Podcast
Questions and Answers
What year did Wilhelm Roentgen discover X-rays?
What year did Wilhelm Roentgen discover X-rays?
1901
Who received the Nobel Prize for the use of isotopes as tracers in 1943?
Who received the Nobel Prize for the use of isotopes as tracers in 1943?
George de Hevesy
Which two scientists were awarded the Nobel Prize for developing X-ray CT in 1979?
Which two scientists were awarded the Nobel Prize for developing X-ray CT in 1979?
Hounsfield & Cormack
What does the acronym SPECT stand for in nuclear medicine?
What does the acronym SPECT stand for in nuclear medicine?
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How is Nuclear Medicine's focus different from that of Radiology?
How is Nuclear Medicine's focus different from that of Radiology?
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What characteristic is primarily measured in MRI imaging?
What characteristic is primarily measured in MRI imaging?
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What type of radiation is used in PET and SPECT imaging modalities?
What type of radiation is used in PET and SPECT imaging modalities?
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What technology did Lauterbur & Mansfield develop that earned them a Nobel Prize in 2003?
What technology did Lauterbur & Mansfield develop that earned them a Nobel Prize in 2003?
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What is the importance of patient preparation in PET imaging?
What is the importance of patient preparation in PET imaging?
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Explain the significance of SUVmax and SUVmean in defining regions of interest in PET scans.
Explain the significance of SUVmax and SUVmean in defining regions of interest in PET scans.
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Describe the typical administered dose and scan time for a PET imaging procedure.
Describe the typical administered dose and scan time for a PET imaging procedure.
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What is the primary purpose of improving the signal-to-noise ratio (SNR) in PET imaging?
What is the primary purpose of improving the signal-to-noise ratio (SNR) in PET imaging?
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What are the key advantages of PET over SPECT in medical imaging?
What are the key advantages of PET over SPECT in medical imaging?
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How does attenuation correction (AC) impact PET imaging results?
How does attenuation correction (AC) impact PET imaging results?
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Identify the limitations associated with functional imaging techniques like PET.
Identify the limitations associated with functional imaging techniques like PET.
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What does a Standard Uptake Value (SUV) of approximately 2.5 usually indicate in PET imaging?
What does a Standard Uptake Value (SUV) of approximately 2.5 usually indicate in PET imaging?
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What was the contribution of H.N. Wagner in the development of hybrid imaging techniques?
What was the contribution of H.N. Wagner in the development of hybrid imaging techniques?
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In what scenario is high FDG uptake observed, according to the provided content?
In what scenario is high FDG uptake observed, according to the provided content?
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Discuss the evolution of SPECT/CT and PET/CT based on historical developments.
Discuss the evolution of SPECT/CT and PET/CT based on historical developments.
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Describe the conditions that may affect the reproducibility of Standard Uptake Values (SUV).
Describe the conditions that may affect the reproducibility of Standard Uptake Values (SUV).
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What are the two components needed to calculate SUV?
What are the two components needed to calculate SUV?
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What effect does inadequate fasting have on PET imaging results?
What effect does inadequate fasting have on PET imaging results?
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What are some factors that can influence the value of SUV?
What are some factors that can influence the value of SUV?
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What does a high uptake of FDG in the lungs typically indicate?
What does a high uptake of FDG in the lungs typically indicate?
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How is SUVmax different from SUVmean?
How is SUVmax different from SUVmean?
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How does the proximity of the camera to the patient affect spatial resolution in SPECT imaging?
How does the proximity of the camera to the patient affect spatial resolution in SPECT imaging?
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What is the typical time spent on each projection during SPECT image acquisition?
What is the typical time spent on each projection during SPECT image acquisition?
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What is the consequence of using fewer than 3 degrees between angular stops in SPECT imaging?
What is the consequence of using fewer than 3 degrees between angular stops in SPECT imaging?
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Why is a high-pass filter, such as a ramp filter, used in filtered back projection?
Why is a high-pass filter, such as a ramp filter, used in filtered back projection?
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In SPECT, what does an increase in the number of iterations and subsets in OSEM lead to?
In SPECT, what does an increase in the number of iterations and subsets in OSEM lead to?
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What is the relationship between the matrix size and the number of views in a 360º SPECT scan?
What is the relationship between the matrix size and the number of views in a 360º SPECT scan?
