Scatter and cross-talk corrections in simultaneous Tc-99m/I-123 brain SPECT using constrained factor analysis and artificial neural networks

Simultaneous imaging of Tc-99m and I-123 would have a high clinical potenti al in the assessment of brain perfusion (Tc-99m) and neurotransmission (I-1 23) but is hindered by cross-talk between the two radionuclides. Monte Carl o simulations of 15 different dual-isotope studies were performed using a d igital brain phantom. Several physiologic Tc-99m and I-123 uptake patterns were modeled in the brain structures. Two methods were considered to correc t for cross-talk from both scattered and unscattered photons: constrained s pectral factor analysis (SFA) and artificial neural networks (ANN). The acc uracy and precision of reconstructed pixel values within several brain stru ctures were compared to those obtained with an energy windowing method (WSA ). In I-123 images, mean bias was close to 10% in all structures for SFA an d ANN and between 14% (in the caudate nucleus) and 25% (in the cerebellum) for WSA. Tc-99m activity was overestimated by 35% in the cortex and 53% in the caudate nucleus with WSA, but by less than 9% in all structures with SF A and ANN. SFA and ANN performed well even in the presence of high-energy I -123 photons. The accuracy was greatly improved by incorporating the contam ination into the SFA model or in the learning phase for ANN. SFA and ANN ar e promising approaches to correct for cross-talk in simultaneous Tc-99m/I-1 23 SPECT.