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SPECT and SPECT/CT. Mol Imaging 2021. [DOI: 10.1016/b978-0-12-816386-3.00008-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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2
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Mankoff DA, Pantel AR, Viswanath V, Karp JS. Advances in PET Diagnostics for Guiding Targeted Cancer Therapy and Studying In Vivo Cancer Biology. CURRENT PATHOBIOLOGY REPORTS 2019; 7:97-108. [PMID: 37092138 PMCID: PMC10117535 DOI: 10.1007/s40139-019-00202-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Purpose of the Review We present an overview of recent advances in positron emission tomography (PET) diagnostics as applied to the study of cancer, specifically as a tool to study in vivo cancer biology and to direct targeted cancer therapy. The review is directed to translational and clinical cancer investigators who may not be familiar with these applications of PET cancer diagnostics, but whose research might benefit from these advancing tools. Recent Findings We highlight recent advances in 3 areas: (1) the translation of PET imaging cancer biomarkers to clinical trials; (2) methods for measuring cancer metabolism in vivo in patients; and (3) advances in PET instrumentation, including total-body PET, that enable new methodologies. We emphasize approaches that have been translated to human studies. Summary PET imaging methodology enables unique in vivo cancer diagnostics that go beyond cancer detection and staging, providing an improved ability to guide cancer treatment and an increased understanding of in vivo human cancer biology.
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Affiliation(s)
- David A Mankoff
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Austin R Pantel
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Varsha Viswanath
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Joel S Karp
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
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3
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Salvatori M, Rizzo A, Rovera G, Indovina L, Schillaci O. Radiation dose in nuclear medicine: the hybrid imaging. Radiol Med 2019; 124:768-776. [PMID: 30771217 DOI: 10.1007/s11547-019-00989-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 01/14/2019] [Indexed: 01/10/2023]
Abstract
Hybrid imaging procedures such as single-photon emission computed tomography/computed tomography (SPECT/CT) and positron emission tomography/computed tomography (PET/CT) showed a rapid diffusion in recent years because of their high sensitivity, specificity, and accuracy, due to a more accurate localization and definition of scintigraphic findings. However, hybrid systems inevitably lead to an increase in patient radiation exposure because of the added CT component. Effective doses due to the radiopharmaceuticals can be estimated by multiplying the administered activities by the effective dose coefficients, while for the CT component the dose-length product can be multiplied by a conversion coefficient k. However, the effective dose value is subject to a high degree of uncertainty and must be interpreted as a broad, generic estimate of biologic risk. Although the effective dose can be used to estimate and compare the risk of radiation exposure across multiple imaging techniques, clinicians should be aware that it represents a generic evaluation of the risk derived from a given procedure to a generic model of the human body. It cannot be applied to a single individual and should not be used for epidemiologic studies or the estimation of population risks due to the inherent uncertainties and oversimplifications involved. Practical ways to reduce radiation dose to patients eligible for hybrid imaging involve adjustments to both the planning phase and throughout the execution of the study. These methods include individual justification of radiation exposure, radiopharmaceutical choice, adherence to diagnostic reference levels (DLR), patient hydration and bladder voiding, adoption of new technical devices (sensitive detectors or collimators) with new reconstruction algorithms, and implementation of appropriate CT protocols and exposure parameters.
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Affiliation(s)
- Massimo Salvatori
- Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Istituto di Medicina Nucleare, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Università Cattolica del Sacro Cuore, Largo Agostino Gemelli 8, Rome, 00168, Italy.
| | - Alessio Rizzo
- Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Istituto di Medicina Nucleare, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Università Cattolica del Sacro Cuore, Largo Agostino Gemelli 8, Rome, 00168, Italy
| | - Guido Rovera
- Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Istituto di Medicina Nucleare, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Università Cattolica del Sacro Cuore, Largo Agostino Gemelli 8, Rome, 00168, Italy
| | - Luca Indovina
- Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Orazio Schillaci
- Dipartimento di Biomedicina e Prevenzione, Università di Roma Tor Vergata, Rome, Italy.,IRCSS Neuromed, Pozzilli, Italy
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4
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Mankoff DA, Katz SI. PET imaging for assessing tumor response to therapy. J Surg Oncol 2018; 118:362-373. [PMID: 29938396 DOI: 10.1002/jso.25114] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 04/28/2018] [Indexed: 12/19/2022]
Abstract
Positron emission tomography (PET) is a radioisotope imaging technique capable of quantifying the regional distribution of molecular imaging probes targeted to biochemical pathways and processes allowing direct measurement of biochemical changes induced by cancer therapy, including the activity of targeted growth pathways and cellular populations. In this manuscript, we review the underlying principles of PET imaging, choices for PET radiopharmaceuticals, methods for tumor analysis and PET applications for cancer therapy response assessment including potential future directions.
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Affiliation(s)
- David A Mankoff
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Sharyn I Katz
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
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5
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Hutton BF, Occhipinti M, Kuehne A, Máthé D, Kovács N, Waiczies H, Erlandsson K, Salvado D, Carminati M, Montagnani GL, Short SC, Ottobrini L, van Mullekom P, Piemonte C, Bukki T, Nyitrai Z, Papp Z, Nagy K, Niendorf T, de Francesco I, Fiorini C. Development of clinical simultaneous SPECT/MRI. Br J Radiol 2017; 91:20160690. [PMID: 28008775 PMCID: PMC5966197 DOI: 10.1259/bjr.20160690] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
There is increasing clinical use of combined positron emission tomography and MRI, but to date there has been no clinical system developed capable of simultaneous single-photon emission computed tomography (SPECT) and MRI. There has been development of preclinical systems, but there are several challenges faced by researchers who are developing a clinical prototype including the need for the system to be compact and stationary with MRI-compatible components. The limited work in this area is described with specific reference to the Integrated SPECT/MRI for Enhanced stratification in Radio-chemo Therapy (INSERT) project, which is at an advanced stage of developing a clinical prototype. Issues of SPECT/MRI compatibility are outlined and the clinical appeal of such a system is discussed, especially in the management of brain tumour treatment.
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Affiliation(s)
- Brian F Hutton
- 1 Institute of Nuclear Medicine, University College London (UCL), London, UK
| | - Michele Occhipinti
- 2 Dipartimento di Elettronica Informazione e Bioingegneria, Politecnico di Milano and Instituto Nacionale di Fisica Nucleare (INFN), Milan, Italy
| | | | - Domokos Máthé
- 4 CROmed Ltd, Budapest, Hungary.,5 Department of Biophysics and Radiation Biology, Semmelweis University, Budapest, Hungary
| | | | | | - Kjell Erlandsson
- 1 Institute of Nuclear Medicine, University College London (UCL), London, UK
| | - Debora Salvado
- 1 Institute of Nuclear Medicine, University College London (UCL), London, UK
| | - Marco Carminati
- 2 Dipartimento di Elettronica Informazione e Bioingegneria, Politecnico di Milano and Instituto Nacionale di Fisica Nucleare (INFN), Milan, Italy
| | - Giovanni L Montagnani
- 2 Dipartimento di Elettronica Informazione e Bioingegneria, Politecnico di Milano and Instituto Nacionale di Fisica Nucleare (INFN), Milan, Italy
| | - Susan C Short
- 6 Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Luisa Ottobrini
- 7 Department of Medical-Surgical Pathophysiology and Transplants, University of Milan, Italy.,8 Institute for Molecular Bioimaging and Physiology (IBFM), National Council of Research (CNR), Milan, Italy
| | | | | | | | | | | | | | | | - Irene de Francesco
- 12 Department of Oncology, University College London Hospitals NHS Foundation Trust, London
| | - Carlo Fiorini
- 2 Dipartimento di Elettronica Informazione e Bioingegneria, Politecnico di Milano and Instituto Nacionale di Fisica Nucleare (INFN), Milan, Italy
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6
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Liu M, Guo H, Liu H, Zhang Z, Chi C, Hui H, Dong D, Hu Z, Tian J. In vivo pentamodal tomographic imaging for small animals. BIOMEDICAL OPTICS EXPRESS 2017; 8:1356-1371. [PMID: 28663833 PMCID: PMC5480548 DOI: 10.1364/boe.8.001356] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Revised: 01/24/2017] [Accepted: 01/27/2017] [Indexed: 05/05/2023]
Abstract
Multimodality molecular imaging emerges as a powerful strategy for correlating multimodal information. We developed a pentamodal imaging system which can perform positron emission tomography, bioluminescence tomography, fluorescence molecular tomography, Cerenkov luminescence tomography and X-ray computed tomography successively. Performance of sub-systems corresponding to different modalities were characterized. In vivo multimodal imaging of an orthotopic hepatocellular carcinoma xenograft mouse model was performed, and acquired multimodal images were fused. The feasibility of pentamodal tomographic imaging system was successfully validated with the imaging application on the mouse model. The ability of integrating anatomical, metabolic, and pharmacokinetic information promises applications of multimodality molecular imaging in precise medicine.
