Abstract: A Compton telescope for dose monitoring in hadron therapy is under development at IFIC. The system consists of three layers of LaBr3 crystals coupled to silicon photomulti-plier arrays. Na-22 sources have been successfully imaged reconstructing the data with an ML-EM code. Calibration and temperature stabilization are necessary for the prototype operation at low coincidence rates. A spatial resolution of 7.8 mm FWHM has been obtained in the first imaging tests.

Abstract: Compton cameras can offer advantages over gamma cameras for some applications, since they are well suited for multitracer imaging and for imaging high-energy radiotracers, such as those employed in radionuclide therapy. While in conventional clinical settings state-of-the-art Compton cameras cannot compete with well-established methods such as PET and SPECT, there are specific scenarios in which they can constitute an advantageous alternative. The combination of PET and Compton imaging can benefit from the improved resolution and sensitivity of current PET technology and, at the same time, overcome PET limitations in the use of multiple radiotracers. Such a system can provide simultaneous assessment of different radiotracers under identical conditions and reduce errors associated with physical factors that can change between acquisitions. Advances are being made both in instrumentation developments combining PET and Compton cameras for multimodal or three-gamma imaging systems, and in image reconstruction, addressing the challenges imposed by the combination of the two modalities or the new techniques. This review article summarizes the advances made in Compton cameras for medical imaging and their combination with PET.

Abstract: Hadron therapy exploits the properties of ion beams to treat tumors by maximizing the dose released to the target and sparing healthy tissue. With hadron beams, the dose distribution shows a relatively low entrance dose which rises sharply at the end of the range, providing the characteristic Bragg peak that drops quickly thereafter. It is of critical importance in order not to damage surrounding healthy tissues and/or avoid targeting underdosage to know where the delivered dose profile ends-the location of the Bragg peak. During hadron therapy, short-lived beta(+)-emitters are produced along the beam path, their distribution being correlated with the delivered dose. Following positron annihilation, two photons are emitted, which can be detected using a positron emission tomography (PET) scanner. The low yield of emitters, their short half-life, and the wash out from the target region make the use of PET, even only a few minutes after hadron irradiation, a challenging application. In-beam PET represents a potential candidate to estimate the distribution of beta(+)-emitters during or immediately after irradiation, at the cost of truncation effects and degraded image quality due to the partial rings required of the PET scanner. Time-of-flight (ToF) information can potentially be used to compensate for truncation effects and to enhance image contrast. However, the highly demanding timing performance required in ToF-PET makes this option costly. Alternatively, the use of maximum-a-posteriori-expectation-maximization (MAP-EM), including total variation (TV) in the cost function, produces images with low noise, while preserving spatial resolution. In this paper, we compare data reconstructed with maximum-likelihood-expectation-maximization (ML-EM) and MAP-EM using TV as prior, and the impact of including ToF information, from data acquired with a complete and a partial-ring PET scanner, of simulated hadron beams interacting with a polymethyl methacrylate (PMMA) target. The results show that MAP-EM, in the absence of ToF information, produces lower noise images and more similar data compared to the simulated beta(+) distributions than ML-EM with ToF information in the order of 200-600 ps. The investigation is extended to the combination of MAP-EM and ToF information to study the limit of performance using both approaches.

Abstract: We present a novel intrinsic method for joint reconstruction of both image and motion in positron emission tomography (PET). Intrinsic motion compensation methods exclusively work on the measured data, without any external motion measurements. Most of these methods separate image from motion estimation: They use deformable image registration/optical flow techniques in order to estimate the motion from individually reconstructed gates. Then, the image is estimated based on this motion information. With these methods, a main problem lies in the motion estimation step, which is based on the noisy gated frames. The more noise is present, the more inaccurate the image registration becomes. As we show both visually and quantitatively, joint reconstruction using a simple deformation field motion model can compete with state-of-the-art image registration methods which use robust multilevel B-spline motion models.

Abstract: In order to exploit the advantages of ion-beam therapy in a clinical setting, delivery verification techniques are necessary to detect deviations from the planned treatment. Efforts are currently oriented towards the development of devices for real-time range monitoring. Among the different detector concepts proposed, Compton cameras are employed to detect prompt gammas and represent a valid candidate for real-time range verification. We present the first on-beam test of MACACO, a Compton telescope (multi-layer Compton camera) based on lanthanum bromide crystals and silicon photo-multipliers. The Compton telescope was first characterized through measurements and Monte Carlo simulations. The detector linearity was measured employing Na-22 and Am-Be sources, obtaining about 10% deviation from linearity at 3.44 MeV. A spectral image reconstruction algorithm was tested on synthetic data. Point-like sources emitting gamma rays with energy between 2 and 7 MeV were reconstructed with 3-5 mm resolution. The two-layer Compton telescope was employed to measure radiation emitted from a beam of 150 MeV protons impinging on a cylindrical PMMA target. Bragg-peak shifts were achieved via adjustment of the PMMA target location and the resulting measurements used during image reconstruction. Reconstructed Bragg peak profiles proved sufficient to observe peak-location differences within 10 mm demonstrating the potential of the MACACO Compton Telescope as a monitoring device for ion-beam therapy.