Background— Recent results from animal studies suggest that stem cells may be able to home to sites of myocardial injury to assist in tissue regeneration. However, the histological interpretation of postmortem tissue, on which many of these studies are based, has recently been widely debated. Methods and Results— With the use of the high sensitivity of a combined single-photon emission CT (SPECT)/CT scanner, the in vivo trafficking of allogeneic mesenchymal stem cells (MSCs) colabeled with a radiotracer and MR contrast agent to acute myocardial infarction was dynamically determined. Redistribution of the labeled MSCs after intravenous injection from initial localization in the lungs to nontarget organs such as the liver, kidney, and spleen was observed within 24 to 48 hours after injection. Focal and diffuse uptake of MSCs in the infarcted myocardium was already visible in SPECT/CT images in the first 24 hours after injection and persisted until 7 days after injection and was validated by tissue counts of...

Dynamic Imaging of Allogeneic Mesenchymal Stem Cells Trafficking to Myocardial Infarction

This report describes recommended techniques for radiopharmaceutical biodistribution data acquisition and analysis in human subjects to estimate radiation absorbed dose using the Medical Internal Radiation Dose (MIRD) schema. The document has been prepared in a format to address two audiences: individuals with a primary interest in designing clinical trials who are not experts in dosimetry and individuals with extensive experience with dosimetry-based protocols and calculational methodology. For the first group, the general concepts involved in biodistribution data acquisition are presented, with guidance provided for the number of measurements (data points) required. For those with expertise in dosimetry, highlighted sections, examples and appendices have been included to provide calculational details, as well as references, for the techniques involved. This document is intended also to serve as a guide for the investigator in choosing the appropriate methodologies when acquiring and preparing product data for review by national regulatory agencies. The emphasis is on planar imaging techniques commonly available in most nuclear medicine departments and laboratories. The measurement of the biodistribution of radiopharmaceuticals is an important aspect in calculating absorbed dose from internally deposited radionuclides. Three phases are presented: data collection, data analysis and data processing. In the first phase, data collection, the identification of source regions, the determination of their appropriate temporal sampling and the acquisition of data are discussed. In the second phase, quantitative measurement techniques involving imaging by planar scintillation camera, SPECT and PET for the calculation of activity in source regions as a function of time are discussed. In addition, nonimaging measurement techniques, including external radiation monitoring, tissue-sample counting (blood and biopsy) and excreta counting are also considered. The third phase, data processing, involves curve-fitting techniques to integrate the source time-activity curves (determining the area under these curves). For some applications, compartmental modeling procedures may be used. Last, appendices are included that provide a table of symbols and definitions, a checklist for study protocol design, example formats for quantitative imaging protocols, temporal sampling error analysis techniques and selected calculational examples. The utilization of the presented approach should aid in the standardization of protocol design for collecting kinetic data and in the calculation of absorbed dose estimates.

https://jnm.snmjournals.org/content/jnumed/40/2/37S.full.pdf

MIRD pamphlet no. 16: Techniques for quantitative radiopharmaceutical biodistribution data acquisition and analysis for use in human radiation dose estimates.

The objective of this investigation was to evaluate small-field-of-view, ultra-high-resolution pinhole collimation for a rotating-camera SPECT system that could be used to image small laboratory animals. Pinhole collimation offers distinct advantages over conventional parallel-hole collimation when used to image small objects. Since geometric sensitivity increases markedly for points close to the pinhole, small-diameter and high-magnification pinhole geometries may be useful for selected imaging tasks when used with large-field-of-view scintillation cameras. The use of large magnifications can minimize the loss of system resolution caused by the intrinsic resolution of the scintillation camera. A pinhole collimator has been designed and built that can be mounted on one of the scintillation cameras of a triple-head SPECT system. Three pinhole inserts with approximate aperture diameters of 0.6, 1.2 and 2.0 mm have been built and can be mounted individually on the collimator housing. When a ramp filter is used with a three-dimensional (3D) filtered backprojection (FBP) algorithm, the three apertures have in-plane SPECT spatial resolutions (FWHM) at 4 cm of 1.5, 1.9 and 2.8 mm, respectively. In-air point source sensitivities at 4 cm from the apertures are 0.9, 2.6 and 5.7 counts s(-1) microCi(-1) (24, 70 and 154 counts s(-1) MBq(-1)) for the 0.6, 1.2 and 2.0 mm apertures, respectively. In vitro image quality was evaluated with a micro-cold-rod phantom and a micro-Defrise phantom using both the 3D FBP algorithm and a 3D maximum likelihood-expectation maximization (ML-EM) algorithm. In vivo image quality was evaluated using two (315 and 325 g) rats. Ultra-high-resolution pinhole SPECT is an inexpensive and simple approach for imaging small animals that can be used with existing rotating-camera SPECT system.

https://iopscience.iop.org/article/10.1088/0031-9155/39/3/010/pdf

Pinhole collimation for ultra-high-resolution, small-field-of-view SPECT

Monte Carlo techniques have become popular in different areas of medical physics with advantage of powerful computing systems. In particular, they have been extensively applied to simulate processes involving random behavior and to quantify physical parameters that are difficult or even impossible to calculate by experimental measurements. Recent nuclear medical imaging innovations such as single-photon emission computed tomography (SPECT), positron emission tomography (PET), and multiple emission tomography (MET) are ideal for Monte Carlo modeling techniques because of the stochastic nature of radiation emission, transport and detection processes. Factors which have contributed to the wider use include improved models of radiation transport processes, the practicality of application with the development of acceleration schemes and the improved speed of computers. In this paper we present a derivation and methodological basis for this approach and critically review their areas of application in nuclear imaging. An overview of existing simulation programs is provided and illustrated with examples of some useful features of such sophisticated tools in connection with common computing facilities and more powerful multiple-processor parallel processing systems. Current and future trends in the field are also discussed.

