Processing Professional Data

No planning procedure can predict the future with complete accuracy. None the less, those managing NHS trusts, like their counterparts in industry and commerce, must somehow try to anticipate it so as to plan appropriately. This is no easy task at the best of times, but during periods of rapid change and uncertainty it is even more difficult. Too much is at stake to rely on good fortune or an irreproachable moral stance as being enough to allow an organisation to win through. Learning theorists claim that we learn through our mistakes. In general the lessons from industry were expensive when it came to planning ahead. Companies have been slow to adopt a marketing approach, and those that went under paid the ultimate price. NHS trusts can learn from the collective mistakes which have gone before. This article attempts to remove some of the mystique which surrounds marketing. It will consider some of the marketing tools which are valuable in the preparation of a marketing plan. A delegate setting out on one of our courses suggested, to the amusement of his fellow students, that marketing is “the application of jargon to common sense.” He was visibly deflated when we tended to agree with him. As in most professions, practitioners develop a convenient vocabulary which aids communication to insiders, but which is opaque and incomprehensible to everyone else. Marketing, like accounting and medicine, among others, is equally guilty of this charge. As a result, the “common sense” element has become obscured by a combination of mystery, hyperbole, and banter. Let's put the record straight. Marketing is not about selling, nor is it about parting the gullible and unwary from their hard earned money. It is far more mundane and down to earth. Reduced to basics, marketing is the process of matching …

A high-speed radiation imaging system based on an image converter of liquid scintillator filled capillary arrays has been developed, which is sensitive to x rays, gamma rays, and neutrons. This imaging system has advantages of both high spatial resolution and high sensitivity because increasing the thickness of the image converter only leads to little deterioration on imaging resolution. The capillary arrays have dimensions of 150mm diameter and 50mm thickness, with 100 µm diameter of each capillary. The fluorescence decay time of the filled liquid scintillator based on the mixture of p-xylene and 2,5-diphenyloxazole has been evaluated to be ∼3ns with the single photon method under the gamma ray excitation. The spatial resolution has been experimentally evaluated to be about 1.15 and 0.6mm, under excitation of x rays and neutrons, respectively. The imaging system has been applied for diagnosing the dynamic x-ray spot generated by the rod pinch. Two frames in single shot with 15ns temporal resolution and 20ns inter-frame separation time have been obtained, which show the spatiotemporal distribution of the electrons bombarding the tungsten rod, indicating the ability of this imaging system in diagnosing dynamic radiation objects. In addition, the technique of capillary arrays provides a promising path for applications of advanced liquid scintillators in the field of radiation imaging.

Introduction: Acquiring a high quality image has assigned an important concern for obtaining accurate diagnosis in nuclear medicine. Detector and collimator are critical component of Single Photon Emission Computed Tomography (SPECT) imaging system for giving accurate information from exact pattern of radionuclide distribution in the target organ. The images are strongly affected by the attenuation, scattering, and response of the detector and collimator. Method and material: The Planar and SPECT scans of a Y90 point source and also an extended Cardiac- Torso(XCAT) computerized phantom with the experiment and simulated systems were prepared. The SIMIND Monte Carlo program was used for simulating Siemen’s dual head variable angle SPECT imaging system with 4 detectors and 10 collimators. After verification and validation of the simulated system, the similar scans of the phantoms were compared from the point of view of image quality for 4 scintillator crystals including: NaI(Tl), BGO, LuAG: Ce, LaBr3 and also 10 collimators: Pb, Pb-Sb, Pb-Sb3, Pb-bi-Sn19, Pb-bi Sn375, Pb-bi-Sn50, Pb-bi-Sn-cd10, Pb-bi-Sn-cd125, Pt and Pt-Co. The parameters of energy and spatial resolution, and sensitivity of the systems were compared. Images were analyzed qualitatively by two nuclear medicine specialists. RESULTS: FWHM of the mentioned crystals and collimators obtained where: NaI (Pb, 0.3853) and BGO (Pb-Sb, 0.406), (Pb-Bi-Sn375, 0.405), (Pb-Bi-Sn-cd125, 0.375), and LuAG: Ce crystal (Pb-Sb, 0.425), (Pb- Bi-Sn19, 0.407), (Pb-Bi-Sn375, 0.417) and also LaBr3 (Pb-Bi-Sn375, 0.407), (Pb-Bi-Sn50, 0.430), (Pt-Co, 0.355). Medical diagnosis of the SPECT images of the phantom showed that the system with NaI(Tl)and LaBr3 by Pb-Sn3 collimator potentially provides a better detectability for hot lesions in the liver of XCAT phantom. CONCLUSIONS: The results showed that crystal NaI(Tl)and LaBr3 by Pb-Sn3 collimator has a high sensitivity and resolution, and also provides a better lesion detectability from the point of view of image quality on XCAT phantom.

