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de Jong TL, Koopman D, van Dalen JA, Tegelaar A, van Dijk JD, Stevens H, Jager PL. Performance of digital PET/CT compared with conventional PET/CT in oncologic patients: a prospective comparison study. Ann Nucl Med 2022; 36:756-764. [PMID: 35727433 DOI: 10.1007/s12149-022-01758-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 05/25/2022] [Indexed: 11/01/2022]
Abstract
PURPOSE Digital PET systems (dPET) improve lesion detectability as compared to PET systems with conventional photomultiplier tubes (cPET). We prospectively studied the performance of high-resolution digital PET scans in patients with cancer, as compared with high- and standard-resolution conventional PET scans, taking the acquisition order into account. METHODS We included 212 patients with cancer, who were referred for disease staging or restaging. All patients underwent FDG-PET/CT on a dPET scanner and on a cPET scanner in a randomized order. The scans were acquired immediately after each other. Three image reconstructions were generated: 1) standard-resolution (4 × 4 × 4 mm3 voxels) cPET, 2) high-resolution (2 × 2 × 2 mm3 voxels) cPET, and 3) high-resolution dPET. Two experienced PET readers visually assessed the three reconstructions side-by-side and ranked them according to scan preference, in an independent and blinded fashion. RESULTS On high-resolution dPET, the PET readers detected more lesions or they had a higher diagnostic confidence than on high- and standard-resolution cPET (p < 0.001). High-resolution dPET was preferred in 90% of the cases, as compared to 44% for high-resolution cPET and 1% for standard-resolution cPET (p < 0.001). However, for the subgroup of patients where dPET was made first (n = 103, 61 ± 10 min after FDG administration) and cPET was made second (93 ± 15 min after FDG administration), no significant difference in preference was found between the high-resolution cPET and dPET reconstructions (p = 0.41). CONCLUSIONS DPET scanners in combination with high-resolution reconstructions clinically outperform cPET scanners with both high- and standard-resolution reconstructions as the PET readers identified more FDG-avid lesions, their diagnostic confidence was increased, and they visually preferred dPET. However, when dPET was made first, high-resolution dPET and high-resolution cPET showed similar performance, indicating the positive effect of a prolonged FDG uptake time. Therefore, high-resolution cPET in combination with a prolonged FDG uptake time can be considered as an alternative.
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Affiliation(s)
- Tonke L de Jong
- Department of Nuclear Medicine, Isala Hospital, Dokter van Heesweg 2, 8025AB, Zwolle, Netherlands.
| | - Daniëlle Koopman
- Department of Nuclear Medicine, Isala Hospital, Dokter van Heesweg 2, 8025AB, Zwolle, Netherlands
| | - Jorn A van Dalen
- Department of Medical Physics, Isala Hospital, Zwolle, Netherlands
| | - Aline Tegelaar
- Department of Nuclear Medicine, Isala Hospital, Dokter van Heesweg 2, 8025AB, Zwolle, Netherlands
| | - Joris D van Dijk
- Department of Nuclear Medicine, Isala Hospital, Dokter van Heesweg 2, 8025AB, Zwolle, Netherlands
| | - Henk Stevens
- Department of Nuclear Medicine, Isala Hospital, Dokter van Heesweg 2, 8025AB, Zwolle, Netherlands
| | - Pieter L Jager
- Department of Nuclear Medicine, Isala Hospital, Dokter van Heesweg 2, 8025AB, Zwolle, Netherlands
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Menendez MI, Moore RR, Abdel-Rasoul M, Wright CL, Fernandez S, Jackson RD, Knopp MV. [ 18F] Sodium Fluoride Dose Reduction Enabled by Digital Photon Counting PET/CT for Evaluation of Osteoblastic Activity. Front Med (Lausanne) 2022; 8:725118. [PMID: 35096851 PMCID: PMC8789749 DOI: 10.3389/fmed.2021.725118] [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: 06/14/2021] [Accepted: 12/17/2021] [Indexed: 11/24/2022] Open
Abstract
The aim of the study was to assess the quality and reproducibility of reducing the injected [18F] sodium fluoride ([18F]NaF) dose while maintaining diagnostic imaging quality in bone imaging in a preclinical skeletal model using digital photon counting PET (dPET) detector technology. Beagles (n = 9) were administered three different [18F]NaF doses: 111 MBq (n = 5), 20 MBq (n = 5), and 1.9 MBq (n = 9). Imaging started ≃45 min post-injection for ≃30 min total acquisition time. Images were reconstructed using Time-of-Flight, ultra-high definition (voxel size of 1 × 1 × 1 mm3), with 3 iterations and 3 subsets. Point spread function was modeled and Gaussian filtering was applied. Skeleton qualitative and quantitative molecular image assessment was performed. The overall diagnostic quality of all images scored excellent (61%) and acceptable (39%) by all the reviewers. [18F]NaF SUVmean showed no statistically significant differences among the three doses in any of the region of interest assessed. This study demonstrated that a 60-fold [18F]NaF dose reduction was not significantly different from the highest dose, and it had not significant effect on overall image quality and quantitative accuracy. In the future, ultra-low dose [18F]NaF dPET/CT imaging may significantly decrease PET radiation exposure to preclinical subjects and personnel.
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Affiliation(s)
- Maria I Menendez
- Department of Radiology, The Wright Center of Innovation in Biomedical Imaging, The Ohio State University Wexner Medical Center, Columbus, OH, United States
| | - Richard R Moore
- Department of Radiology, The Wright Center of Innovation in Biomedical Imaging, The Ohio State University Wexner Medical Center, Columbus, OH, United States
| | - Mahmoud Abdel-Rasoul
- Center for Biostatistics, College of Medicine, The Ohio State University, Columbus, OH, United States
| | - Chadwick L Wright
- Department of Radiology, The Wright Center of Innovation in Biomedical Imaging, The Ohio State University Wexner Medical Center, Columbus, OH, United States
| | - Soledad Fernandez
- Center for Biostatistics, College of Medicine, The Ohio State University, Columbus, OH, United States
| | - Rebecca D Jackson
- Department of Internal Medicine, Endocrinology, Diabetes and Metabolism, The Ohio State University Wexner Medical Center, Columbus, OH, United States
| | - Michael V Knopp
- Department of Radiology, The Wright Center of Innovation in Biomedical Imaging, The Ohio State University Wexner Medical Center, Columbus, OH, United States
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Luo Y, Zhou L, Zhan B, Fei Y, Zhou J, Wang Y, Shen D. Adaptive rectification based adversarial network with spectrum constraint for high-quality PET image synthesis. Med Image Anal 2021; 77:102335. [PMID: 34979432 DOI: 10.1016/j.media.2021.102335] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 11/02/2021] [Accepted: 12/13/2021] [Indexed: 12/13/2022]
Abstract
Positron emission tomography (PET) is a typical nuclear imaging technique, which can provide crucial functional information for early brain disease diagnosis. Generally, clinically acceptable PET images are obtained by injecting a standard-dose radioactive tracer into human body, while on the other hand the cumulative radiation exposure inevitably raises concerns about potential health risks. However, reducing the tracer dose will increase the noise and artifacts of the reconstructed PET image. For the purpose of acquiring high-quality PET images while reducing radiation exposure, in this paper, we innovatively present an adaptive rectification based generative adversarial network with spectrum constraint, named AR-GAN, which uses low-dose PET (LPET) image to synthesize standard-dose PET (SPET) image of high-quality. Specifically, considering the existing differences between the synthesized SPET image by traditional GAN and the real SPET image, an adaptive rectification network (AR-Net) is devised to estimate the residual between the preliminarily predicted image and the real SPET image, based on the hypothesis that a more realistic rectified image can be obtained by incorporating both the residual and the preliminarily predicted PET image. Moreover, to address the issue of high-frequency distortions in the output image, we employ a spectral regularization term in the training optimization objective to constrain the consistency of the synthesized image and the real image in the frequency domain, which further preserves the high-frequency detailed information and improves synthesis performance. Validations on both the phantom dataset and the clinical dataset show that the proposed AR-GAN can estimate SPET images from LPET images effectively and outperform other state-of-the-art image synthesis approaches.
