A comparison of 180 degrees and 360 degrees acquisition for attenuation-compensated thallium-201 SPECT images

This study compared attenuation compensated, myocardial SPECT images reconstructed from 180 degrees and 360 degrees data to determine if either data acquisition method might yield improved image quality. Specifically, this study analyzed how the use of either 180 degrees or 360 degrees data affects: (a) the relative count density distribution, (b) defect contrast and (c) level of statistical noise in the left ventricular (LV) wall in the reconstructed SPECT images. METHODS: Using the three-dimensional MCAT phantom simulating 201Tl uptake in the upper torso and the SIMSET Monte Carlo code, noise-free projection datasets for both 180 degrees (45 degrees LPO to 45 degrees RAO) and 360 degrees acquisition were generated with the effects of nonuniform attenuation, collimator-detector response and scatter. In addition, low-noise experimental phantom data were acquired over 180 degrees and 360 degrees. Assuming the same total acquisition time, four sets of noisy projection data were simulated from scaled noise-free, simulated data for the following acquisitions: (a) 180 degrees and (b) 360 degrees data acquired on a 90 degrees dual-detector system and (c) 180 degrees and (d) 360 degrees data acquired on a 120 degrees triple-detector system. For each of the four acquisition schemes, 400 realizations of noisy projection data were generated, and the normalized s.d. in the reconstructed images was calculated for five ROIs in the LV wall. Images were reconstructed with nonuniform attenuation compensation using ML-EM algorithm for 25, 50 and 75 iterations. RESULTS: Both the simulated noise-free and experimental low-noise images reconstructed from 180 degrees and 360 degrees data showed nearly identical count densities and defect contrasts in the LV wall. For the 90 degrees dual-detector system, 180 degrees images showed less noise, while for the 120 degrees triple-detector system, 360 degrees showed less noise; however, these differences in noise level were extremely small after a smoothing filter was applied. The 180 degrees images acquired with the 90 degrees dual-detector system showed the same noise level as the 360 degrees images acquired with the 120 degrees triple-detector system, so neither system geometry had an advantage with respect to reduced noise in the SPECT images. CONCLUSION: When nonuniform attenuation compensation is included in the reconstruction, the count density in the LV wall is nearly identical for 180 degrees and 360 degrees SPECT images, and the 90 degrees dual-detector and 120 degrees triple-detector SPECT systems produced similar SPECT images for the same total acquisition time.     

Transmission scanning in emission tomography

Attenuation correction in single-photon (SPET) and positron emission (PET) tomography is now accepted as a vital component for the production of artefact-free, quantitative data. The most accurate attenuation correction methods are based on measured transmission scans acquired before, during, or after the emission scan. Alternative methods use segmented images, assumed attenuation coefficients or consistency criteria to compensate for photon attenuation in reconstructed images. This review examines the methods of acquiring transmission scans in both SPET and PET and the manner in which these data are used. While attenuation correction gives an exact correction in PET, as opposed to an approximate one in SPET, the magnitude of the correction factors required in PET is far greater than in SPET. Transmission scans also have a number of other potential applications in emission tomography apart from attenuation correction, such as scatter correction, inter-study spatial co-registration and alignment, and motion detection and correction. The ability to acquire high-quality transmission data in a practical clinical protocol is now an essential part of the practice of nuclear medicine.     

Simultaneous acquisition of iodine-123 emission and technetium-99m transmission data for quantitative brain single-photon emission tomographic imaging

The aim of this study was to obtain quantitative iodine-123 brain single-photon emission tomographic (SPET) images with scatter and attenuation correction. We used a triple-headed SPET gamma camera system equipped with fan-beam collimators with a technetium-99m line transmission source placed at one of the focal lines of the fan-beam collimators. Four energy windows were employed for data acquisition: (a) 126-132 keV, (b) 132-143 keV, (c) 143-175 keV and (d) 175-186 keV. A simultaneous transmission-emission computed tomography scan (TCT-ECT) was carried out for a brain phantom containing 123I solution. The triple energy window scatter correction was applied to the 123I ECT data measured by means of the windows (b), (c) and (d) acquired by two detectors. Attenuation maps were reconstructed from 99mTc TCT data measured by means of the windows (a), (b) and (c) acquired by one detector. Chang's iterative attenuation correction method using the attenuation maps was applied to the 123I ECT images. In the phantom study cross-calibrated SPET values obtained with the simultaneous mode were almost equal to those obtained with the sequential mode, and they were close to the true value, within an error range of 5.5%. In the human study corrected images showed a higher grey-to-white matter count ratio and relatively higher uptake in the cerebellum, basal ganglia and thalamus than uncorrected images. We conclude that this correction method provides improved quantification and quality of SPET images and that the method is clinically practical because it requires only a single scan with a 99mTc external source.     

