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Metrard G, Cohen C, Bailly M. Comprehensive literature review of oral and intravenous contrast-enhanced PET/CT: a step forward? Front Med (Lausanne) 2024; 11:1373260. [PMID: 38566921 PMCID: PMC10985176 DOI: 10.3389/fmed.2024.1373260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 03/06/2024] [Indexed: 04/04/2024] Open
Abstract
The integration of diagnostic CT scans into PET/CT facilitates a comprehensive single examination, presenting potential advantages for patients seeking a thorough one-shot check-up. The introduction of iodinated contrast media during PET scanning raises theoretical concerns about potential interference with uptake quantification, due to the modification of tissue density on CT. Nevertheless, this impact appears generally insignificant for clinical use, compared to the intrinsic variability of standardized uptake values. On the other hand, with the growing indications of PET, especially 18F-FDG PET, contrast enhancement increases the diagnostic performances of the exam, and provides additional information. This improvement in performance achieved through contrast-enhanced PET/CT must be carefully evaluated considering the associated risks and side-effects stemming from the administration of iodinated contrast media. Within this article, we present a comprehensive literature review of contrast enhanced PET/CT, examining the potential impact of iodinated contrast media on quantification, additional side-effects and the pivotal clinically demonstrated benefits of an all-encompassing examination for patients. In conclusion, the clinical benefits of iodinated contrast media are mainly validated by the large diffusion in PET protocols. Contrary to positive oral contrast, which does not appear to offer any major advantage in patient management, intravenous iodine contrast media provides clinical benefits without significant artifact on images or quantification. However, studies on the benefit-risk balance for patients are still lacking.
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Affiliation(s)
- Gilles Metrard
- Nuclear Medicine Department, Orléans University Hospital, Orléans, France
- Centre de Biophysique Moléculaire, CNRS UPR 4301, Université d’Orléans, Orléans, France
| | - Clara Cohen
- Radiology Department, Orléans University Hospital, Orléans, France
| | - Matthieu Bailly
- Nuclear Medicine Department, Orléans University Hospital, Orléans, France
- Centre de Biophysique Moléculaire, CNRS UPR 4301, Université d’Orléans, Orléans, France
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Kimura M, Kato I, Ishibashi K, Sone Y, Nagao T, Umemura M. Texture Analysis Using Preoperative Positron Emission Tomography Images May Predict the Prognosis of Patients With Resectable Oral Squamous Cell Carcinoma. J Oral Maxillofac Surg 2020; 79:1168-1176. [PMID: 33428864 DOI: 10.1016/j.joms.2020.12.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 11/27/2020] [Accepted: 12/04/2020] [Indexed: 11/17/2022]
Abstract
PURPOSE Texture analysis is a computer-assisted technique used to measure intratumoral heterogeneity, which is known to have important roles in cancer research. This study aimed to assess the potential prognostic values of textural features extracted from preoperative 18F-fluorodeoxyglucose positron emission tomography images in patients with resectable oral squamous cell carcinoma. PATIENTS AND METHODS This retrospective cohort study included patients with oral squamous cell carcinoma who underwent resection surgery. We extracted 31 textural indices from preoperative positron emission tomography images. Overall survival (OS) and disease-free survival (DFS) were chosen as the primary outcome variables, and the primary predictor variables were age, sex, primary tumor location, pathological T and N classification, histologic differentiation, resected margin, perineural and lymphovascular invasion, maximum standardized uptake value, and the 14 textural indices selected in the factor analysis. We analyzed OS and DFS using Kaplan-Meier curves, and the differences between survival curves were determined using a log-rank test. The independent prognostic factors were assessed using the Cox-proportional hazards model. RESULTS We enrolled 81 patients (median age, 67.3 years; range, 32 to 88 years). The median follow-up duration was 50.1 months (range, 6.3 to 133.7 months). The univariable and multivariable analyses revealed that higher entropy values (≥1.91) were associated with worse OS (hazard ratio, 21.49; 95% confidence interval, 1.36 to 340.71; P = .03) and DFS (hazard ratio, 50.69; 95% confidence interval, 5.23 to 491.18; P = .001). CONCLUSIONS This study showed that entropy is a statistically significant prognostic factor of both OS and DFS. Texture analysis using preoperative positron emission tomography images may contribute to risk stratification.
