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Measurement of the dwell time and moving speed of a high-activity iridium-192 (Ir-192) source used for high-dose-rate (HDR) brachytherapy is important for estimating the precise dose delivery to a tumor. For this purpose, we used a cerium-doped yttrium aluminum perovskite (YA1OGamma photon imaging was conducted using the gamma camera in list mode for the Ir-192 source of HDR brachytherapy with fixed dwell times and positions. The acquired list-mode images were sorted to millisecond-order interval time sequential images to evaluate the dwell time at each position. Time count rate curves were derived to calculate the dwell time at each source position and moving speed of the source.We could measure the millisecond-order time sequential images for the Ir-192 source. The measured times for the preset dwell times of 2 s and 10 s were 1.98 to 2.00 s full width at half maximum (FWHM) and 10.0 s FWHM, respectively. The dwell times at the first dwell position were larger than those at other positions. We also measured the moving speeds of the source after the dwells while moving back to the afterloader and found the speed increased with the distance from the edge of the field of view to the last dwell position.We conclude that millisecond-order time sequential imaging of the Ir-192 source is possible by using a gamma camera and is useful for evaluating the dwell times and moving speeds of the Ir-192 source.

Purpose We developed a novel and simple method to measure the source positions in applicators directly for high-dose-rate (HDR) brachytherapy based on Cherenkov emission imaging, and evaluated the performance. Methods The light emission from plastic applicators used in cervical cancer treatments, irradiated by an 192 Ir γ-ray source, was captured using a charge-coupled device camera. Moreover, we attached plastics of different shapes, including tapes, tubes, and plates to a metal applicator, to use as screens for the Cherenkov imaging. We determined the source positions and dwell intervals from the light profiles along with the applicator and compared these with preset values and dummy marker measurements. Results The source positions and dwell intervals measured from the light images were comparable to the dummy marker measurements and preset values. The distance from the applicator tip to the first source positions agreed with the dummy marker measurements within 0.2 mm for the plastic tandem. The dwell intervals measured using the Cherenkov method agreed with the preset values within 0.6 mm. The distances measured with three plastic types on the metal applicator also agreed with the dummy marker measurements within 0.2 mm. The dwell intervals measured using the plastic tape agreed with the preset values within 0.7 mm. Conclusions The proposed method should be suitable for rapid and easy quality assurance (QA) investigations in HDR brachytherapy, as it enables source position using a single image. The method allows for real-time, filmless measurements of the source positions to be obtained and is useful for rapid feedback in QA procedures.

Imaging of the secondary electron bremsstrahlung (SEB) X-rays emitted during particle-ion irradiation is a promising method for beam range estimation. However, the SEB X-ray images are not directly correlated to the dose images. In addition, limited spatial resolution of the X-ray camera and low-count situation may impede correctly estimating the beam range and width in SEB X-ray images. To overcome these limitations of the SEB X-ray images measured by the X-ray camera, a deep learning (DL) approach was proposed in this work to predict the dose images for estimating the range and width of the carbon-ion beam on the measured SEB X-ray images. To prepare enough data for the DL training efficiently, 10,000 simulated SEB X-ray and dose image pairs were generated by our in-house developed model function for different carbon-ion beam energies and doses. The proposed DL neural network consists of two U-nets for SEB X-ray to dose image conversion and super-resolution. After the network being trained with these simulated X-ray and dose image pairs, the dose images were predicted from simulated and measured SEB X-ray testing images for performance evaluation. For the 500 simulated testing images, the average mean squared error (MSE) was 2.5 × 10^-5 and average structural similarity index (SSIM) was 0.997 while the error of both beam range and width was within 1 mm FWHM. For the three measured SEB X-ray images, the MSE was no worse than 5.5 × 10^-3 and SSIM was no worse than 0.980 while the error of the beam range and width was 2 mm and 5 mm FWHM, respectively. We have demonstrated the advantages of predicting dose images from not only simulated data but also measured data using our deep learning approach.

