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Calatayud-Jordán J, Carrasco-Vela N, Chimeno-Hernández J, Carles-Fariña M, Olivas-Arroyo C, Bello-Arqués P, Pérez-Enguix D, Martí-Bonmatí L, Torres-Espallardo I. Y-90 PET/MR imaging optimization with a Bayesian penalized likelihood reconstruction algorithm. Phys Eng Sci Med 2024:10.1007/s13246-024-01452-7. [PMID: 38884672 DOI: 10.1007/s13246-024-01452-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Accepted: 05/23/2024] [Indexed: 06/18/2024]
Abstract
Positron Emission Tomography (PET) imaging after90 Y liver radioembolization is used for both lesion identification and dosimetry. Bayesian penalized likelihood (BPL) reconstruction algorithms are an alternative to ordered subset expectation maximization (OSEM) with improved image quality and lesion detectability. The investigation of optimal parameters for90 Y image reconstruction of Q.Clear, a commercial BPL algorithm developed by General Electric (GE), in PET/MR is a field of interest and the subject of this study. The NEMA phantom was filled at an 8:1 sphere-to-background ratio. Acquisitions were performed on a PET/MR scanner for clinically relevant activities between 0.7 and 3.3 MBq/ml. Reconstructions with Q.Clear were performed varying the β penalty parameter between 20 and 6000, the acquisition time between 5 and 20 min and pixel size between 1.56 and 4.69 mm. OSEM reconstructions of 28 subsets with 2 and 4 iterations with and without Time-of-Flight (TOF) were compared to Q.Clear with β = 4000. Recovery coefficients (RC), their coefficient of variation (COV), background variability (BV), contrast-to-noise ratio (CNR) and residual activity in the cold insert were evaluated. Increasing β parameter lowered RC, COV and BV, while CNR was maximized at β = 4000; further increase resulted in oversmoothing. For quantification purposes, β = 1000-2000 could be more appropriate. Longer acquisition times resulted in larger CNR due to reduced image noise. Q.Clear reconstructions led to higher CNR than OSEM. A β of 4000 was obtained for optimal image quality, although lower values could be considered for quantification purposes. An optimal acquisition time of 15 min was proposed considering its clinical use.
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Affiliation(s)
- José Calatayud-Jordán
- Department of Nuclear Medicine, La Fe University and Polytechnical Hospital, Av. Fernando Abril Martorell 106, 46026, Valencia, Spain.
| | - Nuria Carrasco-Vela
- Radiophysics and Radiological Protection Service, Clinical University Hospital of Valencia, Av. Blasco Ibáñez 17, 46010, Valencia, Spain
| | - José Chimeno-Hernández
- Department of Nuclear Medicine, La Fe University and Polytechnical Hospital, Av. Fernando Abril Martorell 106, 46026, Valencia, Spain
| | - Montserrat Carles-Fariña
- Biomedical Imaging Research Group (GIBI230) at Health Research Institute Hospital La Fe (IIS La Fe), La Fe University and Polytechnical Hospital, Av. Fernando Abril Martorell 106, 46026, Valencia, Spain
| | - Consuelo Olivas-Arroyo
- Department of Nuclear Medicine, La Fe University and Polytechnical Hospital, Av. Fernando Abril Martorell 106, 46026, Valencia, Spain
| | - Pilar Bello-Arqués
- Department of Nuclear Medicine, La Fe University and Polytechnical Hospital, Av. Fernando Abril Martorell 106, 46026, Valencia, Spain
| | - Daniel Pérez-Enguix
- Department of Radiology, La Fe University and Polytechnical Hospital, Av. Fernando Abril Martorell 106, 46026, Valencia, Spain
| | - Luis Martí-Bonmatí
- Biomedical Imaging Research Group (GIBI230) at Health Research Institute Hospital La Fe (IIS La Fe), La Fe University and Polytechnical Hospital, Av. Fernando Abril Martorell 106, 46026, Valencia, Spain
- Department of Radiology, La Fe University and Polytechnical Hospital, Av. Fernando Abril Martorell 106, 46026, Valencia, Spain
| | - Irene Torres-Espallardo
- Department of Nuclear Medicine, La Fe University and Polytechnical Hospital, Av. Fernando Abril Martorell 106, 46026, Valencia, Spain
- Biomedical Imaging Research Group (GIBI230) at Health Research Institute Hospital La Fe (IIS La Fe), La Fe University and Polytechnical Hospital, Av. Fernando Abril Martorell 106, 46026, Valencia, Spain
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Fragoso Costa P, Jentzen W, SÜßELBECK F, Fendler WP, Rischpler C, Herrmann K, Conti M, Kersting D, Weber M. Reduction of emission time for [68Ga]Ga-PSMA PET/CT using the digital biograph vision: a phantom study. THE QUARTERLY JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING : OFFICIAL PUBLICATION OF THE ITALIAN ASSOCIATION OF NUCLEAR MEDICINE (AIMN) [AND] THE INTERNATIONAL ASSOCIATION OF RADIOPHARMACOLOGY (IAR), [AND] SECTION OF THE SOCIETY OF... 2023; 67:57-68. [PMID: 34309334 DOI: 10.23736/s1824-4785.21.03300-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The aim of this phantom study was to optimize the [68Ga]Ga-PSMA PET/CT examination in terms of scan time duration and image reconstruction parameters, in combination with PSF and TOF modelling, in a digital Biograph Vision PET/CT scanner. METHODS Three types of phantoms were used: 1) soft-tissue tumor phantom consisting of six spheres mounted in a torso phantom; 2) bone-lung tumor phantom; 3) resolution phantom. Phantom inserts were filled with activity concentrations (ACs) that were derived from clinical data. Phantom data were acquired in list-mode at one bed position. Images with emission data ranging from 30 to 210 s in 30-s increments were reconstructed from a reference image acquired with 3.5-min emission. Iterative image reconstruction (OSEM), point-spread-function (PSF) and time-of-flight (TOF) options were applied using different iterations, Gaussian filters, and voxel sizes. The criteria for image quality was lesion detectability and lesion quantification, evaluated as contrast-to-noise ratio (CNR) and maximum AC (peak AC), respectively. A threshold value of CNR above 6 and percentage maximum AC (peak AC) deviation range of ±20% of the reference image were considered acceptable. The proposed single-bed scan time reduction was projected to a whole-body examination (patient validation scan) using the continuous-bed-motion mode. RESULTS Sphere and background ACs of 20 kBq/mL and 1 kBq/mL were selected, respectively. The optimized single-bed scan time was approximately 60 s using OSEM-TOF or OSEM-TOF+PSF (four iterations, 4.0-mm Gaussian filter and almost isotropic voxel size of 3.0-mm side length), resulting in a PET spatial resolution of 6.3 mm for OSEM-TOF and 5.5 mm for OSEM-TOF+PSF. In the patient validation, the maximum percentage difference in lesion quantification between standard and optimized protocol (whole-body scan time of 15 vs. 5 min) was below 19%. CONCLUSIONS A reduction of single-bed and whole-body scan time for [68Ga]Ga-PSMA PET/CT compared to current recommended clinical acquisition protocols is postulated. Clinical studies are warranted to validate the applicability of this protocol.
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Affiliation(s)
- Pedro Fragoso Costa
- Department of Nuclear Medicine, Essen University Hospital, Duisburg-Essen University, Essen, Germany -
| | - Walter Jentzen
- Department of Nuclear Medicine, Essen University Hospital, Duisburg-Essen University, Essen, Germany
| | - Finja SÜßELBECK
- Department of Nuclear Medicine, Essen University Hospital, Duisburg-Essen University, Essen, Germany
| | - Wolfgang P Fendler
- Department of Nuclear Medicine, Essen University Hospital, Duisburg-Essen University, Essen, Germany
| | - Christoph Rischpler
- Department of Nuclear Medicine, Essen University Hospital, Duisburg-Essen University, Essen, Germany
| | - Ken Herrmann
- Department of Nuclear Medicine, Essen University Hospital, Duisburg-Essen University, Essen, Germany
| | | | - David Kersting
- Department of Nuclear Medicine, Essen University Hospital, Duisburg-Essen University, Essen, Germany
| | - Manuel Weber
- Department of Nuclear Medicine, Essen University Hospital, Duisburg-Essen University, Essen, Germany
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Fragoso Costa P, Jentzen W, Brahmer A, Mavroeidi IA, Zarrad F, Umutlu L, Fendler WP, Rischpler C, Herrmann K, Conti M, Seifert R, Sraieb M, Weber M, Kersting D. Phantom-based acquisition time and image reconstruction parameter optimisation for oncologic FDG PET/CT examinations using a digital system. BMC Cancer 2022; 22:899. [PMID: 35978274 PMCID: PMC9387080 DOI: 10.1186/s12885-022-09993-4] [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: 12/05/2021] [Accepted: 08/08/2022] [Indexed: 11/18/2022] Open
Abstract
Background New-generation silicon-photomultiplier (SiPM)-based PET/CT systems exhibit an improved lesion detectability and image quality due to a higher detector sensitivity. Consequently, the acquisition time can be reduced while maintaining diagnostic quality. The aim of this study was to determine the lowest 18F-FDG PET acquisition time without loss of diagnostic information and to optimise image reconstruction parameters (image reconstruction algorithm, number of iterations, voxel size, Gaussian filter) by phantom imaging. Moreover, patient data are evaluated to confirm the phantom results. Methods Three phantoms were used: a soft-tissue tumour phantom, a bone-lung tumour phantom, and a resolution phantom. Phantom conditions (lesion sizes from 6.5 mm to 28.8 mm in diameter, lesion activity concentration of 15 kBq/mL, and signal-to-background ratio of 5:1) were derived from patient data. PET data were acquired on an SiPM-based Biograph Vision PET/CT system for 10 min in list-mode format and resampled into time frames from 30 to 300 s in 30-s increments to simulate different acquisition times. Different image reconstructions with varying iterations, voxel sizes, and Gaussian filters were probed. Contrast-to-noise-ratio (CNR), maximum, and peak signal were evaluated using the 10-min acquisition time image as reference. A threshold CNR value ≥ 5 and a maximum (peak) deviation of ± 20% were considered acceptable. 20 patient data sets were evaluated regarding lesion quantification as well as agreement and correlation between reduced and full acquisition time standard uptake values (assessed by Pearson correlation coefficient, intraclass correlation coefficient, Bland–Altman analyses, and Krippendorff’s alpha). Results An acquisition time of 60 s per bed position yielded acceptable detectability and quantification results for clinically relevant phantom lesions ≥ 9.7 mm in diameter using OSEM-TOF or OSEM-TOF+PSF image reconstruction, a 4-mm Gaussian filter, and a 1.65 × 1.65 x 2.00-mm3 or 3.30 × 3.30 x 3.00-mm3 voxel size. Correlation and agreement of patient lesion quantification between full and reduced acquisition times were excellent. Conclusion A threefold reduction in acquisition time is possible. Patients might benefit from more comfortable examinations or reduced radiation exposure, if instead of the acquisition time the applied activity is reduced. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-022-09993-4.
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Affiliation(s)
- Pedro Fragoso Costa
- Department of Nuclear Medicine, University Hospital Essen, West German Cancer Center (WTZ), University of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany.,German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany
| | - Walter Jentzen
- Department of Nuclear Medicine, University Hospital Essen, West German Cancer Center (WTZ), University of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany.,German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany
| | - Alissa Brahmer
- Department of Nuclear Medicine, University Hospital Essen, West German Cancer Center (WTZ), University of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany.,German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany
| | - Ilektra-Antonia Mavroeidi
- German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany.,Department of Medical Oncology, University Hospital Essen, West German Cancer Center (WTZ), University Duisburg-Essen, 45147, Essen, Germany
| | - Fadi Zarrad
- Department of Nuclear Medicine, University Hospital Essen, West German Cancer Center (WTZ), University of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany.,German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany
| | - Lale Umutlu
- German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany.,Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University Duisburg-Essen, 45147, Essen, Germany
| | - Wolfgang P Fendler
- Department of Nuclear Medicine, University Hospital Essen, West German Cancer Center (WTZ), University of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany.,German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany
| | - Christoph Rischpler
- Department of Nuclear Medicine, University Hospital Essen, West German Cancer Center (WTZ), University of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany.,German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany
| | - Ken Herrmann
- Department of Nuclear Medicine, University Hospital Essen, West German Cancer Center (WTZ), University of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany.,German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany
| | | | - Robert Seifert
- Department of Nuclear Medicine, University Hospital Essen, West German Cancer Center (WTZ), University of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany.,German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany
| | - Miriam Sraieb
- Department of Nuclear Medicine, University Hospital Essen, West German Cancer Center (WTZ), University of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany.,German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany
| | - Manuel Weber
- Department of Nuclear Medicine, University Hospital Essen, West German Cancer Center (WTZ), University of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany.,German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany
| | - David Kersting
- Department of Nuclear Medicine, University Hospital Essen, West German Cancer Center (WTZ), University of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany. .,German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany.
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Deidda D, Denis-Bacelar AM, Fenwick AJ, Ferreira KM, Heetun W, Hutton BF, Robinson AP, Scuffham J, Thielemans K. Hybrid kernelised expectation maximisation for Bremsstrahlung SPECT reconstruction in SIRT with 90Y micro-spheres. EJNMMI Phys 2022; 9:25. [PMID: 35377085 PMCID: PMC8980141 DOI: 10.1186/s40658-022-00452-4] [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: 11/26/2021] [Accepted: 03/16/2022] [Indexed: 11/16/2022] Open
Abstract
Background Selective internal radiation therapy with Yttrium-90 microspheres is an effective therapy for liver cancer and liver metastases. Yttrium-90 is mainly a high-energy beta particle emitter. These beta particles emit Bremsstrahlung radiation during their interaction with tissue making post-therapy imaging of the radioactivity distribution feasible. Nevertheless, image quality and quantification is difficult due to the continuous energy spectrum which makes resolution modelling, attenuation and scatter estimation challenging and therefore the dosimetry quantification is inaccurate. As a consequence a reconstruction algorithm able to improve resolution could be beneficial. Methods In this study, the hybrid kernelised expectation maximisation (HKEM) is used to improve resolution and contrast and reduce noise, in addition a modified HKEM called frozen HKEM (FHKEM) is investigated to further reduce noise. The iterative part of the FHKEM kernel was frozen at the 72nd sub-iteration. When using ordered subsets algorithms the data is divided in smaller subsets and the smallest algorithm iterative step is called sub-iteration. A NEMA phantom with spherical inserts was used for the optimisation and validation of the algorithm, and data from 5 patients treated with Selective internal radiation therapy were used as proof of clinical relevance of the method. Results The results suggest a maximum improvement of 56% for region of interest mean recovery coefficient at fixed coefficient of variation and better identification of the hot volumes in the NEMA phantom. Similar improvements were achieved with patient data, showing 47% mean value improvement over the gold standard used in hospitals. Conclusions Such quantitative improvements could facilitate improved dosimetry calculations with SPECT when treating patients with Selective internal radiation therapy, as well as provide a more visible position of the cancerous lesions in the liver.
