Collimatorless Scintigraphy for Imaging Extremely Low Activity Targeted Alpha Therapy (TAT) with Weighted Robust Least Squares (WRLS).

A technology for imaging extremely low photon flux is an unmet need, especially in targeted alpha therapy (TAT) imaging, which requires significantly improved sensitivity to detect as many photons as possible while retaining a reasonable spatial resolution. In scintigraphy using gamma cameras, the radionuclide collimator rejects a large number of photons that are both primary photons and scattered photons, unsuitable for photon-starved imaging scenarios like imaging TAT. In this paper we develop a min-min weighted robust least squares (WRLS) algorithm to solve a general reconstruction problem with uncertainties and validate it with the extreme scenario: collimatorless scintigraphy. Ra-223, a therapeutic alpha emitting radionuclide whose decay chain includes x-ray and gamma-ray photons, is selected for an exploratory study. Full Monte Carlo simulations are performed using Geant4 to obtain realistic projection data with collimatorless scintigraphy geometry. The results show that our proposed min-min WRLS algorithm could successfully reconstruct point sources and extended sources in the collimatorless scintigraphy with a resolution close to its system resolution and figures of merit (FOM) better than the collimator-based scintigraphy for extremely low activity TAT. This approach could be expanded as a 3D algorithm, which could lead to 3D collimatorless SPECT.