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Abbott NL, Chauvie S, Marcu L, DeJean C, Melidis C, Wientjes R, Gasnier A, Lisbona A, Luzzara M, Mazzoni LN, O'Doherty J, Koutsouveli E, Appelt A, Hansen CR. The role of medical physics experts in clinical trials: A guideline from the European Federation of Organisations for Medical Physics. Phys Med 2024; 126:104821. [PMID: 39361978 DOI: 10.1016/j.ejmp.2024.104821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 08/26/2024] [Accepted: 09/22/2024] [Indexed: 10/05/2024] Open
Abstract
The EFOMP working group on the Role of Medical Physics Experts (MPEs) in Clinical Trials was established in 2010, with experts from across Europe and different areas of medical physics. Their main aims were: (1) To develop a consensus guidance document for the work MPEs do in clinical trials across Europe. (2) Complement the work by American colleagues in AAPM TG 113 and guidance from National Member Organisations. (3) To cover external beam radiotherapy, brachytherapy, nuclear medicine, molecular radiotherapy, and imaging. This document outlines the main output from this working group. Giving guidance to MPEs, and indeed all Medical Physicists (MP) and MP trainees wishing to work in clinical trials. It also gives guidance to the wider multidisciplinary team, advising where MPEs must legally be involved, as well as highlighting areas where MPEs skills and expertise can really add value to clinical trials.
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Affiliation(s)
- Natalie Louise Abbott
- King George V Building, St. Bartholomews Hospital, West Smithfield, London EC1A 7BE, UK; National RTTQA Group, Cardiff & London, UK.
| | - Stephane Chauvie
- Medical Physics Division, Santa Croce e Carle Hospital, Cuneo, Italy
| | - Loredana Marcu
- Faculty of Informatics and Science, University of Oradea, Oradea 410087, Romania; UniSA Allied Health & Human Performance, University of South Australia, Adelaide SA 5001, Australia
| | | | - Christos Melidis
- CAP Santé, Radiation Therapy, Clinique Maymard. Bastia, France; milliVolt.eu, a Health Physics Company. Bastia, France
| | | | - Anne Gasnier
- Department of Radiation Oncology, Henri Becquerel Cancer Centre, Rouen, France
| | - Albert Lisbona
- MP emeritus, Institut de Cancérologie de l'Ouest, Saint Herblain, France
| | | | | | - Jim O'Doherty
- Siemens Medical Solutions, Malvern, PA, United States; Radiography & Diagnostic Imaging, University College Dublin, Dublin, Ireland; Department of Radiology & Radiological Sciences, Medical University of South Carolina, Charleston, SC, United States
| | - Efi Koutsouveli
- Department of Medical Physics, Hygeia Hospital, Athens, Greece
| | - Ane Appelt
- Leeds Institution of Medical Research at St James's, University of Leeds, Leeds, UK; Department of Medical Physics, Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Christian Rønn Hansen
- Institute of Clinical Research, University of Southern Denmark, Denmark; Danish Center of Particle Therapy, Aarhus University Hospital, Denmark; Department of Oncology, Odense University Hospital, Denmark
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Alqahtani MM. Whole-Body SPECT/CT: Protocol Variation and Technical Consideration-A Narrative Review. Diagnostics (Basel) 2024; 14:1827. [PMID: 39202315 PMCID: PMC11353707 DOI: 10.3390/diagnostics14161827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2024] [Revised: 08/13/2024] [Accepted: 08/16/2024] [Indexed: 09/03/2024] Open
Abstract
Introducing a hybrid imaging approach, such as single-photon emission computerized tomography with X-ray computed tomography (SPECT)/CT, improves diagnostic accuracy and patient management. The ongoing advancement of SPECT hardware and software has resulted in the clinical application of novel approaches. For example, whole-body SPECT/CT (WB-SPECT/CT) studies cover multiple consecutive bed positions, similar to positron emission tomography-computed tomography (PET/CT). WB-SPECT/CT proves to be a helpful tool for evaluating bone metastases (BM), reducing equivocal findings, and enhancing user confidence, displaying effective performance in contrast to planar bone scintigraphy (PBS). Consequently, it is increasingly utilized and might substitute PBS, which leads to new questions and issues concerning the acquisition protocol, patient imaging time, and workflow process. Therefore, this review highlights various aspects of WB-SPECT/CT acquisition protocols that need to be considered to help understand WB-SPECT/CT workflow processes and optimize imaging protocols.
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Affiliation(s)
- Mansour M. Alqahtani
- Department of Radiology and Medical Imaging, Faculty of Applied Medical Sciences, Najran University, Najran 61441, Saudi Arabia;
- Discipline of Medical Imaging Science, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
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Bouchareb Y, AlSaadi A, Zabah J, Jain A, Al-Jabri A, Phiri P, Shi JQ, Delanerolle G, Sirasanagandla SR. Technological Advances in SPECT and SPECT/CT Imaging. Diagnostics (Basel) 2024; 14:1431. [PMID: 39001321 PMCID: PMC11241697 DOI: 10.3390/diagnostics14131431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2024] [Revised: 06/11/2024] [Accepted: 06/15/2024] [Indexed: 07/16/2024] Open
Abstract
Single photon emission tomography/computed tomography (SPECT/CT) is a mature imaging technology with a dynamic role in the diagnosis and monitoring of a wide array of diseases. This paper reviews the technological advances, clinical impact, and future directions of SPECT and SPECT/CT imaging. The focus of this review is on signal amplifier devices, detector materials, camera head and collimator designs, image reconstruction techniques, and quantitative methods. Bulky photomultiplier tubes (PMTs) are being replaced by position-sensitive PMTs (PSPMTs), avalanche photodiodes (APDs), and silicon PMs to achieve higher detection efficiency and improved energy resolution and spatial resolution. Most recently, new SPECT cameras have been designed for cardiac imaging. The new design involves using specialised collimators in conjunction with conventional sodium iodide detectors (NaI(Tl)) or an L-shaped camera head, which utilises semiconductor detector materials such as CdZnTe (CZT: cadmium-zinc-telluride). The clinical benefits of the new design include shorter scanning times, improved image quality, enhanced patient comfort, reduced claustrophobic effects, and decreased overall size, particularly in specialised clinical centres. These noticeable improvements are also attributed to the implementation of resolution-recovery iterative reconstructions. Immense efforts have been made to establish SPECT and SPECT/CT imaging as quantitative tools by incorporating camera-specific modelling. Moreover, this review includes clinical examples in oncology, neurology, cardiology, musculoskeletal, and infection, demonstrating the impact of these advancements on clinical practice in radiology and molecular imaging departments.
