IEEE TRANSACTIONS ON NUCLEAR SCIENCE, VOL. 53, NO.
1, FEBRUARY 2006
Design and Evaluation of the Clear-PEM Scanner for
Positron Emission Mammography
Maria C. Abreu, João D. Aguiar, Fernando G. Almeida, Pedro Almeida, Pedro Bento, Bruno Carriço,
Miguel Ferreira, Nuno C. Ferreira, Fernando Gonçalves, Carlos Leong, Filipe Lopes, Pedro Lousã,
Mónica V. Martins, Student Member, IEEE, Nuno Matela, Student Member, IEEE, Pedro R. Mendes, Member, IEEE,
Rui Moura, João Nobre, Nuno Oliveira, Catarina Ortigão, Luís Peralta, Rui Pereira, Joel Rego, Rui Ribeiro,
Pedro Rodrigues, José Sampaio, Ana I. Santos, Luís Silva, José C. Silva, Patrick Sousa, Isabel C. Teixeira,
João P. Teixeira, Andreia Trindade, and João Varela
Abstract—The design and evaluation of the imaging system
Clear-PEM for positron emission mammography, under devel-
opment by the PEM Consortium within the framework of the
Crystal Clear Collaboration at CERN, is presented. The proposed
apparatus is based on fast, segmented, high atomic number radi-
ation sensors with depth-of-interaction measurement capabilities,
and state-of-the-art data acquisition techniques. The camera
consists of two compact and planar detector heads with dimen-
sions 16.5 14.5 cm2 for breast and axilla imaging. Low-noise
integrated electronics provide signal amplification and analog
multiplexing based on a new data-driven architecture. The coin-
cidence trigger and data acquisition architecture makes extensive
use of pipeline processing structures and multi-event memories for
high efficiency up to a data acquisition rate of one million events/s.
Experimental validation of the detection techniques, namely the
basic properties of the radiation sensors and the ability to measure
the depth-of-interaction of the incoming photons, are presented.
System performance in terms of detection sensitivity, count-rates
and reconstructed image spatial resolution were also evaluated
Manuscript received November 15, 2004; revised October 19, 2005.
This work was supported by the Innovation Agency (AdI) and the Oper-
ational Program for Information Society (POSI), Portugal. The work of
N. Matela, M. V. Martins, R. Moura, P. Rodrigues, and A. Trindade was
supported by the Fundação para a Ciência e a Tecnologia (FCT) under Grants
Number SFRH/BD/6187/2001, SFRH/BD/3002/2000, SFRH/BD/12418/2003,
SFRH/BD/10187/2002 and SFRH/BD/10198/2002. The work of N. Oliveira,
and C. Ortigão was supported by AdI.
M. C. Abreu, B. Carriço, P. R. Mendes, R. Pereira, and P. Sousa are with
LIP, Lab. de Instrumentação e Física Exp. de Partículas, Algarve and Facul. de
Ciências e Tecnologia, Univ. do Algarve, Faro, Portugal.
J. D. Aguiar, F. Lopes, and J. Sampaio are with INEGI, Inst. Eng. Mecânica
Gestão Industrial, Porto, Portugal.
F. G. Almeida and R. Ribeiro are with INEGI, Inst. Eng. Mecânica Gestão
Industrial, Porto, Portugal and also with Facul. Eng. da Univ. do Porto, Portugal.
P. Almeida, M. V. Martins, N. Matela, and N. Oliveira are with Univ. de
Lisboa, Facul. de Ciências, Inst. de Biofísica e Eng. Biomédica, Portugal.
P. Bento, F. Gonçalves, C. Leong, P. Lousã, J. Nobre, J. Rego, L. Silva,
I. C. Teixeira, and J. P. Teixeira are with INESC-ID and INOV, Lisboa, Portugal.
M. Ferreira, R. Moura, C. Ortigão, L. Peralta, R. Ribeiro, P. Rodrigues,
J. C. Silva, and A. Trindade are with Lab. de Instrumentação e Física Exp. de
Partículas, Lisboa, Portugal.
