Detectores monolíticos y sensores compatibles con altos campos magnéticos para tomografía por emisión de positrones

Esta tesis recoje un trabajo experimental centrado en profundizar sobre el conocimiento de los bloques detectores monolíticos como alternativa a los detectores segmentados para tomografía por emisión de positrones (Positron Emission Tomography, PET). El trabajo llevado a cabo incluye el desarrollo, la caracterización, la puesta a punto y la evaluación de prototipos demostradores PET utilizando bloques monolíticos de ortosilicato de lutecio ytrio dopado con cerio (Cerium-Doped Lutetium Yttrium Orthosilicate, LYSO:Ce) usando sensores compatibles con altos campos magnéticos, tanto fotodiodos de avalancha (Avalanche Photodiodes, APDs) como fotomultiplicadores de silicio (Silicon Photomultipliers, SiPMs). Los prototipos implementados con APDs se construyeron para estudiar la viabilidad de un prototipo PET de alta sensibilidad previamente simulado, denominado BrainPET. En esta memoria se describe y caracteriza la electrónica frontal integrada utilizada en estos prototipos junto con la electrónica de lectura desarrollada específicamente para los mismos. Se muestran los montajes experimentales para la obtención de las imágenes tomográficas PET y para el entrenamiento de los algoritmos de red neuronal utilizados para la estimación de las posiciones de incidencia de los fotones γ sobre la superficie de los bloques monolíticos. Con el prototipo BrainPET se obtuvieron resultados satisfactorios de resolución energética (13 % FWHM), precisión espacial de los bloques monolíticos (~ 2 mm FWHM) y resolución espacial de la imagen PET de 1,5 - 1,7 mm FWHM. Además se demostró una capacidad resolutiva en la imagen PET de ~ 2 mm al adquirir simultáneamente imágenes de fuentes radiactivas separadas a distancias conocidas. Sin embargo, con este prototipo se detectaron también dos limitaciones importantes. En primer lugar, se constató una falta de flexibilidad a la hora de trabajar con un circuito integrado de aplicación específica (Application Specific Integrated Circuit, ASIC) cuyo diseño electrónico no era propio sino comercial, unido al elevado coste que requieren las modificaciones del diseño de un ASIC con tales características. Por otra parte, la caracterización final de la electrónica integrada del BrainPET mostró una resolución temporal con amplio margen de mejora (~ 13 ns FWHM). Tomando en cuenta estas limitaciones obtenidas con los prototipos BrainPET, junto con la evolución tecnológica hacia matrices de SiPM, el conocimiento adquirido con los bloques monolíticos se trasladó a la nueva tecnología de sensores disponible, los SiPMs. A su vez se inició una nueva estrategia para la electrónica frontal, con el ASIC FlexToT, un ASIC de diseño propio basado en un esquema de medida del tiempo sobre umbral (Time over Threshold, ToT), en donde la duración del pulso de salida es proporcional a la energía depositada. Una de las características más interesantes de este esquema es la posibilidad de manejar directamente señales de pulsos digitales, en lugar de procesar la amplitud de las señales analógicas. Con esta arquitectura electrónica se sustituyen los conversores analógicos digitales (Analog to Digital Converter, ADCs) por conversores de tiempo digitales (Time to Digital Converter, TDCs), pudiendo implementar éstos de forma sencilla en matrices de puertas programmable ‘in situ’ (Field Programmable Gate Array, FPGA), reduciendo con ello el consumo y la complejidad del diseño. Se construyó un nuevo prototipo demostrador FlexToT para validar dicho ASIC para bloques monolíticos o segmentados. Se ha llevado a cabo el diseño y caracterización de la electrónica frontal necesaria para la lectura del ASIC FlexToT, evaluando su linealidad y rango dinámico, el comportamiento frente a ruido así como la no linealidad diferencial obtenida con los TDCs implementados en la FPGA. Además, la electrónica presentada en este trabajo es capaz de trabajar con altas tasas de actividad y de discriminar diferentes centelleadores para aplicaciones phoswich. El ASIC FlexToT proporciona una excelente resolución temporal en coincidencia para los eventos correspondientes con el fotopico de 511 keV (128 ps FWHM), solventando las limitaciones de resolución temporal del prototipo BrainPET. Por otra parte, la