Dataset Information

High-speed scanning of planar images showing 123I-MIBG uptake using a whole-body CZT camera: a phantom and clinical study.

ABSTRACT: BACKGROUND:The heart-to-mediastinum ratio (HMR) obtained in myocardial sympathetic innervation imaging using 123I-metaiodobenzylguanidine (MIBG) is used for heart failure or Lewy body diseases (LBD). Discovery NM/CT 670 CZT, a novel whole-body scanner, enables direct HMR measurements in planar images, in contrast to cardiac-dedicated CZT-based cameras which require specific post-processing reconstruction. We sought to investigate the clinical utility of the Discovery NM/CT 670 CZT for myocardial innervation imaging and the potential time reduction. RESULTS:Following preliminary phantom examinations, 123I-MIBG planar imaging was performed in 36 patients with suspected or known LBD to measure HMRs with a collection time of 300?s. Images for different collection times were subsequently reframed using already acquired data, and changes in HMRs were evaluated. The HMRs for patients with versus without clinically diagnosed LBD were 1.63?±?0.08 versus 2.21?±?0.08 at early phase (p??0.99), 100-s (ICC coefficients >?0.97), and 50-s (ICC coefficients >?0.89) images. CONCLUSIONS:In planar images with a whole-body CZT-based camera, the HMRs of patients with LBD were significantly lower than those without. HMRs with the collection time of 50?s and longer showed good consistency with those of 300?s in the ICC analysis. These findings indicate a clinical utility of this novel scanner for HMR measurements and potential time reductions.

SUBMITTER: Okano N

PROVIDER: S-EPMC6391509 | biostudies-literature | 2019 Feb

REPOSITORIES: biostudies-literature

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High-speed scanning of planar images showing <sup>123</sup>I-MIBG uptake using a whole-body CZT camera: a phantom and clinical study.

Okano Nanami N Osawa Iichiro I Tsuchihashi Saki S Takahashi Masafumi M Niitsu Mamoru M Matsunari Ichiro I

EJNMMI research 20190226 1

<h4>Background</h4>The heart-to-mediastinum ratio (HMR) obtained in myocardial sympathetic innervation imaging using <sup>123</sup>I-metaiodobenzylguanidine (MIBG) is used for heart failure or Lewy body diseases (LBD). Discovery NM/CT 670 CZT, a novel whole-body scanner, enables direct HMR measurements in planar images, in contrast to cardiac-dedicated CZT-based cameras which require specific post-processing reconstruction. We sought to investigate the clinical utility of the Discovery NM/CT 670 ...[more]

PMID: 30806836

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Project description:Authors' goal is to evaluate the performance of simultaneous (99m)Tc-MDP/(123)I-MIBG tumor imaging with fast Monte-Carlo (MC) based joint iterative reconstruction as compared to sequential (99m)Tc-MDP and (123)I-MIBG tumor imaging.Noise-free (99m)Tc and (123)I SPECT projections were acquired separately using an anthropomorphic torso phantom modified to include a fillable tube around the lungs to mimic ribs. Additionally, (99m)Tc and (123)I projections were acquired separately using a 1-cm spherical "tumor" placed at various distances from one detector. Tumor-present data were generated by adding tumor projections to the torso phantom data, which were scaled to the total counts in typical clinical studies. Twenty-five noise realizations were generated by adding Poisson noise to the projection data for each radionuclide. Dual-radionuclide data were synthesized by summing the (99m)Tc and (123)I projections. Image reconstruction was performed using: (1) SR-OSEM, ordered subset expectation maximization (OSEM) without scatter correction (SC) using single-radionuclide (SR) data; (2) SR-MC-OSEM, OSEM with a fast MC-based SC using SR data; (3) DR-OSEM, OSEM without SC using dual-radionuclide (DR) data; and (4) DR-MC-JOSEM, joint OSEM with a fast MC-based SC using DR data. Ten (99m)Tc-MDP and ten (123)I-MIBG data sets, which had tumors mathematically inserted, were also used to evaluate the performance of authors' approach. For the phantom study, relative bias and relative standard deviation of tumor uptake were computed for each tumor using the tumor uptake in the noise-free single-radionuclide images, which were reconstructed by SR-MC-OSEM, as the gold standard. For both the phantom and constructed patient studies, mean contrast and standard deviation of contrast were computed for each tumor for both the single- and dual-radionuclide images. Additionally, contrast recovery was computed as the ratio between mean contrast and the mean contrast for SR-MC-OSEM.For the phantom study, DR-MC-JOSEM yielded 2.7% on average relative bias of tumor uptake using the images, which were reconstructed from the noise-free SR data with SR-MC-OSEM, as the gold-standard. For both the phantom and constructed patient studies, DR-MC-JOSEM yielded 94.7% and 95.2% tumor contrast recovery on average using SR-MC-OSEM as the reference, in the phantom and constructed patient studies, respectively. DR-MC-JOSEM yielded comparable relative standard deviation of bias and standard deviation of contrast to SR-MC-OSEM.Simultaneous (99m)Tc-MDP/(123)I-MIBG tumor imaging using authors' dual-radionuclide reconstruction approach yielded comparable image quality to sequential (99m)Tc-MDP and (123)I-MIBG imaging. For patients who need to undergo both scans, authors' approach offers perfectly registered dual-tracer images under identical conditions without compromising image quality, and reduces the imaging cost while increasing patient throughput.