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Affiliation(s)
- Masashi Kimura
- Attending staff, Department of Maxillofacial Surgery, School of Dentistry, Aichi Gakuin University, Nagoya, Japan.
| | - Isao Kato
- Radiologist, Department of Medical Technology, Ogaki Municipal Hospital, Ogaki, Japan
| | - Kenichiro Ishibashi
- Chief surgeon, Department of Oral and Maxillofacial Surgery, Ogaki Municipal Hospital, Ogaki, Japan
| | - Yasuhiro Sone
- Director, Department of Diagnostic Radiology, Ogaki Municipal Hospital, Ogaki, Japan
| | - Toru Nagao
- Professor, Department of Maxillofacial Surgery, School of Dentistry, Aichi Gakuin University, Nagoya, Japan
| | - Masahiro Umemura
- Director, Department of Oral and Maxillofacial Surgery, Ogaki Municipal Hospital, Ogaki, Japan
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Rana N, Singh H, Vatsa R, Watts A, Mittal BR. Correction of Positron Emission Tomography Maximum Intensity Projection Image Artifact Using Retro Reconstruction Method. Indian J Nucl Med 2020; 35:235-237. [PMID: 33082682 PMCID: PMC7537923 DOI: 10.4103/ijnm.ijnm_53_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 04/11/2020] [Accepted: 05/04/2020] [Indexed: 11/04/2022] Open
Abstract
Artifacts in positron emission tomography (PET)/computed tomography imaging can result from a number of factors. Presence of imaging artifacts affects interpretation and can sometimes render the image uninterpretable. Correction of artifacts can be attempted by reprocessing of data. In the present study, one PET maximum intensity projection image artifact was corrected by employing the method of retro-reconstruction.
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Affiliation(s)
- Nivedita Rana
- Department of Nuclear Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Harmandeep Singh
- Department of Nuclear Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Rakhee Vatsa
- Department of Nuclear Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Ankit Watts
- Department of Nuclear Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Bhagwant Rai Mittal
- Department of Nuclear Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Barai S, Ora M, Gambhir S, Singh A. Does Intravenous Contrast Improve the Diagnostic Yield of Fluorodeoxyglucose Positron-emission Tomography/Computed Tomography in Patients with Head-and-neck Malignancy. Indian J Nucl Med 2019; 35:13-16. [PMID: 31949363 PMCID: PMC6958953 DOI: 10.4103/ijnm.ijnm_119_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 07/08/2019] [Accepted: 08/30/2019] [Indexed: 11/04/2022] Open
Abstract
Introduction In the present time, iodinated contrast agents are increasingly being used in the computed tomography (CT) component of positron-emission tomography (PET) study with the assumption that contrast-enhanced CT (CECT) will provide better diagnostic yield, although the utility of this procedure is still being debated. The aim of the study was to evaluate the effect of contrast CT on the diagnostic yield of PET-CT scan in patients with head-and-neck malignancies. Materials and Methods In a prospective study, 204 patients (140 males and 64 females) of head-and-neck malignancies underwent contrast-enhanced and nonenhanced fluorodeoxyglucose (FDG)-PET-CT for various clinical indications following informed consent. After a plain CT scan, CECT was done using iodinated contrast iopromide-370 at a dose of 1 ml/kg intravenously. After CECT acquisition, FDG-PET acquisition was done and images were reconstructed to obtain whole-body PET/CT and PET-CECT images. Results Both the modalities could detect similar number of primary lesions (n = 127), lymph nodal lesions (n = 118), and metastatic involvement (n = 55) with no significant difference between SUVmax. However, conspicuity of primary tumors and lymph nodal architecture was significantly better delineated with CECT, leading to better interpreter confidence. Conclusion CECT data as part of the combined PET-CT examination provide precise anatomic localization and delineation of the primary tumor in comparison to nonenhanced PET-CT. However, no significant diagnostic changes are noted in the nodal and metastatic staging.