This paper presents a design study of a single photon emission microscope (SPEM) system for small animal imaging using I-125 labelled radiotracers. This system is based on the use of a very-high resolution gamma camera coupled to a converging non-multiplexing multiple pinhole collimator. This enables one to "zoom" into a small local region inside the object to extract imaging information with a very high spatial resolution and a reasonable sensitivity for gamma rays emitted from this local region. The SPEM system also includes a pinhole (or multiple pinhole) gamma camera that has a full angular coverage of the entire object. The designed imaging spatial resolution for the SPEM system is between 250 μm to 500 μm FWHM.

Faster proximity searching with the distal SAT

A single photon emission computed tomography (SPECT) system with a co-registered X-y computed tomography (CT) system allows the convergence of functional information and morphologic information. The localization of radiopharmaceuticals on a SPECT can be enhanced by combining the SPECT with an anatomical modality, such as X-ray CT. Gamma-ray imaging for nuclear medicine devices and X-ray imaging systems for diagnostics has recently been developed based on semiconductor detectors, and semiconductor detector materials such as cadmium telluride (CdTe) or cadmium zinc telluride (CZT) are available for both X-ray and gamma-ray systems for small-animal imaging. CdTe or CZT detectors provide strong absorption and high detection efficiency of high energy X-ray and gamma-ray photons because of their large atomic numbers. In this study, a pinhole collimator SPECT system sharing a cadmium telluride (CdTe) detector with a CT was designed. The GEANT4 application for tomographic emission (GATE) v.6.1 was used for the simulation. The pinhole collimator was designed to obtain a high spatial resolution of the SPECT system. The acquisition time for each projection was 40 seconds, and 60 projections were obtained for tomographic image acquisition. The reconstruction was performed using ordered subset expectation maximization (OS-EM) algorithms. The sensitivity and the spatial resolution were measured on the GATE simulation to evaluate the system characteristics. The spatial resolution of the system calculated from the FWHM of Gaussian fitted PSF curve was 0.69 mm, and the sensitivity of the system was measured to be 0.354 cps/kBq by using a Tc-99m point source of 1 MBq for 800 seconds. A phantom study was performed to verify the design of the dual imaging modality system. The system will be built as designed, and it can be applied as a pre-clinical imaging system.

Significant effort currently is being devoted to the development of noninvasive imaging systems that allow in vivo assessment of biological and biomolecular interactions in mice and other small animals. While physiological function in small animals can be localized and imaged using conventional radionuclide imaging techniques such as single-photon emission tomography (SPECT) and positron emission tomography (PET), these techniques inherently are limited to spatial resolutions of 1-2 mm. For this reason, we are developing a small animal radionuclide imaging system (SARIS) using grazing incidence optics to focus gamma-rays emitted by 125I and other radiopharmaceuticals. We have developed a prototype optic with sufficient accuracy and precision to focus the 27.5 keV photons from 125I onto a high-resolution imaging detector. Experimental measurements from the prototype have demonstrated that the optic can focus X-rays from a microfocus X-ray tube to a spot having physical dimensions (approximately 1500 microns half-power diameter) consistent with those predicted by theory. Our theoretical and numerical analysis also indicate that an optic can be designed and build that ultimately can achieve 100 μm spatial resolution with sufficient efficiency to perform it in vivo single photon emission imaging studies in small animal.

We present some additional results obtained with the BETAview system, a digital system for real time /spl beta/-imaging based on semiconductor pixel detectors and on a single photon counting read-out chip. We describe the system assembled with a Si detector, 300-/spl mu/m thick, segmented into 64 /spl times/64 square pixels with 170-/spl mu/m pitch. The solid-state pixel array detector is bump-bonded pixel by pixel to a low threshold, single particle counting electronics, the photon counting chip (PCC) developed by the Medipix1 Collaboration for biomedical applications. Each cell (corresponding to a detector pixel) of the front-end chip has a maximum count rate of 2 MHz, a minimum nominal threshold of 1400 e/sup -/ (corresponding about 5 keV in Si), and contains a 15-bit counter. The detector sensitive area is about 1 cm/sup 2/, but several detectors could be assembled in arrays. The measured background counts were about 3.5/spl times/10/sup -2/ cps/cm/sup 2/, which implies a very high sensitivity of the device. The detection threshold used in this experiment was /spl sim/15 keV. We show the results obtained in the real-time monitoring of two biological dynamic processes: an amino acid uptake by living cells and the thermal denaturation process of oligonucleotides. Specifically, we have followed over time the accumulation of a marked amino acid ([/sup 14/C]L-Leucine) into Octopus vulgaris eggs cells. The results, described in Section III-B, show that after about 20 min from the beginning of the uptake process, the radioactively marked eggs become clearly visible over the background culture radioactive medium. In Sections III-C and III-D, we also describe the successful performance of the /spl beta/-imaging system in genetic studies involving the real time reconstruction of denaturation and kinetics curves for two different /sup 32/P-radiolabeled nucleotides.