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Affiliation(s)
- Yassine Bouchareb
- Department of Radiology & Molecular Imaging, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat 123, Oman
| | - Afrah AlSaadi
- Department of Radiology & Molecular Imaging, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat 123, Oman
| | - Jawa Zabah
- Department of Radiology & Molecular Imaging, Sultan Qaboos University Hospital, Muscat 123, Oman
| | - Anjali Jain
- Sultan Qaboos Comprehensive Cancer Care and Research Centre, Department of Radiology, Muscat 123, Oman
| | - Aziza Al-Jabri
- Department of Radiology & Molecular Imaging, Sultan Qaboos University Hospital, Muscat 123, Oman
| | - Peter Phiri
- Southern Health NHS Foundation Trust, Southampton SO40 2RZ, UK
- Psychology Department, Faculty of Environmental and Life Sciences, University of Southampton, Southampton SO17 1BJ, UK
| | - Jian Qing Shi
- Southern Health NHS Foundation Trust, Southampton SO40 2RZ, UK
- Southern University of Science and Technology, Southampton, UK
- Southern University of Science and Technology, Shenzhen 518055, China
| | - Gayathri Delanerolle
- Southern Health NHS Foundation Trust, Southampton SO40 2RZ, UK
- University of Birmingham, Birmingham, UK
| | - Srinivasa Rao Sirasanagandla
- Department of Human & Clinical Anatomy, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat 123, Oman
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Nakamura Y, Yasuno N. Feasibility study of radioactivity estimation of 99mTc and 123I-labeled radiopharmaceuticals using shielded syringes. Radiol Phys Technol 2024; 17:396-401. [PMID: 38517669 DOI: 10.1007/s12194-024-00789-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 01/28/2024] [Accepted: 02/13/2024] [Indexed: 03/24/2024]
Abstract
This study investigates the feasibility of estimating the radioactivity of radiopharmaceuticals using shielded syringes. The radioactivities of 99mTc-MDP, 99mTc-HMDP, 99mTc-ECD, 99mTc-MAG3, and 123I-IMP were measured using a dose calibrator. Correlation coefficients and regression equations were obtained from the radioactivity in the shielded and unshielded syringes. 99mTc-MDP was also measured for residual radioactivity after the administration. The correlation coefficients of 99mTc-MDP, 99mTc-HMDP, 99mTc-ECD, 99mTc-MAG3, and 123I-IMP were rs = 0.9998, rs = 0.9997, rs = 0.9999, rs = 0.9998, and rs = 0.9888, respectively. The regression equations were y = 0.0364x + 0.0913, y = 0.0349x + 0.0273, y = 0.0343x - 0.0018, y = 0.0522x + 0.1215, and y = 0.0383x + 0.0058, respectively. The correlation coefficient for the residual radioactivity of 99mTc-MDP was rs = 0.9887 and the regression equation was y = 0.1505x + 0.0853. The radioactivity of 99mTc- and 123I-labeled radiopharmaceuticals in shielded syringes was accurately measured. It was suggested that the measuring shielded syringes could provide an estimate of the actual radioactivity.
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Affiliation(s)
- Yuto Nakamura
- Department of Radiological Technology, Yamaguchi University Hospital, Minamikogushi, Yamaguchi, 755-8505, Japan.