resolución energética con bloques monolíticos leidos por ASICs FlexToT proporciona una resolución energética de 15,4 % FWHM a 511 keV. Finalmente, se obtuvieron buenos resultados en la calidad de la imagen PET y en la capacidad resolutiva del demostrador FlexToT, proporcionando resoluciones espaciales en el centro del FoV en torno a 1,4 mm FWHM. ABSTRACT This thesis is focused on the development of experimental activities used to deepen the knowledge of monolithic detector blocks as an alternative to segmented detectors for Positron Emission Tomography (PET). It includes the development, characterization, setting up, running and evaluation of PET demonstrator prototypes with monolithic detector blocks of Cerium-doped Lutetium Yttrium Orthosilicate (LYSO:Ce) using magnetically compatible sensors such as Avalanche Photodiodes (APDs) and Silicon Photomultipliers (SiPMs). The prototypes implemented with APDs were constructed to validate the viability of a high-sensitivity PET prototype that had previously been simulated, denominated BrainPET. This work describes and characterizes the integrated front-end electronics used in these prototypes, as well as the electronic readout system developed especially for them. It shows the experimental set-ups to obtain the tomographic PET images and to train neural networks algorithms used for position estimation of photons impinging on the surface of monolithic blocks. Using the BrainPET prototype, satisfactory energy resolution (13 % FWHM), spatial precision of monolithic blocks (~ 2 mm FWHM) and spatial resolution of the PET image (1.5 – 1.7 mm FWHM) in the center of the Field of View (FoV) were obtained. Moreover, we proved the imaging capabilities of this demonstrator with extended sources, considering the acquisition of two simultaneous sources of 1 mm diameter placed at known distances. However, some important limitations were also detected with the BrainPET prototype. In the first place, it was confirmed that there was a lack of flexibility working with an Application Specific Integrated Circuit (ASIC) whose electronic design was not own but commercial, along with the high cost required to modify an ASIC design with such features. Furthermore, the final characterization of the BrainPET ASIC showed a timing resolution with room for improvement (~ 13 ns FWHM). Taking into consideration the limitations obtained with the BrainPET prototype, along with the technological evolution in magnetically compatible devices, the knowledge acquired with the monolithic blocks were transferred to the new technology available, the SiPMs. Moreover, we opted for a new strategy in the front-end electronics, the FlexToT ASIC, an own design ASIC based on a Time over Threshold (ToT) scheme. One of the most interesting features underlying a ToT architecture is the encoding of the analog input signal amplitude information into the duration of the output signals, delivering directly digital pulses. The electronic architecture helps substitute the Analog to Digital Converters (ADCs) for Time to Digital Converters (TDCs), and they are easily implemented in Field Programmable Gate Arrays (FPGA), reducing the consumption and the complexity of the design. A new prototype demonstrator based on SiPMs was implemented to validate the FlexToT ASIC for monolithic or segmented blocks. The design and characterization of the necessary front-end electronic to read-out the signals from the ASIC was carried out by evaluating its linearity and dynamic range, its performance with an external noise signal, as well as the differential nonlinearity obtained with the TDCs implemented in the FPGA. Furthermore, the electronic presented in this work is capable of working at high count rates and discriminates different phoswich scintillators. The FlexToT ASIC provides an excellent coincidence time resolution for events that correspond to 511 keV photopeak (128 ps FWHM), resolving the limitations of the poor timing resolution of the BrainPET prototype. Furthermore, the energy resolution with monolithic blocks read by FlexToT ASICs provides an energy resolution of 15.4 % FWHM at 511 keV. Finally, good results were obtained in the quality of the PET image and the resolving power of the FlexToT demonstrator, providing spatial resolutions in the centre of the FoV at about 1.4 mm FWHM.

