See discussions, stats, and author profiles for this publication at: https://www.researchgate.

net/publication/250613407

Positron emission tomography (PET)

Conference Paper · June 1993

CITATIONS READS

0 1,072

1 author:

Saleh Ahmad Qutaishat

Petra University
17 PUBLICATIONS   22 CITATIONS   

SEE PROFILE

Some of the authors of this publication are also working on these related projects:

Atomic Absorption Spectroscopy View project

Concentrations of specific heavy metals in specific materials by using Atomic Absorption Spectrophotometer. View project

All content following this page was uploaded by Saleh Ahmad Qutaishat on 19 May 2014.

The user has requested enhancement of the downloaded file.

1. Introduction
2. Image formation
3. Positron electron annihilation
4. Isotopes emitting positrons
5. Basic coincidence technique
6. Positron tracers
7. Physical processes in PET
8. Temporal resolution
9. Spatial resolution factors
10. Recent detector developments
11. Tomograph design factors
12. Three dimensional images
13. Conclusions
14. References
 1

Positron Emission Tomography

(PET)
by

Saleh Qutaishat

Physics Department

Chalmers University of Technology

and

Goteborg University

The principle of image formation in tomography is summarised. The principle ofpositron

electron annihilation is introduced. The principle of coincidence techniques is illustrated.
Detector development and perspectives for positron emission tomography (PET)
instrumentation for medical research is presented. The physical processes in in positron
annihilation, photon scattering and tomograph design are discussed.

1. Introduction
X-ray which was discovered by Rotengen marked the dawn of radiography. X-ray beams
were used to image internal parts of the human body . Later on, other techniques for
medical imaging using ultrasound and electromagnetic radiation were developed.
The radiation used to image an internal organ must have adequate energy to penetrate that
organ. since an image results from the absorption patterns. If the radiation has more energy
it passes through unabsorbed.
An other technique for imaging was developed by injecting a radioactive substance into the
human being or animal. The distribution of the substance within a specific organ is
monitored externally by the emitted radiation. Nuclear medicine originated from this
procedure. An isomer of technetium 99mTc is the most widely used radionuclide for
nuclear medicine. It decays with a half life of 6 hours. emitting 140 keY photons. Sodium
iodide are highly efficient detectors of these photons. Other radioactive isotopes, such as
20lTI (80 ke V), 178Ta (55-65 ke V), 133Xe (80 keV), emitting photons of lower energy than
99rnTc can be used. Multiwire proportional chambers are used as detectors for these
photons. The standard imaging device in nuclear medicine is the gamma camera, a large
sodium iodide crystal with photo multiplier read out [1].

2. Image formation
To form an image, a collimator consisting of a thick lead sheet perforated with many
thousands of small holes, must be placed between the incident radiation and the crystal to
eliminate oblique incident photons. Thus, only perpendicular incident radiation pass
through the holes to the detector. The effective sensitivity of the sodium iodide crystal is
reduced by using the collimator.
The images produced are projections of a three-dimensional distribution onto a two­
dimensional plane. Thus depth information is missing. The invention of computer-assisted
(Cf) scanner developed the type of images produced. The CT scanner images a section of
the body transverse to the long axis, perpendicular to the plane of a conventional
radiograph [1,2]. One-dimensional projection profiles are reconstructed into a two­
dimensional image of a transverse body section, as shown in figure (1).
 2

Figure 1.
The Computer-assisted Tomography (CT)
scanner images a section of the body
transverse to the long axis. perpendicular
to the plane of a conventional radiograph.
The section is typically a few millimetres thick.
and is obtained by measuring not just a single
projection. but many, each {rom a different
direction.

X-ray tube
 3

A useful technique for three-dimensional imaging of certain tracer distribution in the brain
and heart is single photon emission computed tomography (SPECT). In this technique a
gamma camera is rotated around the patient and takes a series of two-dimensional
projections from different directions. Applying computer-assisted tomography (CT)
reconstruction techniques, the internal distribution of thee radioactive tracer can be
recovered simultaneously for parallel two-dimensional transverse sections.
Sometimes radionuclides used in nuclear medicine emit photons with energies higher than
140 keY of 99mTc. In such cases, the collimators used in gamma cameras must be thick
enough to stop inclined radiation. Thus the efficiency is reduced and the spatial resolution
is degraded.

