Lecture no 3: Nuclear Imaging

Outlines:
1-PET-CT Physics
2-PET-Image quality

1-PET CT Physics:
• Main idea:
1-The most common isotope Is F-18 which emits a positive beta particle (positron)

2-Positron travel distance of around 2 mm then collides with an electron and causes the
production of 2 gamma photons (annihilation)
3- both gamma photons are produced at 180-degree angles to each other.
4- each photon carries the energy of 511 Kev.

5-the ring detector receives both photons and determines the location of the annihilation
process Inside the patient’s body.

Dr.Eslam Kamal ,PhD in Medical Physics

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 6- the higher activity of F-18 accumulated, cause a higher number of photons (counts ) to be
received by the detectors which are represented by a highly bright signal in the image and vice
versa.
The photons generated during e+ e- annihilation have three significant geometric properties :
¨ They fly out of the annihilation site simultaneously and in the opposite direction - at an
angle of 180° ¨ They move along straight paths ;
¨ They move at a speed of light of 300000 km/s, so they can be detected at laboratory scales
practically simultaneously.

• These properties enable the so-called coincident detection of pairs of annihilation

photons: we place the measured positron emitter between two detectors (small enough in
size), the outputs of which are connected to an electronic coincidence circuit.
• Only pulses corresponding to the simultaneous detection of photons in both detectors pass
through this circuit into the evaluation electronic apparatus.
• Due to the above-mentioned geometric properties, only photons from annihilations that
occurred on a straight-line connection of the sensitive points of both opposing detectors
can be detected in this way.
• If annihilation occurs outside this straight connecting line, then even in the case of detection
of one of the photons by one detector, the other of the annihilation photons is not captured
by the opposite detector - the pulse does not appear at the output of the coincidence circuit.
Thus, when a pulse appears at the output of the coincidence circuit, it means
that e+ e- annihilation has occurred at some point at the junction of the two detectors.
• if we surround the investigated object with a positron radionuclide by a larger number of
oppositely placed detectors in a coincidence circuit, we achieve targeted directional
detection of annihilation g- photons - their electronic collimation, without the need for
physical shielding with a lead hole collimator.

Dr.Eslam Kamal ,PhD in Medical Physics

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 •

• PET Scanner:
1. Ring of detectors is assembled in a gantry that surrounds the patient

2. Blocks of scintillation crystals (detector blocks) are arranged in a circle

mounted on a gantry in one or two rows.
3. The ideal qualities of the scintillation crystal are:
a. High linear attenuation coefficient (LAC) for the 511 keV photons
b. High ratio of photoelectric to Compton interactions
c. The high number of light photons produced per gamma photon
absorbed
d. Short scintillation light decay time

Dr.Eslam Kamal ,PhD in Medical Physics

+201092006709
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 4. The NAI scintillation crystal used in SPECT and planar imaging not suitable
for PET as LAC is not enough for the annihilation photons which have higher
energy of 511 keV
5. The most commonly used scintillator in PET imaging is bismuth germanate
(BGO) But the light output and light decay time are inferior to NaI
6. Newer materials, such as lutetium oxy orthosilicate (LSO and gadolinium
oxy orthosilicate (GSO) are being developed which have more suitable
properties
7. Each scintillation detector block is viewed by four photomultiplier tubes.

Dr.Eslam Kamal ,PhD in Medical Physics

+201092006709
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 8. Block of crystal subdivided by cutting smaller blocks into the scintillation
crystal ("called detector elements") and placing a reflective material in the
slits to prevent cross-talk of the light photons between the elements

9. The scintillator is a transparent material, which absorbs the high energy

photons and emits visible light
10. The light is emitted isotropically and the amount of light emitted is
proportional to the amount of energy that is deposited in the material.
Dr.Eslam Kamal ,PhD in Medical Physics
+201092006709
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 11. Requirements of scintillation crystals

Dr.Eslam Kamal ,PhD in Medical Physics

+201092006709
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 As shown below the difference between crystal properties for different
materials:

2-2D and 3D mode acquisition :

Dr.Eslam Kamal ,PhD in Medical Physics

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 • 2D mode has:
• Collimator
• Low FOV for random coincidence
• Low Sensitivity
• Simple reconstruction

