skip to main content
OSTI.GOV title logo U.S. Department of Energy
Office of Scientific and Technical Information

Title: SU-F-I-55: Performance Evaluation of Digital PET/CT: Medical Physics Basis for the Clinical Applications

Abstract

Purpose: Replacement of conventional PMT-based detector with next generation digital photon counting (DPC) detector is a technology leap for PET imaging. This study evaluated the performance and characteristics of the DPC system and its stability within a 1 year time window following its installation focusing on the medical physics basis for clinical applications. Methods: A digital PET/CT scanner using 1:1 coupling of 23,040 crystal: detector elements was introduced and became operational at OSU. We tested and evaluated system performance and characteristics using NEMA NU2-2012. System stabilities in timing resolution, energy resolution, detector temperature and humidity (T&H) were monitored over 1-yr. Timing, energy and spatial resolution were characterized across clinically relevant count rate range. CQIE uniformity PET and NEMA IEC-Body PET with hot spheres varying with sizes and contrasts were performed. PET reconstructed in standard(4mm), High(2mm) and Ultra-High(1mm) definitions were evaluated. Results: NEMA results showed PET spatial resolution (mm-FWHM) from 4.01&4.14 at 1cm to 5.82&6.17 at 20cm in transverse & axial. 322±3ps timing and 11.0% energy resolution were measured. 5.7kcps/MBq system sensitivity with 24kcps/MBq effective sensitivity was obtained. The peak-NECR was ∼171kcps with the effective peak-NECR >650kcps@50kBq/mL. Scatter fraction was ∼30%, and the maximum trues was >900kcps. NEMA IQ demonstrated hotmore » sphere contrast ranging from ∼62%±2%(10mm) to ∼88%±2%(22mm), cold sphere contrast of ∼86%±2%(28mm) and ∼89%±3%(37mm) and excellent uniformity. Monitoring 1-yr stability, it revealed ∼1% change in timing, ±0.4% change in energy resolution, and <10% variations in T&H. CQIE PET gave <3% SUV variances in axial. 60%–100% recovery coefficients across sphere sizes and contrast levels were achieved. Conclusion: Characteristics and stability of the next generation DPC PET detector system over an 1-yr time window was excellent and better than prior experiences. It demonstrated improved and robust system characteristics and performance in spatial resolution, sensitivity, timing and energy resolution, count rate and image quality. Michael Miller is an employee of Philips Healthcare.« less

Authors:
;  [1];  [2]
  1. The Ohio State University, Columbus, OH (United States)
  2. Philips Healthcare, Highland Heights, OH (United States)
Publication Date:
OSTI Identifier:
22632120
Resource Type:
Journal Article
Resource Relation:
Journal Name: Medical Physics; Journal Volume: 43; Journal Issue: 6; Other Information: (c) 2016 American Association of Physicists in Medicine; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
60 APPLIED LIFE SCIENCES; 61 RADIATION PROTECTION AND DOSIMETRY; BIOMEDICAL RADIOGRAPHY; COUNTING RATES; ENERGY RESOLUTION; EVALUATION; IMAGES; INSTALLATION; PEAKS; PERFORMANCE; POSITRON COMPUTED TOMOGRAPHY; SENSITIVITY; SPATIAL RESOLUTION

