Impact of Reconstruction Parameters on Spatial Resolution and Its Comparison Between Cadmium-Zinc-Telluride&nbsp;SPECT/CT and Conventional SPECT/CT

doi:10.21203/rs.3.rs-375105/v1

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Impact of Reconstruction Parameters on Spatial Resolution and Its Comparison Between Cadmium-Zinc-Telluride SPECT/CT and Conventional SPECT/CT

https://doi.org/10.21203/rs.3.rs-375105/v1

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Background: To evaluate the impact of reconstruction parameters on spatial resolution of tomographic image in SPECT/CT, and to compare spatial resolution between a new polyvalent whole-body Cadmium-Zinc-Telluride camera (CZT-SPECT/CT) and a conventional dual-head Anger camera (conventional SPECT/CT). Spatial resolution was evaluated with four line sources filled with ^99mTc in tomographic images reconstructed by varying reconstruction parameters. Ordered-subset expectation maximization (OSEM) algorithm was performed with varying iterations (1-20), the number of subsets was fixed at 10. Butterworth filter, Gauss filter and no-filter were selected respectively. Computed tomography-based attenuation correction (CTAC), scatter correction (SC), resolution recovery (RR) and no-correction (NC) were adopted for image correction respectively. Filtered back projection (FBP) with Butterworth filter and CTAC was also performed in image reconstruction. Spatial resolution was expressed by full width at half-maximum (FWHM) value.

Results: The impact of reconstruction parameters on spatial resolution was identical in both cameras: FWHM values decreased with the increase of iterations and converged uniformly when the number of iterations was over 4. FWHM values decreased with the increase of cutoff frequency of Butterworth filter and increased with the increase of Gauss filter. SC and RR improved spatial resolution, whereas CTAC had negligible effect on spatial resolution reconstructed by OSEM. FWHM was generally lower with OSEM reconstruction than FBP reconstruction. On the whole, under the same reconstruction conditions, CZT-SPECT/CT had a lower FWHM value than conventional SPECT/CT.

Conclusions: The spatial resolution was improved with the increase of iterations. Increasing the cutoff frequency of Butterworth filter and decreasing the Gauss filter enhanced spatial resolution. The spatial resolution was better reconstructed by OSEM associated with AC, SC and RR than FBP. CZT-SPECT/CT had better spatial resolution than conventional SPECT/CT.

Atomic and Molecular Physics

Nuclear Physics

SPECT/CT

Cadmium-zinc-telluride (CZT)