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What problem in radionuclide imaging does attenuation correction address?
What problem in radionuclide imaging does attenuation correction address?
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What is a common iterative reconstruction algorithm used in SPECT?
What is a common iterative reconstruction algorithm used in SPECT?
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What is the main trade-off when selecting filters for SPECT imaging?
What is the main trade-off when selecting filters for SPECT imaging?
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What factors contribute to non-filter noise in SPECT images?
What factors contribute to non-filter noise in SPECT images?
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What is the purpose of a LEHR collimator in nuclear medicine imaging?
What is the purpose of a LEHR collimator in nuclear medicine imaging?
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Describe the process of beta decay and its end products.
Describe the process of beta decay and its end products.
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How are the effective half-life and biological half-life related in the context of radiopharmaceuticals?
How are the effective half-life and biological half-life related in the context of radiopharmaceuticals?
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What factors contribute to image degradation in nuclear medicine?
What factors contribute to image degradation in nuclear medicine?
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Explain the significance of the decay constant ($, \lambda$) in radioactivity.
Explain the significance of the decay constant ($, \lambda$) in radioactivity.
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What is the relationship between initial activity (A0) and activity at time t (At) in radioactive decay?
What is the relationship between initial activity (A0) and activity at time t (At) in radioactive decay?
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What is the primary unit of radioactivity in the SI system and how does it compare to traditional units?
What is the primary unit of radioactivity in the SI system and how does it compare to traditional units?
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Define system spatial resolution (Rsys) and its components.
Define system spatial resolution (Rsys) and its components.
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What is the relationship between the physical half-life (Tp) and decay constant ($\lambda$)?
What is the relationship between the physical half-life (Tp) and decay constant ($\lambda$)?
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How does scatter negatively affect imaging in nuclear medicine?
How does scatter negatively affect imaging in nuclear medicine?
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Study Notes
Medical Physics Introduction to Nuclear Medicine
- The presentation covered medical imaging techniques and their history.
- Wilhelm Roentgen received the Nobel Prize for the discovery of X-rays in 1901.
- George de Hevesy received the Nobel Prize in 1943 for his work on the use of isotopes as tracers in chemical processes.
- Godfrey Hounsfield and Allan Cormack received the Nobel Prize in 1979 for the development of X-ray computerized tomography (CT).
- Peter Mansfield and Paul Lauterbur received the Nobel Prize in 2003 for their discoveries concerning the development of Magnetic Resonance Imaging (MRI).
Medical Imaging Techniques
- X-rays are remarkable rays that were named after their discoverer.
- Radiopharmaceuticals are used for the study of chemical processes by using isotopes as tracers.
- X-ray CT is a technique for developing computerized tomography.
- MRI is a technique for developing Magnetic Resonance Imaging.
Structural & Functional Imaging
- Nuclear Medicine examines physiology, while Radiology examines anatomy.
What Does Probe Mean in Imaging?
- Radiology: X-ray, electron density
- Mammography: X-ray, electron density
- CT: X-ray, electron density
- Angiography: X-ray, electron density
- MRI: RF, proton density
- SPECT: Gamma ray, radionuclide dis.
- PET: Gamma ray, radionuclide dis.
- Sonography: Ultrasound, acoustic impedance
History
- Wilhelm Conrad Röntgen, a German physicist, discovered X-rays.
- X-rays can pass through objects, like hands, and image the bones and rings.
- Röntgen received the first Nobel Prize for physics in 1901.
NM and PET Process
- Diagrams show the process of Nuclear Medicine (NM) and Positron Emission Tomography (PET) imaging techniques.
Radioisotopes and Radiopharmaceuticals
- Radioisotope is a radioactive atom acting as the radiation source.
- Pharmaceutical is a vector molecule targeting an organ.
- Radioisotope + pharmaceutical = radiopharmaceutical (radiotracer).
- Fluorine-18 + Glucose = 18F-FDG
Why is Nuclear Medicine Different?
- In Nuclear Medicine, the emission source is within the organ, unlike other modalities (X-ray, CT, MR) where the source is external.
- Nuclear Medicine provides functional imaging, while other modalities provide anatomical imaging.
- Nuclear Medicine acts as a complement to other modalities, not a replacement.
NM Activity Poles
- Radiopharmacy (radiopharmaceuticals) involves the creation of radiotracers, produced by nuclear and biochemical industries.
