philips spect/ct systems

Philips SPECT/CT SystemsLing Shao, PhDDirector, Imaging Physics & System AnalysisNuclear Medicine, Philips HealthcareJune 14, 2008

*Presented SNM08 Categorical Seminar - Quantitative SPECT and PET for Molecular Imaging

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Philips SPECT/CT Portfolio

Precedence 6 & 16 BrightView XCT(New)

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Philips SPECT/CT Portfolio

Diagnostic CT appsCa++ scoring

*Coronary CTAHighest coverage/throughput

Short breath hold examsExceptional CT quality

Radiology-basedPremiumPrecedence 16

Diagnostic CT appsCa++ scoring

Exceptional CT qualityRadiology-basedPrecedence 6

Low dose – high resolution localization

Ultra-low dose ACCoPlanar FP

NM tailored workflowSmall room size

NM-basedBrightView XCT(New)

CT Customer valueGeneral positioningProduct

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Precedence System

Product Names:

Key Performances:

• SPECT (Key advances):– Detector intrinsic resolution 3.2 mm – > 5 mm SPECT reconstruction resolution (Astonish)– Half-time acquisition (Cardiac)

• Capable of full cardiac CT:– Speed: 0.5 second rotation– Slice thickness: 0.67 mm slice (spiral), 0.6 mm slice (anode)– Resolution: 24 lp/cm– Dose (CTDI): 12.85 mGy/100 mAs (head), 6.5 mGy/100 mAs (body)

• Registration error– ≥ 4mm (one pixel)

• Precedence 6 slice (NM and Oncology)• Precedence 16 slice (Cardiology and Oncology)

Precedence 6/16 slice

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BrightView XCT

Technology:

Key Performances:

• SPECT (Key advances):– Detector intrinsic resolution 3.2 mm – > 5 mm SPECT reconstruction resolution (Astonish)– Half-time acquisition

• Localization, CT-AC, Bone Imaging– Max. Rotation Speed: 12 sec for 360o (14 cm axial FOV)– Slice thickness: 0.33 – 2.0+ mm (isotropic voxel)– Resolution: >15 lp/cm– Dose (CTDI) - Typical: ~ 6 mGy body localization, ~ 1 mGy Attenuation Correction

• Registration error– ≥ 4mm (one pixel)

• Flat Panel Based Volume CT technology• Coplanar with SPECT Imaging (cardiac -14 cm)

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• Volumetric CT components

– Rotating anode X-ray tube – 120 kVp X-ray generator, pulsed or

continuous– 4030CB flat panel detector

• 10, 30, 60 fps, dynamic gain– X-ray collimator and beam shaper– CBCT image reconstruction using GPU

• Volumetric CT system goals

– X-ray cone-beam overlaps SPECT FOV– 360o Gantry rotation within a breath-hold– Low-dose CT acquisition parameters– Integrated hybrid software solution

14 cm axial coverage

SPECT FOV

54 x 40 cm

X-ray flat panel detector

40 x 30 cm

X-ray flat panel detector

X-ray tube and collimator

Low profile gamma detector

Patient table

SPECT/CT Gantry

BrightView XCT System Components

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System Geometry to Increase Field-of-View

• Detector effectively doubles in size to increase imaging FOV to 47 cm– Reduces truncation

• Flat panel detector is offset ~17.4 cm relative to its center• Half projections from 180o opposite views are weighted and combined• 3- XCT spins to cover 40 cm SPECT FOV

Projection Overlap ~4.5 cm

45 cm88 cm

Gantry center of rotation

UnweightedProjection

WeightedProjection

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Key SPECT/CT Acquisition Features-Precedence and BrightView XCT

16 Energy Windows

MI Tracer Batteries & Advanced

Corrections

Half-time Acquisition

(Astonish 3D Reconstruction)

Optimized Filtering & Resolution

Compensation

True Energy Independence

Uniform Performance at all Energy Levels for

Multi-Peak Imaging(<300 keV)

Concurrent Imaging

Simultaneous MI & Conventional

Acquisition Protocols

SPECT (Precedence & BrightView):

XCT (BrightView XCT):•NM-driven acquisition user interface/protocols•No compromise to SPECT functions•X-ray CT and SPECT are in coplanar for cardiac imaging•Reconstruction with GPU for faster processing speed

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• PET, SPECT and CT on the same platform• Improved access, connectivity - taking Nuclear

Medicine to enterprise • Clinically complete Applications Suite• Full QC functionality on the workstation• Streamlined and fully configurable workflow

– User-adaptive protocols (change parameters, defaults on the fly)

– Access to applications and tools where needed when needed

– Imbedding best in class algorithms into one workflow (AutoSPECT, Astonish AC)

New Workstation-Bringing Simplicity to Nuclear Medicine

Workflow to improve clinical impact and cost of ownership

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Comprehensive clinical applications and methods.

