The choice of injected dose of 18 F -FDG and acquisition time is important in obtaining consistently high-quality PET images. The aim of this study was to determine the optimal acquisition protocols based on patient weight for 3-dimensional lutetium oxyorthosilicate PET/CT. Methods: This study was a retrospective analysis of 76 patients ranging from 29 to101 kg who were injected with 228-395.2 MBq of 18 F -FDG for PET imaging. The study population was divided into 4 weight-based groups: less than 45 kg (group 1), 45-59 kg (group 2), 60-74 kg (group 3), and 75 kg or more (group 4). We measured the true coincidence rate, random coincidence rate, noise-equivalent counting rate (NECR), and random fraction and evaluated image quality by the coefficient of variance (COV) in the largest liver slices. Results: The true coincidence rate, random coincidence rate, and NECR significantly increased with increasing injected dose per kilogram (r = 0.91, 0.83, and 0.90; all P < 0.01). NECR maximized at10.11 MB/kg in underweight patients. The true coincidence rate differed significantly among the 4 groups, except for group 3 versus group 4 (P < 0.01). The ratio of the true coincidence rate for group 2 to groups 3 and 4 was 1.4 and 1.6, respectively. The average random fraction for all 4 groups was approximately 35%.The COV of the 4 groups differed for all pairs (P< 0.01). The COVs in overweight patients were larger than those in underweight patients, and image quality in overweight patients was poor. Conclusion: We modified acquisition protocols for 18 F -FDG PET/CT according to the characteristics of a 3-dimensional lutetium orthosilicate PET scanner

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Objective: A novel multifocal collimator, IQ-SPECT (Siemens) consists of cardio-centric and 3D iterative SPECT reconstruction and makes it possible to perform MPI scans in a short time. The aims are to delineate the normal uptake in thallium-201 ( 201 Tl) SPECT in each acquisition method and to compare the distribution between new and conventional protocol, especially in patients with normal imaging.Methods: Forty patients (eight women, mean age of seventy-five years) who underwent myocardial perfusion imaging were included in the study. All patients underwent one-day protocol perfusion scan after an adenosine-stress test and at rest after administrating 201 Tl and showed normal results. Acquisition was performed on a Symbia T6 equipped with a conventional dual-headed gamma camera system (Siemens ECAM) and with a multifocal collimator called IQ-SPECT. Imaging was performed with a conventional system followed by IQ-SPECT/computed tomography (CT).Reconstruction was performed with or without X-ray CT-derived attenuation correction (AC). Two nuclear physicians blinded to clinical information interpreted all MPI studies.A semi-quantitative myocardial perfusion was analyzed by a 17-segment model with a 5-point visual scoring. The uptake of each segment was measured and left ventricular functions were analyzed by QPS software.Results: IQ-SPECT provided good or excellent image quality. IQ-SPECT images without AC were similar to those of conventional LEHR study. Mid-inferior defect score (0.3±0.5) in conventional LEHR study was increased significantly in IQ-SPECT with AC (0±0). IQ-SPECT (AC) improved the mid-inferior decreased perfusion shown in conventional images. The apex in IQ-SPECT (AC) was decreased compared to that in LEHR (0.1±0.3 vs. 0.5±0.7, p<0.05). The left ventricular ejection fraction from IQ-SPECT was significantly higher than that from the LEHR collimator (p=0.0009). Conclusion:The images of IQ-SPECT acquired in a short time are equivalent with that of conventional LEHR. The results indicated that the IQ-SPECT system with attenuation correction is capable of correcting inferior artifacts with high image quality.(Ann Nucl Med)

