Topics: Introduction To PET Physics

CT-PET calibration : physical principles
and operating procedures
Faustino Bonutti – Ph.D.

Medical Physics, Udine University Hospital
ICTP-AIEA Advanced school on internal dosimetry for medical physicists – 12-16 April 2010 CT-PET calibration : physical principles and operating procedures – F.Bonutti
Topics
Introduction to PET physics
• F-18 production
• β+ decay and annichilation process
• γ γ coincidence detection
• true, random and scatter coincidences
• the NECR, image quality VS patient dose
PET calibration and QC procedures

• the sinogram
• normalization and ECF calibration
• daily QC
• uniformity, sensitivity
PET
POSITRON
EMISSION
TOMOGRAPHY
Positron
The positron (e+) is emitted in the β+ decay process:
p n + e+ + ν e
The β+ decay is forbidden for a free proton. The

process must occur in a nucleus:
(A,Z) (A,Z-1) + e+ + νe
For example:
18F 18O + e+ + νe
Emission
Emission (tomography) : the source γ

of radiation is inside the patient: γ
Transmission (tomography) : the

source of radiation is outside the x-ray
patient:
Tomography
Tómos = from Greek = (cross-) section
Material from “IAEA Educational Course Radiation Protection in Nuclear Medicine”
Intro to PET physics
How the F-18 is produced?
-
H acceleration inside the
H- cyclotron (spiral trajectory)
stripping
e-
e-
p+ e-
e- H+
e- e-
p+ p+ proton beam
Carbon foil
p + 18O n + 18F

FDG synthesis
FDG
Main applications:
• Oncology (cancer
detection and staging)
• Cardiology
• Neurology
FDG administration
uptake time

β+ decays and annnihilation process
18F 18O + e+ + νe
γ (511 keV)
e+e-
γ (511 keV)
e+
e+ range in the patient tissues
+
Radioisotope e Range (mm)
15
O 8.4
13
N 5.4
11
C 4.2
18
F 2.6

e + Emax e + Emean e + Range
Radioisotope T1/2 (min) Decay
(keV) (keV) (mm)
15
O 1720 740 2.07 8.4 100% β+
13
N 1190 490 9.96 5.4 100% β+
11
C 970 390 20.4 4.2 99% β+
18
F 635 250 110 2.6 97% β+, 3% E.C.
Fermi’s Golden Rule

2π 2 dn f
pi → f = ⋅ M if ⋅
i〉 → f 〉 h dE
Transition matrix density of final states

(dynamics) (phase space)
e+e- annnihilation process and γ γ coincidence detection
TRUE COINCIDENCE
useful for the image
reconstruction
γ
annihilation
LOR γ
constant fraction constant fraction

discriminator discriminator
coincidence
window
(6 ns)
SCALER

True, random and scatter coincidences
TRUE COINCIDENCE RANDOM COINCIDENCE
useful for the image generated from two uncorrelated
reconstruction events of annihilation
γ
annihilation
LOR γ
wrong LOR
constant fraction constant fraction

discriminator discriminator
SCATTERING COINCIDENCE
one (or both) of the two 512 keV
photon is scattered by the patient
Compton
scattering
coincidence
window
(6 ns)
annihilation
wrong LOR
SCALER
True, random and scatter coincidences
Cylindrical phantom
water + F-18 filled
LSO CT-PET Biograph Pico3D
2.00E+0
6
1.80E+0
6
1.60E+0
6
1.40E+0
TOTAL
6
1.20E+0 TRUE
cps 6
1.00E+0 SCATTER
6 RANDOMS
8.00E+0
5 NECR
6.00E+0
5
4.00E+0
5
2.00E+0
5
0.00E+0
0 0.00 5.00 10.00 15.00 20.00 25.00
activity (mCi)

Random coincidences : RANDOM COINCIDENCE
they don’t contribute to image

they increase the noise
20 – 50 % of true coincidences
wrong LOR
How to reduce them? CR = 2 τ CS 2
smaller coincidence window

less activity
How to take into account?
delayed window method

SCATTERING COINCIDENCE
Scatter coincidences : Compton

scattering
don’t contribute to image annihilation

in the human thorax, 50% or more of wrong LOR
the measured data may be scattered.
reduce the contrast
How to reduce them?
2D instead of 3D
less activity
How to take into account?
scatter modelling and compensation algorithms


Conventional Nuclear Medicine (planar, SPECT)
N
SNR ≅ = N
N
NECR T
Positron Emission Tomography =
NECR T + S + 2R
TRUE EVENTS contribute to RANDOM AND SCATTERING
SIGNAL and NOISE EVENTS contribute only to NOISE
T2
NECR =
er
TRU
E scatt
from fr om
goo
d L
OR
wro
ng
LOR
T + S + 2R
random
wrong LOR from
T
SNR =
T + S + 2R
PET phantom for IQ
IMAGE QUALITY NECR
30
25
20
NEC [kcps]
20mCi inj.
10mCi inj.
15
10
0
. 0 5 10 15 20 25 30 35 40
(courtesy of CPS Innovation /Siemens) Activity [kBq/mL]