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Affiliation(s)
- Yanmei Luo
- School of Computer Science, Sichuan University, China
| | - Luping Zhou
- School of Electrical and Information Engineering, University of Sydney, Australia
| | - Bo Zhan
- School of Computer Science, Sichuan University, China
| | - Yuchen Fei
- School of Computer Science, Sichuan University, China
| | - Jiliu Zhou
- School of Computer Science, Sichuan University, China; School of Computer Science, Chengdu University of Information Technology, China
| | - Yan Wang
- School of Computer Science, Sichuan University, China.
| | - Dinggang Shen
- School of Biomedical Engineering, ShanghaiTech University, China; Department of Research and Development, Shanghai United Imaging Intelligence Co., Ltd., Shanghai, China
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68Ga-PSMA11 PET/CT for biochemically recurrent prostate cancer: Influence of dual-time and PMT- vs SiPM-based detectors. Transl Oncol 2021; 15:101293. [PMID: 34823095 PMCID: PMC8626686 DOI: 10.1016/j.tranon.2021.101293] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 11/11/2021] [Accepted: 11/19/2021] [Indexed: 11/21/2022] Open
Abstract
68Ga-PSMA11 PET/CT showed high detection rates for recurrent prostate cancer. Standard and new generation PET/CT performed equally on a per-patient basis. Delayed imaging revealed no additional lesions. SiPM-based PET/CT identified more prostate cancer lesions. PSMA positivity rate increased with higher PSA levels and higher PSA velocity.
Objectives 68Ga-PSMA11 PET/CT is excellent for evaluating biochemically recurrent prostate cancer (BCR PC). Here, we compared the positivity rates of dual-time point imaging using a PET/CT scanner (DMI) with silicon photomultiplier (SiPM) detectors and a PET/CT scanner (D690) with photomultiplier tubes (PMT), in patients with BCR PC. Methods Fifty-eight patients were prospectively recruited and randomized to receive scans on DMI followed by D690 or vice-versa. Images from DMI were reconstructed using the block sequential regularized expectation maximization (BSREM) algorithm and images from D690 were reconstructed using ordered subset expectation maximization (OSEM), according to the vendor's recommendations. Two readers independently reviewed all images in randomized order, recorded the number and location of lesions, as well as standardized uptake value (SUV) measurements. Results Twenty-eight patients (group A) had DMI as first scanner followed by D690, while 30 patients (group B) underwent scans in reversed order. Mean PSA was 30±112.9 (range 0.3–600.66) ng/mL for group A and 41.5 ± 213.2 (range 0.21–1170) ng/mL for group B (P = 0.796). The positivity rate in group A was 78.6% (22/28 patients) vs. 73.3% (22/30 patients) in group B. Although the performance of the two scanners was equivalent on a per-patient basis, DMI identified 5 additional sites of suspected recurrent disease when used as first scanner. The second scan time point did not reveal additional abnormal uptake. Conclusions The delayed time point in 68Ga-PSMA11 PET/CT did not show a higher positivity rate. SiPM-based PET/CT identified additional lesions. Further studies with larger cohorts are needed to confirm these results.
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López-Mora DA, Carrió I, Flotats A. Digital PET vs Analog PET: Clinical Implications? Semin Nucl Med 2021; 52:302-311. [PMID: 34836617 DOI: 10.1053/j.semnuclmed.2021.10.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 10/19/2021] [Indexed: 12/17/2022]
Abstract
Positron emission tomography (PET) is a functional imaging technique introduced in 1970s. Over the years, PET was used alone but is in 2000 when the first hybrid PET/CT device was clinically introduced. Since then, PET has continuously been marked by technological developments, being the most recent one the introduction of silicon photomultipliers (SiPMs) as an alternative to standard photomultiplier tubes used in analog PET/CT systems. SiPMs, the basis for the so called digital PET/CT systems, are smaller than standard photomultiplier tubes (enabling higher spatial resolution) and provide up to 100% coverage of the crystal area, as well as high sensitivity, low noise, and fast timing resolution. SiPMs in combination with optimized acquisition and reconstruction parameters improve the localization of the annihilation events, provide high definition PET images, and offer higher sensitivity and higher diagnostic performance. This article summarizes the evidence about the superior performance of the state of the art digital PET and highlights its potential clinical implications. Digital PET opens new perspectives in the quantification and characterization of small lesions, which are mostly undetectable using analog PET systems, potentially changing patient management and improving outcomes in oncological and non-oncological diseases. Moreover, digital PET offers the possibility to reduce radiation dose and scan times which may facilitate the implementation of PET to address unmet clinical needs.
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Affiliation(s)
- Diego Alfonso López-Mora
- Nuclear Medicine Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - Ignasi Carrió
- Nuclear Medicine Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Albert Flotats
- Nuclear Medicine Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
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Filippi L, Schillaci O. Digital PET and detection of recurrent prostate cancer: what have we gained, and what is still missing? Expert Rev Med Devices 2021; 18:1107-1110. [PMID: 34608848 DOI: 10.1080/17434440.2021.1990036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Defined by the TIME magazine 'medical invention of the year 2000,' positron emission computed tomography (PET/CT) has experienced impressive improvements in technology and clinical applications over time. In recent years, silicon photomultipliers (SiPMs) detectors, characterized by excellent intrinsic time resolution and high photon-detection efficiency, have been introduced as an alternative to the classic photomultiplier tubes (PMTs), thus moving the field of PET technology forward and leading to the so-called digital PET/CT (dPET/CT). On the other side, the radiopharmaceutical 68Ga-PSMA-11, approved by the Food and Drug Administration in December 2020, proved to strongly impact prostate cancer (PCa) diagnosis and management. In the study under evaluation, Alberts et al. retrospectively compared the performance of dPET/CT and PMTs-based PET/CT, namely analogue PET/CT (aPET/CT), in two cohorts, each one including 65 patients undergoing PET/CT with 68Ga-PSMA-11 for suspected recurrent PCa. The authors found that dPET/CT presented a higher detection rate of pathological lesions with respect to aPET/CT. Of note, dPET/CT's higher sensitivity results are associated with an increased true-positive rate and high inter-reader agreement. This report underscores how innovative PET/CT instrumentation, by utilizing novel radiopharmaceuticals targeting specific metabolic/molecular signatures expressed by PCa, may represent a successful weapon in uro-oncology.
