The origins of SPECT and SPECT/CT Hutton, Brian F.
European journal of nuclear medicine and molecular imaging,
05/2014, Volume:
41, Issue:
Suppl 1
Journal Article
Peer reviewed
Single photon emission computed tomography (SPECT) has a long history of development since its initial demonstration by Kuhl and Edwards in 1963. Although clinical utility has been dominated by the ...rotating gamma camera, there have been many technological innovations with the recent popularity of organ-specific dedicated SPECT systems. The combination of SPECT and CT evolved from early transmission techniques used for attenuation correction with the initial commercial systems predating the release of PET/CT. The development and acceptance of SPECT/CT has been relatively slow with continuing debate as to what cost/performance ratio is justified. Increasingly, fully diagnostic CT is combined with SPECT so as to facilitate optimal clinical utility.
To provide a contemporary global prevalence of mental health issues among the general population amid the coronavirus disease-2019 (COVID-19) pandemic. We searched electronic databases, preprint ...databases, grey literature, and unpublished studies from January 1, 2020, to June 16, 2020 (updated on July 11, 2020), with no language restrictions. Observational studies using validated measurement tools and reporting data on mental health issues among the general population were screened to identify all relevant studies. We have included information from 32 different countries and 398,771 participants. The pooled prevalence of mental health issues amid the COVID-19 pandemic varied widely across countries and regions and was higher than previous reports before the COVID-19 outbreak began. The global prevalence estimate was 28.0% for depression; 26.9% for anxiety; 24.1% for post-traumatic stress symptoms; 36.5% for stress; 50.0% for psychological distress; and 27.6% for sleep problems. Data are limited for other aspects of mental health issues. Our findings highlight the disparities between countries in terms of the poverty impacts of COVID-19, preparedness of countries to respond, and economic vulnerabilities that impact the prevalence of mental health problems. Research on the social and economic burden is needed to better manage mental health problems during and after epidemics or pandemics. Systematic review registration: PROSPERO CRD 42020177120.
Positron emission tomography (PET) images are degraded by a phenomenon known as the partial volume effect (PVE). Approaches have been developed to reduce PVEs, typically through the utilisation of ...structural information provided by other imaging modalities such as MRI or CT. These methods, known as partial volume correction (PVC) techniques, reduce PVEs by compensating for the effects of the scanner resolution, thereby improving the quantitative accuracy. The PETPVC toolbox described in this paper comprises a suite of methods, both classic and more recent approaches, for the purposes of applying PVC to PET data. Eight core PVC techniques are available. These core methods can be combined to create a total of 22 different PVC techniques. Simulated brain PET data are used to demonstrate the utility of toolbox in idealised conditions, the effects of applying PVC with mismatched point-spread function (PSF) estimates and the potential of novel hybrid PVC methods to improve the quantification of lesions. All anatomy-based PVC techniques achieve complete recovery of the PET signal in cortical grey matter (GM) when performed in idealised conditions. Applying deconvolution-based approaches results in incomplete recovery due to premature termination of the iterative process. PVC techniques are sensitive to PSF mismatch, causing a bias of up to 16.7% in GM recovery when over-estimating the PSF by 3 mm. The recovery of both GM and a simulated lesion was improved by combining two PVC techniques together. The PETPVC toolbox has been written in C++, supports Windows, Mac and Linux operating systems, is open-source and publicly available.
Attenuation correction is an essential requirement for quantification of positron emission tomography (PET) data. In PET/CT acquisition systems, attenuation maps are derived from computed tomography ...(CT) images. However, in hybrid PET/MR scanners, magnetic resonance imaging (MRI) images do not directly provide a patient-specific attenuation map. The aim of the proposed work is to improve attenuation correction for PET/MR scanners by generating synthetic CTs and attenuation maps. The synthetic images are generated through a multi-atlas information propagation scheme, locally matching the MRI-derived patient's morphology to a database of MRI/CT pairs, using a local image similarity measure. Results show significant improvements in CT synthesis and PET reconstruction accuracy when compared to a segmentation method using an ultrashort-echo-time MRI sequence and to a simplified atlas-based method.