Spatial resolution

Reconstruction parameters

Spatial resolution refers to the ability to distinguish subtle structures, that is, the ability to accurately distinguish the smallest lesions or structures. In SPECT, After the radioisotope being injected into patients, the distribution of radioactivity is reproduced by SPECT. Spatial resolution can be understood as the ability to distinguish adjacent point sources in tomographic image. According to NEMA (National Electrical Manufacturers Association) NU 1-2012:Performance Measurements of Gamma Cameras, the spatial resolution of the tomographic image in SPECT can be quantitatively described by the full width at half-maximum(FWHM) of the point spread function(PSF) or the line spread function(LSF)(1). Spatial resolution is a vital factor of image quality, which can influence accuracy diagnosis of lesions. There are many factors influencing spatial resolution, such as detector, collimator, reconstruction parameters and so on. Detector determines the intrinsic spatial resolution. Cadmium-Zinc-Telluride (CZT) is a solid-state semiconductor detector with excellent performance, in recent years, the sensitivity and spatial resolution have enhanced a lot in dedicated cardiac camera of CZT crystal(2–4). As detector, image acquisition and process of CZT is different from that of conventional SPECT detectors, conventional SPECT is mainly composed of scintillation crystal detector(NaI),collimator and photomultiplier tubes, γ-ray emits from a source within a patient and strikes the crystal, photons are converted into visible light in the crystal and that is further transformed into an electrical signal by the PMTs, in this process, PMTs have very large electronic gains (10⁶) with relatively low noise, however, their quantum conversion efficiency is low (~ 20%), leading to a significant loss of signal that affects both energy resolution and intrinsic spatial resolution (5).Different from NaI detector, CZT detectors are solid-state devices that provide direct conversion of absorbed γ-ray photons into an electronic signal, it can operate at room temperature and process 10 million photons/( s·mm2), and highly enhance the sensitivity of SPECT/CT, which allows fast image acquisition(6).Moreover,the energy resolution of the CZT crystal is approximately 1.7 greater than NaI(7)༌the combination of high count rate and high energy resolution greatly improves the sensitivity of the CZT detector system, making it an ideal detector. Regarding of tomographic spatial resolution, it is important to adjust reconstruction parameters, including reconstruction algorithms, pre- or post-filter and image correction. Filtered back projection (FBP) and Ordered-subset expectation maximization (OSEM) are widely used in SPECT/CT, both algorithms are affected by their own adjustable parameters. FBP consists of two steps: filtering of data and back projection of the filtered data, because of its simplicity, speed, and computational efficiency, FBP is the recommended method by NEMA SPECT performance tests(1). OSEM is not a line algorithm, and the reconstructed contrast depends on the true contrast and object size(8), it is characterized by two parameters: iterations and subsets, Brambilla(9) reported the EM-equivalent iteration number that indicated the product between the subsets and the iteration numbers, and measured noise and spatial resolution are associated with EM-equivalent iteration numbers, therefore, we changed the iterations and fixed the subsets based on this view reconstructed by OSEM in our study. Application of filter function in tomographic images reconstruction can suppress statistical noise and simultaneously preserve spatial resolution and contrast. Computed tomography-based attenuation correction(CTAC), scatter correction(SC) and resolution recovery algorithm(RR) are widely used in clinical reconstruction, CTAC, SC and RR can be incorporated into the iterative reconstruction processing to obtain better spatial resolution, which is suggested for the cardiac SPECT in the European Association of Nuclear Medicine/ European Society of Cardiology guidelines(10, 11).There were several studies about the performance of CZT-SPECT/CT, most of them are about dedicated cardiac cameras. Takahashi et al.(12) compared the performance of a dedicated cardiac CZT-SPECT/CT (DNM 530c) and conventional SPECT/CT, they confirmed that DNM 530c was superior to conventional SPECT/CT both in spatial resolution and sensitivity, Morelle et al.(13) compared the performance between the new whole-body CZT-SPECT/CT and DNM 530c for myocardial perfusion imaging, the spatial resolution was identical with the two cameras, but DNM 530c had higher count rates and CNR. Imbert et al.(14) analyzed the spatial resolution of DNM 530c and D-SPECT(a dedicated cardiac with CZT detector) was obviously superior to IQ-SPECT(a conventional cardiac SPECT/CT), Brambilla et al.(15) reported that RR algorithm coupled with solid-state SPECT/CT provided better resolution and contrast than conventional gamma cameras coupled with FBP reconstruction. However, there is little research about comparison of spatial resolution between the whole-body CZT-SPECT/CT and conventional SPECT/CT. The purpose of the present study was to evaluate the impact of reconstruction algorithms on tomographic spatial resolution in SPECT/CT, and to compare spatial resolution between whole-body CZT-SPECT/CT and conventional SPECT/CT.

Phantom preparation

The phantom used was a Jaszczak phantom (Deluxe ECT Data Spectrum Corporation, Chapel Hill, USA), The phantom was a standardized diameter 21.6cm. Four capillary line sources made of plastic material with an inner diameter of 1mm were imbedded parallel to the cylindrical shell of the trunk in water to assess tomographic resolution with scatter. The line sources, filled with ^99mTc(37MBq/cm) were positioned at the center, at 2.5cm, at 5 cm and at 7.5cm away from the center of the phantom, depicted in Fig.1(computed-tomography image), these positions were chosen to permit assessment of the spatial resolution at different distances. Phantom included six cold spheres (diameters respectively:9.5,12.7,15.9,19.1,25.4,31.8 mm) and a cold rod insert (diameters respectively:4.8,6.4,7.9,9.5,11.1,12.7 mm) was adopted to evaluate image quality with the background activity of 370MBq ^99mTc. Image acquisition was started 2 hours later, depicted in Fig.2.