Purpose A high‐energy‐resolution whole‐body SPECT‐CT device (NM/CT 870 CZT; C‐SPECT) equipped with a CZT detector has been developed and is being used clinically. A MEHRS collimator has also been developed recently, with an expected improvement in imaging accuracy using medium‐energy radionuclides. The objective of this study was to compare and analyze the accuracies of the following devices: a WEHR collimator and the MEHRS collimator installed on a C‐SPECT, and a NaI scintillation detector‐equipped Anger‐type SPECT (A‐SPECT) scanner, with a LEHR and LMEGP. Methods A line phantom was used to measure the energy resolutions including collimator characteristics in the planar acquisition of each device using 99mTc and 123I. We also measured the system's sensitivity and high‐contrast resolution using a lead bar phantom. We evaluated SPECT spatial resolution, high‐contrast resolution, radioactivity concentration linearity, and homogeneity, using a basic performance evaluation phantom. In addition, the effect of scatter correction was evaluated by varying the sub window (SW) employed for scattering correction. Results The energy resolution with 99mTc was 5.6% in C‐SPECT with WEHR and 9.9% in A‐SPECT with LEHR. Using 123I, the results were 9.1% in C‐SPECT with WEHR, 5.5% in C‐SPECT with MEHRS, and 10.4% in A‐SPECT with LMEGP. The planar spatial resolution was similar under all conditions, but C‐SPECT performed better in SPECT acquisition. High‐contrast resolution was improved in C‐SPECT under planar condition and SPECT. The sensitivity and homogeneity were improved by setting the SW for scattering correction to 3% of the main peak in C‐SPECT. Conclusion C‐SPECT demonstrates excellent energy resolution and improved high‐contrast resolution for each radionuclide. In addition, when using 123I, careful attention should be paid to SW for scatter correction. By setting the appropriate SW, C‐SPECT with MEHRS has an excellent scattered ray removal effect, and highly homogenous imaging is possible while maintaining the high‐contrast resolution.

BackgroundPhase analysis of gated myocardial perfusion single-photon emission computed tomography (SPECT) for assessment of left ventricular (LV) dyssynchrony was investigated using the following dedicated software packages: Corridor4DM (4DM), cardioREPO (cREPO), Emory Cardiac Toolbox (ECTb), and quantitative gated SPECT (QGS). The purpose of this study was to evaluate the normal values of 95% histogram bandwidth, phase standard deviation (SD), and entropy and to compare the diagnostic performance of the four software packages. A total of 122 patients with normal myocardial perfusion and cardiac function (58.9 ± 12.3 years, 60 women, ejection fraction (EF) 74.3 ± 5.7%, and end-diastolic volume (EDV) 83.5 ± 3.6 mL) and 34 patients with suspected LV dyssynchrony (64.1 ± 12.2 years, 9 women, EF 52.0 ± 18.0%, and EDV 145.0 ± 6.8 mL) who underwent Tc-99m methoxy-isobutyl-isonitrile/tetrofosmin gated SPECT were retrospectively evaluated. Dyssynchrony indices of the 95% histogram bandwidth, phase SD, and entropy were computed with the four software programs. Diagnostic performance of LV phase dyssynchrony assessments was determined by receiver operator characteristic (ROC) analysis. The area under the ROC curve (AUC) was used to compare the software programs. The optimal cutoff point was determined by ROC curve based on the Youden index.ResultsThe average of normal bandwidth significantly differed among the four software programs except in the comparison of 4DM and ECTb. Moreover, the normal phase SD significantly differed among the four software programs except in the comparison of cREPO and ECTb. The software programs showed high correlation levels for bandwidth, phase SD, and entropy (r ≥ 0.73, p < 0.001). ROC AUCs of bandwidth, phase SD, and entropy were ≥0.850, ≥0.858, and ≥0.900, respectively. Moreover, the ROC AUCs of bandwidth, phase SD, and entropy did not significantly differ among the four software programs. Optimal cutoff points for phase parameters were 24°–42° for bandwidth, 8.6°–15.3° for phase SD, and 31–48% for entropy.ConclusionsAlthough the optimal cutoff value for determining LV phase dyssynchrony by ROC analysis varied depending on the use of the different software programs, all software programs can be used reliably for phase dyssynchrony analysis.

