Positron Emission Tomography (PET)

Bringing the Invisible to Light

Created By: Hung Vo

Date: 11/02/2009
Course: Chem 717 - Instrumental Analysis
 What is Emission Tomography?

PET SPECT MRI

Human Illnesses and Behavioral Health. http://www.humanillnesses.com/images/hdc_0000_0001_0_img0004.jpg (accessed October 27,
2009).
Epilepsy. http://www.epilepsinet.dk/images/pictures/spect-scanningstor.jpg (accessed October 27, 2009).
Melissa Memorial Hospital. http://www.melissamemorial.org/userfiles/image/mri01.jpg (accessed Octoberr, 27, 2009).
 Key steps in ET study
 Radiopharmaceutical production:
 Create radiotracers
 Administration of radiopharmaceutical:
 Injection, inhalation
 Higher amount = better quality
 Safety dose
 Data acquisition:
 Imaging hardware record and detect
gamma-rays
 Stored as projection measurements
 Image reconstruction:
 Filtered back projection (FBP)  creates
tomographic images from projection data
 Image analysis:
 Image are analyzed for desired data or Wernick, N., and John N. A. Emission Tomography
The Fundamentals of PET and SPECT. New York:
statistics Academic Press, 2004. p14
 Radiotracers

 Unstable radioisotopes undergo

radioactive decay
 Nucleus is unstable
 Change in the number of protons or
neutrons to form a more stable
configuration
 For example: 18F-FDG (Flourine-
18-fluorodeoxyglucose)
 FDG is an analog of glucose
 18F is unstable radioisotopes that

emits positron

Maisey, M. Positron Emission Tomography and

Basic Sciences. New York: Springer, 2006, p24
 Radioactive decay
 Alpha decay:

 Beta decay:

 Positron decay:

 Electron capture:

 Isometric transition
Saha, B. Basics of PET Imaging Physics, Chemistry, and Regulations. New
York: Springer, 2005, p4
 Annihilation Process
 Positron comes to rest
 Combine with an e- 
two photons (0.511 MeV)
traveling in opposite
direction (~180°)
 Gamma-ray region

Saha, B. Basics of PET Imaging Physics, Chemistry, and Regulations.

New York: Springer, 2005, p6
 General Mechanism of PET Scanner

Wernick, N., and John N. A. Emission Tomography The Fundamentals of PET and SPECT. New York: Academic Press, 2004, p16
 What data is measured by the Ring
Detector in PET scanner?

 To measure (xr, Ф)
(sonogram)
 PET measures sonogram by
electronic collimation
 Coincidence event
 Site of decay event is along
the line

Maisey, M. Positron Emission Tomography and Basic Sciences.

New York: Springer, 2006, p36
 Scintillation Detectors

Maisey, M. Positron
Emission Tomography and
Basic Sciences. New
York: Springer, 2006, p45

 Scintillator  convert high-energy photons into low-

energy photons (in visible region)
 Photon detector (PMTs)  detect optical photons and
amplify the signals to produce electrical current pulse
 Scintillator

 Interactions of incoming
Gamma-rays and
scintillation crystal:
 Compton scattering
 Photoelectric effect
 Pair production
 The produced/recoiling
electrons have kinetic
energy  energy of visible
photons Airy Nothing.
http://www.airynothing.com/high_energy_tutorial/detection/ima
ges/scintillator.gif (accessed October, 27, 2009).
 Scintillator Types
 Organic
 Liquid
 Economical
 Messy
 Solid Special Nuclear Material
http://carlwillis.files.wordpr
 Fast decay time ess.com/2008/07/fs_scintill
ator.jpg (accessed October,
 Long attenuation length 27, 2009)
 Emission spectra
 Inorganic (Preferred)
 NaI, CsI
 Excellent  resolution
 Slow decay time
 BGO
 High density, compact
 Photomultiplier tube (PMTs)

Wernick, N., and John N. A. Emission Tomography The Fundamentals of PET and SPECT. New York: Academic
Press, 2004, p108
 Photodiode

 An alternative for PMTs

is silicon photodiode
 Electron-hole pair
 Electrons  anode
(+)
 Holes  cathode (-)
 Movement of electrons
creates detectable
current

Wernick, N., and John N. A. Emission Tomography The Fundamentals of

PET and SPECT. New York: Academic Press, 2004, p113
 Coincidence Detection System