| | - Narumi Yasuno
- Department of Radiological Technology, Yamaguchi University Hospital, Minamikogushi, Yamaguchi, 755-8505, Japan
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Mansouri Z, Salimi Y, Akhavanallaf A, Shiri I, Teixeira EPA, Hou X, Beauregard JM, Rahmim A, Zaidi H. Deep transformer-based personalized dosimetry from SPECT/CT images: a hybrid approach for [ 177Lu]Lu-DOTATATE radiopharmaceutical therapy. Eur J Nucl Med Mol Imaging 2024; 51:1516-1529. [PMID: 38267686 PMCID: PMC11043201 DOI: 10.1007/s00259-024-06618-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 01/15/2024] [Indexed: 01/26/2024]
Abstract
PURPOSE Accurate dosimetry is critical for ensuring the safety and efficacy of radiopharmaceutical therapies. In current clinical dosimetry practice, MIRD formalisms are widely employed. However, with the rapid advancement of deep learning (DL) algorithms, there has been an increasing interest in leveraging the calculation speed and automation capabilities for different tasks. We aimed to develop a hybrid transformer-based deep learning (DL) model that incorporates a multiple voxel S-value (MSV) approach for voxel-level dosimetry in [177Lu]Lu-DOTATATE therapy. The goal was to enhance the performance of the model to achieve accuracy levels closely aligned with Monte Carlo (MC) simulations, considered as the standard of reference. We extended our analysis to include MIRD formalisms (SSV and MSV), thereby conducting a comprehensive dosimetry study. METHODS We used a dataset consisting of 22 patients undergoing up to 4 cycles of [177Lu]Lu-DOTATATE therapy. MC simulations were used to generate reference absorbed dose maps. In addition, MIRD formalism approaches, namely, single S-value (SSV) and MSV techniques, were performed. A UNEt TRansformer (UNETR) DL architecture was trained using five-fold cross-validation to generate MC-based dose maps. Co-registered CT images were fed into the network as input, whereas the difference between MC and MSV (MC-MSV) was set as output. DL results are then integrated to MSV to revive the MC dose maps. Finally, the dose maps generated by MSV, SSV, and DL were quantitatively compared to the MC reference at both voxel level and organ level (organs at risk and lesions). RESULTS The DL approach showed slightly better performance (voxel relative absolute error (RAE) = 5.28 ± 1.32) compared to MSV (voxel RAE = 5.54 ± 1.4) and outperformed SSV (voxel RAE = 7.8 ± 3.02). Gamma analysis pass rates were 99.0 ± 1.2%, 98.8 ± 1.3%, and 98.7 ± 1.52% for DL, MSV, and SSV approaches, respectively. The computational time for MC was the highest (~2 days for a single-bed SPECT study) compared to MSV, SSV, and DL, whereas the DL-based approach outperformed the other approaches in terms of time efficiency (3 s for a single-bed SPECT). Organ-wise analysis showed absolute percent errors of 1.44 ± 3.05%, 1.18 ± 2.65%, and 1.15 ± 2.5% for SSV, MSV, and DL approaches, respectively, in lesion-absorbed doses. CONCLUSION A hybrid transformer-based deep learning model was developed for fast and accurate dose map generation, outperforming the MIRD approaches, specifically in heterogenous regions. The model achieved accuracy close to MC gold standard and has potential for clinical implementation for use on large-scale datasets.
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Affiliation(s)
- Zahra Mansouri
- Division of Nuclear Medicine and Molecular Imaging, Department of Medical Imaging, Geneva University Hospital, CH-1211, Geneva, Switzerland
| | - Yazdan Salimi
- Division of Nuclear Medicine and Molecular Imaging, Department of Medical Imaging, Geneva University Hospital, CH-1211, Geneva, Switzerland
| | - Azadeh Akhavanallaf
- Division of Nuclear Medicine and Molecular Imaging, Department of Medical Imaging, Geneva University Hospital, CH-1211, Geneva, Switzerland
| | - Isaac Shiri
- Division of Nuclear Medicine and Molecular Imaging, Department of Medical Imaging, Geneva University Hospital, CH-1211, Geneva, Switzerland
| | - Eliluane Pirazzo Andrade Teixeira
- Division of Nuclear Medicine and Molecular Imaging, Department of Medical Imaging, Geneva University Hospital, CH-1211, Geneva, Switzerland
| | - Xinchi Hou
- Department of Radiology, University of British Columbia, Vancouver, BC, Canada
| | - Jean-Mathieu Beauregard
- Cancer Research Centre and Department of Radiology and Nuclear Medicine, Université Laval, Quebec City, QC, Canada
| | - Arman Rahmim
- Department of Radiology, University of British Columbia, Vancouver, BC, Canada
| | - Habib Zaidi
- Division of Nuclear Medicine and Molecular Imaging, Department of Medical Imaging, Geneva University Hospital, CH-1211, Geneva, Switzerland.
- Department of Nuclear Medicine, University Medical Center Groningen, University of Groningen, 9700 RB, Groningen, Netherlands.
- Department of Nuclear Medicine, University of Southern Denmark, DK-500, Odense, Denmark.
- University Research and Innovation Center, Óbuda University, Budapest, Hungary.
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Usanase N, Uzun B, Ozsahin DU, Ozsahin I. A look at radiation detectors and their applications in medical imaging. Jpn J Radiol 2024; 42:145-157. [PMID: 37733205 DOI: 10.1007/s11604-023-01486-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 08/28/2023] [Indexed: 09/22/2023]
Abstract
The effectiveness and precision of disease diagnosis and treatment have increased, thanks to developments in clinical imaging over the past few decades. Science is developing and progressing steadily in imaging modalities, and effective outcomes are starting to show up as a result of the shorter scanning periods needed as well as the higher-resolution images generated. The choice of one clinical device over another is influenced by technical disparities among the equipment, such as detection medium, shorter scan time, patient comfort, cost-effectiveness, accessibility, greater sensitivity and specificity, and spatial resolution. Lately, computational algorithms, artificial intelligence (AI), in particular, have been incorporated with diagnostic and treatment techniques, including imaging systems. AI is a discipline comprised of multiple computational and mathematical models. Its applications aided in manipulating sophisticated data in imaging processes and increased imaging tests' accuracy and precision during diagnosis. Computed tomography (CT), positron emission tomography (PET), and Single Photon Emission Computed Tomography (SPECT) along with their corresponding radiation detectors have been reviewed in this study. This review will provide an in-depth explanation of the above-mentioned imaging modalities as well as the radiation detectors that are their essential components. From the early development of these medical instruments till now, various modifications and improvements have been done and more is yet to be established for better performance which calls for a necessity to capture the available information and record the gaps to be filled for better future advances.
