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Wu Y, Sun T, Ng YL, Liu J, Zhu X, Cheng Z, Xu B, Meng N, Zhou Y, Wang M. Clinical Implementation of Total-Body PET in China. J Nucl Med 2024; 65:64S-71S. [PMID: 38719242 DOI: 10.2967/jnumed.123.266977] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 02/13/2024] [Indexed: 07/16/2024] Open
Abstract
Total-body (TB) PET/CT is a groundbreaking tool that has brought about a revolution in both clinical application and scientific research. The transformative impact of TB PET/CT in the realms of clinical practice and scientific exploration has been steadily unfolding since its introduction in 2018, with implications for its implementation within the health care landscape of China. TB PET/CT's exceptional sensitivity enables the acquisition of high-quality images in significantly reduced time frames. Clinical applications have underscored its effectiveness across various scenarios, emphasizing the capacity to personalize dosage, scan duration, and image quality to optimize patient outcomes. TB PET/CT's ability to perform dynamic scans with high temporal and spatial resolution and to perform parametric imaging facilitates the exploration of radiotracer biodistribution and kinetic parameters throughout the body. The comprehensive TB coverage offers opportunities to study interconnections among organs, enhancing our understanding of human physiology and pathology. These insights have the potential to benefit applications requiring holistic TB assessments. The standard topics outlined in The Journal of Nuclear Medicine were used to categorized the reviewed articles into 3 sections: current clinical applications, scan protocol design, and advanced topics. This article delves into the bottleneck that impedes the full use of TB PET in China, accompanied by suggested solutions.
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Affiliation(s)
- Yaping Wu
- Department of Medical Imaging, Henan Provincial People's Hospital, Zhengzhou, China
- People's Hospital of Zhengzhou University, Zhengzhou, China
- Institute for Integrated Medical Science and Engineering, Henan Academy of Sciences, Zhengzhou, China
| | - Tao Sun
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Yee Ling Ng
- Central Research Institute, United Imaging Healthcare Group Co., Ltd., Shanghai, China
| | - Jianjun Liu
- Department of Nuclear Medicine, RenJi Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xiaohua Zhu
- Department of Nuclear Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhaoping Cheng
- Department of Nuclear Medicine, First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Jinan, China; and
| | - Baixuan Xu
- Department of Nuclear Medicine, Chinese PLA General Hospital, Beijing, China
| | - Nan Meng
- Department of Medical Imaging, Henan Provincial People's Hospital, Zhengzhou, China
- People's Hospital of Zhengzhou University, Zhengzhou, China
- Institute for Integrated Medical Science and Engineering, Henan Academy of Sciences, Zhengzhou, China
| | - Yun Zhou
- Central Research Institute, United Imaging Healthcare Group Co., Ltd., Shanghai, China
| | - Meiyun Wang
- Department of Medical Imaging, Henan Provincial People's Hospital, Zhengzhou, China;
- People's Hospital of Zhengzhou University, Zhengzhou, China
- Institute for Integrated Medical Science and Engineering, Henan Academy of Sciences, Zhengzhou, China
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Besson FL, Nocturne G, Noël N, Gheysens O, Slart RHJA, Glaudemans AWJM. PET/CT in Inflammatory and Auto-immune Disorders: Focus on Several Key Molecular Concepts, FDG, and Radiolabeled Probe Perspectives. Semin Nucl Med 2024; 54:379-393. [PMID: 37973447 DOI: 10.1053/j.semnuclmed.2023.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 10/19/2023] [Accepted: 10/23/2023] [Indexed: 11/19/2023]
Abstract
Chronic immune diseases mainly include autoimmune and inflammatory diseases. Managing chronic inflammatory and autoimmune diseases has become a significant public health concern, and therapeutic advancements over the past 50 years have been substantial. As therapeutic tools continue to multiply, the challenge now lies in providing each patient with personalized care tailored to the specifics of their condition, ushering in the era of personalized medicine. Precise and holistic imaging is essential in this context to comprehensively map the inflammatory processes in each patient, identify prognostic factors, and monitor treatment responses and complications. Imaging of patients with inflammatory and autoimmune diseases must provide a comprehensive view of the body, enabling the whole-body mapping of systemic involvement. It should identify key cellular players in the pathology, involving both innate immunity (dendritic cells, macrophages), adaptive immunity (lymphocytes), and microenvironmental cells (stromal cells, tissue cells). As a highly sensitive imaging tool with vectorized molecular probe capabilities, PET/CT can be of high relevance in the management of numerous inflammatory and autoimmune diseases. Relying on key molecular concepts of immunity, the clinical usefulness of FDG-PET/CT in several relevant inflammatory and immune-inflammatory conditions, validated or emerging, will be discussed in this review, together with radiolabeled probe perspectives.
