Medical Imaging and Nuclear Medicine

Nuclear Medicine

Gizeaddis L.
Jimma University
Jimma Institute of Technology
Biomedical Engineering Department
 Nuclear Medicine
The use of radioactive tracers (radiopharmaceuticals) to obtain
diagnostic information [and for targeted radiotherapy].

Radiation is emitted from inside the human body

Tracers :-
Trace the paths of various biochemical molecules in our body.

Hence can obtain functional information about the bodies

workings (i.e. physiology).
All tissues and organs with measurable perfusion and metabolism can
be investigated
Exceptions: hair , finger nails, teeth, vitreous body, cartilage
 Radiopharmaceuticals

+
Biochemical Radioactive
Pharmaceutical
Bonding nuclide
Traces physiology /
Emits radiation for
localises in organs of
detection or therapy
interest
 Radioactive nuclides
Radioactive decay: rearrangement of nuclei to lower
energy states

Parent atom decays to daughter atom

Daughter has higher binding energy/nucleon than parent

A radio atom is said to decay when its nucleus rearranged

A disintegration is a radioatom undergoing radioactive

decay

Energy is released with disintegration.

 Radioactive Decays

Number of Number of
Number of
protons increase protons
protons and
by 1 and decreases by 1
number of
number of and number of
neutrons is each
neutrons neutrons
diminished by 2
decreased by 1 increases by 1
Radioactive Decays
Radioactive Decay
Fundamental Decay Equation
Activity
Physical Half-Life and Decay Constant
 Production of Radionuclides
Radioactive elements (radionuclides) are produced by:
Natural occurrence, but rarely
Nuclear reactors (bombarding neutron beams to stable nuclides)
Cyclotron (bombarding accelerated charged particles to stable nuclides)
Radionuclides for Diagnostic Applications
 Production of Radiopharmaceuticals
A radioactive compound used for the diagnosis and therapeutic treatment
of human diseases.

Radiopharmaceutical = Radionuclide + Pharmaceutical

For example,

99mTc-MDP = 99mTc (radionuclide) + MDP (methylene diphosphonate)

Used in skeletal scintigraphy primarily for detection of neoplasm,

infection, or trauma.

18F-FDG = 18F (radionuclide) + FDG (fluorodeoxyglucose)

Used in PET primarily to diagnose many brain diseases, measure

regional brain function, measure myocardial viability, and diagnose or
stage a variety of cancers.
Nuclear Medical Diagnostics
 Study of Function and Physiology
Common radiologic imaging (X-ray, CT, MRI )
Basic transmission imaging
Morphological, structural information
The images in anatomical imaging consist of true physical parameters
(e.g., CT number in CT is directly proportional to photon attenuation
coefficient in the imaged object).

Nuclear medicine imaging (Scintigraphy, SPECT, PET)

Basically emission imaging
Physiologic, metabolic , biochemical information
Use of pharmaceutical (physiology or function) chemically labeled
with radioactive elements: Radiopharmaceutical (or radiotracer).
 Anger Scintillation Camera (Gamma Camera)

A gamma camera, also called a scintillation camera or Anger camera,

is a device used to image gamma radiation emitting radioisotopes,

A gamma camera consists

Collimator

flat crystal planes (or detectors)

array of photomultiplier tubes

Position logic circuits

Anger Scintillation Camera (Gamma Camera)
Anger Scintillation Camera (Gamma Camera)

Compare the detected signal to a threshold

Compute the location with highest activity

Convert light to electrical currents

Convert detected photons to lights
Absorb scattered photons
Planar Scinitgraphy
Capture the emitted gamma photons
(one at a time) in a single direction.
Use scintillation camera
single large area NaI(TI) crystal
Increase of sensitivity by using focusing
collimators

Imaging principle:

by capturing the emitted gamma

photons in one direction, determine
the radioactivity distribution within
the body.

on the contrary, X-ray imaging tries

to determine the attenuation
coefficient to the x-ray.
Components of a standard nuclear medicine imaging system
Applications of Planar Scinitgraphy
Skeletal Scintigraphy (99mTc-MDP)
 99mTc-MDP Bone Scan

Normal Metastatic Prostate Cancer

Single Photon Emission Computed Tomography

If the gamma camera can be tilted through a wide range of

angles with respect to the patient, then a collection of 2D
projections can be obtained and combined to make a
tomographic reconstruction

Capture photons in multiple directions, similar to X-ray CT

Uses a rotating Anger camera to obtain projection data from

multiple angles

Recent advances uses multiple Anger cameras (multiple heads),

reducing scanning time (below 30 min.)
 SPECT System

Anger cameras in SPECT

must have significantly
better performances than
for planar scintigraphy to
avoid reconstruction
artifacts.

A dual head system

SPECT System
Simplified Scheme of SPECT Measurement
Multiple Sequential Projections for SPECT Imaging
SPECT
SPECT
 PET Principle

Principle: detect coincident gamma rays

Positron emitters used

Positron annihilation:

Short distance from emission

Produces two 511 keV gamma rays
Gamma rays 1800 opposite directions
PET Principle
 Annihilation Coincidence Detection
Detect two events in opposite directions occurring
(simultaneously)

Time window is 2-20 ns, typically 12 ns

No detector collimation is required

(higher sensitivity)
 Annihilation Coincidence Detection
The emitted positron travels
about 5 mm before
annihilating with an
electron to form two -rays
which travel away from the
annihilation site in opposite
directions.
Coincidence detection is
used to discriminate against
spurious background counts
and define a line of sight
PET Scanner
PET Scanners
 The Basic PET Process

Positron Tracer
emitting injection
isotope Data
production acquisition
(cyclotron)

Tracer Interpret
labeling ation
(radio Image
chemistry) reconstruct
ion
 PET Image Reconstruction

Integral of the
activity along the
line or tube of Detector
response Scattered efficiency
coincidences
Attenuation effects
component True
coincidences
component
Assumed Measured
projection Random projection
coincidences
component
Object
(uniform
cylinder)
 PET Image Reconstruction
2D Reconstruction
Each parallel slice is reconstructed independently (a 2D sinogram
originates a 2D slice)
Slices are stacked to form a 3D volume f(x,y,z)

etc
Slice 5
etc Slice 4
Plane 5 Slice 3
Plane 4 Slice 2
Plane 3
Plane 2

2D reconstruction
2D reconstruction
2D reconstruction
2D reconstruction
Reconstruction Filter
Applications
Applications
 Applications

Figure 1 is a PET scan that shows normal activity in a healthy brain.

Figure 2 is a PET scan of a brain in a person with Alzheimer's disease. The

gray area outlined on Figure 2 shows lower levels of brain activity.
PET/CT Examination with FDG
Commercial PET/CT Scanners
PET/CT Scanner
SPECT/CT Scanner
PET/MRI Scanner
Image Fusion
Comparison SPECT vs. PET
Characteristics Features of Medical Imaging Modalities
Characteristics Features of Medical Imaging Modalities