Biomedical subjects

M Ljungberg

Publications and source records attributed to M Ljungberg.

At least 19 recordsLinked to original sources

PubMed2005

EANM/ESC procedural guidelines for myocardial perfusion imaging in nuclear cardiology.

The European procedural guidelines for radionuclide imaging of myocardial perfusion and viability are presented in 13 sections covering patient information, radiopharmaceuticals, injected activities and dosimetry, stress tests, imaging protocols and acquisition, quality control and reconstruction methods, gated studies and attenuation-scatter compensation, data analysis, reports and image display, and positron emission tomography. If the specific recommendations given could not be based on evidence from original, scientific studies, we tried to express this state-of-art. The guidelines are designed to assist in the practice of performing, interpreting and reporting myocardial perfusion SPET. The guidelines do not discuss clinical indications, benefits or drawbacks of radionuclide myocardial imaging compared to non-nuclear techniques, nor do they cover cost benefit or cost effectiveness.

Cardiology↗

PubMed2005

Development of educational image databases and e-books for medical physics training.

Medical physics education and training requires the use of extensive imaging material and specific explanations. These requirements provide an excellent background for application of e-Learning. The EU projects Consortia EMERALD and EMIT developed five volumes of such materials, now used in 65 countries. EMERALD developed e-Learning materials in three areas of medical physics (X-ray diagnostic radiology, nuclear medicine and radiotherapy). EMIT developed e-Learning materials in two further areas: ultrasound and magnetic resonance imaging. This paper describes the development of these e-Learning materials (consisting of e-books and educational image databases). The e-books include tasks helping studying of various equipment and methods. The text of these PDF e-books is hyperlinked with respective images. The e-books are used through the readers' own Internet browser. Each Image Database (IDB) includes a browser, which displays hundreds of images of equipment, block diagrams and graphs, image quality examples, artefacts, etc. Both the e-books and IDB are engraved on five separate CD-ROMs. Demo of these materials can be taken from www.emerald2.net.

Biomedical Engineering↗

PubMed2003

31P MRS evaluation of fatigue in anterior tibial muscle in postpoliomyelitis patients and healthy volunteers.

Changes in concentration of high energy phosphates and pH were studied during rest, exercise and subsequent recovery in the anterior tibial muscle of 10 patients with late effects of poliomyelitis and 10 age- and sex-matched healthy volunteers using 31P MRS. The exercise was dynamic and isometric, and the force levels were individually adapted to each subject and stepwise increased. In general, there were no differences in metabolite changes between the groups, except for lower Pi and Pi/PCr for the volunteers during the recovery phase, also reflected by shorter recovery half-time for Pi. The interindividual variation was much higher for the patient group. Some of the patients showed deviating results probably because of differences in muscle fibre type.

Adenosine Triphosphate↗

PubMed2003

Calibration of a radioactive ink-based stack phantom and its applications in nuclear medicine.

This paper describes a stack phantom useful for imaging complex activity distributions. It is based on images printed with radioactive ink using a commercial ink-jet printer. The application for the phantom is in the evaluation of planar and SPECT scintillation camera images and for validation of Monte Carlo simulated images. The accuracy in generating the activity distributions on paper sheets is especially important. Here we describe the calibration procedure for the ink-jet printer. The goal of the printer calibration is to find the relationship between the digital image count (voxel grey level) and its corresponding activity on the paper sheets (radioactivity). The relationship between the voxel grey level and the radioactivity on the paper sheets (measured by scanning technique and well counter) was found to be logarithmic, and a 3rd degree polynomial was found to fit the relationship. The distribution of radioactivity in the ink cartridge was investigated by pinhole SPECT. The distribution of (99m)Tc solution was found to be homogeneous in the ink solution. Experimental studies were done directly on Monte Carlo simulated heart images from the NCAT phantom. The result showed that the simulated images are similar to the images measured using the ink-jet technique. This stack phantom could be a promising solution with an advantage that the exact geometry generated in Monte Carlo could be imitated in the phantom. The phantom is a very flexible device and clearly much more versatile than conventional phantoms which have a fixed geometry and spatial limitation.

