Abstract: PurposeThe aim of the study was to evaluate the heterogeneity of primary tumor F-18-fluorodeoxyglucose (F-18-FDG) uptake in breast cancer patients using a dedicated breast PET.Patients and methodsA positron emission tomography/computed tomography (PET/CT) of the thorax was performed 60 min after administration of 180-240 MBq of F-18-FDG in patients with breast cancer. Subsequently, 110 min after injection, a scan was taken with a dedicated high-resolution breast PET [MAMmography with Molecular Imaging (MAMMI)]. Both procedures were performed with the patients in the prone position. Four-point scores were used to compare the intensity (0: none; 1: mild; 2: moderate; 3: high) and heterogeneity (0: none; 1: mild; 2: moderate; 3: high) of F-18-FDG uptake between PET/CT and MAMMI images.ResultsThirty-five patients in whom the primary tumor was visualized on both scans were included in this analysis. The mean primary tumor size was 35.1 mm (range 10-108 mm). The mean intensity score was similar on both devices (2.4 for PET/CT and 2.3 for MAMMI; P=0.439), but the mean heterogeneity score on MAMMI images was significantly higher (PET/CT 1.9 vs. MAMMI 2.3; P=0.005). MAMMI showed a higher heterogeneity score in 11 (31%) of 35 patients, especially in tumors with moderate or high intensity. Significantly higher heterogeneity scores on both PET/CT and MAMMI were seen in large tumors (P=0.005 and 0.014, respectively) and in tumors with high intensity scores (P=0.012 and P<0.001, respectively).ConclusionHeterogeneous tumor F-18-FDG uptake in breast cancer is frequently observed, particularly in large tumors with intense F-18-FDG uptake. It is more often seen on MAMMI PET than on conventional PET/CT. Although the observed heterogeneity should be proven histopathologically, this finding offers a rationale for F-18-FDG-guided biopsies.

Abstract: PET scanners with high spatial resolution offer a great potential in improving diagnosis, therapy monitoring and treatment validation for several severe diseases. One way to improve resolution of a PET scanner is to extend a conventional PET ring with a small probe with excellent spatial resolution. The probe is intended to be placed close to the area of interest. The coincidences of interactions within the probe and the external ring provide a subset of data which combined with data from external ring, greatly improve resolution in the area viewed by the probe. Our collaboration is developing a prototype of a PET probe, composed of high-resolution silicon pad detectors. The detectors are 1 mm thick, measuring 40 by 26 mm(2), and several such sensors are envisaged to either compensate for low stopping power of silicon or increase the area covered by the probe. The sensors are segmented into 1 mm(3) cubic voxels, giving 1040 readout pads per sensor. A module is composed of two sensors placed in a back-to-back configuration, allowing for stacking fraction of up to 70% within a module. The pads are coupled to a set of 16 ASICs (VaTaGP7.1 by IDEAS) per module and read out through a custom designed data acquisition board, allowing for trigger and data interfacing with the external ring. This paper presents an overview of probe requirements and expected performance parameters. It will focus on the characteristics of the silicon modules and their impact on overall probe performance, including spatial resolution, energy resolution and timing resolution. We will show that 1 mm(3) voxels will significantly extend the spatial resolution of conventional PET rings, and that broadening of timing resolution related to varying depth of photon interactions can be compensated to match the timing resolution of the external ring. The initial test results of the probe will also be presented.

