The present innovation finds particular application in patient imaging systems, particularly involving patient imaging devices such as single photon emission computed tomography (SPECT) and the like. However, it will be appreciated that the described technique may also find application in other nuclear imaging systems, other patient imaging scenarios, other image analysis techniques, and the like.
In SPECT imaging systems, a planar detector collects projection data to accumulate a sufficient amount of data. In combined SPECT-computed tomography (CT) systems, typically one to three detectors are stepped to each of a plurality of positions to collect sufficient data along each of a plurality of projection directions for the reconstruction of a diagnostically meaningful 3D image. Tracer uptake, perfusion, and washout dynamics are not typically analyzed, since SPECT is non-dynamic system. Tracer distribution can be adversely affected by, for example, initial uptake by the liver, reduced uptake and washout rates associated with ischemic cardiac tissue, etc., which can lead to unwanted artifacts. These uncontrolled effects degrade a reconstructed SPECT image.
There are two main reasons for a time-varying tracer distribution during a cardiac SPECT acquisition: if aiming for a short work-flow (e.g. a fast rest-stress systolic dyssynchrony index protocol), an initial uptake dynamic may occur combined with signals from the blood-pool and liver. Additionally, in the case of thallium-chloride, ischemic regions show a retarded uptake under stress conditions and slower wash-out in the subsequent rest-phase. Such effects are unwanted during SPECT acquisitions, because they lead to artifacts in the reconstructed volume image. They may be corrected for by preprocessing the measured projections, i.e. by filtering and normalizing along sinogram lines.
Uncontrolled uptake effects after injection and/or re-distribution and wash-out can degrade the reconstructed image quality considerably. On the other hand, a quantitative measure for these gradient “speeds” may help in classifying ischemic, “hibernating,” and infarcted tissue. There are methods for dynamic SPECT reconstruction, but they lack in general stability and robustness, mainly due to the even more severely ill-posed reconstruction problem in this case.
Time-dependent processes in SPECT are a problem due to its inherently static data acquisition, as compared, e.g., with positron emission tomography (PET). At one point in time, there are typically one or two projection views of the region of interest collected. Different projection directions often represent projections of different radioisotope distributions due to the time processes, which leads to artifacts in 3D images. In the case of cardiac acquisitions, for example, the clinical decision is typically done by assessing the perfusion as shown in a polar plot, e.g., a two-dimensional projection of the left chamber myocardium.
The present application provides new and improved systems and methods for estimating a time-dependent polar plot of tracer distribution during a SPECT acquisition, which overcome the above-referenced problems and others.
In accordance with one aspect, an artifact correction system for tracer uptake images includes a processor that receives a plurality of tracer uptake projection data sets from a region of interest, statically reconstructs an image of the region of interest, generates a polar plot of the surface of the region of interest, and back-projects a temporally limited segment of the uptake projection data from the static reconstruction of the image onto the polar plot of the surface of the region of interest.
In accordance with another aspect, a method of generating dynamic cardiac single photon emission computed tomography (SPECT) images includes reconstructing a three-dimensional image including the region of interest, segmenting the region of interest from the three-dimensional image, and generating a polar plot image of a surface of the region of interest. The method further includes back-projecting a contemporaneously collected segment of SPECT projection data onto the polar plot image, and outputting to a user the polar plot image of the surface of the region of interest overlaid with tracer distributions from the SPECT data.
In accordance with another aspect, an apparatus for generating dynamic cardiac single photon emission computed tomography (SPECT) images includes means for performing a SPECT data acquisition on a region of interest after tracer injection, means for reconstructing a three-dimensional image including a region of interest, and means for segmenting the region of interest from the three-dimensional image. The apparatus further includes means for generating a polar plot image of a surface of the region of interest, means back-projecting a contemporaneously collected segment of SPECT projection data onto the polar plot image, and means for outputting to a user the polar plot image of the surface of the region of interest overlaid with tracer distributions from the SPECT data.
One advantage is that time dependent tracer uptake information is used to reduce artifacts.
Another advantage resides in visibility of time-dependent changes to a user.
Still further advantages of the subject innovation will be appreciated by those of ordinary skill in the art upon reading and understand the following detailed description.
The innovation may take form in various components and arrangements of components, and in various steps and arrangements of steps. The drawings are only for purposes of illustrating various aspects and are not to be construed as limiting the invention.
The system 10 includes a user interface 12 that receives SPECT data, in the form of projection data sets, acquired by a SPECT imaging device 14 during a scan of a subject over a plurality of projection directions. In one embodiment, the SPECT device includes a projection region source, e.g., a line source, which causes the SPECT detectors to generate an attenuation data set concurrently with the SPECT data set. The user interface includes a processor 16 that executes, and a memory 18 that stores, acquired SPECT data, attenuation data, and other relevant image data, and a plurality of computer-executable algorithms for carrying out the various procedures and functions described herein. Information is output to a user via a display 20.
