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Annular Detector Gamma Cameras. Vadim L. Gayshan, M.S.E.E. Agenda. Overview CERASPECT 3000 – first truly digital 3D SPECT camera for brain imaging Possible Applications and New Developments as a subject for collaboration World Market. Overview. Principal idea
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Annular Detector Gamma Cameras Vadim L. Gayshan, M.S.E.E. ScintiTech Inc., USA
Agenda • Overview • CERASPECT 3000 – first truly digital 3D SPECT camera for brain imaging • Possible Applications and New Developments as a subject for collaboration • World Market ScintiTech Inc., USA
Overview • Principal idea • Ring crystal vs. rotating head gamma camera ScintiTech Inc., USA
Principal Idea ScintiTech Inc., USA
Principal Idea ScintiTech Inc., USA
Ring crystal vs. rotating head gamma camera • Higher resolution and sensitivity • Artifact free imaging • Anxiety-free patient environment ScintiTech Inc., USA
Artifact free imaging ScintiTech Inc., USA
CERASPECT 3000 – first truly digital 3D SPECT camera for brain imaging • Design and operation: • Annular NaI(Tl) crystal • Image acquiring electronics • Chair and gantry motions • Software. • Clinical. ScintiTech Inc., USA
Design and operation Annular NaI(Tl) crystal ScintiTech Inc., USA
Design and operation Signal Processing ScintiTech Inc., USA
Design and operation Patient Positioning ScintiTech Inc., USA
Software Display Capability · Display and compare multiple files from multiple patients or follow up studies · Simple and intuitive display formatting (complete user control ) · Easy control of on-screen image zooming · Full support for most European extended character sets · Overlap simultaneous display two images from same patient · Simple user-defined color scales ScintiTech Inc., USA
Software ·Coregistration Coregisters using brain contours Markers for automatic co-registration · I123- receptor quantification (lida, Lassen method) · TI 201 - tumor evaluation (works-in-progress with Brigham and Women's Hospital) · Tc 99m -HMPAO linearization ·Automated ROI drawing Threshold-based Draw cold and hot ROI regions Loop through multiple thresholds automatically Automatic segmentation into multiple ROls ·ROI Analysis Works on dynamic and static studies Output in text or plot formats Large set of analysis methods: counts, averages, curve-fits, histograms, asymmetric index, profiles, ... Output format conversions to cm, square cm, cubic cm, cpm Scatter and Penetration correction Unique scatter correction method Unique penetration correction method (for I123) Simple-to-use scatter methods ensures clinical utility ScintiTech Inc., USA
Software Acquisition · 32 multiple windows for multiple isotopes, scatter-correction research · Dynamic acquisitions True continuous acquisition without collimator reversal Minimum scan time - 3 seconds. Simple mechanics minimizes equipment failures during long dynamic experiments. · Patient positioning using markers or visual · Simple multiple-window scatter and penetration protocols • 133-Xenon rCBFACQUISITION • · True continuous acquisition without collimator reversal • · Variable time-length studies • -short studies: Kanno-Lassen images • -long studies: grey and white matter flows • · Acquire using inhalation or I.V. administration • Probe data from either or both lung probe and expired air PROCESSING · Kanno-Lassen and Obrist calculations • User control of details of Kanno-Lassen method such as early picture high flow cutoff. • · User-editing of air and lung probe data • · Air passage artifact detection, removal • · Automated measurement of lung-brain physiological delay ScintiTech Inc., USA
Software Calibrations · All digital camera supports software calibrations · All calibrations available to user · Routine calibrations that are required are short, easy to perform · Calibrations can be performed with variety of radioisotopes (Tc 99m, Co 57, Tl201..) · Automatic saving of complete history of gains of each (PM) photomultiplier, and other system information. Service · Digital camera software with multi-channel analyzer input to each PM signal. · Complete collimator motor diagnostics · Software history of PM performance. Networking · Read/write/display files in Interfile format · Read/write/display files in DICOM format · Read/write/display files in TIFF format · Readability of files in most other 'flat-file' formats · Conforms to worldwide standards for PC networking Output · TIFF file conversion for use with desktop publishing ScintiTech Inc., USA