Calibration↗

PubMed2001

Lateralisation with magnetic resonance spectroscopic imaging in temporal lobe epilepsy: an evaluation of visual and region-of-interest analysis of metabolite concentration images.

We carried out spectroscopic imaging (MRSI) on nine consecutive patients with temporal lobe epilepsy being assessed for epilepsy surgery, and nine neurologically healthy, age-matched volunteers. A volume of interest (VOI) was angled along the temporal horns on axial and sagittal images, and symmetrically over the temporal lobes on coronal images. Images showing the concentrations of N-acetylaspartate (NAA) and of choline-containing compounds plus creatine and phosphocreatine (Cho + Cr) were used for lateralisation. We compared assessment by visual inspection and by signal analysis from regions of interest (ROI) in different positions, where side-to-side differences in NAA/(Cho + Cr) ratio were used for lateralisation. The NAA/ (Cho + Cr) ratio from the different ROI was also compared with that in the brain stem to assess if the latter could be used as an internal reference, e. g., for identification of bilateral changes. The metabolite concentration images were found useful for lateralisation of temporal lobe abnormalities related to epilepsy. Visual analysis can, with high accuracy, be used routinely. ROI analysis is useful for quantifying changes, giving more quantitative information about spatial distribution and the degree of signal loss. There was a large variation in NAA/ (Cho + Cr) values in both patients and volunteers. The brain stem may be used as a reference for identification of bilateral changes.

Adolescent↗

PubMed2001

Monte Carlo evaluation of object shape effects in iodine-131 SPET tumor activity quantification.

In our clinical iodine-131 single-photon emission tomography (SPET) quantification for radioimmunotherapy, calibration and partial volume correction are based on measurements with phantoms containing spheres to simulate patient tumors even though real tumors are frequently nonspherical. In this study, Monte Carlo simulation was used to evaluate how object shape influences "spill-out" and "spill-in", which are major sources of quantification error associated with the poor spatial resolution of 131I SPET. Objects that varied in shape (spheres, cylinders, and an irregular structure) but were identical in activity and volume were simulated. Iterative reconstruction employed both attenuation and triple-energy-window scatter compensation. VOIs were defined in the reconstructed images both using physical boundaries and using expanded boundaries to allow for the limited resolution. When physical boundaries were used, both spill-out and spill-in were more significant for nonspherical structures than for spherical structures. Over the range of object volumes (50-200 ml) and at all background levels, VOI counts in cylinders were lower than VOI counts in spheres. This underestimation increased with decrease in object size (for the cold background -18% at 200 ml and -39% at 50 ml). It also decreased with increase in background activity because spill-in partially compensated for spill-out. It was shown that with a VOI larger than physical size, the results are independent of object shape and size only in the case of cold background. Activity quantification was carried out using a procedure similar to that used in our clinic. Quantification of nonspherical objects was improved by simple sphere-based partial volume correction, but the error was still large in some cases (for example, -39% for a 50-ml cylinder in a cold background and -35% for a 200-ml irregular structure defined on the basis of a typical tumor outlined on an X-ray computed tomography scan of a patient with non-Hodgkin's lymphoma). Partial volume correction by patient-specific Monte Carlo simulation may provide better quantification accuracy.

Computer Simulation↗

PubMed2001

Effects of k-space filtering and image interpolation on image fidelity in (1)H MRSI.

2D MRSI suffers from the effect of the spatial response function due to the truncation of the sampling of k-space. Filtering of the k-space data-set is often used to suppress the side lobes caused by the effects of the SRF, where the sampled data-set is multiplied with a weighting function before inverse FT. Commonly used filters in MRSI are the cosine, Hanning and Hamming filters. The data-set is often interpolated into a larger image matrix size for analysis, where "Fourier interpolation" (FoI) and "cubic spline interpolation" (CSpI) are two common methods. In this work, the effects of k-space filtering in practical usage was examined, and the image representations of the object for the two interpolation methods were compared. This study showed that application of filtering improves the image representation of the structures in the object and should be used in MRSI. FoI correctly visualizes the information inherent in the data-set, while the features of the object were dependent on the position of the object relative the original matrix in the CSpI interpolated images. FoI should therefore be used for quantitative evaluation of MRSI images.

