d ke multi-modality imaging lab comparison of scintimammography and dedicated emission...
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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
D KE Multi-Modality Imaging Lab
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
D KE Multi-Modality Imaging Lab
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)
D KE Multi-Modality Imaging Lab
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
D KE Multi-Modality Imaging Lab
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
D KE Multi-Modality Imaging Lab
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
D KE Multi-Modality Imaging Lab
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
D KE Multi-Modality Imaging Lab
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
D KE Multi-Modality Imaging Lab
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
D KE Multi-Modality Imaging Lab
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
D KE Multi-Modality Imaging Lab
Multi-Modality Imaging Lab