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Rachel A. Powsner. Essentials of Nuclear Medicine Physics, Instrumentation, and Radiation Biology
Table of Contents
List of Tables
List of Illustrations
Guide
Pages
Dedication
Essentials of Nuclear Medicine Physics, Instrumentation, and Radiation Biology
Preface
Acknowledgments
CHAPTER 1 Basic Nuclear Medicine Physics. Properties and structure of matter
Elements
Atomic structure
Electrons
Electron shells and binding energy:
Electron volt
Quantum numbers:
Representation of electron distribution:
Quantum numbers
Stable electron configuration:
Nucleus
Isotopes, isotones, and isobars:
The stable nucleus:
Stability
Radioactivity. The unstable nucleus and radioactive decay
Excessive nuclear mass. Alpha decay:
Fission:
Unstable Neutron–Proton Ratio. Too many neutrons—beta decay:
Too many protons—positron decay and electron capture:
Positron decay:
Energy of beta particles and positrons
Electron capture:
Appropriate numbers of nucleons, but too much energy. Isomeric transition:
Gamma emission:
Internal conversion:
Decay notation
Half‐life
Questions
Answers
CHAPTER 2 Interaction of Radiation with Matter
Interaction of photons with matter
Types of photon interactions in matter
Compton scattering
Photoelectric effect
Attenuation of photons in matter
Half‐value and tenth‐value layers
Beam hardening
Interaction of charged particles with matter
Excitation
Ionization
Specific ionization
Linear energy transfer
Range
Annihilation
Bremsstrahlung
Reference
Questions
Answers
CHAPTER 3 Formation of Radionuclides
Generators
Activity curves for generators
Transient equilibrium
Secular equilibrium
Cyclotrons
Reactors
Reactor basics
Kinetic energy
Fission
Neutron capture
Radionuclide production
Questions
Answers
CHAPTER 4 Nonscintillation Detectors
Gas‐filled detectors. Theory of operation
Principles of measurement. Charge neutralization
Charge flow. Measuring current:
Counting pulses of current:
Characteristics of the major voltage regions applied across a gas‐filled detector. Low
Intermediate
High
Sensitivity. Intrinsic
Geometric
Types of gas‐filled detector. Ionization chambers. Structure and characteristics. Structure:
Function:
Sensitivity:
Energy independence:
Applications. Dose calibrator:
Survey meter:
Roentgen (R)
Pocket dosimeters:
Proportional counters. Structure and characteristics. Chamber and filling gas:
Applications as survey meter:
Geiger counters. Structure and characteristics. The tube and the filling gas:
Quenching:
Applications:
Sensitivity:
Semiconductor detectors. Introduction
Semiconductor materials
Doped silicon for semiconductors
Single photon avalanche detector (SPAD)
P‐N junctions and the depletion zone:
SPAD response to incoming photons:
Silicon photomultipliers (SiPM)
Photographic and luminescent detectors
Photographic detectors
Thermoluminescent and optically luminescent detectors
Thermoluminescent detectors
Optically luminescent detectors
Questions
Answers
CHAPTER 5 Scintillation Detectors
Structure. Scintillation crystals
Photomultiplier tubes
Amplifiers
Pulse‐height analyzer
Sodium iodide detector energy spectrum
Calibrating the energy spectrum
Photopeak
Other peaks in the energy spectrum of the source
Compton peak (or Compton edge)
Iodine escape peak
Annihilation peak
Coincidence peak
Effect of surrounding matter on the energy spectrum
Backscatter peak
Characteristic lead X‐ray peak
Additional Compton scattering from medium surrounding source
Characteristics of scintillation detectors. Energy resolution
Decay time
Efficiency
Overall efficiency
Geometric efficiency
Intrinsic efficiency
Types of scintillation‐based detectors
Thyroid probe
Well counter
Liquid scintillation counters
Dosimeters and area monitors
Questions
Answers
CHAPTER 6 Imaging Instrumentation. Theory and structure
Components of the imaging system
Collimators
Parallel‐hole collimators. Low‐energy all‐purpose collimators (LEAP):
High‐resolution collimators:
High‐ and medium‐energy collimators:
Sensitivity
Spatial resolution
Modulation transfer function
Nonparallel‐hole collimators:
Converging and diverging collimators:
Pinhole collimators:
Fan beam collimators:
Camera head
Crystals, photomultiplier tubes, and amplifiers:
Positioning algorithm:
Pulse‐height analyzer:
Persistence scope
Computers
Planar imaging. Image acquisition
Static images
Dynamic images
Gated images
Questions
Answers
CHAPTER 7 Single‐photon Emission Computed Tomography (SPECT)