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Affiliation(s)
- Natacha Usanase
- Operational Research Centre in Healthcare, Near East University, Mersin 10, Nicosia, Turkey.
| | - Berna Uzun
- Operational Research Centre in Healthcare, Near East University, Mersin 10, Nicosia, Turkey
- Department of Statistics, Carlos III Madrid University, Getafe, Madrid, Spain
| | - Dilber Uzun Ozsahin
- Operational Research Centre in Healthcare, Near East University, Mersin 10, Nicosia, Turkey
- Medical Diagnostic Imaging Department, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Ilker Ozsahin
- Operational Research Centre in Healthcare, Near East University, Mersin 10, Nicosia, Turkey
- Brain Health Imaging Institute, Department of Radiology, Weill Cornell Medicine, New York, NY, 10065, USA
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Massari R, Mok GSP. Editorial: New trends in single photon emission computed tomography (SPECT). Front Med (Lausanne) 2023; 10:1349877. [PMID: 38179273 PMCID: PMC10765537 DOI: 10.3389/fmed.2023.1349877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 12/11/2023] [Indexed: 01/06/2024] Open
Affiliation(s)
- Roberto Massari
- Institute of Biochemistry and Cell Biology, National Research Council of Italy (CNR), Rome, Italy
| | - Greta S. P. Mok
- Biomedical Imaging Laboratory (BIG), Department of Electrical and Computer Engineering, Faculty of Science and Technology, University of Macau, Taipa, Macao SAR, China
- Center for Cognitive and Brain Sciences, Institute of Collaborative Innovation, University of Macau, Taipa, Macao SAR, China
- Ministry of Education Frontiers Science Center for Precision Oncology, Faculty of Health Science, University of Macau, Taipa, Macao SAR, China
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Pham TP, Presles B, Popoff R, Alberini JL, Vrigneaud JM. Pre-treatment dosimetry in 90Y-SIRT: Is it possible to optimise SPECT reconstruction parameters and calculation methods for accurate dosimetry? Phys Med 2023; 115:103145. [PMID: 37852020 DOI: 10.1016/j.ejmp.2023.103145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 06/03/2023] [Accepted: 09/21/2023] [Indexed: 10/20/2023] Open
Abstract
PURPOSE The aim of this study was (a) to optimise the99mTc-SPECT reconstruction parameters for the pre-treatment dosimetry of90Y-selective internal radiation therapy (SIRT) and (b) to compare the accuracy of clinical dosimetry methods with full Monte-Carlo dosimetry (fMCD) performed with Gate. METHODS To optimise the reconstruction parameters, two hundred reconstructions with different parameters were performed on a NEMA phantom, varying the number of iterations, subsets, and post-filtering. The accuracy of the dosimetric methods was then investigated using an anthropomorphic phantom. Absorbed dose maps were generated using (1) the Partition Model (PM), (2) the Dose Voxel Kernel (DVK) convolution, and (3) the Local Deposition Method (LDM) with known activity restricted to the whole phantom (WP) or to the liver and lungs (LL). The dose to the lungs was calculated using the "multiple DVK" and "multiple LDM" methods. RESULTS Optimal OSEM reconstruction parameters were found to depend on object size and dosimetric criterion chosen (Dmean or DVH-derived metric). The Dmean of all three dosimetric methods was close (≤ 10%) to the Dmean of fMCD simulations when considering large segmented volumes (whole liver, normal liver). In contrast, the Dmean to the small volume (∅=31) was systemically underestimated (12%-25%). For lungs, the "multiple DVK" and "multiple LDM" methods yielded a Dmean within 20% for the WP method and within 10% for the LL method. CONCLUSIONS All three methods showed a substantial degradation of the dose-volume histograms (DVHs) compared to fMCD simulations. The DVK and LDM methods performed almost equally well, with the "multiple DVK" method being more accurate in the lungs.
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Affiliation(s)
- Tien-Phong Pham
- Institut de Chimie Moléculaire de l'Université de Bourgogne (ICMUB) - UMR CNRS 6302, University of Burgundy, Dijon, France; Department of Nuclear Medicine, Georges-François Leclerc Cancer Centre, Dijon, France.
| | - Benoit Presles
- Institut de Chimie Moléculaire de l'Université de Bourgogne (ICMUB) - UMR CNRS 6302, University of Burgundy, Dijon, France
| | - Romain Popoff
- Institut de Chimie Moléculaire de l'Université de Bourgogne (ICMUB) - UMR CNRS 6302, University of Burgundy, Dijon, France; Department of Nuclear Medicine, Georges-François Leclerc Cancer Centre, Dijon, France
| | - Jean-Louis Alberini
- Institut de Chimie Moléculaire de l'Université de Bourgogne (ICMUB) - UMR CNRS 6302, University of Burgundy, Dijon, France; Department of Nuclear Medicine, Georges-François Leclerc Cancer Centre, Dijon, France
| | - Jean-Marc Vrigneaud
- Institut de Chimie Moléculaire de l'Université de Bourgogne (ICMUB) - UMR CNRS 6302, University of Burgundy, Dijon, France; Department of Nuclear Medicine, Georges-François Leclerc Cancer Centre, Dijon, France.