Application of models of working at the interface between primary care and mental health services in Israel

A practical method for scatter and attenuation compensation was employed in thallium-201 myocardial single-photon emission tomography (SPET or ECT) with the triple-energy-window (TEW) technique and an iterative attenuation correction method by using a measured attenuation map. The map was reconstructed from technetium-99m transmission CT (TCT) data. A dual-headed SPET gamma camera system equipped with parallel-hole collimators was used for ECT/TCT data acquisition and a new type of external source named "sheet line source" was designed for TCT data acquisition. This sheet line source was composed of a narrow long fluoroplastic tube embedded in a rectangular acrylic board. After injection of 99mTc solution into the tube by an automatic injector, the board was attached in front of the collimator surface of one of the two detectors. After acquiring emission and transmission data separately or simultaneously, we eliminated scattered photons in the transmission and emission data with the TEW method, and reconstructed both images. Then, the effect of attenuation in the scatter-corrected ECT images was compensated with Chang's iterative method by using measured attenuation maps. Our method was validated by several phantom studies and clinical cardiac studies. The method offered improved homogeneity in distribution of myocardial activity and accurate measurements of myocardial tracer uptake. We conclude that the above correction method is feasible because a new type of 99mTc external source may not produce truncation in TCT images and is cost-effective and easy to prepare in clinical situations.     

Adenovirus-mediated gene transfer to liver grafts: an improved method to maximize infectivity

A patient motion-related artefact is one of the most important artefacts in single-photon emission tomography (SPET) imaging. This study evaluated the effect of the number and configuration of SPET detectors on motion artefacts. The following acquisition conditions were simulated based on original 360 degrees projection images: (1) single-detector 180 degrees rotation (S180), (2) a dual-detector rectangular (L-shaped) 180 degrees acquisition (D180L), (3) dual-detector cameras mounted opposite each other with 360 degrees acquisition (D360) and (4) triple-detector 360 degrees acquisition (T360). The motion artefacts were introduced using a syringe and a myocardial phantom. Clinical cases with technetium-99m methoxyisobutylisonitrile and thallium-201 studies were analysed to confirm the validity of this phantom simulation. The effect of continuous alternate rotation acquisition and summing the projections on the reduction of motion artefacts was investigated in each model. The effect of motion depended on the number and the configuration of the SPET detectors. A 1-pixel (6.4 mm) motion in the S180, D180L and D360 models generated only slight artefacts, and a 2-pixel motion led to an apparent decrease in activity or created hot areas in the myocardium. On the other hand, a T360 rotation created few artefacts even with a 2-pixel motion of the last quarter of the projections. Despite the difference in attenuation with 201Tl and 99mTc, similar artefact patterns were observed with both radionuclides in selected patient model studies. Continuous alternate rotation could reduce artefacts caused by less than a 2-pixel motion. In conclusion, calculating the average of the sum of the projections of triple-detector 360 degrees rotations with alternate rotation is the best method to minimize motion artefacts. This "averaging" effect of motion artefacts is a key to this simulation.     

Genetic and developmental influences on infant mouse ultrasonic calling. II. Developmental patterns in the calls of mice 2-12 days of age