Purpose Positron emission tomography (PET) has high sensitivity for imaging radioactive tracer distributions in subjects. However, it is not possible to image free radical distribution in a subject by PET. Since free radicals are quite reactive, they are related to many diseases, including but not limited to cancer, inflammation, strokes, and heart disease. The Overhauser enhanced magnetic resonance imaging (OMRI) is so far the only method that images free radical distribution in vivo. By combining PET and OMRI, a new hybrid imaging modality might be developed that can simultaneously image the radioactive tracer and free radical distributions. For this purpose, the authors developed a PET/OMRI combined system for small animals. Methods The developed PET/OMRI system used an optical fiber-based PET system combined with a permanent magnet-based OMRI system. The optical fiber-based PET system uses flexible optical fiber bundles. Eight optical fiber-based block detectors were arranged in a 56 mm diameter ring to form a PET system. The LGSO blocks were located inside the field-of-view (FOV) of the OMRI, and the position sensitive photomultiplier tubes were positioned behind the OMRI to minimize the interference between the PET and the OMRI. The OMRI system used a 0.0165 T permanent magnet. The system has an electron spin resonance coil to enhance the MRI signal using the Overhauser effect to image the free radical in the FOV of the PET/OMRI system. Results The spatial resolution and sensitivity of the optical fiber-based PET system were 1.2 mm FWHM and 1.2% at the central FOV, respectively. The OMRI system imaged the distribution of a nitroxyl radical (NXR) solution. The interference between PET and OMRI was small. Simultaneous imaging of the positron radiotracer and the NXR solution was successfully conducted with the developed PET/OMRI system for phantom and small animal studies. Conclusions The authors developed a PET/OMRI combined system with the potential to provide interesting new results in molecular imaging research, such as in vivo molecular and free radical distributions.

Purpose Positron emission tomography (PET) is a useful imaging modality that quantifies the physiological distributions of radiolabeled tracers in vivo in humans and animals. However, this technique is unsuitable for multiple-tracer imaging because the annihilation photons used for PET imaging have a fixed energy regardless of the selection of the radionuclide tracer. This study developed a multi-isotope PET (MI-PET) system and evaluated its imaging performance. Methods Our MI-PET system is composed of a PET system and additional γ-ray detectors. The PET system consists of pixelized gadolinium orthosilicate (GSO) scintillation detectors and has a ring geometry that is 95 mm in diameter with an axial field of view of 37.5 mm. The additional detectors are eight bismuth germanium oxide (BGO) scintillation detectors, each of which is 50 × 50 × 30 mm3, arranged into two rings mounted on each side of the PET ring with a 92-mm-inner diameter. This system can distinguish between different tracers using the additional γ-ray detectors to observe prompt γ-rays, which are emitted after positron emission and have an energy intrinsic to each radionuclide. Our system can simultaneously acquire double- (two annihilation photons) and triple- (two annihilation photons and a prompt γ-ray) coincidence events. The system's efficiency for detecting prompt de-excitation γ-rays was measured using a positron-γ emitter, 22Na. Dual-radionuclide (18F and 22Na) imaging of a rod phantom and a mouse was performed to demonstrate the performance of the developed system. Our system's basic performance was evaluated by reconstructing two images, one containing both tracers and the other containing just the second tracer, from list-mode data sets that were categorized by the presence or absence of the prompt γ-ray. Results The maximum detection efficiency for 1275 keV γ-rays emitted from 22Na was approximately 7% at the scanner's center, and the minimum detection efficiency was 5.1% at the edge of the field of view. Dual-radionuclide imaging of the point sources and rod phantom revealed that our system maintained PET's intrinsic spatial resolution and quantitative nature for the second tracer. We also successfully acquired simultaneous double- and triple-coincidence events from a mouse containing 18F-fluoro-deoxyglucose and 22Na dissolved in water. The dual-tracer distributions in the mouse obtained by our MI-PET were reasonable from the viewpoints of physiology and pharmacokinetics. Conclusions This study demonstrates the feasibility of multiple-tracer imaging using PET with additional γ-ray detectors. This method holds promise for enabling the reconstruction of quantitative multiple-tracer images and could be very useful for analyzing multiple-molecular dynamics.