/pdf/relevance-of-accurate-monte-carlo-modeling-in-nuclear-35ml86eq1l.pdf

Relevance of accurate Monte Carlo modeling in nuclear medical imaging.

Background—Soft tissue attenuation is a prominent cause of single-photon emission computed tomography (SPECT) imaging artifacts, which may result in reduced diagnostic accuracy of myocardial perfusion imaging. A method incorporating simultaneously acquired transmission data permits nonuniform attenuation correction and when incorporating scatter correction and resolution compensation may substantially reduce interpretive errors. Methods and Results—A prospective multicenter trial was performed recruiting patients with angiographically documented coronary disease (n=96) and group of subjects with a low likelihood of disease (n=88). The uncorrected and attenuation/scatter corrected images were read independently, without knowledge of the patient’s clinical data. The detection of ≥50% stenosis was similar using uncorrected perfusion data or with attenuation/scatter correction and resolution compensation (visual or visual plus quantitative analysis), 76% versus 75% versus 78%, respectively (P=NS). The normalc...

Multicenter Clinical Trial to Evaluate the Efficacy of Correction for Photon Attenuation and Scatter in SPECT Myocardial Perfusion Imaging

Correction for photon attenuation in cardiac SPECT imaging using a measured attenuation distribution with an iterative expectation maximization (EM) algorithm and an iterative Chang algorithm were compared with the conventional filtered backprojection and an iterative EM algorithm without attenuation correction. The attenuation distribution was determined from a transmission computed tomography study that was obtained using an external collimated sheet source. The attenuation of the emitting photons was modeled in the EM algorithm by an attenuated projector-backprojector that used the estimated attenuation distribution to calculate attenuation factors for each pixel along each projection and backprojection ray. Results from a heart-lung phantom study and a 201Tl patient study demonstrated that the iterative EM algorithm with attenuation correction provided improved image quality in terms of reduced streak artifacts and noise, and more accurate quantitative information in terms of improved radioactivity distribution uniformity where uniformity existed, and better anatomic object definition.

http://jnm.snmjournals.org/content/30/4/497.full.pdf

Correction of nonuniform attenuation in cardiac SPECT imaging.

A long bore fan beam collimator for imaging the head was designed and constructed for a SPECT system with a rotating scintillation camera. In order to avoid the patient9s shoulder during rotation of the camera with a thick camera housing, the long bore design is necessary to allow the collimator to get close to the patient9s head for improved spatial resolution. Operating at the minimum radius of rotation, the prototype fan beam collimator provides about the same spatial resolution as the high resolution collimator, while the geometric efficiency is equal to ∼85% of that of the general purpose and ∼55% higher than the high resolution collimator. Images from a phantom study demonstrate good image quality and are void of artifacts. Comparative clinical studies on temporomandibular joints (TMJ) between the LEGP and fan beam collimators also confirm the superior image quality obtained with the fan beam collimator.

https://jnm.snmjournals.org/content/jnumed/27/6/810.full.pdf

Design and Clinical Utility of a Fan Beam Collimator for SPECT Imaging of the Head

A low-energy fan-beam collimator (LEFB) designed for SPECT imaging of the head was evaluated using physical measurements, phantom and clinical studies. In the transverse image plane, the collimator holes are tapered and converged to a focal point 58 cm from the collimator face. In the longitudinal image plane, the collimator holes are straight and parallel. The collimator holes are hexagonal in shape and 13 cm in length. The extended hole design allows improved clearance of the patient's shoulders during rotation such that the collimator face may be positioned 8.5 cm closer to the patient's head than is possible with conventional collimators. At the center of rotation with the closest rotational radius, the spatial resolutions for the LEGP, LEHR, and LEFB collimators are 17.0, 14.4 and 12.2 mm, respectively. The point source sensitivities are 330, 220 and 190 (at 15 cm) cpm/..mu..Ci, respectively. Line spread functions at various distances from the collimator face, both in air and in water, were measured. Reconstruction algorithms and a special attenuation correction method for the fan beam geometry were developed and various reconstruction parameters for the LEFB collimator were determined experimentally. Images of a SPECT phantom were obtained to evaluate the imaging capabilities of themore » LEFB collimator and the reconstruction algorithm. Clinical comparison of SPECT bone images of the temporomandibular joints obtained with both LEGP and LEFB collimators on the same patients show superior image quality with the LEFB collimator.« less

E. R. Edgerton

Papers

Correction of nonuniform attenuation in cardiac SPECT imaging.

Design and Clinical Utility of a Fan Beam Collimator for SPECT Imaging of the Head

The design and clinical utilities of a fan beam collimator for a SPECT system