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Affiliation(s)
- Florent L Besson
- Department of Nuclear Medicine-Molecular Imaging, Hôpitaux Universitaires Paris-Saclay, AP-HP, DMU SMART IMAGING, CHU Bicêtre, Paris, France; Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France; Université Paris-Saclay, Commissariat à l'énergie Atomique et aux Énergies Alternatives (CEA), Centre National de la Recherche Scientifique (CNRS), INSERM, BioMaps, Le Kremlin-Bicêtre, France.
| | - Gaetane Nocturne
- Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France; Department of Rheumatology, Hôpital Bicêtre Assistance Publique -Hôpitaux de Paris, Le Kremlin-Bicêtre, France; Center for Immunology of Viral Infections and Auto-Immune Diseases (IMVA), Université Paris-Saclay, Institut pour la Santé et la Recherche Médicale (INSERM) UMR 1184, Le Kremlin Bicêtre, Paris, France
| | - Nicolas Noël
- Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France; Center for Immunology of Viral Infections and Auto-Immune Diseases (IMVA), Université Paris-Saclay, Institut pour la Santé et la Recherche Médicale (INSERM) UMR 1184, Le Kremlin Bicêtre, Paris, France; Department of Internal Medicine, Hôpital Bicêtre Assistance Publique -Hôpitaux de Paris, Le Kremlin-Bicêtre, Paris, France
| | - Olivier Gheysens
- Department of Nuclear Medicine, Cliniques Universitaires St-Luc and Institute for Experimental and Clinical Research (IREC), Université Catholique de Louvain, Brussels, Belgium
| | - Riemer H J A Slart
- Department of Nuclear Medicine and Molecular Imaging, University Medical Centre Groningen, Groningen, The Netherlands; Biomedical Photonic Imaging Group, Faculty of Science and Technology, University of Twente, Enschede, The Netherlands
| | - Andor W J M Glaudemans
- Department of Nuclear Medicine and Molecular Imaging, University Medical Centre Groningen, Groningen, The Netherlands
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Sun Y, Cheng Z, Qiu J, Lu W. Performance and application of the total-body PET/CT scanner: a literature review. EJNMMI Res 2024; 14:38. [PMID: 38607510 PMCID: PMC11014840 DOI: 10.1186/s13550-023-01059-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 12/14/2023] [Indexed: 04/13/2024] Open
Abstract
BACKGROUND The total-body positron emission tomography/computed tomography (PET/CT) system, with a long axial field of view, represents the state-of-the-art PET imaging technique. Recently, the total-body PET/CT system has been commercially available. The total-body PET/CT system enables high-resolution whole-body imaging, even under extreme conditions such as ultra-low dose, extremely fast imaging speed, delayed imaging more than 10 h after tracer injection, and total-body dynamic scan. The total-body PET/CT system provides a real-time picture of the tracers of all organs across the body, which not only helps to explain normal human physiological process, but also facilitates the comprehensive assessment of systemic diseases. In addition, the total-body PET/CT system may play critical roles in other medical fields, including cancer imaging, drug development and immunology. MAIN BODY Therefore, it is of significance to summarize the existing studies of the total-body PET/CT systems and point out its future direction. This review collected research literatures from the PubMed database since the advent of commercially available total-body PET/CT systems to the present, and was divided into the following sections: Firstly, a brief introduction to the total-body PET/CT system was presented, followed by a summary of the literature on the performance evaluation of the total-body PET/CT. Then, the research and clinical applications of the total-body PET/CT were discussed. Fourthly, deep learning studies based on total-body PET imaging was reviewed. At last, the shortcomings of existing research and future directions for the total-body PET/CT were discussed. CONCLUSION Due to its technical advantages, the total-body PET/CT system is bound to play a greater role in clinical practice in the future.