Optical imaging of functional domains in the cortex of the awake and behaving monkey

As demonstrated by anatomical and physiological studies, the cerebral cortex consists of groups of cortical modules, each comprising populations of neurons with similar functional properties. This functional modularity exists in both sensory and association neocortices. However, the role of such cortical modules in perceptual and cognitive behavior is unknown. To aid in the examination of this issue we have applied the high spatial resolution optical imaging methodology to the study of awake, behaving animals. In this paper, we report the optical imaging of orientation domains and blob structures, approximately 100–200 μm in size, in visual cortex of the awake and behaving monkey. By overcoming the spatial limitations of other existing imaging methods, optical imaging will permit the study of a wide variety of cortical functions at the columnar level, including motor and cognitive functions traditionally studied with positron-emission tomography or functional MRI techniques.

Neural basis of an inherited speech and language disorder

Investigation of the three-generation KE family, half of whose members are affected by a pronounced verbal dyspraxia, has led to identification of their core deficit as one involving sequential articulation and orofacial praxis. A positron emission tomography activation study revealed functional abnormalities in both cortical and subcortical motor-related areas of the frontal lobe, while quantitative analyses of magnetic resonance imaging scans revealed structural abnormalities in several of these same areas, particularly the caudate nucleus, which was found to be abnormally small bilaterally. A recent linkage study [Fisher, S., Vargha-Khadem, F., Watkins, K. E., Monaco, A. P. & Pembry, M. E. (1998) Nat. Genet. 18, 168–170] localized the abnormal gene (SPCH1) to a 5.6-centiMorgan interval in the chromosomal band 7q31. The genetic mutation or deletion in this region has resulted in the abnormal development of several brain areas that appear to be critical for both orofacial movements and sequential articulation, leading to marked disruption of speech and expressive language.

PET Tracers to Study Clinically Relevant Hepatic Transporters

Date of Acceptance: 02/06/2015

Hippocampal, but not amygdala, activity at encoding correlates with long-term, free recall of nonemotional information

Participation of two medial temporal lobe structures, the hippocampal region and the amygdala, in long-term declarative memory encoding was examined by using positron emission tomography of regional cerebral glucose. Positron emission tomography scanning was performed in eight healthy subjects listening passively to a repeated sequence of unrelated words. Memory for the words was assessed 24 hr later with an incidental free recall test. The percentage of words freely recalled then was correlated with glucose activity during encoding. The results revealed a striking correlation (r = 0.91, P < 0.001) between activity of the left hippocampal region (centered on the dorsal parahippocampal gyrus) and word recall. No correlation was found between activity of either the left or right amygdala and recall. The findings provide evidence for hippocampal involvement in long-term declarative memory encoding and for the view that the amygdala is not involved with declarative memory formation for nonemotional material.

Differences between males and females in rates of serotonin synthesis in human brain

Rates of serotonin synthesis were measured in the human brain using positron emission tomography. The sensitivity of the method is indicated by the fact that measurements are possible even after a substantial lowering of synthesis induced by acute tryptophan depletion. Unlike serotonin levels in human brain, which vary greatly in different brain areas, rates of synthesis of the indolamine are rather uniform throughout the brain. The mean rate of synthesis in normal males was found to be 52% higher than in normal females; this marked difference may be a factor relevant to the lower incidence of major unipolar depression in males.

Vascular imprints of neuronal activity: Relationships between the dynamics of cortical blood flow, oxygenation, and volume changes following sensory stimulation

Modern functional neuroimaging methods, such as positron-emission tomography (PET), optical imaging of intrinsic signals, and functional MRI (fMRI) utilize activity-dependent hemodynamic changes to obtain indirect maps of the evoked electrical activity in the brain. Whereas PET and flow-sensitive MRI map cerebral blood flow (CBF) changes, optical imaging and blood oxygenation level-dependent MRI map areas with changes in the concentration of deoxygenated hemoglobin (HbR). However, the relationship between CBF and HbR during functional activation has never been tested experimentally. Therefore, we investigated this relationship by using imaging spectroscopy and laser-Doppler flowmetry techniques, simultaneously, in the visual cortex of anesthetized cats during sensory stimulation. We found that the earliest microcirculatory change was indeed an increase in HbR, whereas the CBF increase lagged by more than a second after the increase in HbR. The increased HbR was accompanied by a simultaneous increase in total hemoglobin concentration (Hbt), presumably reflecting an early blood volume increase. We found that the CBF changes lagged after Hbt changes by 1 to 2 sec throughout the response. These results support the notion of active neurovascular regulation of blood volume in the capillary bed and the existence of a delayed, passive process of capillary filling.