The authors previously reported successful luminescence imaging of water during proton irradiation and its application to range estimation. However, since the feasibility of this approach for carbon-ion irradiation remained unclear, the authors conducted luminescence imaging during carbon-ion irradiation and estimated the ranges.The authors placed a pure-water phantom on the patient couch of a carbon-ion therapy system and measured the luminescence images with a high-sensitivity, cooled charge-coupled device camera during carbon-ion irradiation. The authors also carried out imaging of three types of phantoms (tap-water, an acrylic block, and a plastic scintillator) and compared their intensities and distributions with those of a phantom containing pure-water.The luminescence images of pure-water phantoms during carbon-ion irradiation showed clear Bragg peaks, and the measured carbon-ion ranges from the images were almost the same as those obtained by simulation. The image of the tap-water phantom showed almost the same distribution as that of the pure-water phantom. The acrylic block phantom's luminescence image produced seven times higher luminescence and had a 13% shorter range than that of the water phantoms; the range with the acrylic phantom generally matched the calculated value. The plastic scintillator showed ∼15 000 times higher light than that of water.Luminescence imaging during carbon-ion irradiation of water is not only possible but also a promising method for range estimation in carbon-ion therapy.

Purpose: Recently, photomultiplier tubes(PMTs) and position sensitive PMTs (PSPMTs) with higher quantum efficiencies (HQE) have been developed. However, it remains unclear whether they actually improve such performances as the energy and spatial resolution for PET and SPECTdetectors. Methods: The authors evaluated the quantum efficiencies (QEs) for PMTs and PSPMTs and measured the energy resolution of a 3-in. round HQE PMT combined with various scintillators and compared the results with a conventional normal quantum efficiency (NQE) PMT of the same type. The authors also measured the position and energy performance of a 2-in. square HQE PSPMT combined with scintillator blocks and compared them with a NQE PSPMT of the same size. Results: The energy resolution of the 3-in. round HQE PMT showed higher energy resolution than the NQE with all scintillators. The improvement of the energy resolution was smaller, for all measurements, than the expected value from the quantum efficiency of the PMT but was higher for the scintillators with smaller light outputs. The energy and position performance of the HQE PSPMT based block detectors showed higher position and energy performance than those with NQE. Conclusions: From these results, the authors conclude that both HQE PMT and PSPMT contribute to improve the energy and position performance for PET and SPECTdetectors. Significant performance improvements will be expected in PET and SPECT systems by the use of the HQE PMTs or PSPMTs.

PURPOSE The simultaneous measurement of PET and magnetic resonance imaging (MRI) is an emerging field for molecular imaging research. Although optical fiber based PET∕MRI systems have advantages on less interference between PET and MRI, there is a drawback in reducing the scintillation light due to the fiber. To reduce the problem, the authors newly developed flexible optical fiber bundle based block detectors and employed them for a high resolution integrated PET∕MRI system. METHODS The flexible optical fiber bundle used 0.5 mm diameter, 80 cm long double clad fibers which have dual 12 mm × 24 mm rectangular inputs and a single 24 mm × 24 mm rectangular output. In the input surface, LGSO scintillators of 0.025 mol.% (decay time: ∼31 ns: 0.9 mm × 1.3 mm × 5 mm) and 0.75 mol.% (decay time: ∼46 ns: 0.9 mm × 1.3 mm × 6 mm) were optically coupled in depth direction to form depth-of-interaction detector, arranged in 11 × 13 matrix and optically coupled to the fiber bundle. The two inputs of the bundle are bent for 90°, bound to one, and are optically coupled to a Hamamatsu 1-in. square position sensitive photomultiplier tube. RESULTS Light loss due to the fiber bundle could be reduced and the performance of the block detectors was improved. Eight optical fiber based block detectors (16 LGSO blocks) were arranged in a 56 mm diameter ring to form a PET system. Spatial resolution and sensitivity were 1.2 mm full-width at half-maximum and 1.2% at the central field-of-view, respectively. Sensitivity change was less than 1% for 2 °C temperature changes. This PET system was integrated with a 0.3 T permanent magnet MRI system which has 17 cm diameter hole at the yoke area for insertion of the PET detector ring. There was no observable interference between PET and MRI. Simultaneous imaging of PET and MRI was successfully performed for small animal studies. CONCLUSIONS The authors confirmed that the developed high resolution PET∕MRI system is promising for molecular imaging research.

