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M Ljungberg

Publications and source records attributed to M Ljungberg.

At least 37 records · Page 2Linked to original sources

A new rectal model for dosimetry applications.

UNLABELLED: A revised geometric representative model of the lower part of the colon, including the rectum, the urinary bladder and prostate, is proposed for use in the calculation of absorbed dose from injected radiopharmaceuticals. The lower segment of the sigmoid colon as described in the 1987 Oak Ridge National Laboratory mathematical phantoms does not accurately represent the combined urinary bladder/rectal/prostate geometry. In the revised model in this study, the lower part of the abdomen includes an explicitly defined rectum. The shape of sigmoid colon is more anatomically structured, and the diameters of the descending colon are modified to better approximate their true anatomic dimensions. To avoid organ overlap and for more accurate representation of the urinary bladder and the prostate gland (in the male), these organs are shifted from their originally defined positions. The insertion of the rectum and the shifting of the urinary bladder will not overlap with or displace the female phantom's ovaries or the uterus. In the adult male phantom, the prostatic urethra and seminal duct are also included explicitly in the model. The relevant structures are defined for the newborn and 1-, 5-, 10- and 15-y-old (adult female) and adult male phantoms. METHODS: Values of the specific absorbed fractions and radionuclide S values were calculated with the SIMDOS dosimetry package. Results for 99mTc and other radionuclides are compared with previously reported values. RESULTS: The new model was used to calculate S values that may be crucial to calculations of the effective dose equivalent. For 131I, the S (prostate<--urinary bladder contents) and S (lower large intestine [LLI] wall<--urinary bladder contents) are 6.7 x 10(-6) and 3.41 x 10(-6) mGy/MBq x s, respectively. Corresponding values given by the MIRDOSE3 computer program are 6.23 x 10(-6) and 1.53 x 10(-6) mGy/MBq x s, respectively. The value of S (rectum wall<--urinary bladder contents) is 4.84 x 10(-5) mGy/MBq x s. For 99mTc, we report S (testes<--prostate) and S (LLI wall<--prostate) of 9.41 x 10(-7) and 1.53 x 10(-7) mGy/MBq x s versus 1.33 x 10(-6) and 7.57 x 10(-6) mGy/MBq x s given by MIRDOSE3, respectively. The value of S (rectum wall<--prostate) for 99mTc is given as 4.05 x 10(-6) mGy/MBq x s in the present model. CONCLUSION: The new revised rectal model describes an anatomically realistic lower abdomen region, thus giving improved estimates of absorbed dose. Due to shifting the prostate gland, a 30%-45% reduction in the testes dose and the insertion of the rectum leads to 48%-55% increase in the LLI wall dose when the prostate is the source organ.

Adult↗

Radioimmunotherapy using 131I-labeled anti-CD22 monoclonal antibody (LL2) in patients with previously treated B-cell lymphomas.

Experience in using rapidly internalizing antibodies, such as the anti-CD22 antibody, for radioimmunotherapy of B-cell lymphomas is still limited. The present study was conducted to assess the efficacy and toxicity of a 131I-labeled anti-CD22 monoclonal antibody (mAb), LL2, in patients with B-cell lymphomas failing first- or second-line chemotherapy. Eligible patients were required to have measurable disease, less than 25% B cells in unseparated bone marrow, and an uptake of 99mTc-labeled LL2Fab' in at least one lymphoma lesion on immunoscintigram. Eight of nine patients examined with immunoscintigraphy were unequivocally found to have an uptake, and therapy with 131I-labeled anti-CD22 [1330 MBq/m2 (36 mCi/m2)] preceded by 20 mg of naked anti-CD22 mAb was administered. Three patients achieved partial remission (duration, 12, 3, and 2 months), and one patient with progressive lymphoma showed stable disease for 17 months. Four patients exhibited progressive disease. The toxicity was hematological. Patients with subnormal counts of neutrophils or platelets before therapy seemed to be more at risk for hematological side effects. Radioimmunotherapy in patients with B-cell lymphomas using 131I-labeled mouse anti-CD22 can induce objective remission in patients with aggressive as well as indolent lymphomas who have failed prior chemotherapy.

Adult↗

Signal profile measurements of single- and double-volume acquisitions with image-selected in vivo spectroscopy for 31P magnetic resonance spectroscopy.

