NUCLEAR MEDICAL IMAGING SYSTEMS

USE OF RADIO-ISOTOPES IN MEDICAL IMAGING

Radio-isotopes are used in medicine both for therapeutic as well as diagnostic
applications. In diagnostic practice, small amounts of radioactive chemicals, called
‘tracers’ (or radio-pharmaceuticals), are injected into an arm vein or administered
through ingestion or inhalation. The amount of radioactivity at different points within
the patient’s body, or in body fluids, is then examined by radiation detectors. Using
these detectors, the amount of radioactivity can be measured within parts of organs
as well as within the whole organ. The images show where biochemical processes are
occurring normally and where they are occurring too slowly or too quickly. The clinical
use of radio-nuclide imaging depends on obtaining a suitable distribution of the radio-
nuclide in the patient. The radio-nuclide is labelled to a compound which will be taken
up or metabolized in some way by the human tissue to be studied. The patient receives
the material, usually by intravenous injection, and after a suitable delay, which may be
minutes or hours, to allow uptake in the target tissues and clearance from the blood,
imaging can commence. In this way useful static images, each taking 2–10 minutes,
can be produced of the bone, brain, thyroid, lung etc.

PHYSICS OF RADIOACTIVITY
Some elements are naturally unstable and exhibit natural radioactivity. On the other
hand, elements can be made radioactive by bombarding them with high-energy
charged particles or neutrons, which are produced by either a cyclotron or a nuclear
reactor. This process will alter the ratio of photons to neutrons in the atoms, thus
creating a new unstable nucleus which could undergo radioactive decay. The extra
neutron disintegrates and, in the process, releases energy in the form of gamma
radiation. Radioactive emissions take place in the following three different forms:

• Alpha Emissions: Alpha particles are composed of the two protons and two
neutrons. They are least penetrating and can be stopped or absorbed by air.
They are most harmful to the human tissue.
 • Beta Emissions: Beta particles are positively or negatively charged, high
speed particles originating in the nucleus. They are not as harmful to tissue as
alpha particles, because they are less ionizing, but are much more harmful than
gamma rays.
• Gamma Emissions: Like X-rays, Gamma particles constitute electromagnetic
radiation that travels at the speed of light. They differ from X-rays only in their
origin. X-rays originate in the orbital electrons of an atom, whereas gamma
rays originate in the nucleus. As they have no mass, they have the greatest
penetrating capability. Gamma rays are of primary interest in nuclear imaging
systems. The energies of alpha and beta particles and gamma radiations are
expressed in terms of the electron volt. One electron volt signifies the energy
that an electron would acquire, if it were accelerated through a potential
difference of one volt.

TIME DECAY OF RADIOACTIVE ISOTOPES

Each radioactive isotope is characterized not only by the type and energy of radiations
emitted, but also by the characteristic life-time of the isotope. This is most conveniently
designated by the half-life or half-period of the isotope. The half-period of a radioactive
isotope is the time required for half of the initial stock of atoms to decay. Thus, after
one-half period has elapsed, the total activity of any single radioactive isotope will have
fallen to half its initial value.
The half-life of a radioactive isotope is given by :
t ½ = 0.693/lambda
where lambda is the decay constant for a particular radio-isotope

UNIT OF RADIOACTIVITY
The unit of radioactivity is curie and is abbreviated as Ci or ci. This was originally
defined to represent the disintegration rate of one gram of radium, but it is now used
as the standard unit of measurement for the activity of any substance, regardless of
whether the emission is alpha or beta particles, or X or gamma radiation.
RADIATION DETECTORS
Several methods are available for detection and measurement of radiation from radio-
nuclides. The choice of a particular method depends upon the nature of the radiation
and the energy of the particle involved. If the radiation falls on a photographic plate, it
would cause darkening when developed after exposure. The photographic method is
useful for measuring the total exposure to radiation of workers, who are provided with
film badges. Better methods are available for an exact measurement of the activity.
These methods are the use of: (i) ionization chamber, (ii) Geiger Muller Counter, (iii)
Proportional Counter, (iv) semiconductor detectors, and (vi) solid state detectors
PROCESS INVOLVED IN THE FORMATION OF FDG
BASIC PRINCIPLE BEHIND THE WORKING OF A CYCLOTRON: A cyclotron is
basically a particle accelerator, that accelerates charged particles outwards from the
center along a spiral path. The particles are held to a spiral trajectory by a static
magnetic field and accelerated by a rapidly varying electric field. The principle of a
cyclotron is the use of cross electric and magnetic fields so as to accelerate
charged particles.