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Affiliation(s)
- Sukanta Barai
- Department of Nuclear Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Manish Ora
- Department of Nuclear Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Sanjay Gambhir
- Department of Nuclear Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Amit Singh
- Department of Nuclear Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
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Çelik F, Tan YZ, Özdemir S, Sılan F. Comparison of SUV max Values Obtained from F-18 FDG PET/CT and Cell-free DNA Levels Measured from Plasma in Oncology Patients. Mol Imaging Radionucl Ther 2019; 28:46-52. [PMID: 31234620 PMCID: PMC6592314 DOI: 10.4274/mirt.galenos.2019.60352] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Objectives The aim of this study was to compare the quantitative value of standardized uptake value (SUV) SUVmax obtained from F-18 FDG positron emission tomography/computed tomography (PET/CT) imaging of oncology patients with the cell-free DNA (cfDNA) amounts measured in plasma of patients and thus investigate if cfDNA is a significant marker to identify the presence of malignancy in the early period. Methods A total of 184 patients were included in the study. The clinical, histopathologic, laboratory and treatment parameters were extracted from patient files. SUVmax and cfDNA quantities were assessed Results There was no statistically significant difference in plasma cfDNA values between patient and control groups. The comparison of SUVmax and cfDNA values in the study showed that there was a weak correlation between SUVmaxand cfDNA. There was a significant difference between tumor size and SUVmax values. However, there was no statistically significant difference between tumor size and cfDNA. Conclusion cfDNA measurements in the blood as a screening test have provided hope for early diagnosis and monitoring of cancer patients. Comparison of cfDNA levels obtained from plasma and quantitative parameters from PET/CT images of oncology patients in detailed advanced studies with larger patient series are required.
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Affiliation(s)
- Fatmanur Çelik
- Çanakkale Onsekiz Mart University Faculty of Medicine, Department of Nuclear Medicine, Çanakkale, Turkey
| | - Yusuf Ziya Tan
- Çanakkale Onsekiz Mart University Faculty of Medicine, Department of Nuclear Medicine, Çanakkale, Turkey
| | - Semra Özdemir
- Çanakkale Onsekiz Mart University Faculty of Medicine, Department of Nuclear Medicine, Çanakkale, Turkey
| | - Fatma Sılan
- Çanakkale Onsekiz Mart University Faculty of Medicine, Department of Medical Genetic, Çanakkale, Turkey
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Li YQ, Liao XX, Lu JH, Liu R, Hu CL, Dai G, Zhang XS, Shi XC, Li X. Assessing the early changes of cerebral glucose metabolism via dynamic (18)FDG-PET/CT during cardiac arrest. Metab Brain Dis 2015; 30:969-77. [PMID: 25703241 DOI: 10.1007/s11011-015-9658-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Accepted: 02/10/2015] [Indexed: 12/31/2022]
Abstract
To study the changes of cerebral glucose metabolism (CGM) during the phase of return of spontaneous circulation (ROSC) after cardiac arrest (CA), we used 18-fluorodeoxyglucose-positron emission tomography/computed tomography ((18)FDG-PET/CT) to measure the CGM changes in six beagle canine models. After the baseline (18)FDG-PET/CT was recorded, ventricular fibrillation (VF) was induced for 6 min, followed by close-chest cardiopulmonary resuscitation (CPR) in conjunction with intravenous (IV) administration of epinephrine and external defibrillator shocks until ROSC was achieved, within 30 min. The (18)FDG was recorded prior to intravenous administration at 0 h (baseline), and at 4, 24, and 48 h after CA with ROSC. We evaluated the expression of two key control factors in canine CGM, hexokinase I (HXK I) and HXK II, by immunohistochemistry at the four above mentioned time points. Electrically induced VF of 6 min duration was successfully induced in the dogs. Resuscitation was then performed to maintain blood pressure stability. Serial (18)FDG-PET/CT scans found that the CGM decreased at 4 h after ROSC and remained lower than the baseline even at 48 h. The expression of HXK I and II levels were consistent with the changes in CGM. These data from our present work showed that (18)FDG-PET/CT imaging can be used to detect decreased CGM during CA and was consistent with the results of CMRgl. Furthermore, there were also concomitant changes in the expression of HXK I and HXK II. The decrease in CGM may be an early sign of hyperacute global cerebral ischemia.