Algorithms↗

PubMed2001

Usefulness and pitfalls of planar gamma-scintigraphy for measuring aerosol deposition in the lungs: a Monte Carlo investigation.

UNLABELLED: Planar gamma-scintigraphy is often used to quantify pulmonary deposition patterns from aerosol inhalers. The results are quite different from those obtained using 3-dimensional PET and SPECT. The purpose of this study was to characterize the effects of scatter and tissue attenuation on the distribution of radiolabeled aerosol as measured by planar scintigraphy using Monte Carlo simulations. This study also investigated the applicability of a few correction methods used in inhalation studies. METHODS: Body density maps were derived from CT scans. Regions of interest-lungs, major airways, and esophagus-were defined from the same CT volume. Two radioactivity source distribution patterns in the lung, uniform and nonuniform, were used. A Monte Carlo program, SIMIND, was used to generate anterior and posterior gamma-images of the composed inhalation distributions for 2 energy windows, photopeak (127-153 keV) and scatter (92-125 keV). The effects of scatter and attenuation were estimated on the basis of the imaging components separated from the simulation. A scatter correction method and 2 attenuation correction methods, all applied to inhalation scintigraphy, were evaluated using the simulated images. RESULTS: The amount of scatter ranges from 24% to approximately 29% in the lungs and from 29% to approximately 35% in the central (airway or esophagus) region on the planar images. Significant differences were found among regions and between source distributions (P < 0.05). The fraction k used for dual-energy-based scatter correction also varied and was found to be less than the commonly used k = 0.5. The simplified narrow-beam attenuation correction and the effective (broad-beam) correction methods were found to either under- or overcorrect the regional activities. CONCLUSION: The amount of scatter and tissue attenuation in the thorax region depends on source distribution and body attenuation. In applying planar scintigraphy for aerosol inhalation studies, it is difficult to obtain precise quantitative measurements because of the uncertainties associated with scatter and attenuation corrections. Accurate corrections require knowledge of both source and density distributions.

Administration, Inhalation↗

PubMed2001

Registration of emission and transmission whole-body scintillation-camera images.

UNLABELLED: In this work, a method for registration of whole-body (WB) scintillation-camera images is presented. The primary motive for the development is to perform activity quantification using the conjugate view method on an image basis. Accurate image registration is required for sequential anterior and posterior scans, for serial emission images for analysis of the biokinetics, and for transmission and emission images for a pixel-based attenuation correction. METHODS: Registration is performed by maximization of the mutual information. The spatial transformation has been tailored for the registration of WB images and is composed of global and local transformations, including rigid, projective, and curved transformations. A coarse registration is first performed using cross-correlation and direct pixel scaling. Optimization is then performed in a sequence, beginning with the 2 legs independently, followed by the upper body and head. Evaluation is performed for clinical images of an (131)I-labeled monoclonal antibody and for Monte Carlo-simulated images. An anthropomorphic WB computer phantom, which has been especially modified to match the patient position during WB scanning, is used for the simulations. RESULTS: For simulated images, registration errors are within 1 pixel (<3.6 mm) for a sufficient image count level. Separate evaluation of the influence of noise shows that the errors increase below a total image count of approximately 10(5) (signal-to-noise ratio, approximately 4). For clinical evaluations, the deviations between point markers are 9 +/- 5 mm. CONCLUSION: An automatic registration method for WB images has been developed, which is applicable to emission-emission and transmission-emission registration. This method has been applied in more than 50 clinical studies and has shown to be robust and reliable.

Gamma Cameras↗

PubMed2000

Extended ISIS sequences insensitive to T(1) smearing.