Detection of cortical activation during averaged single trials of a cognitive task using functional magnetic resonance imaging

Functional neuroimaging studies in human subjects using positron emission tomography or functional magnetic resonance imaging (fMRI) are typically conducted by collecting data over extended time periods that contain many similar trials of a task. Here methods for acquiring fMRI data from single trials of a cognitive task are reported. In experiment one, whole brain fMRI was used to reliably detect single-trial responses in a prefrontal region within single subjects. In experiment two, higher temporal sampling of a more limited spatial field was used to measure temporal offsets between regions. Activation maps produced solely from the single-trial data were comparable to those produced from blocked runs. These findings suggest that single-trial paradigms will be able to exploit the high temporal resolution of fMRI. Such paradigms will provide experimental flexibility and time-resolved data for individual brain regions on a trial-by-trial basis.

Prefrontal cortex and episodic memory retrieval mode

A multistudy analysis of positron emission tomography data identified three right prefrontal and two left prefrontal cortical sites, as well as a region in the anterior cingulate gyrus, where neuronal activity is correlated with the maintenance of episodic memory retrieval mode (REMO), a basic and necessary condition of remembering past experiences. The right prefrontal sites were near the frontal pole [Brodmann's area (BA) 10], frontal operculum (BA 47/45), and lateral dorsal area (BA 8/9). The two left prefrontal sites were homotopical with the right frontal pole and opercular sites. The same kinds of REMO sites were not observed in any other cerebral region. Many previous functional neuroimaging studies of episodic memory retrieval have reported activations near the frontal REMO sites identified here, although their function has not been clear. Many of these, too, probably have signaled their involvement in REMO. We propose that REMO activations largely if not entirely account for the frontal hemispheric asymmetry of retrieval as described by the original hemispheric encoding retrieval asymmetry model.

Correlation of regional cerebral blood flow and change of plasma sodium concentration during genesis and satiation of thirst

Positron emission tomography studies were conducted during genesis of moderate thirst by rapid i.v. infusion of hypertonic saline (0.51 M) and after satiation of thirst by drinking water. The correlation of regional cerebral blood flow with the change in the plasma Na concentration showed a significant group of cerebral activations in the anterior cingulate region and also a site in the middle temporal gyrus and in the periaqueductal gray. Strongest deactivations occurred in the parahippocampal and frontal gyri. The data are consistent with an important role of the anterior cingulate in the genesis of thirst.

High-resolution microPET imaging of carcinoembryonic antigen-positive xenografts by using a copper-64-labeled engineered antibody fragment

Rapid imaging by antitumor antibodies has been limited by the prolonged targeting kinetics and clearance of labeled whole antibodies. Genetically engineered fragments with rapid access and high retention in tumor tissue combined with rapid blood clearance are suitable for labeling with short-lived radionuclides, including positron-emitting isotopes for positron-emission tomography (PET). An engineered fragment was developed from the high-affinity anticarcinoembryonic antigen (CEA) monoclonal antibody T84.66. This single-chain variable fragment (Fv)-CH3, or minibody, was produced as a bivalent 80 kDa dimer. The macrocyclic chelating agent 1,4,7,10-tetraazacyclododecane-N,N′,N′′, N′′′-tetraacetic acid (DOTA) was conjugated to the anti-CEA minibody for labeling with copper-64, a positron-emitting radionuclide (t1/2 = 12.7 h). In vivo distribution was evaluated in athymic mice bearing paired LS174T human colon carcinoma (CEA positive) and C6 rat glioma (CEA negative) xenografts. Five hours after injection with 64Cu-DOTA-minibody, microPET imaging showed high uptake in CEA-positive tumor (17.9% injected dose per gram ± 3.79) compared with control tumor (6.0% injected dose per gram ± 1.0). In addition, significant uptake was seen in liver, with low uptake in other tissues. Average target/background ratios relative to neighboring tissue were 3–4:1. Engineered antibody fragments labeled with positron-emitting isotopes such as copper-64 provide a new class of agents for PET imaging of tumors.

