The history of Compton cameras began with the detection of radiation sources originally for applications in astronomy. A Compton camera is a promising γ-ray detector that operates in the wide energy range of a few tens of keV to MeV. The γ-ray detection method of a Compton camera is based on Compton scattering kinematics, which is used to determine the direction and energy of the γ-rays without using a mechanical collimator. Although the Compton camera was originally designed for astrophysical applications, it was later applied in medical imaging as well. Moreover, its application in environmental radiation measurements is also under study. Although a few review papers regarding Compton cameras have been published, they either focus very specifically on the detectors used in such cameras or the particular applications of Compton cameras. Thus, the aim of this paper is to review the features and types of Compton cameras and introduce their applications, associated imaging algorithms, improvement scopes, and their future aspects.

The Compton camera can simultaneously acquire images of multiple isotopes injected in a body; therefore, it has the potential to introduce a new subfield in the field of biomedical imaging applications. The objective of this study is to assess the ability of a prototype semiconductor-based silicon/cadmium telluride (Si/CdTe) Compton camera to simultaneously image the distributions of technetium (^99mTc)-dimercaptosuccinic acid (DMSA) (141 keV emission) and ¹⁸F-fluorodeoxyglucose (FDG) (511 keV emission) injected into a human volunteer. ^99mTc-DMSA and ¹⁸F-FDG were injected intravenously into a 25-year-old male volunteer. The distributions of ^99mTc-DMSA and ¹⁸F-FDG were simultaneously made visible by setting a specified energy window for each radioisotope. The images of these radiopharmaceuticals acquired using the prototype Compton camera were superimposed onto computed tomography images for reference. The reconstructed image showed that ^99mTc-DMSA had accumulated in both kidneys, which is consistent with the well-known diagnostic distribution determined by clinical imaging via single-photon emission computed tomography. In the ¹⁸F-FDG image, there is broad distribution around the liver and kidneys, which was expected based on routine clinical positron emission tomography imaging. The current study demonstrated for the first time that the Si/CdTe Compton camera was capable of simultaneously imaging the distributions of two radiopharmaceuticals, ^99mTc-DMSA and ¹⁸F-FDG, in a human body. These results suggest that the Si/CdTe Compton camera has the potential to become a novel modality for nuclear medical diagnoses enabling multi-probe simultaneous tracking.

We have been developing a medical imaging technique using a Compton camera. This study evaluates the feasibility of clear imaging with ^99m Tc and ¹⁸ F simultaneously, and demonstrates in vivo imaging with ^99m Tc and/or ¹⁸ F. We used a Compton camera with silicon and cadmium telluride (Si/CdTe) semiconductors. We estimated the imaging performance of the Compton camera for 141 keV and 511 keV gamma rays from ^99m Tc and ²² Na, respectively. Next, we simultaneously imaged ^99m Tc and ¹⁸ F point sources to evaluate the cross-talk artifacts produced by a higher energy gamma-ray background. Then, in the in vivo experiments, three rats were injected with ^99m Tc-dimercaptosuccinic acid and/or ¹⁸ F-fluorodeoxyglucose and imaged. The Compton images were compared with PET images. The rats were euthanized, and the activities in their organs were measured using a well counter. The energy resolution and spatial resolution were measured for the sources. No apparent cross-talk artifacts were observed in the practical-activity ratio ( ^99m Tc: ¹⁸ F = 1:16). We succeeded in imaging the distributions of ^99m Tc and ¹⁸ F simultaneously, and the results were consistent with the PET images and well counter measurements. Our Si/CdTe Compton camera can thus work as a multi-tracer imager, covering various SPECT and PET probes, with less cross-talk artifacts in comparison to the conventional Anger cameras using a collimator. Our findings suggest the possibility of human trials.

In this study, we performed on-beam monitoring of 511 keV annihilation gamma emissions using a Compton camera. Beam monitoring experiments were conducted using carbon ion beams of 290 MeV/u irradiated on a polymethyl methacrylate (PMMA) phantom. The intensity of the beams was 3 × 10 ⁹ particles per pulse, with 20 pulses per minute. A Compton camera based on a silicon/cadmium telluride (Si/CdTe) detector was used to monitor the annihilation gamma rays emitted from the phantom. We successfully reconstructed the energy events of 511 keV annihilation gamma rays and developed Compton images using a simple back-projection method. The distribution of the annihilation gamma ray generation traced the beam trajectory and the peak intensity position was a few millimeters shorter than the Bragg peak position. Moreover, the effect of the beam range shifter with 30, 60, and 90 mm water equivalent thickness (WET) was clearly visualized in the reconstructed Compton images. The experimentally measured values of the corresponding range shifts in the PMMA phantom (28.70 mm, 52.49 mm, and 76.77 mm, respectively) were consistent with the shifts of the Bragg peak position (25.50 mm, 51.30 mm and 76.70 mm, respectively) evaluated by Monte Carlo simulation. The results show that the Si/CdTe Compton camera has strong potential for on-beam monitoring of annihilation gamma rays in particle therapy in clinical situations.

We have been developing a medical imaging system using a Compton camera and demonstrated the imaging ability of Compton camera for ^99mTc-DMSA accumulated in rat kidneys. In this study, we performed imaging experiments using a human body phantom to confirm its applicability to human imaging. Preliminary simulations were conducted using a digital phantom with varying activity ratios between the kidney and body trunk regions. Gamma rays (141 keV) were generated and detected by a Compton camera based on a silicon and cadmium telluride (Si/CdTe) detector. Compton images were reconstructed with the list mode median root prior expectation maximization method. The appropriate number of iterations of the condition was confirmed through simulations. The reconstructed Compton images revealed two bright points in the kidney regions. Furthermore, the numerical value calculated by integrating pixel values inside the region of interest correlated well with the activity of the kidney regions. Finally, experimental studies were conducted to ascertain whether the results of the simulation studies could be reproduced. The kidneys could be successfully visualised. In conclusion, considering that the conditions in this study agree with those of typical human bodies and imaginable experimental setup, the Si/CdTe Compton camera has a high probability of success in human imaging. In addition, our results indicate the capability of (semi-) quantitative analysis using Compton images.

In cancer therapy today, carbon ion radiotherapy is used mainly as monotherapy, whereas cisplatin is used concomitantly with X-ray radiotherapy. The effectiveness of concomitant carbon ions and cisplatin is unclear. To obtain the information on the mechanisms potentially shared between carbon ions or X-rays and cisplatin, we assessed the correlation of sensitivity to the single treatments. In 20 human cancer cell lines, sensitivity to X-rays strongly correlated with sensitivity to cisplatin, indicating the presence of potentially shared target mechanisms. Interestingly, the correlation of sensitivity to carbon ions and cisplatin was much weaker than that of sensitivity to X-rays and cisplatin, indicating the presence of potentially different target mechanisms between carbon ions and cisplatin. Assessment of clonogenic cell death by 4′,6-diamidino-2-phenylindole dihydrochloride staining showed that mitotic catastrophe was more efficiently induced by carbon ions than by the same physical dose of X-rays, while apoptosis and senescence were not. These data indicate that the correlation of sensitivity to carbon ions and cisplatin is weaker than that of sensitivity to X-rays and cisplatin, which are helpful as biological basis to understand the potentially shared mechanism among these treatments. Further investigation is mandatory to elucidate the clinical efficacy of carbon ions and cisplatin combination.