Current Challenges and Opportunities in Positron Emission Tomography. Paul Marsden King s College London
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1 Current Challenges and Opportunities in Positron Emission Tomography Paul Marsden King s College London STFC Particle Physics Department Rutherford Appleton Laboratory - 3 Sept 2014
2 Current Challenges and Opportunities in Positron Emission Tomography Basic principles and applications Limits to performance Current developments Challenges and opportunities
3 Annihilation coincidence detection p n n p p n n p p n p p n n p p n n p p n n 2 e + e - v
4 Detection of pmolar concentrations of tracer Cyclotron Hot cells Synthesis units Chemistry
5 Paul Grasby, MRC Clinical Sciences Centre Specificity of PET radiotracers 18 F-DOPA 11 C-MDL C-Raclopride 11 C-FLB C-WAY C-DASB
6 FDG-PET demonstrates response to Gleevec (tyrosine kinase inhibitor) in gastrointestinal stromal tumor (GIST) Baseline Day 1 3 years Van den Abbeele et al - Dana-Farber Cancer Institute
7 Standard scanner configuration A C Y A B C D X A B A B C D
8 Whole body protocol AC No AC inject Scan Move bed
9 Multimodality: combined PET-CT systems CT PET
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11 Combined PET/CT imaging very different detector technologies LabPET APD small animal PET system PET pulse mode/poor spatial resolution (1mm here) CT 50keV/current mode/high spatial resolution (typically 100um) photon counting mode CT acquisition (energy discrimination..) But..little motivation for human systems as imaging times are so different Christian Thibaudeau, Sherbrooke Molecular Imaging
12 HRRT High resolution brain scanner Small animal PET-CT
13 - plant imaging Budassi, MIC 2012 And long history of many other application-specific prototypes - Breast - Prostate - Brain.. but all commercial development aimed at whole body PET-CT systems
14 Positron range Scanner spatial resolution For 18 F contribution of positron range to spatial resolution is ~ 0.15mm Acollinearity of annihilation gammas Magnitude of error increases linearly with diameter of scanner For 1m diameter contribution to spatial resolution ~ 2 mm Detector element dimensions 180 ± 0.25 Contribution ~ d/2 So typically 2-3 mm d/2 d
15 Limits to resolution: contribution of physical factors Clinical PET (80cm diameter) / 18 F Small animal PET (8cm diameter) / 18 F
16 Depth of interaction effects 75.5mm
17 Collimated single photon system Absolute sensitivity ~ 0.05% Positron Emission Tomography Absolute sensitivity ~ 0.5 5% ~ Ωε 2 /4π
18 Randoms and scatter Contribute background across image easily (!) corrected Increased noise reduces image SNR Both randoms and scatter increase with patient size Randoms also increase with activity Energy and temporal resolution > improved SNR Many prototypes fail to consider these issues Scatter True Line of response Random Standard EU phantom Same true counts but additional fat layer
19 Time of flight Centre Detector 1 Detector 2 x t = 2 x / c 100ps >> 1.5 cm First tried in 1980s using BaF 2 Now being revisited with LSO/SiPM ~ 350 ps Promises significant SNR improvements Bill Moses, LBLN Philips Gemini ToF scanner Surti et al, JNM 2007
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21 First PET-MR images 1997! Yiping Shao, Simon R Cherry, Keyvan Farahani, Ken Meadors, Stefan Siegel, Robert W Silverman and Paul K Marsden, Simultaneous PET and MR imaging, Phys. Med. Biol. 42 (1997)
22
23 MR/PET München (TUM/LMU), Teil der DFG-Großgeräteinitiative
24 Applications clinical imaging PET-CT PET-MR Drzezga et al, 2013
25 Applications - brain Hans Herzog, Julich Schlemmer et al, Tuebingen
26 Avalanche photodiodes (APD) Immune to large magnetic fields PET-MR Very low gain cf PMTs Too slow for ToF Poor temp stability Silicon photomultipliers (SiPM) High gain Very fast ToF PET > 100ps? Better temp stability Potential successor to PMT New photodetectors Digital silicon photomultipliers (dsipm) Electronics/detector on same chip Completely digital design Digital PET scanner PMT SSPD Crystal array Photodetector
27 EU Framework 7 Hyperimage project New MR-compatible SiPM detector technology MR-compatible time-of-flight PET MR-based attenuation correction Motion compensation Example applications in cancer and the heart 8 European partners Human system SiPM based detector module Preclinical system
28 MkII system with digital SiPM detectors Digital silicon photomultiplier (dsipm) Binary cell outputs summed digitally Electronics/detector on same chip Completely digital design Excellent performance Easy to use (Unfortunately carbon fibre RF shielding not suitable for human systems..) KCL Medical Engineering Centre/Sublima F7 projects
29 Dynamic Study of Dual labelled PET/MR Probe 64 Cu(DTCBP)2-Endorem Simultaneous dynamic study PET: 20 MBq 64 Cu frame time s MR: Single slice gradient echo, iron oxide nanoparticle (negative contrast ), ΔT ~ 45s (R. T. M de Rosales et al. Angew. Chem. Int. Ed. 2011, 50, ) PET PET-MRI MRI PET uptake sec MR signal loss sec Minutes p. i. KCL
30 Dynamic MR correct PET for effects of patient motion
31 120 I 4 MeV 18 F MeV Jon Shah, Hans Herzog, Julich
32 Philips digital SiPM PET-CT
33
34
35 EXPLORER Consortium
36 RPC-based small animal PET prototype Paulo Martins
37
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39 Peter Thirolf, Munich
40 Challenges/Opportunities New technologies, notably SiPM/ToF, are now finding their way into clinical systems ToF promises significant performance improvements (but its not there yet..) Applications still based around whole body PET-CT Potential of PET-MR still to be demonstrated/exploited Possible re-emergence of dedicated hi-res brain systems No role currently for solid state detectors Future possibilities from exploiting Compton kinematics..
41 Thankyou...! Acknowledgements : STFC Particle Physics Department Rutherford Appleton Laboratory - 3 Sept 2014
42
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