- Functional Imaging is carried out by physicians, using different instrumentation including cameras and PET scanners.
- Instrument developers and physicists work on the design and manufacturing of cameras and PET scanners.
A Review
- β⁻ decay: AX₂ → AYz+1 + e⁻ + ν
- β⁺ decay: AX₂ → AYZ⁻¹ + e⁺ + ν
- e⁻ capture: AX₂ + e⁻ → AYZ⁻¹ + ν
- γ decay and internal conversion: no changes to A or Z
Radioactivity
- A(t): disintegration rate at time t (decays/sec)
- N(t): number of nuclei at time t
- λ: decay constant (units of 1/sec or 1/hr)
- λ = ln2/T₁/₂ = 0.693/T₁/₂
- T₁/₂: half-life which is also ln2/λ = 0.693/λ
- 1 Bq = 1 disintegration per second (Becquerel)
- 1 Ci = 3.7 × 10¹⁰ dps (1g of Ra-226, discovered by Mme. Curie)
- 1 mCi = 37 MBq
- NM imaging: ~ 1 to 30 mCi (30 – 1100 MBq)
Physical Half-life (Tp)
- T₁/₂: time requires for radioactive atoms to reduce to one half.
- N₁ = N₀e⁻¹t or A₁ = A₀e⁻¹t
- T₁/₂ = 0.693/λ
- λ = 0.693/T₁/₂
Effective half life
- Tₑ = time to reduce radiopharmaceutical in the body to half by function clearance and radioactive decay.
- Tₑ = (Tₚ*Tᵇ)/(Tₚ + Tᵇ)
Radionuclides used in Nuclear Medicine
- A table listing various radionuclides, their decay mode, principal photon emissions, half-lives, and primary uses in nuclear medicine.
Radiation Detectors in NM
- Survey meters (gas-filled detector): Ionization chambers (IC), Geiger-Müller (GM)
- Dose calibrator (gas-filled detector):
- Well counter (scintillation detector):
- Thyroid probe (scintillation detector):
Ionization Chamber (IC)
- Signal strength is proportional to energy deposited.
- Used for measuring amounts of radiation, e.g., exposure and air kerma.
Dose calibrator
- Measures activity only.
- Use the correct isotope button to avoid position effects.
- Quality control is regulated by the NRC or Agreement State.
- Every patient dose must be measured before administering.
Dose calibrator quality control
- Constancy: daily, using Cs-137 (660 keV, 30 y) and Co-57 (122 keV, 9 mo) for all nuclide settings. Errors < 10%
- Linearity: quarterly, using 300 mCi Tc-99m, down to 10 µCi. Errors < 10%
- Accuracy: yearly, using Cs-137 and Co-57. Errors < 5%
- Geometry: using 1 mCi Tc-99m with different volumes, upon installation. Errors < 10%
- Syringes (1 ml, 3 ml, 5 ml, 10 ml)
- Vial (10 ml)
Geiger-Müller (GM) Region
- The signal strength is independent of the energy deposited.
- The detector is used for measuring radiation presence.
Scintillation Detectors
- Scintillator: Radiation deposits energy causing light flashes (fluorescence).
- Photomultiplier tube (PMT): Detects fluorescence and amplifies the signal.
Scintillation Detectors (Thyroid probe)
- Diagram illustrates the components (Nal(TI)), lead shielding, PMT, cable, etc., involved in a thyroid probe.
Gamma Camera, Scintillation Camera
- General descriptions related to gamma camera and scintillation camera operations.
How to Obtain a NM Image?
- Administer radiopharmaceutical (radionuclide labeled pharmaceutical).
- Radiopharmaceutical concentrates in desired locations.
- The radionuclide decays, emitting γ photons.
- Detect γ photons using a γ camera (Anger camera).
Steps to Obtain a NM Image
- Diagram illustrates the steps involved in obtaining a Nuclear Medicine (NM) image: injection, absorption of radiopharmaceutical by the organ, emission of radiation by the organ, focusing of emissions by the collimator, conversion of light into electronic pulses by PMTs, identification of pulse positions by localization electronics, and data display on a monitor.
Basic Principle
- γ-rays directed towards a Nal(Tl) scintillation crystal.
- Multiple PMTs detect light flashes.