Citation Formats

Zhang, J, Knopp, MV, and Miller, M. SU-F-I-55: Performance Evaluation of Digital PET/CT: Medical Physics Basis for the Clinical Applications. United States: N. p., 2016. Web. doi:10.1118/1.4955883.
Zhang, J, Knopp, MV, & Miller, M. SU-F-I-55: Performance Evaluation of Digital PET/CT: Medical Physics Basis for the Clinical Applications. United States. doi:10.1118/1.4955883.
Zhang, J, Knopp, MV, and Miller, M. Wed . "SU-F-I-55: Performance Evaluation of Digital PET/CT: Medical Physics Basis for the Clinical Applications". United States. doi:10.1118/1.4955883.
@article{osti_22632120,
title = {SU-F-I-55: Performance Evaluation of Digital PET/CT: Medical Physics Basis for the Clinical Applications},
author = {Zhang, J and Knopp, MV and Miller, M},
abstractNote = {Purpose: Replacement of conventional PMT-based detector with next generation digital photon counting (DPC) detector is a technology leap for PET imaging. This study evaluated the performance and characteristics of the DPC system and its stability within a 1 year time window following its installation focusing on the medical physics basis for clinical applications. Methods: A digital PET/CT scanner using 1:1 coupling of 23,040 crystal: detector elements was introduced and became operational at OSU. We tested and evaluated system performance and characteristics using NEMA NU2-2012. System stabilities in timing resolution, energy resolution, detector temperature and humidity (T&H) were monitored over 1-yr. Timing, energy and spatial resolution were characterized across clinically relevant count rate range. CQIE uniformity PET and NEMA IEC-Body PET with hot spheres varying with sizes and contrasts were performed. PET reconstructed in standard(4mm), High(2mm) and Ultra-High(1mm) definitions were evaluated. Results: NEMA results showed PET spatial resolution (mm-FWHM) from 4.01&4.14 at 1cm to 5.82&6.17 at 20cm in transverse & axial. 322±3ps timing and 11.0% energy resolution were measured. 5.7kcps/MBq system sensitivity with 24kcps/MBq effective sensitivity was obtained. The peak-NECR was ∼171kcps with the effective peak-NECR >650kcps@50kBq/mL. Scatter fraction was ∼30%, and the maximum trues was >900kcps. NEMA IQ demonstrated hot sphere contrast ranging from ∼62%±2%(10mm) to ∼88%±2%(22mm), cold sphere contrast of ∼86%±2%(28mm) and ∼89%±3%(37mm) and excellent uniformity. Monitoring 1-yr stability, it revealed ∼1% change in timing, ±0.4% change in energy resolution, and <10% variations in T&H. CQIE PET gave <3% SUV variances in axial. 60%–100% recovery coefficients across sphere sizes and contrast levels were achieved. Conclusion: Characteristics and stability of the next generation DPC PET detector system over an 1-yr time window was excellent and better than prior experiences. It demonstrated improved and robust system characteristics and performance in spatial resolution, sensitivity, timing and energy resolution, count rate and image quality. Michael Miller is an employee of Philips Healthcare.},
doi = {10.1118/1.4955883},
journal = {Medical Physics},
number = 6,
volume = 43,
place = {United States},
year = {Wed Jun 15 00:00:00 EDT 2016},
month = {Wed Jun 15 00:00:00 EDT 2016}
}
  • Purpose: The longer patient has to remain on the table during PET imaging, the higher the likelihood of motion artifacts due to patient discomfort. This study was to investigate and optimize PET acquisition overlap in 18F-FDG oncology wholebody PET/CT to speed up PET acquisition and improve patient comfort. Methods: Wholebody 18F-FDG PET/CT of phantoms, 8 pre-clinical patients (beagles) and 5 clinical oncology patients were performed in 90s/bed on a time-of-flight Gemini TF 64 system. Imaging of phantoms and beagles was acquired with reduced PET overlaps (40%, 33%, 27%, 20%, 13% and no overlap) in addition to the system default (53%).more » In human studies, 1 or 2 reduced overlaps from the listed options were used to acquire PET/CT sweeps right after the default standard of care imaging. Image quality was blindly reviewed using visual scoring criteria and quantitative SUV assessment. NEMA PET sensitivity was performed under different overlaps. Results: All PET exams demonstrated no significant impact on the visual grades for overlaps >20%. Blinded reviews assigned the best visual scores to PET using overlaps 53%–27%. Reducing overlap to 27% for oncology patients (12-bed) saved an average of ∼40% acquisition time (11min) compared to using the default overlap (18min). No significant SUV variances were found when reducing overlap to half of default for cerebellum, lung, heart, aorta, liver, fat, muscle, bone marrow, thighs and target lesions (p>0.05), except expected variability in urinary system. Conclusion: This study demonstrated by combined phantom, pre-clinical and clinical PET/CT scans that PET acquisition overlap in axial of today’s systems can be reduced and optimized. It showed that a reduction of PET acquisition overlap to 27% (half of system default) can be implemented to reduce table time by ∼40% to improve patient comfort and minimize potential motion artifacts, without prominently degrading image quality or compromising PET quantification.« less
  • Purpose: Two separate low-dose CT scans are usually performed for attenuation correction of rest and stress N-13 ammonia PET/CT myocardial perfusion imaging (PET/CT). We utilize an automatic exposure control (AEC) technique to reduce CT radiation dose while maintaining perfusion image quality. Our goal is to assess the reproducibility of displayed CT dose index (CTDI) on same-day repeat CT scans (CT1 and CT2). Methods: Retrospectively, we reviewed CT images of PET/CT studies performed on the same day. Low-dose CT utilized AEC technique based on tube current modulation called Smart-mA. The scan parameters were 64 × 0.625mm collimation, 5mm slice thickness, 0.984more » pitch, 1-sec rotation time, 120 kVp, and noise index 50 with a range of 10–200 mA. The scan length matched with PET field of view (FOV) with the heart near the middle of axial FOV. We identified the reference slice number (RS) for an anatomical landmark (carina) and used it to estimate axial shift between two CTs. For patient size, we measured an effective diameter on the reference slice. The effect of patient positioning to CTDI was evaluated using the table height. We calculated the absolute percent difference of the CTDI (%diff) for estimation of the reproducibility. Results: The study included 168 adults with an average body-mass index of 31.72 ± 9.10 (kg/m{sup 2}) and effective diameter was 32.72 ± 4.60 cm. The average CTDI was 1.95 ± 1.40 mGy for CT1 and 1.97 ± 1.42mGy for CT2. The mean %diff was 7.8 ± 6.8%. Linear regression analysis showed a significant correlation between the table height and %diff CTDI. (r=0.82, p<0.001) Conclusion: We have shown for the first time in human subjects, using two same-day CT images, that the AEC technique in low-dose CT is reproducible within 10% and significantly depends on the patient centering.« less
