A New Concept for a Low-Dose Stationary Tomographic Molecular Breast Imaging Camera Using 3D Position Sensitive CZT Detectors

Pixelated CZT detectors have been used in a variety of molecular imaging applications for many years. The interplay of gamma camera and collimator geometric design, gantry motion, and image reconstruction determines the image quality and dose-time-FOV trade-offs. In particular, Molecular Breast Imaging (MBI) has been shown to provide excellent diagnostic results in patients with dense breast tissue, but higher than mammography patient dose and long imaging time impede its wide adoption. We propose a new transformative system concept combining the advantages of CZT detectors (superior energy and position resolution and depth of interaction sensing), multi-pinhole collimation and novel image reconstruction to mitigate those drawbacks without compromising diagnostic content. The closely spaced pinholes allow tomographic image reconstruction, improve sensitivity and angular sampling, but result in significant multiplexing. Novel de-multiplexing algorithms have been developed to mitigate the adverse multiplexing artefacts using the DOI. GATE simulations of the new camera demonstrate a potential to reduce the patient dose by at least a factor of 5 in comparison to planar MBI, thus reducing the dose to the level of an average mammography scan. The first prototype has been built at Kromek with 3D position sensitive CZT detectors and is being evaluated using an "activity-painting" setup with a point ⁵⁷ Co source. Initial results demonstrate the expected performance improvement with the use of sub-pixelisation and DOI. The next steps of the development will include accurate evaluation of the image quality and the dose reduction followed by building a larger scale clinical prototype using optimised detector design.