Basics of PET Imaging (eBook)

Preface 6
Contents 8

14 
Atomic Structure 14
Radioactive Decay 15
Decay 15
- Decay 15
Positron (+) Decay 16
Electron Capture 16
Isomeric Transition 17
Radioactive Decay Equations 18
General Decay Equations 18
Half-life (t1/2) 19
Effective half-life 20
Successive Decay Equations 20
Units of Radioactivity 22
Units of Radioactivity in System Internationale 22
Calculations 22
Interaction of Radiation with Matter 23
Interaction of Charged Particles with Matter 23
Interaction of Radiation with Matter 24
Photoelectric Process: 24
Compton Scattering Process: 25
Pair Production: 26
Attenuation of Radiations: 26
Questions 28
References and Suggested Reading 30

31 
Background 31
Solid Scintillation Detectors in PET 31
Photomultiplier Tube 34
Pulse Height Analyzer 36
Arrangement of Detectors 36
PET Scanners 40
Coincidence Scintillation Cameras 41
PET/CT Scanners 41
Small Animal PET Scanner 46
Mobile PET or PET/CT 49
Questions 49
References and Suggested Reading 51
Data Acquisition and Correctionscolor pop 52
PET Data Acquisition 52
Time of Flight Method 56
Two-Dimensional vs. Three-DimensionalData Acquisition 58
Factors Affecting Acquired PET Data 59
Normalization 59
Photon Attenuation 61
Attenuation Correction Methods 62
Theoretical Method: 62
Transmission Method Using Radioactive Sources: 62
CT Transmission Method: 63
Random Coincidences 65
Scatter Coincidences 66
Correction for Scatter Coincidences 66
Dual Energy Method: 66
Fitting to Scatter Outside the Object: 68
Convolution Method: 68
Calculation/Simulation Method: 68
Dead Time 68
Radial Elongation 70
PET/CT Data Acquisition 70
Factors Affecting PET/CT Data 72
Positioning of Patient: 72
Metal Objects: 72
Contrast Agents: 74
Truncation: 75
Respiratory Movement: 76
Questions 77
References and Suggested Reading 79

81 
Simple Backprojection 81
Filtered Backprojection 82
The Fourier Method 82
Types of Filters 84
Iterative Reconstruction 87
3D Reconstruction 91
Partial Volume Effect 93
Questions 94
References and Suggested Reading 95