- Signals proportional to energy converted into electrical pulses.
- Pulses fed to energy discrimination and positioning circuits.
- Image of radionuclide distribution formed and displayed.
Nuclear medicine is emission imaging.
- γ photons emitted from inside the patient.
- γ photon energy is 70 keV to 511 keV.
- Limited photon number gives relatively poor image quality and spatial resolution.
- Image noise is greater due to the low count density (10⁵-10⁶ lower than X-ray imaging).
- CT is a transmission imaging mode.
BUT: Nuclear medicine is molecular imaging
- Interaction of radiopharmaceutical with cells/molecules.
- Binding directly to a target molecule.
- Accumulation by molecular/cellular activities.
- Detection of molecular/cellular activities (e.g., perfusion for heart, brain, kidneys, lungs, and metabolism of cancers) for early diagnosis.
Major components of gamma camera
- A diagram showing the major components (PMT, Nal(TI) crystal, collimator, pulse height analysis, position analysis, computer, and display) of a gamma camera, including the connections.
Gamma Camera Components (Detailed)
- A diagram illustrating the internal components of a gamma camera, including pre-amplifiers, PMTs, a lucite light pipe, a Nal(TI) crystal, and a collimator, and connecting them.
Collimator
- To establish geometric relationships between γ photon sources and the detector (projection imaging).
- Affects gamma camera count rate and spatial resolution.
Different parallel hole collimators
- LEAP, LEHR, MEAP, HEAP collimators based on energy range for different applications (low energy, low-energy high resolution, medium-energy all-purpose, high-energy all-purpose).
Collimators
- Parallel hole, pin-hole, or converging collimators for different purposes.
Scintillation process in detector
- Converts γ photons to a number of blue photons.
- Number of blue photons proportional to the energy deposited by the y photon.
- Examples: 140 keV → 5,000 blue photons, 70 keV → 2,500 blue photons.
- Number of blue photons determines the number of electrons liberated.
- Electrical pulse height is proportional to the deposited γ photon energy in the crystal.
Desirable Scintillator Properties
- High p, Z for high absorption efficiency & detector sensitivity.
- High light output for high conversion efficiency.
- Improves energy discrimination and spatial resolution.
- Light output proportional to energy deposited for linearity.
- Transparent to light emissions for increased sensitivity.
Photomultiplier tube (PMT)
- Creates and amplifies electrical pulses.
- Photocathode (CsSb): converts blue light to electrons.
- 9-12 dynodes: amplifies electron number (3-6 times).
- Anode: collects electrons.
- Gain in e⁻ number: ~6 × 10⁷ (very efficient).
Photomultiplier Tube (Functions)
- Coupling to the crystal housing using a silicone optical coupling compound.
- Converts scintillation light into electrical current pulses.
- Converts electrical current pulses to voltage pulses for amplification.
Photomultiplier tube (PMT)
- 40 to 100 PMTs (diameter ~5 cm) in a modern gamma camera system.
- Photocathode directly coupled to the detector or connected using plastic light guides.
- Anode connected to electronics in the tube base.
- Highly sensitive to magnetic fields.
PMT Function
- Multiple (many) PMTs arranged on the crystal surface.
- Nearest tube to the scintillation produces the strongest signal.
- Further tubes produce proportionally weaker signals.
- Signals determine where the photon originated in the body.
Localization Electronics
- Analyzing PMT signals into X, Y, and Z pulses.
- Z-pulse sums PMT signals, and amplitude is proportional to the energy deposited in the crystal.
- X and Y pulses are created by sending PMT signals through resistors.
System layout
- A diagram of the components in a nuclear medicine system.
Image Formation (Photopeak)
- Focusing a γ-ray to a crystal.
- Detecting and counting γ-rays in the photopeak with a efficiency of ~0.02%.
Scatter
- Major image degradation source in nuclear medicine.
- Increases image noise, reduces lesion contrast.
- Windowing suppresses scatter events but not completely.
Scatter in patient
- Diagram illustrates scatter, backscatter, energy selection, photopeak, and relative number of counts for patient studies.
Image degradation (Septal penetration)
- Diagram illustrates collimator septal penetration affecting image quality.
Image degradation (Simultaneous detections)
- Diagram illustrates the causes of image degradation related to simultaneous events.
Image degradation (Scatter)
- Diagram illustrates the causes of image degradation due to scatter from the patient.