Habib Zaidi, PhD This is an exciting time for molecular imaging because molecular medicine is expected to lead to a revolutionary paradigm shift in health care. While the nuclear medicine community is witnessing a revolution in the practice of this specialty with the introduction of dual-modality positron emission tomography (PET) and computed tomography (CT), many groups in academic and corporate settings are focusing their efforts on the development of promising multimodality imaging technologies that will combine magnetic resonance (MR) imaging and PET components in a single gantry. One such preclinical system is described by Judenhofer et al (1) in this issue of Radiology, and different design trends have been reported in the literature (2–8). Similar design concepts are also being investigated for combined single photon emission CT (SPECT) and MR imaging instrumentation (9). The recent interest in simultaneous PET/MR imaging is not the consequence of controversies surrounding the role and clinical benefits of PET/CT (10,11) but will likely be the subject of similar critique and debates. The development of PET/MR imaging has been motivated by various factors and has several important incentives (12). First, MR imaging is used to obtain anatomic and structural images with submillimeter spatial resolution that offers better soft-tissue contrast sensitivity than that offered by CT. MR imaging has excellent contrast between white and gray matter and allows for functional imaging in brain studies, and, more importantly, it can be used to assess flow, diffusion, perfusion, and cardiac motion in one examination (13). In addition, MR imaging can be combined with MR spectroscopy to measure the regional biochemical content and to assess the metabolic status or the presence of neoplasia and other diseases in specific tissue areas. Finally, MR imaging does not involve the use of ionizing radiation; thus, it can be used without restrictions in serial studies, for pediatric studies, and in many other situations where radiation exposure is a concern. PET imaging is used to record the regional distribution of radiolabeled tracers; however, unlike MR spectroscopy, it cannot be used to distinguish the specific molecular species to which the radionuclide is attached, and, unlike MR imaging, it provides little anatomic information. While many technical problems have recently been solved, there are still several important challenges to the implementation and operation of a PET/MR imaging system that must be overcome. In comparison with x-ray CT, MR imaging typically is more costly, involves longer examination times, and produces anatomic images from which it is more difficult or at least not as straightforward to derive attenuation maps for photon correction of the emission data (14). The latter issue was not described by Judenhofer et al (1), as it has received only limited attention in the scientific literature and few investigators have addressed the problem of the use of segmented MR data to construct an attenuation map for attenuation correction purposes with PET (15). However, interest in PET/MR imaging has been the driving force behind many worthwhile research efforts recently undertaken by different research groups. The major difficulty lies in the fact that the MR signal or tissue intensity level is not directly related to electronic attenuation, which renders conversion of MR images to attenuation maps less obvious when compared with CT. It is worth emphasizing that the optimal transmission scanning technique for PET/CT (ie, CT versus radionuclide sources) is still an open issue that remains to be addressed (16). This is not an issue for PET/MR imaging because of the limited space available, and thus, placement of external Published online 10.1148/radiol.2443070092

In multipinhole single photon emission computed tomography, the overlapping of projections has been used to increase sensitivity. Avoiding artifacts in the reconstructed image associated with projection overlaps (multiplexing) is a critical issue. In our previous report, two types of artifact-free projection overlaps, i.e., projection overlaps that do not lead to artifacts in the reconstructed image, were formally defined and proved, and were validated via simulations. In this work, a new proposition is introduced to extend the previously defined type-II artifact-free projection overlaps so that a broader range of artifact-free overlaps is accommodated. One practical purpose of the new extension is to design a baffle window multipinhole system with artifact-free projection overlaps. First, the extended type-II artifact-free overlap was theoretically defined and proved. The new proposition accommodates the situation where the extended type-II artifact-free projection overlaps can be produced with incorrectly reconstructed portions in the reconstructed image. Next, to validate the theory, the extended-type-II artifact-free overlaps were employed in designing the multiplexing multipinhole spiral orbit imaging systems with a baffle window. Numerical validations were performed via simulations, where the corresponding 1-pinhole nonmultiplexing reconstruction results were used as the benchmark for artifact-free reconstructions. The mean square error (MSE) was the metric used for comparisons of noise-free reconstructed images. Noisy reconstructions were also performed as part of the validations. Simulation results show that for noise-free reconstructions, the MSEs of the reconstructed images of the artifact-free multiplexing systems are very similar to those of the corresponding 1-pinhole systems. No artifacts were observed in the reconstructed images. Therefore, the testing results for artifact-free multiplexing systems designed using the extended type-II artifact-free overlaps numerically validated the developed theory. First, the extension itself is of theoretical importance because it broadens the selection range for optimizing multiplexing multipinhole designs. Second, the extension has an immediate application: using a baffle window to design a special spiral orbit multipinhole imaging system with projection overlaps in the orbit axial direction. Such an artifact-free baffle window design makes it possible for us to image any axial portion of interest of a long object with projection overlaps to increase sensitivity.