Image acquisition

Image acquisition was performed with CZT-SPECT/CT (Discovery NM/CT 670 CZT; GE Healthcare), equipped with a wide energy high resolution collimator (WEHR) and conventional SPECT/CT (Discovery NM/CT 670; GE Healthcare), equipped with a low energy high resolution collimator (LEHR). Necessary quality control is conducted periodically to maintain the image quality in daily work. The specified phantom shall be aligned with the system's axis of rotation and centered in the field of view. SPECT images were obtained in step-and-shoot mode, the acquisitions were performed using a 180° non circular orbit for each detector, 3° per projection and 120 projection angles in list mode, 256×256 matrix size (pixel size of 2.21 mm), zoom = 1, body contour mode was adopted in the acquisition, total count per projections collected of the line sources is not less than 100k according to NEMA(1), Image quality phantom with inserts was separately collected images 10s, 20s, 30s per projections to evaluate the effect of acquisition time on image quality. all acquisitions were performed with an energy window at 20% centered at ^99mTc photopeak (140 keV) of conventional SPECT/CT and 15% of CZT-SPECT/CT. A CT scan was performed with parameters 120 kV, 220 mA after the SPECT acquisition. The CT data were used for attenuation correction. Dual energy window scatter correction technique (120Kev±5%) was used for two cameras.

Image reconstruction and data analysis

All reconstructions were performed using Xeleris workstation, the reconstruction algorithms considered in this study were FBP and OSEM algorithm, for each reconstruction parameters, the FWHM values were measured.

OSEM Reconstruction

Varying reconstruction parameters in OSEM of line sources reconstruction were as following: the number of subsets was constantly set as 10, (1) the number of iterations was varied from 1 to 20(1,2,3,4,5,6,7,8,9,10,15,20 respectively) with a 4mm Gauss filter. (2) Based on (1), the number of iterations was selected and fixed, Butterworth filter was applied, and the cut-off frequency of Butterworth filter ranged from 0.40 to 0.90(0.40,0.50,0.60,0.70,0.80,0.90 cycles per pixel, respectively) with order being set to 10. (3) Based on (1), the number of iterations was fixed, Gauss filter was applied (characterized by full width at half-maximum values, FWHM), and the Gauss filter ranged from 1.00 to 6.00(FWHM=1.00,2.00,3.00,4.00,5.00,6.00mm, respectively). (4) no-filter was applied and the number of iterations was varied from 1 to 20(1,3,5,7,9,15,20, respectively). CTAC, SC and RR were adopted in (1)-(4). (5) Based on (1), the number of iterations was fixed with a 4mm Gauss filter, AC, SC, RR algorithms and no correction (NC) were adopted separately to evaluate the influence of the correction algorithms on the spatial resolution.

FBP Reconstruction

FBP algorithm with Butterworth filter was also performed to reconstruct tomographic images of line sources, with the cut-off frequency ranging from 0.4 to 0.9(0.4,0.5,0.6,0.7,0.8,0.9 cycles per pixel, respectively), order being set to 10. CTAC was adopted by default.

Image quality phantom with inserts (acquisition time of 10s,20s,30s per projections) was reconstructed by OSEM with a 4mm Gauss filter, the number of iterations was fixed based on (1), and the number of subsets was fixed at 10, CTAC, SC and RR algorithms were adopted.

Spatial resolution: According to the NEMA, we reconstructed transverse slice through center of line sources and thickness of reconstructed slice was 8.84mm (10±3mm recommended by NEMA), four reconstructed point sources in the reconstructed slices shall be analyzed individually with a square ROI (regions of interest). Each ROI shall be centered on the maximum count pixel. The size of this square ROI must be at least four times the FWHM of the count profile to be measured. For each point source in the images, the FWHM in radial and tangential shall be determined(1). Different to the NEMA standard, we measured on the center slice of line sources only. Measured spatial resolution values were plotted as FWHM (mm) values with varying reconstruction parameters.