  • Purpose: The accuracy of PET-based post-treatment dosimetry of yttrium-90 microspheres has been improving over the past decade and is now at a stage, permitting volumetric dose-outcome studies. We outline the recent advances and identify the physical limitations to the accuracy of the dose calculations. Methods: Convolution of the measured PET activity density distribution with a pre-calculated voxel-dose-kernel (VDK) is the most widely used method for dose reconstruction. Therefore, accurate knowledge of the beta+ branching ratio as well as the micro-dosimetric characteristics of electron interactions within the microsphere is essential for the computation of the dose kernel. We implement a modelmore » of the microspheres used in our clinic to calculate the modified electron energy spectrum at the microsphere’s surface and to determine the impact of self-shielding on the dose reconstruction. The three-dimensional dose distributions obtained for 10 patients treated with radio-embolization with yttrium-90 microspheres are evaluated and various DVH markers are investigated for correlation with outcome. Results: The methods for reducing the overall computation uncertainty are systematically outlined in this presentation. Since the latest experimental data on yttrium-90 beta+ branching ratio has a relative uncertainty of 1.5%, all contributing factors derived from Monte Carlo simulations must be brought to a sub 1% level. The self-shielding within the microspheres is found to be responsible for up to 6% reduction of the reconstructed dose in low-gradient regions and must be taken into account. The contribution of trace amounts of other beta+ emitters introduced during the manufacturing process is also discussed. Conclusion: The accelerating pace of clinical adoption of PET-based post-treatment dosimetry is mainly due to advances in both quantitative PET imaging and physical models of dose deposition. We show that the overall physical dose uncertainty in the convolution step can be further reduced, thus making ongoing multi-institutional dose-outcome studies even more reliable.« less
  • Purpose: This study utilizes a commercial PET/CT phantom to investigate two specific properties of a PET/CT system: the alignment accuracy of PET images with those from CT used for attenuation correction and the accuracy of this correction in PET images. Methods: A commercial PET/CT phantom consisting of three aluminum rods, two long central cylinders containing uniform activity, and attenuating materials such as air, water, bone and iodine contrast was scanned using a standard PET/CT protocol. Images reconstructed with 2 mm slice thickness and a 512 by 512 matrix were obtained. The center of each aluminum rod in the PET andmore » CT images was compared to evaluate alignment accuracy. ROIs were drawn on transaxial images of the central rods at each section of attenuating material to determine the corrected activity (in BQML). BQML values were graphed as a function of slice number to provide a visual representation of the attenuation-correction throughout the whole phantom. Results: Alignment accuracy is high between the PET and CT images. The maximum deviation between the two in the axial plane is less than 1.5 mm, which is less than the width of a single pixel. BQML values measured along different sections of the large central rods are similar among the different attenuating materials except iodine contrast. Deviation of BQML values in the air and bone sections from the water section is less than 1%. Conclusion: Accurate alignment of PET and CT images is critical to ensure proper calculation and application of CT-based attenuation correction. This study presents a simple and quick method to evaluate the two with a single acquisition. As the phantom also includes spheres of increasing diameter, this could serve as a straightforward means to annually evaluate the status of a modern PET/CT system.« less
  • Purpose: A survey was taken by NRG Oncology to assess Full Time Equivalent (FTE) contributions to multi institutional clinical trials by medical physicists.No current quantification of physicists’ efforts in FTE units associated with clinical trials is available. The complexity of multi-institutional trials increases with new technologies and techniques. Proper staffing may directly impact the quality of trial data and outcomes. The demands on physics time supporting clinical trials needs to be assessed. Methods: The NRG Oncology Medical Physicist Subcommittee created a sixteen question survey to obtain this FTE data. IROC Houston distributed the survey to their list of 1802 contactmore » physicists. Results: After three weeks, 363 responded (20.1% response). 187 (51.5%) institutions reporting external beam participation were processed. There was a wide range in number of protocols active and supported at each institution. Of the 187 clinics, 134 (71.7%) participate in 0 to 10 trials, 28 (15%) in 11 to 20 trials, 10 (5.3%) in 21 to 30 trials, 9 (4.8%) had 40 to 75 trials. On average, physicist spent 2.7 hours (SD: 6.0) per week supervising or interacting with clinical trial staff. 1.25 hours (SD: 3.37), 1.83 hours (SD: 4.13), and 0.64 hours(SD: 1.13) per week were spent on patient simulation, reviewing treatment plans, and maintaining a DICOM server, respectively. For all protocol credentialing activities, physicist spent an average of 37.05 hours (SD: 96.94) yearly. To support dosimetrists, clinicians, and therapists, physicist spend on average 2.07 hours (SD: 3.52) per week just reading protocols. Physicist attended clinical trial meetings for on average 1.13 hours (SD: 1.85) per month. Conclusion: Responding physicists spend a nontrivial amount of time: 8.8 hours per week (0.22 FTE) supporting, on average, 9 active multi-institutional clinical trials.« less