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Affiliation(s)
- Yuanyuan Sun
- Department of Radiology, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, 271016, China
| | - Zhaoping Cheng
- Department of PET-CT, The First Affiliated Hospital of Shandong First Medical University, Shandong Provincial Qianfoshan Hospital Affiliated to Shandong University, Jinan, 250014, China
| | - Jianfeng Qiu
- Department of Radiology, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, 271016, China
| | - Weizhao Lu
- Department of Radiology, The Second Affiliated Hospital of Shandong First Medical University, No. 366 Taishan Street, Taian, 271000, China.
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Sun Z, Naismith SL, Meikle S, Calamante F. A novel method for PET connectomics guided by fibre-tracking MRI: Application to Alzheimer's disease. Hum Brain Mapp 2024; 45:e26659. [PMID: 38491564 PMCID: PMC10943179 DOI: 10.1002/hbm.26659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 02/20/2024] [Accepted: 02/29/2024] [Indexed: 03/18/2024] Open
Abstract
This study introduces a novel brain connectome matrix, track-weighted PET connectivity (twPC) matrix, which combines positron emission tomography (PET) and diffusion magnetic resonance imaging data to compute a PET-weighted connectome at the individual subject level. The new method is applied to characterise connectivity changes in the Alzheimer's disease (AD) continuum. The proposed twPC samples PET tracer uptake guided by the underlying white matter fibre-tracking streamline point-to-point connectivity calculated from diffusion MRI (dMRI). Using tau-PET, dMRI and T1-weighted MRI from the Alzheimer's Disease Neuroimaging Initiative database, structural connectivity (SC) and twPC matrices were computed and analysed using the network-based statistic (NBS) technique to examine topological alterations in early mild cognitive impairment (MCI), late MCI and AD participants. Correlation analysis was also performed to explore the coupling between SC and twPC. The NBS analysis revealed progressive topological alterations in both SC and twPC as cognitive decline progressed along the continuum. Compared to healthy controls, networks with decreased SC were identified in late MCI and AD, and networks with increased twPC were identified in early MCI, late MCI and AD. The altered network topologies were mostly different between twPC and SC, although with several common edges largely involving the bilateral hippocampus, fusiform gyrus and entorhinal cortex. Negative correlations were observed between twPC and SC across all subject groups, although displaying an overall reduction in the strength of anti-correlation with disease progression. twPC provides a new means for analysing subject-specific PET and MRI-derived information within a hybrid connectome using established network analysis methods, providing valuable insights into the relationship between structural connections and molecular distributions. PRACTITIONER POINTS: New method is proposed to compute patient-specific PET connectome guided by MRI fibre-tracking. Track-weighted PET connectivity (twPC) matrix allows to leverage PET and structural connectivity information. twPC was applied to dementia, to characterise the PET nework abnormalities in Alzheimer's disease and mild cognitive impairment.