Orbitofrontal cortex: A key prefrontal region for encoding information

Little is known about the specific functional contribution of the human orbitofrontal cortex with regard to memory processing, although there is strong evidence from lesion studies in monkeys that it may play an important role. The present investigation measured changes in regional cerebral blood flow with positron emission tomography in normal human subjects who were instructed to commit to memory abstract visual patterns. The results indicated that the rostral orbitofrontal region (area 11), which is primarily linked with the anterior medial temporal limbic region and lateral prefrontal cortical areas, is involved in the process of encoding of new information.

Reactivation of encoding-related brain activity during memory retrieval

Neuronal models predict that retrieval of specific event information reactivates brain regions that were active during encoding of this information. Consistent with this prediction, this positron-emission tomography study showed that remembering that visual words had been paired with sounds at encoding activated some of the auditory brain regions that were engaged during encoding. After word-sound encoding, activation of auditory brain regions was also observed during visual word recognition when there was no demand to retrieve auditory information. Collectively, these observations suggest that information about the auditory components of multisensory event information is stored in auditory responsive cortex and reactivated at retrieval, in keeping with classical ideas about “redintegration,” that is, the power of part of an encoded stimulus complex to evoke the whole experience.

Cerebral cortical hyperactivation in response to mental stress in patients with coronary artery disease

The central nervous system (CNS) effects of mental stress in patients with coronary artery disease (CAD) are unexplored. The present study used positron emission tomography (PET) to measure brain correlates of mental stress induced by an arithmetic serial subtraction task in CAD and healthy subjects. Mental stress resulted in hyperactivation in CAD patients compared with healthy subjects in several brain areas including the left parietal cortex [angular gyrus/parallel sulcus (area 39)], left anterior cingulate (area 32), right visual association cortex (area 18), left fusiform gyrus, and cerebellum. These same regions were activated within the CAD patient group during mental stress versus control conditions. In the group of healthy subjects, activation was significant only in the left inferior frontal gyrus during mental stress compared with counting control. Decreases in blood flow also were produced by mental stress in CAD versus healthy subjects in right thalamus (lateral dorsal, lateral posterior), right superior frontal gyrus (areas 32, 24, and 10), and right middle temporal gyrus (area 21) (in the region of the auditory association cortex). Of particular interest, a subgroup of CAD patients that developed painless myocardial ischemia during mental stress had hyperactivation in the left hippocampus and inferior parietal lobule (area 40), left middle (area 10) and superior frontal gyrus (area 8), temporal pole, and visual association cortex (area 18), and a concomitant decrease in activation observed in the anterior cingulate bilaterally, right middle and superior frontal gyri, and right visual association cortex (area 18) compared with CAD patients without myocardial ischemia. These findings demonstrate an exaggerated cerebral cortical response and exaggerated asymmetry to mental stress in individuals with CAD.

Brain responses associated with consciousness of breathlessness (air hunger)

Little is known about the physiological mechanisms subserving the experience of air hunger and the affective control of breathing in humans. Acute hunger for air after inhalation of CO2 was studied in nine healthy volunteers with positron emission tomography. Subjective breathlessness was manipulated while end-tidal CO2- was held constant. Subjects experienced a significantly greater sense of air hunger breathing through a face mask than through a mouthpiece. The statistical contrast between the two conditions delineated a distributed network of primarily limbic/paralimbic brain regions, including multiple foci in dorsal anterior and middle cingulate gyrus, insula/claustrum, amygdala/periamygdala, lingual and middle temporal gyrus, hypothalamus, pulvinar, and midbrain. This pattern of activations was confirmed by a correlational analysis with breathlessness ratings. The commonality of regions of mesencephalon, diencephalon and limbic/paralimbic areas involved in primal emotions engendered by the basic vegetative systems including hunger for air, thirst, hunger, pain, micturition, and sleep, is discussed with particular reference to the cingulate gyrus. A theory that the phylogenetic origin of consciousness came from primal emotions engendered by immediate threat to the existence of the organism is discussed along with an alternative hypothesis by Edelman that primary awareness emerged with processes of ongoing perceptual categorization giving rise to a scene [Edelman, G. M. (1992) Bright Air, Brilliant Fire (Penguin, London)].