The volume-selection performance was studied for single- and double-volume-of-interest (VOI) acquisition with the volume-selection method image-selected in vivo spectroscopy for 31P magnetic resonance spectroscopy. High-resolution signal profiles were measured using a phantom simulating a brain. Inside the phantom there was a small, remotely controlled, movable signal source filled with ortho-phosphoric acid. Signal profiles of the VOI were measured in three perpendicular directions for 1VOI (single VOI) and 2VOI (double VOI) acquisition. The measured signal profiles for both acquisitions were very similar, but they showed a discrepancy with regard to the intended VOI (iVOI). The transition regions were on average 3.8 mm and the average full width at half maximum of the signal profile was 30 mm for an iVOI size of 30*30*30 (mm3). No displacement was observed in the signal profiles. To avoid overlapping signal profiles, the minimum separation between two iVOIs was found to be 10 mm in our magnetic resonance (MR) system. A substantial negative signal contribution from regions outside the iVOI was measured in the y-direction for 1VOI acquisition and one of the two VOIs in 2VOI acquisition. The other VOI in 2VOI acquisition exhibited only minor contamination. The measurements presented underline the importance of detailed knowledge on the volume selection performance in in vivo magnetic resonance spectroscopy.

Brain↗

Evaluation of attenuation corrections using Monte Carlo simulated lung SPECT.

SPECT (single photon emission computed tomography) images are distorted by photon attenuation. The effect is complex in the thoracic region due to different tissue densities. This study compares the effect on the image homogeneity of two different methods of attenuation correction in lung SPECT; one pre-processing and one post-processing method. This study also investigates the impact of attenuation correction parameters such as lung contour, body contour, density of the lung tissue and effective attenuation coefficient. The Monte Carlo technique was used to simulate SPECT studies of a digital thorax phantom containing a homogeneous activity distribution in the lung. Homogeneity in reconstructed images was calculated as the coefficient of variation (CV). The isolated effect of the attenuation correction was assessed by normalizing pixel values from the attenuation corrected lung by pixel values from the lung with no attenuation effects. Results show that the CV decreased from 12.8% with no attenuation correction to 4.4% using the post-processing method and true densities in the thoracic region. The impact of variations in the definition of the body contour was found to be marginal while the corresponding effect of variations in the lung contour was substantial.

Algorithms↗

Evaluation of optimally designed planar-concave collimators in single-photon emission tomography.

The imaging properties of optimally designed planar-concave (PC) collimators were evaluated by means of Monte Carlo simulations. The evaluation was done with respect to total system spatial resolution and the overall image noise distribution in single-photon emission tomography. The results showed that the non-isotropy with PC collimators, assessed by the ratio of the full-width at half-maximum in the radial and tangential directions, was reduced by about 60% as compared with a conventional parallel-hole collimator for sources located 200 mm away from the centre of rotation. Furthermore, the image noise distribution along the object radius became more uniform when the curved collimator was used. The maximum increase in noise due to use of the curved collimator was about 45% close to the edge of the phantom, where the hole length was about 3 times longer. We also showed with Monte Carlo simulations that the spatial resolution of the lateral cortex when using the curved collimator was significantly improved due to improved radial resolution.

Algorithms↗

Selection of collimator for rCBF studies and evaluation of triple-headed SPET using noise-resolution plots.

We investigated the effect of collimator selection on image quality in regional cerebral blood flow (rCBF) studies of the brain performed with 99Tc(m)-HMPAO. A triple-headed SPET system (GE/CGR Neurocam) was used, together with three sets of parallel-hole collimators - general-purpose (GP), high-resolution (HR) and ultra-high-resolution (UHR). Two image quality parameters were used to describe the image quality, namely, noise and resolution. Noise was measured in experimental and Monte-Carlo simulated SPET studies of a cylinder phantom of uniform activity as the pixel root mean square error (RMS) and as the coefficient of variation (CV) of quantitative rCBF values. Resolution was measured as full-width at half-maximum in experimental SPET studies of a line-source. Plots of noise versus resolution for the different collimators were obtained by varying the cut-off frequency of the Hanning filter applied in the reconstruction of transaxial slices. From these noise-resolution plots, we were able to determine which collimator gave the best resolution for a specific noise level. A lowest reasonable noise level may be established by comparison with the inter-observer CV of the quantification method.

