Nuclear Medicine

 Nuclear medicine is very unique, because it

helps doctors view how your body is
functioning.
 This type of imaging takes very small amounts
of radioactive pharmaceuticals and follows their
path and progress through your body.
 X-rays or CAT scans can show how something
in your body looks, but Nuclear Medicine can
show how your body actually works.

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 Nuclear Medicine
Nuclear medicine is a type of molecular
imaging where radioactive pharmaceuticals
(often called “radiopharmaceuticals”) are
used to evaluate the body’s functions and
processes

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 Nuclear Medicine
NUCLEAR MEDICINE IMAGING
procedures look at the bodily functions to
help make your diagnosis.
NUCLEAR MEDICINE THERAPY can
actually be used to treat the body. If you are
undergoing a therapy process, then larger
amounts of radiation will be used to treat
cancer or thyroid disease.

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 Nuclear Medicine
Also known as nuclide imaging
• Introduce radioactive substance into body
• Allow for distribution and
uptake/metabolism of compound ⇒
Functional Imaging!
• Detect regional variations of radioactivity
as indication of presence or absence of
specific physiologic function
• Detection by “gamma camera” or detector
array
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What will they do to me during a
nuclear medicine procedure?

1. You will be given an “imaging agent.” This could be

given to you in a variety of ways: possibly by
swallowing a pill, through an injection, an inhaler, or
even a special meal you will need to eat.
2. The imaging agent will travel to the specific organ or
tissue that needs to be studied.
3. You will have pictures of your body taken with a
specialized camera from inside a scanner.
4. Your medical team will receive the images of your body
to review and evaluate.

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What about the radiation?

Very small amounts of radiation are given

during nuclear medicine imaging scans.
Larger amounts are used for therapy in order
to target very specific areas.
The scanners (equipment) do not give off
radiation.

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 Nuclear Medicine
Physiological Imaging
Radioactive isotopes which emit gamma rays
or other ionizing forms (half life for most is
hours to days)

Radionuclides are injected intravenously or

inhaled where, depending on substance, they
concentrate in organ of study

The emitted gamma rays are then picked up

by gamma camera and displayed

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 Nuclear Medicine
Physiological Imaging
Conventional Nuclear Medicine
 Emitted gamma rays create image
SPECT (Single Photon Emission Computed
Tomography)
 Tomographic images of emitted gamma rays
 Rotating gamma camera creates 3-D data set
 Data set is then manipulated to create volume images
(sum of all images in stack), multiplanar thin section
images and 3-D volume data sets

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 SPECT (single photon emission
computed tomography)

SPECT (single photon emission computed

tomography)
– Use radiotracers that generate gammay decay
– Capture photons in multiple directions, similar to
X-ray CT
– Uses a rotating

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 SPECT Instrumentation

Similar to CT, uses a rotating Anger camera to detect

photons traversing paths with different directions

 Recent advances uses multiple Anger cameras

(multiple heads), reducing scanning time (below 30
minutes)

 Anger cameras in SPECT must have significantly

better than for planar scintigraphy to avoid
reconstruction artifacts

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A dual head system
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 SPECT applications

• Brain:
– Perfusion (stroke, epilepsy,
schizophrenia, dementia [Alzheimer])
– Tumors
• Heart:
– Coronary artery disease
– Myocardial infarcts
• Respiratory
• Liver
• Kidney

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Gamma Camera (SPECT )

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 SPECT camera
•acquire multiple planar views of the radioactivity in an
organ
•The data are then processed mathematically to create
cross sectional views of the organ

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 Types of Cameras

•similar to that of a planar camera but with two additional

features
1- the SPECT camera is constructed so that the head can
rotate either stepwise or continuously about the patient to
acquire multiple views

2- it is equipped with a computer that integrates the multiple

images to produce the cross-sectional views of the organ

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 SPECT camera designs

More than one head Constructed with a ring of

detectors

the heads are mechanically rotated around the

patient to obtain the multiple projection views

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 Constructed with a ring of
detectors

Ring detectors have a ring of individual small crystals

or a single, donut-shaped crystal that does not rotate
(the collimator does rotate)

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 Angle of Rotation of Heads
* Single-headed cameras must rotate a full 360◦ to obtain
all necessary views of most organs.

