A second‐generation virtual‐pinhole PET device for enhancing contrast recovery and improving lesion detectability of a whole‐body PET/CT scanner

Purpose We have developed a second‐generation virtual‐pinhole (VP) positron emission tomography (PET) device that can position a flat‐panel PET detector around a patient's body using a robotic arm to enhance the contrast recovery coefficient (CRC) and detectability of lesions in any region‐of‐interest using a whole‐body PET/computed tomography (CT) scanner. Methods We constructed a flat‐panel VP‐PET device using 32 high‐resolution detectors, each containing a 4  ×  4 MPPC array and 16  ×  16 LYSO crystals of 1.0  ×  1.0  ×  3.0 mm 3 each. The flat‐panel detectors can be positioned around a patient's body anywhere in the imaging field‐of‐view (FOV) of a Siemens Biograph 40 PET/CT scanner by a robotic arm. New hardware, firmware and software have been developed to support the additional detector signals without compromising a scanner's native functions. We stepped a 22 Na point source across the axial FOV of the scanner to measure the sensitivity profile of the VP‐PET device. We also recorded the coincidence events measured by the scanner detectors and by the VP‐PET detectors when imaging phantoms of different sizes. To assess the improvement in the CRC of small lesions, we imaged an elliptical torso phantom measuring 316  ×  228  ×  162 mm 3 that contains spherical tumors with diameters ranging from 3.3 to 11.4 mm with and without the VP‐PET device. Images were reconstructed using a list mode Maximum‐Likelihood Estimation‐Maximization algorithm implemented on multiple graphics processing units (GPUs) to support the unconventional geometries enabled by a VP‐PET system. The mean and standard deviation of the CRC were calculated for tumors of different sizes. Monte Carlo simulation was also conducted to image clusters of lesions in a torso phantom using a PET/CT scanner alone or the same scanner equipped with VP‐PET devices. Receiver operating characteristic (ROC) curves were analyzed for three system configurations to evaluate the improvement in lesion detectability by the VP‐PET device over the native PET/CT scanner. Results The repeatability in positioning the flat‐panel detectors using a robotic arm is better than 0.15 mm in all three directions. Experimental results show that the average CRC of 3.3, 4.3, and 6.0 mm diameter tumors was 0.82%, 2.90%, and 5.25%, respectively, when measured by the native scanner. The corresponding CRC was 2.73%, 6.21% and 10.13% when imaged by the VP‐PET insert device with the flat‐panel detector under the torso phantom. These values may be further improved to 4.31%, 9.65% and 18.01% by a future dual‐panel VP‐PET insert device if DOI detectors are employed to triple its detector efficiency. Monte Carlo simulation results show that the tumor detectability can be improved by a VP‐PET device that has a single flat‐panel detector. The improvement is greater if the VP‐PET device employs a dual‐panel design. Conclusions We have developed a prototype flat‐panel VP‐PET device and integrated it with a clinical PET/CT scanner. It significantly enhances the contrast of lesions, especially for those that are borderline detectable by the native scanner, within regions‐of‐interest specified by users. Simulation demonstrated the enhancement in lesion detectability with the VP‐PET device. This technology may become a cost‐effective solution for organ‐specific imaging tasks.