Brain↗

Parameters influencing volume and activity quantitation in SPECT.

Several factors influence the accuracy to which information on the in vivo activity concentration can be obtained from SPECT images. The accuracy in image contrast and the quantitation of volume and activity has here been examined for a SPECT system aimed for absorbed dose determinations in systemic radiation therapy. The influence of source dimensions, object contrast, noise level, energy window width and the reconstruction filter was examined. All the investigated parameters affected the recoveries. Volumes of above 20 cm3 could be quantified to within +/- 20%, for object contrasts of above 96%, and within +/- 40% for object contrasts above 81%, providing limited levels of noise. Both the image contrast and the volume quantification is expected to be improved in situations with low object contrasts, if accurate correction for scattered photons can be developed. Obtained limitations in the quantitation of activity with the present method should be reduced by development of a more accurate background subtraction technique.

Absorption↗

A Monte-Carlo program converting activity distributions to absorbed dose distributions in a radionuclide treatment planning system.

In systemic radiation therapy, the absorbed dose distribution must be calculated from the individual activity distribution. A computer code has been developed for the conversion of an arbitrary activity distribution to a 3-D absorbed dose distribution. The activity distribution can be described either analytically or as a voxel based distribution, which comes from a SPECT acquisition. Decay points are sampled according to the activity map, and particles (photons and electrons) from the decay are followed through the tissue until they either escape the patient or drop below a cut off energy. To verify the calculated results, the mathematically defined MIRD phantom and unity density spheres have been included in the code. Also other published dosimetry data were used for verification. Absorbed fractions and S-values were calculated. A comparison with simulated data from the code with MIRD data shows good agreement. The S values are within 10-20% of published MIRD S values for most organs. Absorbed fractions for photons and electrons in spheres (masses between 1 g and 200 kg) are within 10-15% of those published. Radial absorbed dose distributions in a necrotic tumor show good agreement with published data. The application of the code in a radionuclide therapy dose planning system, based on quantitative SPECT, is discussed.

Absorption↗

Signal profile measurements for evaluation of the volume-selection performance of ISIS.

High-resolution signal profiles obtained with a test phantom were used in this study to evaluate the volume-selection performance of an implementation of ISIS (Image Selected In vivo Spectroscopy). The phantom simulated the brain with regard to volume and loading of coil. A remotely controlled, movable signal source inside the phantom was filled with orthophosphoric acid. Signal profiles of the volume of interest (VOI) were measured in three perpendicular directions. Special interest was focused on the transition zones, the position of the profiles, and the effects of off-resonance and T1 smearing. The transition zones were on average 5.6 mm wide and the full width at half maximum (FWHM) was 35 mm for a VOI of 40 x 40 x 40 mm3. The positions of the centre of the signal profiles were x = 3.2, y = -0.7 and z = 3.3 mm off-centre. The deviation of the volume position could be explained by off-resonance effects during imaging and spectroscopy. These data illustrate the importance of detailed knowledge of the volume-selection performance when attempting precision measurements using image-guided in vivo MRS.

Brain↗

A Monte Carlo investigation of dual-energy-window scatter correction for volume-of-interest quantification in 99Tcm SPECT.

Using Monte Carlo simulation of 99Tcm single-photon-emission computed tomography (SPECT), we investigate the effects of tissue-background activity, tumour location, patient size, uncertainty of energy windows, and definition of tumour region on the accuracy of quantification. The dual-energy-window method of correction for Compton scattering is employed and the multiplier which yields correct activity for the VI as a whole calculated. The model is usually a sphere containing radioactive water located within a cylinder filled with a more dilute solution of radioactivity. Two simulation codes are employed. Reconstruction is by ML-EM algorithm with attenuation compensation. The scatter multiplier depends only slightly on the sphere location or the cylinder diameter. It also depends little on whether correction is before or after reconstruction. At low background level, it changes with VOI size, but not at higher background. For a geometrical VOI, it is 1.25 at zero background, decreases sharply to 0.56 for equal concentrations, and is 0.44 when the background concentration is very large. Quantification is accurate (less than 9% error) if the test background is reasonably close to that used in setting the universal scatter-multiplier value, or if the test backgrounds are always large and so is the universal-value background, but not if the test backgrounds cover a large range of values including zero. Results largely agree with those from experiment after the experimental data with background is re-evaluated with prejudice.