A high frequency alternating voltage is used, which is applied between two hollow "D"-
shaped sheet metal electrodes inside a vacuum chamber. They are placed face to
face with a narrow gap between them, creating a cylindrical space within them for the
particles to move. The particles are injected into the centre of this space. Within this
small vacant space in between the two ‘DEES’ a high electric field is applied by the
virtue of an oscillator which makes the two ‘DEES’ opposite in polarity and this change
in polarity occurs in 0.5 times the particle’s cyclotron frequency

[Tosci=0.5 Tcyclo= Pi m/qB]

These electrodes are located between the poles of a large electromagnet which
applies a static magnetic field B perpendicular to the electrode plane. The magnetic
field causes the particles' path to bend in a circle due to the Lorentz Force
perpendicular to their direction of motion.

[F=qE+q(v X B)]

If the particles' speeds were constant, they would travel in a circular path within the
electrodes under the influence of the magnetic field. However, a radio frequency
alternating voltage of several thousand volts is applied between them. Each time after
the particles pass to the other electrode, the polarity of the radio frequency voltage
reverses. Therefore, each time the particles cross the gap from one electrode to the
other, the electric field is in the correct direction to accelerate them. The particles'
increasing speed due to these pushes causes them to move in a larger radius circle
with each rotation, so the path becomes a spiral, causing the particles move from the
center to the rim of the electrodes.

When they reach the rim a small voltage on a metal plate deflects the beam so it exits
the electrodes through a small gap between them, and hits a target located at the exit
point .
MODEL OF CYCLOTRON WE DEALT WITH-ECLIPSE HP
MANUFATURER-SIEMENS
Components used in a cyclotron system-
Ion source and Power Supplies
• ION SOURCE-The gas containing the desired ion (hydrogen at CNTS) is
admitted into tubing at the center of the machine A negative voltage is applied
between two cathodes at the top and bottom of the tubing thereby creating an
arc The magnetic field causes the electrons (in the arc) to spiral up and down
the chimney The spiralling electrons collide with gas molecules, ionizing them
in the process The positive ions are extracted through a narrow slit in the
chimney by the electric field from the dee tip whenever the dee is negative
Fig (a & a.1) depicts the ion source
• ARC power supply (2.5 KVDC) - An electric arc is a device in which an electric
current (a flow of electrons) is caused to flow between two points separated by
a gas. The two points are called electrodes. The one from which the current
originates is the cathode. The electrode toward which electrons flow is the
anode. The term electric arc refers both to the device itself as well as to the
electric discharge that takes place within the device. In an electric arc, the
energy needed to produce ionization comes from an external source, such as
an electric generator. An intense stream of electrons flows into the cathode and
then across the gas-filled gap to the anode. As these electrons pass through
the gas, they cause ionization. Ions formed in the process make the flow of
current between electrodes even easier. For every gas, some minimum amount
of energy is needed
• Bias Power Supply (25 KVDC) -When a Bias power supply voltage is induced
,the H- ions from the plasma chamber are pulled through a narrow slit and enter
into the main acceleration arena of the cyclotron.