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Affiliation(s)
- Ying-Qing Li
- Emergency Department of Guangzhou First People's Hospital, Guangzhou Medical University, Panfu Road 1, Guangzhou, People's Republic of China
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Xu BX, Liu CB, Wang RM, Shao MZ, Fu LP, Li YG, Tian JH. The influence of interpreters' professional background and experience on the interpretation of multimodality imaging of pulmonary lesions using 18F-3'-deoxy-fluorothymidine and 18F-fluorodeoxyglucose PET/CT. PLoS One 2013; 8:e60104. [PMID: 23565188 PMCID: PMC3614939 DOI: 10.1371/journal.pone.0060104] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2012] [Accepted: 01/14/2013] [Indexed: 12/05/2022] Open
Abstract
Objective Based on the results of a recently accomplished multicenter clinical trial for the incremental value of a dual-tracer (18F-FDG and 18F-FLT), dual-modality (PET and CT) imaging in the differential diagnosis of pulmonary lesions, we investigate some issues that might affect the image interpretation and result reporting. Methods The images were read in two separate sessions. Firstly the images were read and reported by physician(s) of the imaging center on completion of each PET/CT scanning. By the end of MCCT, all images collected during the trial were re-read by a collective of readers in an isolated, blinded, and independent way. Results One hundred sixty two patients successfully passed the data verification and entered into the final analysis. The primary reporting result showed adding 18F-FDG image information did not change the clinical performance much in sensitivity, specifity and accuracy, but the ratio between SUVFLT and SUVFDG did help the differentiation efficacy among the three subgroups of patients. The collective reviewing result showed the diagnostic achievement varied with reading strategies. ANOVA indicated significant differences among 18F-FDG, 18F- FLT in SUV (F = 14.239, p = 0.004). CT had almost the same diagnostic performance as 18F-FLT. When the 18F-FDG, 18F- FLT and CT images read in pair, both diagnostic sensitivity and specificity improved. The best diagnostic figures were obtained in full-modality strategy, when dual-tracer PET worked in combination with CT. Conclusions With certain experience and training both radiologists and nuclear physicians are qualified to read and to achieve the similar diagnostic accuracy in PET/CT study. Making full use of modality combination and selecting right criteria seems more practical than professional back ground and personal experience in the new hybrid imaging technology, at least when novel tracer or application is concerned.
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Affiliation(s)
- Bai-xuan Xu
- Department of Nuclear Medicine, Chinese PLA General Hospital, Beijing, People’s Republic of China
| | - Chang-bin Liu
- Department of Nuclear Medicine, Chinese PLA General Hospital, Beijing, People’s Republic of China
| | - Rui-min Wang
- Department of Nuclear Medicine, Chinese PLA General Hospital, Beijing, People’s Republic of China
| | - Ming-zhe Shao
- Department of Nuclear Medicine, Chinese PLA General Hospital, Beijing, People’s Republic of China
| | - Li-ping Fu
- Department of Nuclear Medicine, Chinese PLA General Hospital, Beijing, People’s Republic of China
| | - Yun-gang Li
- Department of Nuclear Medicine, Chinese PLA General Hospital, Beijing, People’s Republic of China
| | - Jia-he Tian
- Department of Nuclear Medicine, Chinese PLA General Hospital, Beijing, People’s Republic of China
- * E-mail:
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Bannas P, Weber C, Adam G, Frenzel T, Derlin T, Mester J, Klutmann S. Contrast-Enhanced [18F]fluorodeoxyglucose-Positron Emission Tomography/Computed Tomography for Staging and Radiotherapy Planning in Patients With Anal Cancer. Int J Radiat Oncol Biol Phys 2011; 81:445-51. [DOI: 10.1016/j.ijrobp.2010.05.050] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2009] [Revised: 05/10/2010] [Accepted: 05/21/2010] [Indexed: 11/30/2022]
