Because of scarcity of photons emitted from the heart, clinical cardiac SPECT imaging is mainly limited by photon statistics. The sub-optimal detection efficiency of current SPECT systems not only limits the quality of clinical cardiac SPECT imaging but also makes more advanced potential applications difficult to be realized. We propose a high-performance system platform - C-SPECT, which has its sampling geometry optimized for detection of emitted photons in quality and quantity. The C-SPECT has a stationary C-shaped gantry that surrounds the left-front side of a patient’s thorax. The stationary C-shaped collimator and detector systems in the gantry provide effective and efficient detection and sampling of photon emission. For cardiac imaging, the C-SPECT platform could achieve 2 to 4 times the system geometric efficiency of conventional SPECT systems at the same sampling resolution. This platform also includes an integrated transmission CT for attenuation correction. The ability of C-SPECT systems to perform sequential high-quality emission and transmission imaging could bring cost-effective high-performance to clinical imaging. In addition, a C-SPECT system could provide high detection efficiency to accommodate fast acquisition rate for gated and dynamic cardiac imaging. This paper describes the design concepts and performance potential of C-SPECT, and illustrates how these concepts can be implemented in a basic system.

A new pixelated detector for high-resolution clinical SPECT applications was designed and tested. The modular detector is based on a scintillator block comprised of 2.75×2.75×10 mm3 NaI(Tl) pixels and decoded by an array of 51 mm diameter single-anode PMTs. Several configurations, utilizing two types of PMTs, were evaluated using a collimated beam source to measure positioning accuracy directly. Good pixel separation was observed, with correct pixel identification ranging from 60 to 72% averaged over the entire area of the modules, depending on the PMT type and configuration. This translates to a significant improvement in positioning accuracy compared to continuous slab detectors of the same thickness, along with effective reduction of “dead” space at the edges. The observed 10% average energy resolution compares well to continuous slab detectors. The combined performance demonstrates the suitability of pixelated detectors decoded with a relatively small number of medium-sized PMTs as a cost-effective approach for high resolution clinical SPECT applications, in particular those involving curved detector geometries.

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Compared to imaging the heart with conventional cameras, dedicated cardiac SPECT systems can achieve much higher performance through use of a small field of view. To realize this potential, however, the heart must be reliably placed in the appropriate small FOV prior to imaging, thus requiring a separate scout operation to locate the heart and estimate its size. Further-more, to achieve high performance across the general population, a system should provide several imaging configurations optimized for different size and location of the heart and the size of the patient. Because of the critical role the collimator plays in SPECT, it would be ideal if a dedicated collimator could be used for each of the different patient groups, as well as for the scout imaging. The ability to exchange collimators without moving the patient can also enable serial studies with different imaging options while preserving anatomic registration. We developed a slit exchange system for the slit-slat collimator of the C-SPECT cardiac platform. The full-scale prototype, a precision link conveyor following a curved, body contouring path, allows four distinct transaxial collimation options. The collimators can be exchanged in 10 seconds without disturbing the patient, thus allowing adaptive clinical SPECT imaging. The positioning precision for all elements of the system is within 0.1 mm and has shown no degradation over 100,000 complete revolutions of the conveyor—twice the expected usage for a clinical system. We consider the rapid and precise operation allowing optimal collimation for different imaging tasks to be an important technological step for cardiac SPECT.