RF Generator-
The RF Generator generates the Radio Frequency which is a high frequency
alternating voltage applied between two hollow "D"-shaped sheet metal electrodes
inside a vacuum chamber. They are placed face to face with a narrow gap between
them, creating a cylindrical space within them for the particles to move. The particles
are injected into the centre of this space. Within this small vacant space in between
the two ‘DEES’ a high electric field is applied by the virtue of an oscillator which makes
the two ‘DEES’ opposite in polarity.
Fig(b) depicts the RF Generator
EXTRACTION SYSTEM
The extractors are used to “extract” the hydrogen(H-) ions. Three extraction foils may
be mounted on the carousel. The carousel is positioned to “catch” the beam. The ions
reverse reverse polarity and divert to strike the target. The accelerating negatively
charged (H-) ions strike the carbon extraction foil and become positively charged
ions(protons).
Figure (c) depicts the carbon extractor foil

PUMP SYSTEM
A.Diffusion Pump -

At the bottom of the pump the heaters are present that sit just below the oil. When the
becomes hot enough to vaporize, the oil vapours rise up the center of the pump and
exit the nozzles at a downward angle. These nozzles are in a ring and form a curtain
or “skirt” of vapor that extends from the nozzles to the pump wall. Any air molecules
that wander into the inlet meet the vapours are captured. When the oil vapor hits the
water-cooled walls of the pump, the oil cools as it runs down the sides of the pump.
By the time the oil reaches the reservoir once again, it has given off its trapped gas and
is ready to begin the cycle anew. Any gas molecule that tries to wander upward is
caught by the vapor “skirt” above it and forced downward again. By continually forcing
the air molecules downward, we create an area at the bottom of the pump that
is higher in pressure than the top of the pump.
Figure (d) depicts the diffusion pump system
B. Mechanical Vacuum Pump
A vacuum pump is a device that removes gas molecules from a sealed volume in
order to leave behind a partial vacuum. Creating a vacuum in a system requires
moving all molecules of gas out of the system. Molecules will only move if there is a
difference in pressure between two regions. The region that has the smaller number
of molecules will be the low-pressure region and the area with more molecules will be
considered the high pressure. A device that can induce pressure difference between
two regions of space is considered a pump. In a certain system, the pump that creates
a vacuum is considered a vacuum pump.

Here a transfer pump is used. The transfer pump, which is also called a kinetic pump
since the gas is being pushed that the gas is transferred from the inlet of the pump to
the outlet. This is often done by a mechanically moving part of the pump that often
rotates, accelerating the molecules of the gas and making the region of low pressure.

Fig(e) depicts the Mechanical Vacuum Pump

TARGET IN THE CYCLOTRON

The target is an O-18 enriched water sample which is irradiated for the production of
radiopharmaceuticals. The target 0-18 after being stroked by the H+ ion leads to the
formation of F-18. Fluorine-18 is a fluorine radioisotope which is an important source
of positrons.
Fig(f) depicts the O-18 enriched water sample

SYNTHESIS CHAMBER-
Formation of FDG (Fluro Deoxy Glucose) occurs in this section
18F-FDG is a glucose analogue in which the hydroxyl group on the 2–carbon of a
glucose molecule is replaced by a fluoride atom. Like glucose, 18F–FDG is taken up
into living cells by facilitated transport and then phosphorylated by hexokinase. Unlike
glucose, 18F–FDG cannot undergo further metabolism because the hydroxyl group at
the 2–carbon is a requirement for the process.Nevertheless, 18F–FDG is a good
indicator of glucose uptake and cell viability.
Fig(g) depicts the synthesis chamber
 PICTURE CORNER [i]

Fig(a) Fig(b)

Fig(c) Fig (a.1)

 PICTURE CORNER [ii]

Fig(d) Fig(e)

