Preclinical or small-animal Single Photon Emission Computed Tomography (SPECT) is a radionuclide based molecular imaging modality for small laboratory animals [1] (e.g. mice and rats). Although SPECT is a well-established imaging technique that is already for decades in use for clinical application, the limited resolution of clinical SPECT (~10 mm) stimulated the development of dedicated small animal SPECT systems with sub-mm resolution. Unlike in clinics, preclinical SPECT outperforms preclinical coincidence PET in terms of resolution (best spatial resolution of SPECT - 0.25mm, [2] PET ≈ 1 mm [3] [4] ) and, at the same time, allows to perform fast dynamic imaging of animals (less than 15s time frames [5] ).
SPECT imaging requires administration of small quantities of γ-emitting radiolabeled molecules (commonly called "tracers") into the animal prior to the image acquisition. These tracers are biochemically designed in such a way that they accumulate at target locations in the body. The radiation emitted by the tracer molecules (single γ-photons) can be detected by gamma detectors and, after image reconstruction, results in a 3-dimensional image of the tracer distribution within the animal. Some key radioactive isotopes used in preclinical SPECT are 99mTc, 123I, 125I, 131I, 111In, 67Ga and 201Tl.
Preclinical SPECT plays an important role in multiple areas of translational research [6] where SPECT can be used for non-invasive imaging of radiolabeled molecules, including antibodies, peptides, and nanoparticles. Among major areas of its applications are oncology, neurology, psychiatry, cardiology, orthopedics, pharmacology and internal medicine.
Due to the small size of the imaged animals (a mouse is about 3000 times smaller than a human measured by weight and volume), it is essential to have a high spatial resolution and detection efficiency for the preclinical scanner.
Looking at spatial resolution first, if we want to see the same level of details relatively to e.g. the size of the organs in a mouse as we can see in a human, the spatial resolution of clinical SPECT needs to be improved by a factor of or higher. Such an obstacle forced scientists to look for a new imaging approach for preclinical SPECT that was found in exploiting the pinhole imaging principle. [7]
A pinhole collimator consists of a piece of dense material containing only a single hole, which typically has the shape of a double cone. First attempts to obtain SPECT images of rodents with a high resolution were based on use of pinhole collimators attached to convectional gamma cameras. [8] [9] In such a way, by placing the object (e.g. rodent) close to the aperture of the pinhole, one can reach a high magnification of its projection on the detector surface and effectively compensate for the limited intrinsic resolution of the detector.
The combined effects of the finite aperture size and the limited intrinsic resolution are described by:
de - effective pinhole diameter, Ri - intrinsic resolution of the detector, M – projection magnification factor.
The resolution of a SPECT system based on the pinhole imaging principle can be improved in one of three ways:
The exact size, shape and material of the pinhole are important to obtain good imaging characteristics and is a subject of collimator design optimization studies via e.g. use of Monte Carlo simulations. Modern preclinical SPECT scanners based on pinhole imaging can reach up to 0.25 mm spatial or 0.015 μL volumetric resolution for in vivo mouse imaging.
The detection efficiency or sensitivity of a preclinical pinhole SPECT system is determined by: [10] [11]
S – detection efficiency (sensitivity), de-effective pinhole diameter with penetration, N – total number of pinholes, rc – collimator radius (e.g. object-to-pinhole distance).
The sensitivity can be improved by:
Possible drawbacks: degradation of spatial resolution
Possible drawbacks: When multiple pinhole projections are projected on a single detector surface, they can either overlap each other (multiplexing projections) or be fully separated (non-overlapping projections). Although pinhole collimators with multiplexing projections allow reaching a higher sensitivity (by allowing to use a higher number of pinholes) when compared to non-overlapping designs, they also suffer from multiple artifacts in reconstructed SPECT images. [12] [13] [14] [15] The artifacts are cause by ambiguity about the origin of γ -photons detected in the areas of the overlap.
Placing the animal close to the pinhole aperture comes at the cost of reducing the size of the area that can be imaged at a given time (the "field-of-view") compared to imaging at a lower magnification. However, when combined with moving the animal (the so-called "scanning-focus method" [16] ) a larger area of interest can still be imaged with a good resolution and sensitivity.
The typical detection efficiency of preclinical SPECT scanner lies within a 0.1-0.2% (1000-2000 cps/MBq) range, which is more than tenfold higher than the average sensitivity of clinical scanners. [17] At the same time, dedicated high-sensitivity collimators can allow >1% detection efficiency and maintain sub-mm image resolution. [18]
Multiple pinhole SPECT system designs have been proposed, including rotating gamma camera, stationary detector but rotating collimator, or completely stationary camera [19] [20] in which a large number of pinholes surround the animal and simultaneously acquire projections from a sufficient number of angles for tomographic image reconstruction. Stationary systems have several advantages over non-stationary systems:
Why: due to the stable position of the detector(s) and the collimator
Why: because all required angular information is acquired simultaneously by multiple pinholes.