Image selected in vivo spectroscopy (ISIS) is a volume selection method often used for in vivo (31)P MRS, since it is suitable for measurements of substances with short T(2). However, ISIS can suffer from significant signal contributions caused by T(1) smearing from regions outside the VOI. A computer model was developed to simulate this contamination. The simulation results for the ISIS experiment order implemented in our MR system (ISIS-0) were in agreement with results obtained from phantom measurements. A new extended ISIS experiment order (E-ISIS) was developed, consisting of four "optimal" ISIS experiment orders (ISIS-1 to ISIS-4) performed consecutively with dummy ISIS experiments in between. The simulation results show that contamination due to T(1) smearing is, effectively, eliminated with E-ISIS and is significantly lower than for ISIS-0 and ISIS-1. E-ISIS offers increased accuracy for quantitative and qualitative determination of substances studied using in vivo MRS. Hence, E-ISIS can be valuable for both clinical and research applications.

Computer Simulation↗

PubMed2000

Point-wise measurements of MRS volume selection performance are insensitive to magnetic susceptibility effects of phantom materials.

The purpose was to analyse magnetic susceptibility effects on accuracy of point-wise measurements of signal profiles in the assessment of MRS volume selection performance. An existing phantom design consisting of a sphere with a movable signal source was used for the investigation. The influence from the phantom on magnetic field homogeneity was measured with phase sensitive 1H imaging and 31P spectroscopy on a 1.5 T whole body MR system. The susceptibility effects for such a phantom design can be separated in 1/ A variation in the background magnetic field, which is caused by the stationary structures and has a significant influence on spatial accuracy. 2/ A magnetic field distortion, which is caused by the movable signal source and has very little influence on accuracy. The spatial inaccuracy due to susceptibility effects in this phantom, was 0.03 mm for positions of the signal source covering a 40-mm VOI. Susceptibility effects from the movable signal source were substantial but had very little influence on spatial accuracy. Still, improvements of this phantom design are possible. Point-wise measurements using a phantom with a movable signal source is inherently insensitive to susceptibility effects from the signal source and permits accurate signal profile measurements of high spatial (sub-mm) resolution.

Electromagnetic Fields↗

PubMed2000

Dual-window scatter correction and energy window setting in cerebral blood flow SPECT: a Monte Carlo study.

The image quality in SPECT studies of the regional cerebral blood flow (rCBF) performed with 99mTc-HMPAO is degraded by scattered photons. The finite energy resolution of the gamma camera makes the detection of scattered photons unavoidable, and this is observed in the image as an impaired contrast between grey and white matter structures. In this work, a Monte Carlo simulated SPECT study of a realistic voxel-based brain phantom was used to evaluate the resulting contrast-to-noise ratio for a number of energy window settings, with and without the dual-window scatter correction. Values of the scaling factor k, used to obtain the fraction of scattered photons in the photopeak window, were estimated for each energy window. The use of a narrower, asymmetric, energy discrimination window improved the contrast, with a subsequent increase in statistical noise due to the lower number of counts. The photopeak-window setting giving the best contrast-to-noise ratio was found to be the same whether or not scatter correction was applied. Its value was 17% centred at 142 keV. At the optimum photopeak-window setting, the contrast was improved by using scatter correction, but the contrast-to-noise ratio was made worse.

Brain↗

PubMed2000

Attenuation correction in quantitative SPECT of cerebral blood flow: a Monte Carlo study.