3. Positron electron annihilation

Beta particles are fast electrons or positrons which result from the weak-interaction decay
of a neutron or a proton in nuclei which contain an excess of the respective nucleon. In
neutron-rich nucleus, a neutron can transform itself into a proton via the process:

n ~ p + e + u (1)
Here an electron and an antineutrino are emitted. (The proton remains bound to the
nucleus). The daughter nucleus now contains one extra protons, so that its atomic number
is increased by 1.
Similarly, in nuclei with too many protons, the decay
p~n+~+u m
can occur, where a positron and a neutrino are now emitted and the atomic number is
decreased by one [3].
An example of positron emitting nuclei is the isotope of oxygen 150 8 • This isotope decays
to nitrogen 15N7 by emitting a positron and a neutrino as shown in equation (2). Among
the principle elements of life only hydrogen does not offer a convenient positron-emitting
isotope.
If the emitted positron hits an absorbing material it annihilates with an electron from the
absorber to produce two photons, each one with an energy equal to the electron mass 511
ke V. These two gamma photons are always emitted in opposite directions, in order to
conserve momentum in the annihilation process. The two photons are detected by two
detectors set opposite to each other. The two detectors are connected to a coincident unit to
detect the coincident photons, i.e, the photons originating from a specific annihilation
process [1]. The annihilation process is demonstrated in figure (2).

4. Isotopes emitting positrons

All ~rinciple elements of life offer a convenient positron-emitting isotopes except hydrogen.
The Isotopes of oxygen, nitrogen and carbon are positron emitters with a short half-lives 2,
ID and 20 minutes. These isotopes are useful for medical imaging. They are produced by
cyclotrons.
 4

Figure 2.
In Positron Emission Tomography (PET), the
annihlletion of e positron with en electron
produces two 51 1 keV photons beck-Io-beck,
and detecting them measures the direction of
the event Immediately.

POSITRON EMISSION

f.
p .... n+e+"

-, mm

, DETECTOR
DETECTOR

+-- 511 keY Y 511 keY Y ---+

...._ _ _ _ _ _ _....., COINCIDENCE

DETECTION t-------..I
 5

5. Basic coincidence technique

Electronic circuits are used to determine coincident photons detected by radiation
detectors. Coincidence in time serves a very powerful criterion for distinguishing reactions.
A simple coincidence measuring system is illustrated in figure (3) [3].

The basic technique is to convert the analog signal coming from the detector into a logic

signal and then send the pulses into a coincidence module. If the two signals are, in fact,

coincident, then a logic signal is produced at the output.

It can be seen in figure (3) that a coincident output signal is produced if any part of the two

incoming signals overlap. Thus all pulses arriving within a time equal to the sum of their

widths are registered as coincident. Figure (4) shows examples of coincident and non­

coincident pulses. The electrical path of each branch leading to the coincidence module

should be of equal length. This can be insured by adding adjustable delay to each line as

shown in figure (3).

L:::~r--::::;:::-r DISC R. -u- DEl AY

SCALER

r=::::-~--I DISCR. I---v----I DElAY -v- COINCIDENCE

("AND")

FIR..3 A system for coincidence measuremcn:

INPUT 1

INPUT 2

COINCIDENCE FIR·4.
OUTPUT Coincidence bel ween puhc.
 6

6. Positron tracers

Positron emission tomography (PET) pennits the non-invasive, quantitative study of

biological processes as they occur using minute quantities of tracer material. Biological
processes in different organs can be studied by using a variety of labeled compounds as
shown in table (1) [4).

Table 1- Positron tracers and the processes they measure

Heart:

ionic 82Rb myocardial perfusion

lle palmitate Catty add transport, oxidation
Ile or uN amino adds protein synthesis, tissue anabolism
Brain:

ionic 82Rb blood brain barrier breakdown

18F deoxyglucose glucose transport, phosphorylation
122 I iodoamphetamines blood flow
lS02 oxygen utilization
11i0water blood flow

lleo hemoglobin blood volume

7. Physical processes in PET

The following Physical processes in PET [4] are discussed
a) Positron stops in a tissue " ,
Positrons are emitted with a variety of energies, with a maximum energy that dep~nds on
the isotope. Thus the resulting positron range i~ ,a tissue vari~s from a sm,all fractIon of a
millimeter to several millimete~s[5], The ability of ~ET mstrume!1tatton t? me~sure
dynamically tracer concentration IS affected by the phYSical processes myolved m pos~tron
emission figure (5), detection of annihillation photons and the tomographiC reconstruction.