Humans↗

Radio-immunotherapy dosimetry with special emphasis on SPECT quantification and extracorporeal immuno-adsorption.

Results from therapeutic trials with radiolabelled monoclonal antibodies are difficult to compare, because of lack of accurate macroscopic and microscopic dosimetry for both tumours and normal tissues. Requirements for such a dosimetry are covered in the paper. Accurate in vivo dosimetric measurement techniques for verification of calculated absorbed doses are also needed to verify treatment planning. In the review, important topics related to dosimetry in therapeutic trials in RIT are covered, such as, absorbed-dose calculations and activity-quantification techniques for planar imaging and SPECT. The latter is particularly discussed, including a summary of different correction techniques. Absorbed-dose calculations and treatment-planning techniques are also discussed. Possible ways of enhancing the therapeutic ratio are reviewed, especially the novel technique with extracorporeal immuno-adsorption. The review could form the basis of the development of future treatment-planning protocols and for dosimetry calculations in radio-immunotherapy, considering some of the most important parameters for approaching an accurate in vivo dosimetry.

Antibodies, Monoclonal↗

Comparison of four scatter correction methods using Monte Carlo simulated source distributions.

UNLABELLED: Scatter correction in SPECT is important for improving image quality, boundary detection and the quantification of activity in different regions. This paper presents a comparison of four scatter correction methods, three using more than one energy window and one convolution-subtraction correction method using spatial variant scatter line-spread functions. METHODS: The comparison is based on Monte Carlo simulated data for point sources on- and off-axis, hot and cold spheres of different diameters, and a clinically realistic source distribution simulating brain imaging. All studies were made for a uniform cylindrical water phantom. Since the nature of the detected photon is known with Monte Carlo simulation, separate images of primary and scattered photons can be recorded. These can then be compared with estimated scatter and primary images obtained from the different scatter correction methods. The criteria for comparison were the normalized mean square error, scatter fraction, % recovery and image contrast. RESULTS: All correction methods significantly improved image quality and quantification compared to those obtained with no correction. Quantitatively, no single method was observed to be the best by all criteria for all the source distributions. Three of the methods were observed to perform the best by at least one of the criteria for one of the source distributions. For brain imaging, the differences between all the methods were much less than the difference between them and no correction at all. CONCLUSION: It is concluded that performing scatter correction is essential for accurate quantification, and that all four methods yield a good, but not perfect, scatter correction. Since it is hard to distinguish the methods consistently in terms of their performance, it may be that the choice should be made on the basis of ease of implementation.

Brain↗

Radioimmunotherapy dosimetry--a review.

Results from therapeutic trials in systemic radiation therapy with radiolabelled monoclonal antibodies are difficult to compare, because of lack of accurate dosimetry. This applies macroscopically as well as microscopically for both tumours and normal tissues. For treatment planning in radioimmunotherapy both the macroscopic and the microscopic absorbed dose distribution must be known. The former is based on a proper knowledge of parameters, such as activity quantitation techniques in both planar and SPECT imaging, different correction techniques, and high activity measurements. Absorbed dose calculations and treatment planning techniques are based on analytical or Monte Carlo calculations. The PET technique with higher resolution is also suggested for radioimmunotherapy planning. Accurate in vivo absorbed dose measurement techniques to verify the calculated absorbed doses are needed in treatment planning. Monitoring the absorbed rate is desirable to assess radiobiological effect. Several ways of enhancing the therapeutic ratio are suggested, especially novel technique with extracorporeal immunoadsorption. An important topic is small scale dosimetry, which is based on techniques for detailed imaging of activity distributions to calculate the absorbed dose distribution.

Adsorption↗

Attenuation and scatter correction in SPECT for sources in a nonhomogeneous object: a monte Carlo study.