1°
TRUE + SCATTER
patients with: [52-62] kg weight and RANDOM
[155-170 cm] height
* PNECR 2°
2.50E+05
3°
2.00E+05
1.50E+05 4°
PNECR-MAX
1.00E+05
5°
5.00E+04
6°
0.00E+00
0.00E+00 5.00E+06 1.00E+07 1.50E+07 2.00E+07 2.50E+07
7°
singles rate (cps)
“COUNT-RATE ANALYSIS FROM CLINICAL SCANS IN PET WITH LSO DETECTORS”

F. Bonutti et al, Radiation Protection Dosimetry, (2008)
200 80
70
150 60
50 PNECR (SNR)
MISSING bed #
ACTIVITY = 70%
100
1
2
but: 40 IMPROVEMENT :
50 3
30 15-20%
4 20
(for central beds) 5
6 10
0 7
1 2 3 4 5 6 7
0 0.0
bed # 0 20 40 60 80 100
% PNECR i mprovement
Attenuation correction
Many true coincidences are lost because of
– scatter (Compton or Rayleigh interactions)
– absorption (photoelectric interaction)
Scattered but detected

⇒“scatter” contribution to data
tte r ⇒“attenuation” of the true LOR intensity
sca
R from
LO
ng
wro
Scattered and not detected

⇒“attenuation” of the true LOR intensity

How much is the attenuation ? I
2 I
@ 511 keV every 7.2 cm of water I 4
half radiation intensity is lost:
7.2 cm 7.2 cm
no AC AC
Ge68 phantom Ge68 phantom
CT-PET
- the emitter distribution is distorted.
- quantification is not possible (SUV)
- lung lesions may not be visible in uncorrected images

Attenuation factors range from < 5 in the brain to > 150 in the body.
In PET the attenuation doesn’t depend on the position of the source point along that LOR:
0 1 3 0 2 3
γ γ detection probability ~ γ γ detection probability ~
=
1 3 3 2 3 3
e ∫0
− µ ( l ) dl − ∫ µ ( l ) dl
= e ∫0
− µ ( l ) dl
e ∫0 e ∫1 = e ∫0
− µ ( l ) dl − µ ( l ) dl − µ ( l ) dl
e 2
CT-PET
Rescaling the attenuation coefficients µ with energy
0.3 Air Muscle Bone

µ/ρ
(cm2/g)
0.2
0.1
CT PET
0
0 100 200 300 400 500
Energy (keV)
The sinogram
sinogram LOR
rappresentation
400
350
300
source
250
phi
200
150
100
50
0
-1 -0.5 0 0.5 1
d
The normalization procedure Ge-68 phantom, 1÷2 mCi
BUCKET
BLOCK
Example : Siemens Biograph LSO Pico3D
number of elementary detectors :
(12 buckets) X (12 blocks) X (64 crystals)
= 9216
(courtesy of CPS Innovation /Siemens)
uniform phantom uniform phantom

sinogram for a sinogram for a
un-normalized normalized
system system
Calibration Factor (CF)
make possible quantifications (SUV)
Ge-68 phantom of known activity

concentration
CF
number of counts
inside voxel

ROI counts
ROI activity = x ECF
ROI 0.969
β+ p → n + e++ νe (branching ratio = 96.9 %)

18F → 18O + νe E.C. p+ e- → n + νe (branching ratio = 3.1 %)
ROI activity concentration

SUV =
ROI mean (body) activity concentration

ECF behavior (Emission Calibration Factor)
ECF behavior
3.00E+06
2.50E+06
2.00E+06
ECF
1.50E+06
1.00E+06
5.00E+05
0.00E+00
01/01/2004 31/12/2004 31/12/2005 31/12/2006 01/01/2008 31/12/2008 31/12/2009
time
(Siemens Biograph LSO Pico3D)
After normalization, the software gives the χ2

If you normalize the system every 1-2 months, typical χ2 are 0.5 ÷ 1.5
If you do it less frequently, the χ2 goes up
χ2 behavior
5
4.5
4
3.5
3
χ2 2.5
2
1.5
1
0.5
0
0 20 40 60 80 100
days
Optimal frequency may depend on the system

In our Departement we do normalization at least every 2 months
The need for normalization come out from the “daily QC” test
For this test, usually a Ge-68 cylindric phantom is used (1-2 mCi)
After the “daily QC” test, give a look to the sinograms :
SUV tests : with a single Ge-68 phantom

(we do it monthly)
CT PET
Ge-68
phantom
SUV tests : with two single Ge-68 phantom

