Technological Development and Advances in Single-Photon Emission Computed Tomography/Computed Tomography

Since their introduction by Hal Anger in the late 1950s, the gamma cameras have been widely used in the field of nuclear medicine. The original concept is based on the association of a large field of view scintillator optically coupled with an array of photomultiplier tubes (PMTs), in order to locate the position of interactions inside the crystal. Using a dedicated accessory, like a parallel hole collimator, to focus the field of view toward a predefined direction, it is possible to built up an image of the radioactive distribution. In terms of imaging performances, three main characteristics are commonly considered: uniformity, spatial resolution and energy resolution. Major improvements were mainly due to progress in terms of industrial process regarding analogical electronic, crystal growing or PMTs manufacturing. Today's gamma camera is highly digital, from the PMTs to the display. All the corrections are applied “on the fly” using up to date signal processing techniques. At the same time some significant progresses have been achieved in the field of collimators. Finally, two new technologies have been implemented, solid detectors like CdTe or CdZnTe, and pixellized scintillators plus photodiodes or position sensitive photomultiplier tubes. These solutions are particularly well adapted to build dedicated gamma camera for breast or intraoperative imaging.

Imaging of gamma emitters using scintillation cameras

Radio-guided brain tumorectomy using a gamma detecting probe and a mobile solid-state gamma camera.

Sestamibi scintigraphy for the application of minimally invasive surgery of hyperfunctioning parathyroid lesions.

Cerebral blood flow (CBF) can be quantified non-invasively using the brain perfusion index (BPI) determined from radionuclide angiographic data generated with 99m Tc-hexamethylpropylene amine oxime ( 99m Tc-HMPAO). When measuring the BPI, manual drawing of regions of interest (ROIs) (manual ROI method) for the extraction of the arterial input function (AIF) can lead to serious individual differences. The purpose of this study was to apply the fuzzy c-means (FCM) clustering method to determine AIF, and to investigate its usefulness in comparison with the manual ROI method. Radionuclide angiography was performed using a bolus injection of about 555 MBq of 99m Tc-HMPAO, followed by sequential Imaging (1 sec/frame x 120s) using a solid-state gamma camera, and the BPI values were calculated using spectral analysis. To investigate the dependence of BPI on the ROI size, we drew five ROIs with different sizes over the aortic arch, and calculated the BPI using the manual ROI method [BPI (manual)] and the FCM clustering method [BPI(FCM)]. Furthermore, we asked 10 Individuals to draw ROIs to investigate the inter-operator variability of the two methods. The mean and standard deviation (SD) of BPI(manual) increased with increasing ROI size, whereas the mean of BPI(FCM) was almost constant regardless of the ROI size; the SD of BPI(FCM) was smaller than that of BPI(manual). The inter-operator variability of the FCM clustering method was smaller than that of the manual ROI method. These results suggest that the FCM clustering method appears to be useful for the measurement of BPI, because it allows a reliable and objective determination of AIF.

Extraction of arterial input function for measurement of brain perfusion index with 99mTc compounds using fuzzy clustering.

99mTc-methoxy-isobutyl-isonitrile (99mTc-MIBI) scintigraphy with Digirad 2020tc ImagerTM (2020tc), which was a multi-crystal scintillation camera with solid-state detectors was performed for patients with secondary hyperparathyroidism having autografts of parathyroid glands in the right arm. With the 2020tc camera, three abnormal accumulations were found in the right arm. The images obtained with this camera were superior in resolution to those obtained with a conventional NaI crystal gamma camera (ZLC7500, Siemens, Germany). The next day, resection of autografts of parathyroid glands was done. Four hyperplastic parathyroid glands were resected and all were hyperplastic in pathological findings.

Use of digirad 2020tc Imager, a multi-crystal scintillation camera with solid-state detectors in one case for the imaging of autografts of parathyroid glands.

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Use of digirad 2020tc Imager, a multi-crystal scintillation camera with solid-state detectors in one case for the imaging of autografts of parathyroid glands.