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New PET Instrumentation and Technology: Biograph Vision PET/CT D U STIN O SBO RNE, PHD, DABSNM D IREC TOR, C L INICAL RESEARCH ASSO C IATE PRO FESSOR M O L ECU LAR IM AGING & TRANSLATIONAL RESEARCH GRAD UATE SC HO OL O F M ED IC INE KNOXVILLE , TN

• The University of Tennessee maintains collaborations with Siemens Healthineers

Disclaimers

• Hospital Overview

• Next Generation PET

• Software Technology

Agenda

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• Not-For-Profit Academic Medical Center

• Magnet recognized

• TNCPE Excellence Award

• 609 beds

• Region’s Only Level I Trauma Center

• #2 Hospital in Tennessee – US News & World Report

• Referral center for Eastern Tennessee, Southeast Kentucky, and Western North Carolina

University of Tennessee Medical Center

• Full lab facilities

• Protein & peptide chemistry

• Radiochemistry

Basic Science

• Inveon PET/SPECT/CT

• microPET P4

• microCAT II + SPECT

Small Animal

• Biograph 6

• 4 ring PET

• HD•PET

• 6-slice CT

Large Animal

• Biograph mCT

• 4 ring PET

• PSF+TOF

• 64-slice CT

Human

Clinical and Translational Research

NEXT GENERATION PET/CT

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Detector Comparison

C U RRENT GENERATION NEXT GENERATION

4x4x20 mm PMT

52x52 mm

3.2x3.2x20 mm SiPM 32x32 mm

Key Detector Design Elements

3.2 mm LSO crystal

element

>3x more electronic channels

(608)

100% coverage of

the LSO array

5x5 crystal mini-block

Biograph mCT (TrueV) Biograph Vision

Bore diameter (cm) 78 78

Axial FoV (cm) 22 26.3

Number of crystals 32,448 60,800

Crystal size (mm) 4.0 x 4.0 x 20 3.2 x 3.2 x 20

FBP spatial res @ 1 cm 4.5 3.7

FBP volumetric resolution

(mm3) 95 51

Sensitivity (cps/kBq) 10.2 16

Peak NEC (kcps) 180 300

ToF (ps) 540 214

Eff. Sensitivity (cps/kBq) 25 100

Eff. NEC (kcps) 445 1870

TOF gain 2.5 6.2

Release Specifications

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Biograph Vision Performance

4 mm crystal Biograph Vision™

High-resolution torso phantom Sphere size (mm): 5.0, 7.9, 9.9, 12.4, 15.4, 19.8 6:1 contrast-to-background

5 mm sphere

5 mm sphere

56%

higher contrast recovery

Biograph Vision Performance

4 mm crystal Biograph Vision

3 mm

4 mm

5 mm

3 mm

4 mm

5 mm

Central position

20 cm off center

Axial resolution phantom

Same acquisition time for both phantom scans

Mini-Derenzo

4 mm crystal Biograph Vision Diameter (mm)

1.2 1.6

2.4

3.2

4.0

4.8

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• To ensure a clean and swift workflow with bullet points, please use the PRE-SET PLACEHOLDERS or FORMATTED TEXTBOXES – do not use “normal” textboxes that have been added via the steps add textbox. These textboxes cannot be formatted with the automatic formatting step

• AUTOMATIC INDENTATIONS IN PLACEHOLDERS are only to be done using the tool decrease or increase the list level (or Shift + Alt + / )

• Formatted textboxes/ placeholders are available in the template – just make a copy OR: generate a new placeholder by following these steps Start new slide choose layout "Content Slide"

• Placeholders can be filled and then copied. The copied placeholder will keep its formatting

Add a Footnote/Source/ Disclaimer directly into the footer.

214 ps timing

resolution1 100%

coverage of the LSO

array

SiPMs Cover Full LSO Array

• Time-of-flight performance depends on collecting light from all photons in the scintillation.

• SiPMs cover LSO-array maximizes light detection

• 100% coverage = fast temporal resolution

• To ensure a clean and swift workflow with bullet points, please use the PRE-SET PLACEHOLDERS or FORMATTED TEXTBOXES – do not use “normal” textboxes that have been added via the steps add textbox. These textboxes cannot be formatted with the automatic formatting step

• AUTOMATIC INDENTATIONS IN PLACEHOLDERS are only to be done using the tool decrease or increase the list level (or Shift + Alt + / )

• Formatted textboxes/ placeholders are available in the template – just make a copy OR: generate a new placeholder by following these steps Start new slide choose layout "Content Slide"

• Placeholders can be filled and then copied. The copied placeholder will keep its formatting

Add a Footnote/Source/ Disclaimer directly into the footer.

TOF Performance

0

100

200

300

400

500

600

0 10 20 30 40Tim

ing

reso

luti

on

1 (p

s)

Activity (mCi)

Timing resolution and activity

3.2 cm

540 ps

8.0 cm

214 ps

• To ensure a clean and swift workflow with bullet points, please use the PRE-SET PLACEHOLDERS or FORMATTED TEXTBOXES – do not use “normal” textboxes that have been added via the steps add textbox. These textboxes cannot be formatted with the automatic formatting step

• AUTOMATIC INDENTATIONS IN PLACEHOLDERS are only to be done using the tool decrease or increase the list level (or Shift + Alt + / )

• Formatted textboxes/ placeholders are available in the template – just make a copy OR: generate a new placeholder by following these steps Start new slide choose layout "Content Slide"

• Placeholders can be filled and then copied. The copied placeholder will keep its formatting

Add a Footnote/Source/ Disclaimer directly into the footer.

Faster TOF amplifies sensitivty

• 1Based on internal measurements available at time of publication. Data on file. 2Gain calculated for a 20 cm cylindrical object.