Equipment. Types of camera
Angle of rotation of heads
Two‐headed cameras: fixed and adjustable
Tomography
Acquisition
Arc of acquisition
Number of projection tomographic views
Collection times
Step‐and‐shoot vs. continuous acquisition
Circular, elliptical, and body contouring orbits
Patient motion and sinograms
Dedicated cardiac SPECT cameras
Quantitation of lesion activity in SPECT studies
Questions
Answers
CHAPTER 8 Positron Emission Tomography (PET)
Advantages of PET imaging. Sensitivity
Resolution. Coincidence detection
Time of flight
Radiopharmaceuticals
PET camera components
Crystals
Photomultipliers
Pulse‐height analyzers, timing discriminators, and coincidence circuits
Septa
Factors affecting resolution in PET imaging. Positron range in tissue
Photon emissions occurring at other than 180°
Parallax error
Attenuation in PET imaging
Attenuation correction
Standard uptake values
References
Questions
Answers
CHAPTER 9 X‐ray Computed Tomography (CT)
X‐ray production
X‐ray imaging
Computed tomography. Overview
Multislice detector configuration
Axial and helical scanning
Pitch
Cone beam CT
Hounsfield units
Questions
Answers
CHAPTER 10 Magnetic Resonance Imaging (MRI)
Background
Spin
Momentum
Magnetism. Electromagnetic fields
Magnetic moments
Introduction to MRI
Application of the magnetic field
Application of radiofrequency pulses
Swings and protons
The MR signal
T1 recovery
T2 recovery
Signal readout: spin–echo and inversion‐recovery
Signal localization
Gradient coils
Generation and acquisition of MR signals
Slice selection and spin excitation:
Spatial encoding:
Contrast manipulation in MR imaging
T1‐weighted images
T2‐weighted images
Combing TR and TE
Proton density images
Other sequences
MRI scanner
References
Questions
Answers
CHAPTER 11 Hybrid Imaging Systems: PET‐CT, SPECT‐CT, and PET‐MRI
PET‐CT and SPECT‐CT imaging
PET‐CT
SPECT‐CT
Current limitations in SPECT‐CT and PET‐CT hybrid imaging. Breathing artifacts
Contrast agent artifacts
PET‐MR imaging. Introduction
PET‐MR scanner design
Attenuation correction
Questions
Answers
CHAPTER 12. Image Reconstruction, Processing, and Display
Reconstruction
Filtered backprojection
Backprojection
Backprojection artifact
Filtering
Signal vs. Noise
Filtering in the spatial domain
Spatial filtering to reduce the backprojection artifact:
Filtering in the frequency domain
Nyquist frequency:
Signal, noise, and the backprojection artifact in the frequency domain:
Frequency filtering to reduce the backprojection artifact:
Frequency filtering to reduce noise:
Low‐pass filters:
• Types of low‐pass filter:
• Cutoff frequency and order:
Sequence for applying filters:
Filter selection:
Attenuation correction. Attenuation:
Correction:
Calculated attenuation correction:
Transmission correction:
Iterative reconstruction
OSEM
Iterative reconstruction internalizing correction of image degradation factors
Resolution recovery
Why reformatting works
Postreconstruction image processing. Multiplanar reformatting
Advanced display techniques. Contrast enhancement
Maximum intensity projections
Surface and volume rendering
Questions
Answers
CHAPTER 13 Information Technology
Network
DICOM
PACS
Information systems
Additional DICOM capabilities
Questions
Answers
CHAPTER 14 Quality Control
Nonimaging devices. Dose calibrator
Accuracy
Constancy
Linearity
Geometry
Survey meters. Constancy
Calibration
Crystal scintillation detectors: well counters and thyroid probes. Calibration
Efficiency
Chi‐square test
Sample chi‐square test
Imaging. Planar gamma camera. Photopeak
Uniformity floods
Daily assessment of uniformity
Correction of nonuniformity
Spatial resolution. Bar phantom:
Linearity
Spatial resolution and distance from source
SPECT
Uniformity
Center of rotation
Measurement of COR:
Assessing spatial resolution and contrast in SPECT
PET
Daily QC
Timing resolution test
Cross‐calibration and SUV validation
Image quality
CT
Tube conditioning
Air calibration
CT phantoms
CT number QC. CT number for water, calculation of noise, and visual inspection:
CT number uniformity:
CT number linearity:
Low‐contrast resolution
Spatial (high‐contrast) resolution
Hybrid system testing
Reference
Questions
Answers
CHAPTER 15 Radiation Biology
Radiation Units. Radiation absorbed dose (rad)
Roentgen‐equivalent man (rem)
The effects of radiation on living organisms
Cellular effects. Individual cells. Cellular structure:
Mechanisms of radiation damage to DNA:
Direct and indirect action of radiation:
