This invention relates to diagnostic imaging and more particularly to a high resolution PET imaging system for imaging the prostate gland and surrounding organs in a patient.
In the current state of the art, standard PET imagers are bulky devices that are placed in dedicated imaging rooms and require the patient to be transported to the imager. These standard imagers have poor spatial resolution that is inadequate for accurate imaging of small organs such as the prostate. In addition, in some clinical situations, there would be an advantage to having a dedicated imager that can be, for example, assisting in the surgery suite where imaging can provide immediate biopsy guidance of (suspected) cancerous lesions, and with cancerous tissue removal both from prostate and from surrounding tissue.
Existing mobile PET imagers do not satisfy the special combined requirements of size, resolution and sensitivity for prostate imaging tests.
A dual-modality prostate PET imager with transrectal ultrasound (TRUS) was described in “Initial Results of a Positron Tomograph for Prostate Imaging”, J. S. Huber et al., IEEE Transactions on Nuclear Science, Volume 53, Issue 5, Part 1, October 2006 Page(s): 2653-2659. TRUS provides anatomical details that can be co-registered with a PET image. This PET imager was constructed from sectors of a standard ECAT HR+ PET with spatial resolution limited to approximately 4-5 mm FWHM. The geometry was closer than standard ring geometry which introduces additional depth of interaction error.
The concept of high-resolution PET imaging in the pelvis region with dual planar detectors has been investigated. For example, see “PET prostate imaging with small planar detectors”, T. G. Turkington et al., T.R.Q Nuclear Science Symposium Conference Record, 2004 IEEEQ Volume 5, Issue, 16-22 Oct. 2004 Page(s): 2806-2809. The scanner consisted of two 20 cm×15 cm (axial) planar detectors made of 3 mm×3 mm×10 mm LGSO scintillator detection elements. The detector heads were mounted on a rotating gantry with adjustable detector radii. Although detection of hot lesions in the pelvis with small dual planar PET detectors was judged to be possible, better characterization of such lesions requires detector orbiting or larger detectors.
A transrectal high resolution (˜1 mm) prostate imager 20 including a PET probe 21 operating in conjunction with a small field of view outside imaging detector 22 and placed by the pelvis region close to the prostate 23, see
Other hybrid imaging systems using conventional PET have been proposed, see Sam S. Huh et al., “Investigation of an internal PET probe for prostate imaging”, accepted for publication in Nuclear Instruments and Methods in Physics Research, 2007. A hybrid imaging system 25 with conventional PET, as shown in
A PET system with an insertable probe 29, shown in exploded and assembled form in
There are practical implementation issues related to the use of insertable transrectal probes. They cannot be treated as non-invasive, with the related patient safety issues involving active probes. There are limits to the useful detection volume, probe positioning relative to prostate, and non-uniformity of sensitivity for different parts of prostate. Insertable probes, while being close to parts of the prostate, will not image enough surrounding tissue.
As described above, although some imaging geometries have been proposed for the prostate, there is still a need for a reliable PET imager capable of providing torso-wide imaging of the prostate and surrounding tissues with a wide active field of view and with a sufficiently high resolution for full scale all-angle 3D tomographic images.
The invention provides a dedicated mobile PET imaging system to image the prostate and surrounding organs. The imaging system includes an outside high resolution PET imager placed close to the patient's torso and an insertable and compact transrectal probe that is placed in close proximity to the prostate and operates in conjunction with the outside imager. The two detector systems are spatially co-registered to each other. The outside imager is mounted on an open rotating gantry to provide torso-wide 3D images of the prostate and surrounding tissue and organs. The insertable probe provides closer imaging, high sensitivity, and very high resolution predominately 2D view of the prostate and immediate surroundings. The probe is operated in conjunction with the outside imager and a fast data acquisition system to provide very high resolution reconstruction of the prostate and surrounding tissue and organs.
Several advantages are achieved with the dedicated prostate PET imager system with insertable probe of the present invention, including:
These and other objects and advantages of the present invention will be better understood by reading the following description along with reference to the drawings.
