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Dickson JC, Armstrong IS, Gabiña PM, Denis-Bacelar AM, Krizsan AK, Gear JM, Van den Wyngaert T, de Geus-Oei LF, Herrmann K. EANM practice guideline for quantitative SPECT-CT. Eur J Nucl Med Mol Imaging 2023; 50:980-995. [PMID: 36469107 PMCID: PMC9931838 DOI: 10.1007/s00259-022-06028-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 10/30/2022] [Indexed: 12/12/2022]
Abstract
PURPOSE Quantitative SPECT-CT is a modality of growing importance with initial developments in post radionuclide therapy dosimetry, and more recent expansion into bone, cardiac and brain imaging together with the concept of theranostics more generally. The aim of this document is to provide guidelines for nuclear medicine departments setting up and developing their quantitative SPECT-CT service with guidance on protocols, harmonisation and clinical use cases. METHODS These practice guidelines were written by members of the European Association of Nuclear Medicine Physics, Dosimetry, Oncology and Bone committees representing the current major stakeholders in Quantitative SPECT-CT. The guidelines have also been reviewed and approved by all EANM committees and have been endorsed by the European Association of Nuclear Medicine. CONCLUSION The present practice guidelines will help practitioners, scientists and researchers perform high-quality quantitative SPECT-CT and will provide a framework for the continuing development of quantitative SPECT-CT as an established modality.
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Affiliation(s)
- John C Dickson
- Institute of Nuclear Medicine, University College London Hospitals Foundation Trust, London, UK
| | - Ian S Armstrong
- Nuclear Medicine, Manchester University NHS Foundation Trust, Manchester, UK
| | - Pablo Minguez Gabiña
- Department of Medical Physics and Radiation Protection, Gurutzeta-Cruces University Hospital/Biocruces Health Research Institute, Barakaldo, Spain
- Department of Applied Physics, Faculty of Engineering, UPV/EHU, Bilbao, Spain
| | | | | | - Jonathan M Gear
- Joint Department of Physics Institute of Cancer Research and Royal Marsden, NHS Foundation Trust, Sutton, Surrey, UK
| | - Tim Van den Wyngaert
- Department of Nuclear Medicine, Antwerp University Hospital, Edegem, Belgium
- Faculty of Medicine and Health Sciences (MICA - IPPON), , University of Antwerp, Wilrijk, Belgium
| | - Lioe-Fee de Geus-Oei
- Department of Radiology, Section of Nuclear Medicine, Leiden University Medical Center, Leiden, The Netherlands
- Biomedical Photonic Imaging Group, University of Twente, Enschede, The Netherlands
| | - Ken Herrmann
- Department of Nuclear Medicine, University of Duisburg-Essen, and German Cancer Consortium (DKTK)-University Hospital Essen, Essen, Germany.
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Zhou B, Chen X, Xie H, Zhou SK, Duncan JS, Liu C. DuDoUFNet: Dual-Domain Under-to-Fully-Complete Progressive Restoration Network for Simultaneous Metal Artifact Reduction and Low-Dose CT Reconstruction. IEEE TRANSACTIONS ON MEDICAL IMAGING 2022; 41:3587-3599. [PMID: 35816532 PMCID: PMC9812027 DOI: 10.1109/tmi.2022.3189759] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
To reduce the potential risk of radiation to the patient, low-dose computed tomography (LDCT) has been widely adopted in clinical practice for reconstructing cross-sectional images using sinograms with reduced x-ray flux. The LDCT image quality is often degraded by different levels of noise depending on the low-dose protocols. The image quality will be further degraded when the patient has metallic implants, where the image suffers from additional streak artifacts along with further amplified noise levels, thus affecting the medical diagnosis and other CT-related applications. Previous studies mainly focused either on denoising LDCT without considering metallic implants or full-dose CT metal artifact reduction (MAR). Directly applying previous LDCT or MAR approaches to the issue of simultaneous metal artifact reduction and low-dose CT (MARLD) may yield sub-optimal reconstruction results. In this work, we develop a dual-domain under-to-fully-complete progressive restoration network, called DuDoUFNet, for MARLD. Our DuDoUFNet aims to reconstruct images with substantially reduced noise and artifact by progressive sinogram to image domain restoration with a two-stage progressive restoration network design. Our experimental results demonstrate that our method can provide high-quality reconstruction, superior to previous LDCT and MAR methods under various low-dose and metal settings.