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Chauvie S, Mazzoni LN, O’Doherty J. A Review on the Use of Imaging Biomarkers in Oncology Clinical Trials: Quality Assurance Strategies for Technical Validation. Tomography 2023; 9:1876-1902. [PMID: 37888741 PMCID: PMC10610870 DOI: 10.3390/tomography9050149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 10/10/2023] [Accepted: 10/13/2023] [Indexed: 10/28/2023] Open
Abstract
Imaging biomarkers (IBs) have been proposed in medical literature that exploit images in a quantitative way, going beyond the visual assessment by an imaging physician. These IBs can be used in the diagnosis, prognosis, and response assessment of several pathologies and are very often used for patient management pathways. In this respect, IBs to be used in clinical practice and clinical trials have a requirement to be precise, accurate, and reproducible. Due to limitations in imaging technology, an error can be associated with their value when considering the entire imaging chain, from data acquisition to data reconstruction and subsequent analysis. From this point of view, the use of IBs in clinical trials requires a broadening of the concept of quality assurance and this can be a challenge for the responsible medical physics experts (MPEs). Within this manuscript, we describe the concept of an IB, examine some examples of IBs currently employed in clinical practice/clinical trials and analyze the procedure that should be carried out to achieve better accuracy and reproducibility in their use. We anticipate that this narrative review, written by the components of the EFOMP working group on "the role of the MPEs in clinical trials"-imaging sub-group, can represent a valid reference material for MPEs approaching the subject.
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Affiliation(s)
- Stephane Chauvie
- Medical Physics Division, Santa Croce e Carle Hospital, 12100 Cuneo, Italy;
| | | | - Jim O’Doherty
- Siemens Medical Solutions, Malvern, PA 19355, USA;
- Department of Radiology & Radiological Sciences, Medical University of South Carolina, Charleston, SC 20455, USA
- Radiography & Diagnostic Imaging, University College Dublin, D04 C7X2 Dublin, Ireland
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Mutuleanu MD, Paun DL, Lazar AM, Petroiu C, Trifanescu OG, Anghel RM, Gherghe M. Quantitative vs. Qualitative SPECT-CT Diagnostic Accuracy in Bone Lesion Evaluation-A Review of the Literature. Diagnostics (Basel) 2023; 13:2971. [PMID: 37761338 PMCID: PMC10529093 DOI: 10.3390/diagnostics13182971] [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: 07/28/2023] [Revised: 09/13/2023] [Accepted: 09/15/2023] [Indexed: 09/29/2023] Open
Abstract
(1) Background: Considering the importance that quantitative molecular imaging has gained and the need for objective and reproducible image interpretation, the aim of the present review is to emphasize the benefits of performing a quantitative interpretation of single photon emission computed tomography-computed tomography (SPECT-CT) studies compared to qualitative interpretation methods in bone lesion evaluations while suggesting new directions for research on this topic. (2) Methods: By conducting comprehensive literature research, we performed an analysis of published data regarding the use of quantitative and qualitative SPECT-CT in the evaluation of bone metastases. (3) Results: Several studies have evaluated the diagnostic accuracy of quantitative and qualitative SPECT-CT in differentiating between benign and metastatic bone lesions. We collected the sensitivity and specificity for both quantitative and qualitative SPECT-CT; their values ranged between 74-92% and 81-93% for quantitative bone SPECT-CT and between 60-100% and 41-100% for qualitative bone SPECT-CT. (4) Conclusions: Both qualitative and quantitative SPECT-CT present an increased potential for better differentiating between benign and metastatic bone lesions, with the latter offering additional objective information, thus increasing diagnostic accuracy and enabling the possibility of performing treatment response evaluation through accurate measurements.
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Affiliation(s)
- Mario-Demian Mutuleanu
- Nuclear Medicine Department, University of Medicine and Pharmacy “Carol Davila”, 050474 Bucharest, Romania
- Nuclear Medicine Department, Institute of Oncology “Prof. Dr. Alexandru Trestioreanu”, 022328 Bucharest, Romania; (A.M.L.); (C.P.)
| | - Diana Loreta Paun
- Endocrinology Department, University of Medicine and Pharmacy “Carol Davila”, 050474 Bucharest, Romania
- Endocrinology Department, National Institute of Endocrinology “C.I. Parhon”, 011863 Bucharest, Romania
| | - Alexandra Maria Lazar
- Nuclear Medicine Department, Institute of Oncology “Prof. Dr. Alexandru Trestioreanu”, 022328 Bucharest, Romania; (A.M.L.); (C.P.)
- Carcinogenesis and Molecular Biology Department, Institute of Oncology “Prof. Dr. Alexandru Trestioreanu”, 022328 Bucharest, Romania
| | - Cristina Petroiu
- Nuclear Medicine Department, Institute of Oncology “Prof. Dr. Alexandru Trestioreanu”, 022328 Bucharest, Romania; (A.M.L.); (C.P.)
| | - Oana Gabriela Trifanescu
- Oncology Department, University of Medicine and Pharmacy “Carol Davila”, 050474 Bucharest, Romania
- Radiotherapy II Department, Institute of Oncology “Prof. Dr. Alexandru Trestioreanu”, 022328 Bucharest, Romania
| | - Rodica Maricela Anghel
- Oncology Department, University of Medicine and Pharmacy “Carol Davila”, 050474 Bucharest, Romania
- Radiotherapy II Department, Institute of Oncology “Prof. Dr. Alexandru Trestioreanu”, 022328 Bucharest, Romania
| | - Mirela Gherghe
- Nuclear Medicine Department, University of Medicine and Pharmacy “Carol Davila”, 050474 Bucharest, Romania
- Nuclear Medicine Department, Institute of Oncology “Prof. Dr. Alexandru Trestioreanu”, 022328 Bucharest, Romania; (A.M.L.); (C.P.)