Abstract: Particle therapy is a highly conformal radiotherapy technique which reduces the dose deposited to the surrounding normal tissues. In order to fully exploit its advantages, treatment monitoring is necessary to minimize uncertainties related to the dose delivery. Up to now, the only clinically feasible technique for the monitoring of therapeutic irradiation with particle beams is Positron Emission Tomography (PET). In this work we have compared a Resistive Plate Chamber (RPC)-based PET scanner with a scintillation-crystal-based PET scanner for this application. In general, the main advantages of the RPC-PET system are its excellent timing resolution, low cost, and the possibility of building large area systems. We simulated a partial-ring scannerbeam monitoring, which has an intrinsically low positron yield compared to diagnostic PET. In addition, for in-beam PET there is a further data loss due to the partial ring configuration. In order to improve the performance of the RPC-based scanner, an improved version of the RPC detector (modifying the thickness of the gas and glass layers), providing a larger sensitivity, has been simulated and compared with an axially extended version of the crystal-based device. The improved version of the RPC shows better performance than the prototype, but the extended version of the crystal-based PET outperforms all other options. based on an RPC prototype under construction within the Fondazione per Adroterapia Oncologica (TERA). For comparison with the crystal-based PET scanner we have chosen the geometry of a commercially available PET scanner, the Philips Gemini TF. The coincidence time resolution used in the simulations takes into account the current achievable values as well as expected improvements of both technologies. Several scenarios (including patient data) have been simulated to evaluate the performance of different scanners. Initial results have shown that the low sensitivity of the RPC hampers its application to hadron

Abstract: The AX-PET collaboration has developed a novel concept for high resolution PET imaging to overcome some of the performance limitations of classical PET cameras, in particular the compromise between spatial resolution and sensitivity introduced by the parallax error. The detector consists of an arrangement of long LYSO scintillating crystals axially oriented around the field of view together with arrays of wave length shifter strips orthogonal to the crystals. This matrix allows a precise 3D measurement of the photon interaction point. This is valid both for photoelectric absorption at 511 key and for Compton scattering down to deposited energies of about 100 keV. Crystals and WLS strips are individually read out using Geiger-mode Avalanche Photo Diodes (G-APDs). The sensitivity of such a detector can be adjusted by changing the number of layers and the resolution is defined by the crystal and strip dimensions. Two AX-PET modules were built and fully characterized in dedicated test set-ups at CERN, with point-like Na-22 sources. Their performance in terms of energy (Renew approximate to 11.8% (FWMH) at 511 key) and spatial resolution was assessed (sigma(axial) approximate to 0.65 mm), both individually and for the two modules in coincidence. Test campaigns at ETH Zurich and at the company AAA allowed the tomographic reconstructions of more complex phantoms validating the 3D reconstruction algorithms. The concept of the AX-PET modules will be presented together with some characterization results. We describe a count rate model which allows to optimize the planing of the tomographic scans.

Abstract: Silicon based devices can extend PET-MR and SPECT-MR imaging to applications, where their advantages in performance outweigh benefits of high statistical counts. Silicon is in many ways an excellent detector material with numerous advantages, among others: excellent energy and spatial resolution, mature processing technology, large signal to noise ratio, relatively low price, availability, versatility and malleability. The signal in silicon is also immune to effects of magnetic field at the level normally used in MR devices. Tests in fields up to 7 T were performed in a study to determine effects of magnetic field on positron range in a silicon PET device. The curvature of positron tracks in direction perpendicular to the field's orientation shortens the distance between emission and annihilation point of the positron. The effect can be fully appreciated for a rotation of the sample for a fixed field direction, compressing range in all dimensions. A popular Ga-68 source was used showing a factor of 2 improvement in image noise compared to zero field operation. There was also a little increase in noise as the reconstructed resolution varied between 2.5 and 1.5 mm. A speculative applications can be recognized in both emission modalities, SPECT and PET. Compton camera is a subspecies of SPECT, where a silicon based scatter as a MR compatible part could inserted into the MR bore and the secondary detector could operate in less constrained environment away from the magnet. Introducing a Compton camera also relaxes requirements of the radiotracers used, extending the range of conceivable photon energies beyond 140.5 keV of the Tc-99m. In PET, one could exploit the compressed sub-millimeter range of positrons in the magnetic field. To exploit the advantage, detectors with spatial resolution commensurate to the effect must be used with silicon being an excellent candidate. Measurements performed outside of the MR achieving spatial resolution below 1 mm are reported.