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Affiliation(s)
- Daniel Deidda
- National Physical Laboratory, Teddington, UK. .,Institute of Nuclear Medicine, University College London, London, UK.
| | | | | | | | | | - Brian F Hutton
- Institute of Nuclear Medicine, University College London, London, UK
| | - Andrew P Robinson
- National Physical Laboratory, Teddington, UK.,Christie Medical Physics and Engineering (CMPE), The Christie NHS Foundation Trust, Manchester, UK.,The University of Manchester, Manchester, UK
| | - James Scuffham
- National Physical Laboratory, Teddington, UK.,Department of Medical Physics, Royal Surrey NHS Foundation Trust, Guildford, UK
| | - Kris Thielemans
- Institute of Nuclear Medicine, University College London, London, UK
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5
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Henry EC, Strugari M, Mawko G, Brewer K, Liu D, Gordon AC, Bryan JN, Maitz C, Karnia JJ, Abraham R, Kappadath SC, Syme A. Precision dosimetry in yttrium-90 radioembolization through CT imaging of radiopaque microspheres in a rabbit liver model. EJNMMI Phys 2022; 9:21. [PMID: 35312882 PMCID: PMC8938593 DOI: 10.1186/s40658-022-00447-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 03/02/2022] [Indexed: 12/24/2022] Open
Abstract
PURPOSE To perform precision dosimetry in yttrium-90 radioembolization through CT imaging of radiopaque microspheres in a rabbit liver model and to compare extracted dose metrics to those produced from conventional PET-based dosimetry. MATERIALS AND METHODS A CT calibration phantom was designed containing posts with nominal microsphere concentrations of 0.5 mg/mL, 5.0 mg/mL, and 25.0 mg/mL. The mean Hounsfield unit was extracted from the post volumes to generate a calibration curve to relate Hounsfield units to microsphere concentration. A nominal bolus of 40 mg of microspheres was administered to the livers of eight rabbits, followed by PET/CT imaging. A CT-based activity distribution was calculated through the application of the calibration curve to the CT liver volume. Post-treatment dosimetry was performed through the convolution of yttrium-90 dose-voxel kernels and the PET- and CT-based cumulated activity distributions. The mean dose to the liver in PET- and CT-based dose distributions was compared through linear regression, ANOVA, and Bland-Altman analysis. RESULTS A linear least-squares fit to the average Hounsfield unit and microsphere concentration data from the calibration phantom confirmed a strong correlation (r2 > 0.999) with a slope of 14.13 HU/mg/mL. A poor correlation was found between the mean dose derived from CT and PET (r2 = 0.374), while the ANOVA analysis revealed statistically significant differences (p < 10-12) between the MIRD-derived mean dose and the PET- and CT-derived mean dose. Bland-Altman analysis predicted an offset of 15.0 Gy between the mean dose in CT and PET. The dose within the liver was shown to be more heterogeneous in CT than in PET with an average coefficient of variation equal to 1.99 and 1.02, respectively. CONCLUSION The benefits of a CT-based approach to post-treatment dosimetry in yttrium-90 radioembolization include improved visualization of the dose distribution, reduced partial volume effects, a better representation of dose heterogeneity, and the mitigation of respiratory motion effects. Post-treatment CT imaging of radiopaque microspheres in yttrium-90 radioembolization provides the means to perform precision dosimetry and extract accurate dose metrics used to refine the understanding of the dose-response relationship, which could ultimately improve future patient outcomes.
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Affiliation(s)
- E Courtney Henry
- Department of Physics and Atmospheric Science, Dalhousie University, Halifax, NS, Canada.
| | - Matthew Strugari
- Department of Physics and Atmospheric Science, Dalhousie University, Halifax, NS, Canada
- Biomedical Translational Imaging Centre, Halifax, NS, Canada
| | - George Mawko
- Department of Physics and Atmospheric Science, Dalhousie University, Halifax, NS, Canada
- Department of Medical Physics, Nova Scotia Health Authority, Halifax, NS, Canada
- Department of Radiation Oncology, Dalhousie University, Halifax, NS, Canada
- Department of Diagnostic Radiology, Dalhousie University, Halifax, NS, Canada
| | - Kimberly Brewer
- Department of Physics and Atmospheric Science, Dalhousie University, Halifax, NS, Canada
- Biomedical Translational Imaging Centre, Halifax, NS, Canada
- Department of Diagnostic Radiology, Dalhousie University, Halifax, NS, Canada
- Department of Biomedical Engineering, Dalhousie University, Halifax, NS, Canada
| | - David Liu
- School of Biomedical Engineering, University of British Columbia, Vancouver, BC, Canada
| | - Andrew C Gordon
- Department of Radiology, Northwestern University, Chicago, IL, USA
| | - Jeffrey N Bryan
- Department of Veterinary Medicine and Surgery, University of Missouri, Columbia, MO, USA
| | - Charles Maitz
- Department of Veterinary Medicine and Surgery, University of Missouri, Columbia, MO, USA
| | - James J Karnia
- Department of Veterinary Medicine and Surgery, University of Missouri, Columbia, MO, USA
| | - Robert Abraham
- Department of Diagnostic Radiology, Dalhousie University, Halifax, NS, Canada
- ABK Biomedical Inc., Halifax, NS, Canada
| | - S Cheenu Kappadath
- Department of Imaging Physics, University of Texas MD Anderson Cancer Centre, Houston, TX, USA
| | - Alasdair Syme
- Department of Physics and Atmospheric Science, Dalhousie University, Halifax, NS, Canada
- Department of Medical Physics, Nova Scotia Health Authority, Halifax, NS, Canada
- Department of Radiation Oncology, Dalhousie University, Halifax, NS, Canada
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Ichikawa H. [[Nuclear Medicine] 4. Phantom Studies in Oncology]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2022; 78:637-645. [PMID: 35718453 DOI: 10.6009/jjrt.2022-2038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
- Hajime Ichikawa
- Department of Radiology, Toyohashi Municipal Hospital
- Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University
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Hesse M, d'Abadie P, Lhommel R, Jamar F, Walrand S. Yttrium-90 TOF-PET-Based EUD Predicts Response Post Liver Radioembolizations Using Recommended Manufacturer FDG Reconstruction Parameters. Front Oncol 2021; 11:592529. [PMID: 34676157 PMCID: PMC8523947 DOI: 10.3389/fonc.2021.592529] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 09/07/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose Explaining why 90Y TOF-PET based equivalent uniform dose (EUD) using recommended manufacturer FDG reconstruction parameters has been shown to predict response. Methods The hot rods insert of a Jaszczak deluxe phantom was partially filled with a 2.65 GBq 90Y - 300ml DTPA water solution resulting in a 100 Gy mean absorbed dose in the 6 sectors. A two bed 20min/position acquisition was performed on a 550ps- and on a 320ps- TOF-PET/CT and reconstructed with recommended manufacturer FDG reconstruction parameters, without and with additional filtering. The whole procedure was repeated on both PET after adding 300ml of water (50Gy setup). The phantom was acquired again after decay by a factor of 10 (5Gy setup), but with 200min per bed position. For comparison, the phantom was also acquired with 18F activity corresponding to a clinical FDG whole body acquisition. Results The 100Gy-setup provided a hot rod sectors image almost as good as the 18F phantom. However, despite acquisition time compensation, the 5Gy-setup provides much lower quality imaging. TOF-PET based sectors EUDs for the three large rod sectors agreed with the actual EUDs computed with a radiosensitivity of 0.021Gy-1 well in the range observed in external beam radiotherapy (EBRT), i.e. 0.01-0.04Gy-1. This agreement explains the reunification of the dose-response relationships of the glass and resin spheres in HCC using the TOF-PET based EUD. Additional filtering reduced the EUDs agreement quality. Conclusions Recommended manufacturer FDG reconstruction parameters are suitable in TOF-PET post 90Y liver radioembolization for accurate tumour EUD computation. The present results rule out the use of low specific activity phantom studies to optimize reconstruction parameters.
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Affiliation(s)
- Michel Hesse
- Nuclear Medicine, Cliniques universitaires Saint-Luc, Brussels, Belgium
| | - Philipe d'Abadie
- Nuclear Medicine, Cliniques universitaires Saint-Luc, Brussels, Belgium
| | - Renaud Lhommel
- Nuclear Medicine, Cliniques universitaires Saint-Luc, Brussels, Belgium
| | - Francois Jamar
- Nuclear Medicine, Cliniques universitaires Saint-Luc, Brussels, Belgium
| | - Stephan Walrand
- Nuclear Medicine, Cliniques universitaires Saint-Luc, Brussels, Belgium
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Labour J, Boissard P, Baudier T, Khayi F, Kryza D, Durebex PV, Martino SPD, Mognetti T, Sarrut D, Badel JN. Yttrium-90 quantitative phantom study using digital photon counting PET. EJNMMI Phys 2021; 8:56. [PMID: 34318383 PMCID: PMC8316557 DOI: 10.1186/s40658-021-00402-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 06/23/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND PET imaging of 90Y-microsphere distribution following radioembolisation is challenging due to the count-starved statistics from the low branching ratio of e+/e- pair production during 90Y decay. PET systems using silicon photo-multipliers have shown better 90Y image quality compared to conventional photo-multiplier tubes. The main goal of the present study was to evaluate reconstruction parameters for different phantom configurations and varying listmode acquisition lengths to improve quantitative accuracy in 90Y dosimetry, using digital photon counting PET/CT. METHODS Quantitative PET and dosimetry accuracy were evaluated using two uniform cylindrical phantoms specific for PET calibration validation. A third body phantom with a 9:1 hot sphere-to-background ratio was scanned at different activity concentrations of 90Y. Reconstructions were performed using OSEM algorithm with varying parameters. Time-of-flight and point-spread function modellings were included in all reconstructions. Absorbed dose calculations were carried out using voxel S-values convolution and were compared to reference Monte Carlo simulations. Dose-volume histograms and root-mean-square deviations were used to evaluate reconstruction parameter sets. Using listmode data, phantom and patient datasets were rebinned into various lengths of time to assess the influence of count statistics on the calculation of absorbed dose. Comparisons between the local energy deposition method and the absorbed dose calculations were performed. RESULTS Using a 2-mm full width at half maximum post-reconstruction Gaussian filter, the dosimetric accuracy was found to be similar to that found with no filter applied but also reduced noise. Larger filter sizes should not be used. An acquisition length of more than 10 min/bed reduces image noise but has no significant impact in the quantification of phantom or patient data for the digital photon counting PET. 3 iterations with 10 subsets were found suitable for large spheres whereas 1 iteration with 30 subsets could improve dosimetry for smaller spheres. CONCLUSION The best choice of the combination of iterations and subsets depends on the size of the spheres. However, one should be careful on this choice, depending on the imaging conditions and setup. This study can be useful in this choice for future studies for more accurate 90Y post-dosimetry using a digital photon counting PET/CT.
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Affiliation(s)
- Joey Labour
- CREATIS; CNRS UMR 5220; INSERM U 1044; Université de Lyon; INSA-Lyon; Université Lyon 1, Lyon, France
- Centre de lutte contre le cancer Léon Bérard, Lyon, France
| | | | - Thomas Baudier
- CREATIS; CNRS UMR 5220; INSERM U 1044; Université de Lyon; INSA-Lyon; Université Lyon 1, Lyon, France
- Centre de lutte contre le cancer Léon Bérard, Lyon, France
| | - Fouzi Khayi
- Centre de lutte contre le cancer Léon Bérard, Lyon, France
| | - David Kryza
- Centre de lutte contre le cancer Léon Bérard, Lyon, France
- Hospices Civils de Lyon; Université de Lyon; Université Claude Bernard Lyon 1; LAGEPP UMR 5007 CNRS, Lyon, France
| | | | | | | | - David Sarrut
- CREATIS; CNRS UMR 5220; INSERM U 1044; Université de Lyon; INSA-Lyon; Université Lyon 1, Lyon, France
- Centre de lutte contre le cancer Léon Bérard, Lyon, France
| | - Jean-Noël Badel
- CREATIS; CNRS UMR 5220; INSERM U 1044; Université de Lyon; INSA-Lyon; Université Lyon 1, Lyon, France
- Centre de lutte contre le cancer Léon Bérard, Lyon, France
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Automatic quantification package (Hone Graph) for phantom-based image quality assessment in bone SPECT: computerized automatic classification of detectability. Ann Nucl Med 2021; 35:937-946. [PMID: 34028702 DOI: 10.1007/s12149-021-01631-6] [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] [Received: 04/06/2021] [Accepted: 05/12/2021] [Indexed: 01/12/2023]
Abstract
OBJECTIVE We previously developed a custom-design thoracic bone scintigraphy-specific phantom ("SIM2 bone phantom") to assess image quality in bone single-photon emission computed tomography (SPECT). We aimed to develop an automatic assessment system for imaging technology in bone SPECT and demonstrate the validity of this system. METHODS Four spherical lesions of 13-, 17-, 22-, and 28-mm diameters in the vertebrae of SIM2 bone phantom simulating the thorax were filled with radioactivity (target-to-background ratio: 4). Dynamic SPECT acquisitions were performed for 15 min; reconstructions were performed using ordered subset expectation maximization at 3-15-min timepoints. Consequently, 216 lesions (54 SPECT images) were obtained: 120 and 96 lesions were used for software development and validation, respectively. The developed software used statistical parametric mapping to rigidly register and automatically calculate quantitative indexes (contrast-to-noise ratio, % coefficient of variance, % detectability equivalence volume, recovery coefficient, target-to-normal bone ratio, and full width at half maximum). A detectability score (DS) was used to define the four observation types (4, excellent; 3, adequate; 2, average; 1, poor) to score hot spherical lesions. The gold standard for DSs was independently classified by three experienced board-certified nuclear medicine technologists using the four observation types; thereafter, a consensus regarding the gold standard for DSs was reached. Using 120 lesions for development, decision tree analysis was performed to determine DS based on the quantitative indexes. We verified the validation of the quantitative indexes and their threshold values for automatic classification using 96 lesions for validation. RESULTS The trends in the automatically calculated quantitative indices were consistent. Decision tree analysis produced four terminal groups; two quantitative indexes (% detectability equivalence volume and contrast-to-noise ratio) were used to classify DS. The automatically classified DSs exhibited an almost perfect agreement with the gold standard. The percentage agreement and kappa coefficient were 91.7% and 0.93, respectively, in 96 lesions for validation. CONCLUSIONS The developed software automatically classified the detectability of hot lesions in the SIM2 bone phantom using the automatically calculated quantitative indexes, suggesting that this software could provide a means to automatically perform detectability analysis after data input that is excellent in reproducibility and accuracy.
