Limited-angle TOF-PET for intraoperative surgical applications: proof of concept and first experimental data

The intraoperative gamma probe (IPG) based on single gamma-ray detection remains the current gold standard modality for sentinel lymph node identification and tumor removal in cancer patients. However, IPGs do not meet the <5% false negative rate (FNR) requirement, a key metric suggested by the American Society of Clinical Oncology (ASCO). We aim to reduce FNR by using time of flight (TOF) PET detector technology in limited angle geometry system by using only two detector panels in coincidence. For proof of concept, we used two Hamamatsu TOF PET detector modules (C13500-4075YC-12) featuring 12× 12 arrays of 4.14× 4.14× 20 mm3 LFS crystal pixels with 4.2 mm pitch and coupled one-one to silicon photomultiplier (SiPM) pixels. The measured detector coincidence timing resolution (CTR) was 271 ps FWHM for the whole detector. We 3D printed lesion phantom containing spheres 2–10 mm in diameter, representing lymph nodes, and placed it inside a 10-liter warm background water phantom. Experimental results showed that with subminute data acquisition, 6 mm diameter spheres could be identified in the image when a lesion phantom with a 10:1 activity ratio to background was used. The simulation results were in good agreement with the experimental data by resolving 6 mm diameter spherical lesions with a 60 second acquisition time in a 25 cm deep background water phantom with a 10:1 activity ratio. As expected, the image quality improved as the CTR improved in the simulation and with decreasing background water phantom depth or increasing lesion-to-background activity ratio in the experiment. With the results presented here, we concluded that using a limited angle TOF PET detector system is a major step forward for intraoperative applications in that lesion detectability is beyond what conventional gamma- and NIR-based probes could achieve.

Scintillation Response Enhancement in Nanocrystalline Lead Halide Perovskite Thin Films on Scintillating Wafers

Lead halide perovskite nanocrystals of the formula CsPbBr3 have recently been identified as potential time taggers in scintillating heterostructures for time-of-flight positron emission tomography (TOF-PET) imaging thanks to their ultrafast decay kinetics. This study investigates the potential of this material experimentally. We fabricated CsPbBr3 thin films on scintillating GGAG:Ce (Gd2.985Ce0.015Ga2.7Al2.3O12) wafer as a model structure for the future sampling detector geometry. We focused this study on the radioluminescence (RL) response of this composite material. We compare the results of two spin-coating methods, namely the static and the dynamic process, for the thin film preparation. We demonstrated enhanced RL intensity of both CsPbBr3 and GGAG:Ce scintillating constituents of a composite material. This synergic effect arises in both the RL spectra and decays, including decays in the short time window (50 ns). Consequently, this study confirms the applicability of CsPbBr3 nanocrystals as efficient time taggers for ultrafast timing applications, such as TOF-PET.

Deep Learning-Based Fast TOF-PET Image Reconstruction Using Direction Information

Deep learning has attracted attention for positron emission tomography (PET) image reconstruction task, however, it remains necessary to further improve the image quality. In this study, we propose a novel CNN-based fast time-of-flight PET (TOF-PET) image reconstruction method to fully utilize the direction information of coincidence events. The proposed method inputs view-grouped histo-images into a 3D CNN as a multi-channel image to use the direction information of coincidence events. We evaluated the proposed method using Monte Carlo simulation data obtained from a digital brain phantom. Compared to the case without it, when using direction information, the peak signal-to-noise ratio and structural similarity were improved by 1.2 dB and 0.02, at a coincidence time resolution of 300 ps. The calculation times of the proposed method were significantly faster than the conventional iterative reconstruction. These results indicate that the proposed method improves both the speed and image quality of TOF-PET image reconstruction.

Image quality and quantification accuracy dependence on patient body mass in 89Zr PET/CT imaging

Background This study was conducted to clarify how patient body mass affects the image quality and quantification accuracy of images obtained using 89Zr PET/CT. 89Zr PET/CT images from time-of-flight (TOF) PET/CT and semiconductor (SC) PET/CT were obtained using three types (M, L, LL; corresponding to increasing patient body weight) of custom-made body phantoms designed similarly to the National Electrical Manufacturers Association (NEMA) IEC body phantom. The phantom data were analyzed visually and quantitatively to derive image quality metrics, namely detectability of the 10-mm-diameter hot sphere, percent contrast for the 10-mm-diameter hot sphere (QH,10 mm), percent background variability (N10mm), contrast-to-noise ratio (QH,10 mm/N10mm), and coefficient of variation of the background area (CVBG). Results Visual assessment revealed that all the 10-mm-diameter hot spheres of the three types of phantoms were identifiable on both SC and TOF PET/CT images. The N10mm and CVBG values were within the proposed reference levels, and decreased with acquisition duration for both PET/CT types. At 10-min acquisition, the QH,10 mm/N10mm of SC PET/CT was greater than the proposed reference level in all phantoms. However, the QH,10 mm/N10mm of TOF PET/CT was greater than the proposed reference level in M-type phantom alone. All the SUVBG values were within 1.00 ± 0.05 for both PET/CT types. Conclusions This study showed that the image quality and quantification accuracy depend on the patient’s body mass, suggesting that acquisition time on 89Zr PET/CT should be changed according to the patient’s body mass.

Yttrium-90 TOF-PET-Based EUD Predicts Response Post Liver Radioembolizations Using Recommended Manufacturer FDG Reconstruction Parameters

PurposeExplaining why 90Y TOF-PET based equivalent uniform dose (EUD) using recommended manufacturer FDG reconstruction parameters has been shown to predict response.MethodsThe hot rods insert of a Jaszczak deluxe phantom was partially filled with a 2.65 GBq 90Y - 300ml DTPA water solution resulting in a 100 Gy mean absorbed dose in the 6 sectors. A two bed 20min/position acquisition was performed on a 550ps- and on a 320ps- TOF-PET/CT and reconstructed with recommended manufacturer FDG reconstruction parameters, without and with additional filtering. The whole procedure was repeated on both PET after adding 300ml of water (50Gy setup). The phantom was acquired again after decay by a factor of 10 (5Gy setup), but with 200min per bed position. For comparison, the phantom was also acquired with 18F activity corresponding to a clinical FDG whole body acquisition.ResultsThe 100Gy-setup provided a hot rod sectors image almost as good as the 18F phantom. However, despite acquisition time compensation, the 5Gy-setup provides much lower quality imaging. TOF-PET based sectors EUDs for the three large rod sectors agreed with the actual EUDs computed with a radiosensitivity of 0.021Gy-1 well in the range observed in external beam radiotherapy (EBRT), i.e. 0.01-0.04Gy-1. This agreement explains the reunification of the dose-response relationships of the glass and resin spheres in HCC using the TOF-PET based EUD. Additional filtering reduced the EUDs agreement quality.ConclusionsRecommended manufacturer FDG reconstruction parameters are suitable in TOF-PET post 90Y liver radioembolization for accurate tumour EUD computation. The present results rule out the use of low specific activity phantom studies to optimize reconstruction parameters.