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Zainudin NAB, Zulkifli NN, Abdul Hamid K, Hashim H, Mansor S. A Pilot Study of the Striatal Dopamine Transporter Levels in Kratom-Dependent and Normal Subjects Using 99mTc-TRODAT-1 Single Photon Emission Computed Tomography-Computed Tomography (SPECT-CT). Cureus 2023; 15:e43251. [PMID: 37692587 PMCID: PMC10491945 DOI: 10.7759/cureus.43251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/09/2023] [Indexed: 09/12/2023] Open
Abstract
OBJECTIVE The study aims to elucidate the effects of kratom addiction on dopamine transporter (DAT) using [2-[[2-[[[3-(4-chlorophenyl)-8-methyl-8-azabicyclo[3.2.1]oct-2-yl]methyl](2-mercaptoethyl)amino]ethyl]amino]ethanethiolato(3-)-N2,N20,S2,S20]oxo-[1R-(exo-exo)]-[99mTc] technetium (99mTc-TRODAT-1) brain single photon emission computed tomography-computed tomography (SPECT-CT) in kratom-dependent and healthy subjects. MATERIALS AND METHODS We recruited 12 kratom-dependent subjects and 13 healthy men to participate in this study. Addiction, craving, depression, and cognitive scores were assessed. All subjects received a single bolus injection of 99mTc-TRODAT-1 with 914.1 MBq ± 65.5 of activity (mean ± SD). The brain SPECT-CT images were reconstructed using 3D ordered subset expectation maximization (3D-OSEM) along with attenuation correction (AC), scatter correction (SC), and resolution recovery (RR) with an iteration number of four and a subset of 10. The Cohen's Kappa interrater-reliability between two raters, the standardized uptake value of body weight (SUVBW), and the asymmetrical index percentage (AI%) were evaluated. RESULTS Kappa statistics showed a fine agreement of abnormal 99mTc-TRODAT-1 uptake in the striatum region for the kratom-dependent group with the κ value of 0.69 (p = 0.0001), and the percentage of agreement for rater 1 and rater 2 was 56% and 64%, respectively. There was a reduction in average SUV in kratom-dependent subjects compared to healthy control subjects in the left caudate and left striatum (0.938 vs. 1.251, p = 0.014, and 1.055 vs. 1.29, p = 0.036, respectively). There was a significant difference in the AI% of the caudate region between the kratom-dependent group and the normal group (33% vs. 14%, p = 0.019). CONCLUSION Our findings signify that kratom addiction, may cause a change in DAT level and the results can be confirmed using 99mTc-TRODAT-1 SPECT-CT.
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Affiliation(s)
| | | | - Khadijah Abdul Hamid
- Biomedical Imaging, Universiti Sains Malaysia, Penang, MYS
- Nuclear Medicine Unit, Universiti Sains Malaysia, Penang, MYS
| | - Hazlin Hashim
- Biomedical Imaging, Universiti Sains Malaysia, Penang, MYS
- Nuclear Medicine Unit, Universiti Sains Malaysia, Penang, MYS
| | - Syahir Mansor
- Biomedical Imaging, Universiti Sains Malaysia, Penang, MYS
- Nuclear Medicine Unit, Universiti Sains Malaysia, Penang, MYS
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12
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Hoog C, Verrecchia-Ramos E, Dejust S, Lalire P, Sezin G, Moubtakir A, El Farsaoui K, Caquot PA, Guendouzen S, Morland D, Papathanassiou D. Implementation of xSPECT, xSPECT bone and Broadquant from literature, clinical survey and innovative phantom study with task-based image quality assessment. Phys Med 2023; 112:102611. [PMID: 37329742 DOI: 10.1016/j.ejmp.2023.102611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 04/19/2023] [Accepted: 05/30/2023] [Indexed: 06/19/2023] Open
Abstract
OBJECTIVE From patient and phantom studies, we aimed to highlight an original implementation process and share a two-years experience clinical feedback on xSPECT (xS), xSPECT Bone (xB) and Broadquant quantification (Siemens) for 99mTc-bone and 177Lu-NET (neuroendocrine tumors) imaging. METHODS Firstly, we checked the relevance of implemented protocols and Broadquant module on the basis of literature and with a homogeneous phantom study respectively. Then, we described xS and xB behaviours with reconstruction parameters (10i-0mm to 40i-20mm) and optimized the protocols through a blinded survey (7 physicians). Finally, the preferred 99mTc-bone reconstruction was assessed through an IEC NEMA phantom including liquid bone spheres. Conventional SNR, CNR, spatial resolution, Q.%error, and recovery curves; and innovative NPS, TTF and detectability score d' were performed (ImQuest software). We also sought to review the adoption of these tools in clinical routine and showed the potential of quantitative xB in the context of theranostics (Xofigo®). RESULTS We showed the need of optimization of implemented reconstruction algorithms and pointed out a decay correction particularity with Broadquant. Preferred parameters were 1s-25i-8mm and 1s-25i-5mm for xS/xB-bone and xS-NET imaging respectively. The phantom study highlighted the different image quality especially for the enhanced spatial resolution xB algorithm (1/TTF10%=2.1 mm) and showed F3D and xB shared the best performances in terms of image quality and quantification. xS was generally less efficient. CONCLUSIONS Qualitative F3D still remains the clinical standard, xB and Broadquant offer challenging perspectives in theranostics. We introduced the potential of innovative metrics for image quality analysis and showed how CT tools should be adapted to fit nuclear medicine imaging.