Modern stationary preclinical SPECT systems can perform dynamic SPECT imaging with up to 15s time-frames during total body [5] and up to 1s time-frames during "focused" (e.g. focusing on heart) [16] image acquisitions.
Medical imaging encompasses many different imaging modalities, which can roughly be divided into anatomical and functional imaging. Anatomical modalities (e.g. CT, MRI) mainly reveal the structure of the tissues and organs, while the functional modalities (SPECT, PET and optical imaging) mainly visualize the physiology and function of the tissue. Because none of the existing imaging modalities can provide information on all aspects of structure and function, an obvious approach is to either alter one imaging modality to the task (e.g. special imaging sequences in MRI) or to try to image a subject using multiple imaging modalities. Following the multimodality approach, in recent years the combination of a SPECT/CT system became a standard molecular imaging modality combination in both the pre-clinical and clinical fields, where the structural information of CT complements the functional information from SPECT. Nevertheless, integration of SPECT with other imaging modalities (e.g. SPECT/MR, SPECT/PET/CT [6] [21] ) is not uncommon.
A SPECT measurement consists of 2-dimensional projections of the radioactive source distribution that are obtained with collimator(s) and gamma-detector(s). It is the goal of an image reconstruction algorithm to accurately reconstruct the unknown 3-dimensional distribution of the radioactivity. [22]
The Maximum Likelihood Expectation Maximization algorithm [23] [24] (MLEM) is an important "gold standard" in iterative image reconstruction of SPECT images, but it is also a computationally costly method. A popular solution of this obstacle is based on the use of so-called block-iterative reconstruction methods. With block-iterative methods, every iteration of the algorithm is subdivided into many subsequent sub-iterations, each using a different subset of the projection data. An example of a widely used block-iterative version of MLEM is the Ordered Subsets Expectation Maximization algorithm [25] (OSEM). The reconstruction speedup of a full iteration OSEM over a single iteration MLEM is approximately equal to the number of subsets.
Preclinical SPECT is a quantitative imaging modality. The uptake of SPECT tracers in organs (regions) of interest can be calculated from reconstructed images. The small size of laboratory animals diminishes the photon’s attenuation in the body of the animal (compared to one in human-sized objects). Nevertheless, depending on the energy of γ-photons and the size of the animal that is used for imaging, correction for photon attenuation and scattering might be required to provide good quantification accuracy. A detailed discussion about effects affecting quantification of SPECT images can be found in Hwang et al. [26]
SPECT tracers emit single γ-photons with the energy of the emitted photon depending on the isotope that was used for radiolabeling of the tracer. Thus, in cases when different tracers are radiolabeled with isotopes of different energies, SPECT provides the ability to probe several molecular pathways simultaneously (multi-isotope imaging). Two examples of common multi-isotope tracer combinations used for SPECT imaging are 123I-NaI/99mTc-pertechnetate (thyroid function [27] ) or 99mTc-MAG3/111In-DTPA (assessment of renal filtration).
The time the tracer can be followed in vivo strongly depends on the half-life of the isotope used for radiolabeling of the compound. The wide range of relatively long-lived isotopes (compared to the isotopes typically used in PET) that can be used for SPECT imaging provide a unique possibility to image slow kinetic processes (days to weeks).
Another important characteristic of SPECT is the simplicity of tracer radiolabeling procedure that can be performed with a wide range of commercially available labelling kits.
Preclinical SPECT and PET are two very similar molecular imaging modalities used for noninvasive visualization of biodistribution of radiolabel tracers that are injected into an animal. The major difference between SPECT and PET lies in the nature of the radioactive decay of their tracers. SPECT tracer emits single γ-photons with the energy of photons that depends on the isotope that was used for radiolabeling. In PET, the tracer emits positrons that, after annihilation with electrons in the subject, produce a pair of 511 keV annihilation photons emitted into opposite directions. Coincidental detection of these annihilation photons is used for image formation in PET. As a result, different detection principles have been developed for SPECT and PET tracers, which has led to separate SPECT and PET scanners.