F. Gonçalves, I. C. Teixeira, J. P. Teixeira, and J. Varela are also with IST,
Inst. Superior Técnico, Univ. Técnica de Lisboa, Portugal.
N. C. Ferreira is with IBILI, Inst. Biomédica de Investigação da Luz e
Imagem, Facul Medicina, Univ. Coimbra, Coimbra, Portugal.
L. Peralta is with Lab. de Instrumentação e Física Exp. de Partículas, Lisboa,
Portugal and also with Facul. de Ciências da Univ. de Lisboa, Portugal.
A. I. Santos is with Hospital Garcia de Orta, Almada, Portugal.
J. Varela is with Lab. de Instrumentação e Física Exp. de Partículas,
Lisboa, Portugal and also with CERN, Geneva, Switzerland (e-mail:
Joao.Varela@cern.ch. is).
Digital Object Identifier 10.1109/TNS.2006.870173
0018-9499/$20.00 © 2006 IEEE
71
by means of a detailed Monte Carlo simulation and an iterative
image reconstruction algorithm.
Index Terms—Avalanche photodiodes, biomedical imaging,
gamma-ray detectors, image reconstruction, positron emis-
sion mammography, positron emission tomography, simulation
software.
I. INTRODUCTION
B REAST cancer is reportedly among the deadliest. Studies
show that one out of every 8 women will develop breast
cancer along her lifetime [1]–[3]. In 85% to 90% of the cases,
the patient can fully recover if the cancer is detected in its early
stage. As a consequence, cancer early detection is recognized
worldwide as a priority in health care. Unfortunately the speci-
ficity of conventional X-ray mammography is rather low, typi-
cally 30% [4]. A large number of unnecessary biopsies or even
axillary dissections are therefore performed. On the other hand,
X-ray detection sensitivity is compromised in the case of dense
breasts, where it is difficult to distinguish between the tumor and
the normal tissues. Therefore, new diagnosis processes and sys-
tems for breast cancer are object of heavy research efforts. One
such research line relies on the use of Positron Emission based
technology [5]–[15]. This is the case of the development of the
Clear-PEM scanner, a high-resolution positron emission mam-
mography (PEM) system, which aims the detection of tumors
with diameters down to 2 mm [16], [17].
Early stage breast cancer detection can be performed through
functional imaging, where a localized increase of metabolic
activity in breast tissue may indicate the presence of a neo-
plasm before the morphological changes detectable by standard
mammography techniques take place. Because of the small
dimensions of these lesions, a few millimeters in diameter, a
detector system for such application must have high sensitivity
and good spatial resolution. Such requirements can be fulfilled
by a new generation of dedicated positron emission scanners,
which combine high-Z crystals, compact photo-detectors, large
angular acceptance, depth-of-interaction (DoI) measurement
capability and efficient data acquisition systems.
In this paper, the Clear-PEM prototype for positron emission
mammography is presented. Focus is given to the system
design, experimental validation of the detection techniques and
system performance indicators for different exam scenarios.
72 IEEE TRANSACTIONS ON NUCLEAR SCIENCE, VOL. 53, NO. 1, FEBRUARY 2006

The design of the Clear-PEM positron emission mammography

camera relies on critical assumptions and technical devel-
opments that need to be validated in order to guarantee that
the final scanner has the expected performance. This was the
purpose of the work described in this paper, which is comple-
mented by more detailed work on the Clear-PEM electronics
systems and image reconstruction algorithms reported else-
where [18], [19].

II. DESIGN PRINCIPLES

The Clear-PEM scanner is being developed with three
main guidelines: low background, minimizing the fraction of
random coincidences under a high flux of single photons (up to
10 MHz); high sensitivity; and spatial resolution down to 2 mm.
The first requirement arises from the fact that in this type
of exams 99% of the injected dose is located outside the
FoV. As a result, the scanner must cope with a large single
photon rate which imposes the use of fast radiation sensors and
readout electronics, capable of achieving high-resolution time
measurements.