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Affiliation(s)
| | | | | | - Paul Lalire
- Nuclear Medicine Department, Institut Godinot, Reims, France
| | - Ghali Sezin
- Nuclear Medicine Department, Institut Godinot, Reims, France
| | | | | | | | | | - David Morland
- Nuclear Medicine Department, Institut Godinot, Reims, France; UFR de médecine, université de Reims-Champagne Ardenne, 1, rue Cognacq-Jay, 51095 Reims cedex, France; CReSTIC Centre de recherche en sciences et technologies de l'information et de la communication, EA 3804, université de Reims-Champagne Ardenne, Moulin de la Housse, BP 1039, 51687 Reims Cedex 2, France
| | - Dimitri Papathanassiou
- Nuclear Medicine Department, Institut Godinot, Reims, France; UFR de médecine, université de Reims-Champagne Ardenne, 1, rue Cognacq-Jay, 51095 Reims cedex, France; CReSTIC Centre de recherche en sciences et technologies de l'information et de la communication, EA 3804, université de Reims-Champagne Ardenne, Moulin de la Housse, BP 1039, 51687 Reims Cedex 2, France
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13
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Gherghe M, Mutuleanu MD, Stanciu AE, Irimescu I, Lazar AM, Toma RV, Trifanescu OG, Anghel RM. Quantitative Assessment of Treatment Response in Metastatic Breast Cancer Patients by SPECT-CT Bone Imaging-Getting Closer to PET-CT. Cancers (Basel) 2023; 15:696. [PMID: 36765651 PMCID: PMC9913230 DOI: 10.3390/cancers15030696] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/15/2023] [Accepted: 01/21/2023] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Cancer represents the major cause of death mainly through its ability to spread to other organs, highlighting the importance of metastatic disease diagnosis and accurate follow up for treatment management purposes. Although until recently the main method for imaging interpretation was represented by qualitative methods, quantitative analysis of SPECT-CT data represents a viable, objective option. METHODS Seventy-five breast cancer patients presenting metastatic bone disease underwent at least two Bone SPECT-CT studies using [99mTc]-HDP between November 2019 to October 2022. RESULTS Our findings show a good positive relationship between the qualitative methods of imaging interpretation and quantitative analysis, with a correlation coefficient of 0.608 between qualitative whole body scintigraphy and quantitative SPECT-CT, and a correlation coefficient of 0.711 between the qualitative and quantitative interpretation of SPECT-CT data; nevertheless, there is a need for accurate, objective and reproducible methods for imaging interpretation, especially for research purposes. CONCLUSIONS Quantitative evaluation of the SPECT-CT data has the potential to be the first choice of imaging interpretation for patient follow up and treatment response evaluation, especially for research purposes, because of its objectivity and expression of uptake changes in absolute units.
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Affiliation(s)
- Mirela Gherghe
- Nuclear Medicine Department, University of Medicine and Pharmacy Carol Davila Bucharest, 050474 București, Romania
- Nuclear Medicine Department, Institute of Oncology “Prof. Dr. Alexandru Trestioreanu”, 022328 Bucharest, Romania
| | - Mario-Demian Mutuleanu
- Nuclear Medicine Department, University of Medicine and Pharmacy Carol Davila Bucharest, 050474 București, Romania
- Nuclear Medicine Department, Institute of Oncology “Prof. Dr. Alexandru Trestioreanu”, 022328 Bucharest, Romania
| | - Adina Elena Stanciu
- Carcinogenesis and Molecular Biology Department, Institute of Oncology “Prof. Dr. Alexandru Trestioreanu”, 022328 Bucharest, Romania
| | - Ionela Irimescu
- Nuclear Medicine Department, Institute of Oncology “Prof. Dr. Alexandru Trestioreanu”, 022328 Bucharest, Romania
| | - Alexandra Maria Lazar
- Nuclear Medicine Department, Institute of Oncology “Prof. Dr. Alexandru Trestioreanu”, 022328 Bucharest, Romania
| | - Radu Valeriu Toma
- Oncology Department, University of Medicine and Pharmacy Carol Davila Bucharest, 050474 Bucharest, Romania
- Radiotherapy I Department, Institute of Oncology “Prof. Dr. Alexandru Trestioreanu”, 022328 Bucharest, Romania
| | - Oana Gabriela Trifanescu
- Oncology Department, University of Medicine and Pharmacy Carol Davila Bucharest, 050474 Bucharest, Romania
- Radiotherapy II Department, Institute of Oncology “Prof. Dr. Alexandru Trestioreanu”, 022328 Bucharest, Romania
| | - Rodica Maricela Anghel
- Oncology Department, University of Medicine and Pharmacy Carol Davila Bucharest, 050474 Bucharest, Romania
- Radiotherapy II Department, Institute of Oncology “Prof. Dr. Alexandru Trestioreanu”, 022328 Bucharest, Romania
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14
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Mukhatov A, Le T, Pham TT, Do TD. A comprehensive review on magnetic imaging techniques for biomedical applications. NANO SELECT 2023. [DOI: 10.1002/nano.202200219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Affiliation(s)
- Azamat Mukhatov
- Department of Robotics School of Engineering and Digital Sciences Nazarbayev University Astana Kazakhstan
| | - Tuan‐Anh Le
- Department of Physiology and Biomedical Engineering Mayo Clinic Scottsdale Arizona USA
| | - Tri T. Pham
- Department of Biology School of Sciences and Humanities Nazarbayev University Astana Kazakhstan
| | - Ton Duc Do
- Department of Robotics School of Engineering and Digital Sciences Nazarbayev University Astana Kazakhstan
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15
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Carnegie-Peake L, Taprogge J, Murray I, Flux GD, Gear J. Quantification and dosimetry of small volumes including associated uncertainty estimation. EJNMMI Phys 2022; 9:86. [PMID: 36512147 PMCID: PMC9748012 DOI: 10.1186/s40658-022-00512-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 11/17/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Accurate quantification of radioactivity in a source of interest relies on accurate registration between SPECT and anatomical images, and appropriate correction of partial volume effects (PVEs). For small volumes, exact registration between the two imaging modalities and recovery factors used to correct for PVE are unreliable. There is currently no guidance relating to quantification or the associated uncertainty estimation for small volumes. MATERIAL AND METHODS A method for quantification of small sources of interest is proposed, which uses multiple oversized volumes of interest. The method was applied to three Na[131I]I activity distributions where a Na[131I]I capsule was situated within a cylindrical phantom containing either zero background, uniform background or non-uniform background and to a scenario with small lesions placed in an anthropomorphic phantom. The Na[131I]I capsule and lesions were quantified using the proposed method and compared with measurements made using two alternative quantification methods. The proposed method was also applied to assess the absorbed dose delivered to a bone metastasis following [131I]mIBG therapy for neuroblastoma including the associated uncertainty estimation. RESULTS The method is accurate across a range of activities and in varied radioactivity distributions. Median percentage errors using the proposed method in no background, uniform backgrounds and non-uniform backgrounds were - 0.4%, - 0.3% and 1.7% with median associated uncertainties of 1.4%, 1.4% and 1.6%, respectively. The technique is more accurate and robust when compared to currently available alternative methods. CONCLUSIONS The proposed method provides a reliable and accurate method for quantification of sources of interest, which are less than three times the spatial resolution of the imaging system. The method may be of use in absorbed dose calculation in cases of bone metastasis, lung metastasis or thyroid remnants.