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Affiliation(s)
- Muhan Liu
- Engineering Research Center of Molecular and Neuro Imaging of Ministry of Education & School of Life Science and Technology, Xidian University, Xi'an, Shaanxi 710071, China
- Key Laboratory of Molecular Imaging of Chinese Academy of Sciences, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190, China
- Contributed equally
| | - Hongbo Guo
- Key Laboratory of Molecular Imaging of Chinese Academy of Sciences, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190, China
- School of Information Sciences and Technology, Northwest University, Xi'an, 710069, China
- Contributed equally
| | - Hongbo Liu
- Engineering Research Center of Molecular and Neuro Imaging of Ministry of Education & School of Life Science and Technology, Xidian University, Xi'an, Shaanxi 710071, China
- Key Laboratory of Molecular Imaging of Chinese Academy of Sciences, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190, China
| | - Zeyu Zhang
- Key Laboratory of Molecular Imaging of Chinese Academy of Sciences, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190, China
| | - Chongwei Chi
- Key Laboratory of Molecular Imaging of Chinese Academy of Sciences, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190, China
| | - Hui Hui
- Key Laboratory of Molecular Imaging of Chinese Academy of Sciences, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190, China
| | - Di Dong
- Key Laboratory of Molecular Imaging of Chinese Academy of Sciences, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190, China
| | - Zhenhua Hu
- Key Laboratory of Molecular Imaging of Chinese Academy of Sciences, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190, China
- The State Key Laboratory of Management and Control of Complex Systems, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190, China
| | - Jie Tian
- Engineering Research Center of Molecular and Neuro Imaging of Ministry of Education & School of Life Science and Technology, Xidian University, Xi'an, Shaanxi 710071, China
- Key Laboratory of Molecular Imaging of Chinese Academy of Sciences, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190, China
- The State Key Laboratory of Management and Control of Complex Systems, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190, China
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7
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Lee SW. SPECT/CT in the Treatment of Differentiated Thyroid Cancer. Nucl Med Mol Imaging 2017; 51:297-303. [PMID: 29242723 DOI: 10.1007/s13139-017-0473-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Revised: 12/07/2016] [Accepted: 01/20/2017] [Indexed: 01/25/2023] Open
Abstract
Single-photon emission computed tomography with integrated computed tomography (SPECT/CT) systems has been applied in a wide range of clinical circumstances, and differentiated thyroid cancer (DTC) is one of the most important indications of SPECT/CT imaging. In the treatment of DTC, SPECT/CT images have been reported to have many advantages over conventional planar whole-body scintigraphy based on its precise localization and characterization of abnormal foci of radioactive iodine (RAI) accumulation, influencing the staging, risk stratification, and clinical management as well as reader confidence. On the other hand, SPECT/CT has limitations including additional radiation exposure from the CT component, additional imaging time, and cost-related issues. Each SPECT/CT image acquired at different time points throughout the management of DTC may have a different clinical meaning and significance. This review article addresses the clinical usefulness of RAI SPECT/CT images acquired during the pre-ablation period, post-therapy period, and long-term follow-up period, respectively.
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Affiliation(s)
- Sang-Woo Lee
- Department of Nuclear Medicine, Kyungpook National University Medical Center and School of Medicine, 807 Hoguk-ro, Buk-gu, Daegu, Republic of Korea 41404
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8
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van der Velden S, Beijst C, Viergever MA, de Jong HWAM. Simultaneous fluoroscopic and nuclear imaging: impact of collimator choice on nuclear image quality. Med Phys 2017; 44:249-261. [PMID: 28044322 DOI: 10.1002/mp.12010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Revised: 11/04/2016] [Accepted: 11/04/2016] [Indexed: 11/10/2022] Open
Abstract
PURPOSE X-ray-guided oncological interventions could benefit from the availability of simultaneously acquired nuclear images during the procedure. To this end, a real-time, hybrid fluoroscopic and nuclear imaging device, consisting of an X-ray c-arm combined with gamma imaging capability, is currently being developed (Beijst C, Elschot M, Viergever MA, de Jong HW. Radiol. 2015;278:232-238). The setup comprises four gamma cameras placed adjacent to the X-ray tube. The four camera views are used to reconstruct an intermediate three-dimensional image, which is subsequently converted to a virtual nuclear projection image that overlaps with the X-ray image. The purpose of the present simulation study is to evaluate the impact of gamma camera collimator choice (parallel hole versus pinhole) on the quality of the virtual nuclear image. METHODS Simulation studies were performed with a digital image quality phantom including realistic noise and resolution effects, with a dynamic frame acquisition time of 1 s and a total activity of 150 MBq. Projections were simulated for 3, 5, and 7 mm pinholes and for three parallel hole collimators (low-energy all-purpose (LEAP), low-energy high-resolution (LEHR) and low-energy ultra-high-resolution (LEUHR)). Intermediate reconstruction was performed with maximum likelihood expectation-maximization (MLEM) with point spread function (PSF) modeling. In the virtual projection derived therefrom, contrast, noise level, and detectability were determined and compared with the ideal projection, that is, as if a gamma camera were located at the position of the X-ray detector. Furthermore, image deformations and spatial resolution were quantified. Additionally, simultaneous fluoroscopic and nuclear images of a sphere phantom were acquired with a physical prototype system and compared with the simulations. RESULTS For small hot spots, contrast is comparable for all simulated collimators. Noise levels are, however, 3 to 8 times higher in pinhole geometries than in parallel hole geometries. This results in higher contrast-to-noise ratios for parallel hole geometries. Smaller spheres can thus be detected with parallel hole collimators than with pinhole collimators (17 mm vs 28 mm). Pinhole geometries show larger image deformations than parallel hole geometries. Spatial resolution varied between 1.25 cm for the 3 mm pinhole and 4 cm for the LEAP collimator. The simulation method was successfully validated by the experiments with the physical prototype. CONCLUSION A real-time hybrid fluoroscopic and nuclear imaging device is currently being developed. Image quality of nuclear images obtained with different collimators was compared in terms of contrast, noise, and detectability. Parallel hole collimators showed lower noise and better detectability than pinhole collimators.
