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A new combined lutetium oxyorthosilicate (LSO) PET/CT scanner with an extended axial field-of-view (FOV) of 21.8 cm has been developed (Biograph TruePoint PET/CT with TrueV; Siemens Molecular Imaging) and introduced into clinical practice. The scanner includes the recently announced point spread function (PSF) reconstruction algorithm. The PET components incorporate four rings of 48 detector blocks, 5.4 cm x 5.4 cm in cross-section. Each block comprises a 13 x 13 matrix of 4 x 4 x 20 [mm.sup.3] elements. Data are acquired with a 4.5 ns coincidence time window and an energy window of 425-650 keV. The physical performance of the new scanner has been evaluated according to the recently revised National Electrical Manufacturers Association (NEMA) NU 2-2007 standard and the results have been compared with a previous PET/CT design that incorporates three rings of block detectors with an axial coverage of 16.2 cm (Biograph TruePoint PET/CT; Siemens Molecular Imaging). In addition to the phantom measurements, patient Noise Equivalent Count Rates (NECRs) have been estimated for a range of patients with different body weights (42-154 kg). The average spatial resolution is the same for both scanners: 4.4 mm (FWHM) and 5.0 mm (FWHM) at 1 cm and 10 cm respectively from the center of the transverse FOV. The scatter fractions of the Biograph TruePoint and Biograph TruePoint TrueV are comparable at 32%. Compared to the three ring design, the system sensitivity and peak NECR with smoothed randoms correction (1R) increase by 82% and 73%, respectively. The increase in sensitivity from the extended axial coverage of the Biograph TruePoint PET/CT with TrueV should allow a decrease in either scan time or injected dose without compromising diagnostic image quality. The contrast improvement with the PSF reconstruction potentially offers enhanced detectability for small lesions. Index Terms--Extended FOV, NEMA measurements, PET/CT, PSF reconstruction.

The combination of PET and SPECT in one device may have clinical and economic advantages. The PET/SPECT camera developed as a joint venture between CPS Innovations, Knoxville, TN, and Siemens Medical Systems, Hoffmann Estates, IL, is a fully 3-D system with 511 keV transmission sources. The detector is based on a NaI-LSO phoswich scintillator. The individual LSO and NaI crystals have a size of 4.3 x 4.3 10 [mm.sup.3]. The 12 x 12 crystal blocks are read out by 2 x 2 in photomultiplier tubes, arranged in a low cost quadrant sharing system. The purpose of this paper is to illustrate phoswich detector setup and to evaluate the detector performance for both modes, PET, and SPECT. The quadrant sharing method and the two crystal layers require special algorithms to find the individual crystal regions and distinguish them from light cross talk caused by adjacent blocks. The base for this procedure is a position profile acquired with a flood source. The mean energy resolution for the NaI(TI) crystal layer was 13.1% (FWHM) at 140 keV and 15.7% (FWHM) at 511 keV for the LSO crystal layer. For the PET setup the average time resolution was 3.4 ns (FWHM). A daily quality check showed a very stable detector condition. Peak shifts due to room temperature changes were very little for both modes and both crystal layers. Index Terms--NaI-LSO detector, PET/SPECT, quadrant-sharing.

Abstract. Longitudinal positron emission tomography (PET) studies of 6-[sup 18]F-L-dopa uptake in the striatum are used to assess the progression of Parkinson's disease or the survival of neuronal cells grafted in parkinsonian patients. These studies are performed over several years, and data analysis may suffer from the change from old tomographs to new machines with better sensitivity and spatial resolution. Furthermore, such studies on parkinsonian patients may be accomplished in either 2D or 3D acquisition mode. The aforementioned improvements offer great benefits for the study of neurodegenerative diseases, especially those affecting the striatum. However, direct comparison of data is not straightforward owing to variation in scanner characteristics. In this study, we assessed the feasibility of comparing the 6-[sup 18]F-L-dopa striatal uptake values (K[sub c]) measured in two groups of healthy subjects using two tomographs of different generations. We re-studied and compared acquisitions performed on 14 healthy subjects using 6-[sup 18]F-L-dopa. Half of these studies had been performed in 2D acquisition mode using an ECAT 953B. The other half had been performed in 3D acquisition mode using an ECAT EXACT HR+. Different reconstruction protocols were used and the K[sub c] values obtained were statistically compared. The results showed that lowering the transverse spatial resolution of images obtained with the scanner having the better spatial resolution, so that it more closely matched that of the other... [ABSTRACT FROM AUTHOR]