• Biograph Vision and its features and applications are not commercially available in all countries. Their future availability cannot be guaranteed. Please contact your local Siemens Healthineers organization for further details.

214 ps timing

resolution1

100% coverage1 of the LSO

array

Faster scanning & lower dose

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Phantom Comparison

BIO GRAPH M C T

1.67 mCi

402x106 Trues + Scatter

TOF OPOSEM: 2i21s 4 mm Gaussian

BIO GRAPH VIS IO N

1.28 mCi

422x106 Trues+Scatter

TOF OPOSEM: 2i9s 4 mm Gaussian

• To ensure a clean and swift workflow with bullet points, please use the PRE-SET PLACEHOLDERS or FORMATTED TEXTBOXES – do not use “normal” textboxes that have been added via the steps add textbox. These textboxes cannot be formatted with the automatic formatting step

• AUTOMATIC INDENTATIONS IN PLACEHOLDERS are only to be done using the tool decrease or increase the list level (or Shift + Alt + / )

• Formatted textboxes/ placeholders are available in the template – just make a copy OR: generate a new placeholder by following these steps Start new slide choose layout "Content Slide"

• Placeholders can be filled and then copied. The copied placeholder will keep its formatting

Add a Footnote/Source/ Disclaimer directly into the footer.

Small Lesion Detection

• Left and middle image acquired on Biograph mCT. Right image acquired on Biograph Vision. Based on internal measurements available at time of publication. Data on file.

• Biograph Vision and its features and applications are not commercially available in all countries. Their future availability cannot be guaranteed. Please contact your local Siemens Healthineers organization for further details.

non TOF TOF (540 ps) TOF (214 ps)

High-resolution torso phantom Sphere size (mm): 5.0, 7.9, 9.9, 12.4, 15.4, 19.8 6:1 contrast-to-background

Clinical Comparison: Body

BIO GRAPH M C T

BIO GRAPH VIS IO N

Images courtesy of Siemens Healthineers and The University of Tennessee

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• To ensure a clean and swift workflow with bullet points, please use the PRE-SET PLACEHOLDERS or FORMATTED TEXTBOXES – do not use “normal” textboxes that have been added via the steps add textbox. These textboxes cannot be formatted with the automatic formatting step

• AUTOMATIC INDENTATIONS IN PLACEHOLDERS are only to be done using the tool decrease or increase the list level (or Shift + Alt + / )

• Formatted textboxes/ placeholders are available in the template – just make a copy OR: generate a new placeholder by following these steps Start new slide choose layout "Content Slide"

• Placeholders can be filled and then copied. The copied placeholder will keep its formatting

Evaluate left lung lesion

Data courtesy of University Medical Center Groningen, Groningen, The Netherlands.

1 min per bed MIP 2 min per bed MIP 3 min per bed MIP

58yr female, 119 lbs, 4.6 mCi, UHD 440 matrix, 4i5s, AllPass

• To ensure a clean and swift workflow with bullet points, please use the PRE-SET PLACEHOLDERS or FORMATTED TEXTBOXES – do not use “normal” textboxes that have been added via the steps add textbox. These textboxes cannot be formatted with the automatic formatting step

• AUTOMATIC INDENTATIONS IN PLACEHOLDERS are only to be done using the tool decrease or increase the list level (or Shift + Alt + / )

• Formatted textboxes/ placeholders are available in the template – just make a copy OR: generate a new placeholder by following these steps Start new slide choose layout "Content Slide"

• Placeholders can be filled and then copied. The copied placeholder will keep its formatting

Data courtesy of University Medical Center Groningen, Groningen, The Netherlands.

1 min per bed coronal Image

Evaluate left lung lesion

58yr female, 119 lbs, 4.6 mCi, UHD 440 matrix, 4i5s, AllPass

Clinical Comparison: Brain

BIO GRAPH M C T

BIO GRAPH VIS IO N

Images courtesy of Siemens Healthineers and The University of Tennessee

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Courtesy of: Lausanne University Hospital, Lausanne, Switzerland

Dose: 158.2 MBq (4.3mCi) Acquisition time: 15 min

Brain Imaging: 18F-FDG

Data courtesy of Lausanne, Switzerland.

SOFTWARE TECHNOLOGY

Respiratory Motion

Decreases image quality

Reduces quantitative accuracy

Reduces diagnostic confidence

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Improves Visualization

Motion Noise

Standard PET vs. 4D Gated PET vs. Amplitude-Based Gating PET

No Gating

4D Gating

Amplitude- Gating

Amplitude gating + MoCo

Improved motion correction

Minimal loss of counts

Shorter scan times

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Amplitude gating Only Amplitude gating + MoCo

Amplitude gating only Amplitude gating + MoCo

ECG + Data Driven Gating

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Standard Gating vs. ECG+Data

On-bed Injection

6 minutes over heart

Input function collection

Parametric Imaging

On-bed Injection

6 minutes over heart

Input function collection

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Parametric Imaging

CT PET

FlowMotion – WB dynamic shuttle

What are Kinetics?

• Dynamic images

• ROI or voxel-based

Time-Activity Analysis

• TAC described by compartments

• Two-compartment FDG Model Modeling

• Compartment non-specific

• Equilibrium of plasma/tissue

Patlak Methods

FDG in Plasma

Cp(t)

FDG in Tissue Cf(t)

FDG-6-P in Tissue Cb(t)

K1

k2

k3

k4

Bq/ml

Kinetic Modeling

3 Images: SUV, MRGlu, DV

SUV MRGlu DV

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Acknowledgements: Shelley Acuff, RT(R), CNMT, CT: Clinical Research Leader Chris Carr, CNMT: Lead PET/CT Technologist Erica Carroll, RT(R), CNMT: PET/CT Techologist