Pleomorphic adenoma is a very rare benign tumor of the breast. Only 70 cases have been reported in the world literature. Recently, we encountered a case of pleomorphic adenoma of the breast and thus present here the mammographic and ultrasonographic findings with the pathology of this rare breast tumor. The patient was a 76-year-old Japanese woman with a right breast mass. The mammography showed a 1.5-cm, lobulated high-density mass with partially ill-defined margins. Ultrasonography revealed an irregularly shaped mass with partially ill defined borders, hypoechoic and heterogeneous internal echoes, and posterior acoustic enhancement. These findings suggested an invasive carcinoma. Awareness of this type of tumor will help in correct diagnosis, in spite of the rarity of this disease.

Tc-PYP accumulation in the myocardium. Patients were divided into two groups with and without a diagnosis of cardiac amyloidosis, and we examined the PYP accumulation rates in both groups. In addition, we examined the PYP scores of the two groups by conventional qualitative evaluation. Results: The PYP scores of the cardiac amyloidosis group were significantly higher than those of the other group. The PYP accumulation rates of the cardiac amyloidosis group were significantly higher than those of the other group. There was a significant difference in the PYP accumulation rate and PYP score between the two groups. There was considered to be the threshold between two groups in the case of PYP accumulation rate. Conclusions: When the threshold of the PYP score was defined as 3+ and that of the PYP accumulation rate was defined as 41.5%, the sensitivity of the PYP score and PYP accumulation rate was 84.6%. However, the specificity of the PYP accumulation rate was higher than that of the PYP score.Quantitative evaluation by PYP accumulation rate of the degree of 99m Tc-PYP accumulation in the myocardium may be useful in the diagnosis of cardiac amyloidosis. Novel quantitative cardiac amyloidosis evaluation method

Background Small-animal single-photon emission computed tomography (SPECT) systems with multi-pinhole collimation and large stationary detectors have advantages compared to systems with moving small detectors. These systems benefit from less labour-intensive maintenance and quality control as fewer prone parts are moving, higher accuracy for focused scans and maintaining high resolution with increased sensitivity due to focused pinholes on the field of view. This study aims to investigate the performance of a novel ultra-high-resolution scanner with two-detector configuration (U-SPECT5-E) and to compare its image quality to a conventional micro-SPECT system with three stationary detectors (U-SPECT+). Methods The new U-SPECT5-E with two stationary detectors was used for acquiring data with 99mTc-filled point source, hot-rod and uniformity phantoms to analyse sensitivity, spatial resolution, uniformity and contrast-to-noise ratio (CNR). Three dedicated multi-pinhole mouse collimators with 75 pinholes each and 0.25-, 0.60- and 1.00-mm pinholes for extra ultra-high resolution (XUHR-M), general-purpose (GP-M) and ultra-high sensitivity (UHS-M) imaging were examined. For CNR analysis, four different activity ranges representing low- and high-count settings were investigated for all three collimators. The experiments for the performance assessment were repeated with the same GP-M collimator in the three-detector U-SPECT+ for comparison. Results Peak sensitivity was 237 cps/MBq (XUHR-M), 847 cps/MBq (GP-M), 2054 cps/MBq (UHS-M) for U-SPECT5-E and 1710 cps/MBq (GP-M) for U-SPECT+. In the visually analysed sections of the reconstructed mini Derenzo phantoms, rods as small as 0.35 mm (XUHR-M), 0.50 mm (GP-M) for the two-detector as well as the three-detector SPECT and 0.75 mm (UHS-M) were resolved. Uniformity for maximum resolution recorded 40.7% (XUHR-M), 29.1% (GP-M, U-SPECT5-E), 16.3% (GP-M, U-SPECT+) and 23.0% (UHS-M), respectively. UHS-M reached highest CNR values for low-count images; for rods smaller than 0.45 mm, acceptable CNR was only achieved by XUHR-M. GP-M was superior for imaging rods sized from 0.60 to 1.50 mm for intermediate activity concentrations. U-SPECT5-E and U-SPECT+ both provided comparable CNR. Conclusions While uniformity and sensitivity are negatively affected by the absence of a third detector, the investigated U-SPECT5-E system with two stationary detectors delivers excellent spatial resolution and CNR comparable to the performance of an established three-detector-setup.