d ke multi-modality imaging lab comparison of scintimammography and dedicated emission...

D KE Multi-Modality Imaging Lab

Comparison of Scintimammography and Dedicated Emission

Mammotomography

Martin P. Tornai, Caryl N. Brzymialkiewicz, Martin P. Tornai, Caryl N. Brzymialkiewicz,

Spencer J. Cutler, Priti MadhavSpencer J. Cutler, Priti Madhav

Multi-Modality Imaging LaboratoryMulti-Modality Imaging LaboratoryDepartment of RadiologyDepartment of Radiology

Department of Biomedical EngineeringDepartment of Biomedical EngineeringDuke University Medical Center, Durham, NC, USADuke University Medical Center, Durham, NC, USA

Supported by NIH Grant Supported by NIH Grant RO1-CA96821 and DAMD 17-03-1-0558RO1-CA96821 and DAMD 17-03-1-0558

D KE Multi-Modality Imaging Lab

OverviewOverview

Develop a “universal” breast phantom for emission and/or Develop a “universal” breast phantom for emission and/or transmission imagingtransmission imaging

Needs to be compressible for uncompressed and partial Needs to be compressible for uncompressed and partial compression imaging comparisonscompression imaging comparisons

Needs to accommodate inserted lesionsNeeds to accommodate inserted lesions

Needs to have physical attributes similar to human torsoNeeds to have physical attributes similar to human torso

Make direct comparison of uncompressed breast SPECT and Make direct comparison of uncompressed breast SPECT and compressed scintimammographycompressed scintimammography

Develop and compare various fillable lesion sizesDevelop and compare various fillable lesion sizes

Compare different activity concentrationsCompare different activity concentrations

D KE Multi-Modality Imaging Lab

Solid State Imaging DetectorSolid State Imaging Detector

6.6 cm

6.6 cm

20.0 cm20.0 cm

16.0 cm16.0 cm

LumaGEM™ 3200-SLumaGEM™ 3200-S

(Gamma Medica Inc.)(Gamma Medica Inc.)

DetectorDetector CdZnTeCdZnTe

DensityDensity 5.78 g/cm5.78 g/cm33

Effective ZEffective Z 4949

ElementsElements 64 x 8064 x 80

Crystal DimensionsCrystal Dimensions 2.3 x 2.3 x 5 mm2.3 x 2.3 x 5 mm33

Pixel SizePixel Size 2.5 x 2.5 mm2.5 x 2.5 mm22

FOVFOV 16 x 20 cm16 x 20 cm22

SensitivitySensitivity 38 cts/sec/MBq38 cts/sec/MBq

Uniformity (post corr)Uniformity (post corr) < ±4%< ±4%

Energy ResolutionEnergy Resolution 6.1% @ 140 keV6.1% @ 140 keV

D KE Multi-Modality Imaging Lab

Prototype Emission MammotomographPrototype Emission Mammotomograph

Polar Polar Tilt, Tilt,

RORROR

Azimuth, Azimuth, Rotation stage and Rotation stage and goniometer goniometer ((Newport Corp.Newport Corp.))

Radius of Rotation control Radius of Rotation control ((Newport Corp., Sanyo-DenkiNewport Corp., Sanyo-Denki))

Integrated Gamma Integrated Gamma CameraCamera

((Gamma Medica, Inc.)Gamma Medica, Inc.)

Anthropomorphic torso and Anthropomorphic torso and breast phantomsbreast phantoms

((Radiology Support Devices, Inc.)Radiology Support Devices, Inc.)

D KE Multi-Modality Imaging Lab

Compressible Breast Phantom & Chest PlateCompressible Breast Phantom & Chest Plate

(Radiology Support Devices, Inc.)(Radiology Support Devices, Inc.)