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Affiliation(s)
- Sandra van der Velden
- Radiology and Nuclear Medicine, UMC Utrecht, 85500, 3508 GA, Utrecht, Netherlands.,Image Sciences Institute, UMC Utrecht, 85500, 3508 GA, Utrecht, Netherlands
| | - Casper Beijst
- Radiology and Nuclear Medicine, UMC Utrecht, 85500, 3508 GA, Utrecht, Netherlands.,Image Sciences Institute, UMC Utrecht, 85500, 3508 GA, Utrecht, Netherlands
| | - Max A Viergever
- Image Sciences Institute, UMC Utrecht, 85500, 3508 GA, Utrecht, Netherlands
| | - Hugo W A M de Jong
- Radiology and Nuclear Medicine, UMC Utrecht, 85500, 3508 GA, Utrecht, Netherlands
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9
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Qureshi WT, Alirhayim Z, Khalid F, Al-Mallah MH. Prognostic value of extracardiac incidental findings on attenuation correction cardiac computed tomography. J Nucl Cardiol 2016; 23:1266-1274. [PMID: 26202878 DOI: 10.1007/s12350-015-0223-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Accepted: 06/23/2015] [Indexed: 12/22/2022]
Abstract
BACKGROUND Attenuation corrected computed tomography (CTAC) is often performed to improve the specificity of single-photon emission tomography imaging. Extracardiac incidental findings are frequently observed. It is unclear whether these findings have any prognostic value. METHODS Consecutive patients (n = 1139) at a tertiary care center were retrospectively evaluated for incidental findings on CTAC. Clinically significant incidental findings were defined as findings warranting physician follow-up. Information regarding subsequent resource utilization was obtained by chart review. Cox proportional hazard model adjusted for demographic and clinical variables was used to evaluate association of these incidental findings with all-cause and cancer-specific mortality. RESULTS A total of 135 (12%) patients with incidental findings were identified, 83 of whom (68%) were newly diagnosed. Lung nodules were the most common finding, present in 92 (68%) patients. Over a median follow-up of 468 days, incidental findings were not significantly associated with increased risk of all-cause mortality (HR 1.34; 95% CI 0.77-2.33, P = 0.29) but was significantly associated with cancer-specific mortality (HR 3.21; 95% CI 1.26-8.14, P = 0.01). This association remained statistically significant when the analysis was limited to newly diagnosed incidental findings. Among patients with incidental findings, follow-up radiographic studies were conducted in 87%, and invasive procedures performed in 32%. Physician office-based follow-up of these findings occurred in 42% of patients and incidental finding-related hospitalization occurred in 14%. CONCLUSIONS This study shows that incidental findings are common and were associated with all-cause and cancer-specific mortality but only the later remained statistically significant after multivariable adjustment.
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Affiliation(s)
- Waqas T Qureshi
- Wake Forest University School of Medicine, Winston Salem, NC, 27157, USA
| | - Zaid Alirhayim
- Henry Ford Hospital/Wayne State University, 2799 W. Grand Blvd., Detroit, MI, 48202, USA
- The University of Kansas Medical Center, Kansas City, KS, 66160, USA
| | - Fatima Khalid
- Wake Forest University School of Medicine, Winston Salem, NC, 27157, USA
| | - Mouaz H Al-Mallah
- Henry Ford Hospital/Wayne State University, 2799 W. Grand Blvd., Detroit, MI, 48202, USA.
- Wayne State University, 540 E Canfield St., Detroit, MI, 48201, USA.
- King Abdul-Aziz Cardiac Center, King Abdul-Aziz Medical City (Riyadh), Ministry of National Guard - Health Affairs, MC 1413, P.O. Box 22490, Riyadh, 11426, Kingdom of Saudi Arabia.
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10
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Griffiths M. Creating the Hybrid Workforce: Challenges and Opportunities. J Med Imaging Radiat Sci 2015; 46:262-270. [PMID: 31052132 DOI: 10.1016/j.jmir.2015.06.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Marc Griffiths
- Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK.
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11
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Froeling V, Heimann U, Huebner RH, Kroencke TJ, Maurer MH, Doellinger F, Geisel D, Hamm B, Brenner W, Schreiter NF. Ventilation/perfusion SPECT or SPECT/CT for lung function imaging in patients with pulmonary emphysema? Ann Nucl Med 2015; 29:528-34. [PMID: 25939639 DOI: 10.1007/s12149-015-0976-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Accepted: 04/13/2015] [Indexed: 11/30/2022]
Abstract
PURPOSE To evaluate the utility of attenuation correction (AC) of V/P SPECT images for patients with pulmonary emphysema. MATERIALS AND METHODS Twenty-one patients (mean age 67.6 years) with pulmonary emphysema who underwent V/P SPECT/CT were included. AC/non-AC V/P SPECT images were compared visually and semiquantitatively. Visual comparison of AC/non-AC images was based on a 5-point likert scale. Semiquantitative comparison assessed absolute counts per lung (aCpLu) and lung lobe (aCpLo) for AC/non-AC images using software-based analysis; percentage counts (PC = (aCpLo/aCpLu) × 100) were calculated. Correlation between AC/non-AC V/P SPECT images was analyzed using Spearman's rho correlation coefficient; differences were tested for significance with the Wilcoxon rank sum test. RESULTS Visual analysis revealed high conformity for AC and non-AC V/P SPECT images. Semiquantitative analysis of PC in AC/non-AC images had an excellent correlation and showed no significant differences in perfusion (ρ = 0.986) or ventilation (ρ = 0.979, p = 0.809) SPECT/CT images. CONCLUSION AC of V/P SPECT images for lung lobe-based function imaging in patients with pulmonary emphysema do not improve visual or semiquantitative image analysis.
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Affiliation(s)
- Vera Froeling
- Department of Radiology, Charité, Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany,
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12
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Takahashi T, Tanaka H, Kozono N, Tanakamaru Y, Idei N, Ohashi N, Ohtsubo H, Okada T, Yasunobu Y, Kaseda S. Characteristics of images of angiographically proven normal coronary arteries acquired by adenosine-stress thallium-201 myocardial perfusion SPECT/CT-IQ[Symbol: see text]SPECT with CT attenuation correction changed stepwise. Ann Nucl Med 2014; 29:256-67. [PMID: 25472779 DOI: 10.1007/s12149-014-0935-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Accepted: 11/20/2014] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Although several studies have shown the diagnostic and prognostic value of CT-based attenuation correction (AC) of single photon emission computed tomography (SPECT) images for diagnosing coronary artery disease (CAD), this issue remains a matter of debate. To clarify the characteristics of CT-AC SPECT images that might potentially improve diagnostic performance, we analyzed images acquired using adenosine-stress thallium-201 myocardial perfusion SPECT/CT equipped with IQ[Symbol: see text]SPECT (SPECT/CT-IQ[Symbol: see text]SPECT) from patients with angiographically proven normal coronary arteries after changing the CT attenuation correction (CT-AC) in a stepwise manner. METHODS We enrolled 72 patients (Male 36, Female 36) with normal coronary arteries according to findings of invasive coronary angiography or CT-angiography within three months after a SPECT/CT study. Projection images were reconstructed at CT-AC values of (-), 40, 60, 80 and 100 % using a CT number conversion program according to our definition and analyzed using polar maps according to sex. RESULTS CT attenuation corrected segments were located from the mid- and apical-inferior spread through the mid- and apical-septal regions and finally to the basal-anterior and basal- and mid-lateral regions in males, and from the mid-inferior region through the mid-septal and mid-anterior, and mid-lateral regions in females as the CT-AC values increased. Segments with maximal mean counts shifted from the apical-anterior to mid-anterolateral region under both stress and rest conditions in males, whereas such segments shifted from the apical-septal to the mid-anteroseptal region under both stress and rest conditions in females. CONCLUSIONS We clarified which part of the myocardium and to which degree CT-AC affects it in adenosine-stress thallium-201 myocardial perfusion SPECT/CT-IQ[Symbol: see text]SPECT images by changing the CT-AC value stepwise. We also identified sex-specific shifts of segments with maximal mean counts that changed as CT-AC values increased.