Both 360 degrees and 180 degrees rotation acquisition methods have been used in myocardial single photon emission tomography (SPET) studies. We compared both methods using 201Tl, 99Tcm and 123I radiopharmaceuticals with phantoms and clinical models. Myocardial phantom studies with anterior and inferior defects were performed using 201Tl, 99Tcm and 123I. Clinical models of 14 typical situations, including normal subjects, patients with anterior or inferior defects and a high right hemi-diaphragm, were studied. The radiopharmaceuticals were 201Tl, 99Tcm-sestamibi, 123I-BMIPP and 123I-MIBG. Four sets of 180 degrees anterior rotation data with starting angles of (A) posterior, (B) LPO 30 degrees, (C) LPO 60 degrees and (D) left lateral direction were generated and compared with 360 degrees rotation SPET. A polar map display was used for quantification. In phantom studies, the defect contrast on the map was higher in the anterior defect with 180 degrees rotation than with 360 degrees rotation. However, it was decreased in the inferior defect, particularly with 201Tl, because of decreased wall activity around the defect. In the patient model with anterior or inferior defects, the defect contrast was improved with 180 degrees SPET by up to 10%. A slight decrease in the normal region was also noted in the 180 degrees reconstruction. The effect of diffuse liver activity on the inferior region depended on the rotation range. A patient with a high right hemi-diaphragm showed a lower inferior count with 360 degrees SPET. In conclusion, the 360 degrees acquisition was superior to the 180 degrees acquisition in the phantom with defects. Clinically, the quantitative differences in radionuclide types (99Tcm, 123I or 201Tl) were not significant for quantifying a moderate degree (50-60% of peak count) of defect. However, we note quantitative variation depending on the rotation range in the 180 degrees method.     

Evaluation of right and left ventricular volume and ejection fraction using a mathematical cardiac torso phantom

The availability of gated SPECT has increased the interest in the determination of volume and ejection fraction of the left ventricle (LV) for clinical diagnosis. However, the same indices for the right ventricle (RV) have been neglected. The objective of this investigation was to use a mathematical model of the anatomical distribution of activity in gated blood-pool imaging to evaluate the accuracy of two ventricular volume and ejection fraction determination methods. In this investigation, measurements from the RV were emphasized. METHODS: The mathematical cardiac torso phantom, developed to study LV myocardium perfusion, was modified to simulate the radioactivity distribution of a 99mTc-gated blood-pool study. Twenty mathematical cardiac torso phantom models of the normal heart with different LV volumes (122.3 +/- 11.0 ml), RV volumes (174.6 +/- 22.3 ml) and stroke volumes (75.7 +/- 3.3 ml) were randomly generated to simulate variations among patients. An analytical three-dimensional projector with attenuation and system response was used to generate SPECT projection sets, after which noise was added. The projections were simulated for 128 equidistant views in a 360 degrees rotation mode. RESULTS: The radius of rotation was varied between 24 and 28 cm to mimic such variation in patient acquisitions. The 180 degrees and 360 degrees projection sets were reconstructed using the filtered backprojection reconstruction algorithm with Butter-worth filtering. Comparison was made with and without application of the iterative Chang attenuation correction algorithm. Volumes were calculated using a modified threshold and edge detection method (hybrid threshold), as well as a count-based method. A simple background correction procedure was used with both methods. CONCLUSION: Results indicate that cardiac functional parameters can be measured with reasonable accuracy using both methods. However, the count-based method had a larger bias than the hybrid threshold method when RV parameters were determined for 180 degrees reconstruction without attenuation correction. This bias improved after attenuation correction. The count-based method also tended to overestimate the end systolic volume slightly. An improved background correction could possibly alleviate this bias.     

Combined scatter and attenuation correction for 201Tl myocardial perfusion SPECT using OS-EM algorithm

There are two possible ways to obtain scatter-corrected images with the ML-EM (maximum likelihood expectation maximization) algorithm: one is the subtraction of scatter estimate si from projection data pi, and then (pi-si) is used for scatter-corrected projection data (denoted as SC(T)); the other method is the addition of scatter estimate si to the projections calculated from the reconstructed image without performing data subtraction (SC(E)). This paper investigated these two ML-EM algorithms of combined scatter and attenuation correction on 201Tl myocardial perfusion SPECT imaging. Scatter windows were placed one full width at half maximum (FWHM) below and above the photopeak centerline. The scatter fraction in the primary peak was estimated using trapezoidal approximation by the triple energy window method. Phantom and clinical images were reconstructed using 6 iterations of ordered subsets EM algorithm (OS-EM). A cylindrical phantom with a cold-rod insert and a heart/thorax phantom with liver insert were used to evaluate scatter and the attenuation compensation technique. A cylindrical phantom filled with uniform 201Tl solution was used to evaluate statistical noise. The percent root-mean-square uncertainty (%RMSU) was used as a quantitative measure of noise amplification. %RMSU showed that the SC(E) method amplified noise less in comparison with the SC(T) method, however, no significant difference in image quality was observed between the two methods. In conclusion, both the SC(T) and SC(E) methods provided significant and similar improvement in the removal of scatter in 201Tl myocardial perfusion SPECT imaging.     

