After injection, the radiopharmaceutical circulates and accumulates according to its biological targeting and clearance. Technetium-99m undergoes an isomeric nuclear transition, producing approximately 140keV gamma rays; its roughly six-hour half-life permits useful counting with limited persistence. Some photons undergo absorption or Compton scattering in the patient. A lead collimator in the gamma camera accepts a narrow range of directions so the accepted event retains positional information.
An accepted gamma ray deposits energy, commonly in a NaI(Tl) scintillator, by photoelectric effect or Compton scattering. The resulting visible particle scintillation light is collected by photomultipliers. Their relative pulse sizes determine an event position and their summed pulse estimates its energy. A pulse-height analyser accepts an energy window around the photopeak to reject many scattered events. Position and uniformity corrections are applied; accepted events increment a two-dimensional pixel histogram. After acquisition the computer displays this count map as a planar projection of tracer activity. Finite counting statistics, attenuation, scattering and the collimator limit the image's quantitative accuracy and spatial resolution.[ref]
A diagnostic example is technetium-99m methylene diphosphonate, which accumulates at sites of bone turnover for bone scintigraphy. A therapeutic example is sodium iodide iodine-131, taken up by thyroid tissue and used for selected thyroid disease including differentiated thyroid cancer.
For diagnosis, an escaping gamma ray or a Positron followed by annihilation photons allows external detection, with an appropriate short half-life and limited deposited energy. For molecular radiotherapy, short-range charged emissions such as beta particles, alpha particles or Auger electrons deposit substantial local energy in the targeted tissue. Iodine-131 emits therapeutic beta particles as well as imageable gamma rays, so these categories are functional rather than mutually exclusive isotope classes.
Single-photon emission computed tomography detects individual gamma rays from a tracer. Mechanically collimated gamma cameras acquire projections from multiple angles for tomography. The collimator discards most emitted photons, creating a strong sensitivity–spatial resolution trade-off.
Positron emission tomography uses a Positron-emitting tracer. The emitted Positron travels a short distance before electron-positron annihilation produces an approximately back-to-back photon pair. Coincident detection in a detector ring defines a line of response, giving electronic collimation and greater detection efficiency; time-of-flight PET further constrains position along that line. The positron range, non-collinearity, detector size, scatter and accidental coincidences limit spatial resolution and quantification. In both hybrids, computed tomography supplies anatomy and an attenuation correction map, with attention to registration and respiratory motion.[ref]
Nuclear medicine by NIBIB. Sections describing SPECT, PET and hybrid CT imaging
After thermalization, approximate the electron and Positron as initially at rest in their centre-of-momentum frame. Their total energy is 2mec2 and total momentum is zero. Two photons must therefore have equal energies and opposite momenta, since ∣pγ∣=Eγ/c. Conservation of energy givesResidual pair momentum and electron binding cause small departures from exact collinearity and exact photon energy; the standard PET calculation neglects them.
2Eγ=2mec2,Eγ=mec2=511keV.
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