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Lin P, Koh ES, Lin M, Vinod SK, Ho-Shon I, Yap J, Som S. Diagnostic and staging impact of radiotherapy planning FDG-PET-CT in non-small-cell lung cancer. Radiother Oncol 2011; 101:284-90. [PMID: 21777988 DOI: 10.1016/j.radonc.2011.06.030] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2011] [Revised: 05/31/2011] [Accepted: 06/13/2011] [Indexed: 11/18/2022]
Abstract
BACKGROUND AND PURPOSE To evaluate whether FDG-PET performed for radiotherapy (RT) planning can detect disease progression, compared with staging PET. MATERIALS AND METHODS Twenty-six patients with newly-diagnosed non-small-cell lung cancer underwent planning PET-CT for curative RT within 8 weeks (mean: 33±14days) of staging PET-CT. Progressive disease (PD) was defined as >25% increase in tumour size (transaxial) or volume, as delineated by SUV threshold of 2.5, or new sites (SUV>2.5). RESULTS The planning PET detected PD in 16 patients (61%), compared to four patients (15%) by CT component of PET-CT. The mean scan interval was longer in patients with progression: 40±12days, compared to 22±11days without progression. Planning PET detected PD in 13/17 (76%), 12/14 (86%) and 7/7 patients if the interval was ≥4, 5 and 6 weeks, respectively, compared with 3/9 patients if interval <4 weeks. Planning PET detected PD in primary metabolic volume in seven patients, 20 new nodal sites in 12 new nodal stations and nine patients, five extra-nodal sites in five patients. This resulted in upstaging in nine patients (35%): stage IIIA in three, IIIB in three and IV in three. CONCLUSIONS RT-planning FDG-PET can provide incremental diagnostic information and may impact on staging in a significant number of patients.
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Affiliation(s)
- Peter Lin
- Department of Nuclear Medicine and PET, Liverpool Hospital, Liverpool, NSW 1871, Australia.
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Lee MS, Ko J, Lee AR, Lee IH, Jung MA, Austin B, Chung H, Nahm S, Eom K. Effects of anesthetic protocol on normal canine brain uptake of 18F-FDG assessed by PET/CT. Vet Radiol Ultrasound 2010; 51:130-5. [PMID: 20402395 DOI: 10.1111/j.1740-8261.2009.01636.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
The purpose of this study was to assess the effects of four anesthetic protocols on normal canine brain uptake of 2-deoxy-2-[18F]fluoro-D-glucose (FDG) using positron emission tomography/computed tomography (PET/CT). Five clinically normal beagle dogs were anesthetized with (1) propofol/isoflurane, (2) medetomidine/pentobarbital, (3) xylazine/ketamine, and (4) medetomidine/tiletamine-zolazepam in a randomized cross-over design. The standard uptake value (SUV) of FDG was obtained in the frontal, parietal, temporal and occipital lobes, cerebellum, brainstem and whole brain, and compared within and between anesthetic protocols using the Friedman test with significance set at P < 0.05. Significant differences in SUVs were observed in various part of the brain associated with each anesthetic protocol. The SUV for the frontal and occipital lobes was significantly higher than in the brainstem in all dogs. Dogs receiving medetomidine/tiletamine-zolazepam also had significantly higher whole brain SUVs than the propofol/isoflurane group. We concluded that each anesthetic protocol exerted a different regional brain glucose uptake pattern. As a result, when comparing brain glucose uptake using PET/CT, one should consider the effects of anesthetic protocols on different regions of the glucose uptake in the dog's brain.