Fig(g)
Fig(f)
POSITRON EMISSION TOMOGRAPHY
Model we dealt with-Biograph mCT
Manufacturer-SIEMENS
▪ PET SCANNER AND IT’S ESSENTIALS:
Positron emission tomography is an imaging modality for obtaining in vivo
cross-sectional images of positron-emitting isotopes that demonstrate
biological function, physiology or pathology. In this technique, a chemical
compound with the desired biological activity is labelled with a radioactive
isotope that decays by emitting a positron, or positive electrons. The emitted
positron almost immediately combines with an electron and the two are
mutually annihilated with the emission of two gamma rays. The two gamma ray
photons travel in almost opposite directions, penetrate the surrounding tissue
and are recorded outside the subject by a circular array of detectors. A
mathematical algorithm applied by computer rapidly reconstructs the spatial
distribution of the radioactivity within the subject for a selected plane and
displays the resulting image on the monitor. Thus, PET provides a non-invasive
regional assessment of many biochemical processes that are essential to the
functioning of the organ being visualized.The positron (b+) is emitted from a
proton-rich nucleus with a variable amount of kinetic energy, the maximum
amount being the endpoint energy (Eb+). The compounds used and quantitated
are labelled with proton-rich positron (b+ ) emitters that are usually cyclotron-
produced. If the compound of interest is labelled in a known position and it
maintains this positron, a PET scan permits measurement of the positron
concentration (mCi/mL) in a small-volume element within an organ or region of
interest. This metabolic volume is typically 1 cm3 .
GANTRY AND ARRAY OF DETECTORS
Two design types of positron-emission tomographs have been introduced, one
employing opposed large-area detectors which require rotation around the patient to
provide the necessary degree of angular sampling, and the other, employing multiple
individual crystal detectors surrounding the patient in a circular or hexagonal array.
Conventional lead absorption collimators are not required because the coincident
detection of two 511 keV photons indicates the line of origin along which the photons
were emitted. However, in order to reduce the random coincidence count rate, some
degree of collimation is normally employed. Pulse processing needs to be much faster
than with single-photon systems, to keep random coincidences to manageable
proportions. With fast-response detectors and suitably fast electronics, it may be
possible to use the difference in the time of arrival of the annihilation photons at
opposite detectors to locate the site of positron decay and improve spatial resolution.
The gantry has a large opening (diameter = 65 cm) and can image both the brain and
torso of an adult patient. The entire detector assembly may be tilted to obtain oblique
sections. Bismuth germanate (BGO) scintillation crystals, 5.6 mm wide, 30 mm high,
and 30 mm deep, are used to detect the 511 keV annihilation radiation. The detectors
are arranged in a circular ring geometry, with 512 detectors per ring. The system has
two rings and produces three scanning planes (two direct and one cross plane). In
order to facilitate replacement, the detectors are arranged in modules or buckets
containing 16 detector packages. Each package contains two crystals and two PMTs.
Besides containing the two BGO crystals and PMTs, the bucket also contains
amplifiers/ discriminators and other front-end processing electronics. Horizontal or
axial table positioning can be controlled manually from the gantry controls or by
computer from the operator’s console. The axial range of the table is 170 cm, the
height is adjustable from 60 to 120 cm, and the maximum weight the table will support
is 300 Ibs.
Available Models of SIEMENS
Model
Biograph Vision
Biograph mCT Flow
Biograph Mct
Biograph Horizon Flow edition
Biograph RT Pro edition
Biograph RT edition
Features
▪ Biograph Vision introduces the first detector
with 3.2 mm LSO crystals2, helping you to
visualize smaller lesions
▪ Biograph Vision helps reduce scan time and
injected dose by a factor of 3.94 to improve
throughput and reduce patient exposure to
radiation and tracer cost.
▪ Biograph mCT Flow1 with FlowMotion™
technology combines our standard-setting
PET/CT with a unique system design that
enables continuous motion of the patient
table—allowing increased image quality,
greater patient comfort, better performance
and expanded Biograph mCT Flow and
FlowMotion™ technology
▪ Large 78 cm bore, short 135 cm tunnel and
227 kg (500 lb) table capacity support the
examination of a heavier patient
population, allow for easier patient
positioning, offer space for additional
therapy accessories and help increase
patient comfort.
▪ Premium LSO-based detectors and Time-
of-Flight technology, you can go beyond
the capabilities of BGO-based PET/CT
scanners for high count-rate applications.
▪ Biograph Horizon Flow3 edition's high
image quality supports early identification
of distant metastasis, leading to a more
accurate disease staging.
▪ Biograph RT Pro edition is built upon the
OptisoHD detection system, which
optimizes each component of the imaging
chain.
▪ Metal artefact reduction
▪ Reproducible patient positioning between
the Biograph Horizon family's TG-66-
compliant patient handling system and the
linear accelerator couch top, full suite of
motion management technologies and a
comprehensive metal artefact solution.
 PICTURE CORNER [iii]

Gantry XRT-Detector assembly and beta detectors

Phantom kept within lead cover Radioactive Phantom