20 prior art prostate imager
21 PET probe
22 outside imaging detector
23 prostate
25 hybrid imaging system with conventional PET
26 external PET ring
27 prior art transrectal probe
28 prostate
29 prior art insertable probe
30 outside PET imager
32 detector section
34 patient
36 patient bed
37 detector super-module
38 direction of angular rotation
39 prostate region
40 dedicated prostate imager
41 external or outside PET imaging system
42 internal transrectal PET probe
43 front external detector module
44 rear external detector module
45 detector section or head
46 patient
47 mobile patient bed
48 line of response
50 prostate
51 rotatable mobile gantry
52 direction of angular rotation
53 direction of distance adjustment between detection modules
54 outside imager section or head
55 array of flat PSPMTs
56 PSPMT
57 scintillator sensor
58 pixellated or scintillation array
59 optical window
60 outer window
61 dead region
62 reflective strip
63 outer shell or shield
70 compact silicon imaging module or detector
72 basic silicon imaging module
74 basic SiPM unit or pad
75 dead space
76 readout channel with 4 pads
78 readout channel with 16 pads
80 SiPM sensor unit
82 scintillator array
84 light guide
86 SiPM array
88 preamplifier
W width of detector head
Wp width of probe detector head
Lp length of probe detector head
According to the present invention, a dedicated mobile high resolution PET imager to image the prostate and surrounding organs combines two major components including an outside high resolution dedicated PET imager placed close to the patient's torso with an insertable compact transrectal probe that is placed close to the prostate. The insertable probe operates in conjunction with the outside imager. The two detector systems are spatially co-registered to each other via electronic sensor positioning systems placed on all detector modules. The outside imager mounted on an open rotating gantry provides torso-wide 3D images of the prostate and surrounding tissue and organs. The insertable probe provides closer high sensitivity and very high resolution but limited, mostly 2D, view of the prostate and immediate surroundings. While the outside imager can operate separately, the critical focus of the present invention is the operation of the probe in conjunction with the outside imager in a mobile, open geometry organ-specific structure. Open structure of the system can allow for implementation of the system in therapy and surgical situations.
With reference to
Referring to
A dedicated mobile high resolution PET imager 40 according to the present invention will include a multi-channel fast Data Acquisition (DAQ) system and fast data acquisition software to process and save data digitized in the DAQ system. Low voltage and high voltage power supplies will be included for onboard readout electronics on the detector heads 45. An electronic positioning system is included to control absolute and relative positioning of all the outside detector modules 43 and 44, the probe 42 and the rotatable open geometry mobile gantry 51. The dedicated prostate imager 40 will include a mobile cabinet with computer, trigger and data acquisition electronics, and power supplies and an optional mobile patient bed 47. Additionally, tomographic reconstruction software can be provided with the imaging system 40.
The dedicated mobile high resolution PET imager 40 of the present invention will provide an active field of view that is torso-wide (at least 40 cm) by at least 10 cm wide. The outside imager will achieve a 3D reconstruction resolution of at least 1.5-2.0 mm (over body slice involved). The probe 42 in coincidence with the outside imager 41 will provide at least 1.0-1.5 mm 2D reconstruction resolution over the small field of view of the probe. The rotating open geometry gantry 51 enables 360 degree angular sampling in the 3D imaging mode with the outside imager 41. The multi-channel fast data acquisition and processing system is capable of recording data with at least 200 kHz trigger rate in a list mode, to enable prompt limited data analysis, and fast data replay and image reconstruction during the same scan session.
The operation of the dedicated mobile high resolution PET imager 40 of the present invention will be explained with reference to
Outside and inside imaging can be also used in a repeated sequence with more than two separate imaging fragments of the full procedure. Finally, in principle imaging with both parts 41 and 42 of the system can be done at the same time, with the probe 42 and the front outside modules 43 providing local enhanced view, while the front 43 and back outside imaging modules 44 providing the broader view.
Several imaging technologies can be implemented in the dedicated mobile high resolution PET imager 40 of the present invention. The preferred PET imager will have a scintillator as a sensor/energy converter of the 511 keV annihilation gamma rays, while different photodetectors can serve as detectors of the scintillation light produced by the absorbed 511 keV gamma rays in the scintillator gamma sensor. The scintillator sensor part can be made of pixellated or plate crystal scintillator materials such as LSO, LYSO, GSO, BGO, LaBr3, NaI(Tl), CsI(Tl), or CsI(Na).
The photodetector part in general can be a standard or multi-element photomultiplier, position sensitive, flat panel or microchannel plate based photomultiplier, avalanche photodiode arrays or large size avalanche photodiodes with resistive etc readout, and different variants of the novel so-called silicon photomultiplier. The photodetector can include light guides such as simple plates, fiberoptic straight or tapered light guides, bunches of straight or bent fibers.
However, the requirements of a compact insertable probe limit the above choices to a much smaller group of options. In principle, photomultipliers can be still employed when placed outside the patient's body with properly designed fiberoptic light guide schemes, but practically such an optical coupling scheme will be very difficult to implement due to size limitations. Therefore, the design of the transrectal probe will be limited to solid state photodetectors such as avalanche photodiodes or silicon photomultipliers with the same choices of scintillators as used in outside detectors.
The outside imager section or head 54 of a preferred scintillator/photodetector type can include a contiguous array 55 of flat position sensitive photomultiplier tubes (PSPMTs) 56 coupled to a scintillator sensor 57 in the form of pixellated array 58 as shown in
Typically a plastic or metal outer shell or box 63 with opening in front of the scintillation array 58 encloses the detector 54. A special variant of the box 63 is to implement a high Z material such as tungsten or lead or an alloy or mixture of these metals with other metals in the side walls and the back plate to shield the detector head 54 from the scattered gamma radiation background arriving from all other sides than the front of the detector. The housing provides a structural container for the detector head 54 and a means for attaching it to the fixtures and the gantry and enabling detector head placement in the vicinity of the patient's torso.