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Nodari G, Popoff R, Riedinger JM, Lopez O, Pellegrinelli J, Dygai-Cochet I, Tabouret-Viaud C, Presles B, Chevallier O, Gehin S, Gallet M, Latournerie M, Manfredi S, Loffroy R, Vrigneaud JM, Cochet A. Impact of contouring methods on pre-treatment and post-treatment dosimetry for the prediction of tumor control and survival in HCC patients treated with selective internal radiation therapy. EJNMMI Res 2021; 11:24. [PMID: 33687596 PMCID: PMC7943673 DOI: 10.1186/s13550-021-00766-x] [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: 10/28/2020] [Accepted: 02/23/2021] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION The aim of this study was to evaluate the impact of the contouring methods on dose metrics and their predictive value on tumor control and survival, in both situations of pre-treatment and post-treatment dosimetry, for patients with advanced HCC treated with SIRT. METHODS Forty-eight patients who underwent SIRT between 2012 and 2020 were retrospectively included in this study. Target volumes were delineated using two methods: MRI-based contours manually drawn by a radiologist and then registered on SPECT/CT and PET/CT via deformable registration (Pre-CMRI and Post-CMRI), 99mTc-MAA-SPECT and 90Y-microspheres-PET 10% threshold contouring (Pre-CSPECT and Post-CPET). The mean absorbed dose (Dm) and the minimal absorbed dose delivered to 70% of the tumor volume (D70) were evaluated with both contouring methods; the tumor-to-normal liver uptake ratio (TNR) was evaluated with MRI-based contours only. Tumor response was assessed using the mRECIST criteria on the follow-up MRIs. RESULTS No significant differences were found for Dm and TNR between pre- and post-treatment. TNR evaluated with radiologic contours (Pre-CMRI and Post-CMRI) were predictive of tumor control at 6 months on pre- and post-treatment dosimetry (OR 5.9 and 7.1, respectively; p = 0.02 and 0.01). All dose metrics determined with both methods were predictive of overall survival (OS) on pre-treatment dosimetry, but only Dm with MRI-based contours was predictive of OS on post-treatment images with a median of 23 months for patients with a supramedian Dm versus 14 months for the others (p = 0.04). CONCLUSION In advanced HCC treated with SIRT, Dm and TNR determined with radiologic contours were predictive of tumor control and OS. This study shows that a rigorous clinical workflow (radiologic contours + registration on scintigraphic images) is feasible and should be prospectively considered for improving therapeutic strategy.
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Affiliation(s)
- Guillaume Nodari
- Department of Nuclear Medicine, Centre Georges-François Leclerc, Dijon, France.
| | - Romain Popoff
- Department of Nuclear Medicine, Centre Georges-François Leclerc, Dijon, France.,ImViA Laboratory, IFTIM Team, EA 7535, University of Burgundy, Dijon, France
| | - Jean Marc Riedinger
- Department of Nuclear Medicine, Centre Georges-François Leclerc, Dijon, France
| | - Olivier Lopez
- Department of Vascular and Interventional Radiology, University Hospital Dijon, Dijon, France
| | - Julie Pellegrinelli
- Department of Vascular and Interventional Radiology, University Hospital Dijon, Dijon, France
| | - Inna Dygai-Cochet
- Department of Nuclear Medicine, Centre Georges-François Leclerc, Dijon, France
| | | | - Benoit Presles
- ImViA Laboratory, IFTIM Team, EA 7535, University of Burgundy, Dijon, France
| | - Olivier Chevallier
- ImViA Laboratory, IFTIM Team, EA 7535, University of Burgundy, Dijon, France.,Department of Vascular and Interventional Radiology, University Hospital Dijon, Dijon, France
| | - Sophie Gehin
- Department of Vascular and Interventional Radiology, University Hospital Dijon, Dijon, France
| | - Matthieu Gallet
- Department of Nuclear Medicine, Centre Georges-François Leclerc, Dijon, France
| | | | - Sylvain Manfredi
- Department of Gastroenterology, University Hospital Dijon, Dijon, France
| | - Romaric Loffroy
- ImViA Laboratory, IFTIM Team, EA 7535, University of Burgundy, Dijon, France.,Department of Vascular and Interventional Radiology, University Hospital Dijon, Dijon, France
| | - Jean Marc Vrigneaud
- Department of Nuclear Medicine, Centre Georges-François Leclerc, Dijon, France.,ImViA Laboratory, IFTIM Team, EA 7535, University of Burgundy, Dijon, France
| | - Alexandre Cochet
- Department of Nuclear Medicine, Centre Georges-François Leclerc, Dijon, France.,ImViA Laboratory, IFTIM Team, EA 7535, University of Burgundy, Dijon, France
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Collimator and energy window optimization for practical imaging protocol and quantification of Yttrium-90 bremsstrahlung spect/ct: A phantom study. Radiat Phys Chem Oxf Engl 1993 2021. [DOI: 10.1016/j.radphyschem.2020.109080] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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12
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Hou X, Ma H, Esquinas PL, Uribe C, Tolhurst S, Bénard F, Liu D, Rahmim A, Celler A. Impact of image reconstruction method on dose distributions derived from 90Y PET images: phantom and liver radioembolization patient studies. Phys Med Biol 2020; 65:215022. [PMID: 33245057 DOI: 10.1088/1361-6560/aba8b5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
PET images acquired after liver 90Y radioembolization therapies are typically very noisy, which significantly challenges both visualization and quantification of activity distributions. To improve their noise characteristics, regularized iterative reconstruction algorithms such as block sequential regularized expectation maximization (Q.Clear for GE Healthcare, USA) have been proposed. In this study, we aimed to investigate the effects which different reconstruction algorithms may have on patient images, with reconstruction parameters initially narrowed down using phantom studies. Moreover, we evaluated the impact of these reconstruction methods on voxel-based dose distribution in phantom and patient studies (lesions and healthy livers). The International Electrotechnical Commission (IEC)/NEMA phantom, containing six spheres, was filled with 90Y and imaged using a GE Discovery 690 PET/CT scanner with time-of-flight enabled. The images were reconstructed using Q.Clear (with β parameter ranging from 0 to 8000) and ordered subsets expectation maximization. The image quality and quantification accuracy were evaluated by computing the hot ([Formula: see text]) and cold ([Formula: see text]) contrast recovery coefficients, background variability (BV) and activity bias. Next, dose distributions and dose volume histograms were generated using MIM® software's SurePlan LiverY90 toolbox. Subsequently, parameters optimized in these phantom studies were applied to five patient datasets. Dose parameters, such as Dmax, Dmean, D70, and V100Gy, were estimated, and their variability for different reconstruction methods was investigated. Based on phantom studies, the β parameter values optimized for image quality and quantification accuracy were 2500 and 300, respectively. When all investigated reconstructions were applied to patient studies, Dmean, D50, D70, and V100Gy showed coefficients of variation below 8%; whereas the variability of Dmax was up to 30% for both phantom and patient images. Although β = 300-1000 would provide accurate activity quantification for a region of interest, when considering activity/dose voxelized distribution, higher β value (e.g. 4000-5000) would provide the greatest accuracy for dose distributions. In this 90Y radioembolization PET/CT study, the β parameter in regularized iterative (Q.Clear) reconstruction was investigated for image quality, accurate quantification and dose distributions based on phantom experiments and then applied to patient studies. Our results indicate that more accurate dose distribution can be achieved from smoother PET images, reconstructed with larger β values than those yielding the best activity quantifications but noisy images. Most importantly, these results suggest that quantitative measures, which are commonly used in clinics, such as SUVmax or SUVpeak( equivalent of Dmax), should not be employed for 90Y PET images, since their values would highly depend on the image reconstruction.
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Affiliation(s)
- Xinchi Hou
- Department of Radiology, University of British Columbia, Vancouver, Canada
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Siman W, Mawlawi OR, Mourtada F, Kappadath SC. Systematic and random errors of PET‐based
90
Y 3D dose quantification. Med Phys 2020; 47:2441-2449. [DOI: 10.1002/mp.14117] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 01/21/2020] [Accepted: 02/26/2020] [Indexed: 11/10/2022] Open
Affiliation(s)
- W. Siman
- Department of Radiology The University of Colorado School of Medicine Denver CO USA
| | - O. R. Mawlawi
- Department of Imaging Physics The University of Texas MD Anderson Cancer Center Houston TX USA
- The University of Texas Graduate School of Biomedical Sciences at Houston Houston TX USA
| | | | - S. C. Kappadath
- Department of Imaging Physics The University of Texas MD Anderson Cancer Center Houston TX USA
- The University of Texas Graduate School of Biomedical Sciences at Houston Houston TX USA
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Local experience in Saudi Arabia of selective internal radiation therapy with yttrium-90 microspheres for the treatment of unresectable liver tumours. JOURNAL OF RADIOTHERAPY IN PRACTICE 2019. [DOI: 10.1017/s1460396919000074] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractAim:To assess local experience in Saudi Arabia of the effectiveness and tolerability of selective internal radiation therapy (SIRT) in patients with liver tumours.Materials and methods:In a retrospective study, patients with unresectable liver tumours treated with yttrium-90-labelled resin microspheres (SIR-Spheres®, Sirtex, Australia) at the King Fahad Specialist Hospital Dammam (KFSHD) were followed up for at least 12 months, or until death. Data were extracted from medical records. The primary outcome measure was overall survival (OS). Tumour response was recorded using the modified Response Evaluation Criteria in Solid Tumors (mRECIST): tumour control (TC) was defined as the proportion of patients with stable disease (SD), partial response (PR) and complete response (CR).Results:A total of 30 patients (21 males, 9 females) with hepatocellular carcinoma (76⋅7%), metastatic colorectal cancer (13⋅3%), cholangiocarcinoma (6⋅7%) or carcinoid tumour (3⋅3%) were evaluated. Mean OS was 16⋅98 months. Eighty-five percent of patients showed TC, 35% had SD, 15% a PR and 35% a CR. No severe complications were observed. Four deaths were considered unrelated to treatment.Findings:In this cohort, SIRT showed similar efficacy to that in other studies, with an acceptable tolerability profile. SIRT appears a feasible procedure for liver tumour treatment in the KFSHD.
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Siman W, Mikell JK, Mawlawi OR, Mourtada F, Kappadath SC. Dose volume histogram-based optimization of image reconstruction parameters for quantitative 90 Y-PET imaging. Med Phys 2018; 46:229-237. [PMID: 30375655 DOI: 10.1002/mp.13269] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 10/21/2018] [Accepted: 10/22/2018] [Indexed: 12/20/2022] Open
Abstract
PURPOSE 90 Y-microsphere radioembolization or selective internal radiation therapy is increasingly being used as a treatment option for tumors that are not candidates for surgery and external beam radiation therapy. Recently, volumetric 90 Y-dosimetry techniques have been implemented to explore tumor dose-response on the basis of 3D 90 Y-activity distribution from PET imaging. Despite being a theranostic study, the optimization of quantitative 90 Y-PET image reconstruction still uses the mean activity concentration recovery coefficient (RC) as the objective function, which is more relevant to diagnostic and detection tasks than is to dosimetry. The aim of this study was to optimize 90 Y-PET image reconstruction by minimizing errors in volumetric dosimetry via the dose volume histogram (DVH). We propose a joint optimization of the number of equivalent iterations (the product of the iterations and subsets) and the postreconstruction filtration (FWHM) to improve the accuracy of voxel-level 90 Y dosimetry. METHODS A modified NEMA IEC phantom was used to emulate clinically relevant 90 Y-PET imaging conditions through various combinations of acquisition durations, activity concentrations, sphere-to-background ratios, and sphere diameters. PET data were acquired in list mode for 300 min in a single-bed position; we then rebinned the list mode PET data to 60, 45, 30, 15, and 5 min per bed, with 10 different realizations. Errors in the DVH were calculated as root mean square errors (RMSE) of the differences in the image-based DVH and the expected DVH. The new optimization approach was tested in a phantom study, and the results were compared with the more commonly used objective function of the mean activity concentration RC. RESULTS In a wide range of clinically relevant imaging conditions, using 36 equivalent iterations with a 5.2-mm filtration resulted in decreased systematic errors in volumetric 90 Y dosimetry, quantified as image-based DVH, in 90 Y-PET images reconstructed using the ordered subset expectation maximization (OSEM) iterative reconstruction algorithm with time of flight (TOF) and point spread function (PSF) modeling. Our proposed objective function of minimizing errors in DVH, which allows for joint optimization of 90 Y-PET iterations and filtration for volumetric quantification of the 90 Y dose, was shown to be superior to conventional RC-based optimization approaches for image-based absorbed dose quantification. CONCLUSION Our proposed objective function of minimizing errors in DVH, which allows for joint optimization of iterations and filtration to reduce errors in the PET-based volumetric quantification 90 Y dose, is relevant to dosimetry in therapy procedures. The proposed optimization method using DVH as the objective function could be applied to any imaging modality used to assess voxel-level quantitative information.