* double-headed camera need rotate only half as far, 180◦

* a triple headed camera only 120◦ to obtain the same

views

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 Two-Headed Cameras: Fixed and
Adjustable

Fixed

Parallel configuration perpendicular configuration

used for simultaneous anterior used almost

exclusively for cardiac
and posterior planar imaging
or brain SPECT
imaging (L-shaped unit)

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 Adjustable heads

* allow positioning of the heads in different angular configurations

parallel (opposing), perpendicular (L-

shaped) or separated by an intermediate
angle.

used for planar imaging and for large

and
small organ tomography

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 Acquisition

The numerous, sequential planar views acquired during

tomographic acquisition are called projection views

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entire set of projection
views that can be used to
construct tomographic
images of the liver and
spleen.

cine view.

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 Arc of Acquisition

The 360◦ arc of rotation of the camera heads is regularly used

for most organs

The 180◦ arc is used for organs that are positioned on one
side of the body, such as the heart.

Views of the heart are obtained in a

◦
180 arc extending from the right
anterior oblique position to the left
posterior oblique position

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Number of Projection Tomographic Views
360◦ arc 64 or 128 tomographic projections
180◦ arc 32 or 64 tomographic projections

Collection Times
Better images are generated using the higher
count statistics from longer acquisitions

comfort and cooperation of the patient

standard (Acquisition times of ) 20 to 40

seconds per projection view
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Step-and-Shoot vs. Continuous Acquisition

 step-and-shoot acquisition The standard method

for collection of tomographic projection views

Each projection view is acquired in entirety at each angular stop

 There is a short pause of a few seconds between views to allow

for the automatic rotation of the camera head to the next stop.

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projection views of 20 s
duration were obtained every
5.6◦ for a total of 64 views

camera paused for 2 s

total acquisition time was 1408s.

126 s of this total were

“consumed” by pauses

total imaging time of 1282s

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Continuous acquisition data are collected
over one or several sequential 360◦ rotations.

* The camera rotated a full 360◦ every 140.8 s

such rotations provided 1408 s of imaging time (compared to

the 1282 s from the step-and-shoot acquisition).

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 Circular vs. Elliptical Orbits

Circular obit Elliptical Orbits

image statistics and resolution are

The camera head is rotated at a fixed better if the camera is as close to an
distance from the center of the body organ as possible

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 Patient Motion and Sinograms

Significant patient motion cause artifacts or

blurring in an
image

cine display and/or the sinogram should be

reviewed prior to releasing the patient

Patient motion can be corrected by automated correction algorithms

which shift the projection views to align the organ of interest

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 sinogram
A sinogram image is a stack of slices of the acquired projection
◦ ◦ ◦
views from 0 to maximum angle of rotation, either 180 or 360 .

Each row of the sinogram image consists of

data acquired at a different angle of rotation

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 EmissionSinogram
0°

45°

90°

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 Complete sinogram containing
all of the projection views
the construction of a sinogram
representing a thin slice of the heart
obtained from sample projection views
from a 180◦ arc around the patient
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 Reconstruction

Reconstruction is the process of creating transaxial

slices from projection views

transaxial slices

Filtered backprojection Iterative reconstruction

the data acquired by the camera

are used to create multiple
transaxial slices

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 The ten projection views are cut into seven bands and shown
pulled apart

The bands forming each view are then shown smeared along a
radius, like the spokes of a wheel.

It is this smearing back

toward the center that
gives us the term
backprojection

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 radioactive disk

an imaginary grid
is placed over the disk

the disk is imaged

the counts for each

pixelare recorded

The counts in each of the

cells of a column are
summed and stored in an
array

the rows are summed and

stored in an array of
sums to the right of the
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 During backprojection, the two arrays of projection data
are used to recreate the original disk.

the upper array is spread or backprojected across the columns of

a blank matrix so that each of the values in any single column are
identical

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The array to the right of the matrix is backprojected across
the rows, and these values are added cell by cell to the values
of the preceding set

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 If the counts in each pixel are represented by dots one begins to see
a relatively dense central area that corresponds generally to the
size and the location of the original disk

The wide bands of dots extending

in four directions from this central
density are an artifact of the
backprojection process; they are
residual counts from the
backprojection of the arrays

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