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Affiliation(s)
- Min Su Lee
- Department of Veterinary Diagnostic Imaging, the College of Veterinary Medicine, Konkuk University, Seoul, Korea
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García García-Esquinas M, Ortega Candil A, Lapeña Gutierrez L, Mucientes Rasilla J, Carreras Delgado J, Arrazola García J. Calidad diagnóstica y repercusión del empleo de contrastes en los estudios de tomografía computarizada de exploraciones con tomografía por emisión de positrones en combinación con tomografía computarizada. RADIOLOGIA 2010; 52:327-32. [DOI: 10.1016/j.rx.2010.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2009] [Revised: 03/24/2010] [Accepted: 03/25/2010] [Indexed: 10/19/2022]
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Devine CE, Mawlawi O. Radiation Safety With Positron Emission Tomography and Computed Tomography. Semin Ultrasound CT MR 2010; 31:39-45. [DOI: 10.1053/j.sult.2009.09.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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García García-Esquinas M, Ortega Candil A, Lapeña Gutierrez L, Mucientes Rasilla J, Carreras Delgado J, Arrazola García J. The impact on diagnostic quality of using contrast media in PET-CT studies. RADIOLOGIA 2010. [DOI: 10.1016/s2173-5107(10)70021-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Chang G, Chang T, Pan T, Clark JW, Mawlawi OR. Implementation of an automated respiratory amplitude gating technique for PET/CT: clinical evaluation. J Nucl Med 2009; 51:16-24. [PMID: 20008993 DOI: 10.2967/jnumed.109.068759] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
UNLABELLED Amplitude gating techniques have recently been shown to be better at suppressing respiratory motion artifacts than phase gating. However, most commercial PET/CT scanners are equipped with phase gating capabilities only. The objective of this article was to propose and evaluate using patient studies an automated respiratory amplitude gating technique that could be implemented on current whole-body PET/CT scanners. A primary design feature of the proposed technique is to automatically match the respiratory amplitude captured during the CT scan with a corresponding amplitude during the PET scan. METHODS The proposed amplitude gating technique consists of a CT scan, followed by a list-mode PET scan. The CT scan was acquired while the patient's respiratory motion was recorded by a monitoring device that determined the respiratory motion amplitude captured during the CT scan. A program was designed to inject triggers into the PET list stream whenever the patient's respiration crossed a preset amplitude range determined by the captured amplitude during CT. To implement this proposed amplitude gating technique in whole-body PET/CT, a PET-first protocol was necessary to minimize the respiratory baseline drift between the CT and PET scans. In this implementation, a regular PET scan was first acquired over the patient's whole body but excluding the bed position that covered the lesion of interest. The whole-body CT scan was then acquired, followed by a list-mode PET acquisition over the bed position that covered the area of interest (lesion). The proposed amplitude gating technique was tested using 13 patients with 21 lung or thoracic tumors. RESULTS In the patient studies, the gated images-when compared with the ungated images-showed statistically significant improvements, with an average 27% and 28% increase in maximum and mean standardized uptake value, respectively, for all lesions. Furthermore, the tumors in the gated images showed better contrast using visual inspection and line profiles. CONCLUSION The implementation of the proposed respiratory amplitude gating technique on current PET/CT scanners is feasible, and amplitude-matched CT and PET data can be automatically generated using our proposed procedures without requiring patients to hold their breath or increase their radiation exposure.