Interesting Brain SPECT Images from CERASPECT These are 5.0 mm. thick transaxial slices from a 72-year-old normal male. Brain SPECT images from the CERASPECT were performed using a 30 minute, 128 x 128 matrix, 64 slices 1.66 mm thick. Tc99m-HMPAO images were acquired with photopeak and scatter connections. (Images courtesy of Brigham and Women's Hospital, Harvard Medical School, Boston, MA, Basem Garada, M.D. and B. Leonard Holman, M.D.) ScintiTech Inc., USA
Interesting Brain SPECT Images from CERASPECT These are transaxial slices of sequential brain SPECT studies done post i.v. injection of 3 mCi of TI-201 and 20 mCi of Tc-99m-HMPAO. They were taken on a 44-year-old female who had been discovered to have a glioblastoma in her right posterior frontal cortex. Surgury and radiotherapy were performed, with follow up radiotherapy 4 months later. This SPECT scan was done one year post-surgury due to recurrent attacks of seisures. Her TI-201 study showed two foci of abnormal high thallium uptake involving the right frontal cortex and right occipital cortex; these two focal areas are found to have increased rCBF as seen on the HMPAO brain SPECT study. Her brain SPECT studies were superimposed and resliced to T2 MRI images taken the same day of her SPECT Brain SPECT images from the CERASPECT were performed using a 30 minute, 128 x 128 matrix, 64 slices 1.66 mm. thick. Tc99m-HMPAO images were acquired with photopeak and scatter corrections. TI201 images were acquired with photopeak only (Images courtesy of Brigham and Women's Hospital, Harvard Medical School, Boston, MA, Basem Garada, M.D. and B. Leonard Holman, M.D.) ScintiTech Inc., USA
Interesting Brain SPECT Images from CERASPECT Alzheimer's Disease These are transaxial slices 5 mm thick for a 64 year old male. His brain SPECT study was done because he was complaining of memory loss for the last three years. Brain SPECT images from the CERASPECT were performed using a 30 minute, 128 x 128 matrix, 64 slices 1.66 mm thick. TC99m-HMPAO images were acquired with photopeak and scatter corrections. (Images courtesy of Brigham and Women's Hospital, Harvard Medical School, Boston, MA, Basem Garada, M.D. and B. Leonard Holman, M.D.) ScintiTech Inc., USA
Interesting Brain SPECT Images from CERASPECT These are transaxial slices of a baseline and activated-with-Diamox brain SPECT studies done on a 63-year-old female who had a history of a transient ischemic attack three days prior to the brain SPECT studies. Her brain SPECT data sets were superimposed and resliced with her T2 MRI images done at the time of the attack. Her brain SPECT post-Diamox infusion showed reduced vascular reserve in the left internal carotid artery area distribution (reduced blood flow to the entire left MCA and left ACA territories). Her angiogram done four days post SPECT studies showed total occlusion of the internal carotid artery at its origin. Brain SPECT images from the CERASPECT were performed using a 30 minute, 128 x 128 matrix, 64 slices 1.66 mm. thick. Tc99m-HMPAO images were acquired with photopeak and scatter connections. (Images courtesy of Brigham and Women's Hospital, Harvard Medical School, Boston, MA, Basem Garada, M.D. and B. Leonard Holman, M.D.) ScintiTech Inc., USA
Interesting Brain SPECT Images from CERASPECT I123-b-CIT Dopamine Transporter Imaging for an Alcoholism Research Study (Image courtesy of Dr. Richard Coppola at the National Institute of Mental Health in Washington, D.C.) ScintiTech Inc., USA
Interesting Brain SPECT Images from CERASPECT I123-QNB Receptor Imaging for an Alzheimer's Disease Study (Image courtesy of Dr. Richard Coppola at the National Institute of Mental Health in Washington, D.C.) ScintiTech Inc., USA
Interesting Brain SPECT Images from CERASPECT axial view coronal view An 82 year old female with no significant past medical history presented with a 2 year history of slowly progressive decline, initially mainly short term memory loss. However the decline recently accelerated, especially due to severe word finding and orientation difficulties, visual and auditory hallucinations. A brain SPECT study axial and coronal views revealed bilateral temporo-parietal perfusion defects, which were more prominent in the left hemisphere. These findings indicate the diagnosis of Alzheimer's disease. (Images courtesy of Brigham and Women's Hospital, Harvard Medical School, Boston, MA, AlexanderMatthies, MDFinn Mannting, MD, PhD) ScintiTech Inc., USA