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Affiliation(s)
- Teruyuki Takahashi
- Department of Radiology, Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital, Hiroshima, Japan
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Hutton BF. The contribution of Medical Physics to Nuclear Medicine: looking back - a physicist's perspective. EJNMMI Phys 2014; 1:2. [PMID: 26501444 PMCID: PMC4545618 DOI: 10.1186/2197-7364-1-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Accepted: 02/20/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This paper is the first in a series of invited perspectives by four pioneers of Nuclear Medicine imaging and physics. A medical physicist and a Nuclear Medicine clinical specialist each take a backward look and a forward look at the contributions of Medical Physics to Nuclear Medicine. DISCUSSION Contributions of Medical Physics are presented from the early discovery of radioactivity, development of first imaging devices, computers and emission tomography to recent development of hybrid imaging. There is evidence of significant contribution of Medical Physics throughout the development of Nuclear Medicine.
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Affiliation(s)
- Brian F Hutton
- Institute of Nuclear Medicine, University College London, Level 5 UCH, 235 Euston Road, London, NW1 2BU, UK.
- Centre for Medical Radiation Physics, University of Wollongong, Wollongong, NSW, 2522, Australia.
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14
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Muzic RF, DiFilippo FP. Positron emission tomography-magnetic resonance imaging: technical review. Semin Roentgenol 2014; 49:242-54. [PMID: 25497909 DOI: 10.1053/j.ro.2014.10.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Raymond F Muzic
- Department of Radiology, University Hospitals Case Medical Center & Case Center for Imaging Research, Case Western Reserve University, Cleveland, OH.
| | - Frank P DiFilippo
- Department of Nuclear Medicine, Cleveland Clinic, Cleveland, OH; Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH
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15
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Is computed tomography attenuation correction more efficient than gated single photon emission computed tomography analysis in improving the diagnostic performance of myocardial perfusion imaging in patients with low prevalence of ischemic heart disease? Nucl Med Commun 2014; 36:69-77. [PMID: 25279709 DOI: 10.1097/mnm.0000000000000218] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The purpose of this study was to compare computed tomography (CT)-based attenuation correction (AC) using a hybrid single photon emission computed tomography (SPECT)-CT system and quantitative analysis of wall thickening using gated SPECT with regard to the diagnostic accuracy of myocardial perfusion imaging. MATERIALS AND METHODS We prospectively included 70 patients with low prevalence of acute coronary artery disease who underwent a myocardial stress-rest SPECT study. Interpretation was based on supine nongated SPECT data with (AC) or without (NC) CT-based attenuation correction, and on gated SPECT data without attenuation correction (GNC). The scintigraphic diagnosis was obtained using standard automated quantitative analysis software and compared with a 23±14 months' clinical follow-up for 57 patients or with the results of a coronary angiography for 13 patients. RESULTS The sensitivity, specificity, and overall accuracy were, respectively, 77, 60, and 63% for NC SPECT, 67, 81, and 79% for AC SPECT, and 69, 98, and 93% for GNC SPECT. The initial diagnosis was modified in about one-third of the cases for both AC and GNC, this rate being independent of any clinical parameter (including BMI) except sex (two to four times more artifact correction in men). CONCLUSION Its widespread availability, cost effectiveness, safety in terms of radiation exposure, and ability to significantly improve myocardial perfusion imaging specificity and accuracy make gated SPECT a self-sufficient modality for coronary artery disease screening and follow-up, whereas CT-AC should be discussed on a case-by-case basis.
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Sherwood V, Civale J, Rivens I, Collins DJ, Leach MO, ter Haar GR. Development of a hybrid magnetic resonance and ultrasound imaging system. BIOMED RESEARCH INTERNATIONAL 2014; 2014:914347. [PMID: 25177702 PMCID: PMC4142177 DOI: 10.1155/2014/914347] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Revised: 07/11/2014] [Accepted: 07/16/2014] [Indexed: 12/29/2022]
Abstract
A system which allows magnetic resonance (MR) and ultrasound (US) image data to be acquired simultaneously has been developed. B-mode and Doppler US were performed inside the bore of a clinical 1.5 T MRI scanner using a clinical 1-4 MHz US transducer with an 8-metre cable. Susceptibility artefacts and RF noise were introduced into MR images by the US imaging system. RF noise was minimised by using aluminium foil to shield the transducer. A study of MR and B-mode US image signal-to-noise ratio (SNR) as a function of transducer-phantom separation was performed using a gel phantom. This revealed that a 4 cm separation between the phantom surface and the transducer was sufficient to minimise the effect of the susceptibility artefact in MR images. MR-US imaging was demonstrated in vivo with the aid of a 2 mm VeroWhite 3D-printed spherical target placed over the thigh muscle of a rat. The target allowed single-point registration of MR and US images in the axial plane to be performed. The system was subsequently demonstrated as a tool for the targeting and visualisation of high intensity focused ultrasound exposure in the rat thigh muscle.
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Affiliation(s)
- Victoria Sherwood
- Division of Radiotherapy and Imaging, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, 123 Old Brompton Road, London SW7 3RP, UK
| | - John Civale
- Division of Radiotherapy and Imaging, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, 123 Old Brompton Road, London SW7 3RP, UK
| | - Ian Rivens
- Division of Radiotherapy and Imaging, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, 123 Old Brompton Road, London SW7 3RP, UK
| | - David J. Collins
- Department of Clinical Magnetic Resonance, CRUK and EPSRC Cancer Imaging Centre, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, 123 Old Brompton Road, London SW7 3RP, UK
| | - Martin O. Leach
- Department of Clinical Magnetic Resonance, CRUK and EPSRC Cancer Imaging Centre, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, 123 Old Brompton Road, London SW7 3RP, UK
| | - Gail R. ter Haar
- Division of Radiotherapy and Imaging, The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, 123 Old Brompton Road, London SW7 3RP, UK
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The origins of SPECT and SPECT/CT. Eur J Nucl Med Mol Imaging 2013; 41 Suppl 1:S3-16. [PMID: 24218098 DOI: 10.1007/s00259-013-2606-5] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Accepted: 10/02/2013] [Indexed: 10/26/2022]
Abstract
Single photon emission computed tomography (SPECT) has a long history of development since its initial demonstration by Kuhl and Edwards in 1963. Although clinical utility has been dominated by the rotating gamma camera, there have been many technological innovations with the recent popularity of organ-specific dedicated SPECT systems. The combination of SPECT and CT evolved from early transmission techniques used for attenuation correction with the initial commercial systems predating the release of PET/CT. The development and acceptance of SPECT/CT has been relatively slow with continuing debate as to what cost/performance ratio is justified. Increasingly, fully diagnostic CT is combined with SPECT so as to facilitate optimal clinical utility.