Accurate quantification in PET and SPECT requires correction for a number of physical factors, such as photon attenuation, Compton scattering and random coincidences (in PET). Another factor ...affecting quantification is the limited spatial resolution. While considerable effort has gone into development of routine correction techniques for the former factors, less attention has been paid to the latter. Spatial resolution-related effects, referred to as 'partial volume effects' (PVEs), depend not only on the characteristics of the imaging system but also on the object and activity distribution. Spatial and/or temporal variations in PVE can often be confounding factors. Partial volume correction (PVC) could in theory be achieved by some kind of inverse filtering technique, reversing the effect of the system PSF. However, these methods are limited, and usually lead to noise-amplification or image artefacts. Some form of regularization is therefore needed, and this can be achieved using information from co-registered anatomical images, such as CT or MRI. The purpose of this paper is to enhance understanding of PVEs and to review possible approaches for PVC. We also present a review of clinical applications of PVC within the fields of neurology, cardiology and oncology, including specific examples.
Purpose
Alzheimer’s disease (AD) is the most common form of dementia. Clinically, it is characterized by progressive cognitive and functional impairment with structural hallmarks of cortical atrophy ...and ventricular expansion. Amyloid plaque aggregation is also known to occur in AD subjects. In-vivo imaging of amyloid plaques is now possible with positron emission tomography (PET) radioligands. PET imaging suffers from a degrading phenomenon known as the partial volume effect (PVE). The quantitative accuracy of PET images is reduced by PVEs primarily due to the limited spatial resolution of the scanner. The degree of PVE is influenced by structure size, with smaller structures tending to suffer from more severe PVEs such as atrophied grey matter regions. The aims of this paper were to investigate the effect of partial volume correction (PVC) on the quantification of amyloid PET and to highlight the importance of selecting an appropriate PVC technique.
Methods
An improved PVC technique, region-based voxel-wise (RBV) correction, was compared against existing Van-Cittert (VC) and Müller-Gärtner (MG) methods using amyloid PET imaging data. Digital phantom data were produced using segmented MRI scans from a control subject and an AD subject. Typical tracer distributions were generated for each of the phantom anatomies. Also examined were 70 clinical PET scans acquired using
18
Fflutemetamol. Volume of interest (VOI) analysis was performed for corrected and uncorrected images.
Results
PVC was shown to improve the quantitative accuracy of regional analysis performed on amyloid PET images. Of the corrections applied, VC deconvolution demonstrated the worst recovery of grey matter values. MG PVC was shown to induce biases in some grey matter regions due to grey matter variability. In addition, white matter variability was shown to influence the accuracy of MG PVC in cortical grey matter and also cerebellar grey matter, a typical reference region for amyloid PET normalization in sporadic AD. RBV was shown to be more accurate than MG in terms of grey matter and white matter uptake. An increase in within-group variability after PVC was observed and is believed to be a genuine, more accurate representation of the data rather than a correction-induced error. The standardized uptake value ratio (SUVR) threshold for classifying subjects as either amyloid-positive or amyloid-negative was found to be 1.64 in the uncorrected dataset, rising to 2.25 after PVC.
Conclusion
Care should be taken when applying PVC to amyloid PET images. Assumptions made in existing PVC strategies can induce biases that could lead to erroneous inferences about uptake in certain regions. The proposed RBV PVC technique accounts for within-compartment variability, with the potential to reduce errors of this kind.
Olfactory loss has been identified as one of the common symptoms related to COVID-19 infection. Although olfactory loss is recognized, our understanding of both the extent of loss and time to ...olfactory recovery following infection is less well known. Similarly, knowledge of potential impactful patient factors and therapies that influence olfactory recovery is desirable but is not overtly clear in the literature. Our systematic review sought to fill this knowledge gap. We included studies that: involved either an observational or an interventional design that reported data on patients with olfactory dysfunction due to Reverse Transcription Polymerase Chain Reaction (RT-PCR) diagnosed COVID-19 infection; and reported data regarding olfactory recovery measured by an objective olfactory test, Likert scale and/or visual analog scale (VAS). The study methods were determined a priori and registered in PROSPERO (Registration Number CRD42020204354). An information specialist searched Medline, Embase, LitCovid and the Cochrane Register of Controlled Trials up to March 2021, and two reviewers were involved in all aspects of study selection and data collection. After screening 2788 citations, a total of 44 studies of assorted observational designs were included. Patients had undergone objective COVID-19 testing, and most were adult patients with mild to moderate COVID-19. Olfactory recovery was found to occur as early as 7 days, with most patients recovering olfaction within 30 days. Few studies included prolonged follow-up to 6 months or longer duration. Poor olfaction at initial presentation was associated with poor recovery rates. Only a small number of studies assessed olfactory retraining and steroid therapy. Additional trials are underway.