Respiratory motion in the chest region during single photon emission computed tomography (SPECT) is a major degrading factor that reduces the accuracy of image quantification. This effect is more notable when the tumor is very small, or the spatial resolution of the imaging system is less than the respiratory motion amplitude. Small animals imaging systems with sub-millimeter spatial resolution need more attention to the respiratory motion for quantitative studies. We developed a motion-embedded four-dimensional (4D)-multi pinhole SPECT (MPS) reconstruction algorithm for respiratory motion correction. This algorithm makes full use of projection statistics for reconstruction of every individual frame. The ROBY phantom with small tumors in liver was generated in eight different phases during one respiratory cycle. The MPS projections were modeled using a fast ray tracing method simulating an MPS acquisition. Individual frames were reconstructed and used for motion estimation. The Demons non-rigid registration algorithm was used to calculate deformation vector fields (DVFs) for simultaneous motion correction and image reconstruction. A motion-embedded 4D-MPS method was used to reconstruct images using all the projections and corresponding DVFs, simultaneously. The 4D-MPS reconstructed images were compared to the low-count single frame (LCSF) reconstructed image, the three-dimensional (3D)-MPS images reconstructed using individual frames, and post reconstruction registration (PRR) that aligns all individual phases to a reference frame using Demons-derived DVFs. The tumor volume relative error (TVE), tumor contrast relative error (TCE), and dice index (DI) for 2, 3, and 4mm liver were calculated and compared for different reconstruction methods. For the 4D-MPS reconstruction method, TVE was reduced and DI was higher compared to PRR, 3D-MPS, and LCSF. The extent of the improvement was higher for the small tumor size (i.e. 2mm). For the biggest tumor in contrast 3 (i.e. 4mm) TVE for 4D-MPS, PRR, 3D-MPS and, LCSF were 1.33%, 8%, 8%, and 14.67%, respectively. The results suggest that motion-embedded 4D-MPS method is an effective and practical way for respiratory motion correction. It reconstructs high quality gated frames while using all projection data to reconstruct each frame.

Optical link based readout system for Medipix2 quad X-ray detector

Cardiovascular disease remains a leading killer in the United States. Although much progress has been made in diagnosing and treating this deadly disease, many questions remain. By studying disease pathogenesis at the genomic and proteomic levels, researchers have developed new strategies for managing disease, but only few have successfully translated these methods into routine clinical implementation. Molecular imaging enables the visualization of biological processes in vivo, providing valuable information that will likely improve clinical translation of these novel therapies. Molecular imaging utilizes imaging probes that interact with specific molecular targets which are then detected by an imaging system, such as single photon emission computed tomography (CT), positron emission tomography (PET), ultrasound, and magnetic resonance imaging (MRI). Patients can then be followed serially using noninvasive methodologies to evaluate disease progression and the effects of therapeutic interventions. Using these specialized probes, researchers have evaluated the role of the following biological processes in atherosclerosis and heart failure: inflammation, thrombosis, apoptosis, vascular remodeling, and angiogenesis. This chapter presents the state of the art in molecular imaging and its role in the management of cardiovascular disease.

The response characteristics of two tomographic systems were compared for imaging of positron emitters: a) a SPECT system with a 3/8 in crystal and 511 keV detector shielding, equipped with a specially designed 511 keV collimator, and b) a PET V system using coincidence detection. SPECT transverse plane resolution was 19 mm FWHM and 35 mm FWTM for a radius of rotation of 16 cm. Corresponding resolution for PET was 14 mm FWHM and 28 mm FWTM. Transverse images through a phantom containing cylindrical sources of various cross sections and uniform activity were obtained for each detector. The measured count density or recovery coefficient was found to decrease with source size, the dependence being similar for both systems. The theoretical values for recovery coefficients were calculated by convolution of a Gaussian fit to the SPECT resolution (FWHM, FWTM) values with the uniform cross section of each source. This simple mathematical model confirmed that the recovery coefficient dependence on source size was primarily related to the limited resolution of the detector. Experimental measurements demonstrated that the SPECT resolution for volume sources was sufficient for quantitation, although some limitations exist with respect to source sizes smaller than the detector resolution.

Ann-Shyn Chiang