Purpose: In small animal imaging using a single photon emitting radionuclide, a high resolution gamma camera is required. Recently, position sensitive photomultiplier tubes (PSPMTs) with high quantum efficiency have been developed. By combining these with nonhygroscopic scintillators with a relatively low light output, a high resolution gamma camera can become useful for low energy gamma photons. Therefore, the authors developed a gamma camera by combining a pixelated Ce-doped Gd{sub 2}SiO{sub 5} (GSO) block with a high quantum efficiency PSPMT. Methods: GSO was selected for the scintillator, because it is not hygroscopic and does not contain any natural radioactivity. An array of 1.9 mm x 1.9 mm x 7 mm individual GSO crystal elements was constructed. These GSOs were combined with a 0.1-mm thick reflector to form a 22 x 22 matrix and optically coupled to a high quantum efficiency PSPMT (H8500C-100 MOD8). The GSO gamma camera was encased in a tungsten gamma-ray shield with tungsten pixelated parallel hole collimator, and the basic performance was measured for Co-57 gamma photons (122 keV). Results: In a two-dimensional position histogram, all pixels were clearly resolved. The energy resolution was {approx}15% FWHM. With the 20-mm thick tungsten pixelated collimator, the spatial resolution was 4.4-mmmore » FWHM 40 mm from the collimator surface, and the sensitivity was {approx}0.05%. Phantom and small animal images were successfully obtained with our developed gamma camera. Conclusions: These results confirmed that the developed pixelated GSO gamma camera has potential as an effective instrument for low energy gamma photon imaging.« less

Purpose: Proton therapy has the ability to selectively deliver a dose to the target tumor, so the dose distribution should be accurately measured by a precise and efficient method. The authors found that luminescence was emitted from water during proton irradiation and conjectured that this phenomenon could be used for estimating the dose distribution. Methods: To achieve more accurate dose distribution, the authors set water phantoms on a table with a spot scanning proton therapy system and measured the luminescence images of these phantoms with a high-sensitivity, cooled charge coupled device camera during proton-beam irradiation. The authors imaged the phantoms of pure water, fluorescein solution, and an acrylic block. Results: The luminescence images of water phantoms taken during proton-beam irradiation showed clear Bragg peaks, and the measured proton ranges from the images were almost the same as those obtained with an ionization chamber. Furthermore, the image of the pure-water phantom showed almost the same distribution as the tap-water phantom, indicating that the luminescence image was not related to impurities in the water. The luminescence image of the fluorescein solution had ∼3 times higher intensity than water, with the same proton range as that of water. The luminescence image of themore » acrylic phantom had a 14.5% shorter proton range than that of water; the proton range in the acrylic phantom generally matched the calculated value. The luminescence images of the tap-water phantom during proton irradiation could be obtained in less than 2 s. Conclusions: Luminescence imaging during proton-beam irradiation is promising as an effective method for range estimation in proton therapy.« less

In proton therapy, imaging of the positron distribution produced by fragmentation during or soon after proton irradiation is a useful method to monitor the proton range. Although positron emission tomography (PET) is typically used for this imaging, its spatial resolution is limited. Cerenkov light imaging is a new molecular imaging technology that detects the visible photons that are produced from high-speed electrons using a high sensitivity optical camera. Because its inherent spatial resolution is much higher than PET, the authors can measure more precise information of the proton-induced positron distribution with Cerenkov light imaging technology. For this purpose, they conducted Cerenkov light imaging of induced positron distribution in proton therapy.First, the authors evaluated the spatial resolution of our Cerenkov light imaging system with a (22)Na point source for the actual imaging setup. Then the transparent acrylic phantoms (100 × 100 × 100 mm(3)) were irradiated with two different proton energies using a spot scanning proton therapy system. Cerenkov light imaging of each phantom was conducted using a high sensitivity electron multiplied charge coupled device (EM-CCD) camera.The Cerenkov light's spatial resolution for the setup was 0.76 ± 0.6 mm FWHM. They obtained high resolution Cerenkov light images of the positron distributions in the phantoms for two different proton energies and made fused images of the reference images and the Cerenkov light images. The depths of the positron distribution in the phantoms from the Cerenkov light images were almost identical to the simulation results. The decay curves derived from the region-of-interests (ROIs) set on the Cerenkov light images revealed that Cerenkov light images can be used for estimating the half-life of the radionuclide components of positrons.High resolution Cerenkov light imaging of proton-induced positron distribution was possible. The authors conclude that Cerenkov light imaging of proton-induced positron is promising for proton therapy.