System spatial resolution
-
Rsys = Rᵢₙₜ + R₁₂₃
-
Rᵢₙₜ = intrinsic (detector) resolution
-
R₁₂₃ = collimator resolution
-
Rᵢₙₜ typically 2.9–4.5 mm, R₁₂₃ typically 7.4–13.2 mm.
-
Rsys typically 1 cm
Collimator Resolution
- Spatial resolution degrades with increasing pt-collimator distance.
Data acquisition
- Collimator matching the radioisotope energy window needed.
- Pixel size is ~1/3-to-1/2 of spatial resolution.
- Detector size matches the matrix size. Typical matrix sizes include 64 × 64, 128 × 128, and 256 × 256.
- Pixel depth of 2 bytes.
- Count rate < 20,000/sec.
- Patient close to the detector.
Effect of matrix size
- Image quality improved in the larger matrix (128 × 128).
- 64 × 64 matrix shows low image quality.
Planar NM Imaging
- General descriptions/illustrations related to planar NM imaging techniques.
Uniformity
- Illustrations showing examples of collimator defects, bad PMTs, and energy peak shifts affecting image uniformity.
Bar phantom
- Made of lead stripes with different orientations and spacing (in 4 quadrants) to measure extrinsic/intrinsic linearity and spatial resolution.
- Used to assess extrinsic (with the collimator) and intrinsic (with the collimator removed) linearity.
- The Co-57 sheet source is placed on top of with a Tc-99m point source placed 5 × detector size from the image detector.
Tomographic NM Imaging (SPECT)
- Single-photon emission computed tomography (SPECT) produces tomographic images.
- SPECT uses conventional γ camera projection data at several angles around the patient.
- Similar to CT imaging.
SPECT
- Using 3D images to remove overlying/underlying activity.
- Advantages: better contrast and lesion localization.
- Disadvantages: more demanding technically and longer data acquisition time.
- More severe image noise.
SPECT data acquisition
- Typically using two detectors mounted 180º or 90º on a rotating gantry.
- Acquires a sequence of 2D static images at different angular positions (views).
- Methods: 180° with two perpendicular detectors or 360° with two opposite detectors, circular/elliptical orbit, closer to the patient results in better spatial resolution.
SPECT image acquisition
- Typically using two camera heads rotating around the patient.
- Obtaining projections every 3-6 degrees.
- Scan time is approximately 15 minutes.
- The acquisition/detection matrix is 64 × 64 or 128 × 128.
Data collection: Angular stops
- Using 3 to 6 degrees as a common acquisition angle may produce streaking.
- More acquisition angles do not improve image quality, and step and shoot acquisition method has slight loss of time but does not produce blurring.
View number for 360º SPECT
- The image views' number should match the matrix size.
- Example: 128 × 128 matrix yields 128 views, whereas a 64 × 64 matrix results in 64 views.
An image with 128 x 128 matrix
- Shows 128 projections, each projection with 128 data points which is equivalent to 128 slice CT of which the data points from each projection are used to create tomographic slices.
Sinogram (for one of many slices)
- Diagram illustrates the sinogram creation which maps a set of one-dimensional projection profiles into two-dimensional sinogram space for one of many slices.
Back Projection
- Back projection causes blurring of the image in the form of streaks and star-like artifacts.
Filtered Back Projection
- Suppresses blurring through filtering the projections.
- High-pass filtering (ramp filter) supresses blurring.
Filtered Back Projection (of noiseless data)
- Illustration shows examples of filtered back-projection results for 2, 4, and 256 angles, with noiseless data to demonstrate the sharpening effect by filtering.
Filter
- Applied filter is the product of ramp and user-selected/characterized filters (Shepp-Logan, Hahn, Butterworth, Wiener, Hamming, Hanning).
Selection of Filters for SPECT
- Filters trade noise for resolution in SPECT.
- No standard way to optimize filter selection.
- Patient to patient variation and physician preferences also alter filter type selection.
- Vendor recommendations are frequently used.
Iterative Reconstruction (IR)
- Filtered back projection (FBP) has limitations.
- Attenuation, Compton scatter corrections are needed because of noise.
- Optimized reconstruction algorithms like ordered subsets expectation maximization (OSEM) are used.
Iterative Reconstruction
- Slower compared to filtered back-projection.