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Affiliation(s)
- Luca Filippi
- Department of Nuclear Medicine, Santa Maria Goretti Hospital, Latina, Italy
| | - Orazio Schillaci
- Department of Biomedicine and Prevention, University Tor Vergata, Rome, Italy.,IRCCS Neuromed, Pozzilli, Italy
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Urbano N, Scimeca M, Tavolozza M, Bonanno E, Mauriello A, Schillaci O. 18F-FDG-PET/CT analysis in hospitalized patients affected by pulmonary disease: The experience of the Nuclear Medicine Unit of "Policlinico Tor Vegata". Nucl Med Commun 2021; 42:1104-1111. [PMID: 34528930 DOI: 10.1097/mnm.0000000000001444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The main aim of this study was to retrospectively evaluate the clinical data and outcomes of a cohort of 492 hospitalized patients who underwent fluorine-18-fluorodeoxyglucose (F-FDG)-PET/CT analysis at the nuclear medicine unit of 'Policlinico Tor Vergata' in Rome during the years 2017 and 2018 with particular emphasis for patients affected by pulmonary diseases. METHODS Anamnestic data (age and gender), main pathologic conditions, results of F-FDG-PET/CT examination, appropriateness of the request, and medical records of 492 consecutive hospitalized patients who underwent F-FDG-PET/CT analysis (55.38 ± 3.78 years; range 33-81 years) from January 2017 to December 2018 were obtained. RESULTS Considering all examinations, positive results were observed in 66.9% of cases whereas it was not possible to perform a diagnosis in 12.7% of cases (doubt results). About 20-fold increase in the percentage of doubt results was observed in F-FDG-PET/CT analysis with no appropriateness as compared to those with double appropriateness (both the request and clinical). Noteworthy, our data showed a 95% higher concordance between the positive results of the F-FDG-PET/CT examination and the histologic diagnosis. Conversely, the concordance between the analysis of the bronchoalveolar lavages and the PET analysis was very low. CONCLUSION Data here reported showed the high accuracy of the F-FDG-PET/CT performed in our department, mainly for pulmonary diseases, also highlighting the importance of continuously updating the selection criteria for patients who need PET examinations.
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Affiliation(s)
- Nicoletta Urbano
- Nuclear Medicine Unit, Department of Oncohaematology, Policlinico "Tor Vergata"
| | - Manuel Scimeca
- Department of Experimental Medicine, University of Rome "Tor Vergata", Via Montpellier 1
- San Raffaele University, Via di Val Cannuta 247
- Saint Camillus International University of Health Sciences, Via di Sant'Alessandro
| | - Mario Tavolozza
- Nuclear Medicine Unit, Department of Oncohaematology, Policlinico "Tor Vergata"
| | - Elena Bonanno
- Department of Experimental Medicine, University of Rome "Tor Vergata", Via Montpellier 1
| | - Alessandro Mauriello
- Nuclear Medicine Unit, Department of Oncohaematology, Policlinico "Tor Vergata"
- Tor Vergata Oncoscience Research (TOR)
| | - Orazio Schillaci
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", IRCCS Neuromed, Via Atinense, 18, 8607 Pozzilli, Italy
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Wright CL, Miller ED, Contreras C, Knopp MV. Precision Nuclear Medicine: The Evolving Role of PET in Melanoma. Radiol Clin North Am 2021; 59:755-772. [PMID: 34392917 DOI: 10.1016/j.rcl.2021.05.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The clinical management of melanoma patients has been rapidly evolving with the introduction of new targeted immuno-oncology (IO) therapeutics. The current diagnostic paradigms for melanoma patients begins with the histopathologic confirmation of melanoma, initial staging of disease burden with imaging and surgical approaches, treatment monitoring during systemic cytotoxic chemotherapy or IO therapeutics, restaging after completion of adjuvant systemic, surgical, and/or external radiation therapy, and the detection of recurrent malignancy/metastatic disease following therapy. New and evolving imaging approaches with positron-emission tomography (PET) imaging technologies, imaging methodologies, image reconstruction, and image analytics will likely continue to improve tumor detection, tumor characterization, and diagnostic confidence, enabling novel precision nuclear medicine practices for managing melanoma patients. This review will examine current concepts and challenges with existing PET imaging diagnostics for melanoma patients and introduce exciting new opportunities for PET in the current era of IO therapeutics.
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Affiliation(s)
- Chadwick L Wright
- Department of Radiology, Wright Center of Innovation in Biomedical Imaging, The Ohio State University Wexner Medical Center, 395 W. 12th Avenue, Suite 460, Columbus, OH 43210, USA.
| | - Eric D Miller
- Department of Radiation Oncology, James Cancer Center, The Ohio State University Wexner Medical Center, 460 W. 10th Avenue, 2nd Floor, Columbus, OH 43210, USA
| | - Carlo Contreras
- Division of Surgical Oncology, Department of Surgery, The Ohio State University Wexner Medical Center, 2050 Kenny Road, Tower 4th Floor, Columbus, OH 43221, USA
| | - Michael V Knopp
- Department of Radiology, Wright Center of Innovation in Biomedical Imaging, The Ohio State University Wexner Medical Center, 395 W. 12th Avenue, Suite 460, Columbus, OH 43210, USA
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Abstract
AIM To assess if digital PET/CT improves liver lesion detectability compared to analog PET/CT in patients with known or suspected liver metastases. MATERIALS AND METHODS We prospectively included 83 cancer patients, with one or more of these conditions: history of liver metastases, clinical risk of having liver metastases or presence of suspected liver metastases on the first of the two PET/CTs. All patients were consecutively scanned on each PET/CT on the same day after a single [18F]fluorodeoxyglucose dose injection. The order of acquisition was randomly assigned. Three nuclear medicine physicians assessed both PET/CTs by counting the foci of high uptake suspicious of liver metastases. Findings were correlated with appropriate reference standards; 19 patients were excluded from the analysis due to insufficient lesion nature confirmation. The final sample consisted of 64 patients (34 women, mean age 68 ± 12 years). RESULTS As per-patient analysis, the mean number of liver lesions detected by the digital PET/CT (3.84 ± 4.25) was significantly higher than that detected by the analog PET/CT (2.91 ± 3.31); P < 0.001. Fifty-five patients had a positive PET/CT study for liver lesions. In 26/55 patients (47%), the digital PET/CT detected more lesions; 7/26 patients (27%) had detectable lesions only by the digital system and had <10 mm of diameter. Twenty-nine patients had the same number of liver lesions detected by both systems. In nine patients both PET/CT systems were negative for liver lesions. CONCLUSION Digital PET/CT offers improved detectability of liver lesions over the analog PET/CT in patients with known or suspected liver metastases.