High sensitivity means less injected dose or faster exams. In
order to accomplish this requirement the Clear-PEM imaging
system uses high-Z scintillation crystals and exploits both
photoelectric and Compton interactions in the detector im-
proving substantially the detection sensitivity. In the case of
Compton events, the reconstruction of the scattering topology
is required in order to not degrade the spatial resolution. The
trigger and data acquisition system is able to process and
acquire two-hit interactions in the detector head, corresponding
to Compton diffusion followed by photoelectric absorption,
which are reconstructed using the energy and coordinates of
the measured hits. Finally, in order to deliver the required
2 mm spatial resolution after reconstruction, without com-
promising the sensitivity allowed by large angular acceptance
and long crystals, the detectors should be able to measure the
depth-of-interaction of the incoming photons [20].
III. SYSTEM DESCRIPTION
A. Detector Heads
Clear-PEM has two parallel detector heads each one
holding 96 detector modules. Each module is composed by a
4 8 LYSO:Ce crystal array. The crystals have dimensions
2 2 20 mm and are optically isolated by a Tyvek reflector
of thickness 250 m. Each side of the crystal matrix is optically
coupled to a 32-pixel Hamamatsu S8550 APD array for DoI
measurement. The components of a detector module are housed
and sealed in a dedicated plastic mechanical assembly with a
precision of 0.1 mm. Each module has external dimensions
of 12 20 35 mm and shows a 40-pin connector in each
side. Twenty-four detector modules are mechanically fixed
and electrically connected to front and back electronics PCB’s
forming a supermodule, in a 2 12 arrangement covering
an area of 4 14 cm . Four supermodules are mounted in a
detector head. The packaging fraction for the detector is of
the order of 52%, covering a 16.5 14.5 cm field-of-view.
A schematic representation of one detector module in its final
arrangement is shown in Fig. 1.
Fig. 1. Mechanics of the Clear-PEM detector module.
B. Electronics Systems
Low-noise integrated electronics mounted on the detector
PCB’s provide signal amplification and analog multiplexing
based on a new data-driven architecture, for the 12 288 APD
output channels. The front-end amplifier is specified for a
peaking time of 30 ns and an equivalent noise charge (ENC)
smaller than 1 000 electrons r.m.s., compatible with a time
resolution better than 1 ns. The front-end chip under develop-
ment integrates 192 channels, matching one side of six detector
modules. The chip selects one or two channels above threshold,
allowing off-line exploitation of two-hit Compton events.
Sampling ADCs running at 100 MHz provide input digital data
streams to the off-detector trigger system which is implemented
in a set of boards housed in a 6 U crate. Two types of electronic
boards are used, namely the Data Acquisition Boards and the
Trigger and Data Concentrator Board. DAQ Boards perform
pipeline data storage and parallel algorithmic processing (in
order to minimize dead time) to extract the amplitude and time
of the detector pulses. Potentially interesting information is
transmitted to the Trigger and Data Concentrator Board. This
board selects events in coincidence and interfaces to the data
acquisition computer [18].
C. Mechanical Systems
The Clear-PEM mechanical system is being designed to allow
the exam of both the breast and the auxiliary lymph nodes. The
system will be used in conjunction with a shielded examina-
tion table that enables exams to be performed with the patient
kept in prone position. Configurable openings in the examina-
tion table allow the exam of both breasts with the detector heads
positioned in each side of the breast (standard exam)—Fig. 2.
During the exam the detector heads can rotate around the de-
tector main axis in order to collect data at several angular orien-
tations as required for tomographic reconstruction.
The examinations of the breast region close to the chest and
of the axilla region are performed in a front-back configuration.
In these exams one detector head is facing the breast (comple-
mentary exam) or the shoulder (axilla exam) under the scanner
table and the other is positioned against the patient back—Fig. 2.
Small angle projections can also be obtained in the front-back
configurations. The position of the detector heads as well as their
separation can be adjusted to fit the anatomical region under
analysis.
ABREU et al.: DESIGN AND EVALUATION OF THE CLEAR-PEM SCANNER 73

Fig. 2. Configurations of the mechanical system and the analogous simulation models (scanner and NCAT phantom [34]) for breast exam (top) and for the
2
front-back configurations (complementary breast exams and axilla) (bottom). The table dimensions are 2000 700 mm and its height (exam position) is 1400 mm.