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Affiliation(s)
- Guoping Chang
- Department of Electrical and Computer Engineering, Rice University, Houston, Texas, USA
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Krug B, Van Zanten A, Pirson AS, Crott R, Borght TV. Activity-based costing evaluation of a [18F]-fludeoxyglucose positron emission tomography study. Health Policy 2009; 92:234-43. [DOI: 10.1016/j.healthpol.2009.04.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2008] [Revised: 04/07/2009] [Accepted: 04/13/2009] [Indexed: 11/24/2022]
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PET/CT image fusion error due to urinary bladder filling changes: consequence and correction. Ann Nucl Med 2009; 23:739-44. [PMID: 19787311 DOI: 10.1007/s12149-009-0304-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2009] [Accepted: 08/19/2009] [Indexed: 10/20/2022]
Abstract
OBJECTIVE A considerable change of urinary bladder (UB) shape in PET compared with CT in integrated PET/CT system is frequently noted. This study initially evaluated this finding with and without oral contrast (OC) use. In addition, a one bed pelvic section (PLV) repeat acquisition was investigated as a solution to this problem. METHODS (18)FDG PET/CTs of 88 patients were analyzed. OC was administered in 68 patients, of whom 31 had PLV images taken 5-10 min later. Three-dimensional mid-UB CT and PET matching measurements were compared. In addition, UB walls displacement between CT and PET were analyzed. RESULTS The mean UB height was significantly increased (P < 0.001) in PET when compared with CT, both anteriorly and posteriorly; however, UB width and depth were not significantly different. An upward shift of superior UB wall in PET from equivalent CT images was noted, whereas there was no appreciable displacement of the other UB walls. The percent UB height increase on PET from CT was significantly greater with than without OC use. The UB height difference between PET and CT was markedly reduced on PLV when compared with the original scans. CONCLUSIONS Caution should be exerted during the interpretation of PET/CT scans of the pelvis as there is significant upward expansion of UB on PET compared with CT that appears to be exaggerated by OC use, likely due to additional fluid load. The PET/CT fusion errors of UB can be substantially resolved through a separate PLV acquisition presumably due to the shorter time interval of UB scan completion between CT and PET.
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de Geus-Oei LF, Vriens D, van Laarhoven HWM, van der Graaf WTA, Oyen WJG. Monitoring and predicting response to therapy with 18F-FDG PET in colorectal cancer: a systematic review. J Nucl Med 2009; 50 Suppl 1:43S-54S. [PMID: 19403879 DOI: 10.2967/jnumed.108.057224] [Citation(s) in RCA: 178] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Molecular imaging with (18)F-FDG PET has been proven useful in the management of colorectal cancer. (18)F-FDG PET plays a pivotal role in staging before surgical resection of recurrent colorectal cancer and metastases, in the localization of recurrence in patients with an unexplained rise in serum carcinoembryonic antigen levels, and in the assessment of residual masses after treatment. Currently, there is increasing interest in the role of (18)F-FDG PET beyond staging. The technique appears to have significant potential for the characterization of tumors and for the prediction of prognosis in the context of treatment stratification and early assessment of tumor response to therapy. This systematic review provides an overview of the literature on the value of (18)F-FDG PET for monitoring and predicting the response to therapy in colorectal cancer. The review covers chemotherapy response monitoring in advanced colorectal cancer, monitoring of the effects of local ablative therapies, and preoperative radiotherapy and multimodality treatment response evaluation in primary rectal cancer. Given the added value of (18)F-FDG PET for these indications, implementation in clinical practice and systematic inclusion in therapeutic trials to exploit the potential of (18)F-FDG PET are warranted.
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Affiliation(s)
- Lioe-Fee de Geus-Oei
- Department of Nuclear Medicine, Radboud University, Nijmegen Medical Centre, Nijmegen, The Netherlands.
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Krajicek BJ, Ryu JH, Hartman TE, Lowe VJ, Vassallo R. Abnormal Fluorodeoxyglucose PET in Pulmonary Langerhans Cell Histiocytosis. Chest 2009; 135:1542-1549. [DOI: 10.1378/chest.08-1899] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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García Garzón J, Rodríguez A, Cabrera A. Tomografía por emisión de positrones de cuerpo completo (PET/TAC) con 18F-fluorodesoxiglucosa. ACTA ACUST UNITED AC 2009; 28:85-9. [DOI: 10.1016/s0212-6982(09)70706-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Tang L, Hamarneh G, Celler A. Validation of mutual information-based registration of CT and bone SPECT images in dual-isotope studies. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2008; 92:173-185. [PMID: 18691787 DOI: 10.1016/j.cmpb.2008.06.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2007] [Revised: 06/07/2008] [Accepted: 06/08/2008] [Indexed: 05/26/2023]
Abstract
The registration of computed tomography (CT) and nuclear medicine (NM) images can substantially enhance patient diagnosis as it allows for the fusion of anatomical and functional information, as well as the attenuation correction of NM images. However, irrespective of the method used, registration accuracy depends heavily on the characteristics of the images that are registered and the degree of similarity between them. This poses a challenge for registering CT and NM images as they have very different characteristics and content. To address the particular problem of registering single photon emission computed tomography (SPECT) oncology studies with corresponding CT, we have proposed to perform a dual-isotope study with simultaneous injection of a tumor tracer and a bone imaging agent to obtain a tumor SPECT and a bone SPECT image that are inherently registered. As bone structures are generally visible in both CT and bone SPECT, performing registration of these images will be more easily attainable than registration of CT and tumor SPECT. By subsequently applying the spatial transformation determined from this registration to the tumor SPECT acquired from the same dual-isotope study, the optimal alignment between the CT and tumor SPECT images can be obtained. In this paper, we present the proof-of-concept of the proposed approach, the MI-based algorithm employed, and the techniques used to select the algorithm's parameters. Our objectives are to show the feasibility of CT and bone SPECT registration using this algorithm and to validate quantitatively the results generated using clinical data.