OSEM and FBP algorithm with varying parameters were considered in this study, the influence of reconstruction parameters on spatial resolution of both cameras were identical:

OSEM

Reconstructed by OSEM algorithm: (1) As shown in Fig.3A and Fig.3B, represented by the line sources located at the center and at 7.5cm away from the center of the phantom, the radial and tangential FWHM values decreased with an increasing number of iterations and converged uniformly when the number of iterations was over 4, the spatial resolution was enhanced gradually, and a better spatial resolution could be obtained when the number of iterations was over 4, the convergence of the iterative reconstruction process became slower and the time of image reconstruction increased with the increase of the number of iterations, whereas the spatial resolution was not improved much. (2) On the basis of (1), the number of iterations was fixed at 5, Butterworth filter was selected, as shown in Fig.3C and Fig.3D, represented by the line sources located at the center and at 7.5cm away from the center of phantom, the radial and tangential FWHM values decreased with an increasing cutoff frequency, and the spatial resolution was enhanced, compared with the cutoff frequency of 0.6-0.9 cycles per pixel, FWHM values were higher when the cutoff frequency was less than 0.6 cycles per pixel, we would obtain better spatial resolution when the cutoff frequency was over 0.5 cycles per pixel. (3) Based on (1), the number of iterations was fixed at 5, as shown in Fig.3E and Fig.3f, represented by the line sources located at the center and at 7.5cm away from the center of phantom, the radial and tangential FWHM values increased gradually with an increasing Gauss filter, and the spatial resolution was lowered. When Gauss filter was ranging from 5 to 6mm, FWHM values were obviously higher than that of 1 to 4mm, we would obtain better spatial resolution when Gauss filter was below 5mm. (4) when there was no-filter was applied, as shown in Fig.4, represented by the line source located at the center, the radial and tangential FWHM values decreased gradually with an increasing number of iterations, and were obviously lower than that reconstructed by Gauss filter under the same number of iterations, and the spatial resolution highly enhanced. (5) Based on (1), we also evaluated the influence of AC, SC, RR algorithms and no correction (NC) on spatial resolution reconstructed by OSEM, as shown in Fig.5, represented by the line sources located at the center and at 7.5cm away from the center of phantom, Application of SC and RR lower FWHM values than NC, and FWHM values slightly changed after application of AC. SC and RR algorithms could enhance spatial resolution, whereas AC had negligible effect on spatial resolution.

FBP

Reconstructed by FBP with Butterworth filter, as shown in fig.6, represented by the line source located at the center, the radial and tangential FWHM values decreased with an increasing cutoff frequency, and the spatial resolution was enhanced, but FWHM values were obviously higher and spatial resolution was obviously lower compared to that reconstructed by OSEM with the same cutoff frequency, in addition, serious star artifact appeared on tomographic image reconstructed by FBP.

According to Fig.3A-F and Fig.6, we could observe that comparison of FWHM values at different positions showed clearly inferior FWHM values at the central position, regardless of the radial or tangential. Under each same reconstruction conditions, FWHM values of CZT-SPECT/CT is lower, which indicated CZT-SPECT/CT had superior spatial resolution than conventional SPECT/CT.

Fig.7 showed the different inserts of the Jaszczak phantom, cold spheres and rod sections, for the three tested acquisition times and for both cameras. In visual, for the 20s per projection acquisition performed on both cameras, all cold spheres were clearly visible acquired by CZT-SPECT/CT (corresponding to the spheres with an inner diameter of 31.8,25.4,19.1,15.9,12.7 and 9.5mm), however, only the five largest cold spheres were visible acquired by conventional SPECT/CT, for the 30s per projection, all cold spheres were visible in both cameras. The three largest sections of rods (12.7, 11.1, 9.5 mm, respectively) were entirely to partially visible in both cameras but there was no obvious difference in these visible sections acquired by two cameras, we could notice a gradually increase in sharpness with a long acquisition time of 30s per projection.

