6-1. What is Positron Emission Tomography ?

PET
Positron Emission tomography: Injection of positron
measured are x-rays emitted by emitter (tracer)
annihilation of positrons -

emitted by exogenous substance

(tracer) in body
Two issues:
The principle is as emission
tomography, but there is one major 1. How to determine directionality of x-rays ?
difference (see later) 2. Absorption is undesirable

Most widely used tracer for PET

18Fluoro-deoxy-glucose

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 What does one want to measure with PET ?
Annihilation photons

Question: Why are two photons are produced?

Conservation of linear momentum is not possible with
one photon (p=E/c) → 2 photons

-
Energie of photons ?
+ hν=mec2=511keV
(1eV = 1.6·10-19 J)
p→n

n
Unstable
parent
p
nucleus

Annihilation coincidence detection :

two events detected at same time
NB. Light travels 1m in 3ns : → annihilation event along a line (defined by detector)
1[m]/3 108 [m/s]=3ns ⇒ NO need for a collimator
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 What is coincidence detection ?
electronic collimation (i.e. w/o physical collimators)
Electronic signal What defines simultaneity (coincidence) ?

Crystal Photomultiplier

Leading edge defines time of detection

(sharper, i.e. higher 1st derivative)
Bi4Ge3O12 (BGO): τ~10ns.
Position logic electronics

PET-camera
Photomultipliers

Light guide
Scintillating crystal
Collimator

Elimination of collimator material is a major

source of sensitivity increase (why?)
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 6-2. What is really measured with PET ?

bb
Random coincidences

True coincidence

aa Scattered coincidence

Trues

Yab = Nab (AabTab + Sab + Rab )

What is measured Normalization

Scatter
(Instrument imperfection) Attenuation Randoms 6-8
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 Why are Random and Scattered Events bad?
mimic a true coincidence
Random Scatter
emissions from unrelated nuclear transformations At least one annihilation photon is (Compton)
interact simultaneously with the detectors scattered

Erroneous Line of incidence (LOI)

⇒ assignment to wrong Radon transform

Rate of random coincidences :

Rrand = 2τS1S 2
S1 and S2 : count rates on the individual
detectors (singles rates)
τ : separation of singles (=coincidence time)
Reduce randoms by reducing τ Does not work for scattered
(coincidence interval) events (why?)
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 How can scattered events be distinguished from true coincidence ?
Energy discrimination & background subtraction

Measure Ef → identify severely scattered photons

ENERGY WINDOW 511 keV photons
ENERGY
WINDOW

Emission Transmission Some crystals

Scatter
BGO (BGO) only allow

Counts
30% energy
LSO discrimination
Other
350 – 650
Scatter Corrected 425 – 650
approaches
Most scattering is by Compton 0 100 200 300 400 500 600 700 Energy (keV)
are needed:

Ei 2 Subtract background (= scatter + randoms)

Ef = m−e c θ measured in signal void regions → polynomial interpolation
Ef =1 + Ei
(1 cos )
2 − mcosec
2
i θ
theta/Ei 511 (keV)
2000
20 482
45 395
90 256
110 218
180 170 6-10
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 6-3. How is attenuation correction performed ?
simpler for PET than SPECT

Probability P1:
S1=CT(x)*e-µ(d-x)
CT*(x) ⇒ P1=S1/CT*(x)

Probability P2:
S2 = CT*(x)e-µx ⇒ P2=S2/CT*(x)
Attenuation :
Probability of detecting the photon pair

S = CT ( x)e − µd
*
P1 P2 = e − µx e − µ (d − x )
*
S = P1 ⋅ P2 ⋅ CT
Compare to geometric average of SPECT (Lesson 5) uncorrected corrected 6-11
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 What are the steps in Attenuation Correction for PET ?