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Bahouth SM, Yeboa DN, Ghia AJ, Tatsui CE, Alvarez-Breckenridge CA, Beckham TH, Bishio AJ, Li J, McAleer MF, North RY, Rhines LD, Swanson TA, Chenyang W, Amini B. Multidisciplinary management of spinal metastases: what the radiologist needs to know. Br J Radiol 2022; 95:20220266. [PMID: 35856792 PMCID: PMC9815745 DOI: 10.1259/bjr.20220266] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 06/17/2022] [Accepted: 07/11/2022] [Indexed: 01/13/2023] Open
Abstract
The modern management of spinal metastases requires a multidisciplinary approach that includes radiation oncologists, surgeons, medical oncologists, and diagnostic and interventional radiologists. The diagnostic radiologist can play an important role in the multidisciplinary team and help guide assessment of disease and selection of appropriate therapy. The assessment of spine metastases is best performed on MRI, but imaging from other modalities is often needed. We provide a review of the clinical and imaging features that are needed by the multidisciplinary team caring for patients with spine metastases and stress the importance of the spine radiologist taking responsibility for synthesizing imaging features across multiple modalities to provide a report that advances patient care.
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Affiliation(s)
- Sarah M Bahouth
- Musculoskeletal Imaging and Intervention Department, Brigham and Women’s Hospital, Boston MA, USA
| | - Debra N Yeboa
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Amol J Ghia
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Claudio E Tatsui
- Department of Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - Thomas H Beckham
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Andrew J Bishio
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jing Li
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Mary Frances McAleer
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Robert Y North
- Department of Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Laurence D Rhines
- Department of Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Todd A Swanson
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Wang Chenyang
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Behrang Amini
- Department of Musculoskeletal Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Kugler A, Kuwert T, Ritt P, Grings A. Influence of CT metal artifact reduction on SPECT/CT quantification of bone scintigraphy - Retrospective study for selected types of metal implants. Nuklearmedizin 2022; 61:449-457. [PMID: 35944578 DOI: 10.1055/a-1883-9281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
AIM Implanted metal prostheses can cause severe artifacts in reconstructed computed tomography (CT) images. To reduce the diagnostic impact of these artifacts and improve attenuation correction in single photon emission computed tomography (SPECT), an algorithm of iterative metal artifact reduction (iMAR) for SPECT/CT systems was developed. The aims of this study were (a) to assess the difference in visual image quality by comparing CT and SPECT images reconstructed with and without iMAR and (b) to determine the influence of iMAR on quantitative 99mTc-uptake in SPECT/CT. METHODS This retrospective study includes 21 patients with implanted metal prostheses who underwent SPECT/CT bone scintigraphy. CT data were reconstructed with iMAR and without (noMAR) and were used for attenuation correction of SPECT data for xSPECT Quant and xSPECT Bone reconstruction. The effect of iMAR on image quality was evaluated by visual analysis and the effect on quantitative SPECT/CT was assessed by measuring HU values and absolute uptake values (kBq/mL) in volumes of interest (VOIs). RESULTS There was a significant reduction of visible metal artifacts with iMAR (p<0.01) in the CT images, but visual differences in the SPECT images were minor. The values of quantitative tracer uptake in VOIs near metal implants were lower for iMAR vs. noMAR xSPECT Quant (p<0.01). Only VOIs near metal showed significant differences in HU values, which were 14.6% lower for iMAR CT (p<0.01). CONCLUSION The use of iMAR reduces metal artifacts in CT and improves the perceived image quality. Although in some cases a significant difference in the quantitative evaluation of SPECT/CT was observed, the influence of iMAR can be considered small in relation to other factors in the clinical setting.