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Affiliation(s)
- Zhuopin Sun
- School of Biomedical EngineeringThe University of SydneySydneyNew South WalesAustralia
| | - Sharon L. Naismith
- Brain and Mind CentreThe University of SydneySydneyNew South WalesAustralia
- Faculty of Science, School of PsychologyThe University of SydneySydneyNew South WalesAustralia
- Charles Perkins CenterThe University of SydneySydneyNew South WalesAustralia
| | - Steven Meikle
- Brain and Mind CentreThe University of SydneySydneyNew South WalesAustralia
- Sydney ImagingThe University of SydneySydneyNew South WalesAustralia
- School of Health SciencesThe University of SydneySydneyNew South WalesAustralia
| | - Fernando Calamante
- School of Biomedical EngineeringThe University of SydneySydneyNew South WalesAustralia
- Brain and Mind CentreThe University of SydneySydneyNew South WalesAustralia
- Sydney ImagingThe University of SydneySydneyNew South WalesAustralia
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Lu W, Duan Y, Li K, Cheng Z, Qiu J. Metabolic interactions between organs in overweight and obesity using total-body positron emission tomography. Int J Obes (Lond) 2024; 48:94-102. [PMID: 37816863 DOI: 10.1038/s41366-023-01394-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 09/15/2023] [Accepted: 09/28/2023] [Indexed: 10/12/2023]
Abstract
BACKGROUND AND OBJECTIVES Overweight and obesity is a complex condition resulting from unbalanced energy homeostasis among various organs. However, systemic abnormalities in overweight and obese people are seldom explored in vivo by metabolic imaging techniques. The aim of this study was to determine metabolic abnormities throughout the body in overweight and obese adults using total-body positron emission tomography (PET) glucose uptake imaging. METHODS Thirty normal weight subjects [body mass index (BMI) < 25 kg/m2, 55.47 ± 13.94 years, 16 men and 14 women], and 26 overweight and obese subjects [BMI ≥ 25 kg/m2, 52.38 ± 9.52 years, 21 men and 5 women] received whole-body 18F-fluorodeoxyglucose PET imaging using the uEXPLORER. Whole-body standardized uptake value normalized by lean body mass (SUL) images were calculated. Metabolic networks were constructed based on the whole-body SUL images using covariance network approach. Both group-level and individual-level network differences between normal weight and overweight/obese subjects were evaluated. Correlation analysis was conducted between network properties and BMI for the overweight/obese subjects. RESULTS Compared with normal weight subjects, overweight/obese subjects exhibited altered network connectivity strength in four network nodes, namely the pancreas (p = 0.033), spleen (p = 0.021), visceral adipose tissue (VAT) (p = 1.12 × 10-5) and bone (p = 0.021). Network deviations of overweight/obese subjects from the normal weight were positively correlated with BMI (r = 0.718, p = 3.64 × 10-5). In addition, overweight/obese subjects experienced altered connections between organs, and some of the altered connections, including pancreas-right lung and VAT-bilateral lung connections were significantly correlated with BMI. CONCLUSION Overweight/obese individuals exhibit metabolic alterations in organ level, and altered metabolic interactions at the systemic level. The proposed approach using total-body PET imaging can reveal individual metabolic variability and metabolic deviations between organs, which would open up a new path for understanding metabolic alterations in overweight and obesity.
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Affiliation(s)
- Weizhao Lu
- School of Radiology, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, 271016, China
| | - Yanhua Duan
- Department of PET-CT, the First Affiliated Hospital of Shandong First Medical University, Shandong Provincial Qianfoshan Hospital Affiliated to Shandong University, Jinan, 250014, China
| | - Kun Li
- Department of PET-CT, the First Affiliated Hospital of Shandong First Medical University, Shandong Provincial Qianfoshan Hospital Affiliated to Shandong University, Jinan, 250014, China
| | - Zhaoping Cheng
- Department of PET-CT, the First Affiliated Hospital of Shandong First Medical University, Shandong Provincial Qianfoshan Hospital Affiliated to Shandong University, Jinan, 250014, China.
| | - Jianfeng Qiu
- School of Radiology, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, 271016, China.
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6
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Ding J, Shen C, Wang Z, Yang Y, El Fakhri G, Lu J, Liang D, Zheng H, Zhou Y, Sun T. Tau-PET abnormality as a biomarker for Alzheimer's disease staging and early detection: a topological perspective. Cereb Cortex 2023; 33:10649-10659. [PMID: 37653600 DOI: 10.1093/cercor/bhad312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 08/10/2023] [Accepted: 08/10/2023] [Indexed: 09/02/2023] Open
Abstract
Alzheimer's disease can be detected early through biomarkers such as tau positron emission tomography (PET) imaging, which shows abnormal protein accumulations in the brain. The standardized uptake value ratio (SUVR) is often used to quantify tau-PET imaging, but topological information from multiple brain regions is also linked to tau pathology. Here a new method was developed to investigate the correlations between brain regions using subject-level tau networks. Participants with cognitive normal (74), early mild cognitive impairment (35), late mild cognitive impairment (32), and Alzheimer's disease (40) were included. The abnormality network from each scan was constructed to extract topological features, and 7 functional clusters were further analyzed for connectivity strengths. Results showed that the proposed method performed better than conventional SUVR measures for disease staging and prodromal sign detection. For example, when to differ healthy subjects with and without amyloid deposition, topological biomarker is significant with P < 0.01, SUVR is not with P > 0.05. Functionally significant clusters, i.e. medial temporal lobe, default mode network, and visual-related regions, were identified as critical hubs vulnerable to early disease conversion before mild cognitive impairment. These findings were replicated in an independent data cohort, demonstrating the potential to monitor the early sign and progression of Alzheimer's disease from a topological perspective for individual.