Single-photon emission computed tomography (SPECT) is important for imaging radioactivity distributions in vivo. Quantitative SPECT is limited due to attenuation and scatter contribution. Approximations such as constant attenuation and mono-exponential scatter functions will not be valid for non-homogeneous regions. A correction method is described where non-uniform density-maps are used in the attenuation correction. Correction for non-uniform scatter is made by a convolution technique based on scatter line-spread functions (SLSF) calculated for different locations inside a clinically realistic, nonhomogeneous, computer phantom. Calculations have been made for a myocardiac source, a uniform source in the lungs and a tumor located in the lungs. Projections were simulated for photon energies corresponding to 201Tl, 99mTc, and 111In. The results show that quantitative images can be obtained in nonhomogeneous regions. An increased contrast has also been demonstrated in the SLSF-corrected images. Comparison with measurements have been made to validate the Monte Carlo code and the scatter and attenuation method.

Humans↗

Quantitative SPECT by attenuation correction of the projection set using transmission data: evaluation of a method.

A method for measuring attenuation coefficients in single-photon emission tomography (SPECT) is described and evaluated, together with a method for attenuation correction using these measured attenuation coefficients. Build-up, caused by scattered photons, is corrected for by a simple substitution in the algorithms. Transmission studies are performed with a 99mTc- or 57Co flood source, and emission phantom studies with 99mTc line sources. The method is evaluated with variable but well-defined phantoms. The result is accurate attenuation coefficients for different densities, dimensions and geometries, and an accuracy of corrected emission activities of better than +/- 10% in most cases. The present limitations of the method for attenuation correction are discussed.

Algorithms↗

Attenuation correction in SPECT based on transmission studies and Monte Carlo simulations of build-up functions.

The quantitative information in SPECT images is distorted by photon attenuation and contribution of photons scattered in the object. It is, therefore, important to know the distribution of different attenuating tissues in order to be able to perform a proper attenuation correction. A correction method, based on correcting one pixel at a time by using density maps and build-up functions, has been developed. The density map has been produced by transmission measurements of the object using an external, solid 57Co flood source mounted on the scintillation camera head. The outline of the object is accurately defined by the map since the density values outside the object are very close to zero. The build-up of photons scattered in the object has been simulated by a Monte-Carlo code. SPECT-studies with 99mTc, 201T1 and 111In line sources in different parts of a non homogeneous Alderson phantom have been performed. The emission images have been corrected for photon attenuation using the measured density maps and the simulated build-up functions. The results show that quantitative measurements of the radioactivity in nonhomogeneous area can be accomplished to within +/- 10% for different radionuclides by using the attenuation correction described.

Algorithms↗

Scatter and attenuation correction in SPECT using density maps and Monte Carlo simulated scatter functions.

A new scatter and attenuation correction method is presented in which Monte Carlo simulated scatter line-spread functions for different depth and lateral positions are used. A reconstructed emission image is used as an estimate of the source distribution in order to calculate the scatter contribution in the projection data. The scatter contribution is then subtracted from the original projection prior to attenuation correction. The attenuation correction method uses density maps for the attenuation correction of projection data. Simulation studies have been done with a clinically realistic source distribution in cylindrical, homogeneous water phantoms of different sizes and with photon energies corresponding to 201T1, 99mTc, and 111In. The results show excellent quantitative results with an accuracy within +/- 10% for most of the source positions and phantom sizes. It has also been shown that the variation in the event distribution within the source region in the images has been significantly decreased and that an enhancement in the contrast has been achieved.

Humans↗

A Monte Carlo program for the simulation of scintillation camera characteristics.

There is a need for mathematical modelling for the evaluation of important parameters for photon imaging systems. A Monte Carlo program which simulates medical imaging nuclear detectors has been developed. Different materials can be chosen for the detector, a cover and a phantom. Cylindrical, spherical, rectangular and more complex phantom and source shapes can be simulated. Photoelectric, incoherent, coherent interactions and pair production are simulated. Different detector parameters, e.g. the energy pulse-height distribution and pulse pile-up due to finite decay time of the scintillation light emission, can be calculated. An energy resolution of the system is simulated by convolving the energy imparted with an energy-dependent Gaussian function. An image matrix of the centroid of the events in the detector can be simulated. Simulation of different collimators permits studies of spatial resolution and sensitivity. Comparisons of our results with experimental data and other published results have shown good agreement. The usefulness of the Monte Carlo code for the accurately simulation of important parameters in scintillation camera systems, stationary as well as SPECT (single-photon emission computed tomography) systems, has been demonstrated.

Computer Simulation↗