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The development of the first clinical simultaneous Single Photon Emission Computed Tomography (SPECT) and Magnetic Resonance Imaging (MRI) system was carried out within the INSERT project. The INSERT scanner was constructed under the initial project, but its performance was not fully evaluated; here we have reconstructed the first images on the SPECT system. Calibration and acquisition protocols were developed and used to establish the clinical feasibility of the system. The image reconstruction procedures were implemented on the first phantom images in order to assess the system's imaging capabilities. This study solved issues involving incomplete data sets and pixel failure in the prototype detector system. The final images determined a measure of trans-axial image resolution, giving average values of 9.14 mm and 6.75 mm in the radial and tangential directions respectively. The work carried out on the complete system produced several clinical phantom images which utilized the capabilities of both SPECT and MRI.

The INSERT is the world's first clinical SPECT-MRI brain imaging system based on scintillation detectors with a SiPM readout. Here we demonstrate its use within a clinical MRI environment for the first time. Using a standard transmit-receive head coil, and with an appropriate selection of a custom MRI sequence (GRE), we overcome mutual interference. The INSERT and its bulky 50 kg tungsten collimator introduce magnetic field inhomogeneity. Due to the specific MRI-compatible collimator design, inhomogeneity is compensated by shimming, leading to simultaneous acquisition. We process the SPECT data acquired alongside the MRI sequence to evaluate the SPECT system performance and the impact of the MRI. Finally, we present a set of simultaneous SPECT-MRI acquisitions, demonstrating multimodal imaging capabilities, albeit with a limited MRI sequence.

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A prototype clinical brain SPECT insert has been designed for use in simultaneous SPECT/MRI. The system utilises novel slit-slat collimators which, like pinhole collimators, suffers from parallax errors due to the large incident angle of photons. A statistical algorithm has been developed to determine the depthof-interaction (DOI) with a view to improving image performance. The importance of DOI correction was demonstrated using Monte Carlo simulation. This simulation also indicated that 4 DOI layers (3×1.5 mm+3.5 mm) may be sufficient. The improvement in event localisation was demonstrated on a single detector before implementing the algorithm on the full clinical prototype where some limitations in event localisation in layers close to the readout plane were observed. Nevertheless DOI enabled the rejection of poorly localised events with improved resolution in reconstructed line sources.