Hybrid PET/Compton-camera imaging: an imager for the next generation

Compton cameras can offer advantages over gamma cameras for some applications, since they are well suited for multitracer imaging and for imaging high-energy radiotracers, such as those employed in radionuclide therapy. While in conventional clinical settings state-of-the-art Compton cameras cannot compete with well-established methods such as PET and SPECT, there are specific scenarios in which they can constitute an advantageous alternative. The combination of PET and Compton imaging can benefit from the improved resolution and sensitivity of current PET technology and, at the same time, overcome PET limitations in the use of multiple radiotracers. Such a system can provide simultaneous assessment of different radiotracers under identical conditions and reduce errors associated with physical factors that can change between acquisitions. Advances are being made both in instrumentation developments combining PET and Compton cameras for multimodal or three-gamma imaging systems, and in image reconstruction, addressing the challenges imposed by the combination of the two modalities or the new techniques. This review article summarizes the advances made in Compton cameras for medical imaging and their combination with PET.