In one embodiment, the processor 18 receives acquired SPECT data from the SPECT device, and attenuation data from the SPECT device, a CT scanner, or the like. The processor generates image data by executing reconstruction algorithm(s) 24 on the acquired SPECT and/or attenuation data to generate a static SPECT reconstructed image and/or a 3D attenuation image or a combination of the two. The image(s) is then segmented and a polar plot of the heart is generated using segmentation algorithm(s) 26 and polar plot algorithm(s) 28, respectively. In an additional reconstruction step, the individual projections used during the original SPECT static image reconstruction are backprojected onto the heart surface, which is known from the polar plot, by executing SPECT back-projection algorithm(s) 30. The processor executes subtraction algorithm(s) 32 to subtract emissions from outside of the heart to leave an image of just the heart surface with the SPECT data projected thereon. In one embodiment, emissions from outside the heart are estimated from the static reconstruction, which is performed by executing the reconstruction algorithm(s) 24. By back-projecting SPECT projection data sets that were acquired at different times, a time-dependent polar plot of tracer distribution during SPECT acquisition is generated. In one embodiment, the SPECT data is collected in a list mode, i.e., each received SPECT radiation event is time-stamped. This permits temporal resolution of the data within a single projection data set. Moreover, temporal windows can be defined that span parts of two or more projection data sets.
The dynamics of tracer uptake, re-distribution and wash-out for cardiac SPECT imaging gives relevant information, but conventionally has been considered a source of reconstruction problems due to the inherent non-dynamic nature of SPECT. The systems and methods described herein estimate the time-dependent polar-plot of tracer distribution during a SPECT acquisition. This additional information is used to correct for artifacts, such as occur due to acquisitions early after a technetium-99m (Tc-99m) injection, or for clinical evaluation, such as is related to the thallium-201 (Tl-201) speed of re-distribution and wash-out. The procedure is based on a raw heart segmentation (which may be combined with an automatic segmentation method developed) and uses an examined image (e.g., the polar-plot), which is effectively two-dimensional. Moreover, the procedure can be performed as part of a standard reconstruction and hence does not disturb the usual workflow. The described systems and methods can be combined with simultaneous transmission measurements to correct the time-dependent data and heart registration for patient movements and/or breathing. A generalization to other applications (e.g., cardiac or oncology with localized hot-spots) is also contemplated.
Obtained segmented perfusion values at a given time are used in addition to the 3D-reconstructed data and are used to correct them and/or give additional information on time dependencies. In one embodiment, it is assumed that the myocardium is essentially two-dimensional, at least with respect to perfusion evaluation, and that emissions outside the heart are either weak (e.g., as in the lungs) or of a known timely behavior (e.g., as in the liver), so that they may be taken into account when performing the backprojection. This results in a quantitative estimation of the time variation of the myocardium perfusion.
With reference to
It will be appreciated that although the system is described as having two detectors or camera heads arranged at approximately a 90 degree angle to each other, N detectors or camera heads, where N is an integer, may be used in different orientations that are not limited to orthogonal arrangements.
The processor then performs a normal static reconstruction, for instance by executing reconstruction algorithm(s) 24. In one embodiment, a few iterations of a statistical algorithm, such as an ordered subset expectation maximization (OSEM) algorithm or a filtered back-projection (FBP) reconstruction algorithm are sufficient. After reconstruction, the heart is located and segmented for polar-plot purposes. The segmentation is either semi-automated, as is performed using, e.g., AutoQuant+, or fully automatic with a tool such as an automatic heart-segmentation tool. The latter may be adapted and simplified for this purpose. In one embodiment, the foregoing is performed by the processor 16 by executing segmentation algorithm(s) 26 and polar plot algorithm(s) 28, respectively.
In an additional reconstruction step, the processor executes back-projection algorithm(s) 30, to back-project orthogonal pairs of contemporaneous projections onto the now known heart surface. Any ambiguity between anterior and posterior intersections of a ray with the left myocardium is resolved by the orthogonal view provided by the other camera. Two non-parallel projections are sufficient for the reconstruction of a two-dimensional object. The processor executes subtraction algorithm(s) 32 to subtract or segment emissions originating outside the heart from the image. Such emissions are estimated from the static reconstruction.