MR evaluation of the articular cartilage of the femoral head during traction. Correlation with resected femoral head

As a result of a high percentage of hypoactive upper poles of kidneys in traditional 99mTc-dimercaptosuccinic acid (DMSA) SPECT, a prospective study was conducted using 180 degrees acquisition technique compared with 360 degrees to minimize tissue attenuation. METHODS: Anterior 180 degrees, posterior 180 degrees and 360 degrees renal SPECT images were obtained simultaneously using a dual-head camera. Forty-one subjects without renal disease and 16 subjects with 21 cortical defects were included in this study. The total counts of the raw data in the anterior 180 degrees, posterior 180 degrees and full 360 degrees were calculated. Small regions of interest were drawn over the cortex of the kidney on coronal and reoriented sagittal slices. Quantitative evaluation of regional activity was performed on the same frames in all three acquisition methods. RESULTS: Comparison of the total renal counts between the anterior and posterior 180 degrees data showed reduced counts in the anterior 180 degrees data collection (P < 0.01). Visual evaluation of the reconstructed images from anterior 180 degrees, posterior 180 degrees and full 360 degrees data collection showed the best image uniformity in the posterior 180 degrees image. The upper/lower pole ratio in the posterior 180 degrees renal SPECT images increased significantly in comparison to full 360 degrees renal SPECT images (P < 0.01) and anterior 180 degrees SPECT images (P < 0.01). The renal defects were more clearly visualized in the posterior 180 degrees renal SPECT images than the full 360 degrees renal SPECT images. The defect/normal cortex ratios in the posterior 180 degrees renal SPECT images were much lower than those from the full 360 degrees SPECT images (P < 0.01) and those from the anterior 180 degrees SPECT images (P < 0.01). CONCLUSION: The posterior 180 degrees acquisition technique can avoid the problem of hypoactive upper pole and can be less time consuming in 99mTc-DMSA SPECT images. It also provides superior lesion contrast in the clinical evaluation of patients with renal scarring.     

Multiple line source array for SPECT transmission scans: simulation, phantom and patient studies

Accurate attenuation and scatter corrections in quantitative SPECT studies require attenuation maps of the density distribution in the scanned object. These can be obtained from simultaneous emission/transmission scans. METHODS: A new method has been developed using a multiple line source array (MLA) for transmission scans, and its performance has been investigated using computer simulations and experimental data. The activity in the central lines of the MLA was higher than at the edges of the system, so that more transmission photons would be directed toward the thicker parts of the human body. A series of transmission-only and simultaneous emission/transmission studies were performed for different phantom configurations and human subjects. Attenuation maps were generated and used in reconstruction of attenuation-corrected emission images. RESULTS: The mu coefficients for attenuation maps obtained using the MLA system and simulated and experimental data display no artifacts and are qualitatively and quantitatively correct. For phantoms, the agreement between the measured and the true value of mu for water was found to be better than 4%. The attenuation-corrected emission images for the phantom studies demonstrate that the activity in the heart can be accurately reconstructed. A significant qualitative improvement was also obtained when the attenuation correction was used on patient data. CONCLUSION: Our results indicate that the MLA transmission source can be used in simultaneous transmission/emission imaging to generate accurate attenuation maps. These maps allow for performing an object-specific, attenuation correction of the emission images.     

