PROOF COPY 014204MPH PROOF COPY 014204MPH Efficient simulation of SPECT down-scatter including photon interactions with crystal and lead Hugo W. A. M. de Jong Image Sciences Institute, University Medical Center, Utrecht, The Netherlands Wen-Tung Wang and Eric C. Frey Department of Biomedical Engineering and Department of Radiology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina Max A. Viergever and Freek J. Beekman Image Sciences Institute, University Medical Center, Utrecht, The Netherlands Received 28 June 2001; accepted for publication 29 January 2002 A major image degrading factor in simultaneous Dual Isotope DISPECT or simultaneous Emission–Transmission ECT–TCTimaging, is the detection of photons emitted by the higher energy isotope in the energy window used for imaging the lower energy isotope. In Tc-99m/Tl-201 DI-SPECT typically tens of percents of the total detected down-scatter is caused by lead x rays. In Tc-99m/Gd-153 ECT–TCT, a comparable fraction of the down-scatter originates from Tc-99m photons which only partly deposit their energy in the detector crystal i.e., due to crystal interac- tions. Efficient simulation methods which model down-scatter can be used to optimize DI-SPECT or ECT–TCT imaging acquisition or reconstruction protocols. In this paper we adapt a previously proposed efficient down-scatter simulation method, to include the interactions of photons with the detector crystal and collimator lead. To this end, point spread function tables including crystal and lead interactions are precalculated. Subsequently, photons are traced through the patient body until their last scatter position, and the precalculated responses are used to project the photons onto the detector plane, while photon attenuation in the patient is taken into account. The approach is evaluated by comparing simulated Tc-99m down-scatter projections with measured projections. Incorporation of photon interaction with crystal and lead leads to significantly improved accuracy of the shape of down-scatter responses, while differences in total counts between simulated and measured projections typically decrease from tens of percents to a couple of percents. Calculating 60 down-scatter projections of an extended distribution on a 646464 grid takes about three minutes on a PC with two 1.2 GHz processors. We conclude that accurate and efficient simulation of down-scatter is now possible including the major effects of the nonuniform mass density of the patient as well as photon interactions with the crystal and collimator lead. © 2002 American Association of Physicists in Medicine. DOI: 10.1118/1.1462638 Key words: dual-isotope SPECT, Monte Carlo simulation, down-scatter, lead x-rays, scintigraphy. I. INTRODUCTION Simultaneous Dual-Isotope DISPECT allows for the studying different biological properties of organs or tissues with a single acquisition. This is possible by acquiring events in separate energy windows corresponding to the energies of the isotopes in question. The projection sets obtained in such a way are reconstructed to give radionuclide distributions of the isotopes with different information captured by each. The advantages of DI-SPECT over sequential imaging are the avoidance of image registration problems and the reduction of total scan time. The latter results in increased patient throughout and patient comfort. Two examples of DI-SPECT are found in myocardial perfusion imaging 1 where Tc-99m sestamibi 140 keVcan be used in conjunction with Tl-201 majority of emissions have an energy between 69 keV and 80 keVfor simultaneous rest and stress imaging or with Gd-153 around 100 keVin combined transmission– emission CT TCT–ECT. 2,3 Other examples of DI-SPECT include Tc-99m/FDG 4 and Tc-99m/I-123 SPECT. 5 In a typical Tc-99m/Tl-201 DI-SPECT cardiac study the number of Tc-99m photons detected on the Tl-201 photopeak window is significant e.g., typically 50% of total counts. Only a small amount less than 2–3% of the Tc-99m counts 6 of higher energy Tl-201 photons 135 keV and 167 keVis detected in the Tc-99m photopeak window.This down-scatter causes an overestimation of activity and im- proper fill-in of defects in the reconstructed Tl-201 distribution. 7–9 In a similar way, in TCT–ECT down-scatter of Tc-99m photons in the Gd-153 transmission window cen- tered around 100 keV hampers the reconstruction of the transmission map. 3,10–12 The number of detected down-scattered photons depends on several factors, i.e., the SPECT system used, the energy window settings and the activity ratio of the two isotopes. Furthermore, the amount of down-scatter is patient depen- 1 1 Med. Phys. 29 4, April 2002 0094-2405Õ2002Õ294Õ1Õ11Õ$19.00 © 2002 Am. Assoc. Phys. Med. PROOF COPY 014204MPH