Fillable Volume: ~700 mLFillable Volume: ~700 mL

Nipple-Chest:Nipple-Chest: 9 cm 9 cm

Medial-Lateral: 12 cmMedial-Lateral: 12 cm

Superior-Inferior: 13 cmSuperior-Inferior: 13 cm

““Skin” thickness: 0.16 cmSkin” thickness: 0.16 cm

Fill portFill port

3 cm 3 cm insertion port insertion port

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Compressible Breast Phantom & LesionsCompressible Breast Phantom & Lesions

(Harvard Apparatus)(Harvard Apparatus)

Stems:Stems: 1.6 mm OD x 4.5 cm polyethylene1.6 mm OD x 4.5 cm polyethylene

Digital X-ray imageDigital X-ray image

LesionsLesions

VolumeVolume “Diameter”“Diameter” (microL)(microL) (mm) (mm)

40 +/- 0.15 40 +/- 0.15 4.2 4.2

70 +/- 0.1570 +/- 0.15 5.1 5.1

140 +/- 0.15140 +/- 0.15 6.4 6.4

300 +/- 0.30300 +/- 0.30 8.2 8.2

500 +/- 0.30 500 +/- 0.30 9.8 9.8

40407070140140

140140

140140

300300500500

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Scintimammography Acquisition ParametersScintimammography Acquisition Parameters

Lesion ConcentrationLesion Concentration 40 microCi / mL40 microCi / mL 20X clinical !20X clinical !

Lesion : BackgroundLesion : Background Inf., 12 : 1, 7 : 1, 3 : 1Inf., 12 : 1, 7 : 1, 3 : 1

ViewView Lateral (single view)Lateral (single view)

CompressionCompression 12 cm, 9 cm, 6 cm12 cm, 9 cm, 6 cm

Acquisition TimeAcquisition Time 10 min (equivalent)10 min (equivalent)

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Breast CompressionBreast Compression

12 cm12 cm

Cra

nio

-Ca

uda

lC

ran

io-C

au

dal

La

tera

l

L

ate

ral

9 cm9 cm 6 cm6 cm4 cm4 cm

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Scintimammography (Planar) ProjectionsScintimammography (Planar) Projections

12 cm12 cm

Compression ThicknessCompression Thickness

12 : 112 : 1

7 : 17 : 1

3 : 13 : 1

9 cm9 cm 6 cm6 cm

Leaky Leaky PhantomPhantom

9cm 12 : 19cm 12 : 19cm 7 : 19cm 7 : 19cm 3 : 19cm 3 : 1

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0

2

4

6

8

10

12

14

16

6 7 8 9 10 11 12

SIG

NA

L-to

-NO

ISE

RA

TIO

COMPRESSION THICKNESS (cm)

0

0.2

0.4

0.6

0.8

1

1.2

6 7 8 9 10 11 12

40 uL70 uL140 uL300 uL500 uL

CO

NT

RA

ST

COMPRESSION THICKNESS (cm)

Scintimammography: Effects of CompressionScintimammography: Effects of Compression

12 : 1 Concentration Ratio12 : 1 Concentration Ratio

D KE Multi-Modality Imaging Lab

0

0.2

0.4

0.6

0.8

1

1.2

0 100 200 300 400 500 600

12 : 17 : 1

CO

NT

RA

ST

LESION VOLUME (microL)

0

2

4

6

8

10

12

14

16

0 100 200 300 400 500 600

12 : 17 : 1

SIG

NA

L-to

-NO

ISE

RA

TIO

LESION VOLUME (microL)

Scintimammography: Effects of Activity ConcentrationScintimammography: Effects of Activity Concentration

6 cm Compression6 cm Compression

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SPECT Acquisition ParametersSPECT Acquisition Parameters

Lesion ConcentrationLesion Concentration 40 microCi / mL40 microCi / mL 20X clinical !20X clinical !

Lesion : Background RatiosLesion : Background Ratios Inf., 12 : 1, 7 : 1, 3 : 1Inf., 12 : 1, 7 : 1, 3 : 1

Mammotomography (Mammotomography ( = 0 – 360) = 0 – 360)

Orbits:Orbits: Vertical Axis of Rotation (Vertical Axis of Rotation (VAORVAOR))ROR = 6.6 cm, ROR = 6.6 cm, = 0 deg = 0 deg

Tilted Parallel Beam (Tilted Parallel Beam (TPBTPB))ROR = 5.2 cm, ROR = 5.2 cm, = 45 deg = 45 deg

3 Lobed Sinusoid on Hemisphere (3 Lobed Sinusoid on Hemisphere (ProjSineProjSine))ROR = 2.8 – 5.2 cm, ROR = 2.8 – 5.2 cm, = 15 – 45 deg = 15 – 45 deg