In SPECT/CT, limited spatial resolution results in partial volume effect (PVE), which causes image distortion, especially for small objects, this limited spatial resolution leads to quantitative bias and influences accurate diagnosis of small lesions, an approach of compensating PVE is to enhance spatial resolution during reconstruction(16).So we explored the impact of reconstruction parameters on spatial resolution in tomographic image. OSEM and FBP algorithms were performed, although FBP is the recommended method according to NEMA, iterative algorithms for spatial resolution assessment do allow(1), therefore, we applied OSEM algorithm in present study, and the measured FWHM values were generally lower with OSEM reconstruction than with FBP reconstruction, Seret et al.(17) also reported this result. Theoretically,FBP is a mathematical process of noise suppression, the randomness of count is ignored, and the statistic noise in the data cannot be modeled. The advantage of OSEM algorithm is that it is based on a realistic object, and it takes into account the Poisson count distribution and the radioactivity distribution in the field of view. Besides, Iterative reconstruction methods allow the incorporation of more accurate imaging models rather than the Radon model assumed in the FBP algorithm, including scatter and attenuation corrections as well as collimator and distance response and more realistic statistical noise models, thus more accurate distribution of radioactivity will be reproduced(18).With an increasing EM-equivalent iteration number, spatial resolution enhanced and reached plateaus at 50 update numbers, and the time of reconstruction increased. FWHMs depended slightly on the choices of the numbers of subsets and iterations in the study of Seret et al.(17), this might be related to no correction was adopted. Butterworth and Gauss are often used in clinical reconstruction, cutoff frequency of Butterworth which is the point at which the filter starts its roll off to zero and the order or power changes the slope of the filter(18, 19). lowering the filter cutoff frequency will suppress noise but deteriorate resolution, and image will be smoother, which causes details of image decreasing and even hides some small lesions, whereas an increasing cutoff frequency will enhance spatial resolution, and noise will also increase, there are always trade-offs involved: the reduction in noise comes at the cost of a loss of spatial resolution(20).images reconstructed by Gauss filter are smoother, and an increasing Gauss filter will result in a lower spatial resolution. Knoll et al.(21) confirmed that application of filter lower spatial resolution, in our study, if no filter was used, spatial resolution would be obviously improved, and noise was serious in visual. We also assessed the effects of AC, SC and RR algorithms on spatial resolution, and observed that RR and SC improved the spatial resolution. In clinical use, Chang AC and CTAC correction can compensate for the reduction of tissue count caused by tissue attenuation to reduce the quantitative bias of image distortion, but in the phantom of line sources, CTAC had negligible effect on spatial resolution.

In our study, spatial resolution was better at the position of 7.5cm away from the center of phantom, which might be attributed to being closer to detector. Both cameras were equipped by parallel-hole collimator, and the difference of spatial resolution caused by the position was identical. A parallel-hole collimator is placed between the detected object and crystal. It consists of an array of long narrow parallel holes that exclude all photons except those that are traveling parallel to the direction of the hole. The spatial resolution is usually characterized by the point-spread function (PSF)(1), which essentially corresponds to the image of a point source. How much the point spreads out, which also determines PSF, the larger profile of the PSF, the lower the spatial resolution will be. The crucial difference between the source close to collimator and one positioned faraway resides in which hole the γ-rays actually end up passing through. Photons traveling parallel to the collimator correctly go through the hole in line with the source, whereas oblique rays likely pass thorough adjacent holes, the profile of the latter will be larger, that’s why the FWHM at the center position showed clearly inferior FWHM values. This feature, commonly termed, detector-response, or geometric response, results in deteriorating of spatial resolution(22, 23). This problem can be compensated by the OSEM algorithm cooperated with RR. O'Mahoney et al. (24) evaluated that RR could not only significantly enhance spatial resolution and reduce PVE, but also suppress noise and provide better contrast. In myocardial perfusion SPECT/CT, OSEM combined with RR could correct myocardial perfusion distribution and compensate for the depth-dependent blurring(25).In our study, RR highly enhanced spatial resolution, as shown in Fig. 5, the radial spatial resolution of conventional SPECT/CT was improved by 1.15mm and 1.12mm (position of 0 and 7.5cm), and 1.41mm and 0.76mm of the tangential, respectively. For the CZT-SPECT/CT, the radial spatial resolution was improved by 1.06mm and 1.11mm (position 0 and 7.5cm), and 1.32mm and 0.58mm of the tangential, respectively. Especially for the tangential spatial resolution, the discrepancy of the spatial resolution between position of the center and 7.5cm away from the phantom was reduced after RR(conventional SPECT/CT: before RR vs after RR: 1.30mm vs 0.65mm,CZT-SPECT/CT༚before RR vs after RR :1.34mm vs 0.60mm).