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Currie GM, Iqbal B, Wheat JM, Davidson R, Kiat H. Single photon emission computed tomography (SPECT)/computed tomography (CT): an introduction. ACTA ACUST UNITED AC 2013. [DOI: 10.1002/j.2051-3909.2011.tb00157.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- GM Currie
- School of Dentistry and Health Sciences, Faculty of Science; Charles Sturt University; Wagga Wagga New South Wales 2650 Australia
- Australian School of Advanced Medicine; Macquarie University; Sydney New South Wales 2109 Australia
| | - B Iqbal
- School of Dentistry and Health Sciences, Faculty of Science; Charles Sturt University; Wagga Wagga New South Wales 2650 Australia
| | - JM Wheat
- School of Dentistry and Health Sciences, Faculty of Science; Charles Sturt University; Wagga Wagga New South Wales 2650 Australia
- Australian School of Advanced Medicine; Macquarie University; Sydney New South Wales 2109 Australia
| | - R Davidson
- School of Dentistry and Health Sciences, Faculty of Science; Charles Sturt University; Wagga Wagga New South Wales 2650 Australia
| | - H Kiat
- School of Dentistry and Health Sciences, Faculty of Science; Charles Sturt University; Wagga Wagga New South Wales 2650 Australia
- Australian School of Advanced Medicine; Macquarie University; Sydney New South Wales 2109 Australia
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Casas-Zamora JA, Kashyap R. The IAEA technical cooperation programme and nuclear medicine in the developing world: objectives, trends, and contributions. Semin Nucl Med 2013; 43:172-80. [PMID: 23561454 DOI: 10.1053/j.semnuclmed.2012.11.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The International Atomic Energy Agency's technical cooperation (TC) programme helps Member States in the developing world with limited infrastructure and human resource capacity to harness the potential of nuclear technologies in meeting socioeconomic development challenges. As a part of its human health TC initiatives, the Agency, through the TC mechanism, has the unique role of promoting nuclear medicine applications of fellowships, scientific visits, and training courses, via technology procurement, and in the past decade has contributed nearly $54 million through 180 projects in supporting technology procurement and human resource capacity development among Member States from the developing world (low- and middle-income countries). There has been a growing demand in nuclear medicine TC, particularly in Africa and ex-Soviet Union States where limited infrastructure presently exists, based on cancer and cardiovascular disease management projects. African Member States received the greatest allocation of TC funds in the past 10 years dedicated to building new or rehabilitating obsolete nuclear medicine infrastructure through procurement support of single-photon emission computed tomography machines. Agency support in Asia and Latin America has emphasized human resource capacity building, as Member States in these regions have already acquired positron emission tomography and hybrid modalities (positron emission tomography/computed tomography and single-photon emission computed tomography/computed tomography) in their health systems. The strengthening of national nuclear medicine capacities among Member States across different regions has enabled stronger regional cooperation among developing countries who through the Agency's support and within the framework of regional cooperative agreements are sharing expertise and fostering the sustainability and productive integration of nuclear medicine within their health systems.
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Radio-guided sentinel lymph node identification by lymphoscintigraphy fused with an anatomical vector profile: clinical applications. Ann Nucl Med 2013; 27:942-50. [PMID: 23893476 DOI: 10.1007/s12149-013-0758-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2013] [Accepted: 07/18/2013] [Indexed: 01/18/2023]
Abstract
OBJECTIVE To develop a method to fuse lymphoscintigraphic images with an adaptable anatomical vector profile and to evaluate its role in the clinical practice. METHODS We used Adobe Illustrator CS6 to create different vector profiles, we fused those profiles, using Adobe Photoshop CS6, with lymphoscintigraphic images of the patient. We processed 197 lymphoscintigraphies performed in patients with cutaneous melanomas, breast cancer or delayed lymph drainage. RESULTS Our models can be adapted to every patient attitude or position and contain different levels of anatomical details ranging from external body profiles to the internal anatomical structures like bones, muscles, vessels, and lymph nodes. If needed, more new anatomical details can be added and embedded in the profile without redrawing them, saving a lot of time. Details can also be easily hidden, allowing the physician to view only relevant information and structures. Fusion times are about 85 s. The diagnostic confidence of the observers increased significantly. The validation process showed a slight shift (mean 4.9 mm). CONCLUSIONS We have created a new, practical, inexpensive digital technique based on commercial software for fusing lymphoscintigraphic images with built-in anatomical reference profiles. It is easily reproducible and does not alter the original scintigraphic image. Our method allows a more meaningful interpretation of lymphoscintigraphies, an easier recognition of the anatomical site and better lymph node dissection planning.
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Solomon M, Nothdruft RE, Akers W, Edwards WB, Liang K, Xu B, Suddlow GP, Deghani H, Tai YC, Eggebrecht AT, Achilefu S, Culver JP. Multimodal fluorescence-mediated tomography and SPECT/CT for small-animal imaging. J Nucl Med 2013; 54:639-46. [PMID: 23447655 DOI: 10.2967/jnumed.112.105742] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
UNLABELLED Spatial and temporal coregistration of nuclear and optical images can enable the fusion of the information from these complementary molecular imaging modalities. A critical challenge is in integrating the optical and nuclear imaging hardware. Flexible fiber-based fluorescence-mediated tomography (FMT) systems provide a viable solution. The various bore sizes of small-animal nuclear imaging systems can potentially accommodate the FMT fiber imaging arrays. In addition, FMT imaging facilitates coregistration of the nuclear and optical contrasts in time. Herein, we combine a fiber-based FMT system with a preclinical SPECT/CT platform. Feasibility of in vivo imaging is demonstrated by tracking a monomolecular multimodal imaging agent (MOMIA) during transport from the forepaw to the axillary lymph node region of a rat. METHODS The fiber-based, video-rate FMT imaging system is composed of 12 sources (785- and 830-nm laser diodes) and 13 detectors. To maintain high temporal sampling, the system simultaneously acquires ratio-metric data at each detector. A 3-dimensional finite element model derived from CT projections provides anatomically based light propagation modeling. Injection of a MOMIA intradermally into the forepaw of rats provided spatially and temporally coregistered nuclear and optical contrasts. FMT data were acquired concurrently with SPECT and CT data. The incorporation of SPECT data as a priori information in the reconstruction of FMT data integrated both optical and nuclear contrasts. RESULTS Accurate depth localization of phantoms with different thicknesses was accomplished with an average center-of-mass error of 4.1 ± 2.1 mm between FMT and SPECT measurements. During in vivo tests, fluorescence and radioactivity from the MOMIA were colocalized in spatially coincident regions with an average center-of-mass error of 2.68 ± 1.0 mm between FMT and SPECT for axillary lymph node localization. Intravital imaging with surgical exposure of the lymph node validated the localization of the optical contrast. CONCLUSION The feasibility of integrating a fiber-based, video-rate FMT system with a commercial preclinical SPECT/CT platform was established. These coregistered FMT and SPECT/CT results with MOMIAs may facilitate the development of the next generation of preclinical and clinical multimodal optical-nuclear platforms for a broad array of imaging applications and help elucidate the underlying biologic processes relevant to cancer diagnosis and therapy monitoring.