Angular Increment : 2.8 degAngular Increment : 2.8 deg

Acquisition Time : 10 min (equivalent)Acquisition Time : 10 min (equivalent)

Details Details about orbits about orbits

and and sampling on sampling on POSTER #POSTER #

M2-269M2-269

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Mammotomography OrbitsMammotomography Orbits

00oo

3030oo 6060oo 9090oo

Cam

era C

amera

Tilt (

Tilt ( ) )

VAORVAOR TPB45TPB45 ProjSineProjSine

Details about orbits and sampling on POSTER # M2-269Details about orbits and sampling on POSTER # M2-269

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Maximum Intensity Maximum Intensity Projection (MIP)Projection (MIP)

Mammotomography ReconstructionsMammotomography Reconstructions

TransverseTransverse SagittalSagittal

12 : 1 Concentration ProjSine Data12 : 1 Concentration ProjSine Data

OSEM reconstruction with 5 iterations, 8 subsets, calculated attenuation OSEM reconstruction with 5 iterations, 8 subsets, calculated attenuation correction, 3D Hann filtration with fcorrection, 3D Hann filtration with fcc = 0.8*Nyquist = 0.8*Nyquist

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Mammotomography MIPsMammotomography MIPs

VAORVAOR

12 : 112 : 1

7 : 17 : 1

3 : 13 : 1

TPB45TPB45 ProjSineProjSine

300 uL300 uL500 uL500 uL

40 uL40 uL

70 uL70 uL

140 uL140 uL

D KE Multi-Modality Imaging Lab

0

0.5

1

1.5

2

2.5

3

3.5

0 100 200 300 400 500

VAORTPBProjSine

CO

NT

RA

ST

LESION VOLUME (uL)

0

5

10

15

20

25

0 100 200 300 400 500

VAORTPBProjSine

SIG

NA

L-to

-NO

ISE

RA

TIO

LESION VOLUME (uL)

SPECT SNR & ContrastSPECT SNR & Contrast12 : 1 Concentration Data12 : 1 Concentration Data

ROI data from OSEM reconstruction with 3 iterations, 8 subsets, calculated ROI data from OSEM reconstruction with 3 iterations, 8 subsets, calculated attenuation correction, 3D Hann filtration with fattenuation correction, 3D Hann filtration with fcc = 0.8*Nyquist = 0.8*Nyquist

D KE Multi-Modality Imaging Lab

0

0.5

1

1.5

2

2.5

3

3.5

0 100 200 300 400 500

Projsine 12:1Projsine 7:1Projsine 3:1

6cm Compr 12:16cm Compr 7:1

CO

NT

RA

ST

LESION VOLUME (uL)

0

5

10

15

20

25

0 100 200 300 400 500

SIG

NA

L-to

-NO

ISE

RA

TIO

LESION VOLUME (uL)

SPECT & Scintimammography SNR & ContrastSPECT & Scintimammography SNR & Contrast

D KE Multi-Modality Imaging Lab

Conclusions Developed a compressible breast+chest phantom useful for Developed a compressible breast+chest phantom useful for

comparative emission breast imaging with physical comparative emission breast imaging with physical limitations more consistent with a human torsolimitations more consistent with a human torso

Measured various lesion sizes, locations (esp. near chest Measured various lesion sizes, locations (esp. near chest wall), and activity concentrations relative to backgroundswall), and activity concentrations relative to backgrounds

Compared compressed breast, planar scintimammography Compared compressed breast, planar scintimammography with uncompressed breast SPECT mammotomographywith uncompressed breast SPECT mammotomography

Scintimammography has limited viewable breast volume Scintimammography has limited viewable breast volume towards the anterior chest walltowards the anterior chest wall

Under a wide range of “low noise” measurement conditions:Under a wide range of “low noise” measurement conditions:

More lesions, lesion sizes, and (3D) lesion locations can be More lesions, lesion sizes, and (3D) lesion locations can be detected (and thus quantitated) with dedicated emission detected (and thus quantitated) with dedicated emission mammotomography than with compressed breast mammotomography than with compressed breast scintimammographyscintimammography

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Multi-Modality Imaging Lab