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Delcroix O, Bourhis D, Keromnes N, Robin P, Le Roux PY, Abgral R, Salaun PY, Querellou S. Assessment of Image Quality and Lesion Detectability With Digital PET/CT System. Front Med (Lausanne) 2021; 8:629096. [PMID: 33693016 PMCID: PMC7937710 DOI: 10.3389/fmed.2021.629096] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 01/26/2021] [Indexed: 01/13/2023] Open
Abstract
Purpose: The aim of this study was to assess image quality and lesion detectability acquired with a digital Positron Emission Tomography/Computed Tomography (PET/CT) Siemens Biograph Vision 600 system. Material and Methods: Consecutive patients who underwent a FDG PET/CT during the first week of use of a digital PET/CT (Siemens Biograph Vision 600) at the nuclear medicine department of the university hospital of Brest were analyzed. PET were realized using list mode acquisition. For all patients, 4 datasets were reconstructed. We determined, according to phantom measurements, an equivalent time acquisition/reconstruction parameters pair of the digital PET/CT corresponding to an analog PET/CT image quality (“analog-like”) as reference dataset. We compared the reference dataset with 3 others digital PET/CT reconstruction parameters, allowing a decrease of emission duration: 60, 90, and 120 s per bed position. Three nuclear medicine physicians evaluated independently, for each dataset, overall image quality [Maximal Intensity Projection (MIP), noise, sharpness] using a 4-point scale. Physicians assessed also lesion detection capability by reporting new visible lesions on each digital datasets with their confidence level in comparison with analog-like dataset. Results: Ninety-eight patients were analyzed. Image quality of MIP (IQMIP), sharpness (IQSHARPNESS), and noise (IQNOISE) of all digital datasets (60, 90, and 120 s) were better than those evaluated with analog-like reconstruction. Moreover, digital PET/CT system improved IQMIP, IQNOISE, and IQSHARPNESS whatever the BMI. Lesion detection capability and confidence level were higher for 60, 90, 120 s per bed position, respectively, than for analog-like images. Conclusion: Our study demonstrated an improvement of image quality and lesion detectability with a digital PET/CT system.
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Affiliation(s)
- Olivier Delcroix
- Nuclear Medicine Department, Brest University Hospital, Brest, France
| | - David Bourhis
- Nuclear Medicine Department, Brest University Hospital, Brest, France.,EA 3878 GETBO IFR, Brest, France.,University of Bretagne Occidental, Brest, France
| | - Nathalie Keromnes
- Nuclear Medicine Department, Brest University Hospital, Brest, France
| | - Philippe Robin
- Nuclear Medicine Department, Brest University Hospital, Brest, France.,EA 3878 GETBO IFR, Brest, France.,University of Bretagne Occidental, Brest, France
| | - Pierre-Yves Le Roux
- Nuclear Medicine Department, Brest University Hospital, Brest, France.,EA 3878 GETBO IFR, Brest, France.,University of Bretagne Occidental, Brest, France
| | - Ronan Abgral
- Nuclear Medicine Department, Brest University Hospital, Brest, France.,EA 3878 GETBO IFR, Brest, France.,University of Bretagne Occidental, Brest, France
| | - Pierre-Yves Salaun
- Nuclear Medicine Department, Brest University Hospital, Brest, France.,EA 3878 GETBO IFR, Brest, France.,University of Bretagne Occidental, Brest, France
| | - Solène Querellou
- Nuclear Medicine Department, Brest University Hospital, Brest, France.,EA 3878 GETBO IFR, Brest, France.,University of Bretagne Occidental, Brest, France
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11
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Salvadori J, Odille F, Karcher G, Marie PY, Imbert L. Fully digital PET is unaffected by any deterioration in TOF resolution and TOF image quality in the wide range of routine PET count rates. EJNMMI Phys 2021; 8:1. [PMID: 33409746 PMCID: PMC7788141 DOI: 10.1186/s40658-020-00344-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 11/30/2020] [Indexed: 12/11/2022] Open
Abstract
PURPOSE Digital PET involving silicon photomultipliers (SiPM) provides an enhanced time-of-flight (TOF) resolution as compared with photomultiplier (PMT)-based PET, but also a better prevention of the count-related rises in dead time and pile-up effects mainly due to smaller trigger domains (i.e., the detection surfaces associated with each trigger circuit). This study aimed to determine whether this latter property could help prevent against deteriorations in TOF resolution and TOF image quality in the wide range of PET count rates documented in clinical routine. METHODS Variations, according to count rates, in timing resolution and in TOF-related enhancement of the quality of phantom images were compared between the first fully digital PET (Vereos) and a PMT-based PET (Ingenuity). Single-count rate values were additionally extracted from the list-mode data of routine analog- and digital-PET exams at each 500-ms interval, in order to determine the ranges of routine PET count rates. RESULTS Routine PET count rates were lower for the Vereos than for the Ingenuity. For Ingenuity, the upper limits were estimated at approximately 21.7 and 33.2 Mcps after injection of respectively 3 and 5 MBq.kg-1 of current 18F-labeled tracers. At 5.8 Mcps, corresponding to the lower limit of the routine count rates documented with the Ingenuity, timing resolutions provided by the scatter phantom were 326 and 621 ps for Vereos and Ingenuity, respectively. At higher count rates, timing resolution was remarkably stable for Vereos but exhibited a progressive deterioration for Ingenuity, respectively reaching 732 and 847 ps at the upper limits of 21.7 and 33.2 Mcps. The averaged TOF-related gain in signal/noise ratio was stable at approximately 2 for Vereos but decreased from 1.36 at 5.8 Mcps to 1.14 and 1.00 at respectively 21.7 and 33.2 Mcps for Ingenuity. CONCLUSION Contrary to the Ingenuity PMT-based PET, the Vereos fully digital PET is unaffected by any deterioration in TOF resolution and consequently, in the quality of TOF images, in the wide range of routine PET count rates. This advantage is even more striking with higher count-rates for which the preferential use of digital PET should be further recommended (i.e., dynamic PET recording, higher injected activities).