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Affiliation(s)
- Metasebya Solomon
- Department of Biomedical Engineering, Washington University, St. Louis, MO 63110, USA
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Martí-Climent J, Prieto E, Domínguez-Prado I, García-Velloso M, Rodríguez-Fraile M, Arbizu J, Vigil C, Caicedo C, Peñuelas I, Richter J. Contribution of time of flight and point spread function modeling to the performance characteristics of the PET/CT Biograph mCT scanner. Rev Esp Med Nucl Imagen Mol 2013. [DOI: 10.1016/j.remnie.2012.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Abstract
During the last decade, positron emission tomography/computed tomography (PET/CT) and single-photon emission computed tomography/computed tomography (SPECT/CT) have procured advances in research and clinical application of fusion imaging. The recent introduction of systems that combine PET and MRI opens new horizons for multimodality molecular imaging. These systems offer simultaneous morphologic, functional, and molecular information of a living system. Moreover, other combinations of anatomic and functional imaging modalities (for example CT and MRI or PET and optical imaging) are emerging, holding promise in basic medical research or in clinical medicine. These developments are paralleled by advances in the field of biomolecules and particles, to provide new agents useful for more than one imaging modality and to facilitate the study of the same target by different imaging devices. In the near future PET/MRI may emerge as a new powerful multimodality technique in clinical oncology, offering considerable potential for imaging applications beyond correlation of functional and anatomic images. Future developments should include the simultaneous acquisition of multifunctional data such as PET tracer uptake, MR spectroscopy, or fMRI along with high-resolution anatomic MRI.
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Bural GG, Muthukrishnan A, Oborski MJ, Mountz JM. Improved Benefit of SPECT/CT Compared to SPECT Alone for the Accurate Localization of Endocrine and Neuroendocrine Tumors. Mol Imaging Radionucl Ther 2012; 21:91-6. [PMID: 23487541 PMCID: PMC3590979 DOI: 10.4274/mirt.80299] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2012] [Accepted: 11/19/2012] [Indexed: 01/16/2023] Open
Abstract
Objective: To assess the clinical utility of SPECT/ CT in subjects with endocrine and neuroendocrine tumors compared to SPECT alone. Material and Methods: 48 subjects (31 women;17 men; mean age 54±11) with clinical suspicion or diagnosis of endocrine and neuroendocrine tumor had 50 SPECT/CT scans (32 Tc-99m MIBI, 5 post treatment I-131, 8 In-111 Pentetreotide, and 5 I-123 MIBG). SPECT alone findings were compared to SPECT/CT and to pathology or radiological follow up. Results: From the 32 Tc-99m MIBI scans, SPECT accurately localized the lesion in 22 positive subjects while SPECT/CT did in 31 subjects. Parathyroid lesions not seen on SPECT alone were smaller than 10 mm. In five post treatment I-131 scans, SPECT alone neither characterized, nor localized any lesions accurately. SPECT/CT revealed 3 benign etiologies, a metastatic lymph node, and one equivocal lesion. In 8 In-111 Pentetreotide scans, SPECT alone could not localize primary or metastatic lesions in 6 subjects all of which were localized with SPECT/CT. In five I-123 MIBG scans, SPECT alone could not detect a 1.1 cm adrenal lesion or correctly characterize normal physiologic adrenal uptake in consecutive scans of the same patient with prior history of adrenelectomy, all of which were correctly localized and characterized with SPECT/CT. Conclusion: SPECT/CT is superior to SPECT alone in the assessment of endocrine and neuroendocrine tumors. It is better in lesion localization and lesion characterization leading to a decrease in the number of equivocal findings. SPECT/CT should be included in the clinical work up of all patients with diagnosis or suspicion of endocrine and neuroendocrine tumors. Conflict of interest:None declared.
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Affiliation(s)
- Gonca G Bural
- University of Pittsburgh Medical Center, Department of Radiology, Pittsburgh, PA, USA
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Weber K, Berger F, Mustafa M, Reiser MF, Bartenstein P, Haug A. [SPECT/CT for staging and treatment monitoring in oncology. Applications in differentiated thyroid cancer and liver tumors]. Radiologe 2012; 52:646-52. [PMID: 22710988 DOI: 10.1007/s00117-011-2267-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
CLINICAL/METHODICAL ISSUE Hybrid imaging of function and morphology has gained significant importance for lesion detection and treatment monitoring in oncology. In patients with differentiated thyroid carcinoma (DTC) a planar whole body scan is carried out after radioiodine therapy (RIT) for staging. However, due to limited spatial resolution the diagnostic accuracy of this scintigraphy method is impaired. Radioembolization utilizing (90)Yttrium loaded micro-spheres by selective internal radiotherapy (SIRT) allows a minor invasive therapy of primary and secondary liver tumors. In order to avoid side effects of the micro-spheres caused by an outflow into intestines, stomach or lungs, imaging the arteries supplying the liver has to be performed by means of technetium-99m macroaggregated albumin ((99m)Tc-MAA) and scintigraphy. The limited morphological information supplied by scintigraphy is again a challenge in treatment monitoring. STANDARD RADIOLOGICAL/NUCLEAR MEDICAL METHODS: (131)Iodine whole body scanning is used for staging in patients with DTC 3-4 days after ablation. Monitoring of the tumor marker thyroglobulin and selective radioiodine whole body scans are available for patients with a high risk profile in the further follow-up with imaging of the arteries supplying the liver by means of (99m)Tc-MAA scintigraphy in preparation of SIRT. METHODICAL INNOVATIONS Single photon emission computed tomography/computed tomography (SPECT/CT) of the neck and thorax with a therapeutic activity of radioiodine for staging after ablation. Techniques include imaging of arteries supplying the liver by means of (99m)Tc-MAA SPECT/CT before SIRT and evaluation and quantification of the uptake of liver tumors, especially in comparison to the uptake of liver parenchyma by means of SPECT/CT. PERFORMANCE Due to the integration of combined functional and morphological information SPECT/CT can be used to characterize the morphology and iodine uptake of lesions more accurately, resulting in optimized staging in patients with DTC in comparison to whole body iodine scans and SPECT/CT provides more accurate imaging of the arterial supply of the liver and of potential outflows of micro-spheres into other organs. SPECT/CT allows evaluation and quantification of the uptake of liver tumors. ACHIEVEMENTS Improved postablative staging in patients with differentiated thyroid cancer by SPECT/CT in comparison to radioiodine whole body scans can be achieved. Improved planning and monitoring of SIRT therapies utilizing SPECT/CT leads to optimized therapeutic doses within liver lesions. PRACTICAL RECOMMENDATIONS Integration of SPECT/CT into the clinical standard for postablative staging in patients with DTC is recommended as well as utilization of SPECT/CT during the planning process, for dose calculation and treatment monitoring of SIRT therapies.
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Affiliation(s)
- K Weber
- Institut für Klinische Radiologie, Klinikum der Ludwig-Maximilians-Universität München, Campus Innenstadt, München, Deutschland
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Martí-Climent JM, Prieto E, Domínguez-Prado I, García-Velloso MJ, Rodríguez-Fraile M, Arbizu J, Vigil C, Caicedo C, Peñuelas I, Richter JA. [Contribution of time of flight and point spread function modeling to the performance characteristics of the PET/CT Biograph mCT scanner]. Rev Esp Med Nucl Imagen Mol 2012; 32:13-21. [PMID: 22995150 DOI: 10.1016/j.remn.2012.07.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2012] [Accepted: 07/24/2012] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To characterize the performance of the Biograph mCT PET/CT TrueV scanner with time of flight (TOF) and point spread function (PSF) modeling. MATERIAL AND METHODS The PET/CT scanner combines a 64-slice CT and PET scanner that incorporates in the reconstruction the TOF and PSF information. PET operating characteristics were evaluated according to the standard NEMA NU 2-2007, expanding some tests. In addition, different reconstruction algorithms were included, and the intrinsic radiation and tomographic uniformity were also evaluated. RESULTS The spatial resolution (FWHM) at 1 and 10cm was 4.4 and 5.3mm, improving to 2.6 and 2.5mm when PSF is introduced. Sensitivity was 10.9 and 10.2 Kcps/MBq at 0 and 10cm from the axis. Scatter fraction was less than 34% at low concentrations and the noise equivalent count rate (NECR) was maximal at 27.8 kBq/mL with 182 Kcps, the intrinsic radiation produced a rate of 4.42 true coincidences per second. Coefficient of variation of the volume and system uniformity were 4.7 and 0.8% respectively. The image quality test showed better results when PSF and TOF were included together. PSF improved the hot spheres contrast and background variability, while TOF improved the cold spheres contrast. CONCLUSIONS The Biograph mCT TrueV scanner has good performance characteristics. The image quality improves when the information from the PSF and the TOF is incorporated in the reconstruction.