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Affiliation(s)
- Jie Ding
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 100864, People's Republic of China
| | - Chushu Shen
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 100864, People's Republic of China
| | - Zhenguo Wang
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 100864, People's Republic of China
| | - Yongfeng Yang
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 100864, People's Republic of China
| | - Georges El Fakhri
- Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, United States
| | - Jie Lu
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing 100053, People's Republic of China
| | - Dong Liang
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 100864, People's Republic of China
| | - Hairong Zheng
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 100864, People's Republic of China
| | - Yun Zhou
- Central Research Institute, United Imaging Healthcare Group Co., Ltd, Shanghai 201807, People's Republic of China
- School of Biomedical Engineering, Shanghai Tech University, Shanghai 201210, People's Republic of China
| | - Tao Sun
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 100864, People's Republic of China
- United Imaging Research Institute of Innovative Medical Equipment, Shenzhen 518055, People's Republic of China
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Cherry SR, Diekmann J, Bengel FM. Total-Body Positron Emission Tomography: Adding New Perspectives to Cardiovascular Research. JACC Cardiovasc Imaging 2023; 16:1335-1347. [PMID: 37676207 DOI: 10.1016/j.jcmg.2023.06.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 06/26/2023] [Accepted: 06/27/2023] [Indexed: 09/08/2023]
Abstract
The recent advent of positron emission tomography (PET) scanners that can image the entire human body opens up intriguing possibilities for cardiovascular research and future clinical applications. These new systems permit radiotracer kinetics to be measured in all organs simultaneously. They are particularly well suited to study cardiovascular disease and its effects on the entire body. They could also play a role in quantitatively measuring physiologic, metabolic, and immunologic responses in healthy individuals to a variety of stressors and lifestyle interventions, and may ultimately be instrumental for evaluating novel therapeutic agents and their molecular effects across different tissues. In this review, we summarize recent progress in PET technology and methodology, discuss several emerging cardiovascular applications for total-body PET, and place this in the context of multiorgan and systems medicine. Finally, we discuss opportunities that will be enabled by the technology, while also pointing to some of the challenges that still need to be addressed.
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Affiliation(s)
- Simon R Cherry
- Departments of Biomedical Engineering and Radiology, University of California, Davis, California, USA.
| | - Johanna Diekmann
- Departments of Biomedical Engineering and Radiology, University of California, Davis, California, USA; Department of Nuclear Medicine, Hannover Medical School, Hannover, Germany
| | - Frank M Bengel
- Department of Nuclear Medicine, Hannover Medical School, Hannover, Germany
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Alberts I, Sari H, Mingels C, Afshar-Oromieh A, Pyka T, Shi K, Rominger A. Long-axial field-of-view PET/CT: perspectives and review of a revolutionary development in nuclear medicine based on clinical experience in over 7000 patients. Cancer Imaging 2023; 23:28. [PMID: 36934273 PMCID: PMC10024603 DOI: 10.1186/s40644-023-00540-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 02/25/2023] [Indexed: 03/20/2023] Open
Abstract
Recently introduced long-axial field-of-view (LAFOV) PET/CT systems represent one of the most significant advancements in nuclear medicine since the advent of multi-modality PET/CT imaging. The higher sensitivity exhibited by such systems allow for reductions in applied activity and short duration scans. However, we consider this to be just one small part of the story: Instead, the ability to image the body in its entirety in a single FOV affords insights which standard FOV systems cannot provide. For example, we now have the ability to capture a wider dynamic range of a tracer by imaging it over multiple half-lives without detrimental image noise, to leverage lower radiopharmaceutical doses by using dual-tracer techniques and with improved quantification. The potential for quantitative dynamic whole-body imaging using abbreviated protocols potentially makes these techniques viable for routine clinical use, transforming PET-reporting from a subjective analysis of semi-quantitative maps of radiopharmaceutical uptake at a single time-point to an accurate and quantitative, non-invasive tool to determine human function and physiology and to explore organ interactions and to perform whole-body systems analysis. This article will share the insights obtained from 2 years' of clinical operation of the first Biograph Vision Quadra (Siemens Healthineers) LAFOV system. It will also survey the current state-of-the-art in PET technology. Several technologies are poised to furnish systems with even greater sensitivity and resolution than current systems, potentially with orders of magnitude higher sensitivity. Current barriers which remain to be surmounted, such as data pipelines, patient throughput and the hindrances to implementing kinetic analysis for routine patient care will also be discussed.