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Affiliation(s)
- Wendy Siman
- Department of Radiology, The University of Tennessee Medical Center, Knoxville, TN, USA.,The University of Tennessee Graduate School of Medicine, Knoxville, TN, USA
| | - Justin K Mikell
- Department of Radiation Oncology, University of Michigan Hospital and Health Systems, Ann Arbor, MI, USA
| | - Osama R Mawlawi
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.,The University of Texas Graduate School of Biomedical Sciences at Houston, Houston, TX, USA
| | | | - S Cheenu Kappadath
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.,The University of Texas Graduate School of Biomedical Sciences at Houston, Houston, TX, USA
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17
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Bastiaannet R, Kappadath SC, Kunnen B, Braat AJAT, Lam MGEH, de Jong HWAM. The physics of radioembolization. EJNMMI Phys 2018; 5:22. [PMID: 30386924 PMCID: PMC6212377 DOI: 10.1186/s40658-018-0221-z] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 06/19/2018] [Indexed: 12/11/2022] Open
Abstract
Radioembolization is an established treatment for chemoresistant and unresectable liver cancers. Currently, treatment planning is often based on semi-empirical methods, which yield acceptable toxicity profiles and have enabled the large-scale application in a palliative setting. However, recently, five large randomized controlled trials using resin microspheres failed to demonstrate a significant improvement in either progression-free survival or overall survival in both hepatocellular carcinoma and metastatic colorectal cancer. One reason for this might be that the activity prescription methods used in these studies are suboptimal for many patients.In this review, the current dosimetric methods and their caveats are evaluated. Furthermore, the current state-of-the-art of image-guided dosimetry and advanced radiobiological modeling is reviewed from a physics' perspective. The current literature is explored for the observation of robust dose-response relationships followed by an overview of recent advancements in quantitative image reconstruction in relation to image-guided dosimetry.This review is concluded with a discussion on areas where further research is necessary in order to arrive at a personalized treatment method that provides optimal tumor control and is clinically feasible.
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Affiliation(s)
- Remco Bastiaannet
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Room E01.132, P.O. Box 85500, 3508 GA Utrecht, The Netherlands
| | - S. Cheenu Kappadath
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, 1155 Pressler St, Unit 1352, Houston, TX 77030 USA
| | - Britt Kunnen
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Room E01.132, P.O. Box 85500, 3508 GA Utrecht, The Netherlands
| | - Arthur J. A. T. Braat
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Room E01.132, P.O. Box 85500, 3508 GA Utrecht, The Netherlands
| | - Marnix G. E. H. Lam
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Room E01.132, P.O. Box 85500, 3508 GA Utrecht, The Netherlands
| | - Hugo W. A. M. de Jong
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Room E01.132, P.O. Box 85500, 3508 GA Utrecht, The Netherlands
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Kappadath SC, Mikell J, Balagopal A, Baladandayuthapani V, Kaseb A, Mahvash A. Hepatocellular Carcinoma Tumor Dose Response After 90Y-radioembolization With Glass Microspheres Using 90Y-SPECT/CT-Based Voxel Dosimetry. Int J Radiat Oncol Biol Phys 2018; 102:451-461. [DOI: 10.1016/j.ijrobp.2018.05.062] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 05/16/2018] [Accepted: 05/22/2018] [Indexed: 12/17/2022]
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Kunnen B, van der Velden S, Bastiaannet R, Lam MGEH, Viergever MA, de Jong HWAM. Radioembolization lung shunt estimation based on a 90
Y pretreatment procedure: A phantom study. Med Phys 2018; 45:4744-4753. [DOI: 10.1002/mp.13168] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 08/20/2018] [Accepted: 08/28/2018] [Indexed: 12/15/2022] Open
Affiliation(s)
- Britt Kunnen
- Radiology and Nuclear Medicine; UMC Utrecht; P.O. Box 85500 3508 GA Utrecht The Netherlands
- Image Sciences Institute; UMC Utrecht; University Utrecht; Heidelberglaan 100 3584 CX Utrecht The Netherlands
| | - Sandra van der Velden
- Radiology and Nuclear Medicine; UMC Utrecht; P.O. Box 85500 3508 GA Utrecht The Netherlands
- Image Sciences Institute; UMC Utrecht; University Utrecht; Heidelberglaan 100 3584 CX Utrecht The Netherlands
| | - Remco Bastiaannet
- Radiology and Nuclear Medicine; UMC Utrecht; P.O. Box 85500 3508 GA Utrecht The Netherlands
- Image Sciences Institute; UMC Utrecht; University Utrecht; Heidelberglaan 100 3584 CX Utrecht The Netherlands
| | - Marnix G. E. H. Lam
- Radiology and Nuclear Medicine; UMC Utrecht; P.O. Box 85500 3508 GA Utrecht The Netherlands
| | - Max A. Viergever
- Image Sciences Institute; UMC Utrecht; University Utrecht; Heidelberglaan 100 3584 CX Utrecht The Netherlands
| | - Hugo W. A. M. de Jong
- Radiology and Nuclear Medicine; UMC Utrecht; P.O. Box 85500 3508 GA Utrecht The Netherlands
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20
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18F-FCH and 90Y PET/CT data for the early evaluation of HCC radioembolisation. Clin Transl Imaging 2018. [DOI: 10.1007/s40336-018-0295-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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21
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D'Arienzo M, Pimpinella M, Capogni M, De Coste V, Filippi L, Spezi E, Patterson N, Mariotti F, Ferrari P, Chiaramida P, Tapner M, Fischer A, Paulus T, Pani R, Iaccarino G, D'Andrea M, Strigari L, Bagni O. Phantom validation of quantitative Y-90 PET/CT-based dosimetry in liver radioembolization. EJNMMI Res 2017; 7:94. [PMID: 29185067 PMCID: PMC5705539 DOI: 10.1186/s13550-017-0341-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 10/29/2017] [Indexed: 12/20/2022] Open
Abstract
Background PET/CT has recently been shown to be a viable alternative to traditional post-infusion imaging methods providing good quality images of 90Y-laden microspheres after selective internal radiation therapy (SIRT). In the present paper, first we assessed the quantitative accuracy of 90Y-PET using an anthropomorphic phantom provided with lungs, liver, spine, and a cylindrical homemade lesion located into the hepatic compartment. Then, we explored the accuracy of different computational approaches on dose calculation, including (I) direct Monte Carlo radiation transport using Raydose, (II) Kernel convolution using Philips Stratos, (III) local deposition algorithm, (IV) Monte Carlo technique (MCNP) considering a uniform activity distribution, and (V) MIRD (Medical Internal Radiation Dose) analytical approach. Finally, calculated absorbed doses were compared with those obtained performing measurements with LiF:Mg,Cu,P TLD chips in a liquid environment. Results Our results indicate that despite 90Y-PET being likely to provide high-resolution images, the 90Y low branch ratio, along with other image-degrading factors, may produce non-uniform activity maps, even in the presence of uniform activity. A systematic underestimation of the recovered activity, both for the tumor insert and for the liver background, was found. This is particularly true if no partial volume correction is applied through recovery coefficients. All dose algorithms performed well, the worst case scenario providing an agreement between absorbed dose evaluations within 20%. Average absorbed doses determined with the local deposition method are in excellent agreement with those obtained using the MIRD and the kernel-convolution dose calculation approach. Finally, absorbed dose assessed with MC codes are in good agreement with those obtained using TLD in liquid solution, thus confirming the soundness of both calculation approaches. This is especially true for Raydose, which provided an absorbed dose value within 3% of the measured dose, well within the stated uncertainties. Conclusions Patient-specific dosimetry is possible even in a scenario with low true coincidences and high random fraction, as in 90Y–PET imaging, granted that accurate absolute PET calibration is performed and acquisition times are sufficiently long. Despite Monte Carlo calculations seeming to outperform all dose estimation algorithms, our data provide a strong argument for encouraging the use of the local deposition algorithm for routine 90Y dosimetry based on PET/CT imaging, due to its simplicity of implementation.
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Affiliation(s)
- Marco D'Arienzo
- ENEA, Italian National Institute of Ionizing Radiation Metrology, Via Anguillarese 301, 00123, Rome, Italy. .,Department of Anatomical, Histological, Forensic Medicine and Orthopedic Sciences, Sapienza University, Rome, Italy.
| | - Maria Pimpinella
- ENEA, Italian National Institute of Ionizing Radiation Metrology, Via Anguillarese 301, 00123, Rome, Italy
| | - Marco Capogni
- ENEA, Italian National Institute of Ionizing Radiation Metrology, Via Anguillarese 301, 00123, Rome, Italy
| | - Vanessa De Coste
- ENEA, Italian National Institute of Ionizing Radiation Metrology, Via Anguillarese 301, 00123, Rome, Italy
| | - Luca Filippi
- Nuclear Medicine Department, Santa Maria Goretti Hospital, Latina, Italy
| | - Emiliano Spezi
- School of Engineering, Cardiff University, Cardiff, CF24 3AA, United Kingdom.,Department of Medical Physics, Velindre Cancer Centre, Cardiff, UK
| | - Nick Patterson
- Department of Medical Physics, Velindre Cancer Centre, Cardiff, UK
| | - Francesca Mariotti
- ENEA, Radiation Protection Institute, Bologna Via Martiri di Monte Sole 4, 40129, Bologna, Italy
| | - Paolo Ferrari
- ENEA, Radiation Protection Institute, Bologna Via Martiri di Monte Sole 4, 40129, Bologna, Italy
| | | | | | - Alexander Fischer
- Philips Technologie GmbH Innovative Technologies, Research Laboratories Pauwelsstr, 17, 52074, Aachen, Germany
| | - Timo Paulus
- Philips Technologie GmbH Innovative Technologies, Research Laboratories Pauwelsstr, 17, 52074, Aachen, Germany
| | - Roberto Pani
- Depertment of Medico-surgical Sciences and Biotecnologies, Sapienza University of Rome, Rome, Italy
| | - Giuseppe Iaccarino
- Laboratory of Medical Physics and Expert Systems, Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy
| | - Marco D'Andrea
- Laboratory of Medical Physics and Expert Systems, Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy
| | - Lidia Strigari
- Laboratory of Medical Physics and Expert Systems, Regina Elena National Cancer Institute, Via Elio Chianesi 53, 00144, Rome, Italy
| | - Oreste Bagni
- Nuclear Medicine Department, Santa Maria Goretti Hospital, Latina, Italy
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Low-dose 90Y PET/CT imaging optimized for lesion detectability and quantitative accuracy. Nucl Med Commun 2017; 38:985-997. [DOI: 10.1097/mnm.0000000000000742] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Dewaraja YK, Chun SY, Srinivasa RN, Kaza RK, Cuneo KC, Majdalany BS, Novelli PM, Ljungberg M, Fessler JA. Improved quantitative 90 Y bremsstrahlung SPECT/CT reconstruction with Monte Carlo scatter modeling. Med Phys 2017; 44:6364-6376. [PMID: 28940483 DOI: 10.1002/mp.12597] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 09/13/2017] [Accepted: 09/15/2017] [Indexed: 01/07/2023] Open
Abstract
PURPOSE In 90 Y microsphere radioembolization (RE), accurate post-therapy imaging-based dosimetry is important for establishing absorbed dose versus outcome relationships for developing future treatment planning strategies. Additionally, accurately assessing microsphere distributions is important because of concerns for unexpected activity deposition outside the liver. Quantitative 90 Y imaging by either SPECT or PET is challenging. In 90 Y SPECT model based methods are necessary for scatter correction because energy window-based methods are not feasible with the continuous bremsstrahlung energy spectrum. The objective of this work was to implement and evaluate a scatter estimation method for accurate 90 Y bremsstrahlung SPECT/CT imaging. METHODS Since a fully Monte Carlo (MC) approach to 90 Y SPECT reconstruction is computationally very demanding, in the present study the scatter estimate generated by a MC simulator was combined with an analytical projector in the 3D OS-EM reconstruction model. A single window (105 to 195-keV) was used for both the acquisition and the projector modeling. A liver/lung torso phantom with intrahepatic lesions and low-uptake extrahepatic objects was imaged to evaluate SPECT/CT reconstruction without and with scatter correction. Clinical application was demonstrated by applying the reconstruction approach to five patients treated with RE to determine lesion and normal liver activity concentrations using a (liver) relative calibration. RESULTS There was convergence of the scatter estimate after just two updates, greatly reducing computational requirements. In the phantom study, compared with reconstruction without scatter correction, with MC scatter modeling there was substantial improvement in activity recovery in intrahepatic lesions (from > 55% to > 86%), normal liver (from 113% to 104%), and lungs (from 227% to 104%) with only a small degradation in noise (13% vs. 17%). Similarly, with scatter modeling contrast improved substantially both visually and in terms of a detectability index, which was especially relevant for the low uptake extrahepatic objects. The trends observed for the phantom were also seen in the patient studies where lesion activity concentrations and lesion-to-liver concentration ratios were lower for SPECT without scatter correction compared with reconstruction with just two MC scatter updates: in eleven lesions the mean uptake was 4.9 vs. 7.1 MBq/mL (P = 0.0547), the mean normal liver uptake was 1.6 vs. 1.5 MBq/mL (P = 0.056) and the mean lesion-to-liver uptake ratio was 2.7 vs. 4.3 (P = 0.0402) for reconstruction without and with scatter correction respectively. CONCLUSIONS Quantitative accuracy of 90 Y bremsstrahlung imaging can be substantially improved with MC scatter modeling without significant degradation in image noise or intensive computational requirements.