Positron annihilation photons

1800 ± 0.25°

XBL 953 8057

FigureS: A positron emitted by nuclear decay stops in tissue and annihilatf's with a nearby
electron, producing two 511 keY photons that fly off in nearly opposite directions.

b) Scatter in a tissue
A 511 keY photon travels an average of 10 cm in water before interacting by Compton
scattering, The probability that both annihilation photons leave the body unscattered is
20% [6]. This results in a significant loss of events.
c) Interaction with the detectors
Two types of interaction occur in the detection process. One is by the photoelectric effect,
whereby the entire photoenergy is transfered into a recoil electron. The other is by
Compton scattering, where the photon energy is reduced by being scattered by a recoil
electron which picked part of the photon energy. For successful detection both annihilation
photons have to pass pulse hight requirements in the opposing detectors. The fraction of
annihilation photons reaching the scintillator that produce an acceptable pulse is called the
detection efficiency.
d) Scintillation
The recoil eJectrons produce scintiHation light via the excitation process with a certain
luminous efficiency.
 8

e) Light transfer to photodetectors

Part of the scintillation light is collected by the photo detectors while the rest is lost via
other processes. The fraction of light that reaches the photo detectors is called the light
collection efficiency.
f) Production of an electron pulse
Collected scintillation light is converted into electric pulses that are amplified by a photo
multiplier tube.
g) Electronics
Electronic circuits determine whenever two opposing detectors detect photons with a short
time interval (5 to 20 nsec) and store the address of the crystals involved [7,8]. The
differential time of arrival is also recorded for the time of flight mode [9,10].
h) Attenuation correction
The patient has to be placed in the tomograph and positioned at a slice to be imaged before
the administration of any radioactive isotope.
i) Additional data correction
The data must be corrected for accidental background events, scattered background events
and the loss of events due to the dead time in the detectors and electronics.
j) Reconstruction
Filtering the parallel-ray projections and then back projecting to the image array is involved
in tomographic reconstruction

8. Temporal resolution
The ability to measure the tracer concentration with good temporal resolution ( i.e, increase
of rapid time sequence images) requires the collection of a large number of events during
the study, which requires good detection efficiency, low dead time, high maximum data
rates, and a maximum of detection motion.

9. Spatial resolution factors

An overall system spatial resolution with fwhm less than or equal D/2 for quantitation
within regions of size D. The principle components of the system resolution are:
i) Positron range
Positron annihilation shows a distribution with a bright center and extensive tails. The
resulting full width at half maximum is <1 mm.
ii) Deviations from 1800 emission.
The angular distribution of annihilation photons in water shows nearly a gaussian
distribution with a fwhm .&=0.50 [11]. This blurring factor represents the most fundamental
limit to spatial resolution in PET.
iii) Dr!tector aperture
The geometrical component of the detector resolution is about one half of the exposed
width w of a discrete crystal.
iv) Linear sampling
For detectors of width w, the geometrical resolution w/2 is not realized in the
reconstruction image unless the tomographic sampling distance is w/4 or finer through out
the image region.
v) Multiple crystal interactions
Compton scattering of the annihilation photons can result in mis-identification of the
detector of the first interaction. This effect is reduced by coupling each scintillator to its
individual photodetector or placing shielding materials between the detectors.
 9

vi) Off-axis penetration

Annihilation photons from off-axis sources can penetrate one or. more detectors before
interacting. This results in uncertainty of the depth of interaction.
vii) Reconstruction filter
The reconstruction filter upper frequency roll-off should be detennined by the system
resolution in order to get the best estimation of the tracer activity within regions of interest.
viii) Organ motion
For cardiac imaging and rapid sequence imaging for fast dynamic studies gating is used to
reduce the effect of organ and tracer motion.

10. Recent detector developments

10.1 Small PMTs
The development of small photomultiplier tubes (PMTs) -10 mm diameter tube) permitted
the construction of positron tomographs with 3mm crystals where each crystal is coupled to
onePMT.
10.2 Light division coding
In this type of detectors. each PMT is coupled to two or more crystals. The crystal of
interaction is determined by the ratio or difference of the PMT signals.
10.3 Anger-type coding
In thi:; type of detection. a single large scintillation crystal is coupled to many PMTs and the
ratio of outputs is used to determine the center of intensity.
10.4 Wire chambers
An efficient scintillation detector. e.g, BaF2 that produces UV emission is used with a
wire proportional chamber with a special liquid photocathode that converts the UV into an
electron avalanche. A detector of BaF2 scintillators and wire chambers for 511 keY
gamma-ray was developed by George Charpak (the Nobil prise winner in physics this year
1993) group at CERNin 1986. The wire chamber was filled with tetrakis (diethylamine)
ethylene (TMAE) vapour and operated at a pressure of a few Torr. using different gases at
various temperatures. Energr' time, and position resolution were given for BaF2 crystals
with sections of lOXI0 mm and 5X5 mm2. The spatial precision with a matrix of small
crystals was better than with a single large crystal. They expected that a medical PET
camera based on a solid state proportional counter SSPC will have a high-rate capability
and allow a dramatic improvement of the axial precision and of the acceptance [12].