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Affiliation(s)
- Amelie Kugler
- Erlangen University Hospital Department of Nuclear Medicine, Erlangen, Germany
| | - Torsten Kuwert
- Erlangen University Hospital Department of Nuclear Medicine, Erlangen, Germany
| | - Philipp Ritt
- Erlangen University Hospital Department of Nuclear Medicine, Erlangen, Germany
| | - Andreas Grings
- Erlangen University Hospital Department of Nuclear Medicine, Erlangen, Germany
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He J, Dong G, Deng Y, He J, Xiu Z, Feng F. Comparison of Application Value of Different Radiation Dose Evaluation Methods in Evaluating Radiation Dose of Adult Thoracic and Abdominal CT Scan. Front Surg 2022; 9:860968. [PMID: 35402481 PMCID: PMC8990916 DOI: 10.3389/fsurg.2022.860968] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 02/22/2022] [Indexed: 11/13/2022] Open
Abstract
Objective To explore the differences among volumetric CT dose index (CTDIvol), body-specific dose assessment (SSDEED) based on effective diameter (ED), and SSDEWED based on water equivalent diameter (WED) in evaluating the radiation dose of adult thoracic and abdominal CT scanning. Methods From January 2021 to October 2021, enhanced chest CT scans of 100 patients and enhanced abdomen CT scans of another 100 patients were collected. According to the body mass index (BMI), they can be divided into groups A and D (BMI < 20 kg/m2), groups B and E (20 kg/m2 ≤ BMI ≤ 24.9 kg/m2), and groups C and F (BMI > 24.9 kg/m2). The CTDIvol, anteroposterior diameter (AP), and the left and rght diameter (LAT) of all the patients were recorded, and the ED, water equivalent diameter (WED), the conversion factor (f size,ED), (f size, WED), SSDEED, and SSDEWED were calculated. The differences were compared between the different groups. Results The AP, LAT, ED, and WED of groups B, E, C, and F were higher than those of groups A and D, and those of groups C and F were higher than those of groups B and E (P < 0.05). The f size,ED and f size, WED of groups B, E, C, and F are lower than those of groups A and D, and those of groups C and F are lower than those of groups B and E (P < 0.05). CTDIvol, SSDEED, and SSDEWED in groups B, E, C, and F are higher than those in groups A and D, and those in groups C and F are higher than those in groups B and E (p < 0.05). In the same group, patients with chest- and abdomen-enhanced have higher SSDEWED and SSDEED than CTDIvol, patients with chest-enhanced CT scans have higher SSDEWED than SSDEED, and patients with abdomen-enhanced CT scans have higher SSDEED than SSDEWED (P < 0.05). Conclusion CTDIvol and ED-based SSDEED underestimated the radiation dose of the subject exposed, where the patient was actually exposed to a greater dose. However, SSDEWED based on WED considers better the difference in patient size and attenuation characteristics, and can more accurately evaluate the radiation dose received by patients of different sizes during the chest and abdomen CT scan.
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Affiliation(s)
- Jimin He
- Department of Radiology, The First People's Hospital of Longquanyi District, Chengdu, China
| | - Guanwei Dong
- Department of Radiology, The First People's Hospital of Longquanyi District, Chengdu, China
| | - Yi Deng
- Department of Rehabilitation, The First People's Hospital of Longquanyi District, Chengdu, China
| | - Jun He
- Department of Radiology, The First People's Hospital of Longquanyi District, Chengdu, China
| | - ZhiGang Xiu
- Department of Radiology, The First People's Hospital of Longquanyi District, Chengdu, China
| | - Fanzi Feng
- Department of Radiology, The First People's Hospital of Longquanyi District, Chengdu, China
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Konishi T. [[SPECT] 4. Introductions of SPECT Reconstruction Algorithm Using the Conjugated Gradient Method and Metal Artifact Reduction Technologies in the Latest SPECT System]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2022; 78:895-901. [PMID: 35989260 DOI: 10.6009/jjrt.2022-2075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
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Zhou B, Chen X, Zhou SK, Duncan JS, Liu C. DuDoDR-Net: Dual-domain data consistent recurrent network for simultaneous sparse view and metal artifact reduction in computed tomography. Med Image Anal 2022; 75:102289. [PMID: 34758443 PMCID: PMC8678361 DOI: 10.1016/j.media.2021.102289] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 09/03/2021] [Accepted: 10/20/2021] [Indexed: 01/03/2023]
Abstract
Sparse-view computed tomography (SVCT) aims to reconstruct a cross-sectional image using a reduced number of x-ray projections. While SVCT can efficiently reduce the radiation dose, the reconstruction suffers from severe streak artifacts, and the artifacts are further amplified with the presence of metallic implants, which could adversely impact the medical diagnosis and other downstream applications. Previous methods have extensively explored either SVCT reconstruction without metallic implants, or full-view CT metal artifact reduction (MAR). The issue of simultaneous sparse-view and metal artifact reduction (SVMAR) remains under-explored, and it is infeasible to directly apply previous SVCT and MAR methods to SVMAR which may yield non-ideal reconstruction quality. In this work, we propose a dual-domain data consistent recurrent network, called DuDoDR-Net, for SVMAR. Our DuDoDR-Net aims to reconstruct an artifact-free image by recurrent image domain and sinogram domain restorations. To ensure the metal-free part of acquired projection data is preserved, we also develop the image data consistent layer (iDCL) and sinogram data consistent layer (sDCL) that are interleaved in our recurrent framework. Our experimental results demonstrate that our DuDoDR-Net is able to produce superior artifact-reduced results while preserving the anatomical structures, that outperforming previous SVCT and SVMAR methods, under different sparse-view acquisition settings.