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Affiliation(s)
- Julien Salvadori
- Department of Nuclear Medicine and Nancyclotep Molecular Imaging Platform, CHRU-Nancy, Université de Lorraine, F54000, Nancy, France. .,Université de Lorraine, INSERM, UMR 1254, F54000, Nancy, France.
| | - Freddy Odille
- Department of Nuclear Medicine and Nancyclotep Molecular Imaging Platform, CHRU-Nancy, Université de Lorraine, F54000, Nancy, France.,Université de Lorraine, INSERM, UMR 1254, F54000, Nancy, France
| | - Gilles Karcher
- Department of Nuclear Medicine and Nancyclotep Molecular Imaging Platform, CHRU-Nancy, Université de Lorraine, F54000, Nancy, France.,Université de Lorraine, INSERM, UMR 1254, F54000, Nancy, France
| | - Pierre-Yves Marie
- Department of Nuclear Medicine and Nancyclotep Molecular Imaging Platform, CHRU-Nancy, Université de Lorraine, F54000, Nancy, France.,Université de Lorraine, INSERM, UMR 1116, F54000, Nancy, France
| | - Laetitia Imbert
- Department of Nuclear Medicine and Nancyclotep Molecular Imaging Platform, CHRU-Nancy, Université de Lorraine, F54000, Nancy, France.,Université de Lorraine, INSERM, UMR 1254, F54000, Nancy, France
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Kim SH, Song BI, Kim HW, Won KS. Comparison of Image Quality and Semi-quantitative Measurements with Digital PET/CT and Standard PET/CT from Different Vendors. Nucl Med Mol Imaging 2020; 54:233-240. [PMID: 33088352 DOI: 10.1007/s13139-020-00661-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 07/13/2020] [Accepted: 08/04/2020] [Indexed: 02/07/2023] Open
Abstract
Purpose This study aimed to evaluate the concordance and equivalence of results between the newly acquired digital PET/CT(dPET) and the standard PET/CT (sPET) to investigate possible differences in visual and semi-quantitative analyses. Methods A total of 30 participants were enrolled and underwent a single 18F-FDG injection followed by dual PET/CT scans, by a dPET scan, and immediately after by the sPET scan or vice versa. Two readers reviewed overall image quality using a 5-point scale and counted the number of suggestive 18F-FDG avid lesions. The SUV values were measured in the background organs and in hypermetabolic target lesions. Additionally, we objectively evaluated image quality using the liver signal-to-noise ratio (SNR). Results The dPET identified 4 additional 18F-FDG avid lesions in 3 of 30 participants with improved visual image quality. The standard deviations of SUV of the background organs were significantly lower with DigitalPET than with sPET, and dPET could acquire images with better SNR (11.13 ± 2.01 vs. 8.71 ± 1.32, P < 0.001). The reliability of SUV values between scanners showed excellent agreement. Bland-Altman plot analysis of 81 lesions showed an acceptable agreement between scanners for most of the SUVmax and SUVpeak values. No relationship between the SUV values and time delays of dual PET/CT acquisition was found. Conclusions The dPET provides improved image quality and lesion detectability than the sPET. The semi-quantitative values of the two PET/CT systems of different vendors are comparable. This pilot study will be an important basis for possible interchangeable use of either system in clinical practice.
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Affiliation(s)
- Sung Hoon Kim
- Department of Nuclear Medicine, Keimyung University Daegu Dongsan Hospital, Daegu, South Korea.,Department of Nuclear Medicine, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, 1095 Dalgubeol-daero, Dalseo-gu, Daegu, 42601 Republic of Korea
| | - Bong-Il Song
- Department of Nuclear Medicine, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, 1095 Dalgubeol-daero, Dalseo-gu, Daegu, 42601 Republic of Korea
| | - Hae Won Kim
- Department of Nuclear Medicine, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, 1095 Dalgubeol-daero, Dalseo-gu, Daegu, 42601 Republic of Korea
| | - Kyoung Sook Won
- Department of Nuclear Medicine, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, 1095 Dalgubeol-daero, Dalseo-gu, Daegu, 42601 Republic of Korea
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13
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Yu S, Wang Q, Ru C, Pang M. Location detection of key areas in medical images based on Haar-like fusion contour feature learning. Technol Health Care 2020; 28:391-399. [PMID: 32364172 PMCID: PMC7369033 DOI: 10.3233/thc-209040] [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] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Key area location is an important content of medical image processing and an important detail of auxiliary medical diagnosis. OBJECTIVE: In this paper, a prior knowledge fusion method based on Haar-like feature and contour feature is proposed to locate and detect key areas in medical images. METHOD: For the image to be processed, six Haar-like features and five contour features are extracted respectively. The improvement of Haar-like feature extraction template better adapts to the complexity of regional structure of medical images. The design of the contour feature extraction process fully reflects the consideration of feature invariance. The two features, together with prior knowledge, are fed into their respective decision makers and final fusers as the basis for determining and locating key regions. RESULTS: The experimental results show that the proposed method has excellent performance in locating key regions of medical images on MRI. When the capacity of the database increases from 10 to 200, the accuracy of locating the key areas of the image to be processed still reaches more than 90%. CONCLUSION: The proposed method realizes the accurate location of the key areas of medical images, which is of great significance for the auxiliary medical diagnosis.
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Affiliation(s)
- Shuchun Yu
- Higher Educational Key Laboratory for Measuring and Control Technology and Instrumentation of Heilongjiang Province, Harbin University of Science and Technology, Harbin, Heilongjiang, China
| | - Qi Wang
- Higher Educational Key Laboratory for Measuring and Control Technology and Instrumentation of Heilongjiang Province, Harbin University of Science and Technology, Harbin, Heilongjiang, China
| | - Changhai Ru
- Research Center of Robotics and Micro System and Collaborative Innovation Center of Suzhou Nanoscience and Technology, Soochow University, Suzhou, Jiangsu, China
| | - Ming Pang
- College of Automation, Harbin Engineering University, Harbin, Heilongjiang, China
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14
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Salvadori J, Labour J, Odille F, Marie PY, Badel JN, Imbert L, Sarrut D. Monte Carlo simulation of digital photon counting PET. EJNMMI Phys 2020; 7:23. [PMID: 32335787 PMCID: PMC7183520 DOI: 10.1186/s40658-020-00288-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 03/17/2020] [Indexed: 12/14/2022] Open
Abstract
A GATE Monte Carlo model of the Philips Vereos digital photon counting PET imaging system using silicon photo-multiplier detectors was proposed. It was evaluated against experimental data in accordance with NEMA guidelines. Comparisons were performed using listmode data in order to remain independent of image reconstruction algorithms. An original line of response-based method is proposed to estimate intrinsic spatial resolution without reconstruction. Four sets of experiments were performed: (1) count rates and scatter fraction, (2) energy and timing resolutions, (3) sensitivity, and (4) intrinsic spatial resolution. Experimental and simulated data were found to be in good agreement, with overall differences lower than 10% for activity concentrations used in most standard clinical applications. Illustrative image reconstructions were provided. In conclusion, the proposed Monte Carlo model was validated and can be used for numerous studies such as optimizing acquisition parameters or reconstruction algorithms.
