Initial demonstration of the Scratch-PET concept: an intraoperative PET with a hand-held detector.

Positron emission tomography (PET) is a valuable tool for diagnosing malignant tumors. Intraoperative PET imaging is expected to allow the more accurate localization of tumors that need resections. However, conventional devices feature a large detector ring that obstructs surgical procedures, preventing their intraoperative application. This paper proposes a new PET device, Scratch-PET, for image-guided tumor resection. The key feature of Scratch-PET is its use of a hand-held detector to scan the surgical field, ensuring open space for surgery while measuring annihilation radiation with a fixed detector array placed below the patient. We developed a prototype device using two detectors: the hand-held detector and a fixed detector, to demonstrate the feasibility of the proposed concept. Both detectors consisted of 16 × 16 arrays of lutetium yttrium orthosilicates (3 × 3 × 15 mm) coupled one-to-one with 16 × 16 silicon photomultiplier arrays. The position and orientation of the hand-held detector are tracked using an optical tracking sensor that detects attached markers. We measured a Na multi-rod phantom and two Na point sources separately for 180 s while moving the hand-held detector. The rod diameters were 6.0, 5.0, 4.0, 3.0, 2.2, and 1.6 mm. Each point source was placed at the field-of-view center and 35 mm off-center which was outside the sensitive area when the hand-held detector was positioned facing the fixed detector. The 2.2 mm rods were partially resolved, and both point sources were successfully visualized. The potential of the proposed device to visualize small tumors was validated.