Cerenkov-light imaging is a new molecular imaging technology that detects visible photons from high-speed electrons using a high sensitivity optical camera. However, the merit of Cerenkov-light imaging remains unclear. If a PET/Cerenkov-light hybrid imaging system were developed, the merit of Cerenkov-light imaging would be clarified by directly comparing these two imaging modalities.The authors developed and tested a PET/Cerenkov-light hybrid imaging system that consists of a dual-head PET system, a reflection mirror located above the subject, and a high sensitivity charge coupled device (CCD) camera. The authors installed these systems inside a black box for imaging the Cerenkov-light. The dual-head PET system employed a 1.2×1.2×10 mm3 GSO arranged in a 33 × 33 matrix that was optically coupled to a position sensitive photomultiplier tube to form a GSO block detector. The authors arranged two GSO block detectors 10 cm apart and positioned the subject between them. The Cerenkov-light above the subject is reflected by the mirror and changes its direction to the side of the PET system and is imaged by the high sensitivity CCD camera.The dual-head PET system had a spatial resolution of ∼1.2 mm FWHM and sensitivity of ∼0.31% at the center of the FOV. The Cerenkov-light imaging system's spatial resolution was ∼275 μm for a 22Na point source. Using the combined PET/Cerenkov-light hybrid imaging system, the authors successfully obtained fused images from simultaneously acquired images. The image distributions are sometimes different due to the light transmission and absorption in the body of the subject in the Cerenkov-light images. In simultaneous imaging of rat, the authors found that 18F-FDG accumulation was observed mainly in the Harderian gland on the PET image, while the distribution of Cerenkov-light was observed in the eyes.The authors conclude that their developed PET/Cerenkov-light hybrid imaging system is useful to evaluate the merits and the limitations of Cerenkov-light imaging in molecular imaging research.

Purpose: Since proton therapy has the ability to selectively deliver a dose to a target tumor, the dose distribution should be accurately measured. A precise and efficient method to evaluate the dose distribution is desired. We found that luminescence was emitted from water during proton irradiation and thought this phenomenon could be used for estimating the dose distribution. Methods: For this purpose, we placed water phantoms set on a table with a spot-scanning proton-therapy system, and luminescence images of these phantoms were measured with a high-sensitivity cooled charge coupled device (CCD) camera during proton-beam irradiation. We also conducted the imaging of phantoms of pure-water, fluorescein solution and acrylic block. We made three dimensional images from the projection data. Results: The luminescence images of water phantoms during the proton-beam irradiations showed clear Bragg peaks, and the measured proton ranges from the images were almost the same as those obtained with an ionization chamber. The image of the pure-water phantom also showed almost the same distribution as the tap-water phantom, indicating that the luminescence image was not related to impurities in the water. The luminescence image of fluorescein solution had ∼3 times higher intensity than water, with the same proton range as that of water. The luminescence image of the acrylic phantom had 14.5% shorter proton range than that of water; the proton range in the acrylic phantom was relatively matched with the calculated value. The luminescence images of the tap-water phantom during proton irradiation could be obtained in less than 2 sec. Three dimensional images were successfully obtained which have more quantitative information. Conclusion: Luminescence imaging during proton-beam irradiation has the potential to be a new method for range estimations in proton therapy.

The simultaneous measurement of PET and magnetic resonance imaging (MRI) is an emerging field for molecular imaging research. Although optical fiber based PET∕MRI systems have advantages on less interference between PET and MRI, there is a drawback in reducing the scintillation light due to the fiber. To reduce the problem, the authors newly developed flexible optical fiber bundle based block detectors and employed them for a high resolution integrated PET∕MRI system.The flexible optical fiber bundle used 0.5 mm diameter, 80 cm long double clad fibers which have dual 12 mm × 24 mm rectangular inputs and a single 24 mm × 24 mm rectangular output. In the input surface, LGSO scintillators of 0.025 mol.% (decay time: ∼31 ns: 0.9 mm × 1.3 mm × 5 mm) and 0.75 mol.% (decay time: ∼46 ns: 0.9 mm × 1.3 mm × 6 mm) were optically coupled in depth direction to form depth-of-interaction detector, arranged in 11 × 13 matrix and optically coupled to the fiber bundle. The two inputs of the bundle are bent for 90°, bound to one, and are optically coupled to a Hamamatsu 1-in. square position sensitive photomultiplier tube.Light loss due to the fiber bundle could be reduced and the performance of the block detectors was improved. Eight optical fiber based block detectors (16 LGSO blocks) were arranged in a 56 mm diameter ring to form a PET system. Spatial resolution and sensitivity were 1.2 mm full-width at half-maximum and 1.2% at the central field-of-view, respectively. Sensitivity change was less than 1% for 2 °C temperature changes. This PET system was integrated with a 0.3 T permanent magnet MRI system which has 17 cm diameter hole at the yoke area for insertion of the PET detector ring. There was no observable interference between PET and MRI. Simultaneous imaging of PET and MRI was successfully performed for small animal studies.The authors confirmed that the developed high resolution PET∕MRI system is promising for molecular imaging research.

