Browsing by Author "Roper, Justin R"

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Open Access
On-board Single Photon Emission Computed Tomography (SPECT) for Biological Target Localization
(2010) Roper, Justin R
On-board imaging is useful for guiding radiation to patients in the treatment position; however, current treatment-room imaging modalities are not sensitive to physiology - features that may differentiate tumor from nearby tissue or identify biological targets, e.g., hypoxia, high tumor burden, or increased proliferation. Single photon emission computed tomography (SPECT) is sensitive to physiology. We propose on-board SPECT for biological target localization.
Localization performance was studied in computer-simulated and scanner-acquired parallel-hole SPECT images. Numerical observers were forced to localize hot targets in limited search volumes that account for uncertainties common to radiation therapy delivery. Localization performance was studied for spherical targets of various diameters, activity ratios, and anatomical locations. Also investigated were the effects of detector response function compensation (DRC) and observer normalization on target localization. Localization performance was optimized as a function of iteration number and degree of post-reconstruction smoothing. Localization error patterns were analyzed for directional dependencies and were related to the detector trajectory. Localization performance and the effect of the detector trajectory were investigated in a hardware study using a whole-body phantom.
Typically targets of 6:1 activity were localized as accurately using 4-minute scans as those of 3:1 activity using 20-minute scans. This trend is consistent with the relationship between contrast and noise in the contrast-to-noise ratio (CNR) and implies that higher contrast targets are better candidates for on-board SPECT because of time constraints in the treatment room. Using 4-minute scans, mean localization errors were within 2 mm for superficial targets of 6:1 activity that were proximal to the detector trajectory and of at least 14 mm in diameter. Localization was significantly better (p < 0.05, Wilcoxon signed-rank test) with than without observer normalization and DRC at 5 of 6 superficial tumor sites. Observer normalization improved localization substantially for a target proximal to the much hotter heart. Localization error patterns were shown to be anisotropic and dependent on target position relative to the detector trajectory. Detector views of close approach and of minimal attenuation were predictive of directions with the smallest (magnitude) localization bias and precision. The detector trajectory had a substantial effect on localization performance. In scanner-acquired SPECT images, mean localization errors of a 22-mm-diameter superficial target were 0.8, 1.5, and 6.9 mm respectively using proximal 180°, 360°, and distal 180° detector trajectories, thus demonstrating the benefits of using a proximal 180° detector trajectory.
In conclusion, the potential performance characteristics of on-board SPECT were investigated using computer-simulation and real-detector studies. Mean localization errors < 2 mm were obtained for proximal, superficial targets with diameters >14 mm and of 6:1 activity relative to background using scan times of approximately 5 minutes. The observed direction-dependent localization errors are related to the detector trajectory and have important implications for radiation therapy. This works shows that parallel-hole SPECT could be useful for localizing certain biological targets.
Open Access
Target localization using scanner-acquired SPECT data.
(Journal of applied clinical medical physics, 2012-05-10) Roper, Justin R; Bowsher, James E; Wilson, Joshua M; Turkington, Timothy G; Yin, Fang-Fang
Target localization using single photon emission computed tomography (SPECT) and planar imaging is being investigated for guiding radiation therapy delivery. Previous studies on SPECT-based localization have used computer-simulated or hybrid images with simulated tumors embedded in disease-free patient images where the tumor position is known and localization can be calculated directly. In the current study, localization was studied using scanner-acquired images. Five fillable spheres were placed in a whole body phantom. Sphere-to-background 99mTc radioactivity was 6:1. Ten independent SPECT scans were acquired with a Trionix Triad scanner using three detector trajectories: left lateral 180°, 360°, and right lateral 180°. Scan time was equivalent to 4.5 min. Images were reconstructed with and without attenuation correction. True target locations were estimated from 12 hr SPECT and CT images. From the 12 hr SPECT scan, 45 sets of orthogonal planar images were used to assess target localization; total acquisition time per set was equivalent to 4.5min. A numerical observer localized the center of the targets in the 4.5 min SPECT and planar images. SPECT-based localization errors were compared for the different detector trajectories. Across the four peripheral spheres, and using optimal iteration numbers and postreconstruction smoothing, means and standard deviations in localization errors were 0.90 ± 0.25 mm for proximal 180° trajectories, 1.31 ± 0.51 mm for 360° orbits, and 3.93 ± 1.48 mm for distal 180° trajectories. This rank order in localization performance is predicted by target attenuation and distance from the target to the collimator. For the targets with mean localization errors < 2 mm, attenuation correction reduced localization errors by 0.15 mm on average. The improvement from attenuation correction was 1.0 mm on average for the more poorly localized targets. Attenuation correction typically reduced localization errors, but for well-localized targets, the detector trajectory generally had a larger effect. Localization performance was found to be robust to iteration number and smoothing. Localization was generally worse using planar images as compared with proximal 180° and 360° SPECT scans. Using a proximal detector trajectory and attenuation correction, localization errors were within 2 mm for the three superficial targets, thus supporting the current role in biopsy and surgery, and demonstrating the potential for SPECT imaging inside radiation therapy treatment rooms.