11. Tomograph design factors

The aim of most tomograph designs is the accurate and rapid measurement of tracer
concentration in sharply defined tissue volume elements. Thus, temporal resolution. spatial
resolution, and the quantitative measurement of activity concentration are required.
11.1 Quantitative accuracy - Statistical factors
Statistical accuracy in the reconstructed image depends on the number of coincident events
that can be collected within the available time. This is determined by the available positron
activity and the sensitivity of the tomograph which is expressed as the number of coincident
events detected per second per IlCi/cm3 in a 20 cm diameter cylinder of water. The system
sensitivity depends on:
a) Solid angle coverage
The best acceptance solid angle for annihilation photons is provided by multiple rings of
detectors that encircles the patient.
b) Axial coverage
A higher event rate for a given amount of tracer activity is provided by multiple detector
rings that cover a larger volume of tissue.
 10

c) Detector material
Bismuth gennanate (BGO) crystals has better stopping power than Nal for the 511 keY
gamma rays, but poorer energy resolution. Thus BGO replaced NaI in non-time of flight
PET instrumentation. BaF2 replaced CsF for time of flight PETs.
d) Single vs multiple crystal detections
Multiple crystal detectors enhance the detection efficiency, but they degrade the position
resolution.
e) Time of flight information
excellent timing resolution -0.4 ns is achieved by using BaF2 detectors. Such detectors are
able to measure the arrival time difference between the two photons and determine the
annihilation point.

11.2 Quantitative accuracy - systematic errors

PET data are subject also to systematic errors, e.g, background events due to accidental
coincidences.

12. Three dimensional images

By imaging parallel slices at different levels and processing them by computers, it is
possible to combine such two dimensional images to obtain a three dimensional image. A
PET scanner is shown in figure (6).

Figure 6.
PET scanner assembled at CERN and
operational at Geneva's UnIVerSity Hospital for
the past two years, About 200 patients have
been scanned,
 11

13. Conclusions
Positron emission tomography (PET) proved to be an efficient research and diagnostic
technique in medicine in spite of its complexity and cost

14. References
[1]. Townsend DW: Physics instrumentation for medical imaging. CERN courier 33-3:
1-8,1993
[2]. Dale S: Ectomography - Theory and hnplementation in Gamma Camera Imaging,
Ph.D thesis, Department of Medical Engineering, Karolinska Institute, and
Department of Clinical Physiology Thoracic, Karolinska Hospital, Kungl. Tekniska
Hogskolan, Stockholm, Sweden, ISBN 91-7170-946-0, 1989, pp 1-44
[3]. Leo WL: Techniques for Nuclear and Particle Physics Experiments,ed Springer­
Verlag, 1992, pp 2-9 & pp 302-303
[4]. Derenzo SE: Recent developments in positron emission tomography (PET)
instrumentation. Phys and Eng of Computerized Multidim lmag and Process.
Vol. 671: 232-242,1986
[5]. Cho ZH, Chan JK, Erikson L, et al: Positron ranges obtained from biomedocal
important positron emitting radionuclides. J Nucl Med 16: 1174-1176,1975
[6]. Budinger TF, Derenzo SE, Gullberg GT, Greenberg WL, and Huesman RH:
Emission computer assisted tomography with single-photon and positron
annihilation photon emitter. J Comput Assist Tomogr 1: 131-145,1977
[7]. Huesman RH, Cahoon JL; Derenzo SE, et al: Crystal positron tomograph. IEEE
Trans Nucl Sci NS-27: 474-478, 1980
[8]. Cahoon JL, Huesman RH, Derenzo SE, et al: The electronics for the Donner, high
resolution 600-crystal positron tomograph. IEEE Trans NUcl Sci NS-33:570-574,
1986
[9]. Blaine J, Fike D, Hitchens R, et al: Data acquisition aspects of super-PETT. IEEE
Trans Nucl Sci NS-29:544-547, 1982
[10]. Philippe EA, Mullani N, Hartz E, et al: Real time multi-processor image
reconstructor for time of flight positron emission tomography (TOFPET). IEEE
Trans Nucl Sci NS-29: 524-527, 1982
[11]. Colombino P, Fiscella B, Trossi L: Study of positronium in water and ice from 22
to -144 OC by annihilation quantum measurements. Nuovo Cimento 38: 707-723,
1965
[12]. Mine P, Charpak G, Stantiard J-C, Scigosld D, Suffert M and Tavernier S: Nucl.
Inst. and Meth. A269:385-391, 1988

View publication stats