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Affiliation(s)
- Yuni K Dewaraja
- Department of Radiology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Se Young Chun
- School of Electrical and Computer Engineering, Ulsan National Institute of Science and Technology, Ulsan, Korea
| | - Ravi N Srinivasa
- Department of Radiology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Ravi K Kaza
- Department of Radiology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Kyle C Cuneo
- Department of Radiation Oncology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Bill S Majdalany
- Department of Radiology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Paula M Novelli
- Department of Radiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Michael Ljungberg
- Department of Medical Radiation Physics, Lund University, Lund, Sweden
| | - Jeffrey A Fessler
- Department of Electrical Engineering and Computer Science, University of Michigan, Ann Arbor, MI, USA
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Siman W, Kappadath SC. Comparison of Step-and-Shoot and Continuous-Bed-Motion PET Modes of Acquisition for Limited-View Organ Scans. J Nucl Med Technol 2017; 45:290-296. [PMID: 29042468 DOI: 10.2967/jnmt.117.195438] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2017] [Accepted: 08/31/2017] [Indexed: 01/20/2023] Open
Abstract
Continuous-bed-motion (CBM) acquisition mode has been made commercially available in PET/CT scanners. CBM mode is designed for whole-body imaging, with a long scan length (multiple axial fields of view [aFOVs]) and short acquisition duration (2-3 min/aFOV). PET/CT has recently been used after 90Y-microsphere therapy to quantify 90Y activity distribution in the liver. Here we compared counting efficiencies along the bed-motion direction (z-axis) between CBM and step-and-shoot (SS) acquisition modes for limited-view organ scans, such as 90Y PET/CT liver studies, that have short scan lengths (≤2 aFOVs) and long acquisition durations (10-30 min/aFOV). Methods: The counting efficiencies, that is, analytic sensitivities, in SS mode (single-aFOV and multiple-aFOV scans) and CBM mode were theoretically derived and experimentally validated using a cylindric 68Ge phantom. The sensitivities along the z-axis were compared between the SS and CBM modes. Results: The analytic and experimental count profiles were in good agreement, validating the analytic models. For fixed scan durations, the overall coincidence counting efficiency in CBM mode was lower (∼60%) than those in SS modes, and the maximum sensitivity in CBM mode was 50% or less of that in 1-aFOV SS mode and 100% or less of that in 2-aFOV SS mode. Conclusion: The ability of CBM mode to tailor-fit the PET/CT scan length and local scan duration is not realized in studies with a short scan length (≤30 cm) and long scan duration (20 min/aFOV for the scanner). SS acquisition mode is preferable to CBM mode for limited-view organ and count-starved scans, such as 90Y PET/CT liver scans, because of the higher counting efficiency of SS mode, which leads to better image quality and quantification precision.
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Affiliation(s)
- Wendy Siman
- Department of Radiology, University of Tennessee Medical Center, Knoxville, Tennessee.,University of Tennessee Graduate School of Medicine, Knoxville, Tennessee
| | - S Cheenu Kappadath
- Department of Imaging Physics, University of Texas MD Anderson Cancer Center, Houston, Texas; and .,University of Texas Graduate School of Biomedical Sciences, Houston, Texas
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Optimisation of reconstruction, volumetry and dosimetry for 99mTc-SPECT and 90Y-PET images: Towards reliable dose-volume histograms for selective internal radiation therapy with 90Y-microspheres. Phys Med 2017; 39:147-155. [PMID: 28687192 DOI: 10.1016/j.ejmp.2017.06.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Revised: 05/19/2017] [Accepted: 06/24/2017] [Indexed: 01/10/2023] Open
Abstract
PURPOSE In Selective Internal Radiation Therapy (SIRT), 99mTc-MAA SPECT images are commonly used to predict microspheres distribution but recent works used 90Y-microspheres PET images. Nevertheless, evaluation of the predictive power of 99mTc-MAA has been hampered by the lack of reliable comparisons between 99mTc-SPECT and 90Y-PET images. Our aim was to determine the "in situ" optimisation procedure in order to reliably compare 99mTc-SPECT and 90Y-PET images and achieve optimal personal dosimetry. METHODS We acquired 99mTc-SPECT/CT and 90Y-PET/CT images of NEMA and Jaszczak phantoms. We found the best reconstruction parameters for quantification and for volume estimations. We determined adaptive threshold curves on the volumetric reconstruction. We copied the optimised volumes on the quantitative reconstruction, named here the "cross volumes" technique. Finally, we compared 99mTc-SPECT and 90Y-PET Dose Volume Histograms. RESULTS Our "in situ" optimisation procedure decreased errors on volumes and quantification (from -44.2% and -15.8% to -3.4% and -3.28%, respectively, for the 26.5mL PET phantom sphere). Moreover, 99mTc-SPECT and 90Y-PET DVHs were equivalent only after the optimisation procedure (difference in mean dose <5% for the three biggest spheres). CONCLUSIONS This work showed that a preliminary "in situ" phantom study was necessary to optimise volumes and quantification of 99mTc-SPECT and 90Y-PET images and allowed to achieve a reliable comparison between patient treatment planning and post implant dosimetry, notably by the use of the "cross volumes" technique. Methodology developed in this work will enable robust evaluations of the predictive power of 99mTc-SPECT, as well as dose-response relationship and side effects in SIRT treatments.
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Beijst C, de Keizer B, Lam MGEH, Janssens GO, Tytgat GAM, de Jong HWAM. A phantom study: Should 124 I-mIBG PET/CT replace 123 I-mIBG SPECT/CT? Med Phys 2017; 44:1624-1631. [PMID: 28273347 DOI: 10.1002/mp.12202] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Revised: 02/24/2017] [Accepted: 02/28/2017] [Indexed: 11/11/2022] Open
Abstract
PURPOSE The isotope 123 I is commonly labeled with meta-iodobenzylguanidine (mIBG) for imaging of neuroendocrine tumors, such as pheochromocytomas and neuroblastomas. 123 I-mIBG SPECT/CT imaging is performed for staging, follow-up and selection of patients for treatment with 131 I mIBG. As an alternative to 123 I, 124 I-mIBG PET/CT may be used, potentially taking advantage of the superior PET image quality. The purpose of this study was to investigate whether 124 I PET/CT improves image quality as compared with 123 I SPECT/CT for equal patient effective radiation dose (in mSv). METHODS Phantom measurements were performed using the NEMA-2007 image quality phantom. SPECT and PET reconstruction settings were used with and without time-of-flight (TOF) and point-spread-function (PSF) modeling. As a measure of image quality, the contrast-to-noise ratio (CNR) was calculated. The ratio of the 123 I to 124 I activity concentration was determined at which the contrast-to-noise ratio was equal for both modalities. This metric was defined as the contrast equivalent activity ratio (CEAR). RESULTS CEARs of 47.7, 25.6, 23.1, 14.6, 10.0, and 9.1 were obtained for a TOF and PSF modeled 124 I reconstruction method and an attenuation and scatter-corrected 123 I reconstruction method for sphere sizes of 10 to 37 mm, respectively. As the effective radiation dose of 124 I-mIBG is higher than of 123 I-mIBG (in mSv/MBq), an equal effective dose corresponds to a CEAR of 5 to 10. Therefore, CEARs higher than 5 to 10 indicate that 124 I PET/CT outperforms 123 I SPECT/CT in the sense of image quality for equal patient effective radiation dose. CONCLUSION The CEAR is much larger than a factor of 5 to 10 (needed for equal patient effective radiation dose) for most of the reconstruction methods and sphere sizes. Therefore, 124 I-mIBG PET/CT is expected to improve image quality and/or may be used to reduce effective patient dose as compared with 123 I-mIBG SPECT/CT.
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Affiliation(s)
- Casper Beijst
- Department of Radiology and Nuclear Medicine, UMC Utrecht, Utrecht, The Netherlands.,Image Sciences Institute, UMC Utrecht, Utrecht, The Netherlands
| | - Bart de Keizer
- Department of Radiology and Nuclear Medicine, UMC Utrecht, Utrecht, The Netherlands
| | - Marnix G E H Lam
- Department of Radiology and Nuclear Medicine, UMC Utrecht, Utrecht, The Netherlands
| | - Geert O Janssens
- Department of Radiation Oncology, UMC Utrecht, Utrecht, The Netherlands
| | | | - Hugo W A M de Jong
- Department of Radiology and Nuclear Medicine, UMC Utrecht, Utrecht, The Netherlands
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Siman W, Mikell JK, Kappadath SC. Practical reconstruction protocol for quantitative (90)Y bremsstrahlung SPECT/CT. Med Phys 2017; 43:5093. [PMID: 27587040 DOI: 10.1118/1.4960629] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
PURPOSE To develop a practical background compensation (BC) technique to improve quantitative (90)Y-bremsstrahlung single-photon emission computed tomography (SPECT)/computed tomography (CT) using a commercially available imaging system. METHODS All images were acquired using medium-energy collimation in six energy windows (EWs), ranging from 70 to 410 keV. The EWs were determined based on the signal-to-background ratio in planar images of an acrylic phantom of different thicknesses (2-16 cm) positioned below a (90)Y source and set at different distances (15-35 cm) from a gamma camera. The authors adapted the widely used EW-based scatter-correction technique by modeling the BC as scaled images. The BC EW was determined empirically in SPECT/CT studies using an IEC phantom based on the sphere activity recovery and residual activity in the cold lung insert. The scaling factor was calculated from 20 clinical planar (90)Y images. Reconstruction parameters were optimized in the same SPECT images for improved image quantification and contrast. A count-to-activity calibration factor was calculated from 30 clinical (90)Y images. RESULTS The authors found that the most appropriate imaging EW range was 90-125 keV. BC was modeled as 0.53× images in the EW of 310-410 keV. The background-compensated clinical images had higher image contrast than uncompensated images. The maximum deviation of their SPECT calibration in clinical studies was lowest (<10%) for SPECT with attenuation correction (AC) and SPECT with AC + BC. Using the proposed SPECT-with-AC + BC reconstruction protocol, the authors found that the recovery coefficient of a 37-mm sphere (in a 10-mm volume of interest) increased from 39% to 90% and that the residual activity in the lung insert decreased from 44% to 14% over that of SPECT images with AC alone. CONCLUSIONS The proposed EW-based BC model was developed for (90)Y bremsstrahlung imaging. SPECT with AC + BC gave improved lesion detectability and activity quantification compared to SPECT with AC only. The proposed methodology can readily be used to tailor (90)Y SPECT/CT acquisition and reconstruction protocols with different SPECT/CT systems for quantification and improved image quality in clinical settings.
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Affiliation(s)
- W Siman
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030 and The University of Texas Graduate School of Biomedical Sciences at Houston, Houston, Texas 77030
| | - J K Mikell
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030 and The University of Texas Graduate School of Biomedical Sciences at Houston, Houston, Texas 77030
| | - S C Kappadath
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030 and The University of Texas Graduate School of Biomedical Sciences at Houston, Houston, Texas 77030
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Strydhorst J, Carlier T, Dieudonné A, Conti M, Buvat I. A gate evaluation of the sources of error in quantitative 90 Y PET. Med Phys 2017; 43:5320-5329. [PMID: 28105711 DOI: 10.1118/1.4961747] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Revised: 07/28/2016] [Accepted: 08/13/2016] [Indexed: 01/08/2023] Open
Abstract
PURPOSE Accurate reconstruction of the dose delivered by 90 Y microspheres using a postembolization PET scan would permit the establishment of more accurate dose-response relationships for treatment of hepatocellular carcinoma with 90 Y. However, the quality of the PET data obtained is compromised by several factors, including poor count statistics and a very high random fraction. This work uses Monte Carlo simulations to investigate what impact factors other than low count statistics have on the quantification of90 Y PET. METHODS PET acquisitions of two phantoms-a NEMA PET phantom and the NEMA IEC PET body phantom-containing either 90 Y or 18 F were simulated using gate. Simulated projections were created with subsets of the simulation data allowing the contributions of random, scatter, and LSO background to be independently evaluated. The simulated projections were reconstructed using the commercial software for the simulated scanner, and the quantitative accuracy of the reconstruction and the contrast recovery of the reconstructed images were evaluated. RESULTS The quantitative accuracy of the 90 Y reconstructions were not strongly influenced by the high random fraction present in the projection data, and the activity concentration was recovered to within 5% of the known value. The contrast recovery measured for simulated 90 Y data was slightly poorer than that for simulated 18 F data with similar count statistics. However, the degradation was not strongly linked to any particular factor. Using a more restricted energy range to reduce the random fraction in the projections had no significant effect. CONCLUSIONS Simulations of 90 Y PET confirm that quantitative 90 Y is achievable with the same approach as that used for 18 F, and that there is likely very little margin for improvement by attempting to model aspects unique to 90 Y, such as the much higher random fraction or the presence of bremsstrahlung in the singles data.