Myocardial infarction in rats: high-resolution single-photon emission tomographic imaging with a pinhole collimator

The purpose of this study was to evaluate the accuracy of myocardial imaging by means of high-resolution single-photon emission tomography (SPET) with a pinhole collimator in rats with experimental infarction. Myocardial infarctions were induced in male Wistar rats by ligation of the left coronary artery for 30 min, followed by reperfusion. Two days after the reperfusion, pinhole SPET was performed after the intravenous administration of 111 MBq of thallium-201 chloride, using a rotating gamma camera equipped with a pinhole insert (2.0-mm aperture) in a low-energy pinhole collimator. SPET projection data were collected at 6 degrees increments over 360 degrees using a 4-cm radius of rotation to reconstruct the short- and long-axis images. Projection data were acquired in 15 or 30 s, the SPET imaging being accomplished within 40 min after the injection of 201Tl. After SPET, the rats were sacrificed to remove the hearts for autoradiography (ARG) and nitroblue tetrazolium (NBT) staining as a visual correlative study. Quantitative correlative studies between pinhole SPET and ARG were performed with linear regression analysis for infarct size and distribution properties (relative counts on SPET images and relative density on autoradiographs) on the short-axis sections. All infarcts (4 mm in minimum diameter) in seven rats were detected by pinhole SPET. The SPET images in rats with or without myocardial infarction were consistent with the findings of ARG and NBT staining. There were significant correlations between pinhole SPET and ARG with respect to the infarct size (r=0.933, P <0.001; n=15) and the relative radiotracer distribution (r=0.931, P <0.001; n=68). This study therefore confirmed the accuracy of myocardial pinhole SPET imaging in rats with myocardial infarction. This method may partially substitute for ARG and prove useful for assessing new myocardial imaging agents in vivo in small laboratory animals.     

An attenuation measurement technique for rotating planar detector positron tomographs

This paper presents a new attenuation measurement technique suitable for rotating planar detector positron tomographs. Transmission measurements are made using two unshielded positron-emitting line sources, one attached to the front face of each detector. Many of the scattered and accidental coincidences are rejected by including only those coincidences that form a vector passing within a predetermined distance of either line source. Some scattered and accidental coincidences are still included, which reduces the measured linear attenuation: in principle their contribution can be accurately estimated and subtracted, but in practice, when limited statistics are available (as is the case with the multi-wire Birmingham positron camera), this background subtraction unacceptably increases the noise. Instead an attenuation image having the correct features can be reconstructed from the measured projections. For objects containing only a few discrete linear attenuation coefficients, segmentation of this attenuation image reduces noise and allows the correct linear attenuation coefficients to be restored by renormalization. Reprojection through the segmented image may then provide quantitatively correct attenuation correction factors of sufficient statistical quality to correct for attenuation in PET emission images.     

Clinical value of triple-energy window scatter correction in simultaneous dual-isotope single-photon emission tomography with 123I-BMIPP and 201Tl

To improve the image quality in simultaneous dual-isotope single-photon emission tomography (SPET) with iodine-123 labelled 15-(p-iodophenyl)-3-methylpentadecanoic acid (BMIPP) and thallium-201, we applied the triple-energy window method (TEW) for correction of the cross-talk and scatter artifact. Seventy-one patients with coronary artery disease were included. 201Tl cross-talk into the 123I acquisition window (group 1, n = 30) and 123I cross-talk into the 201Tl window (group 2, n = 41) were studied. In group 1, 123I images were first obtained (single-isotope images), followed by 201Tl injection and SPET acquisition using dual-isotope windows (dual-isotope images). In group 2, the order was reversed. The dual-isotope SPET images with and without TEW were compared with the single-isotope images. Qualitative evaluation was performed by scoring the segmental defect pattern. Detectability of the mismatched fatty acid metabolism on dual-isotope SPET was evaluated by receiver operating characteristic (ROC) curve analysis. Segmental defect pattern agreement between dual and corrected single images was significantly improved by TEW correction (P<0.01). The agreement was particularly improved in segments with absence of uptake. There was no significant difference between TEW-corrected dual-isotope SPET and corresponding single-isotope SPET with regard to either % defect count or background activity. Mismatched fatty acid metabolism depicted by dual-isotope SPET predicted abnormal wall motion more accurately with TEW than without TEW. With TEW, a practical method for scatter and cross-talk correction in clinical settings, simultaneous dual 123I-BMIPP/201Tl SPET is feasible for the assessment of myocardial perfusion/metabolism mismatch.     