Objective: The authors investigated changes in brain function associated with cocaine dependence and withdrawal to provide clues regarding the processes that lead to the uncontrollable self-administration of cocaine. Method: They measured regional brain metabolism with [18F]-fluorodeoxyglucose (FDG) and positron emission tomography in 15 outpatients with the diagnosis of cocaine abuse and 17 normal comparison subjects. Ten of the patients were studied less than 1 week after they had last had cocaine, and five were studied 2-4 weeks after withdrawal. Results: Patients studied within 1 week of cocaine withdrawal but not those studied within 2-4 weeks of cocaine withdrawal had higher levels of global brain metabolism as well as higher levels of regional brain metabolism in the basal ganglia and orbitofrontal cortex than did normal subjects, probably as a consequence of less brain dopamine activity. There was also a significant relationship between the number of days since cocaine withdrawal and regional brain glucose metabolism in the orbitofrontal cortex and in the basal ganglia, and the correlations between cocaine craving and metabolic activity were significant in the prefrontal cortex and the orbitofrontal cortex. Conclusions: Although the time-dependent fall in metabolic activity suggests that the higher metabolic activity observed less than a week after cocaine withdrawal may represent a nonspecific expression of drug withdrawal, the selectivity of changes in glucose metabolism for the basal ganglia and for the orbitofrontal cortex suggests that the regional metabolic changes seen in cocaine abusers during detoxification are related to changes in brain dopamine activity. [ABSTRACT FROM AUTHOR]

To assess the effects of chronic cocaine intoxication on dopamine receptors in human subjects, the authors evaluated [18F]N-methylspiroperidol binding using positron emission tomography in 10 cocaine abusers and 10 normal control subjects. Cocaine abusers who had been detoxified for 1 week or less showed significantly lower values for uptake of [18F]N-methylspiroperidol in striatum than the normal subjects, whereas the cocaine abusers who had been detoxified for 1 month showed values comparable to those obtained from normal subjects. The authors conclude that postsynaptic dopamine receptor availability decreases with chronic cocaine abuse but may recover after a drug-free interval. [ABSTRACT FROM AUTHOR]

Unlabelled: Quantitative imaging biomarkers could speed the development of new treatments for unmet medical needs and improve routine clinical care. However, it is not clear how the various regulatory and nonregulatory (eg, reimbursement) processes (often referred to as pathways) relate, nor is it clear which data need to be collected to support these different pathways most efficiently, given the time- and cost-intensive nature of doing so. The purpose of this article is to describe current thinking regarding these pathways emerging from diverse stakeholders interested and active in the definition, validation, and qualification of quantitative imaging biomarkers and to propose processes to facilitate the development and use of quantitative imaging biomarkers. A flexible framework is described that may be adapted for each imaging application, providing mechanisms that can be used to develop, assess, and evaluate relevant biomarkers. From this framework, processes can be mapped that would be applicable to both imaging product development and to quantitative imaging biomarker development aimed at increasing the effectiveness and availability of quantitative imaging., Supplemental Material: http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.10100800/-/DC1., (RSNA, 2011)

A tube-voltage-dependent scheme is presented for transforming Hounsfield units (HU) measured by different computed tomography (CT) scanners at different x-ray tube voltages (kVp) to 511 keV linear attenuation values for attenuation correction in positron emission tomography (PET) data reconstruction. A Gammex 467 electron density CT phantom was imaged using a Siemens Sensation 16-slice CT, a Siemens Emotion 6-slice CT, a GE Lightspeed 16-slice CT, a Hitachi CXR 4-slice CT, and a Toshiba Aquilion 16-slice CT at kVp ranging from 80 to 140 kVp. All of these CT scanners are also available in combination with a PET scanner as a PET/CT tomograph. HU obtained for various reference tissue substitutes in the phantom were compared with the known linear attenuation values at 511 keV. The transformation, appropriate for lung, soft tissue, and bone, yields the function 9.6 x 10(-5). (HU+ 1000) below a threshold of approximately 50 HU and a (HU+ 1000)+b above the threshold, where a and b are fixed parameters that depend on the kVp setting. The use of the kVp-dependent scaling procedure leads to a significant improvement in reconstructed PET activity levels in phantom measurements, resolving errors of almost 40% otherwise seen for the case of dense bone phantoms at 80 kVp. Results are also presented for patient studies involving multiple CT scans at different kVp settings, which should all lead to the same 511 keV linear attenuation values. A linear fit to values obtained from 140 kVp CT images using the kVp-dependent scaling plotted as a function of the corresponding values obtained from 80 kVp CT images yielded y = 1.003 x -0.001 with an R2 value of 0.999, indicating that the same values are obtained to a high degree of accuracy.

Time-of-flight (TOF) positron emission tomography (PET) was studied and preliminarily developed in the 1980s, but the lack of a scintillator able to deliver at the same time proper time resolution and stopping power has prevented this technique from becoming widespread and commercially available. With the introduction of LSO in PET, TOF is now a feasible option. TOF reconstruction has been implemented in the CPS Hi-Rez PET scanner, both with 2D filtered-back-projection (FBP2D) and 3D ordered subset expectation maximization (OSEM3D). A new procedure has been introduced in the time alignment to compensate for the limited digital time resolution of the present electronics. A preliminary version of scatter correction for TOF has been devised and is presented. The measured time resolution of 1.2 ns (FWHM) allowed for a signal-to-noise ratio increase of about 50% in phantoms of about 40 cm transaxial size, or a gain larger than 2 in noise equivalent counts (NEC). TOF reconstruction has shown the expected improvement in SNR, both in simulation and experimental data. First experimental results show two improvements of TOF reconstruction over conventional (non-TOF) reconstruction: a lower noise level and a better capability to resolve structures deep inside large objects.