Attenuation and scatter are compensated in the same way as for the 3D-reconstruction, e.g. by scaling the projection ray accordingly. Monte-Carlo or effective source scatter estimation (ESSE) type correction data is already calculated in the static reconstruction and can be re-used. The results are tracer-distributions across the heart segments per projection time. They may be presented on the display 20 as a gradient overlaid to the static polar-plot or 3D-image, or may be used for additional post-processing. The process can be repeated for a plurality of the orthogonal projection data pairs and the overlaid polar plots can be displayed sequentially, e.g., in a cine type display, to show the time evolution of the tracer distributions.
According to another embodiment, when time dependent information on the position, heart registration and attenuation of the patient is available, the projections can be backprojected using a heart registration and attenuation map optimized from the simultaneously obtained transmission projection. That is, patient motion may be corrected by matching the transmission projection with the 3D-transmission reconstruction/attenuation map from the whole data. Additionally or alternatively, a systolic dyssynchrony index (SDI) acquisition can be performed with simultaneous measurement of Tc-99m and Tl-201 in an analog manner Other nuclides such as Tc-99m and iodine-123 (I-123) can be also used. Moreover, other objects can be imaged, as long as their emission distribution is less than three-dimensional. This holds for quantitative oncology applications, where tumors are either small hot spots (e.g., point-like) or, when extended, their absolute integrated emission is of interest. In the latter case, an initial 3D reconstruction is performed for detection, classification, and delineation of a region of interest (ROI). In the classification step, the time-dependent absolute tracer uptake is estimated as before, from the projections.
For a small ROI, the nuclear camera detectors or heads can be arranged in a 180-degree orientation. Time dependencies over longer periods of time can be measured without successive full scans. For example, after the initial acquisition with a full 180/360 degree gantry rotation, single projections may be obtained to be processed with the earlier determined ROI, with the portions of interest (e.g., lesions) are in the field of view.
According to other embodiments, the described systems and methods are used for the evaluation of SPECT acquisitions. Although the main embodiment is described with regard to cardiologic applications, it will be appreciated that other applications are contemplated and that the described systems and methods are not limited thereto. It is suited to SPECT systems with simultaneous transmission for time-dependent registration and attenuation estimation. Alternatively, standard SPECT/CT or transmission source systems can be used. Moreover, the system 10 can be used to correct standard reconstructions, for instance in a fast work-flow where reconstruction is performed after tracer injection. Furthermore, the system can be used for obtaining additional dynamic information related to tracer uptake and re-distribution (e.g., for Tl-201, Tc-99m, or 1-123).
With reference to
At a station 110 connected with the network, an operator uses the user interface 12 to move a selected 3D patient image representation to or between the central memory 106 and the local memory 114. A video processor 116 displays the selected patient image representation in a first viewport 1181, of the display 20. Tracer distributions are displayed in a second viewport 1182. A third view port 1183 can display an overlay of the tracer distributions and the image representation. For example, a user can be permitted to register landmarks in a tracer distribution image to corresponding structures or landmarks in a polar plot image. For instance, the operator, through the interface 12, selects the polar plot image landmarks (e.g., using a mouse, stylus, or other suitable user input device) that correspond to landmarks in the tracer uptake image. Alternately, the tracer uptake can be aligned automatically by a program in the processor 116. The processor 16 (
The overlay image can then be used in other applications. For instance, a therapy planning station 130 can use the overlay image to plan a therapy session. Once planned to the satisfaction of the operator, the planned therapy can, where appropriate to an automated procedure, be transferred to a therapy device 132 that implements the planned session. Other stations may use the overlay image in various other planning processes.
In another embodiment, the overlay displayed in viewport 1183 is adjustable to weight the patient image data relative to the tracer uptake image, or vice versa. For instance a slider bar or knob (not shown), which may be mechanical or presented on the display 20 and manipulated with an input device, may be adjusted to vary the weight of the patient image or the tracer uptake image. In one example, an operator can adjust the image in viewport 1183 from purely patient (polar plot) image data (as is shown in viewport 1181), through multiple and/or continuous combinations of patient and tracer uptake image data, to purely tracer uptake image data (as is shown in viewport 1182). For instance, a ratio of patient image data to tracer uptake image data can be discretely or continuously adjusted from 0:1 to 1:0.
The innovation has been described with reference to several embodiments. Modifications and alterations may occur to others upon reading and understanding the preceding detailed description. It is intended that the innovation be construed as including all such modifications and alterations insofar as they come within the scope of the appended claims or the equivalents thereof.
Filing Document | Filing Date | Country | Kind | 371c Date |
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PCT/IB2009/052282 | 5/29/2009 | WO | 00 | 11/22/2010 |
Number | Date | Country | |
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61058579 | Jun 2008 | US |