LIST OF CASES • Depression • Herpes simplex encephalitis • Alzheimer's disease • Cocaine abuse (case 1: continued abuse) • Astrocytoma • ? Pick's disease/ ? Alzheimer's dementia • Stroke: Crossed cerebellar diaschisis • Superficial trauma with primary brain tumor • Multi-infarct (vascular) dementia • Diamox interventional study • Lyme disease • Stroke: Luxury perfusion • Recurrent metastatic melanoma • Cocaine abuse (case 2: abstinence) • Familial alternating hemiplegia • Parkinson's disease dementia • Epilepsy: baseline and post-activation imaging with ECD • Chronic fatigue syndrome (case 1) • AIDS dementia complex • Chronic fatigue syndrome (case 2) • Pick's disease • Glioblastoma multiforme ScintiTech Inc., USA
PossibleApplications and New Developments PET/SPECT Tutorial SPECT PET ScintiTech Inc., USA
PossibleApplications and New Developments Proprietary Opportunities • Weoffer : • World’s first SPECT imaging of isolated breast • World’s first nuclear image-guided-biopsy • World’s first annular brain SPECT and PET hybrid • World’s most sensitive brain SPECT • World’s first portable brain SPECT and PET • Higher performance and lower cost whole-body PET ScintiTech Inc., USA
PossibleApplications and New Developments Whole-body Imaging • OpetTM -Higher Performing Annular PET • Narrower scintillation light spread • Higher light collection efficiency • Higher counting rate • Higher spatial resolution • Higher energy resolution • Thicker crystal and higher packing fraction • Higher sensitivity ScintiTech Inc., USA
PossibleApplications and New Developments Breast Imaging • MammOspectTM -3D breast tumor imaging • Isolated SPECT imaging of “whole” breast • Higher sensitivity and specificity • Stable and dependable • 80 - 90% smaller tumor detection • MammOcamTM- image-guided biopsy add-on • unique follow-up to image findings ScintiTech Inc., USA
MammOspect MammOcore PossibleApplications and New Developments MammOspect - More accurately detect 80-90% smaller tumors. MammOcore - Image-guided biopsy (or radio-opaque localizer ) low cost add-on ScintiTech Inc., USA
PossibleApplications and New Developments Brain Imaging • NeurOscopeTM- High sensitivity CeraspectTM replacement • Low-cost high sensitivity portable camera • Offered as SPECT or with added PET upgrade • Three-fold improved sensitivity for PD and ADHD diagnoses • Stable and dependable operation ScintiTech Inc., USA
PossibleApplications and New Developments NeurOtome – dedicated brain SPECT/PET hybrid • Outperforms all SPECT and PET cameras • Over 3x sensitivity for PD and ADHD • Portable for auxiliary use in ER • Artifact free • Reliable • A Revitalizing Market • - new therapeutic interventions expand market • - new diagnostic pharmaceuticals expand market • - portable “point and shoot” focuses market • - extraordinary sensitivity focuses market • High sensitivity requirements for ADHD ScintiTech Inc., USA
PossibleApplications and New Developments • CERASPECT on wheels • Portable brain imager for emergency room • 3D SPECT mammography • Brain and Mammo SPECT scanners with CPET option ScintiTech Inc., USA
CERASPECT on wheels - No Compromises - The mobile chair/gantry assembly possesses the same range of motion as a fixed location hospital setup. Combined with the rear lift gate and wide back door, this allows for fast setup and easy access for patients with disabilities, or on a standard hospital stretcher. A fully functional data processing center with high quality image printing provides scan results within 5 to 10 minutes after completion of the procedure. Certified chemistry lab for preparation of Tc99m-HMPAO and other drug prior to administration. ScintiTech Inc., USA
Subject for collaboration Design and manufacturing ultra-high resolution and variable sensitivity collimators for SPECT Liquid interfaced NaI(Tl) crystal based gamma camera detector heads ScintiTech Inc., USA
Subject for collaboration Add text here Add text here Add text here Continue with text here ScintiTech Inc., USA
Subject for collaboration Add text here ScintiTech Inc., USA
World Market Nuclear Medicine Equipment Market* Millions of $ 2000 2005 SPECT $670 $760 30% with CD capability in 2000 PET $135 $215 *Frost & Sullivan ScintiTech Inc., USA
Summary • Unique Unified Technology • Versatility • Performance • Cost • Proprietary • Market Direction • Annular PET - fastest growing market • Annular brain imaging - revitalizing market • 3-D breast imaging - emerging market ScintiTech Inc., USA
Thank you! Copies of this presentation is available on requestmail@scintitech.com ScintiTech Inc., USA