Purpose: In proton therapy, imaging of the positron distribution produced by fragmentation during or soon after proton irradiation is a useful method to monitor the proton range. Although positron emission tomography (PET) is typically used for this imaging, its spatial resolution is limited. Cerenkov light imaging is a new molecular imaging technology that detects the visible photons that are produced from high-speed electrons using a high sensitivity optical camera. Because its inherent spatial resolution is much higher than PET, the authors can measure more precise information of the proton-induced positron distribution with Cerenkov light imaging technology. For this purpose, they conducted Cerenkov light imaging of induced positron distribution in proton therapy. Methods: First, the authors evaluated the spatial resolution of our Cerenkov light imaging system with a 22 Na point source for the actual imaging setup. Then the transparent acrylic phantoms (100 × 100 × 100 mm3) were irradiated with two different proton energies using a spot scanning proton therapy system. Cerenkov light imaging of each phantom was conducted using a high sensitivity electron multiplied charge coupled device (EM-CCD) camera. Results: The Cerenkov light’s spatial resolution for the setup was 0.76 ± 0.6 mm FWHM. They obtained high resolution Cerenkov light images of the positron distributions in the phantoms for two different proton energies and made fused images of the reference images and the Cerenkov light images. The depths of the positron distribution in the phantoms from the Cerenkov light images were almost identical to the simulation results. The decay curves derived from the region-of-interests (ROIs) set on the Cerenkov light images revealed that Cerenkov light images can be used for estimating the half-life of the radionuclide components of positrons. Conclusions: High resolution Cerenkov light imaging of proton-induced positron distribution was possible. The authors conclude that Cerenkov light imaging of proton-induced positron is promising for proton therapy.

Purpose: Cerenkov-light imaging is a new molecular imaging technology that detects visible photons from high-speed electrons using a high sensitivity optical camera. However, the merit of Cerenkov-light imaging remains unclear. If a PET/Cerenkov-light hybrid imaging system were developed, the merit of Cerenkov-light imaging would be clarified by directly comparing these two imaging modalities. Methods: The authors developed and tested a PET/Cerenkov-light hybrid imaging system that consists of a dual-head PET system, a reflection mirror located above the subject, and a high sensitivity charge coupled device (CCD) camera. The authors installed these systems inside a black box for imaging the Cerenkov-light. The dual-head PET system employed a 1.2 × 1.2 × 10 mm{sup 3} GSO arranged in a 33 × 33 matrix that was optically coupled to a position sensitive photomultiplier tube to form a GSO block detector. The authors arranged two GSO block detectors 10 cm apart and positioned the subject between them. The Cerenkov-light above the subject is reflected by the mirror and changes its direction to the side of the PET system and is imaged by the high sensitivity CCD camera. Results: The dual-head PET system had a spatial resolution of ∼1.2 mm FWHM and sensitivity of ∼0.31%more » at the center of the FOV. The Cerenkov-light imaging system's spatial resolution was ∼275μm for a {sup 22}Na point source. Using the combined PET/Cerenkov-light hybrid imaging system, the authors successfully obtained fused images from simultaneously acquired images. The image distributions are sometimes different due to the light transmission and absorption in the body of the subject in the Cerenkov-light images. In simultaneous imaging of rat, the authors found that {sup 18}F-FDG accumulation was observed mainly in the Harderian gland on the PET image, while the distribution of Cerenkov-light was observed in the eyes. Conclusions: The authors conclude that their developed PET/Cerenkov-light hybrid imaging system is useful to evaluate the merits and the limitations of Cerenkov-light imaging in molecular imaging research.« less