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Affiliation(s)
- Jared Strydhorst
- IMIV, U1023 Inserm/CEA/Université Paris-Sud and ERL 9218 CNRS, Université Paris-Saclay, CEA/SHFJ, Orsay 91401, France
| | - Thomas Carlier
- Department of Nuclear Medicine, Centre Hospitalier Universitaire de Nantes and CRCNA, Inserm U892, Nantes 44000, France
| | - Arnaud Dieudonné
- Department of Nuclear Medicine, Hôpital Beaujon, HUPNVS, APHP and Inserm U1149, Clichy 92110, France
| | - Maurizio Conti
- Siemens Healthcare Molecular Imaging, Knoxville, Tennessee, 37932
| | - Irène Buvat
- IMIV, U1023 Inserm/CEA/Université Paris-Sud and ERL 9218 CNRS, Université Paris-Saclay, CEA/SHFJ, Orsay 91401, France
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Khazaee Moghadam M, Kamali Asl A, Geramifar P, Zaidi H. Evaluating the Application of Tissue-Specific Dose Kernels Instead of Water Dose Kernels in Internal Dosimetry: A Monte Carlo Study. Cancer Biother Radiopharm 2017; 31:367-379. [PMID: 27996311 DOI: 10.1089/cbr.2016.2117] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
PURPOSE The aim of this work is to evaluate the application of tissue-specific dose kernels instead of water dose kernels to improve the accuracy of patient-specific dosimetry by taking tissue heterogeneities into consideration. MATERIALS AND METHODS Tissue-specific dose point kernels (DPKs) and dose voxel kernels (DVKs) for yttrium-90 (90Y), lutetium-177 (177Lu), and phosphorus-32 (32P) are calculated using the Monte Carlo (MC) simulation code GATE (version 7). The calculated DPKs for bone, lung, adipose, breast, heart, intestine, kidney, liver, and spleen are compared with those of water. The dose distribution in normal and tumorous tissues in lung, liver, and bone of a Zubal phantom is calculated using tissue-specific DVKs instead of those of water in conventional methods. For a tumor defined in a heterogeneous region in the Zubal phantom, the absorbed dose is calculated using a proposed algorithm, taking tissue heterogeneity into account. The algorithm is validated against full MC simulations. RESULTS The simulation results indicate that the highest differences between water and other tissue DPKs occur in bone for 90Y (12.2% ± 0.6%), 32P (18.8% ± 1.3%), and 177Lu (16.9% ± 1.3%). The second highest discrepancy corresponds to the lung for 90Y (6.3% ± 0.2%), 32P (8.9% ± 0.4%), and 177Lu (7.7% ± 0.3%). For 90Y, the mean absorbed dose in tumorous and normal tissues is calculated using tissue-specific DVKs in lung, liver, and bone. The results are compared with doses calculated considering the Zubal phantom water equivalent and the relative differences are 4.50%, 0.73%, and 12.23%, respectively. For the tumor in the heterogeneous region of the Zubal phantom that includes lung, liver, and bone, the relative difference between mean calculated dose in tumorous and normal tissues based on the proposed algorithm and the values obtained from full MC dosimetry is 5.18%. CONCLUSIONS A novel technique is proposed considering tissue-specific dose kernels in the dose calculation algorithm. This algorithm potentially enables patient-specific dosimetry and improves estimation of the average absorbed dose of 90Y in a tumor located in lung, bone, and soft tissue interface by 6.98% compared with the conventional methods.
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Affiliation(s)
| | - Alireza Kamali Asl
- 1 Department of Radiation Medicine Engineering, Shahid Beheshti University , Tehran, Iran
| | - Parham Geramifar
- 2 Research Center for Nuclear Medicine, Shariati Hospital, Tehran University of Medical Sciences , Tehran, Iran
| | - Habib Zaidi
- 3 Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospital , Geneva, Switzerland .,4 Geneva Neuroscience Center, Geneva University , Geneva, Switzerland .,5 Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen , Groningen, The Netherlands
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Siman W, Mawlawi OR, Mikell JK, Mourtada F, Kappadath SC. Effects of image noise, respiratory motion, and motion compensation on 3D activity quantification in count-limited PET images. Phys Med Biol 2016; 62:448-464. [DOI: 10.1088/1361-6560/aa5088] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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van den Hoven AF, Prince JF, Bruijnen RCG, Verkooijen HM, Krijger GC, Lam MGEH, van den Bosch MAAJ. Surefire infusion system versus standard microcatheter use during holmium-166 radioembolization: study protocol for a randomized controlled trial. Trials 2016; 17:520. [PMID: 27782851 PMCID: PMC5080784 DOI: 10.1186/s13063-016-1643-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 10/05/2016] [Indexed: 12/31/2022] Open
Abstract
Background An anti-reflux catheter (ARC) may increase the tumor absorbed dose during radioembolization (RE) by elimination of particle reflux and its effects on hemodynamics. Since the catheter is fixed in a centro-luminal position, it may also increase the predictive accuracy of a scout dose administration before treatment. The purpose of the SIM trial is to compare the effects of ARC use during RE with holmium-166 (166Ho) microspheres in patients with colorectal liver metastases (CRLM), with the use of a standard end-hole microcatheter. Methods/Design A within-patient randomized controlled trial (RCT) will be conducted in 25 patients with unresectable chemorefractory liver-dominant CRLM. Study participants will undergo a 166Ho scout dose procedure in the morning and a therapeutic procedure in the afternoon. The ARC will be randomly allocated to the left/right hepatic artery, and a standard microcatheter will be used in the contralateral artery. SPECT/CT imaging will be performed for quantitative analyses of the microsphere distribution directly after the scout and treatment procedure. Baseline and follow-up investigations include 18F-FDG-PET + liver CT, clinical and laboratory examinations. The primary endpoint is the comparison of tumor to non-tumor (T/N) activity ratio in both groups. Secondary endpoints include comparisons of mean absorbed dose in tumors and healthy liver tissue, infusion efficiency, the predictive value of 166Ho scout dose for tumor response. In the entire cohort, a dose-response relationship, clinical toxicity, and overall survival will be assessed. The sample was determined for the expectation that the ARC will increase the T/N ratio by 25 % (mean T/N ratio 2.0 vs. 1.6). Discussion The SIM trial is a within-patient RCT that will assess whether 166Ho RE treatment can be optimized by using an ARC. Trial registration The SIM trial is registered at clinicaltrials.gov (NCT02208804). Registered on 31 July 2014. Electronic supplementary material The online version of this article (doi:10.1186/s13063-016-1643-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Andor F van den Hoven
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
| | - Jip F Prince
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Rutger C G Bruijnen
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Helena M Verkooijen
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Gerard C Krijger
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Marnix G E H Lam
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Maurice A A J van den Bosch
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
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Rowley LM, Bradley KM, Boardman P, Hallam A, McGowan DR. Optimization of Image Reconstruction for 90Y Selective Internal Radiotherapy on a Lutetium Yttrium Orthosilicate PET/CT System Using a Bayesian Penalized Likelihood Reconstruction Algorithm. J Nucl Med 2016; 58:658-664. [PMID: 27688476 DOI: 10.2967/jnumed.116.176552] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Accepted: 09/08/2016] [Indexed: 02/07/2023] Open
Abstract
Imaging on a γ-camera with 90Y after selective internal radiotherapy (SIRT) may allow for verification of treatment delivery but suffers relatively poor spatial resolution and imprecise dosimetry calculation. 90Y PET/CT imaging is possible on 3-dimensional, time-of-flight machines; however, images are usually poor because of low count statistics and noise. A new PET reconstruction software using a Bayesian penalized likelihood (BPL) reconstruction algorithm (termed Q.Clear) was investigated using phantom and patient scans to optimize the reconstruction for post-SIRT imaging and clarify whether BPL leads to an improvement in clinical image quality using 90Y. Methods: Phantom studies over an activity range of 0.5-4.2 GBq were performed to assess the contrast recovery, background variability, and contrast-to-noise ratio for a range of BPL and ordered-subset expectation maximization (OSEM) reconstructions on a PET/CT scanner. Patient images after SIRT were reconstructed using the same parameters and were scored and ranked on the basis of image quality, as assessed by visual evaluation, with the corresponding SPECT/CT Bremsstrahlung images by 2 experienced radiologists. Results: Contrast-to-noise ratio was significantly better in BPL reconstructions when compared with OSEM in phantom studies. The patient-derived BPL and matching Bremsstrahlung images scored higher than OSEM reconstructions when scored by radiologists. BPL with a β value of 4,000 was ranked the highest of all images. Deadtime was apparent in the system above a total phantom activity of 3.3 GBq. Conclusion: BPL with a β value of 4,000 is the optimal image reconstruction in PET/CT for confident radiologic reading when compared with other reconstruction parameters for 90Y imaging after SIRT imaging. Activity in the field of view should be below 3.3 GBq at the time of PET imaging to avoid deadtime losses for this scanner.
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Affiliation(s)
- Lisa M Rowley
- Radiation Physics and Protection, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - Kevin M Bradley
- Department of Radiology, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom; and
| | - Philip Boardman
- Department of Radiology, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom; and
| | - Aida Hallam
- Radiation Physics and Protection, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - Daniel R McGowan
- Radiation Physics and Protection, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom.,Department of Oncology, University of Oxford, Oxford, United Kingdom
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Vaquero JJ, Kinahan P. Positron Emission Tomography: Current Challenges and Opportunities for Technological Advances in Clinical and Preclinical Imaging Systems. Annu Rev Biomed Eng 2016; 17:385-414. [PMID: 26643024 DOI: 10.1146/annurev-bioeng-071114-040723] [Citation(s) in RCA: 171] [Impact Index Per Article: 21.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Positron emission tomography (PET) imaging is based on detecting two time-coincident high-energy photons from the emission of a positron-emitting radioisotope. The physics of the emission, and the detection of the coincident photons, give PET imaging unique capabilities for both very high sensitivity and accurate estimation of the in vivo concentration of the radiotracer. PET imaging has been widely adopted as an important clinical modality for oncological, cardiovascular, and neurological applications. PET imaging has also become an important tool in preclinical studies, particularly for investigating murine models of disease and other small-animal models. However, there are several challenges to using PET imaging systems. These include the fundamental trade-offs between resolution and noise, the quantitative accuracy of the measurements, and integration with X-ray computed tomography and magnetic resonance imaging. In this article, we review how researchers and industry are addressing these challenges.
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Affiliation(s)
- Juan José Vaquero
- Departamento de Bioingeniería e Ingeniería Aeroespacial, Universidad Carlos III de Madrid, 28911 Madrid, Spain, and Instituto de Investigación Sanitaria Gregorio Marañón, 28007 Madrid, Spain;
| | - Paul Kinahan
- Departments of Radiology, Bioengineering, and Physics, University of Washington, Seattle, Washington 98195;
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Analysis of the influence of 111In on 90Y-bremsstrahlung SPECT based on Monte Carlo simulation. Ann Nucl Med 2016; 30:675-681. [PMID: 27510893 DOI: 10.1007/s12149-016-1112-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Accepted: 08/01/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE 90Y-ibritumomab tiuxetan (Zevalin) which is used for the treatment of malignant lymphomas can be used for SPECT imaging based on bremsstrahlung from 90Y beta particles. However, gamma rays emitted by 111In, which is administered to evaluate the indication for the treatment, contaminate the 90Y bremsstrahlung images. Our objective is to investigate the influence of 111In on the 90Y SPECT images using Monte Carlo simulation. METHODS We used an in-house developed simulation code for the Monte Carlo simulation of electrons and photons (MCEP). Two hot spheres with diameters of 40 mm were put in an elliptical phantom. Both spheres ("sphere 1" and "sphere 2") were filled with 90Y and 111In mixed solutions. The activities of 90Y in sphere 1 and sphere 2 were 241 and 394 kBq/mL, respectively, and the ones of 111In were 8.14 and 13.3 kBq/mL, respectively. The background activity of 90Y was 38.6 kBq/mL, whereas that of 111In was 1.30 kBq/mL; moreover, the acquisition time was 30 min. Two energy windows were used: one is 90-190 keV included the 111In photopeak; the other is 90-160 keV. To evaluate the quality of the SPECT images, the contrast recovery coefficient (CRC) and the constant noise ratio (CNR) of the SPECT images were derived. RESULTS For the energy window between 90 and 160 keV, the 111In count was 74 % of the total. In that case, the CRC values were 30.1 and 30.7 % for "sphere 1" and "sphere 2", respectively, whereas the CNR values were 6.8 and 12.1, respectively. For the energy window between 90 and 190 keV, the 111In count reached 85 % of the total count. The CRC and CNR values were 38.6 and 40.0 % and 10.6 and 19.4, respectively. CONCLUSIONS Our simulation study revealed that the cross talk between 111In and 90Y in SPECT imaging is rather serious. Even for the energy window excluding the 111In photopeak, the count ratio of 90Y was less than 30 % of the total. However, the influence of 111In on 90Y-SPECT imaging cannot be ignored, and the count ratio because of 111In is important to estimate the density of 90Y.
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Conti M, Eriksson L. Physics of pure and non-pure positron emitters for PET: a review and a discussion. EJNMMI Phys 2016; 3:8. [PMID: 27271304 PMCID: PMC4894854 DOI: 10.1186/s40658-016-0144-5] [Citation(s) in RCA: 202] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Accepted: 05/31/2015] [Indexed: 01/09/2023] Open
Abstract
With the increased interest in new PET tracers, gene-targeted therapy, immunoPET, and theranostics, other radioisotopes will be increasingly used in clinical PET scanners, in addition to 18F. Some of the most interesting radioisotopes with prospective use in the new fields are not pure short-range β+ emitters but can be associated with gamma emissions in coincidence with the annihilation radiation (prompt gamma), gamma-gamma cascades, intense Bremsstrahlung radiation, high-energy positrons that may escape out of the patient skin, and high-energy gamma rays that result in some e+/e− pair production. The high level of sophistication in data correction and excellent quantitative accuracy that has been reached for 18F in recent years can be questioned by these effects. In this work, we review the physics and the scientific literature and evaluate the effect of these additional phenomena on the PET data for each of a series of radioisotopes: 11C, 13N, 15O, 18F, 64Cu, 68Ga, 76Br, 82Rb, 86Y, 89Zr, 90Y, and 124I. In particular, we discuss the present complications arising from the prompt gammas, and we review the scientific literature on prompt gamma correction. For some of the radioisotopes considered in this work, prompt gamma correction is definitely needed to assure acceptable image quality, and several approaches have been proposed in recent years. Bremsstrahlung photons and 176Lu background were also evaluated.