The preferred embodiment of the outside imager is composed of individual detection modules 54, each based on a Hamamatsu H8500 flat panel PMT coupled to an array of 24×24 LYSO 2×2×15 mm pixels with a 2.1 mm pitch. Each module has four analog position outputs and one (fast) energy output. The position outputs are recorded and digitized in the DAQ system to calculate position of the interacting 511 keV gamma ray. The fast sum signal is used to create the coincident trigger events in the trigger electronics, and then provided to the DAQ system to record the event data from the detector modules. The optimal on-board readout design will include PMT gain uniformity correction assuring high energy and spatial resolutions and high rate performance with minimal number of readout channels.
An alternative more economical embodiment for the basic detection module of the outside detector heads can be based on multi-element PMTs such as small-profile 2″ square nine-element Photonis XP1470 PMTs. However, while the achieved intrinsic spatial resolution was only marginally satisfactory for 2 mm pitch scintillation pixels, these PMTs are much slower than H8500 PSPMTs, primarily due to time shifts between the individual nine inner channels. Partial remedy schemes are in principle possible but the readout design and calibrations become more complicated and complete problem correction is not possible. The system built on these PMTs would be also much more bulky.
In another preferred example of the outside detector head, Silicon Photomultipliers SiPMs can be used in lieu of the position sensitive PMTs. Typically SiPM modules come in smaller units of about 3 mm in size. Therefore, for the outside detector, arrays of these devices are needed to cover the desired active field of view. Referring to
Silicon PM is the preferred photodetector technology for the necessarily compact transrectal probe 42. The limited imaging geometry between the probe 42 and the front external detector module 43 allows practically only for very high resolution planar PET imaging. Therefore, the preferred design of the transrectal probe, still allowing for high spatial 2D resolution (projective geometry), is a flat-type module with one scintillator layer coupled to a compact photodetector array.
With reference to
The advantage of constructing both the external detector modules 43 and 44 and the internal transrectal probe 42 with SiPM sensor units is that such a system could be in principle used in the vicinity of or alternatively inside of an MRI magnet due to known immunity of SiPMs to strong multi-Tesla magnetic fields.
A very important and integral part of the prostate imager is the data acquisition system for accepting and digitizing signals from the readout system and then forwarding the digitized data to the computer system for data processing, data analysis and to tomographic image reconstruction. The readout system will depend on the particular choice of the technical solution selected for the imager modules, both outside and the inside probe. An example will be give below for a particular design choice for the imager.
In the preferred embodiment of the DAQ, as discussed above, the PET imager 40 as shown in
In the part of the imaging procedure without the probe 42 inserted, the event trigger will be a sum (a logical OR) of the four coincident trigger types between the four outside detectors 45. With the probe 42 inserted there will be only two types of coincident triggers involving the prostate region, however a limited imaging of the organ region in the prostate vicinity is also possible at the same time. Therefore, in principle a six-component coincident trigger option is also possible.
In case of a prostate PET imager design involving other module size combinations, different from the presently described example with four outside modules 45 and one probe 42, a different readout/DAQ system is used, matching the imager design. For example, a separate embodiment can include an imaging system with six or more modules in the outside system and a multi-component insertable probe.
A preferred embodiment for the data acquisition system is the FPGA-based USB data acquisition system designed at Jlab. This system has a modular, extensible architecture with up to 64 channels of simultaneous-sampling ADCs per unit and a sustained trigger rate of over 150 kHz for all 64 channels. In standard operation, each unit corresponds to one individual detector module. Each coincident pair of modules is time synchronized in order to match event timing of the two detectors. Both corresponding units are triggered simultaneously by the external coincidence trigger logic. Each DAQ unit sends time-stamped raw event data over high-speed USB to its own acquisition computer. Each acquisition computer performs then centroid and energy calculations on all incoming data and sends this time-stamped processed data over gigabit Ethernet to the event builder/reconstruction computer. The event builder uses the time stamps to merge the separate detector events into a single coincident event. It may also perform image reconstruction or send the data to another computer for image reconstruction. The set of reconstructed tomographic images is sent to a user interface.
A further embodiment of the prostate PET imager according to the present invention will implement time-of-flight (TOF) option when measuring timing between the coincident 511 keV gamma ray signals between all the outside detector modules and the front outside detector modules and the probe. In this PET imager, the timing is measured with such accuracy that the reconstructed volume in processed images can be smaller than the torso width. TOF PET can be used in the dedicated prostate PET imager to improve the detection of the radioactive signal emerging from the prostate, as well as other close by structures.
Although the description above contains many specific descriptions, materials, and dimensions, these should not be construed as limiting the scope of the invention but as merely providing illustrations of some of the presently preferred embodiments of this invention. Thus the scope of the invention should be determined by the appended claims and their legal equivalents, rather than by the examples given.
The contents of each of the following publications are hereby incorporated in their entireties by reference:
The United States of America may have certain rights to this invention under Management and Operating contract No. DE-AC05-06OR23177 from the Department of Energy.