• 3D mode has:
• No collimator
• Large FOV for random coincidence
• High sensitivity
• Harder to reconstruct

Dr.Eslam Kamal ,PhD in Medical Physics

+201092006709
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 SF: scatter fraction

• Types of recorded photons by PET -Detectors:

1-True Events

Dr.Eslam Kamal ,PhD in Medical Physics

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 2-Scattered Events

• Increased scatter coincidence:

1. More material to travel through (e.g. body vs brain imaging)
2. 3D acquisitions instead of 2D
Solution:
• Energy Resolution:Energy discrimination However the photopeak window is wide due to
poor energy resolution of the scintillators so scatter coincidence is not totally eliminated
• Energy Resolution
• Energy resolution determines the accuracy with which the scanner can measure
the energy of the 511 keV photon interactions and affects the ability to reject
scatter coincidences where at least one of the two 511 keV photons has incident
energy <511 keV. Current clinical whole-body PET scanners using LSO/LYSO
scintillators have ~12 % energy resolution that allows the use of a high event
energy acceptance threshold (up to 440 keV), thereby collecting all true
coincidences with a small fraction of scattered coincidences as well.

Dr.Eslam Kamal ,PhD in Medical Physics

+201092006709
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 3- Random events:

totally

• Increased random coincidence:

1. 3D instead of 2D acquisition
2. Increased administered radioactivity
3. Dead time : increased duration of the coincidence window
Solution
• Using crystal with less dead time to increase the timing resolution

Data correction in PET-CT

1-Dead time ;
Problem:
• Following the detection of a photon, a detector element cannot detect another photon for
a period of time (dead time)
• Results in loss of counts especially in 3D scanning
Solution:
• Deadtime measured and mathematical algorithms that take into account

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detector behavior applied to extrapolate from measured counts.
To reduce this problem, faster electronics and shorter crystal decay times have been
developed.
2-Attenuation :
Attenuation correction
Problem:
Attenuation is greater in PET than in SPECT due to the longer path the
The photon must travel through the patient.
Correction:

• Assume cross-sectional shape and uniform LAC of tissue at 511 keV

• Measure the transmission of 511 keV photons through the patient for
• each line of response. A radioactive rod source (gallium-68) that gives
• rise to annihilation radiation is rotated around inside the detector
gantry
• without the patient and then with the patient. This allows a calculation
to be made correcting for the attenuation by the patient.
• If linear attenuation drops in an area being acquired this mean that
there is increased density. This translates to adding counts to the PET
data
• Alternatively, if the attenuation drops, then counts are removed from
the related LORs

Dr.Eslam Kamal ,PhD in Medical Physics

+201092006709
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 1. Consider photons being emitted from the lungs. This causes less
attenuation which CT corrects by subtracting photons
2. Consider photons being emitted from bone. This causes greater
attenuation which CT corrects by adding photons

3-Normalization
Problem:
Individual detector elements differ in dimensions and fraction of scintillation light
photons that reach the PMTs. The same radiation source May not produce the same
response in every detector element.

Solution:
• Rotating rod source used without an object in the scanner to calculate the correction
factor required for differences in the individual detector elements
Correction factor = measured counts for a line of response / average counts for all lines
i. Uniformity can be initiated with the acquisition of a coincidence source placed at the
center of the PET's FOV. Data is then collected in 2D and/or 3D formats where
normalization factors are calculated for both imaging modes. In the above example a
cylinder contains a 68Ge, however, many PET units have their own 68Ge rod sources
housed within the PET scanner and "pop" out when a Blank Scan or Normalization scan
is required

Dr.Eslam Kamal ,PhD in Medical Physics

+201092006709
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 ii. Normalization Procedure
i. Normalization factor (Fi) is determined by first looking at all the LORs in a given
plain and finding its average (Amean). Then each individual LOR in that plane (A i)
is assessed and ratios is calculated for every LOR, that results in generating
"normalized" homogenous LORs through the entire plain