Comparison of preclinical SPECT and PET is provided in the table below
Characteristics | SPECT | PET |
---|---|---|
Radiation decay | single γ-photons | β+ decay |
Basic principle of detection | Collimation, single γ -photons | Coincidence detection, annihilation photons |
Energy of γ-photons | Different for different isotopes | 511 keV |
Most popular isotope | 99mTc: half-life 6.03 hours, γ-energy 141 keV | 18F: half-life 108 minutes, γ-energy 511 keV |
Multi-isotope imaging | Yes, for isotopes with different γ-photon energy | No, all isotopes emit photons with 511 keV energy |
Imaging slow dynamic processes | Yes, for isotope with longer half-life (e.g. 99mTc - 6.03 hours, 123I - 13 hours, 111In - 2.8 days, 125I - 60.14 days) | Limited by decay of the isotope (half-life 18F - 108 minutes, 11C - 24 minutes, 124I - 4.18 days) |
Imaging fast dynamic processes | >15s frames (total body imaging) [5] >1s frames (focused imaging) [18] | Yes, seconds to minutes frames |
Resolution, best | 0.25 mm (0.015 μL) [2] | 0.75 mm (0.422 μL) [28] |
Detection efficiency | 0.1-1.3% | 1- 10% |
Tracer radiolabeling (costs) | Low to high | High |
Manufacturers of preclinical SPECT systems include MILabs, Siemens, Bruker, Mediso and MOLECUBES. [29] [30] Systems are available combining SPECT with multiple other modalities including MR, PET and CT. [31] [32] They can achieve up to 0.25 mm spatial resolution (0.015 μL volumetric resolution) and up to 1 second-frame dynamic noninvasive SPECT imaging of rodents. [33]
SPECT can be used for diagnostic or therapeutic imaging. When a radioactive tracer is labeled with primary gamma-emitting isotopes (e.g. 99mTc, 123I, 111In, 125I), the acquired images provide functional information about the bio-distribution of the compound that can be used for multiple diagnostic purposes. Examples of diagnostic applications: metabolism and perfusion imaging, cardiology, orthopedics.
When SPECT tracer is labeled with a combined gamma and α- or β-emitting isotope (e.g. 213Bi or 131I), it is possible to combine cancer radioisotope therapy with α- or β- particles with noninvasive imaging of response to the therapy that is achieved with SPECT.
Positron emission tomography (PET) is a functional imaging technique that uses radioactive substances known as radiotracers to visualize and measure changes in metabolic processes, and in other physiological activities including blood flow, regional chemical composition, and absorption. Different tracers are used for various imaging purposes, depending on the target process within the body.
Medical imaging is the technique and process of imaging the interior of a body for clinical analysis and medical intervention, as well as visual representation of the function of some organs or tissues (physiology). Medical imaging seeks to reveal internal structures hidden by the skin and bones, as well as to diagnose and treat disease. Medical imaging also establishes a database of normal anatomy and physiology to make it possible to identify abnormalities. Although imaging of removed organs and tissues can be performed for medical reasons, such procedures are usually considered part of pathology instead of medical imaging.
Single-photon emission computed tomography is a nuclear medicine tomographic imaging technique using gamma rays. It is very similar to conventional nuclear medicine planar imaging using a gamma camera, but is able to provide true 3D information. This information is typically presented as cross-sectional slices through the patient, but can be freely reformatted or manipulated as required.
Nuclear medicine or nucleology is a medical specialty involving the application of radioactive substances in the diagnosis and treatment of disease. Nuclear imaging, in a sense, is "radiology done inside out" because it records radiation emitted from within the body rather than radiation that is transmitted through the body from external sources like X-ray generators. In addition, nuclear medicine scans differ from radiology, as the emphasis is not on imaging anatomy, but on the function. For such reason, it is called a physiological imaging modality. Single photon emission computed tomography (SPECT) and positron emission tomography (PET) scans are the two most common imaging modalities in nuclear medicine.
A radioactive tracer, radiotracer, or radioactive label is a synthetic derivative of a natural compound in which one or more atoms have been replaced by a radionuclide. By virtue of its radioactive decay, it can be used to explore the mechanism of chemical reactions by tracing the path that the radioisotope follows from reactants to products. Radiolabeling or radiotracing is thus the radioactive form of isotopic labeling. In biological contexts, experiments that use radioisotope tracers are sometimes called radioisotope feeding experiments.
A gamma camera (γ-camera), also called a scintillation camera or Anger camera, is a device used to image gamma radiation emitting radioisotopes, a technique known as scintigraphy. The applications of scintigraphy include early drug development and nuclear medical imaging to view and analyse images of the human body or the distribution of medically injected, inhaled, or ingested radionuclides emitting gamma rays.
Scintigraphy, also known as a gamma scan, is a diagnostic test in nuclear medicine, where radioisotopes attached to drugs that travel to a specific organ or tissue (radiopharmaceuticals) are taken internally and the emitted gamma radiation is captured by gamma cameras, which are external detectors that form two-dimensional images in a process similar to the capture of x-ray images. In contrast, SPECT and positron emission tomography (PET) form 3-dimensional images and are therefore classified as separate techniques from scintigraphy, although they also use gamma cameras to detect internal radiation. Scintigraphy is unlike a diagnostic X-ray where external radiation is passed through the body to form an image.