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Affiliation(s)
- Julien Salvadori
- IADI, INSERM UMR 1254, Université de Lorraine, Nancy, France. .,Département de médecine nucléaire et plateforme Nancyclotep, CHRU-Nancy, Université de Lorraine, Nancy, France.
| | - Joey Labour
- CREATIS, Centre Léon Bérard, CNRS UMR 5220, INSERM U 1044, Université de Lyon; INSA-Lyon; Université Lyon 1, Lyon, France
| | - Freddy Odille
- IADI, INSERM UMR 1254, Université de Lorraine, Nancy, France
| | - Pierre-Yves Marie
- Département de médecine nucléaire et plateforme Nancyclotep, CHRU-Nancy, Université de Lorraine, Nancy, France.,DCAC, INSERM UMR 1116, Université de Lorraine, Nancy, France
| | - Jean-Noël Badel
- CREATIS, Centre Léon Bérard, CNRS UMR 5220, INSERM U 1044, Université de Lyon; INSA-Lyon; Université Lyon 1, Lyon, France
| | - Laëtitia Imbert
- IADI, INSERM UMR 1254, Université de Lorraine, Nancy, France.,Département de médecine nucléaire et plateforme Nancyclotep, CHRU-Nancy, Université de Lorraine, Nancy, France
| | - David Sarrut
- CREATIS, Centre Léon Bérard, CNRS UMR 5220, INSERM U 1044, Université de Lyon; INSA-Lyon; Université Lyon 1, Lyon, France
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15
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Ortega C, Schaefferkoetter J, Veit-Haibach P, Anconina R, Berlin A, Perlis N, Metser U. 18F-DCFPyL PET/CT in Patients with Subclinical Recurrence of Prostate Cancer: Effect of Lesion Size, Smoothing Filter, and Partial-Volume Correction on PROMISE Criteria. J Nucl Med 2020; 61:1615-1620. [PMID: 32198311 DOI: 10.2967/jnumed.120.241737] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 03/09/2020] [Indexed: 11/16/2022] Open
Abstract
Our purpose was to determine the effect of a smoothing filter and partial-volume correction (PVC) on measured prostate-specific membrane antigen (PSMA) activity in small metastatic lesions and to determine the impact of these changes on molecular imaging PSMA (miPSMA) scoring. Methods: Men who had biochemical recurrence of prostate cancer with negative findings on CT and bone scintigraphy were referred for 18F-DCFPyL (2-(3-(1-carboxy-5-[(6-18F-fluoro-pyridine-3-carbonyl)-amino]-pentyl) PET/CT. Examinations were performed on 1 of 2 different brands of PET/CT scanner. All suspected tumor sites were manually contoured on coregistered CT and PET images, and each was assigned an miPSMA score as per the PROMISE criteria. The PVC factors were calculated for every lesion using the anatomic CT and then applied to the unsmoothed PET images. The miPSMA scores, with and without the corrections, were compared, and a simplified rule-of-thumb (RoT) correction factor (CF) was derived for lesions at various sizes (<4 mm, 4-7 mm, 7-9 mm, and 9-12 mm). This CF was then applied to the original dataset and the miPSMA scores that were obtained using the RoT CF were compared with those obtained using the actual corrections. Results: There were 75 men (median age, 69 y; median serum PSA, 3.69 μg/L) with 232 metastatic nodes less than 12 mm in diameter (mean lesion volume, 313.5 ± 309.6 mm3). The mean SUVmax before and after correction was 11.0 ± 9.3 and 28.5 ± 22.8, respectively (P < 0.00001). The mean CF for lesions smaller than 4 mm (n = 22), 4-7 mm (n = 140), 7-9 mm (n = 50), and 9-12 mm (n = 20) was 4 (range, 2.5-6.4), 2.8 (range, 1.6-4.9), 2.3 (range, 1.6-3.3), and 1.8 (range, 1.4-2.4), respectively. Overall, the miPSMA scores were concordant between the corrected dataset and the RoT dataset for 205 of 232 lesions (88.4%). Conclusion: A smoothing filter and PVC had a significant effect on measured PSMA activity in small nodal metastases, impacting the miPSMA score.
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Affiliation(s)
- Claudia Ortega
- Joint Department of Medical Imaging, Princess Margaret Hospital, University Health Network, Mount Sinai Hospital and Women's College Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Josh Schaefferkoetter
- Joint Department of Medical Imaging, Princess Margaret Hospital, University Health Network, Mount Sinai Hospital and Women's College Hospital, University of Toronto, Toronto, Ontario, Canada.,Siemens Healthcare Limited, Oakville, Ontario, Canada
| | - Patrick Veit-Haibach
- Joint Department of Medical Imaging, Princess Margaret Hospital, University Health Network, Mount Sinai Hospital and Women's College Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Reut Anconina
- Joint Department of Medical Imaging, Princess Margaret Hospital, University Health Network, Mount Sinai Hospital and Women's College Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Alejandro Berlin
- Radiation Medicine Program, Princess Margaret Hospital, University Health Network, Toronto, Ontario, Canada; and
| | - Nathan Perlis
- Urologic Oncology, University Health Network, Princess Margaret Cancer Centre Research Institute, University of Toronto, Toronto, Ontario, Canada
| | - Ur Metser
- Joint Department of Medical Imaging, Princess Margaret Hospital, University Health Network, Mount Sinai Hospital and Women's College Hospital, University of Toronto, Toronto, Ontario, Canada
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16
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Salvadori J, Odille F, Verger A, Olivier P, Karcher G, Marie PY, Imbert L. Head-to-head comparison between digital and analog PET of human and phantom images when optimized for maximizing the signal-to-noise ratio from small lesions. EJNMMI Phys 2020; 7:11. [PMID: 32086646 PMCID: PMC7035408 DOI: 10.1186/s40658-020-0281-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 02/13/2020] [Indexed: 02/07/2023] Open
Abstract
Background Routine PET exams are increasingly performed with reduced injected activities, leading to the use of different image reconstruction parameters than the NEMA parameters, in order to prevent from any deleterious decrease in signal-to-noise ratio (SNR) and thus, in lesion detectability. This study aimed to provide a global head-to-head comparison between digital (Vereos, Philips®) and analog (Ingenuity TF, Philips®) PET cameras of the trade-off between SNR and contrast through a wide-ranging number of reconstruction iterations, and with a further reconstruction optimization based on the SNR of small lesions. Methods Image quality parameters were compared between the two cameras on human and phantom images for a number of OSEM reconstruction iterations ranging from 1 to 10, the number of subsets being fixed at 10, and with the further identification of reconstruction parameters maximizing the SNR of spheres and adenopathies nearing 10 mm in diameter. These reconstructions were additionally obtained with and without time-of-flight (TOF) information (TOF and noTOF images, respectively) for further comparisons. Results On both human and phantom TOF images, the compromise between SNR and contrast was consistently more advantageous for digital than analog PET, with the difference being particularly pronounced for the lowest numbers of iterations and the smallest spheres. SNR was maximized with 1 and 2 OSEM iterations for the TOF images from digital and analog PET, respectively, whereas 4 OSEM iterations were required for the corresponding noTOF images from both cameras. On the TOF images obtained with this SNR optimization, digital PET exhibited a 37% to 44% higher SNR as compared with analog PET, depending on sphere size. These relative differences were however much lower for the noTOF images optimized for SNR (− 4 to + 18%), as well as for images reconstructed according to NEMA standards (− 4 to + 12%). Conclusion SNR may be dramatically higher for digital PET than for analog PET, especially when optimized for small lesions. This superiority is mostly attributable to enhanced TOF resolution and is significantly underestimated in NEMA-based analyses.