Project description:BACKGROUND:Evaluate the physical performance of the VERITON CzT camera (Spectrum Dynamics, Caesarea, Israel) that benefits from new detection architecture enabling whole-body imaging compared to that of a conventional dual-head Anger camera. METHODS:Different line sources and phantom measurements were performed on each system to evaluate spatial resolution, sensitivity, energy resolution and image quality with acquisition and reconstruction parameters similar to those used in clinical routine. Extrinsic resolution was assessed using 99mTc capillary sources placed successively in air, in a head and in a body phantom filled with background activity. Spectral acquisitions for various radioelements used in nuclear medicine (99mTc, 123I, 201Tl, 111In) were performed to evaluate energy resolution by computing the FWHM of the measured photoelectric peak. Tomographic sensitivity was calculated by recording the total number of counts detected during tomographic acquisition for a set of source geometries representative of different clinical situations. Sensitivity was also evaluated in focus mode for the CzT camera, which consisted of forcing detectors to collect data in a reduced field-of-view. Image quality was assessed with a Jaszczak phantom filled with 350 MBq of 99mTc and scanned on each system with 30-,20-,10- and 5-min acquisition times. RESULTS:Extrinsic and tomographic resolution in the brain and body phantoms at the centre of the FOV was estimated at 3.55, 7.72 and 6.66 mm for the CzT system and 2.47, 7.75 and 7.72 mm for the conventional system, respectively. The energy resolution measured at 140 keV was 5.46% versus 9.21% for the Anger camera and was higher in a same manner for all energy peaks tested. Tomographic sensitivity for a point source in air was estimated at 236 counts·s-1·MBq-1 and increased to 1159 counts·s-1·MBq-1 using focus mode, which was 1.6 times and 8 times greater than the sensitivity measured on the scintillation camera (144 counts·s-1·MBq-1). Head and body measurements also showed higher sensitivity for the CzT camera in particular with focus mode. The Jaszczak phantom showed high image contrast uniformity and a high signal-to-noise ratio on the CzT system, even when decreasing acquisition time by 6-fold. Representative clinical cases are shown to illustrate these results. CONCLUSION:The CzT camera has a superior sensitivity, higher energy resolution and better image contrast than the conventional SPECT camera, whereas spatial resolution remains similar. Introduction of this new technology may change current practices in nuclear medicine such as decreasing acquisition time and activity injected to patient.

Dataset Information

High-speed scanning of planar images showing 123I-MIBG uptake using a whole-body CZT camera: a phantom and clinical study.

Publications

High-speed scanning of planar images showing <sup>123</sup>I-MIBG uptake using a whole-body CZT camera: a phantom and clinical study.

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