The channel ratio method of scatter correction for radionuclide image quantitation

The accuracy of quantitation of radionuclide distributions in human tissue with the scintillation camera is decreased by attenuation and scatter of photons. If scatter correction is applied satisfactorily, narrow beam attenuation can be applied. In this article, a scatter correction technique, the channel ratio (CR) method, is introduced. The CR scatter correction method is proposed for quantitation of the radionuclide distribution in organs. The improvement in the geometrical resolution was measured and examples of clinical images are presented. In this method, the change in the ratio of counts from two symmetrical adjacent energy windows straddling the energy photopeak was used to eliminate the contribution of scattered photons during imaging with 99mTc. The theory and methods for the empirical affirmation are described. To apply the CR scatter correction method, two constants, the ratio of primary photons G and the ratio of scattered photons H in the same windows, were determined. Different sized sources in varying depths of water were imaged. When the source activities were quantified after scatter correction with the CR method, the measurements ranged from 96%-108% in comparison to the reference value in 100 mm water. The scatter fraction increased from 0.20 in 10 mm water to 1.44 in 200 mm water. The geometrical resolution expressed as full width at tenth maximum in 150 mm water improved by 30.4% and was restored to the value of the geometrical resolution in air. The CR scatter correction method is a simple method to correct for scatter in order to facilitate accurate quantitation of the radionuclide distribution during imaging with a scintillation camera.     

Multifrequency interpolation for fast off-resonance correction

Field inhomogeneities or susceptibility variations produce blurring in images acquired using non-2DFT k-space readout trajectories. This problem is more pronounced for sequences with long readout times such as spiral imaging. Theoretical and practical correction methods based on an acquired field map have been reported in the past. This paper introduces a new correction method based on the existing concept of frequency segmented correction but which is faster and theoretically more accurate. It consists of reconstructing the data at several frequencies to form a set of base images that are then added together with spatially varying linear coefficients derived from the field map. The new algorithm is applied to phantom and in vivo images acquired with projection reconstruction and spiral sequences, yielding sharply focused images.     

Correction for photon attenuation in SPECT: analytical framework, average attenuation factors, and a new hybrid approach

We provide a unified framework for the investigation of convergence properties of the iterative algorithms for photon attenuation correction in SPECT, including the iterative Chang method--a commonly used approach in which an average attenuation factor calculated over all projection angles is employed in a pointwise correction scheme. A new average attenuation factor calculated along the projection line is introduced, which can compensate exactly for the attenuation effect in the case of a uniform activity distribution. We propose a new hybrid approach in which we use this new average attenuation factor initially and then shift to the iterative Chang method in later iterations. This hybrid approach was evaluated in a simulation study by use of a computer-generated phantom with both non-uniform activity and non-uniform attenuation distributions. The results demonstrate that this hybrid approach improves the convergence speed of the iterative Chang method and produces reconstructed images of high quality.     

The Mark IV system for radionuclide computed tomography of the brain

The Mark IV scanning system is a simple four-sided arrangement of 32 independent detectors which rotate continously as a unit, detecting, processing, and displaying the reconstructed data while the study progresses. Detection is by single photon counting and is compatible with commercially available radionuclides. An empirical correction is applied for attenuation, difference in detector response, and scatter. It is a high-sensitivity device with approximately uniform resolution throughout the section plane. There is good reproducibility and accuracy for absolute quantification of radionuclide concentration in the brain. Clinical applications include scans of 99mTcO4, 99mTc-RBC, 123I-iodoantipyrine, 99mTc-diphosphonate, and 111In-DTPA.     

The relative contributions of scatter and attenuation corrections toward improved brain SPECT quantification

Mounting evidence indicates that scatter and attenuation are major confounds to objective diagnosis of brain disease by quantitative SPECT. There is considerable debate, however, as to the relative importance of scatter correction (SC) and attenuation correction (AC), and how they should be implemented. The efficacy of SC and AC for 99mTc brain SPECT was evaluated using a two-compartment fully tissue-equivalent anthropomorphic head phantom. Four correction schemes were implemented: uniform broad-beam AC, non-uniform broad-beam AC, uniform SC + AC, and non-uniform SC + AC. SC was based on non-stationary deconvolution scatter subtraction, modified to incorporate a priori knowledge of either the head contour (uniform SC) or transmission map (non-uniform SC). The quantitative accuracy of the correction schemes was evaluated in terms of contrast recovery, relative quantification (cortical:cerebellar activity), uniformity ((coefficient of variation of 230 macro-voxels) x 100%), and bias (relative to a calibration scan). Our results were: uniform broad-beam (mu = 0.12 cm(-1)) AC (the most popular correction): 71% contrast recovery, 112% relative quantification, 7.0% uniformity, +23% bias. Non-uniform broad-beam (soft tissue mu = 0.12 cm(-1)) AC: 73%, 114%, 6.0%, +21%, respectively. Uniform SC + AC: 90%, 99%, 4.9%, +12%, respectively. Non-uniform SC + AC: 93%, 101%, 4.0%, +10%, respectively. SC and AC achieved the best quantification; however, non-uniform corrections produce only small improvements over their uniform counterparts. SC + AC was found to be superior to AC; this advantage is distinct and consistent across all four quantification indices.     