- Commonly used in PET scans, being increasingly applied to SPECT scans.
Image recon - Iterative (OSEM)
- Diagram shows/illustrates an image reconstruction algorithm (OSEM) processing steps, e.g., comparison of projections, update estimates, forward projections.
- The number of iterations (I) and number of subsets (S) affect image quality: increasing I/S leads to higher noise but also sharper images.
Iterative reconstruction algorithms
- Iteration 1, 3, 5, 10, 20, and 30 are examples of steps in an algorithm.
Brain Phantom
- Images illustrate the comparison between filtered back projection (FBP) and iterative reconstruction with Ordered Subsets Expectation Maximization (OSEM) used to process brain phantom images.
Non-filter Noise Factors
- Collimator, Matrix (64 × 64 or 128 × 128), Slice thickness, Time per stop/number of stops, and administered dose are non-filter factors.
Data Collection: Counts
- Activity in the patient.
- Time per stop.
- Number of stops.
Attenuation Correction
- Attenuation is an issue in radionuclide imaging.
- Correction is needed for accurate lesion activity assessment in nuclear images where the photon path length from source to detector is through the body.
Uniform phantom with evenly distributed 99mTc
- Illustrations show uniform phantom images with and without attenuation, demonstrating the need for attenuation correction to produce uniform images.
SPECT/CT
- Combining SPECT and CT scans in a single device.
Patient Studies
- Advantages: No overlapping structures, 3D lesion locations, and fusion with high-resolution (CT, MRI) images.
- Disadvantages: Time-consuming and images are noisy.
Introduction to the physics of Positron Emission Tomography (PET)
- General introduction to PET imaging techniques.
Biograph Vision Quadra™
- A brand of medical imaging equipment from SIEMENS Healthineers.
Gamma Camera Components
- Illustrations demonstrating the parts of a gamma imaging system: stationary gantry, rotating gantry, detectors, and the patient table.
PET Scanner Components
- Diagram illustrating the elements (gantry, detector ring, and acquisition/processing station, and patient table) of a PET scanner.
PET/CT Scanner
- Diagram showing the typical composition of components of a PET/CT scanner: gantry, PET detector ring and CT module.
The PET/CT Power..
- The power of combined CT (anatomical) and PET (functional) images for diagnostic purposes, e.g., presence of a lesion.
Anatomic and Functional Imaging
- CT (anatomical) and NM (functional) images to provide complementary diagnostic information.
Effective dose of NM procedures
- A table listing the effective dose values for various nuclear medicine procedures.
Dose Limits
- A table describing occupational and general public radiation exposure limits for various applications.
SPECT & PET
- Describing resolution and simultaneous acquisition in SPECT and PET technologies.
Advantages of PET over SPECT
- Superior spatial resolution, higher sensitivity, and attenuation correction benefits make PET more advanced than SPECT.
Limitation of Functional Imaging
- Limited spatial resolution, poor signal-to-noise ratio.
- Poor uptake of radiotracer in the diseased condition.
Medical imaging techniques
- An example or illustrations of anatomical, functional, and hybrid imaging techniques.
Fusing Anatomy and Function
- Hand-drawn, visual, and hardware methods of combining anatomical (CT) and functional (NM) images.
History of dual-modality imaging
- History of combining SPECT and CT in a single device, in particular the first prototype and commercial devices.
Gamma Camera Components (revisited)
- Components of a stationary/rotating gantry, detectors/acquisition and processing stations, along with illustrations.
PET Scanner Components (Revisited)
- Various components (gantry, detector ring, patient table, and acquisition/ processing station) and their function in a PET scanner are described through various illustrations, and diagrams are provided.
PET/CT Scanner (revisited)
- Illustration of the components of a PET/CT scanner, including gantry, PET detectors, and CT modules.
PET/CT Power...
- Illustrating the combined use of CT (anatomical) and PET (functional) images for detecting/diagnosing a lesion.
Anatomic and Functional Imaging (revisited)
- Combining CT (anatomical) and NM (functional) images in tandem is better than either alone to diagnose or analyze medical conditions.
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Test your knowledge on key concepts and developments in Nuclear Medicine. This quiz covers important discoveries, technologies, and the distinctions between various imaging modalities like PET and SPECT. Perfect for students and professionals seeking to deepen their understanding of this field.