Molecular imaging is a field of medical imaging that focuses on imaging molecules of medical interest within living patients. This is in contrast to conventional methods for obtaining molecular information from preserved tissue samples, such as histology. Molecules of interest may be either ones produced naturally by the body, or synthetic molecules produced in a laboratory and injected into a patient by a doctor. The most common example of molecular imaging used clinically today is to inject a contrast agent into a patient's bloodstream and to use an imaging modality to track its movement in the body. Molecular imaging originated from the field of radiology from a need to better understand fundamental molecular processes inside organisms in a noninvasive manner.
Neuroimaging is the use of quantitative (computational) techniques to study the structure and function of the central nervous system, developed as an objective way of scientifically studying the healthy human brain in a non-invasive manner. Increasingly it is also being used for quantitative research studies of brain disease and psychiatric illness. Neuroimaging is highly multidisciplinary involving neuroscience, computer science, psychology and statistics, and is not a medical specialty. Neuroimaging is sometimes confused with neuroradiology.
Iodine-123 (123I) is a radioactive isotope of iodine used in nuclear medicine imaging, including single-photon emission computed tomography (SPECT) or SPECT/CT exams. The isotope's half-life is 13.2230 hours; the decay by electron capture to tellurium-123 emits gamma radiation with a predominant energy of 159 keV. In medical applications, the radiation is detected by a gamma camera. The isotope is typically applied as iodide-123, the anionic form.
Radioactivity is generally used in life sciences for highly sensitive and direct measurements of biological phenomena, and for visualizing the location of biomolecules radiolabelled with a radioisotope.
Myocardial perfusion imaging or scanning is a nuclear medicine procedure that illustrates the function of the heart muscle (myocardium).
Nuclear medicine physicians, also called nuclear radiologists or simply nucleologists, are medical specialists that use tracers, usually radiopharmaceuticals, for diagnosis and therapy. Nuclear medicine procedures are the major clinical applications of molecular imaging and molecular therapy. In the United States, nuclear medicine physicians are certified by the American Board of Nuclear Medicine and the American Osteopathic Board of Nuclear Medicine.
Rubidium-82 (82Rb) is a radioactive isotope of rubidium. 82Rb is widely used in myocardial perfusion imaging. This isotope undergoes rapid uptake by myocardiocytes, which makes it a valuable tool for identifying myocardial ischemia in Positron Emission Tomography (PET) imaging. 82Rb is used in the pharmaceutical industry and is marketed as Rubidium-82 chloride under the trade names RUBY-FILL and CardioGen-82.
Preclinical imaging is the visualization of living animals for research purposes, such as drug development. Imaging modalities have long been crucial to the researcher in observing changes, either at the organ, tissue, cell, or molecular level, in animals responding to physiological or environmental changes. Imaging modalities that are non-invasive and in vivo have become especially important to study animal models longitudinally. Broadly speaking, these imaging systems can be categorized into primarily morphological/anatomical and primarily molecular imaging techniques. Techniques such as high-frequency micro-ultrasound, magnetic resonance imaging (MRI) and computed tomography (CT) are usually used for anatomical imaging, while optical imaging, positron emission tomography (PET), and single photon emission computed tomography (SPECT) are usually used for molecular visualizations.
Positron emission tomography–magnetic resonance imaging (PET–MRI) is a hybrid imaging technology that incorporates magnetic resonance imaging (MRI) soft tissue morphological imaging and positron emission tomography (PET) functional imaging.
Emission computed tomography (ECT) is a type of tomography involving radioactive or emissions. Types include positron emission tomography (PET) and Single-photon emission computed tomography (SPECT).
Positron emission mammography (PEM) is a nuclear medicine imaging modality used to detect or characterise breast cancer. Mammography typically refers to x-ray imaging of the breast, while PEM uses an injected positron emitting isotope and a dedicated scanner to locate breast tumors. Scintimammography is another nuclear medicine breast imaging technique, however it is performed using a gamma camera. Breasts can be imaged on standard whole-body PET scanners, however dedicated PEM scanners offer advantages including improved resolution.
Radiofluorination is the process by which a radioactive isotope of fluorine is attached to a molecule and is preferably performed by nucleophilic substitution using nitro or halogens as leaving groups. Fluorine-18 is the most common isotope used for this procedure. This is due to its 97% positron emission and relatively long 109.8 min half-life. The half-life allows for a long enough time to be incorporated into the molecule and be used without causing exceedingly harmful effects. This process has many applications especially with the use of positron emission tomography (PET) as the aforementioned low positron energy is able to yield a high resolution in PET imaging.
The problem of reconstructing a multidimensional signal from its projection is uniquely multidimensional, having no 1-D counterpart. It has applications that range from computer-aided tomography to geophysical signal processing. It is a problem which can be explored from several points of view—as a deconvolution problem, a modeling problem, an estimation problem, or an interpolation problem.