IV. DETECTOR PERFORMANCE

A. Experimental Methods
The depth-of-interaction in LYSO:Ce crystals has been eval-
uated by measuring the light at both ends of 2 2 20 mm
crystals with different surface roughness (polished, slightly pol-
ished and very rough, obtained with mechanical polishing) and
wrappings (Tyvek and PTFE). Each crystal under test was sand-
wiched between two photomultiplier (PM) tubes and irradiated
at different depths with a 3.33 MBq (90 Ci) Na radioac-
tive source with 1 mm extension. A third PM tube coupled to
a NaI:Tl scintillator of 3.8 cm diameter was aligned with the
source and perpendicular to the crystal longest axis for elec-
tronic collimation coincidence purposes, such that a gamma spot
with about 1 mm diameter was obtained on the LYSO crystal.
The coincidence window between the three PM’s signals was
150 ns. The asymmetry of the light sharing was estimated on
an event-by-event basis, and its dependence with the coordinate
along the crystal axis where the photon interacts was studied in
detail. The purpose of this DoI study was the optimization of the
light collection system (crystal surface treatment, light reflector
properties and geometry, optical coupling to crystal ends). For
this reason we have used photomultipliers which provide a much
higher gain than APDs, allowing to decouple the light collection
study from the electronics processing of very small pulses.
A setup for characterizing the Clear-PEM detector mod-
ules was also assembled. This setup consists of a LYSO:Ce
matrix composed of 32 individual 2 2 20 mm crystals
wrapped in 250 m thick Tyvek, all of them optically cou-
pled to Hamamatsu S8550 APD matrices, read by discrete
front-end electronics based on Cremat CR-101D pre-amplifiers
and a VME-based data acquisition system with multichannel
peak-sensing ADCs. The temperature dependence of the ra-
diation sensors was evaluated from 11 C to 43 C with single
APD readout (light collection only at one top of the LYSO:Ce
matrix, the other covered by a 500 m thick PTFE reflector).
Fig. 3. Asymmetry between light collected in the two crystal extremities for
two LYSO:Ce crystals, one polished and the other very rough, wrapped in
Tyvek (bars represent the FWHM of the asymmetry distributions). Asymmetry
is defined as the difference of signal amplitude at the two crystal extremities
[referred as top (t) and bottom (b)], divided by the sum, in percent.
B. Results
Results from DoI measurements of two crystals in Fig. 3 show
a linear correlation between the collected light asymmetry at
both ends of the crystal and the depth-of-interaction, for Tyvek
wrapping and two different crystal polishings. The distributions
of light asymmetry at different depths for the very rough crystal
are shown in Fig. 4. The total light yield and the gradient of the
light asymmetry depend strongly on the optical properties of the
crystal surfaces. The spatial resolution (FWHM not deconvo-
luted by the beam spot size), the total light yield and the energy
resolution at total energy sum of 511 keV, at the center and at
2 mm from the crystal extremity, and for different optical con-
figurations, are shown in Table I, averaged over three crystals in
each case. DoI resolutions of the order of 2 mm were obtained
irrespective of the coordinate of the interaction point along the
crystal. This is a consequence of observed linearity between po-
sition and light asymmetry. The energy estimated from the sum
74
Fig. 4. The distributions of light asymmetry for different photon interaction
coordinates along the crystal, for one very rough crystal. The crystal center is
at 0 mm.
of the two outputs has a resolution that is not very sensitive to
the crystal surface treatment. We found that slightly polished
crystals give a reasonable compromise between light yield and
DoI performance.
These results are in general agreement with previous DoI
measurements using double crystal readout [21], [22]. However,
the light asymmetry is strongly dependent on the precise light
collection system being used, preventing direct comparisons.
The present measurements allowed to validate our light collec-
tion design, however measurements with double APD readout
are still needed to demonstrate that the optical coupling to a dif-
ferent photosensor does not affect the observed trend.