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Affiliation(s)
- Ian Alberts
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstr. 18, 3010, Bern, Switzerland
| | - Hasan Sari
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstr. 18, 3010, Bern, Switzerland
- Advanced Clinical Imaging Technology, Siemens Healthcare AG, Lausanne, Switzerland
| | - Clemens Mingels
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstr. 18, 3010, Bern, Switzerland
| | - Ali Afshar-Oromieh
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstr. 18, 3010, Bern, Switzerland
| | - Thomas Pyka
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstr. 18, 3010, Bern, Switzerland
| | - Kuangyu Shi
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstr. 18, 3010, Bern, Switzerland
| | - Axel Rominger
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstr. 18, 3010, Bern, Switzerland.
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Reed MB, Ponce de León M, Vraka C, Rausch I, Godbersen GM, Popper V, Geist BK, Komorowski A, Nics L, Schmidt C, Klug S, Langsteger W, Karanikas G, Traub-Weidinger T, Hahn A, Lanzenberger R, Hacker M. Whole-body metabolic connectivity framework with functional PET. Neuroimage 2023; 271:120030. [PMID: 36925087 DOI: 10.1016/j.neuroimage.2023.120030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 02/22/2023] [Accepted: 03/13/2023] [Indexed: 03/15/2023] Open
Abstract
The nervous and circulatory system interconnects the various organs of the human body, building hierarchically organized subsystems, enabling fine-tuned, metabolically expensive brain-body and inter-organ crosstalk to appropriately adapt to internal and external demands. A deviation or failure in the function of a single organ or subsystem could trigger unforeseen biases or dysfunctions of the entire network, leading to maladaptive physiological or psychological responses. Therefore, quantifying these networks in healthy individuals and patients may help further our understanding of complex disorders involving body-brain crosstalk. Here we present a generalized framework to automatically estimate metabolic inter-organ connectivity utilizing whole-body functional positron emission tomography (fPET). The developed framework was applied to 16 healthy subjects (mean age ± SD, 25 ± 6 years; 13 female) that underwent one dynamic 18F-FDG PET/CT scan. Multiple procedures of organ segmentation (manual, automatic, circular volumes) and connectivity estimation (polynomial fitting, spatiotemporal filtering, covariance matrices) were compared to provide an optimized thorough overview of the workflow. The proposed approach was able to estimate the metabolic connectivity patterns within brain regions and organs as well as their interactions. Automated organ delineation, but not simplified circular volumes, showed high agreement with manual delineation. Polynomial fitting yielded similar connectivity as spatiotemporal filtering at the individual subject level. Furthermore, connectivity measures and group-level covariance matrices did not match. The strongest brain-body connectivity was observed for the liver and kidneys. The proposed framework offers novel opportunities towards analyzing metabolic function from a systemic, hierarchical perspective in a multitude of physiological pathological states.