Monte Carlo simulation has been used to produce projections from a voxel-based brain phantom, simulating a 99mTc-HMPAO single photon emission computed tomography (SPECT) brain investigation. For comparison, projections free from the effects of attenuation and scattering were also simulated, giving ideal transaxial images after reconstruction. Three methods of attenuation correction were studied: (a) a pre-processing method, (b) a post-processing uniform method and (c) a post-processing non-uniform method using a density map. The accuracy of these methods was estimated by comparison of the reconstructed images with the ideal images using the normalized mean square error, NMSE, and quantitative values of the regional cerebral blood flow, rCBF. A minimum NMSE was achieved for the effective linear attenuation coefficient mu(eff) = 0.07 (0.09) cm(-1) for the uniform(pre) method, the effective mass attenuation coefficient mu(eff)/rho = 0.08 (0.10) cm2 g(-1) for the uniform(post) method and mu(eff)/rho = 0.12 (0.13) cm2 g(-1) for the non-uniform(post) method. Values in parentheses represent the case of dual-window scatter correction. The non-uniform(post) method performed better, as measured by the NMSE, both with and without scatter correction. Furthermore, the non-uniform(post) method gave, on average, more accurate rCBF values. Although the difference in rCBF accuracy was small between the various methods, the same method should be used for patient studies as for the reference material.

Humans↗

PubMed2000

Characterization of scatter and penetration using Monte Carlo simulation in 131I imaging.

UNLABELLED: In 131I SPECT, image quality and quantification accuracy are degraded by object scatter as well as scatter and penetration in the collimator. The characterization of energy and spatial distributions of scatter and penetration performed in this study by Monte Carlo simulation will be useful for the development and evaluation of techniques that compensate for such events in 131I imaging. METHODS: First, to test the accuracy of the Monte Carlo model, simulated and measured data were compared for both a point source and a phantom. Next, simulations to investigate scatter and penetration were performed for four geometries: point source in air, point source in a water-filled cylinder, hot sphere in a cylinder filled with nonradioactive water, and hot sphere in a cylinder filled with radioactive water. Energy spectra were separated according to order of scatter, type of interaction, and gamma-ray emission energy. A preliminary evaluation of the triple-energy window (TEW) scatter correction method was performed. RESULTS: The accuracy of the Monte Carlo model was verified by the good agreement between measured and simulated energy spectra and radial point spread functions. For a point source in air, simulations show that 73% of events in the photopeak window had either scattered in or penetrated the collimator, indicating the significance of collimator interactions. For a point source in a water-filled phantom, the separated energy spectra showed that a 20% photopeak window can be used to eliminate events that scatter more than two times in the phantom. For the hot sphere phantoms, it was shown that in the photopeak region the spectrum shape of penetration events is very similar to that of primary (no scatter and no penetration) events. For the hot sphere regions of interest, the percentage difference between true scatter counts and the TEW estimate of scatter counts was <12%. CONCLUSION: In 131I SPECT, object scatter as well as collimator scatter and penetration are significant. The TEW method provides a reasonable correction for scatter, but the similarity between the 364-keV primary and penetration energy spectra makes it difficult to compensate for these penetration events using techniques that are based on spectral analysis.

Computer Simulation↗

PubMed2000

Accuracy of 131I tumor quantification in radioimmunotherapy using SPECT imaging with an ultra-high-energy collimator: Monte Carlo study.

UNLABELLED: Accuracy of 131I tumor quantification after radioimmunotherapy (RIT) was investigated for SPECT imaging with an ultra-high-energy (UHE) collimator designed for imaging 511-keV photons. METHODS: First, measurements and Monte Carlo simulations were carried out to compare the UHE collimator with a conventionally used, high-energy collimator. On the basis of this comparison, the UHE collimator was selected for this investigation, which was carried out by simulation of spherical tumors in a phantom. Reconstruction was by an expectation-maximization algorithm that included scatter and attenuation correction. Keeping the tumor activity constant, simulations were carried out to assess how volume-of-interest (VOI) counts vary with background activity, radius of rotation (ROR), tumor location, and size. The constant calibration factor for quantification was determined from VOI counts corresponding to a 3.63-cm-radius sphere of known activity. Tight VOIs corresponding to the physical size of the spheres or tumors were used. RESULTS: Use of the UHE collimator resulted in a large reduction in 131I penetration, which is especially significant in RIT where background uptake is high. With the UHE collimator, typical patient images showed an improvement in contrast. Considering the desired geometric events, sensitivity was reduced, but only by a factor of 1.6. Simulation results for a 3.63-cm-radius tumor showed that VOI counts vary with background, location, and ROR by less than 3.2%, 3%, and 5.3%, respectively. The variation with tumor size was more significant and was a function of the background. Good quantification accuracy (<6.5% error) was achieved when tumor size was the same as the sphere size used in the calibration, irrespective of the other parameters. For smaller tumors, activities were underestimated by up to -15% for the 2.88-cm-radius sphere, -23% for the 2.29-cm-radius sphere, and -47% for the 1.68-cm-radius sphere. CONCLUSION: Reasonable accuracy can be achieved for VOI quantification of 131I using SPECT with an UHE collimator and a constant calibration factor. Difference in tumor size relative to the size of the calibration sphere had the biggest effect on accuracy, and recovery coefficients are needed to improve quantification of small tumors.