Dr.Eslam Kamal ,PhD in Medical Physics

+201092006709
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4-Radioactive decay
Problem:
Radioactivity decays as the scanner moves down the patient. The longer
the delay from start to finish the more the radioactivity will have
decayed
Solution:
Counts corrected for radioactive decay
5-Structured noise:

Non-random count density that interferes with object of interest due to:
• Uptake in structure that is not of interest e.g. muscle uptake in PET
• after excercise, bowel uptake in gallium-67 citrate
• Imaging system artefacts e.g. non-uniformity of the gamma camera

6-Random noise:

• statistical noise or quantum mottle

• Due to random variations in count density as a result of random
activity of radioactive decay
• More significant contributor of noise

2-PET-Image Quality:

• Contrast
o PET-image contrast is represented by showing the lesion in high difference with
the background
o CT increases the image contrast by attenuation correction.
o High Random and scatter events reduce the image contrast.
o Wide Coincidence window reduce the image contrast.

• Noise
o PET-image noise is highly dependent on the number of counts per pixel, where
high number of counts will reduce the noise
Dr.Eslam Kamal ,PhD in Medical Physics
+201092006709
Islam_ptj@yahoo.com
 o The higher injected activity will reduce the noise
o Wide Coincidence window reduce the image noise.
o A High number of photons collected in 3D mode (higher sensitivity) vs. 2D
mode, decrease the image noise.

• Resolution

• Positron range
1. The greater the energy is given to the positron the farther a
particle will travel - this affects resolution
2. The greater the density of the surrounding medium, the less the
particle will travel
Compare 82Rb to 18F in water and note their energies to the distance
traveled
18
3. F - 1/3 β-max is about 0.213 meV and with a max energy of 0.64
MeV. Therefore, it can travel up to 2.2 mm in water
82
4. Rb - 1/3 β-max is about 1.12 meV with a maximum energy of 3.35
meV. It can travel up to 15.5 mm in water
5. The conclusion is that the greater the energy given to the particle
the poorer the resolution
According to the literature the actual effect to the FWHM is 0.2mm
for 18F and 2.6mm for 82Rb
Distance from the site of disintegration to annihilation
• Longer range = poorer spatial resolution
。 150 is 2 mm, 18F is better at 0.6 mm

Dr.Eslam Kamal ,PhD in Medical Physics

+201092006709
Islam_ptj@yahoo.com
Dr.Eslam Kamal ,PhD in Medical Physics
+201092006709
Islam_ptj@yahoo.com
 • Non-collinearity of the annihilation photons
o If a positron or electron has residual momentum at the time of
annihilation the angle between the paths of the two gamma photons
produced will not be exactly 180°
• The greater the deviation the poorer the spatial resolution
• Detector element size
• Smaller elements = between spatial resolution

Dr.Eslam Kamal ,PhD in Medical Physics

+201092006709
Islam_ptj@yahoo.com
Dr.Eslam Kamal ,PhD in Medical Physics
+201092006709
Islam_ptj@yahoo.com
 Thickness of crystal
o thicker crystal = poorer resolution
o Resolution better through the center than periphery of the detector ring •
Radial Elongation (parallax error/radial astigmatism)
a. As the words imply distortion occurs via the elongation of actual data
b. This becomes more prevalent in the peripheral regions of the FOV
c. From the above diagram, a coincident event is recorded at the edge of the detector
block or element where the photons arrive at a tangent to the opposing crystals
d. The distance between the actual location and its distortion causes "blurring" of the
image by essentially elongating the data. As noted, 2 blocks above are involved in
this detection, where essentially there should be just one
e. This elongation effect increases when
a. The FOV is smaller
b. In PET systems that have thicker crystals

Parallax error in a PET scanner: for off-center positron annihilations, there is an error
in determining the correct line of response, which degrades the overall spatial resolution
of the scanner

Reconstruction filter
• PET has much higher count rate sensitivity than SPECT and so noise is
less of a problem
• PET images can be reconstructed with much higher spatial
frequency.

Dr.Eslam Kamal ,PhD in Medical Physics

+201092006709
Islam_ptj@yahoo.com
Dr.Eslam Kamal ,PhD in Medical Physics
+201092006709
Islam_ptj@yahoo.com