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Affiliation(s)
- J M Martí-Climent
- Servicio de Medicina Nuclear, Clínica Universidad de Navarra, Pamplona, España.
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Fahey FH, Treves ST, Adelstein SJ. Minimizing and communicating radiation risk in pediatric nuclear medicine. J Nucl Med Technol 2012; 40:13-24. [PMID: 22393223 DOI: 10.2967/jnumed.109.069609] [Citation(s) in RCA: 108] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
The value of pediatric nuclear medicine is well established. Pediatric patients are referred to nuclear medicine from nearly all pediatric specialties including urology, oncology, cardiology, gastroenterology, and orthopedics. Radiation exposure is associated with a potential, small, risk of inducing cancer in the patient later in life and is higher in younger patients. Recently, there has been enhanced interest in exposure to radiation from medical imaging. Thus, it is incumbent on practitioners of pediatric nuclear medicine to have an understanding of dosimetry and radiation risk to communicate effectively with their patients and their families. This article reviews radiation dosimetry for radiopharmaceuticals and also CT given the recent proliferation of PET/CT and SPECT/CT. It also describes the scientific basis for radiation risk estimation in the context of pediatric nuclear medicine. Approaches for effective communication of risk to patients' families are discussed. Lastly, radiation dose reduction in pediatric nuclear medicine is explicated.
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Affiliation(s)
- Frederic H Fahey
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Children's Hospital Boston, Boston, Massachusetts 02115, USA.
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Zuckier LS. Hybrid imaging in planar scintigraphy: new implementations and historical precedents. Semin Nucl Med 2012; 42:62-72. [PMID: 22117814 DOI: 10.1053/j.semnuclmed.2011.08.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Fusion of tomographic radionuclide studies with anatomical examinations has become standard practice in positron emission tomography (PET) and single photon emission computed tomography (SPECT) imaging. Nonetheless, fusion of planar scintigraphic images with an anatomical modality remains distinctly uncommon, although methods to do so have appeared sporadically in the literature during the past 2 decades. In this article we review several techniques that have been used to combine planar scintigraphic images with radiographs and visual (photographic) images. Rigid or affine transformations have been performed to co-register the planar images with each other using custom, commercial, or public domain software. Display of the hybrid images has been achieved primarily with nonselective color-fusion methods. Promising efforts are underway to develop a technique of fusing planar lymphoscintigraphic images with CT topograms (scout images) obtained on the SPECT-CT camera in a manner that compensates for position-dependent variation in magnification that affects the CT scout. An advantage of this approach is that both of the component images are acquired on the same gantry, without need for repositioning of the patient. It is instructive to note that techniques of fusing rectilinear scans with radiographic and visual images were first developed more than 50 years ago. The revisiting of these methods after many decades reflects a fundamental need for spatial orientation in nuclear medicine that fusion imaging can also bring to planar scintigraphic studies.
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Towards omni-tomography--grand fusion of multiple modalities for simultaneous interior tomography. PLoS One 2012; 7:e39700. [PMID: 22768108 PMCID: PMC3387257 DOI: 10.1371/journal.pone.0039700] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2012] [Accepted: 05/24/2012] [Indexed: 12/01/2022] Open
Abstract
We recently elevated interior tomography from its origin in computed tomography (CT) to a general tomographic principle, and proved its validity for other tomographic modalities including SPECT, MRI, and others. Here we propose “omni-tomography”, a novel concept for the grand fusion of multiple tomographic modalities for simultaneous data acquisition in a region of interest (ROI). Omni-tomography can be instrumental when physiological processes under investigation are multi-dimensional, multi-scale, multi-temporal and multi-parametric. Both preclinical and clinical studies now depend on in vivo tomography, often requiring separate evaluations by different imaging modalities. Over the past decade, two approaches have been used for multimodality fusion: Software based image registration and hybrid scanners such as PET-CT, PET-MRI, and SPECT-CT among others. While there are intrinsic limitations with both approaches, the main obstacle to the seamless fusion of multiple imaging modalities has been the bulkiness of each individual imager and the conflict of their physical (especially spatial) requirements. To address this challenge, omni-tomography is now unveiled as an emerging direction for biomedical imaging and systems biomedicine.
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Abdoli M, Dierckx RAJO, Zaidi H. Metal artifact reduction strategies for improved attenuation correction in hybrid PET/CT imaging. Med Phys 2012; 39:3343-60. [DOI: 10.1118/1.4709599] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Dondi M, Kashyap R, Paez D, Pascual T, Zaknun J, Bastos FM, Pynda Y. Trends in Nuclear Medicine in Developing Countries. J Nucl Med 2011; 52 Suppl 2:16S-23S. [DOI: 10.2967/jnumed.111.089193] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Varrone A, Gulyás B, Takano A, Stabin MG, Jonsson C, Halldin C. Simplified quantification and whole-body distribution of [18F]FE-PE2I in nonhuman primates: prediction for human studies. Nucl Med Biol 2011; 39:295-303. [PMID: 22033024 DOI: 10.1016/j.nucmedbio.2011.08.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2011] [Revised: 08/08/2011] [Accepted: 08/09/2011] [Indexed: 11/20/2022]
Abstract
INTRODUCTION [(18)F]FE-PE2I is a promising dopamine transporter (DAT) radioligand. In nonhuman primates, we examined the accuracy of simplified quantification methods and the estimates of radiation dose of [(18)F]FE-PE2I. METHODS In the quantification study, binding potential (BP(ND)) values previously reported in three rhesus monkeys using kinetic and graphical analyses of [(18)F]FE-PE2I were used for comparison. BP(ND) using the cerebellum as reference region was obtained with four reference tissue methods applied to the [(18)F]FE-PE2I data that were compared with the kinetic and graphical analyses. In the whole-body study, estimates of adsorbed radiation were obtained in two cynomolgus monkeys. RESULTS All reference tissue methods provided BP(ND) values within 5% of the values obtained with the kinetic and graphical analyses. The shortest imaging time for stable BP(ND) estimation was 54 min. The average effective dose of [(18)F]FE-PE2I was 0.021 mSv/MBq, similar to 2-deoxy-2-[(18)F]fluoro-d-glucose. CONCLUSIONS The results in nonhuman primates suggest that [(18)F]FE-PE2I is suitable for accurate and stable DAT quantification, and its radiation dose estimates would allow for a maximal administered radioactivity of 476 MBq in human subjects.
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Affiliation(s)
- Andrea Varrone
- Karolinska Institutet, Department of Clinical Neuroscience, Centre for Psychiatry Research, SE-17176 Stockholm, Sweden.