Radiosensitivity and cell cycle:
Cell survival curves
Free radicals
Factors affecting cell survival. Dose rate: Low‐LET radiation:
High‐LET radiation:
Chemical interventions:
Radiosensitizers:
• Radioprotectors:
Tissue effects
Organ toxicity
Embryo and fetus:
Acute whole‐body radiation toxicity:
Heritable and cancer effects
Stochastic and nonstochastic risks
Heritable effects
Carcinogenic effects
References
Questions
Answers
CHAPTER 16 Radiation Dosimetry
Nuclear medicine dosimetry
Physical, biologic, and effective half‐lives
Calculation of organ doses
S value:
Sample calculation of
Self‐dose, target, and source organs:
Effective dose
CT dosimetry
Absorbed dose in CT. CTDI
DLP
Estimation of relative risk: effective dose
Derivation of CTDIvol
Reference
Questions
Answers
CHAPTER 17 Radiation Safety. Rationale
Dose limits
Occupational exposure
Hospital workers
Exposure to the general public
Methods for limiting exposure. Limiting occupational exposure. Limiting external exposure
Time:
Distance:
Shielding:
Limiting internal exposure
Reducing the risk of contamination following a radiation spill
Employer and employee responsibilities in controlling risk
Limiting exposure to patients
Limiting exposure to family members and the public
Regulations
References
Questions
Answers
CHAPTER 18 Radiopharmaceutical Therapy
Introduction
Paired diagnostic and therapeutic radiopharmaceuticals
Tissue‐specific radiopharmaceutical treatments. The thyroid gland and radioiodine. The thyroid gland
Thyroid diseases treated with radioiodine:
Hyperthyroidism:
Thyroid cancer:
Radioiodine (131 I and 123I sodium iodide)
131 I:
123 I:
Uses of 123I and 131I in diagnostic imaging and therapy
223Ra‐dichloride and treatment of bone metastatic disease. Bone physiology
223Ra:
223Ra dichloride treatment
Radioactive 90Y‐microsphere treatment of liver tumors. Liver physiology
90Y:
90 Y‐microspheres
90 Y‐microsphere treatment
Prescribed activity for 90Y treatment
90Y imaging. Bremsstrahlung:
Positron:
Imaging and therapy targeting cancer cell membranes. Cancer cell targeting
Monoclonal antibody targeting:
Peptide receptor targeting:
177 Lutetium‐dotatate and 68gallium‐dotatate for neuroendocrine tumors. Neuroendocrine cells:
177 Lu dotatate administration:
Prostate‐specific membrane antigen (PMSA) agents for prostate cancer
Prostate‐specific membrane antigen (PMSA):
Radiolabeled PMSA:
Radiation protection
Written directives
Dose preparation
Dose calibrator measurement of beta and alpha emitters
Dose administration
177 Lu‐dotatate
90 Y‐microspheres
131 I sodium iodide
Post‐therapy radiation precautions
Gamma emissions
Contamination
Written hygiene instructions
References
Questions
Answers
CHAPTER 19 Management of Nuclear Event Casualties
Interaction of radiation with tissue. Alpha particles
Beta particles
Gamma rays and X‐rays
Neutrons
Radionuclides
Hospital response to a radiation accident
Exposure and contamination
Hospital facilities. Decontamination facility
Treatment/decontamination room for seriously wounded individuals
External decontamination
Patient radiation survey
Survey meter
Survey meter quality control
Personnel. Personal protection
Reducing exposure
Dosimeters
Evaluation of the radiation accident victim
Early estimation of whole‐body radiation exposure
Symptoms and time of onset following exposure
Blood count estimates of exposure
Chromosomal aberrations
Early estimation of local radiation exposure
Acute radiation sickness
Acute radiation syndromes
Hematopoetic syndrome
Gastrointestinal syndrome
Central nervous system (CNS) and cardiovascular syndrome
Treatment of acute radiation sickness
Treatment of internal contamination
Local radiation injury to the skin
Medical and industrial accidental overexposure
References
Questions
Answers
Appendix A Common Nuclides
Appendix B Major Dosimetry for Common Pharmaceuticals
Appendix C Guide to Nuclear Regulatory Commission (NRC) Publications. Title 10, “Energy”, Code of Federal Regulations (10CFR) [1]
NUREG – 1556, Vol. 9, Revision 3, Consolidated Guidance About Materials Licenses [2]
References
Appendix D Recommended Reading by Topic. Review of Basic Physics
Nuclear Medicine
Basic Nuclear Medicine Physics and Instrumentation
PET Technology
CT Technology
MRI Technology
DICOM and Information Technology
Nuclear Medicine Quality Control
Radiobiology
Radiation Dosimetry
NRC Regulations
Therapeutics in Nuclear Medicine
Index
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