Comprehensive Planar Suite• Planar Gated Analysis• Whole Body Analysis• Pulmonary Analysis• Renal Analysis• Endocrine Analysis• Hepatobiliary Analysis• Gastric Analysis• Esophageal Analysis• Salivary Analysis

Comprehensive QA Suite• Daily QC• NEMA Suite

Comprehensive SPECT Suite• Integrated SPECT/CT AC, Reconstruction, Review

New Workstation: NM Application Suite-Bringing Simplicity to Nuclear Medicine

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Set Up

AC Map

Automated Workflow Example:- CT-AC Reconstruction

Automate your Workflow with Auto-Proceed …or pause at each Workstep.

Recon

Reorient

Review

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Image Quality & Acquisition Speed

• 3D Astonish Reconstruction– 3D OSEM with resolution, attenuation and

scatter correction– Multiple peak isotope– Better image quality– Toward to better quantitation

• Half-time Acquisition– Astonish provide equal or better with half-time

acquisition

• Typical SPECT/CT acquisition (typical US Protocols.)– Total body scan

• 15 min SPECT + 2 min CT 7 min SPECT + 2 min CT

– Cardiac scan• 15 min SPECT + 2 min CT 7 min SPECT + 2

min CT

FBP

Astonish

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Relative Image quality Score Comparison

-2.5-2

-1.5-1

-0.50

0.51

1.52

0.17 0.33 0.67 1

Count Statistics ( % with respect to reference image)

IQ S

core

ASTONISHFBP

Astonish provides constant image quality with wide range of count statistics

5 Observers: A relative image quality (RIQ) score with respect to a standard image (64x64x64 matrix, clinical counts, FBP reconstruction) was assigned to each image by each observer (3: much better, 2: better, 1: slightly better, 0: equivalent, -1: slightly worse, -2: worse and -3: much worse).

Reference image (conventional acquisition time)

Astonish -- 32 projection

FBP – 64 projection

Image Quality and Acquisition Speed

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Clinical Images of BrightView XCT

Separate control room is not required for the CT acquisition

Flexible breathing protocols to minimize mis-registration

Plan the SPECT/CT off the nuclear medicine p-scope

Images from Radiological Associates of Sacramento, Courtesy of Dr. Richard Myers, MD

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Patient 1: Cardiac Attenuation Correction

• Single 60-second CT, tidal breathing• Single 12-second CT, end expiration breath hold

CT parameters: SPECT parameters:60 second 12 second Persantine stress, 2.5 hrs p.i.120 kVp 120 kVp 35 mCi Tc-99m MIBI5 mA 2.5 mA 64 x 6410 msec pulse width continuous 64 azimuths1.2 mGy CTDIVOL 0.79 mGy CTDIVOL 20 sec/azimuth

1.46 zoom

• 194 lbs (88 kg) , Male, 49 yrs• Dx: Pre-op clearance, Abnormal EKG

BrightView XCT launch to sales

Breath hold CT, 0.8mGy

Tidal breathing CT, 1.2mGy

12 second

60 second

Comparison of breath hold and tidal breathing

Images courtesy of Radiological Associates of Sacramento

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Inferior wall attenuation – 12 sec breath hold

AC

No AC

AC

No AC

AC

No AC


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Inferior wall attenuation–60 sec tidal breathing

AC

No AC

AC

No AC

AC

No AC


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Patient 2: Localization• 143 lbs (65 kg), Female, 54 yrs• Dx: Lung CA

• Three 12 second CT (breath hold)

CT parameters: SPECT parameters:120 kVp 22.9 mCi Tc-99m MDP, 2.5 hrs p.i.20 mA 128 x 128continuous pulse width 128 azimuth6.8 mGy CTDIVOL 20 sec/azimuth

1.0 zoom


Lung Cancer – bilateral facet disease


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Patient 3: Bone Localization

• 202 lbs (92 kg), Male, 25 yrs• Dx: Right knee sarcoma

• One 24 second CT

CT parameters: SPECT parameters:120 kVp 25.3 mCi Tc-99m MDP, 3 hrs p.i.80 mA 128 x 12810 msec pulse width 128 azimuths14.9 mGy CTDIVOL 20 sec/azimuth

1.4 zoom


Osteosarcoma, CT resampled to 0.64 mm voxels


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