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Affiliation(s)
- Julien Salvadori
- Departement of Nuclear Medicine and Nancyclotep molecular imaging platform, CHRU-Nancy, Université de Lorraine, 54000, Nancy, France. .,IADI, INSERM, UMR 1254, Université de Lorraine, 54000, Nancy, France.
| | - Freddy Odille
- IADI, INSERM, UMR 1254, Université de Lorraine, 54000, Nancy, France
| | - Antoine Verger
- Departement of Nuclear Medicine and Nancyclotep molecular imaging platform, CHRU-Nancy, Université de Lorraine, 54000, Nancy, France.,IADI, INSERM, UMR 1254, Université de Lorraine, 54000, Nancy, France
| | - Pierre Olivier
- Departement of Nuclear Medicine and Nancyclotep molecular imaging platform, CHRU-Nancy, Université de Lorraine, 54000, Nancy, France
| | - Gilles Karcher
- Departement of Nuclear Medicine and Nancyclotep molecular imaging platform, CHRU-Nancy, Université de Lorraine, 54000, Nancy, France
| | - Pierre-Yves Marie
- Departement of Nuclear Medicine and Nancyclotep molecular imaging platform, CHRU-Nancy, Université de Lorraine, 54000, Nancy, France.,DCAC, INSERM, UMR 1116, Université de Lorraine, 54000, Nancy, France
| | - Laetitia Imbert
- Departement of Nuclear Medicine and Nancyclotep molecular imaging platform, CHRU-Nancy, Université de Lorraine, 54000, Nancy, France.,IADI, INSERM, UMR 1254, Université de Lorraine, 54000, Nancy, France
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17
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Lyu X, Hu J, Dong W, Xu X. Intellectual Structure and Evolutionary Trends of Precision Medicine Research: Coword Analysis. JMIR Med Inform 2020; 8:e11287. [PMID: 32014844 PMCID: PMC7055756 DOI: 10.2196/11287] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 10/07/2019] [Accepted: 10/19/2019] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Precision medicine (PM) is playing a more and more important role in clinical practice. In recent years, the scale of PM research has been growing rapidly. Many reviews have been published to facilitate a better understanding of the status of PM research. However, there is still a lack of research on the intellectual structure in terms of topics. OBJECTIVE This study aimed to identify the intellectual structure and evolutionary trends of PM research through the application of various social network analysis and visualization methods. METHODS The bibliographies of papers published between 2009 and 2018 were extracted from the Web of Science database. Based on the statistics of keywords in the papers, a coword network was generated and used to calculate network indicators of both the entire network and local networks. Communities were then detected to identify subdirections of PM research. Topological maps of networks, including networks between communities and within each community, were drawn to reveal the correlation structure. An evolutionary graph and a strategic graph were finally produced to reveal research venation and trends in discipline communities. RESULTS The results showed that PM research involves extensive themes and, overall, is not balanced. A minority of themes with a high frequency and network indicators, such as Biomarkers, Genomics, Cancer, Therapy, Genetics, Drug, Target Therapy, Pharmacogenomics, Pharmacogenetics, and Molecular, can be considered the core areas of PM research. However, there were five balanced theme directions with distinguished status and tendencies: Cancer, Biomarkers, Genomics, Drug, and Therapy. These were shown to be the main branches that were both focused and well developed. Therapy, though, was shown to be isolated and undeveloped. CONCLUSIONS The hotspots, structures, evolutions, and development trends of PM research in the past ten years were revealed using social network analysis and visualization. In general, PM research is unbalanced, but its subdirections are balanced. The clear evolutionary and developmental trend indicates that PM research has matured in recent years. The implications of this study involving PM research will provide reasonable and effective support for researchers, funders, policymakers, and clinicians.
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Affiliation(s)
- Xiaoguang Lyu
- The Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Jiming Hu
- School of Information Management, Wuhan University, Wuhan, China.,Center for the Study of Information Resources, Wuhan University, Wuhan, China
| | - Weiguo Dong
- The Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Xin Xu
- The Intensive Care Unit of Coronary Heart Disease, Renmin Hospital of Wuhan University, Wuhan, China
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18
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Jones MP, Hruby G, Metser U, Sridharan S, Capp A, Kumar M, Gallagher S, Rutherford N, Holder C, Oldmeadow C, Martin J. FDG-PET parameters predict for recurrence in anal cancer - results from a prospective, multicentre clinical trial. Radiat Oncol 2019; 14:140. [PMID: 31387597 PMCID: PMC6685144 DOI: 10.1186/s13014-019-1342-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 07/18/2019] [Indexed: 12/19/2022] Open
Abstract
Background To investigate the prognostic significance of positron emission tomography (PET) parameters from F-18 fluorodeoxyglucose (FDG) PET scans performed pre- and post- chemo-radiotherapy (CRT) for squamous cell carcinoma of the anal canal (AC). Methods From January 2013 to January 2017, 19 patients with non-metastatic AC enrolled on a prospective trial underwent FDG-PET/CT imaging before and 12 weeks following CRT. A computer-generated volume of interest (VOI) was snapped around the primary tumour using six different standard uptake value (SUV) thresholds and the following parameters were extracted: SUV max, mean, median, standard deviation and peak as well as metabolic tumour volume (MTV) and total lesion glycolysis. Exact logistic regression and ROC AUC analyses were performed for each metric at each timepoint. Results With a median follow up of 15.8 months, 3/19 patients had a local recurrence and 5/19 had any recurrence. On post-CRT PET, the median SUV within a VOI bounded by an SUV of 3 correlated with local recurrence (p < 0.01) and demonstrated excellent discrimination (ROC AUC 1.00, perfect separation was achieved at a median SUV of 3.38). The mean SUV at this threshold did not quite reach significance for prediction of local recurrence (p = 0.06) but demonstrated excellent discrimination (ROC AUC 0.91). The MTV bounded by a threshold of 41% SUVmax on the pre-CRT PET predicted for any recurrence (p = 0.03) and showed excellent discrimination (ROC AUC 0.89). Conclusions FDG-PET parameters are predictive of recurrence in AC. FDG-PET may represent a valuable tool for prognostication and response assessment in AC. Trial registration ANZCTR, ACTRN12614001219673. Registered 19 November 2014 - Retrospectively registered.