Measurements made with the detector module, confirmed
the expected behavior of the LYSO:Ce crystals coupled to the
S8550 APD arrays [23]–[27]. In single readout mode, a energy
resolution of 13% FWHM at the 511 keV photopeak was ob-
served with a flood irradiation. Regarding the detector behavior
with respect to temperature, results show an improvement by
a factor 1.9 in signal amplitude for the detection of 511 keV
photons when cooling down from 39 to 20 C (see Fig. 5)
and a noise reduction of about 30%. Cooling down to 11 C
has shown improvements following the above trends (signal
amplitude increasing by a factor 1.5 with respect to opera-
tion at 20 C). However the technological difficulties arising
from implementing such stabilized temperatures ( C)
inside the compact detector heads called for a compromise
between detector performance and simplified cooling. An op-
erating temperature of 20 C was consequently chosen and the
cooling system for the Clear-PEM scanner is presently under
development.
V. SYSTEM PERFORMANCE
A. Methods
The performance of the Clear-PEM scanner was assessed
using simulated detector data and an iterative image reconstruc-
tion method. The Geant4 Monte Carlo code has been the basis
of Clear-PEM detector simulation [28]. This has allowed to de-
velop a simulation tool able to reproduce in a realistic way the
conditions of a typical breast exam with the Clear-PEM imaging
IEEE TRANSACTIONS ON NUCLEAR SCIENCE, VOL. 53, NO. 1, FEBRUARY 2006
TABLE I
DoI RESOLUTION (FWHM), RELATIVE LIGHT YIELD (LY) AND ENERGY
RESOLUTION FOR MIDDLE POSITION AND NEAR LYSO:Ce CRYSTAL TOPS
Fig. 5. Signal amplitude as a function of APD temperature at different energies
(operation at 370 V bias voltage for a gain M  50).
system. It includes a patient model to simulate the radiation en-
vironment produced by FDG uptake in the different organs, a
detailed description of the detector geometry and a digitization
module for front-end electronics, trigger and data filtering al-
gorithms simulation. The geometry and material properties of
the Clear-PEM scanner includes APDs, external housing, op-
tical coupling, crystals wrapping and front-end electronic com-
ponents ( k volumes). The deposited energy in each crystal
was used as input for the digitization simulator [29]. Main func-
tional blocks includes the translation of the detector hits infor-
mation into a parameterized pulse shape, reproduction of the
photo-detector and front-end electronics chain (crystals, APDs,
amplifiers, multiplexing, and analogue-digital conversion), sim-
ulation of data filtering algorithms implemented in FPGA’s and
trigger logic for each valid dataframe as well as the simulation
of the binary datastream output. An energy threshold of 350 keV
and a 4 ns coincidence window were considered throughout data
analysis.
The library STIR—Software for Tomographic Image Re-
construction [30] was used as the basis for the 3-D image
reconstruction tools. STIR is an open source reconstruction
library which efficiently deals with 3-D PET data sets. As it
was originally designed for cylindrical scanners, modifications
were introduced, allowing for the reconstruction of Clear-PEM
images. These modifications included modules for describing
and dealing with the planar scanner projection data and mod-
ules for the adequate projection operators. Throughout the
studies, simulated data was reconstructed with the 3-D-OSEM
algorithm [31] available in STIR.
ABREU et al.: DESIGN AND EVALUATION OF THE CLEAR-PEM SCANNER
Fig. 6. Reconstructed transaxial central plane image of a simulated phantom
containing seven point sources placed in a 3-D cross formation, along the three
coordinate axis. The off-center sources are at distance 2.5 cm from the center.
The two sources not seen in the image are located in the axis perpendicular to
the image plane.
Fig. 7. Profile along a vertical line passing through the center of the transaxial
central plane in the reconstructed image. The pixel size is 1.2 mm.
B. Results
1) Spatial Resolution: In order to measure spatial reso-
lution, a phantom containing seven point sources placed in
a 3-D cross formation was simulated in air without activity
background or positron range. DoI coordinate included a
2 mm FWHM uncertainty. The reconstruction volume had
111 111 127 voxels and the voxel size was 1.2 1.2
1.2 mm . Two perpendicular heads position were considered
for the detector heads.