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Affiliation(s)
- Lisa Tang
- Medical Image Analysis Lab, School of Computing Science, Simon Fraser University, Canada.
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Respiratory motion handling is mandatory to accomplish the high-resolution PET destiny. Eur J Nucl Med Mol Imaging 2008; 35:1961-70. [PMID: 18787822 DOI: 10.1007/s00259-008-0931-x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2008] [Accepted: 08/18/2008] [Indexed: 10/21/2022]
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Quality assurance of positron emission tomography/computed tomography for radiation therapy. Int J Radiat Oncol Biol Phys 2008; 71:S38-42. [PMID: 18406935 DOI: 10.1016/j.ijrobp.2007.05.091] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2007] [Revised: 05/04/2007] [Accepted: 05/05/2007] [Indexed: 11/22/2022]
Abstract
Recent advances in radiation delivery techniques, such as intensity-modulated radiation therapy, provide unprecedented ability to exquisitely control three-dimensional dose distribution. Development of on-board imaging and other image-guidance methods significantly improved our ability to better target a radiation beam to the tumor volume. However, in reality, accurate definition of the location and boundary of the tumor target is still problematic. Biologic and physiologic imaging promises to solve the problem in a fundamental way and has a more and more important role in patient staging, treatment planning, and therapeutic assessment in radiation therapy clinics. The last decade witnessed a dramatic increase in the use of positron emission tomography and computed tomography in radiotherapy practice. To ensure safe and effective use of nuclide imaging, a rigorous quality assurance (QA) protocol of the imaging tools and integration of the imaging data must be in place. The application of nuclide imaging in radiation oncology occurs at different levels of sophistication. Quantitative use of the imaging data in treatment planning through image registration and standardized uptake value calculation is often involved. Thus, QA should not be limited to the performance of the scanner, but should also include the process of implementing image data in treatment planning, such as data transfer, image registration, and quantitation of data for delineation of tumors and sensitive structures. This presentation discusses various aspects of nuclide imaging as applied to radiotherapy and describes the QA procedures necessary for the success of biologic image-guided radiation therapy.
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Gorospe Sarasúa L, Vicente Bártulos A, González Gordaliza C, García Poza J, Lourido García D, Jover Díaz R. PET/TC: aspectos de protocolo y controversias legales. RADIOLOGIA 2008; 50:207-14. [DOI: 10.1016/s0033-8338(08)71966-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Nehmeh SA, Erdi YE. Respiratory Motion in Positron Emission Tomography/Computed Tomography: A Review. Semin Nucl Med 2008; 38:167-76. [DOI: 10.1053/j.semnuclmed.2008.01.002] [Citation(s) in RCA: 244] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Abstract
Since the discovery of X-rays by Wilhelm Conrad R?entgen at the end of the 19th century, diagnostic imaging techniques have been continously improved by technological advances, bringing radiological diagnosis into the very center of modern medicine. Nowadays, it is hard to imagine therapy planning without previous radiological examination. Great advances in the field of computer technology have been accompanied by development of radiological techniques, and today they include not only morphological and anatomical, but also dynamic, functional and molecular imaging. This paper is an overview of new and improved radiological techniques and their implementation.
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