(we do it every 6 months)
CT PET
new Ge-68 old Ge-68

phantom phantom
÷2 mCi
1÷ ÷0.5 mCi
0.3÷

LEO2
SUV tests : with two F-18 bottles min max averg
1.17 1.26 1.21
(we do it yearly) 0.60 0.68 0.64
tool "eliss oide"
1.17 1.26 1.21

tool "3D is ocontour"
0.61 0.68 0.64
Check the SUV results on the 1.13 1.26 1.20 tool "multiframe
polygon"
0.59 0.69 0.64
workstationsd using the different 1.16 1.28 1.22 tool "multiframe
contour"
0.59 0.69 0.64
available tools
LEO3
min max averg
CT PET 1.13 1.26 1.21
tool "eliss oide"
0.59 0.68 0.64
1.15 1.26 1.21
0.59 0.67 0.64
new F-18 old F-18 1.17 1.29 1.22 tool "multiframe
phantom phantom 0.59 0.69 0.64 polygon"
1.16 1.29 1.22 tool "multiframe
0.59 0.69 0.64 contour"
ESOFT
÷2 mCi
1÷ ÷0.5 mCi
0.3÷ min max averg
1.13 1.26 1.20
tool "eliss oide"
0.59 0.67 0.64
1.20 1.26 1.22
0.59 0.66 0.65
0.59 0.68 0.64 polygon"
0.60 0.69 0.65 contour"
Uniformity test : with Ge-68 phantom
Uniformity Specification (from

CPS/Siemens standards):
The measured volume RMS
variation will be < 10%
NEMA : NUvol < 15%

Sensitvity test : with Ge-68 phantom
Sensitivity Specification (from

CPS/Siemens standards):
The measured system

sensitivity will be
> 725000 counts/sec/µCi/ml
NEMA : Smeas > 95% Sref
CT calibration and QC procedures
Daily :
• X-ray tube check-up and calibration
Every 3 months :
• Noise, constancy and uniformity of CT numbers
• CT numbers linearity, contrast scale
• High and low contrast spatial resolution
• Slice thickness
• Table accuracy movement
• Laser alignement
Every 6 months :
• Dose (in head and body CT phantoms)
CT-PET calibration and QC procedures

Yearly : attenuation correction check
Ge-68, no AC Ge-68, AC
S.D. average avedev

5.00 167.47 2.99
CT-PET calibration and QC procedures
Yearly : CT-PET co-registration check
PET/CT UDINE SCAN PROTOCOL
Survey CT
CT PET
62 mAs; 130 kVp
X-Ray
FUSION
scatter correction
attenuation correction
CT PET
WB PET: 20 min
370 MBq
Γ
γ
γΓ
e+ e-
Annihilation
Fused PET/CT
PET

Topics: Introduction To PET Physics

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CT-PET calibration : physical principles

and operating procedures

Faustino Bonutti – Ph.D.

PET calibration and QC procedures

The β+ decay is forbidden for a free proton. The

Emission (tomography) : the source γ

Transmission (tomography) : the

Tómos = from Greek = (cross-) section

Material from “IAEA Educational Course Radiation Protection in Nuclear Medicine”

Intro to PET physics

Intro to PET physics

Intro to PET physics

Fermi’s Golden Rule

Transition matrix density of final states

constant fraction constant fraction

Intro to PET physics

constant fraction constant fraction

Intro to PET physics

they don’t contribute to image

How to reduce them? CR = 2 τ CS 2

smaller coincidence window

How to take into account?

delayed window method

Scatter coincidences : Compton

don’t contribute to image annihilation

How to reduce them?

How to take into account?

scatter modelling and compensation algorithms

Intro to PET physics

Intro to PET physics

“COUNT-RATE ANALYSIS FROM CLINICAL SCANS IN PET WITH LSO DETECTORS”

Scattered but detected

Scattered and not detected

Intro to PET physics

Ge68 phantom Ge68 phantom

Intro to PET physics

γ γ detection probability ~ γ γ detection probability ~

0.3 Air Muscle Bone

PET calibration and QC procedures

Example : Siemens Biograph LSO Pico3D

number of elementary detectors :

(12 buckets) X (12 blocks) X (64 crystals)

PET calibration and QC procedures

uniform phantom uniform phantom

Ge-68 phantom of known activity

PET calibration and QC procedures

β+ p → n + e++ νe (branching ratio = 96.9 %)

ROI activity concentration

PET calibration and QC procedures

(Siemens Biograph LSO Pico3D)

After normalization, the software gives the χ2

Optimal frequency may depend on the system

PET calibration and QC procedures

After the “daily QC” test, give a look to the sinograms :

PET calibration and QC procedures

SUV tests : with a single Ge-68 phantom

SUV tests : with two single Ge-68 phantom

new Ge-68 old Ge-68

PET calibration and QC procedures

1.17 1.26 1.21

Uniformity Specification (from

NEMA : NUvol < 15%

PET calibration and QC procedures