PET Discussion:

1. What are the key terms related to PET imaging? Be able to describe these in a
sentence (no semi-colons) and how they relate to one another

 Positron emission tomography (PET), as any nuclear imaging method, is a

functional imaging modality.
 Functional imaging: is based on the bio-distribution of a radioactive agent over
time and space, enabling visualization of dynamic physiological and
pathophysiological processes that define the functional characteristics of disease
or the specific organ.

Applicability of PET in radiation oncology for:

 Detect cancer Primary tumor assessment.

 Assess the effectiveness of treatment Follow up .

Other applications:

 Determine blood flow to the heart muscle.

 Evaluate brain abnormalities, such as tumors, memory disorders and other central
nervous system disorders.
 To map normal human brain and heart function.
 Radionuclide: the tracer radioisotope.
 Pharmaceutical: it is an origin based substances depend on the pharmacological
properties like mode of action and their pharmacological action or activity.
 Annihilation Detection: In coincidence counting an event is ONLY registered if a
signal is received from two detectors within a narrow window of time. A few
nanoseconds is usually used.
 Time-of-Flight PET: In “Time-of-Flight” pet, use of a very small-time window
(<100 picoseconds) can localize an annihilation event to within a few cm along the
line of coincidence. Time-of-Flight PET can improve SNR.


2. What does PET acronym stand for? What is it used for?

 Positron emission tomography (PET) is a modern non-invasive imaging technique for
quantification of radioactivity in vivo. It involves the intravenous injection of a
positron-emitting radiopharmaceutical, waiting to allow for systemic distribution, and
then scanning for detection and quantification of patterns of radiopharmaceutical
accumulation in the body.
 3. What types of scintillators are used for PET?

 Although NaI(Tl) is ideal for lower energy single photon imaging, its relatively low
linear attenuation coefficient for 511 keV photons makes it less attractive for PET
applications.
 Lutetium oxyorthosilicate (LSO) and bismuth germanate (BGO) scintillator
 BGO and, more recently, LSO have replaced NaI(Tl) as the scintillator of choice for
PET.
 BGO is well suited for scanner designs that minimize scatter and count rate via
physical collimation (2D).
 LSO has become the scintillator of choice for scanner designs that operate without
interplane septa (3D) because of its short decay time.
 4. Describe the response of the scintillator – what is Compton Edge, Compton
Continuum, Compton Gap?

 Compton plateau represents Compton scatter interactions in the patient and/or crystal, broadly
distributed in energy due to the random nature of the Compton scatter angle
 Compton edge, represents Compton interactions in which the incoming (unscattered) gamma
photon is backscattered 180◦ in the crystal, thus depositing the maximum energy possible in a
single Compton interaction
 The photopeak represents gamma photons that come directly from the source without
interacting and losing any energy and deposit all of their energy in either a single photoelectric
interaction or one or more Compton interactions followed by a photoelectric interaction

5. What is 'electronic collimation'?

The opposed photons from positron decay can be detected by using pairs of collinearly aligned
detectors in coincidence.

This “electronic collimation” is the reason why PET is much more sensitive (factor >100) than
the conventional nuclear medical technique, namely single photon emission tomography
(SPECT) using gamma cameras and lead collimators.

6. How does energy discrimination work for these systems/detectors?

7. Types of coincidences for PET?
 8. Describe how the Timing window is used
a. Detector response time
b. Effect on Random coincidences
c. What is typical timing window magnitude?
• The time window of the detection system is a time interval if two events at different
detectors occur within that time window the two events considered to be in coincident

 Time window for BGO 12 ns LYSO 4.5 ns

• Effect on Random coincidences

occur when two simultaneous annihilation events occur and absorption of two photons from
independent events occurs, leading to an assumed line of response from the two remaining
photons from independent events. Cannot be avoided totally, but the probability increases with
increasing activity administered to the patient.

R random = τS1S2 ( S are the detectors signals ,τ is the coincidence window )

• Random coincidence proportional to squared activity injected in the patient

• True coincidence rate:
• True coincidence proportional to Activity in patient
• The highest parameter that affect is the intrinsic efficiency of the detector
• 2D, 3D data acquisition increase acceptance angle of the coincidence --> increase sensitivity

9. What is the main radiotracer used and characteristics?

a. Max energy
b. Half-life
10. Factors affecting spatial resolution in center of bore
11. How does attenuation correction work?
a. CT-based
b. Radionuclide-based
c. Which of the images below (B or C) is attenuation corrected?
12. Describe how each types of reconstruction works:
a. FBP
b. Iterative
13. Definition/meaning of SUV - what does it stand for, what is it?