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Affiliation(s)
- Maurizio Conti
- Siemens Healthcare Molecular Imaging, Knoxville, TN, USA.
| | - Lars Eriksson
- Siemens Healthcare Molecular Imaging, Knoxville, TN, USA.,Department of Physics, University of Stockholm, Stockholm, Sweden.,Karolinska Institute, Stockholm, Sweden.,Scintillation Material Research Center, University of Tennessee, Knoxville, TN, USA
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Uribe CF, Esquinas PL, Gonzalez M, Celler A. Characteristics of Bremsstrahlung emissions of (177)Lu, (188)Re, and (90)Y for SPECT/CT quantification in radionuclide therapy. Phys Med 2016; 32:691-700. [PMID: 27157626 DOI: 10.1016/j.ejmp.2016.04.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Revised: 04/27/2016] [Accepted: 04/28/2016] [Indexed: 11/29/2022] Open
Abstract
PURPOSE Beta particles emitted by radioisotopes used in targeted radionuclide therapies (TRT) create Bremsstrahlung (BRS) which may affect SPECT quantification when imaging these isotopes. The purpose of the current study was to investigate the characteristics of Bremsstrahlung produced in tissue by three β-emitting radioisotopes used in TRT. METHODS Monte Carlo simulations of (177)Lu, (188)Re, and (90)Y sources placed in water filled cylinders were performed. BRS yields, mean energies and energy spectra for (a) all photons generated in the decays, (b) photons that were not absorbed and leave the cylinder, and (c) photons detected by the camera were analyzed. Next, the results of simulations were compared with those from experiments performed on a clinical SPECT camera using same acquisition conditions and phantom configurations as in simulations. RESULTS Simulations reproduced relatively well the shapes of the measured spectra, except for (90)Y which showed an overestimation in the low energy range. Detailed analysis of the results allowed us to suggest best collimators and imaging conditions for each of the investigated isotopes. Finally, our simulations confirmed that the BRS contribution to the energy spectra in quantitative imaging of (177)Lu and (188)Re could be ignored. CONCLUSIONS For (177)Lu and (188)Re, BRS contributes only marginally to the total spectra recorded by the camera. Our analysis shows that MELP and HE collimators are the best for imaging these two isotopes. For (90)Y, HE collimator should be used.
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Affiliation(s)
- Carlos F Uribe
- Medical Imaging Research Group, University of British Columbia, Vancouver, British Columbia, Canada; Department of Physics and Astronomy, University of British Columbia, Vancouver, British Columbia, Canada.
| | - Pedro L Esquinas
- Medical Imaging Research Group, University of British Columbia, Vancouver, British Columbia, Canada; Department of Physics and Astronomy, University of British Columbia, Vancouver, British Columbia, Canada
| | - Marjorie Gonzalez
- Vancouver Coastal Health Authority, Vancouver, British Columbia, Canada
| | - Anna Celler
- Medical Imaging Research Group, University of British Columbia, Vancouver, British Columbia, Canada
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PET/MRI of Hepatic 90Y Microsphere Deposition Determines Individual Tumor Response. Cardiovasc Intervent Radiol 2015; 39:855-64. [PMID: 26721589 PMCID: PMC4858549 DOI: 10.1007/s00270-015-1285-y] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Accepted: 12/06/2015] [Indexed: 12/13/2022]
Abstract
Purpose The purpose of our study is to determine if there is a relationship between dose deposition measured by PET/MRI and individual lesion response to yttrium-90 (90Y) microsphere radioembolization. Materials and Methods 26 patients undergoing lobar treatment with 90Y microspheres underwent PET/MRI within 66 h of treatment and had follow-up imaging available. Adequate visualization of tumor was available in 24 patients, and contours were drawn on simultaneously acquired PET/MRI data. Dose volume histograms (DVHs) were extracted from dose maps, which were generated using a voxelized dose kernel. Similar contours to capture dimensional and volumetric change of tumors were drawn on follow-up imaging. Response was analyzed using both RECIST and volumetric RECIST (vRECIST) criteria. Results A total of 8 hepatocellular carcinoma (HCC), 4 neuroendocrine tumor (NET), 9 colorectal metastases (CRC) patients, and 3 patients with other metastatic disease met inclusion criteria. Average dose was useful in predicting response between responders and non-responders for all lesion types and for CRC lesions alone using both response criteria (p < 0.05). D70 (minimum dose to 70 % of volume) was also useful in predicting response when using vRECIST. No significant trend was seen in the other tumor types. For CRC lesions, an average dose of 29.8 Gy offered 76.9 % sensitivity and 75.9 % specificity for response. Conclusions PET/MRI of 90Y microsphere distribution showed significantly higher DVH values for responders than non-responders in patients with CRC. DVH analysis of 90Y microsphere distribution following treatment may be an important predictor of response and could be used to guide future adaptive therapy trials.
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Takahashi A, Himuro K, Yamashita Y, Komiya I, Baba S, Sasaki M. Monte Carlo simulation of PET and SPECT imaging of 90Y. Med Phys 2015; 42:1926-35. [PMID: 25832083 DOI: 10.1118/1.4915545] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE Yittrium-90 ((90)Y) is traditionally thought of as a pure beta emitter, and is used in targeted radionuclide therapy, with imaging performed using bremsstrahlung single-photon emission computed tomography (SPECT). However, because (90)Y also emits positrons through internal pair production with a very small branching ratio, positron emission tomography (PET) imaging is also available. Because of the insufficient image quality of (90)Y bremsstrahlung SPECT, PET imaging has been suggested as an alternative. In this paper, the authors present the Monte Carlo-based simulation-reconstruction framework for (90)Y to comprehensively analyze the PET and SPECT imaging techniques and to quantitatively consider the disadvantages associated with them. METHODS Our PET and SPECT simulation modules were developed using Monte Carlo simulation of Electrons and Photons (MCEP), developed by Dr. S. Uehara. PET code (MCEP-PET) generates a sinogram, and reconstructs the tomography image using a time-of-flight ordered subset expectation maximization (TOF-OSEM) algorithm with attenuation compensation. To evaluate MCEP-PET, simulated results of (18)F PET imaging were compared with the experimental results. The results confirmed that MCEP-PET can simulate the experimental results very well. The SPECT code (MCEP-SPECT) models the collimator and NaI detector system, and generates the projection images and projection data. To save the computational time, the authors adopt the prerecorded (90)Y bremsstrahlung photon data calculated by MCEP. The projection data are also reconstructed using the OSEM algorithm. The authors simulated PET and SPECT images of a water phantom containing six hot spheres filled with different concentrations of (90)Y without background activity. The amount of activity was 163 MBq, with an acquisition time of 40 min. RESULTS The simulated (90)Y-PET image accurately simulated the experimental results. PET image is visually superior to SPECT image because of the low background noise. The simulation reveals that the detected photon number in SPECT is comparable to that of PET, but the large fraction (approximately 75%) of scattered and penetration photons contaminates SPECT image. The lower limit of (90)Y detection in SPECT image was approximately 200 kBq/ml, while that in PET image was approximately 100 kBq/ml. CONCLUSIONS By comparing the background noise level and the image concentration profile of both the techniques, PET image quality was determined to be superior to that of bremsstrahlung SPECT. The developed simulation codes will be very useful in the future investigations of PET and bremsstrahlung SPECT imaging of (90)Y.
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Affiliation(s)
- Akihiko Takahashi
- Department of Health Sciences, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Kazuhiko Himuro
- Division of Radiology, Department of Medical Technology, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Yasuo Yamashita
- Division of Radiology, Department of Medical Technology, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Isao Komiya
- Division of Radiology, Department of Medical Technology, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Shingo Baba
- Department of Clinical Radiology, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Masayuki Sasaki
- Department of Health Sciences, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
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Beijst C, Kist JW, Elschot M, Viergever MA, Hoekstra OS, de Keizer B, de Jong HWAM. Quantitative Comparison of 124I PET/CT and 131I SPECT/CT Detectability. J Nucl Med 2015; 57:103-8. [PMID: 26493205 DOI: 10.2967/jnumed.115.162750] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 10/09/2015] [Indexed: 11/16/2022] Open
Abstract
UNLABELLED Radioiodine therapy with (131)I is used for treatment of suspected recurrence of differentiated thyroid carcinoma. Pretherapeutic (124)I PET/CT with a low activity (~1% of (131)I activity) can be performed to determine whether uptake of (131)I, and thereby the desired therapeutic effect, may be expected. However, false-negative (124)I PET/CT results as compared with posttherapeutic (131)I SPECT/CT have been reported by several groups. The purpose of this study was to investigate whether the reported discrepancies may be ascribed to a difference in lesion detectability between (124)I PET/CT and (131)I SPECT/CT and, hence, whether the administered (124)I activity is sufficient to achieve equal detectability. METHODS Phantom measurements were performed using the National Electrical Manufacturers Association 2007 image-quality phantom. As a measure of detectability, the contrast-to-noise ratio was calculated. The (124)I activity was expressed as the percentage of (131)I activity required to achieve the same contrast-to-noise ratio. This metric was defined as the detectability equivalence percentage (DEP). RESULTS Because lower DEPs were obtained for smaller spheres, a relatively low (124)I activity was sufficient to achieve similar lesion detectability between (124)I PET/CT and (131)I SPECT/CT. DEP was 1.5%, 1.9%, 1.9%, 4.4%, 9.0%, and 16.2% for spheres with diameters of 10, 13, 17, 18, 25, and 37 mm, respectively, for attenuation- and scatter-corrected SPECT versus point-spread function (PSF) model-based and time-of-flight (TOF) PET. For no-PSF no-TOF PET, DEP was 3.6%, 2.1%, 3.5%, 7.8%, 15.1%, and 23.3%, respectively. CONCLUSION A relatively low (124)I activity of 74 MBq (~1% of (131)I activity) is sufficient to achieve similar lesion detectability between (124)I PSF TOF PET/CT and (131)I SPECT/CT for small spheres (≤10 mm), since the reported DEPs are close to 1%. False-negative (124)I PET/CT results as compared with posttherapeutic (131)I SPECT/CT may be ascribed to differences in detectability for large lesions (>10 mm) and for no-PSF no-TOF PET, since DEPs are greater than 1%. On the basis of DEPs of 3.5% for lesion diameters of up to 17 mm on no-PSF no-TOF PET, (124)I activities as high as 170 MBq may be warranted to obtain equal detectability.
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Affiliation(s)
- Casper Beijst
- Department of Radiology and Nuclear Medicine, UMC Utrecht, Utrecht, The Netherlands Image Sciences Institute, UMC Utrecht, Utrecht, The Netherlands
| | - Jakob W Kist
- Department of Nuclear Medicine, Antoni van Leeuwenhoek Hospital, The Netherlands Cancer Institute, Amsterdam, The Netherlands Department of Surgical Oncology and Endocrine Surgery, UMC Utrecht, Utrecht, The Netherlands; and
| | - Mattijs Elschot
- Department of Radiology and Nuclear Medicine, UMC Utrecht, Utrecht, The Netherlands
| | - Max A Viergever
- Image Sciences Institute, UMC Utrecht, Utrecht, The Netherlands
| | - Otto S Hoekstra
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - Bart de Keizer
- Department of Radiology and Nuclear Medicine, UMC Utrecht, Utrecht, The Netherlands
| | - Hugo W A M de Jong
- Department of Radiology and Nuclear Medicine, UMC Utrecht, Utrecht, The Netherlands
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Soderlund AT, Chaal J, Tjio G, Totman JJ, Conti M, Townsend DW. Beyond 18F-FDG: Characterization of PET/CT and PET/MR Scanners for a Comprehensive Set of Positron Emitters of Growing Application--18F, 11C, 89Zr, 124I, 68Ga, and 90Y. J Nucl Med 2015; 56:1285-91. [PMID: 26135111 DOI: 10.2967/jnumed.115.156711] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Accepted: 06/23/2015] [Indexed: 01/30/2023] Open
Abstract
UNLABELLED This study aimed to investigate image quality for a comprehensive set of isotopes ((18)F, (11)C, (89)Zr, (124)I, (68)Ga, and (90)Y) on 2 clinical scanners: a PET/CT scanner and a PET/MR scanner. METHODS Image quality and spatial resolution were tested according to NU 2-2007 of the National Electrical Manufacturers Association. An image-quality phantom was used to measure contrast recovery, residual bias in a cold area, and background variability. Reconstruction methods available on the 2 scanners were compared, including point-spread-function correction for both scanners and time of flight for the PET/CT scanner. Spatial resolution was measured using point sources and filtered backprojection reconstruction. RESULTS With the exception of (90)Y, small differences were seen in the hot-sphere contrast recovery of the different isotopes. Cold-sphere contrast recovery was similar across isotopes for all reconstructions, with an improvement seen with time of flight on the PET/CT scanner. The lower-statistic (90)Y scans yielded substantially lower contrast recovery than the other isotopes. When isotopes were compared, there was no difference in measured spatial resolution except for PET/MR axial spatial resolution, which was significantly higher for (124)I and (68)Ga. CONCLUSION Overall, both scanners produced good images with (18)F, (11)C, (89)Zr, (124)I, (68)Ga, and (90)Y.
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Affiliation(s)
| | - Jasper Chaal
- A*STAR-NUS Clinical Imaging Research Center, Singapore
| | - Gabriel Tjio
- A*STAR-NUS Clinical Imaging Research Center, Singapore
| | - John J Totman
- A*STAR-NUS Clinical Imaging Research Center, Singapore
| | - Maurizio Conti
- Siemens Healthcare Molecular Imaging, Knoxville, Tennessee; and
| | - David W Townsend
- A*STAR-NUS Clinical Imaging Research Center, Singapore Department of Diagnostic Radiology, National University Hospital, Singapore
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Carlier T, Willowson KP, Fourkal E, Bailey DL, Doss M, Conti M. 90Y -PET imaging: Exploring limitations and accuracy under conditions of low counts and high random fraction. Med Phys 2015; 42:4295-309. [DOI: 10.1118/1.4922685] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Theranostic Imaging of Yttrium-90. BIOMED RESEARCH INTERNATIONAL 2015; 2015:481279. [PMID: 26106608 PMCID: PMC4464848 DOI: 10.1155/2015/481279] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/01/2015] [Accepted: 04/22/2015] [Indexed: 01/07/2023]
Abstract
This paper overviews Yttrium-90 ((90)Y) as a theranostic and nuclear medicine imaging of (90)Y radioactivity with bremsstrahlung imaging and positron emission tomography. In addition, detection and optical imaging of (90)Y radioactivity using Cerenkov luminescence will also be reviewed. Methods and approaches for qualitative and quantitative (90)Y imaging will be briefly discussed. Although challenges remain for (90)Y imaging, continued clinical demand for predictive imaging response assessment and target/nontarget dosimetry will drive research and technical innovation to provide greater clinical utility of (90)Y as a theranostic agent.