 Coincidence detection
system:
 Pair of gamma-rays
detector
 Amplifiers
 Pulse Height Analyzer
 Coincidence circuit
 Detectors  detect gamma
rays Wernick, N., and John N. A. Emission Tomography The Fundamentals of
PET and SPECT. New York: Academic Press, 2004, p16
 Amplifiers  amplify these
electrical signals
 Coincidence Detection System

 PHA  accepts photons with

selected above a certain
threshold
 PHA generates a logic
pulse and feeds into a
coincidence circuit
 Coincidence circuit analyzes
pool of pulses to find overlap
= a coincidence
 Time period window
 Coincidence event  sent to
1st computer for data
correction

Maisey, M. Positron Emission Tomography and Basic Sciences. New

York: Springer, 2006, p112
 4 Types of Coincidences

 True coincidence:
 Opposite direction
(~180°)
 Scattered coincidence:
 One photon
interacts with body
and scatters
 Misposition of the
event
Maisey, M. Positron Emission Tomography and Basic Sciences. New
York: Springer, 2006, p126
 4 Types of Coincidences

 Random coincidence:
 Separate
annihilation events
 Multiple coincidence:
 Three or more
photons are
detected
simultaneously
Maisey, M. Positron Emission Tomography and Basic Sciences. New
York: Springer, 2006, p126
 Data Correction

 Desired data  true

coincidences
 Errors random,
scattered, and multiple
coincidences
 One computer to correct
data prior to sending to
another computer for
image reconstruction

Wernick, N., and John N. A. Emission Tomography The

Fundamentals of PET and SPECT. New York: Academic Press,
2004, p16
 Image Reconstruction
 Backprojection:
 Each image pixel in (x, y) position at projection angle Ф, r is calculated by
the equation: r = x sinФ + y cosФ
 The backprojected image pixel A(x,y) is calculated by using the equation

Wernick, N., and John N. A. Emission Tomography The

Fundamentals of PET and SPECT. New York: Academic Press,
2004, p13
 PET Scanner

Canadian Agency for Drugs and Technology in Health. http://www.cadth.ca/media/healthupdate/issue1/hta_update_pet_scanner.jpg

(accessed October, 27, 2009)
 Applications of PET in Medicine
A B
 Various areas of clinical
diagnosis and management:
 Cancer diagnoses and
management
 Cardiology and cardiac
surgery
 Neurology and psychiatry
 Drug development and
regulation:
 Drug distribution
 Process of clearing drugs
by our body
Maisey, M. Positron Emission Tomography and Basic Sciences. New
York: Springer, 2006, p10
 Application of PET in Staging Lung
Adenocarcinomas

 TNM staging system:

 T – tumor size
 N – lymph node involvement
 M – metastasis
 Cancer staging can also be divided into:
 Clinical stage  c-stage
 Pathologic stage  p-stage
 Tumor genes that are often associated with proliferative activity of
cancer:
 Ki-67
 Cyclin D1
 p53
 Application of PET in Staging Lung
Adenocarcinomas

 71 patients (c-stage IA lung

adenocarcinomas with a tumor size range
of 1-3 cm)
 Contrast ratio (CR) value = index of FDG
uptake
 CR = (T-N)/(T+N)
 T – ROI
 N – contralateral lung
 Immunohistochemical analysis with
staining scores from 0 to 3 for three genes
 0 – none
 1 – weak intensity
 2 – intermediate intensity
Nomori H, Watanabe K, Ohtsuka T, Naruke
 3 – strong intensity T, Suemasu K, Uno K. Japanese Journal of
Clinical Oncology 2004;45:98–105.
 Results
Watanabe, Ken-ichi. Japanese Journal of
Clinical Oncology ,2004;45:19–27.

 CR value is proportional to the invasion of the tumor

 The staining score of Ki-67 shows a positive correlation with the invasiveness
 Staining scores of p53 and Cyclin D1 do not show significance difference
between different stages
 Correlation between CR and Ki-67

Watanabe, Ken-ichi. Japanese

Journal of Clinical Oncology ,
2004;45:19–27.

 Data from the table are used to construct a calibration curve between CR values and Ki-67
staining score
 The curve with a slope of 0.42 indicates a strong correlation between CR values and Ki-67
staining score
 Thus, it is possible to use PET as a tool to diagnose stage of lung adenocarcinomas as well
as how proliferative these adenomas are.