We implemented a fully-3D ordered-subsets expectation-maximization (OSEM) algorithm with attenuation compensation, distance-dependent blurring (DDB), and sensitivity modeling for SPECT performed with a cone-beam collimator (CBC). The experimentally obtained detector response to point sources across FOV was fitted to a two-dimensional Gaussian function with its width (FWHM) varying linearly with the source-to-detector distance and with very weak sensitivity dependence on the emission angle. We obtained CBC SPECT scans of a physical point-source phantom, a Defrise phantom, and a female patient, and we investigated performance of our algorithm. To correctly simulate DDB and sensitivity, a blurring kernel with a radius of up to 10 elements had to be used for a 128x128 acquisition matrix, and volumetric ray tracing rather than line-element-based ray tracing has to be implemented. In the point-source phantom reconstruction we evaluated the uniformity of FWHM for the radial, tangential and longitudinal directions, and sensitivity vs. distance. An isotropic and stationary resolution was obtained at any location by OSEM with DDB and sensitivity modeling, only when volumetric ray tracing was used. We analyzed axial and transaxial profiles obtained for the Defrise phantom and evaluated the reconstructed breast SPECT patient images. The proposed fully-3D OSEM reconstruction algorithm with DBB and sensitivity modeling, and attenuation compensation with volumetric rays tracing is efficient and effective with significant resolution and sensitivity recovery.
Standard MLEM and OSEM algorithms used in SPECT Tc-99m sestamibi scintimammography produce hot-spot artifacts (HSA) at the image support peripheries. We investigated a suitable adaptation of MLEM and OSEM algorithms needed to reduce HSA. Patients with suspicious breast lesions were administered 10 mCi of Tc-99m sestamibi and SPECT scans were acquired for patients in prone position with uncompressed breasts. In addition, to simulate breast lesions, some patients were imaged with a number of breast skin markers each containing 1 μCi of Tc-99m. In order to reduce HSA in reconstruction, we removed from the backprojection step the rays that traverse the periphery of the support region on the way to a detector bin, when their path length through this region was shorter than some critical length. Such very short paths result in a very low projection counts contributed to the detector bin, and consequently to overestimation of the activity in the peripheral voxels in the backprojection step -- thus creating HSA. We analyzed the breast-lesion contrast and suppression of HSA in the images reconstructed using standard and modified MLEM and OSEM algorithms vs. critical path length (CPL). For CPL ≥ 0.01 pixel size, we observed improved breast-lesion contrast and lower noise in the reconstructed images, and a very significant reduction of HSA in the maximum intensity projection (MIP) images.