We compared the difference of image quality acquired by both cameras with three tested acquisition time, when the acquisition time was short (within 20s), conventional SPECT/CT could only distinguish five largest cold spheres, however, all cold spheres could be visible in CZT-SPECT/CT, which was consistent with line sources, spatial resolution of CZT-SPECT/CT was superior to conventional SPECT/CT. When the acquisition time was extended to 30 per projection, all cold spheres could be visible in both cameras, high count rate and high sensitivity of CZT-SPECT/CT improve detection efficiency and reduce acquisition time. In bone scintigraphy scan, the whole-body CZT-SPECT was demonstrated having the potential to reduce image acquisition time in bone scintigraphy scan(26).However, the detection efficiency and sensitivity of NaI crystal detector are lower, only when the acquisition time is enough and total count is sufficient can the small lesions be distinguished, but it will take longer to acquire images. In our clinical application, in condition that image quality was maintained to ensure physician’s diagnosis, CZT-SPECT/CT has more advantages in short acquisition time.

There were several shortcomings in this study. First of all, the spatial resolution in this study was measured according to the NEMA standard, and there was no quantitative evaluation standard for the spatial resolution. The NEMA standard is simplified and rough, among which the parameters of image acquisition and reconstruction was not exact defined. There are many factors that affect measured FWHM values and image quality in tomographic image, such as matrix, acquisition time, reconstruction algorithms and so on, and there was not a set of unified acquisition condition in the literature, and there is little research on which reconstruction parameters of whole-body CZT-SPECT/CT can obtain better spatial resolution. In our study, a better level of spatial resolution only referred to comparative values measured in other reconstruction parameters. Secondly, the improvement of spatial resolution will inevitably lead to the increase of noise. In this study, only spatial resolution was evaluated, in clinical work, there should be a tradeoff among spatial resolution, contrast and noise. As a factor to assess the image quality of SPECT, spatial resolution should be combined with other index to adjust the reconstruction parameters in order to achieve better image quality. More comprehensive assessment should be performed. Moreover, the problem of algorithm selection is intrinsically multi parametric and a simple recipe that holds for every situation cannot be devised. In clinical implication, the optimal set of parameters depends on clinical task and experience of physician.

This study provided evidence that the spatial resolution of CZT- SPECT/CT cameras was superior to that of conventional SPECT/CT. Higher spatial resolution had the potential to detect more subtle lesions. We evaluated the impact of the reconstruction parameters on spatial resolution, and concluded the law of change. On the basis of the optimized reconstruction parameters of spatial resolution, we can further evaluate other index that affect the image quality, such as noise, contrast, and obtain optimized and comprehensive reconstruction parameter of image quality.

SPECT, single-photon emission computed tomography; CT, computed tomography; CZT, cadmium-zinc-telluride; OSEM, ordered-subset expectation maximization; FBP, CTAC, Computed tomography-based attenuation correction; SC, scatter correction; RR, resolution recovery; NC, no-correction; FWHM, full width at half-maximum; NEMA, national electrical manufacturers association; PSF, point spread function; LSF, line spread function; PMT, photomultiplier tubes; CNR, contrast-to-noise ratio; WEHR, wide energy high resolution; LEHR, low energy high resolution; ROI, regions of interest; PVE, partial volume effect;

Competing interests

The authors declare that they have no competing interests.

Authors' contributions

ZM, QJ, SW and NL created the study design. MW, SD, QJ, SW, YS and PW directed the phantom acquisitions, and performed the visual analysis, and SW, RZ and MW processed the acquired data and lead the analysis of results. All authors participated in the drafting and editing of the manuscript. All authors read and approved the final manuscript.

Ethics approval and consent to participate

Not applicable

Consent for publication

Not applicable

Availability of data and material

The data that support the findings of this study are available on reasonable request from the corresponding author.

Funding

This study was funded by the National Natural Science Foundation of China grants (grant number: #81571709 and #81971650), the Key Project of Tianjin Science and Technology Committee Foundation grant (grant number: #16JCZDJC34300).

Acknowledgements

Not applicable

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Impact of Reconstruction Parameters on Spatial Resolution and Its Comparison Between Cadmium-Zinc-Telluride SPECT/CT and Conventional SPECT/CT

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