96 
Storage 96
Display 96
Software and DICOM 99
PACS 99
Teleradiology 101
Questions 101
References and Suggested Reading 104
Performance Characteristics of PET Scanners 
105 
Spatial Resolution 105
Sensitivity 108
Noise Equivalent Count Rate 109
Scatter Fraction 110
Contrast 111
Quality Control of PET Scanners 111
Daily Quality Control Tests 111
Weekly Quality Control Tests 111
Acceptance Tests for PET Scanners 114
Spatial Resolution 115
Scatter Fraction 118
Sensitivity 119
Count Rate Losses and Random Coincidences 120
Quality Control of CT Scanners 121
Questions 121
References and Suggested Reading 123
Cyclotron and Production of PET Radionuclides 
125 
Cyclotron Operation 125
Medical Cyclotron 126
Nuclear Reaction 126
Target and Its Processing 129
Equation for Production of Radionuclides 129
Specific Activity 132
Production of Positron-Emitting Radionuclides 133
Fluorine-18 134
Carbon-11 134
Nitrogen-13 134
Oxygen-15 134
Iodine-124 134
Strontium-82 134
Technetium-94m 134
Germanium-68 134
Copper-62 134
Questions 134
References and Suggested Reading 138
Synthesis of PET Radiopharmaceuticals 
139 
PET Radiopharmaceuticals 139
18F-Sodium Fluoride 139
18F-Fluorodeoxyglucose 140
6-18F-L-Fluorodopa 140
18F-Fluorothymidine (FLT) 142
18F-BMS-747158-02 142
18F-O-(2-Fluoroethyl)-L-Tyrosine (FET) 142
18F-Fluoromisonidazole (FMISO) 142
18F-1-(5-fluoro-5-deoxy–arabinofuranosyl)-2-nitroimidazole (FAZA) 142
15O-Water 142
n-15O-Butanol 142
13N-Ammonia 142
11C-Sodium Acetate 142
11C-Flumazenil 142
11C-Methylspiperone 142
11C-L-Methionine 142
11C-Raclopride 142
11C-Choline 142
62Cu-Pyruvaldehyde-bis(N4- methylthiosemicarbazonato)Copper(II) (PTSM) 142
82Rb-Rubidium Chloride 142
Automated Synthesis Devices 142
Compounding of PET Radiopharmaceuticalsfor Human Use 149
Components, Materials, and Supplies 149
Compounding Procedure Verification 149
Dispensing of PET Radiopharmaceuticals 149
Aseptic Technique 149
Quality Control of PET Radiopharmaceuticals 149
Methods of Quality Control 149
Physicochemical Tests: 149
Biological Tests: 149
USP Specifications for Routine PETRadiopharmaceuticals 149
18F-Fluorodeoxyglucose 149
Regulations Governing PET Radiopharmaceuticals 
159 
Food and Drug Administration 159
Exploratory IND 159
Radioactive Drug Research Committee 159
Difference Between RDRC and Exploratory IND 159
Radiation Regulations for PET Radiopharmaceuticals 164
License or Registration 164
Facilities 164
Physicians 164
Technologists 164
Accreditation of PET Center 167
Regulations for Radiation Protection 167
Definitions 167
Caution Signs and Labels 171
Radiation Safety Officer 172
Occupational Dose Limits 172
Personnel Monitoring 172
Receiving and Monitoring of Radioactive Packages 172
ALARA Program 175
Radioactive Waste Disposal 175
Surveys for Radiation Exposure and Contamination 175
Syringe and Vial Shields 175
Use of Dose Calibrator 177
Radioactive Spill 177
Record Keeping 177
Principles of Radiation Protection 177
Time 177
Distance 178
Shielding 179
Activity 179
Do's and Don'ts in Radiation Protection Practice 179
Department of Transportation 179
Distribution of 18F-FDG 183
Questions 183
References and Suggested Reading 185
Reimbursement for PET Procedures 
187 
Background 187
Coverage 187
Coding 187
CPT, HCPCS, and APC Codes 187
Diagnosis Codes 189
Payment 190
Hospital Inpatient Services: Medicare 190
Hospital Outpatient Services: Medicare 190
Payment for PET Radiopharmaceuticals 190
Physician's Payment by Medicare 190
Freestanding Facilities: Medicare 190
Nonmedicare Payers: All Settings 190
Billing 190
Billing Process 190
Chronology of Reimbursement for PET Procedures 190
National Oncologic PET Registry 190
Questions 190
References and Suggested Reading 197
Design and Cost of PET Center 
198 
Site Planning 199
Passage 199
PET Center 199
Scanner Section 199
Cyclotron Section 199
Office Area 199
Caveat 199
Shielding 199
Case Study 206
Cost of PET/CT and Cyclotron Operation 206
Questions 206
References and Suggested Reading 210
Procedures for PET Studies 
211 
Whole-Body PET Imaging with 18F-FDG 211
Physician's Directive 211
Patient Preparation 211
Dosage Administration 211
Scan 211
Reconstruction and Storage 211
Whole-Body PET/CT Imaging with 18F-FDG 211
Physician Directive 211
Patient Preparation 213
Dosage Administration 213
Scan 213
Reconstruction and Storage 213
Myocardial Metabolic PET or PET/CT Imagingwith 18F-FDG 213
Patient Preparation 213
Scan 215
Reconstruction and Storage 215
Myocardial Perfusion PET or PET/CT Imagingwith 82Rb-RbCl 215
Patient Preparation 215
Dosage Administration and Scan 216
Reconstruction and Storage 216
Addendum 216
82Rb Infusion Pump 216
References and Suggested Reading 218
Appendix A. Abbreviations Used in the Text 220
Appendix B. Terms Used in the Text 222
Appendix C. Units and Constants 227
Appendix D. Estimated Absorbed Doses from Intravenous Administration of 18F-FDG and 82Rb-RbCl 229
Appendix E. Evaluation of Tumor Uptake of 18F-FDG by PET 231
Appendix F. Answers to Selected Questions 234
Index 236