Algorithms↗

PubMed1999

Performance of 2D 1H spectroscopic imaging of the brain: some practical considerations regarding the measurement procedure.

This paper deals with some of the practical considerations in the planning and performance of chemical shift imaging (MRSI or CSI) of the brain. It contains some aspects of 1) the imaging procedure (MRI), i.e., suggestions of an imaging protocol useful for the spectroscopic planning, 2) the planning of the spectroscopic volume, i.e., size and position, 3) evaluation and judgment of the preparation results, and 4) evaluation of the MRSI images. The paper also contains suggestions of developmental work and quality assessment to be done before patient studies are begun. Examples are given for MRSI studies of temporal lobe epilepsy. Several of the aspects described are obvious for the experienced spectroscopist but may be useful in the initiation of MRSI. The goal of this paper was to share our experiences of how to achieve high quality MRSI, experiences that we would had been grateful for in our prelude of MRSI experiments.

Brain↗

PubMed1999

Radiation dosimetry in nuclear medicine.

Radionuclides are used in nuclear medicine in a variety of diagnostic and therapeutic procedures. A knowledge of the radiation dose received by different organs in the body is essential to an evaluation of the risks and benefits of any procedure. In this paper, current methods for internal dosimetry are reviewed, as they are applied in nuclear medicine. Particularly, the Medical Internal Radiation Dose (MIRD) system for dosimetry is explained, and many of its published resources discussed. Available models representing individuals of different age and gender, including those representing the pregnant woman are described; current trends in establishing models for individual patients are also evaluated. The proper design of kinetic studies for establishing radiation doses for radiopharmaceuticals is discussed. An overview of how to use information obtained in a dosimetry study, including that of the effective dose equivalent (ICRP 30) and effective dose (ICRP 60), is given. Current trends and issues in internal dosimetry, including the calculation of patient-specific doses and in the use of small scale and microdosimetry techniques, are also reviewed.

Alpha Particles↗

PubMed1999

The influence of backscatter material on 99mTc and 201Tl line source responses.

SPECT projections are contaminated by scatter, resulting in reduced image contrast and quantitative errors. When tissue is present behind the source, some of the detected photons backscatter via this tissue. Particularly in dual-isotope SPECT and in combined emission-transmission SPECT, backscatter constitutes a major part of the down-scatter contamination in lower-energy windows. In this paper, the effects of backscatter material were investigated. Planar images of 99mTc and 201Tl line sources between varying numbers of Perspex slabs were analysed using the photopeak windows and various scatter windows. In the 99mTc photopeak window no significant change in total counts due to backscatter material was measured. In the 201Tl photopeak window an increase of about 10% in total counts was observed. In the scatter windows an even more explicit influence of backscatter material was measured. For instance, at a forward depth of 10 cm, total counts of a 99mTc source detected in the 72 keV window eventually doubled with increasing backscatter material, compared with the situation without backscatter material. The backscatter contribution plateaued when more than 5-10 cm of scatter material was placed behind the source. In conclusion, backscatter should be taken into account, particularly in model-based down-scatter correction methods in dual-isotope SPECT and combined emission-transmission SPECT.

Gadolinium↗