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Affiliation(s)
- Michael Peter Jones
- WP Holman Clinic, Royal Hobart Hospital, Hobart, Tasmania, Australia. .,The University of Newcastle, Callaghan, New South Wales, Australia.
| | - George Hruby
- Department of Radiation Oncology, Royal North Shore Hospital, St Leonards, New South Wales, Australia
| | - Ur Metser
- Department of Medical Imaging, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Swetha Sridharan
- Department of Radiation Oncology, Calvary Mater Newcastle, Waratah, New South Wales, Australia
| | - Anne Capp
- Department of Radiation Oncology, Calvary Mater Newcastle, Waratah, New South Wales, Australia
| | - Mahesh Kumar
- Department of Radiation Oncology, Calvary Mater Newcastle, Waratah, New South Wales, Australia
| | - Sarah Gallagher
- Department of Radiation Oncology, Calvary Mater Newcastle, Waratah, New South Wales, Australia
| | - Natalie Rutherford
- Department of Nuclear Medicine, Calvary Mater Newcastle, Waratah, New South Wales, Australia
| | - Carl Holder
- Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | | | - Jarad Martin
- The University of Newcastle, Callaghan, New South Wales, Australia.,Department of Radiation Oncology, Calvary Mater Newcastle, Waratah, New South Wales, Australia
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19
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Landini L. The Future of Medical Imaging. Curr Pharm Des 2019; 24:5487-5488. [DOI: 10.2174/138161282446190426115124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Luigi Landini
- Department of Information Engineering, University of Pisa, 56126 Pisa, Italy; Fondazione G. Monasterio, CNR-Regione Toscana, Via Moruzzi 1, 56124 Pisa, Italy
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20
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López-Mora DA, Flotats A, Fuentes-Ocampo F, Camacho V, Fernández A, Ruiz A, Duch J, Sizova M, Domènech A, Estorch M, Carrió I. Comparison of image quality and lesion detection between digital and analog PET/CT. Eur J Nucl Med Mol Imaging 2019; 46:1383-1390. [DOI: 10.1007/s00259-019-4260-z] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Accepted: 01/02/2019] [Indexed: 12/13/2022]
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21
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Digital vs. analog PET/CT: intra-subject comparison of the SUVmax in target lesions and reference regions. Eur J Nucl Med Mol Imaging 2019; 46:1745-1750. [DOI: 10.1007/s00259-018-4256-0] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 12/27/2018] [Indexed: 11/26/2022]
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22
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Performance evaluation of the next generation solid-state digital photon counting PET/CT system. EJNMMI Res 2018; 8:97. [PMID: 30402779 PMCID: PMC6219999 DOI: 10.1186/s13550-018-0448-7] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 10/10/2018] [Indexed: 12/21/2022] Open
Abstract
Background The first solid-state silicon photomultiplier (SiPM) digital photon counting (DPC) clinical PET/CT system was introduced by Philips in recent years. The system differs from other SiPM-based PET/CT systems and uses lutetiumyttrium oxyorthosilicate (LYSO) scintillators directly coupled with their own individual SiPM DPC detectors eliminating the need for Anger-logic positioning decoding. We evaluated the system performance, characteristics, and stability of the next generation DPC clinical PET/CT based on NEMA NU2-2012 tests, NEMA NU2-2018 test (timing resolution) and human studies. Results An energy resolution of 11.2% was measured. NEMA NU2-2012 tests revealed a spatial resolution (mm in FWHM) from (3.96, 4.01, 4.01) at 1 cm to (5.81, 5.83, 4.95) at 20 cm for (axial, radial, tangential). A 5.7 cps/kBq system sensitivity was measured. Peak noise equivalent count rate (NECR) and peak true count rate could not be determined as each exhibited increasing values up to the maximum activity measured (~ 1100 MBq). The maximum NECR was 171 kcps @ 50.5 kBq/mL, with corresponding scatter fraction of 30.8% and maximum trues of 681 kcps. NEMA hot sphere contrast ranged from 62% (10 mm) to 88% (22 mm), cold sphere contrast of 86% (28 mm) and 89% (37 mm). A timing resolution of 322 ps (22Na point source based) and 332 ps (NEMA NU2-2018) was obtained. It revealed < 1% change in TOF timing and ± 0.4% change in energy resolution during 31-month stability monitoring. CQIE assessment found < 3% axial variance in SUV. 100–60% recovery coefficients of activity concentration at various sphere sizes and contrast levels were measured. Conclusions This scanner represents the first solid-state DPC PET/CT, a technologic leap beyond photomultipliers tubes and anger logic. It presents considerable improvements in system performance and characteristics with excellent time-of-flight capability compared to conventional photomultiplier tube (PMT) PET/CT systems. The DPC system leads to promising clinical opportunities with excellent image quality, lesion detectability, and diagnostic confidence.
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23
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The renaissance of functional 18F-FDG PET brain activation imaging. Eur J Nucl Med Mol Imaging 2018; 45:2338-2341. [DOI: 10.1007/s00259-018-4165-2] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 09/10/2018] [Indexed: 10/28/2022]
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24
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Konert T, van de Kamer JB, Sonke JJ, Vogel WV. The developing role of FDG PET imaging for prognostication and radiotherapy target volume delineation in non-small cell lung cancer. J Thorac Dis 2018; 10:S2508-S2521. [PMID: 30206495 DOI: 10.21037/jtd.2018.07.101] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Advancements in functional imaging technology have allowed new possibilities in contouring of target volumes, monitoring therapy, and predicting treatment outcome in non-small cell lung cancer (NSCLC). Consequently, the role of 18F-fluorodeoxyglucose positron emission tomography (FDG PET) has expanded in the last decades from a stand-alone diagnostic tool to a versatile instrument integrated with computed tomography (CT), with a prominent role in lung cancer radiotherapy. This review outlines the most recent literature on developments in FDG PET imaging for prognostication and radiotherapy target volume delineation (TVD) in NSCLC. We also describe the challenges facing the clinical implementation of these developments and present new ideas for future research.
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Affiliation(s)
- Tom Konert
- Nuclear Medicine Department, Netherlands Cancer Institute, Amsterdam, The Netherlands.,Department of Radiation Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Jeroen B van de Kamer
- Department of Radiation Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Jan-Jakob Sonke
- Department of Radiation Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Wouter V Vogel
- Nuclear Medicine Department, Netherlands Cancer Institute, Amsterdam, The Netherlands.,Department of Radiation Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
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