Detection of scattered gamma quanta degrades image contrast and quantitative accuracy of single-photon emission computed tomography (SPECT) imaging. This paper reviews methods to characterize and ...model scatter in SPECT and correct for its image degrading effects, both for clinical and small animal SPECT. Traditionally scatter correction methods were limited in accuracy, noise properties and/or generality and were not very widely applied. For small animal SPECT, these approximate methods of correction are often sufficient since the fraction of detected scattered photons is small. This contrasts with patient imaging where better accuracy can lead to significant improvement of image quality. As a result, over the last two decades, several new and improved scatter correction methods have been developed, although often at the cost of increased complexity and computation time. In concert with (i) the increasing number of energy windows on modern SPECT systems and (ii) excellent attenuation maps provided in SPECT/CT, some of these methods give new opportunities to remove degrading effects of scatter in both standard and complex situations and therefore are a gateway to highly quantitative single- and multi-tracer molecular imaging with improved noise properties. Widespread implementation of such scatter correction methods, however, still requires significant effort.
Advances in clinical molecular imaging instrumentation Hutton, Brian F.; Erlandsson, Kjell; Thielemans, Kris
Clinical and translational imaging : reviews in nuclear medicine and molecular imaging,
02/2018, Volume:
6, Issue:
1
Journal Article
Peer reviewed
Open access
In this article, we describe recent developments in the design of both single-photon emission computed tomography (SPECT) and positron emission tomography (PET) instrumentation that have led to the ...current range of superior performance instruments. The adoption of solid-state technology for either complete detectors e.g., cadmium zinc telluride (CZT) or read-out systems that replace photomultiplier tubes avalanche photodiodes (APD) or silicon photomultipliers (SiPM) provide the advantage of compact technology, enabling flexible system design. In SPECT, CZT is well suited to multi-radionuclide and kinetic studies. For PET, SiPM technology provides MR compatibility and superior time-of-flight resolution, resulting in improved signal-to-noise ratio. Similar SiPM technology has also been used in the construction of the first SPECT insert for clinical brain SPECT/MRI.
D-SPECT (Spectrum Dynamics, Israel) is a novel SPECT system for cardiac perfusion studies. Based on CZT detectors, region-centric scanning, high-sensitivity collimators and resolution recovery, it ...offers potential advantages over conventional systems. A series of measurements were made on a beta-version D-SPECT system in order to evaluate its performance in terms of energy resolution, scatter fraction, sensitivity, count rate capability and resolution. Corresponding measurements were also done on a conventional SPECT system (CS) for comparison. The energy resolution of the D-SPECT system at 140 keV was 5.5% (CS: 9.25%), the scatter fraction 30% (CS: 34%), the planar sensitivity 398 s(-1) MBq(-1) per head ((99m)Tc, 10 cm) (CS: 72 s(-1) MBq(-1)), and the tomographic sensitivity in the heart region was in the range 647-1107 s(-1) MBq(-1) (CS: 141 s(-1) MBq(-1)). The count rate increased linearly with increasing activity up to 1.44 M s(-1). The intrinsic resolution was equal to the pixel size, 2.46 mm (CS: 3.8 mm). The average reconstructed resolution using the standard clinical filter was 12.5 mm (CS: 13.7 mm). The D-SPECT has superior sensitivity to that of a conventional system with similar spatial resolution. It also has excellent energy resolution and count rate characteristics, which should prove useful in dynamic and dual radionuclide studies.
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