Planar imaging quantification using 3D attenuation correction data and Monte Carlo simulated buildup factors

A new method to correct for attenuation and the buildup of scatter in planar imaging quantification is presented. The method is based on the combined use of 3D density information provided by computed tomography to correct for attenuation and the application of Monte Carlo simulated buildup factors to correct for buildup in the projection pixels. CT and nuclear medicine images were obtained for a purpose-built nonhomogeneous phantom that models the human anatomy in the thoracic and abdominal regions. The CT transverse slices of the phantom were converted to a set of consecutive density maps. An algorithm was developed that projects the 3D information contained in the set of density maps to create opposing pairs of accurate 2D correction maps that were subsequently applied to planar images acquired from a dual-head gamma camera. A comparison of results obtained by the new method and the geometric mean approach based on published techniques is presented for some of the source arrangements used. Excellent results were obtained for various source-phantom configurations used to evaluate the method. Activity quantification of a line source at most locations in the nonhomogeneous phantom produced errors of less than 2%. Additionally, knowledge of the actual source depth is not required for accurate activity quantification. Quantification of volume sources placed in foam, Perspex and aluminium produced errors of less than 7% for the abdominal and thoracic configurations of the phantom.     

Significance of nonuniform attenuation correction in quantitative brain SPECT imaging

The purposes of this study were to develop a method for nonuniform attenuation correction of 123I emission brain images based on transmission imaging with a longer-lived isotope (i.e., 57Co) and to evaluate the relative improvement in quantitative SPECT images achieved with nonuniform attenuation correction. METHODS: Emission and transmission SPECT scans were acquired on three different sets of studies: a heterogeneous brain phantom filled with 1231 to simulate the distribution of dopamine transporters labeled with 2beta-carbomethoxy-3beta-(4-123I-iodophenyl)tropane (123I-beta-CIT); nine healthy human control subjects who underwent transmission scanning using two separate line sources (57Co and 123I); and a set of eight patients with Parkinson's disease and five healthy control subjects who received both emission and transmission scans after injection of 123I-beta-CIT. Attenuation maps were reconstructed using a Bayesian transmission reconstruction algorithm, and attenuation correction was performed using Chang's postprocessing method. The spatial distribution of errors within the brain was obtained from attenuation correction factors computed from uniform and nonuniform attenuation maps and was visualized on a pixel-by-pixel basis as an error image. RESULTS: For the heterogeneous brain phantom, the uniform attenuation correction had errors of 2%-6.5% for regions corresponding to striatum and background, whereas nonuniform attenuation correction was within 1%. Analysis of 123I transmission images of the nine healthy human control subjects showed differences between uniform and nonuniform attenuation correction to be in the range of 6.4%-16.0% for brain regions of interest (ROIs). The human control subjects who received transmission scans only were used to generate a curvilinear function to convert 57Co attenuation values into those for 123I, based on a pixel-by-pixel comparison of two coregistered transmission images for each subject. These values were applied to the group of patients and healthy control subjects who received transmission 57Co scans and emission 123I scans after injection of 123I-beta-CIT. In comparison to nonuniform attenuation correction as the gold standard, uniform attenuation with the ellipse drawn around the transmission image caused an approximately 5% error, whereas placement of the ellipse around the emission image caused a 15% error. CONCLUSION: Nonuniform attenuation correction allowed a moderate improvement in the measurement of absolute activity in individual brain ROIs. When images were analyzed as target-to-background activity ratios, as is commonly performed with 123I-beta-CIT, these outcome measures showed only small differences when Parkinson's disease patients and healthy control subjects were compared using nonuniform, uniform or even no attenuation correction.