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Affiliation(s)
- Murray Bruce Reed
- Department of Psychiatry and Psychotherapy, Comprehensive Center for Clinical Neurosciences and Mental Health (C3NMH), Medical University of Vienna, Austria
| | - Magdalena Ponce de León
- Department of Psychiatry and Psychotherapy, Comprehensive Center for Clinical Neurosciences and Mental Health (C3NMH), Medical University of Vienna, Austria
| | - Chrysoula Vraka
- Division of Nuclear Medicine, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Austria
| | - Ivo Rausch
- QIMP Team, Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Godber Mathis Godbersen
- Department of Psychiatry and Psychotherapy, Comprehensive Center for Clinical Neurosciences and Mental Health (C3NMH), Medical University of Vienna, Austria
| | - Valentin Popper
- Department of Psychiatry and Psychotherapy, Comprehensive Center for Clinical Neurosciences and Mental Health (C3NMH), Medical University of Vienna, Austria
| | - Barbara Katharina Geist
- Division of Nuclear Medicine, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Austria
| | - Arkadiusz Komorowski
- Department of Psychiatry and Psychotherapy, Comprehensive Center for Clinical Neurosciences and Mental Health (C3NMH), Medical University of Vienna, Austria
| | - Lukas Nics
- Division of Nuclear Medicine, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Austria
| | - Clemens Schmidt
- Department of Psychiatry and Psychotherapy, Comprehensive Center for Clinical Neurosciences and Mental Health (C3NMH), Medical University of Vienna, Austria
| | - Sebastian Klug
- Department of Psychiatry and Psychotherapy, Comprehensive Center for Clinical Neurosciences and Mental Health (C3NMH), Medical University of Vienna, Austria
| | - Werner Langsteger
- Division of Nuclear Medicine, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Austria
| | - Georgios Karanikas
- Division of Nuclear Medicine, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Austria
| | - Tatjana Traub-Weidinger
- Division of Nuclear Medicine, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Austria
| | - Andreas Hahn
- Department of Psychiatry and Psychotherapy, Comprehensive Center for Clinical Neurosciences and Mental Health (C3NMH), Medical University of Vienna, Austria
| | - Rupert Lanzenberger
- Department of Psychiatry and Psychotherapy, Comprehensive Center for Clinical Neurosciences and Mental Health (C3NMH), Medical University of Vienna, Austria.
| | - Marcus Hacker
- Division of Nuclear Medicine, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Austria
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Sundar LKS, Hacker M, Beyer T. Whole-Body PET Imaging: A Catalyst for Whole-Person Research? J Nucl Med 2023; 64:197-199. [PMID: 36460342 PMCID: PMC9902855 DOI: 10.2967/jnumed.122.264555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 11/17/2022] [Accepted: 11/17/2022] [Indexed: 12/03/2022] Open
Affiliation(s)
| | - Marcus Hacker
- Division of Nuclear Medicine, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Thomas Beyer
- Quantitative Imaging and Medical Physics Team, Medical University of Vienna, Vienna, Austria; and
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Sun T, Wu Y, Wei W, Fu F, Meng N, Chen H, Li X, Bai Y, Wang Z, Ding J, Hu D, Chen C, Hu Z, Liang D, Liu X, Zheng H, Yang Y, Zhou Y, Wang M. Motion correction and its impact on quantification in dynamic total-body 18F-fluorodeoxyglucose PET. EJNMMI Phys 2022; 9:62. [PMID: 36104468 PMCID: PMC9474756 DOI: 10.1186/s40658-022-00493-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 09/01/2022] [Indexed: 12/17/2022] Open
Abstract
Background The total-body positron emission tomography (PET) scanner provides an unprecedented opportunity to scan the whole body simultaneously, thanks to its long axial field of view and ultrahigh temporal resolution. To fully utilize this potential in clinical settings, a dynamic scan would be necessary to obtain the desired kinetic information from scan data. However, in a long dynamic acquisition, patient movement can degrade image quality and quantification accuracy. Methods In this work, we demonstrated a motion correction framework and its importance in dynamic total-body FDG PET imaging. Dynamic FDG scans from 12 subjects acquired on a uEXPLORER PET/CT were included. In these subjects, 7 are healthy subjects and 5 are those with tumors in the thorax and abdomen. All scans were contaminated by motion to some degree, and for each the list-mode data were reconstructed into 1-min frames. The dynamic frames were aligned to a reference position by sequentially registering each frame to its previous neighboring frame. We parametrized the motion fields in-between frames as diffeomorphism, which can map the shape change of the object smoothly and continuously in time and space. Diffeomorphic representations of motion fields were derived by registering neighboring frames using large deformation diffeomorphic metric matching. When all pairwise registrations were completed, the motion field at each frame was obtained by concatenating the successive motion fields and transforming that frame into the reference position. The proposed correction method was labeled SyN-seq. The method that was performed similarly, but aligned each frame to a designated middle frame, was labeled as SyN-mid. Instead of