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Hrycushko BA, Ware S, Li S, Bao A. Improved tumour response prediction with equivalent uniform dose in pre-clinical study using direct intratumoural infusion of liposome-encapsulated ¹⁸⁶Re radionuclides. Phys Med Biol 2011; 56:5721-34. [PMID: 21841210 PMCID: PMC3164288 DOI: 10.1088/0031-9155/56/17/016] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Crucial to all cancer therapy modalities is a strong correlation between treatment and effect. Predictability of therapy success/failure allows for the optimization of treatment protocol and aids in the decision of whether additional treatment is necessary to prevent tumour progression. This work evaluated the relationship between cancer treatment and effect for intratumoural infusions of liposome-encapsulated ¹⁸⁶Re to head and neck squamous cell carcinoma xenografts of nude rats. Absorbed dose calculations using a dose-point kernel convolution technique showed significant intratumoural dose heterogeneity due to the short range of the beta-particle emissions. The use of three separate tumour infusion locations improved dose homogeneity compared to a single infusion location as a result of a more uniform radioactivity distribution. An improved dose-response correlation was obtained when using effective uniform dose (EUD) calculations based on a generic set of radiobiological parameters (R² = 0.84) than when using average tumour absorbed dose (R² = 0.22). Varying radiobiological parameter values over ranges commonly used for all types of tumours showed little effect on EUD calculations, which suggests that individualized parameter use is of little significance as long as the intratumoural dose heterogeneity is taken into consideration in the dose-response relationship. The improved predictability achieved when using EUD calculations for this cancer therapy modality may be useful for treatment planning and evaluation.
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Affiliation(s)
- Brian A Hrycushko
- Department of Radiology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Steve Ware
- Department of Radiology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Shihong Li
- Department of Radiology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Ande Bao
- Department of Radiology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
- Department of Otolaryngology-Head and Neck Surgery, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
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Cuocolo A. Attenuation correction for myocardial perfusion SPECT imaging: still a controversial issue. Eur J Nucl Med Mol Imaging 2011; 38:1887-9. [PMID: 21874324 DOI: 10.1007/s00259-011-1898-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2011] [Accepted: 07/29/2011] [Indexed: 10/17/2022]
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Impact of attenuation correction and gated acquisition in SPECT myocardial perfusion imaging: results of the multicentre SPAG (SPECT Attenuation Correction vs Gated) study. Eur J Nucl Med Mol Imaging 2011; 38:1890-8. [DOI: 10.1007/s00259-011-1855-4] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2011] [Accepted: 05/26/2011] [Indexed: 10/18/2022]
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Roach M, Alberini JL, Pecking AP, Testori A, Verrecchia F, Soteldo J, Ganswindt U, Joyal JL, Babich JW, Witte RS, Unger E, Gottlieb R. Diagnostic and therapeutic imaging for cancer: therapeutic considerations and future directions. J Surg Oncol 2011; 103:587-601. [PMID: 21480253 DOI: 10.1002/jso.21805] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
As cancer treatment cost soar and the mantra for "personalized medicine" grows louder, we will increasingly be searching for solutions to these diametrically opposed forces. In this review we highlight several exciting novel imaging strategies including MRI, CT, PET SPECT, sentinel node, and ultrasound imaging that hold great promise for improving outcomes through detection of lymph node involvement. We provide clinical data that demonstrate how these evolving strategies have the potential to transform treatment paradigms.
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Affiliation(s)
- Mack Roach
- UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, California, USA.
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Alberini JL, Edeline V, Giraudet AL, Champion L, Paulmier B, Madar O, Poinsignon A, Bellet D, Pecking AP. Single photon emission tomography/computed tomography (SPET/CT) and positron emission tomography/computed tomography (PET/CT) to image cancer. J Surg Oncol 2011; 103:602-6. [DOI: 10.1002/jso.21695] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Wild JM, Ajraoui S, Deppe MH, Parnell SR, Marshall H, Parra-Robles J, Ireland RH. Synchronous acquisition of hyperpolarised 3He and 1H MR images of the lungs - maximising mutual anatomical and functional information. NMR IN BIOMEDICINE 2011; 24:130-134. [PMID: 20821726 DOI: 10.1002/nbm.1565] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2010] [Revised: 04/06/2010] [Accepted: 04/19/2010] [Indexed: 05/29/2023]
Abstract
The development of hybrid medical imaging scanners has allowed imaging with different detection modalities at the same time, providing different anatomical and functional information within the same physiological time course with the patient in the same position. Until now, the acquisition of proton MRI of lung anatomy and hyperpolarised gas MRI of lung function required separate breath-hold examinations, meaning that the images were not spatially registered or temporally synchronised. We demonstrate the spatially registered concurrent acquisition of lung images from two different nuclei in vivo. The temporal and spatial registration of these images is demonstrated by a high degree of mutual consistency that is impossible to achieve in separate scans and breath holds.
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Affiliation(s)
- Jim M Wild
- Unit of Academic Radiology, University of Sheffield, Sheffield, UK.
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Martí-Bonmatí L, Sopena R, Bartumeus P, Sopena P. Multimodality imaging techniques. CONTRAST MEDIA & MOLECULAR IMAGING 2010; 5:180-9. [DOI: 10.1002/cmmi.393] [Citation(s) in RCA: 95] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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40
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Joshi BP, Wang TD. Exogenous Molecular Probes for Targeted Imaging in Cancer: Focus on Multi-modal Imaging. Cancers (Basel) 2010; 2:1251-87. [PMID: 22180839 PMCID: PMC3237638 DOI: 10.3390/cancers2021251] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2010] [Revised: 05/31/2010] [Accepted: 06/02/2010] [Indexed: 01/09/2023] Open
Abstract
Cancer is one of the major causes of mortality and morbidity in our health care system. Molecular imaging is an emerging methodology for the early detection of cancer, and the development of exogenous molecular probes that can be labeled for multi-modality imaging is critical to this process. Today, molecular imaging is at crossroad, and new targeted imaging agents are expected to broadly expand our ability to detect pre-malignant lesions. This integrated imaging strategy will permit clinicians to not only localize lesions within the body, but also to visualize the expression and activity of specific molecules. This information is expected to have a major impact on diagnosis, therapy, drug development and understanding of basic cancer biology. At this time, a number of molecular probes have been developed by conjugating various labels to affinity ligands for targeting in different imaging modalities. This review will describe the current status of exogenous molecular probes for optical, nuclear and MRI imaging platforms. Furthermore, we will also shed light on how these techniques can be used synergistically in multi-modal platforms and how these techniques are being employed in current research.
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Affiliation(s)
- Bishnu P. Joshi
- Division of Gastroenterology, Department of Medicine, University of Michigan, School of Medicine, 109 Zina Pitcher Place, BSRB 1722, Ann Arbor, MI 48109, USA
| | - Thomas D. Wang
- Division of Gastroenterology, Department of Medicine, University of Michigan, School of Medicine, 109 Zina Pitcher Place, BSRB 1722, Ann Arbor, MI 48109, USA
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI 48109, USA
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Schwaiger M, Ziegler SI, Nekolla SG. PET/CT challenge for the non-invasive diagnosis of coronary artery disease. Eur J Radiol 2010; 73:494-503. [PMID: 20206454 DOI: 10.1016/j.ejrad.2009.12.025] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2009] [Accepted: 12/15/2009] [Indexed: 10/19/2022]
Abstract
This review will focus on the clinical potential of PET/CT for the characterization of cardiovascular diseases. We describe the technical challenges of combining instrumentation with very different imaging performance and discuss the clinical applications in the field of cardiology.
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Affiliation(s)
- Markus Schwaiger
- Klinikum rechts der Isar, Technische Universität München, Nuklearmedizinische Klinik und Poliklinik, München, Germany
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Torres Martin de Rosales R, Årstad E, Blower PJ. Nuclear imaging of molecular processes in cancer. Target Oncol 2009; 4:183-97. [DOI: 10.1007/s11523-009-0120-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2009] [Accepted: 09/09/2009] [Indexed: 12/25/2022]
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