cm-long cylindric phantom. The longer configuration permits measurement of these performance characteristics over the entire axial field of view of all current PET scanners and incorporates the effects of activity outside the scanner. A measurement of image quality has been added in an effort to measure overall image quality under clinically realistic conditions. This measurement replaces the individual measurements of uniformity and of the accuracy of corrections for attenuation and scatter. CONCLUSION: The changes from the NU 2-1994 standard to the NU 2-2001 standard strive toward establishing relevance with clinical studies. The tests in the updated standard also are, in general, simpler and less time-consuming to perform than those in the NU 2-1994 standard.