SyN, the method that performed the sequential affine registration was labeled as Aff-seq. The original uncorrected images were labeled as NMC. Qualitative and quantitative analyses were performed to compare the performance of the proposed method with that of other correction methods and uncorrected images. Results The results indicated that visual improvement was achieved after correction of the SUV images for the motion present period, especially in the brain and abdomen. For subjects with tumors, the average improvement in tumor SUVmean was 5.35 ± 4.92% (P = 0.047), with a maximum improvement of 12.89%. An overall quality improvement in quantitative Ki images was also observed after correction; however, such improvement was less obvious in K1 images. Sampled time–activity curves in the cerebral and kidney cortex were less affected by the motion after applying the proposed correction. Mutual information and dice coefficient relative to the reference also demonstrated that SyN-seq improved the alignment between frames over non-corrected images (P = 0.003 and P = 0.011). Moreover, the proposed correction successfully reduced the inter-subject variability in Ki quantifications (11.8% lower in sampled organs). Subjective assessment by experienced radiologists demonstrated consistent results for both SUV images and Ki images. Conclusion To conclude, motion correction is important for image quality in dynamic total-body PET imaging. We demonstrated a correction framework that can effectively reduce the effect of random body movements on dynamic images and their associated quantification. The proposed correction framework can potentially benefit applications that require total-body assessment, such as imaging the brain-gut axis and systemic diseases.
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Kirienko M, Biroli M, Pini C, Gelardi F, Sollini M, Chiti A. COVID-19 vaccination, implications for PET/CT image interpretation and future perspectives. Clin Transl Imaging 2022; 10:631-642. [PMID: 35992042 PMCID: PMC9379874 DOI: 10.1007/s40336-022-00521-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 07/28/2022] [Indexed: 11/25/2022]
Abstract
Introduction The present paper aims to systematically review the literature on COVID-19 vaccine-related findings in patients undergoing PET/CT. Methods The search algorithms included the following combination of terms: “PET” OR “positron emission tomography” AND “COVID”; “PET” OR “positron emission tomography” AND “COVID” AND “vaccination”; “PET” OR “positron emission tomography” AND “COVID”, AND “autoimmune”. Results We selected 17 articles which were assessed for quality and included in the systematic analysis. The most frequent vaccine-related signs on PET/CT were the deltoid [18F]FDG uptake and axillary hypermetabolic lymph nodes, which were described in 8–71% and 7–90% of the patients, respectively. Similarly, frequency of these findings using other tracers than [18F]FDG was greatly variable. This large variability was related to the variability in time elapsed between vaccination and PET/CT, and the criteria used to define positivity. In addition, vaccine-related findings were detected more frequently in young and immunocompetent patients than in elderly and immunocompromised ones. Discussion Therefore, awareness on vaccination status (timing, patient characteristics, and concurrent therapies) and knowledge on patterns of radiopharmaceutical uptake are necessary to properly interpret PET/CT findings.
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Affiliation(s)
- Margarita Kirienko
- Fondazione IRCCS Istituto Nazionale Tumori, Via G. Venezian 1, 20133 Milan, Italy
| | - Matteo Biroli
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy
| | - Cristiano Pini
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy
- IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy
| | - Fabrizia Gelardi
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy
- IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy
| | - Martina Sollini
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy
- IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy
| | - Arturo Chiti
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy
- IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy
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Lan X, Huo L, Li S, Wang J, Cai W. State-of-the-art of nuclear medicine and molecular imaging in China: after the first 66 years (1956-2022). Eur J Nucl Med Mol Imaging 2022; 49:2455-2461. [PMID: 35665836 PMCID: PMC9167647 DOI: 10.1007/s00259-022-05856-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Xiaoli Lan
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Key Laboratory of Molecular Imaging, Wuhan, China
| | - Li Huo
- Department of Nuclear Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College Hospital, Beijing, China
- Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College Hospital, Beijing, China
| | - Shuren Li
- Division of Nuclear Medicine, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Jing Wang
- Department of Nuclear Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, China.
| | - Weibo Cai
- Departments of Radiology and Medical Physics, University of Wisconsin Madison, Madison, WI, USA.
- University of Wisconsin Carbone Cancer Center, Madison, WI, USA.
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