Figs. 6 and 7 show the transaxial central plane of the phantom
image at EM iteration number 10 and the profile taken along
a vertical line through the center of that plane. Profiles were
taken along the central axis and include the central and two off-
central point sources. After 10 EM iterations, the central point
source presents a resolution of 1.4 mm FWHM (transaxial and
axial resolution). A point source placed 2.5 cm apart from the
FoV center presents transaxial and axial FWHM resolutions of
1.7 mm and 2.6 mm, respectively. These values depend on future
validation of DoI resolution with APDs.
2) Detection Sensitivity: For evaluation of the detection sen-
sitivity, a point source emitting back-to-back 511 keV photons
in air was positioned along two of the detector axis. The sen-
sitivity profiles for different heads separation distances along
the detector axis in the center plane of the FoV are shown in
Fig. 8. The peak sensitivity values for the four separation dis-
75
Fig. 8. Sensitivity profiles along one of the detector axis in the central plane
of the FoV for different heads distances.
Fig. 9. Sensitivity profile along the detector’s separation axis classified
into photoelectric-photoelectric (PE-PE), photoelectric-Compton (PE-C), and
Compton-Compton (C-C) topologies for a fixed distance of 10 cm and a
sensitivity profile for an axilla-like exam scenario.
tances were found to be 10.7% (5 cm), 6.6% (10 cm), 4.4%
(15 cm), and 3.2% (20 cm). The observed fluctuations in the
sensitivity profiles are due to the dead-spaces in the detector
geometry.
Sensitivity profiles along the detector’s separation axis clas-
sified into different event coincidences topologies are shown in
Fig. 9. A two-fold increase in the detection sensitivity of the
system is expected, using an off-line algorithm for reconstruc-
tion of Compton events which preserves the spatial resolution.
For events with more than one active crystal (hit) in a detector
plate, the algorithm makes use of the DoI coordinates and hit
energies to reconstruct the Compton diffusion and to estimated
the first interaction crystal [32], [33]. Also shown in Fig. 9 is
the scanner sensitivity for a radioisotope source located inside a
14 cm thick tissue and bone phantom. This configuration is sim-
ilar to the expected scenario of axilla examination and shows a
maximum sensitivity of 1.8%. This value combines the effect
of a reduction in the solid angular coverage and additional pres-
ence of in-object Compton scattering.
3) Count-Rate Performance: The count-rate performance of
Clear-PEM system was evaluated using Monte Carlo simula-
tion in realistic operational conditions. That means to account
76
for the presence of background activity from adjacent organs
to the breast due to normal radiotracer uptake and not only
from the object under imaging. This radiation is responsible for
background events (random coincidences) that affect the recon-
structed image quality. Three possible exam configurations were
under study: the standard exam covering almost all the mam-
mary gland, the complementary breast exam in order to improve
lesion detectability in the breast region close to the chest and the
axilla and surrounding regions covering the lymph node area.
The NURBS Cardiac Torso (NCAT) phantom [34], [35]
was implemented in the simulation framework to generate
the 18F-fluorodeoxyglucose (FDG) activity distribution of the
different organs. The FDG radiotracer concentrations were
computed from average standardized uptake values measured
one hour after the injection of 300–370 MBq. Activity con-
centration of soft tissue: liver: myocardium: blood pool: lungs
was considered to be with a
concentration of 2.12 kBq/cc for the soft tissue [36]. For the
breast a conservative activity of 2.12 kBq/cc was assumed [37].
The phantom has a total of 128 128 128 voxels with a
resolution of about 3.5 mm . The number of radioactive decays
in each voxel is proportional to the activity concentration of the
organ it belongs. Each voxel is indexed to an organ density and
chemical composition extracted from ICRU annual report [38].
In order to reduce the background coming from outside the
detector’s field-of-view, the phantom was shielded by a 7 mm
thick 50 50 cm lead plate with 20 20 cm aperture for the
breast. The final setups are shown in Fig. 2 for the standard and
front-back configurations. For comparison purposes a math-
ematical anthropomorphic phantom (MIRD) where the main
organs were represented by geometric shapes with approxi-
mated volumes of a female adult was also implemented [39].
The relevant bones for lymph node examination (ribs, scapulae
and spine) were considered and detector heads positioned in
the front-back configuration. Count rates were assessed along
the trunk, particularly at the shoulder region.