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Affiliation(s)
- Bo Zhou
- Department of Biomedical Engineering, Yale University, New Haven, CT, USA.
| | - Xiongchao Chen
- Department of Biomedical Engineering, Yale University, New Haven, CT, USA
| | - S Kevin Zhou
- School of Biomedical Engineering & Suzhou Institute for Advanced Research, University of Science and Technology of China, Suzhou, China; Institute of Computing Technology, Chinese Academy of Sciences, Beijing, China
| | - James S Duncan
- Department of Biomedical Engineering, Yale University, New Haven, CT, USA; Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA; Department of Electrical Engineering, Yale University, New Haven, CT, USA
| | - Chi Liu
- Department of Biomedical Engineering, Yale University, New Haven, CT, USA; Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA.
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Braun M, Cachovan M, Kaul F, Caobelli F, Bäumer M, Hans Vija A, Pagenstert G, Wild D, Kretzschmar M. Accuracy comparison of various quantitative [ 99mTc]Tc-DPD SPECT/CT reconstruction techniques in patients with symptomatic hip and knee joint prostheses. EJNMMI Res 2021; 11:60. [PMID: 34128128 PMCID: PMC8203767 DOI: 10.1186/s13550-021-00794-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 05/25/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is a need for better diagnostic tools that identify loose total hip and knee arthroplasties. Here, we present the accuracy of different 99mTc-dicarboxypropandiphosphate ([99mTc]Tc-DPD) SPECT/CT quantification tools for the detection of loose prostheses in patients with painful hip and knee arthroplasties. METHODS Quantitative reconstruction of mineral phase SPECT data was performed using Siemens xSPECT-Quant and xSPECT-Bone, with and without metal artefact reduction (iMAR) of CT-data. Quantitative data (SUVmax values) were compared to intraoperative diagnosis or clinical outcome after at least 1 year as standard of comparison. Cut-off values and accuracies were calculated using receiver operator characteristics. Accuracy of uptake quantification was compared to the accuracy of visual SPECT/CT readings, blinded for the quantitative data and clinical outcome. RESULTS In this prospective study, 30 consecutive patients with 33 symptomatic hip and knee prostheses underwent [99mTc]Tc-DPD SPECT/CT. Ten arthroplasties were diagnosed loose and 23 stable. Mean-SUVmax was significantly higher around loose prostheses compared to stable prostheses, regardless of the quantification method (P = 0.0025-0.0001). Quantification with xSPECT-Bone-iMAR showed the highest accuracy (93.9% [95% CI 79.6-100%]) which was significantly higher compared to xSPECT-Quant-iMAR (81.8% [67.5-96.1%], P = 0.04) and xSPECT-Quant without iMAR (77.4% [62.4-92.4%], P = 0.02). Accuracies of clinical reading were non-significantly lower compared to quantitative measures (84.8% [70.6-99.1%] (senior) and 81.5% [67.5-96.1%] (trainee)). CONCLUSION Quantification with [99mTc]Tc-DPD xSPECT-Bone-iMAR discriminates best between loose and stable prostheses of all evaluated methods. The overall high accuracy of different quantitative measures underlines the potential of [99mTc]Tc-DPD-quantification as a biomarker and demands further prospective evaluation in a larger number of prosthesis.
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Affiliation(s)
- Martin Braun
- Division of Nuclear Medicine, University Hospital Basel, Basel, Switzerland
| | - Michal Cachovan
- Siemens Healthcare GmbH, Molecular Imaging, Forchheim, Germany
| | - Felix Kaul
- Division of Nuclear Medicine, University Hospital Basel, Basel, Switzerland
| | - Federico Caobelli
- Division of Nuclear Medicine, University Hospital Basel, Basel, Switzerland
| | - Markus Bäumer
- Division of Nuclear Medicine, University Hospital Basel, Basel, Switzerland
| | - A. Hans Vija
- Siemens Medical Solutions USA, Inc., Molecular Imaging, Hoffman Estates, USA
| | - Geert Pagenstert
- Department of Orthopedic Surgery, University Hospital Basel, Basel, Switzerland
| | - Damian Wild
- Division of Nuclear Medicine, University Hospital Basel, Basel, Switzerland
| | - Martin Kretzschmar
- Division of Nuclear Medicine, University Hospital Basel, Basel, Switzerland
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