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Philips SPECT/CT Systems Ling Shao, PhD Director, Imaging Physics & System Analysis Nuclear Medicine, Philips Healthcare June 14, 2008 *Presented SNM08 Categorical Seminar - Quantitative SPECT and PET for Molecular Imaging Philips SPECT/CT Portfolio Precedence 6 & 16 BrightView XCT (New) 2 Philips SPECT/CT Portfolio Product BrightView XCT (New) Precedence 6 Precedence 16 General positioning CT Customer value NM-based Low dose – high resolution localization Ultra-low dose AC CoPlanar FP NM tailored workflow Small room size Radiology-based Diagnostic CT apps Ca++ scoring Exceptional CT quality Radiology-based Premium Diagnostic CT apps Ca++ scoring *Coronary CTA Highest coverage/throughput Short breath hold exams Exceptional CT quality 3 Precedence System Precedence 6/16 slice Product Names: • Precedence 6 slice (NM and Oncology) • Precedence 16 slice (Cardiology and Oncology) 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) 4 BrightView XCT Technology: • Flat Panel Based Volume CT technology • Coplanar with SPECT Imaging (cardiac -14 cm) 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) 5 BrightView XCT System Components • Volumetric CT components – – – – – • X-ray tube and collimator 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 flat panel detector Patient table X-ray collimator and beam shaper CBCT image reconstruction using GPU Volumetric CT system goals SPECT FOV 54 x 40 cm – – – – Low profile gamma detector 14 cm axial coverage X-ray cone-beam overlaps SPECT FOV o 360 Gantry rotation within a breath-hold Low-dose CT acquisition parameters Integrated hybrid software solution X-ray flat panel detector 40 x 30 cm SPECT/C T Gantry 6 System Geometry to Increase Field-of-View Gantry center of rotation Projection Overlap ~4.5 cm 88 cm 45 cm Unweighted Projection • • • • 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 o Half projections from 180 opposite views are weighted and combined 3- XCT spins to cover 40 cm SPECT FOV Weighted Projection 7 Key SPECT/CT Acquisition Features -Precedence and BrightView XCT SPECT (Precedence & BrightView): True Energy Independence 16 Energy Windows Uniform Performance at all Energy Levels for Multi-Peak Imaging (<300 keV) MI Tracer Batteries & Advanced Corrections Concurrent Imaging Simultaneous MI & Conventional Acquisition Protocols Half-time Acquisition (Astonish 3D Reconstruction) Optimized Filtering & Resolution Compensation 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 8 New Workstation -Bringing Simplicity to Nuclear Medicine Workflow to improve clinical impact and cost of ownership • 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) 9 New Workstation: NM Application Suite -Bringing Simplicity to Nuclear Medicine 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 SPECT Suite • Integrated SPECT/CT AC, Reconstruction, Review Comprehensive QA Suite • • Daily QC NEMA Suite 10 Automated Workflow Example: - CT-AC Reconstruction Automate your Workflow with Auto-Proceed …or pause at each Workstep. Set Up AC Map Recon Reorient Review 11 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 FB P Astonish • Typical SPECT/CT acquisition (typical US Protocols.) – Total body scan • 15 min SPECT + 2 min CT Æ 7 min SPECT + 2 min CT – Cardiac scan • 15 min SPECT + 2 min CT Æ 7 min SPECT + 2 min CT 12 Image Quality and Acquisition Speed 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). Relative Image quality Score Comparison 2 IQ Score 1.5 1 Astonish -- 32 projection ASTONISH FBP 0.5 0 -0.5 FBP – 64 projection 0.17 0.33 0.67 1 -1 -1.5 -2 -2.5 Count Statistics ( % with respect to reference image) Reference image (conventional acquisition time) 13 Clinical Images of BrightView XCT Separate control room is not required for the CT acquisition Plan the SPECT/CT off the nuclear medicine p-scope Flexible breathing protocols to minimize mis-registration Images from Radiological Associates of Sacramento, Courtesy of Dr. Richard Myers, MD 14 Patient 1: Cardiac Attenuation Correction • 194 lbs (88 kg) , Male, 49 yrs • Dx: Pre-op clearance, Abnormal EKG • 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 MIBI 5 mA 2.5 mA 64 x 64 10 msec pulse width continuous 64 azimuths 1.2 mGy CTDIVOL 0.79 mGy CTDIVOL 20 sec/azimuth 1.46 zoom 15 Comparison of breath hold and tidal breathing 12 second Breath hold CT, 0.8mGy 60 second BrightView XCT launch to sales Tidal breathing CT, 1.2mGy Images courtesy of Radiological Associates of Sacramento Inferior wall attenuation – 12 sec breath hold AC No AC AC No AC AC No AC Images courtesy of Radiological Associates of Sacramento 17 Inferior wall attenuation–60 sec tidal breathing AC No AC AC No AC AC No AC Images courtesy of Radiological Associates of Sacramento 18 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 128 continuous pulse width 128 azimuth 6.8 mGy CTDIVOL 20 sec/azimuth 1.0 zoom 19 Lung Cancer – bilateral facet disease BrightView XCT launch to sales Images courtesy of Radiological Associates of Sacramento 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 128 10 msec pulse width 128 azimuths 14.9 mGy CTDIVOL 20 sec/azimuth 1.4 zoom 21 Osteosarcoma, CT resampled to 0.64 mm voxels BrightView XCT launch to sales Images courtesy of Radiological Associates of Sacramento Thank you you Thank 23