For high-sensitivity brain imaging, we have developed a two-head single-photon emission computed tomography (SPECT) system using a CdTe semiconductor detector and 4-pixel matched collimator (4-PMC). The term, '4-PMC' indicates that the collimator hole size is matched to a 2 × 2 array of detector pixels. By contrast, a 1-pixel matched collimator (1-PMC) is defined as a collimator whose hole size is matched to one detector pixel. The performance of the higher-sensitivity 4-PMC was experimentally compared with that of the 1-PMC. The sensitivities of the 1-PMC and 4-PMC were 70 cps/MBq/head and 220 cps/MBq/head, respectively. The SPECT system using the 4-PMC provides superior image resolution in cold and hot rods phantom with the same activity and scan time to that of the 1-PMC. In addition, with half the usual scan time the 4-PMC provides comparable image quality to that of the 1-PMC. Furthermore, (99m)Tc-ECD brain perfusion images of healthy volunteers obtained using the 4-PMC demonstrated acceptable image quality for clinical diagnosis. In conclusion, our CdTe SPECT system equipped with the higher-sensitivity 4-PMC can provide better spatial resolution than the 1-PMC either in half the imaging time with the same administered activity, or alternatively, in the same imaging time with half the activity.

We propose a wide aperture parallel-hole collimator that we call a 4-pixel matched collimator (4-PMC) for high-sensitivity SPECT imaging. The hole size of the 4-PMC is matched to four detector pixels; that is, there are four (2 × 2) pixels per collimator hole. By contrast, a 1-pixel matched collimator (1-PMC) is defined as a collimator whose hole size is matched to one detector pixel. We evaluated four types of collimator (high-resolution collimator versions and high-sensitivity collimator versions of both 4-PMC and 1-PMC) by simulation. SPECT images of a cylindrical phantom with cold spots in the noise-free condition demonstrated that the 4-PMC provided a higher-contrast image than the 1-PMC for the same collimator version. In addition, SPECT images at the noise level corresponding to a human cerebral blood flow study suggested that the high-sensitivity version of the 4-PMC provided the highest contrast image among the four collimator types. In conclusion, the high-sensitivity SPECT system using the 4-PMC can improve the trade-off between spatial resolution and sensitivity and will consequently provide improved image contrast for clinical studies of the human brain compared with the SPECT system using the 1-PMC.

The basic performance of the CdTe-gamma camera system was evaluated, and its stability was verified. It was shown that the camera could be operated daily for several months without calibration.

To predict the probability of radiation-induced liver toxicity (RILT) and implement the normal tissue complication probability (NTCP) model-based approach considering confidence intervals (CIs) to select patients for new treatment techniques, such as proton beam therapy, based on a certain NTCP reduction (DNTCP) threshold for primary liver cancer patients. Methods and materials: Common Toxicity Criteria for Adverse Events (CTCAE) grade !2 RILT was scored. The Lyman NTCP models predicting the probability of CTCAE grade !2 RILT as a function of the fractionsize adjusted mean liver dose (MLD), using reference fraction size = 2 Gy/fraction and a/b ratio = 2 Gy, were fitted using the maximum likelihood method. At certain combinations of MLDs, DNTCP with a CI was evaluated by the delta method. Results: Of the 239 patients, the incidence of CTCAE grade !2 RILT was 55% (46% in the Child-Pugh (CP)-A vs. 81% in the CP-B/C, p < 0.001). Among 180 CP-A patients, 40% who had viral hepatitis infections experienced toxicity vs. 32% in the nonhepatitis subgroup. The MLD was 18 Gy in the toxicity group vs. 16.1 Gy in the nontoxicity group (p = 0.002). The estimated NTCP model parameters specific to the patient subgroups and the DNTCP with CI assuming a particular CP classification and viral hepatitis infection status were considerably different which possible changed treatment decision. Conclusions: Patients with CP-A and viral hepatitis infection or CP-B/C cirrhosis had greater susceptibility to CTCAE grade !2 RILT. The estimated NTCP and DNTCP for individual patients along with a consideration of uncertainties improve the reliability of the NTCP model-based approach.