Mass attenuation coefficient µ/ρ in soft PET imaging of the body

tissue = 0.095cm2/g (511keV)
HVL = 0.693/μ HVL≅7cm
Average path length for the photon pair
longer than for a single photon
different lines of response attenuate to
varying degrees

Attenuation correction in practice:

Spatially uniform attenuation coefficient
assumed More attenuation (x4) Less attenuation
Transmission technique using e.g. Cs source
(662keV, why is this good enough ?)
e∫
− µ ( x ) dx
single photon emitter
Comparison with blank
scan
− µd (ϕ )
i.e. subject removed e
Correction factor for each
L Radon transform
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 Why is PET/CT the industry standard ?
PET-Attenuation correction using CT-Data
µ/ρ
(cm/g)
0.3
CT + PET = PET/CT
CT ~70 keV

0.2
Bone

0.1 Soft tissue PET 511 keV

0
0 100 200 300 400 500
Energy (keV) PET/CT: Two separate scanners in
one package

Bone

511 keV CT PET

CT

scatter &
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Soft tissue
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 6-4. Why is Resolution never perfect ?
Annihilation Range and photon non-collinearity

Collinearity: Assumed for Reconstruction

Background: At time of annihilation, e-p pair has
non-zero kinetic energy
→ conservation of momentum

Photon momentum w/zero momentum e-p

Range: limits spatial resolution pe+pp

(In air, β+ range ~ several m) nucleus
β+
Isotope Half-life Max. Energy Range in H2O
e- θ ~ 0.25° } ∆x
(min) (MeV) (FWHM, mm)
18F 110 0.6 1 511 keV 511 keV
11C 21 1.0 1.2
15O D (detector distance)
2 1.7 1.5
13N
D (cm) ∆x (mm)
10 1.2 1.4
∆x = 0.5 D tan(0.25°) 60 1.3
68Ga 68 1.9 1.7
80 1.7
82Rb 1 3.2 1.7 100 2.2

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 How does the detector affect PET spatial resolution ?

Example: BGO Block Detector Photomultiplier tube

Coincidence window: 12 ns
Energy resolution: ~ 25%

True coincidence count rate RT 3 cm

RT=2C*TGε2 scintillator
1. CT* - tissue activity of a voxel
2. ε : the intrinsic detector efficiency (1-e-µx) Crystal thickness
3. G : the geometric efficiency (solid angle
defined by the detector surface/4π).
NB. ε = 0.9→ 81% of photon pairs emitted
towards detectors produce coincidence Resolution
is best at
the center
This is a reason for the 3cm thick
crystals used for PET detection.

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 6-5. What are typical PET tracers ?
Oncology and neuroscience

Oncology
18Fluoroethyl-Tyrosine (FET) Amino acid transport
Deoxy-18fluoro-thymidine (FLT) Proliferation
18Fluoromisonidazole (FMISO) Hypoxia
11C-Methionine
Amino acid transport and metabolism
H215O Blood flow
18Fluoro-Deoxyglucose (FDG)
Glucose metabolism
18FDOPA Presynaptic dopaminergic function
15O-Butanol Blood Flow
11C-Flumazenil Benzodiazepine-receptor mapping

Neuroscience

FDG or
F18 fluorodeoxyglucose O15 Water
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 X-ray imaging modalities. Overview
CT, SPECT, PET
Measurement of signal integrated along line of Apply correction to
incidence (LOI) measured Radon transform
(Radon transform)
(attenuation, scatter, etc.)
1.CT: attenuated incident x-ray beam
(direction of beam given by source) Backprojection or
2.SPECT: emitted single photon central slice theorem:
(need collimation to determine ray direction)
3.PET: annihilation photon pair Finally an image!
(directionality by electronic collimation)
CT SPECT PET
Projection Encoding Defined by incident x-ray Collimator essential Coincidence detection
(collimation to reduce scatter) (electronic collimation)

Spatial Resolution 100µm-mm Typical 10mm 4.5-5mm at center

(Variable and complex)
(rodent) (µm) (1.5-3 mm) (1mm)
Attenuation = measurement variable Complex correction Accurate correction
(Varies with energy) (Varies with photon (transmission method)
energy)
Radionuclides None Any with hν= 60- Positron emitters only
(contrast agents) 200keV

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