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Willowson KP, Tapner M, Bailey DL. A multicentre comparison of quantitative (90)Y PET/CT for dosimetric purposes after radioembolization with resin microspheres : The QUEST Phantom Study. Eur J Nucl Med Mol Imaging 2015; 42:1202-22. [PMID: 25967868 PMCID: PMC4480824 DOI: 10.1007/s00259-015-3059-9] [Citation(s) in RCA: 107] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Accepted: 04/01/2015] [Indexed: 01/02/2023]
Abstract
Purpose To investigate and compare the quantitative accuracy of 90Y imaging across different generation PET/CT scanners, for the purpose of dosimetry after radioembolization with resin microspheres. Methods A strict experimental and imaging protocol was followed by 47 international sites using the NEMA 2007/IEC 2008 PET body phantom with an 8-to-1 sphere-to-background ratio of 90Y solution. The phantom was imaged over a 7-day period (activity ranging from 0.5 to 3.0 GBq) and all reconstructed data were analysed at a core laboratory for consistent processing. Quantitative accuracy was assessed through measures of total phantom activity, activity concentration in background and hot spheres, misplaced counts in a nonradioactive insert, and background variability. Results Of the 69 scanners assessed, 37 had both time-of-flight (ToF) and resolution recovery (RR) capability. These current generation scanners from GE, Philips and Siemens could reconstruct background concentration measures to within 10 % of true values over the evaluated range, with greater deviations on the Philips systems at low count rates, and demonstrated typical partial volume effects on hot sphere recovery, which dominated spheres of diameter <20 mm. For spheres >20 mm in diameter, activity concentrations were consistently underestimated by about 20 %. Non-ToF scanners from GE Healthcare and Siemens were capable of producing accurate measures, but with inferior quantitative recovery compared with ToF systems. Conclusion Current generation ToF scanners can consistently reconstruct 90Y activity concentrations, but they underestimate activity concentrations in small structures (≤37 mm diameter) within a warm background due to partial volume effects and constraints of the reconstruction algorithm. At the highest count rates investigated, measures of background concentration (about 300 kBq/ml) could be estimated on average to within 1 %, 5 % and 2 % for GE Healthcare (all-pass filter, RR + ToF), Philips (4i8s ToF) and Siemens (2i21s all-pass filter, RR + ToF) ToF systems, respectively. Over the range of activities investigated, comparable performance between GE Healthcare and Siemens ToF systems suggests suitability for quantitative analysis in a scenario analogous to that of postradioembolization imaging for treatment of liver cancer.
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Affiliation(s)
- Kathy P Willowson
- Institute of Medical Physics, School of Physics, University of Sydney, Sydney, 2006, NSW, Australia,
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O' Doherty J. A review of 3D image-based dosimetry, technical considerations and emerging perspectives in 90Y microsphere therapy. ACTA ACUST UNITED AC 2015; 2:1-34. [PMID: 27182449 DOI: 10.17229/jdit.2015-0428-016] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Yttrium-90 radioembolization (90Y-RE) is a well-established therapy for the treatment of hepatocellular carcinoma (HCC) and also of metastatic liver deposits from other malignancies. Nuclear Medicine and Cath Lab diagnostic imaging takes a pivotal role in the success of the treatment, and in order to fully exploit the efficacy of the technique and provide reliable quantitative dosimetry that are related to clinical endpoints in the era of personalized medicine, technical challenges in imaging need to be overcome. In this paper, the extensive literature of current 90Y-RE techniques and challenges facing it in terms of quantification and dosimetry are reviewed, with a focus on the current generation of 3D dosimetry techniques. Finally, new emerging techniques are reviewed which seek to overcome these challenges, such as high-resolution imaging, novel surgical procedures and the use of other radiopharmaceuticals for therapy and pre-therapeutic planning.
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Affiliation(s)
- Jim O' Doherty
- PET Imaging Centre, Division of Imaging Sciences and Biomedical Engineering, King's College London, King's Health Partners, St. Thomas' Hospital, London, United Kingdom
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Fabbri C, Bartolomei M, Mattone V, Casi M, De Lauro F, Bartolini N, Gentili G, Amadori S, Agostini M, Sarti G. (90)Y-PET/CT Imaging Quantification for Dosimetry in Peptide Receptor Radionuclide Therapy: Analysis and Corrections of the Impairing Factors. Cancer Biother Radiopharm 2015; 30:200-10. [PMID: 25860616 DOI: 10.1089/cbr.2015.1819] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
PURPOSE We evaluated the possibility to assess (90)Y-PET/CT imaging quantification for dosimetry in (90)Y-peptide receptor radionuclide therapy. METHODS Tests were performed by Discovery 710 Elite (GE) PET/CT equipment. A body-phantom containing radioactive-coplanar-spheres was filled with (90)Y water solution to reproduce different signal-to-background-activity-ratios (S/N). We studied minimum detectable activity (MDA) concentration, contrast-to-noise ratio (CNR), and full-width-at-half-maximum (FWHM). Subsequently, three recovery coefficients (RC)-based correction approaches were evaluated: maximum-RC, resolution-RC, and isovolume-RC. The analysis of the volume segmentation thresholding method was also assessed to derive a relationship between the true volume of the targets and the threshold to be applied to the PET images. (90)Y-PET/CT imaging quantification was then achieved on some patients and related with preclinical tests. Moreover, the dosimetric evaluation was obtained on the target regions. RESULTS CNR value was greater than 5 if the MDA was greater than 0.2 MBq/mL with no background activity and 0.5-0.7 MBq/mL with S/N ranging from 3 to 6. FWHM was equal to 7 mm. An exponential fitting of isovolume RCs-based correction technique was adopted for activity quantification. Adaptive segmentation thresholding exponential curves were obtained and applied for target volume identification in three signal-to-background-activity-ratios. The imaging quantification study and dosimetric evaluations in clinical cases was feasible and the results were coherent with those obtained in preclinical tests. CONCLUSIONS (90)Y-PET/CT imaging quantification is possible both in phantoms and in patients. Absorbed dose evaluations in clinical applications are strongly related to targets activity concentration.
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Affiliation(s)
- Cinzia Fabbri
- 1 Physics and Biomedical Technologies Unit, Bufalini Hospital , AUSL della Romagna, Cesena, Italy .,2 Medical Physics Unit, AORMN , Pesaro, Italy
| | - Mirco Bartolomei
- 3 Nuclear Medicine Unit, Bufalini Hospital , AUSL della Romagna, Cesena, Italy
| | - Vincenzo Mattone
- 3 Nuclear Medicine Unit, Bufalini Hospital , AUSL della Romagna, Cesena, Italy
| | - Michela Casi
- 3 Nuclear Medicine Unit, Bufalini Hospital , AUSL della Romagna, Cesena, Italy
| | - Francesco De Lauro
- 3 Nuclear Medicine Unit, Bufalini Hospital , AUSL della Romagna, Cesena, Italy
| | - Nerio Bartolini
- 3 Nuclear Medicine Unit, Bufalini Hospital , AUSL della Romagna, Cesena, Italy
| | - Giovanni Gentili
- 3 Nuclear Medicine Unit, Bufalini Hospital , AUSL della Romagna, Cesena, Italy
| | - Sonia Amadori
- 3 Nuclear Medicine Unit, Bufalini Hospital , AUSL della Romagna, Cesena, Italy
| | - Monica Agostini
- 3 Nuclear Medicine Unit, Bufalini Hospital , AUSL della Romagna, Cesena, Italy
| | - Graziella Sarti
- 1 Physics and Biomedical Technologies Unit, Bufalini Hospital , AUSL della Romagna, Cesena, Italy
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Zhou JJ, Gonzalez A, Lenox MW, Fossum TW, Frank RK, Simon J, Stearns S, Ruoff CM, Wendt RE, Akabani G. Dosimetry of a (90)Y-hydroxide liquid brachytherapy treatment approach to canine osteosarcoma using PET/CT. Appl Radiat Isot 2015; 97:193-200. [PMID: 25638490 DOI: 10.1016/j.apradiso.2014.11.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Revised: 09/14/2014] [Accepted: 11/13/2014] [Indexed: 11/19/2022]
Abstract
A new treatment strategy based on direct injections of (90)Y-hydroxide into the tumor bed in dogs with osteosarcoma was studied. Direct injections of the radiopharmaceutical into the tumor bed were made according to a pretreatment plan established using (18)F-FDG images. Using a special drill, cannulas were inserted going through tissue, tumor and bone. Using these cannulas, direct injections of the radiopharmaceutical were made. The in vivo biodistribution of (90)Y-hydroxide and the anatomical tumor bed were imaged using a time-of-flight (TOF) PET/CT scanner. The material properties of the tissues were estimated from corresponding CT numbers using an electron-density calibration. Radiation absorbed dose estimates were calculated using Monte Carlo methods where the biodistribution of the pharmaceutical from PET images was sampled using a collapsing 3-D rejection technique. Dose distributions in the tumor bed and surrounding tissues were calculated, showing significant heterogeneity with multiple hot spots at injection sites. Dose volume histograms showed that approximately 33.9% of bone and tumor and 70.2% of bone marrow and trabecular bone received an absorbed dose over 200Gy; approximately 3.2% of bone and tumor and 31.0% of bone marrow and trabecular bone received a total dose of over 1000Gy.
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Affiliation(s)
- Jien Jie Zhou
- Department of Nuclear Engineering, Texas A&M University, College Station, TX 77843-3133, USA
| | - Arnulfo Gonzalez
- Department of Nuclear Engineering, Texas A&M University, College Station, TX 77843-3133, USA
| | - Mark W Lenox
- Texas A&M Institute for Preclinical Studies, Texas A&M University, College Station, TX, USA
| | - Theresa W Fossum
- Texas A&M Institute for Preclinical Studies, Texas A&M University, College Station, TX, USA
| | | | - Jaime Simon
- IsoTherapeutics Group, LLC, Angleton, TX, USA
| | | | - Catherine M Ruoff
- Texas A&M Institute for Preclinical Studies, Texas A&M University, College Station, TX, USA
| | - Richard E Wendt
- Department of Imaging Physics, The University of Texas, M.D. Anderson Cancer Center, Houston, TX, USA
| | - Gamal Akabani
- Department of Nuclear Engineering, Texas A&M University, College Station, TX 77843-3133, USA; Texas A&M Institute for Preclinical Studies, Texas A&M University, College Station, TX, USA.
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48
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Radioembolization Dosimetry: The Road Ahead. Cardiovasc Intervent Radiol 2014; 38:261-9. [DOI: 10.1007/s00270-014-1042-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Accepted: 10/28/2014] [Indexed: 12/25/2022]
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49
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Attarwala AA, Molina-Duran F, Büsing KA, Schönberg SO, Bailey DL, Willowson K, Glatting G. Quantitative and qualitative assessment of Yttrium-90 PET/CT imaging. PLoS One 2014; 9:e110401. [PMID: 25369020 PMCID: PMC4219690 DOI: 10.1371/journal.pone.0110401] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Accepted: 09/22/2014] [Indexed: 11/24/2022] Open
Abstract
Yttrium-90 is known to have a low positron emission decay of 32 ppm that may allow for personalized dosimetry of liver cancer therapy with 90Y labeled microspheres. The aim of this work was to image and quantify 90Y so that accurate predictions of the absorbed dose can be made. The measurements were performed within the QUEST study (University of Sydney, and Sirtex Medical, Australia). A NEMA IEC body phantom containing 6 fillable spheres (10–37 mm ∅) was used to measure the 90Y distribution with a Biograph mCT PET/CT (Siemens, Erlangen, Germany) with time-of-flight (TOF) acquisition. A sphere to background ratio of 8∶1, with a total 90Y activity of 3 GBq was used. Measurements were performed for one week (0, 3, 5 and 7 d). he acquisition protocol consisted of 30 min-2 bed positions and 120 min-single bed position. mages were reconstructed with 3D ordered subset expectation maximization (OSEM) and point spread function (PSF) for iteration numbers of 1–12 with 21 (TOF) and 24 (non-TOF) subsets and CT based attenuation and scatter correction. Convergence of algorithms and activity recovery was assessed based on regions-of-interest (ROI) analysis of the background (100 voxels), spheres (4 voxels) and the central low density insert (25 voxels). For the largest sphere, the recovery coefficient (RC) values for the 30 min –2-bed position, 30 min-single bed and 120 min-single bed were 1.12±0.20, 1.14±0.13, 0.97±0.07 respectively. For the smaller diameter spheres, the PSF algorithm with TOF and single bed acquisition provided a comparatively better activity recovery. Quantification of Y-90 using Biograph mCT PET/CT is possible with a reasonable accuracy, the limitations being the size of the lesion and the activity concentration present. At this stage, based on our study, it seems advantageous to use different protocols depending on the size of the lesion.
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Affiliation(s)
- Ali Asgar Attarwala
- Medical Radiation Physics/Radiation Protection, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Flavia Molina-Duran
- Medical Radiation Physics/Radiation Protection, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Karen-Anett Büsing
- Institute of Clinical Radiology and Nuclear Medicine, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Stefan O. Schönberg
- Institute of Clinical Radiology and Nuclear Medicine, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Dale L. Bailey
- Department of Nuclear Medicine, Royal North Shore Hospital, Sydney, Australia
| | - Kathy Willowson
- Institute of Medical Physics, School of Physics, University of Sydney, Sydney, NSW, Australia
| | - Gerhard Glatting
- Medical Radiation Physics/Radiation Protection, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- * E-mail:
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50
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Lea WB, Tapp KN, Tann M, Hutchins GD, Fletcher JW, Johnson MS. Microsphere Localization and Dose Quantification Using Positron Emission Tomography/CT following Hepatic Intraarterial Radioembolization with Yttrium-90 in Patients with Advanced Hepatocellular Carcinoma. J Vasc Interv Radiol 2014; 25:1595-603. [DOI: 10.1016/j.jvir.2014.06.028] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Revised: 06/25/2014] [Accepted: 06/26/2014] [Indexed: 01/17/2023] Open
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