Exam scenarios for each configuration (standard, comple-
mentary, and axilla) representative of possible exam conditions
were chosen. For the standard exam the breast volume was
1200 cm . In the first exam scenario no breast compression was
assumed and the detector heads separation distance was kept at
13 cm. In the second scenario a mild breast compression was
applied allowing a 10 cm separation between detector heads.
In the first scenario established for the complementary config-
uration, the patient was kept in prone position with the breast
hanging through the examination table hole and the heads
adjusted to 45 cm. In the second scenario the hole was covered
with a plastic layer in order to keep the breast above the scanner
table allowing for a shorter distance between heads of 37 cm.
In the axilla exam the detector heads were positioned 16 cm
apart. and random rates after data acquisition
and trigger simulation [18] are shown in Table II. Random
coincidences for the standard exam were weighted by a factor
defined as the fraction of random coincidences lying within the
breast, determined by Monte Carlo simulation.
The breast compression scenario is the most favorable
case with a coincidences ratio
of 19% and a coincidence rate of
IEEE TRANSACTIONS ON NUCLEAR SCIENCE, VOL. 53, NO. 1, FEBRUARY 2006
TABLE II
TRUE + SCATTER AND RANDOM COUNT RATES AFTER DATA ACQUISITION
AND TRIGGER/DAQ SIMULATION FOR THE EVALUATED EXAM SCENARIOS
about 16 kHz. This rate increases up to 40 kHz for the highest
breast uptakes described in the medical literature (4.8 kBq/cc)
[36]. Regarding the complementary exams, simulation results
indicate the second scenario (37 cm head separation) as the most
favorable with a rate of 11 kHz and a
ratio of the order of 35 %. However it is evident that small
angle projections for tomographic image reconstruction will be
more difficult to obtain. A maximum rate of 1.9 MHz/detector
head for single events above 15 keV for the standard exam
and 3.0 MHz/detector head for the complementary exam were
found. The counting rate due to Lu natural radiation for the
same threshold was estimated at 60 kHz per detector head [40].
Results obtained with the MIRD phantom for the shoulder
region indicate a rate of 42 kHz and a
ratio of 66%, while the single photon flux is 5.5 MHz/detector
head. The increase of rate, ratio and
single photon flux are due to the smaller separation between
detector heads in comparison with the complementary breast
exam scenarios.
VI. CONCLUSION
We have shown experimentally that a detector module based
on double crystal readout has adequate performance, achieving
in particular a measurement of the photon interaction point
along the crystal length with a precision smaller than 2 mm.
Provided it is confirmed with APDs, this DoI performance
provides a clear advantage for a planar camera combining
high spatial resolution with high counting sensitivity. We have
implemented a very detailed Geant4 simulation of the detector
geometry and properties, complemented by a dedicated sim-
ulation of the front-end electronics, trigger and data filtering
algorithms that were used in conjunction with a realistic
anthropomorphic phantom of the torso and breast volumes.
These tools allowed reproducing as accurately as possible the
conditions of realistic exams of the breast and axilla region. At
this point of the investigation the following statements can be
made: 1) the spatial resolution of a reconstructed point source
is 1.4 mm at the center of the FoV, and 1.7 mm (transaxial) and
2.6 mm (axial) at 2.5 cm from the center, for a DoI uncertainty
of 2 mm; 2) despite the low FDG uptake in the breast, the
counting sensitivity is sufficient to detect about 160 counts per
minute from a tumor of 8 mm located in the center of the FoV,
assuming a ratio lesion/tissue of 4; 3) the fraction of random
coincidences due to background radiation from the body is
below 25%, in standard breast exams, and below 40% to 66%
in front-back breast and axilla exams, respectively.
Experimental work is now under way to validate the final de-
tector module with double APD readout and to test the front-end
ABREU et al.: DESIGN AND EVALUATION OF THE CLEAR-PEM SCANNER
and data acquisition electronics. In parallel, extensive simula-
tions of realistic breast phantoms and lesions are being per-
formed allowing beforehand the tuning of the reconstruction al-
gorithms and the assessment of lesion detectability in breast and
axilla exams.
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