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Affiliation(s)
- Lily Carnegie-Peake
- Joint Department of Physics, Royal Marsden NHSFT, Downs Road, Sutton, SM2 5PT UK
- The Institute of Cancer Research, 15 Cotswold Road, Sutton, SM2 5NG UK
| | - Jan Taprogge
- Joint Department of Physics, Royal Marsden NHSFT, Downs Road, Sutton, SM2 5PT UK
- The Institute of Cancer Research, 15 Cotswold Road, Sutton, SM2 5NG UK
| | - Iain Murray
- Joint Department of Physics, Royal Marsden NHSFT, Downs Road, Sutton, SM2 5PT UK
- The Institute of Cancer Research, 15 Cotswold Road, Sutton, SM2 5NG UK
| | - Glenn D. Flux
- Joint Department of Physics, Royal Marsden NHSFT, Downs Road, Sutton, SM2 5PT UK
- The Institute of Cancer Research, 15 Cotswold Road, Sutton, SM2 5NG UK
| | - Jonathan Gear
- Joint Department of Physics, Royal Marsden NHSFT, Downs Road, Sutton, SM2 5PT UK
- The Institute of Cancer Research, 15 Cotswold Road, Sutton, SM2 5NG UK
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16
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Filippi L, Palumbo B, Frantellizzi V, Nuvoli S, De Vincentis G, Spanu A, Schillaci O. Prostate-specific membrane antigen-directed imaging and radioguided surgery with single-photon emission computed tomography: state of the art and future outlook. Expert Rev Med Devices 2022; 19:815-824. [PMID: 36370108 DOI: 10.1080/17434440.2022.2146999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Prostate-specific membrane antigen (PSMA) has emerged as a highly relevant target for prostate cancer (PC) diagnosis and therapy. PSMA inhibitors targeting PSMA-enzymatic domain have been successfully labeled with radionuclides emitting positrons or gamma-photons, thus obtaining tracers suitable for imaging with positron emission computed tomography (PET/CT) or single-photon emission tomography (SPECT). AREAS COVERED The different approaches for obtaining PSMA-ligands labeled with gamma-emitting nuclides (99mTc or111In) are reviewed. Furthermore, the applications of 99mTc/111In-PSMA SPECT for the imaging of PC patients in different clinical settings (staging or biochemical recurrence) are covered. Lastly, the employment of PSMA-targeted SPECT tracers for radioguided surgery (RGS) during primary or salvage lymphadenectomy is discussed. EXPERT OPINION RGS provided satisfying preliminary results in both primary and salvage lymphadenectomy, allowing to discriminate between pathological and non-pathological nodes with high accuracy, although prospective studies with larger cohorts are needed to further validate this surgical approach. The potential of PSMA-targeted SPECT/CT has not been fully explored yet, but it might represent a relatively cost-effective alternative to PSMA PET/CT in limited resource environments. In this perspective, the implementation of novel SPECT technologies or algorithms, such as semiconductor-ionization detectors or resolution recovery reconstruction, will be topic of future investigation.
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Affiliation(s)
- Luca Filippi
- Department of Nuclear Medicine, Santa Maria Goretti Hospital, Latina, Italy
| | - Barbara Palumbo
- Section of Nuclear Medicine and Health Physics, Department of Medicine and Surgery, Università Degli Studi di Perugia, Piazza Lucio Severi 1, 06132 Perugia, Italy
| | - Viviana Frantellizzi
- Department of Radiological Sciences, Oncology and Anatomo-Pathology, Sapienza University of Rome, 00161 Rome, Italy
| | - Susanna Nuvoli
- Unit of Nuclear Medicine, Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy
| | - Giuseppe De Vincentis
- Department of Radiological Sciences, Oncology and Anatomo-Pathology, Sapienza University of Rome, 00161 Rome, Italy
| | - Angela Spanu
- Unit of Nuclear Medicine, Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy
| | - Orazio Schillaci
- Department of Biomedicine and Prevention, University Tor Vergata, Rome, Italy.,IRCCS Neuromed, Pozzilli, Italy
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17
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Zhou Z, Mei H, Li R, Wang C, Fang K, Wang W, Tang Y, Dai Z. Progresses of animal robots: A historical review and perspectiveness. Heliyon 2022; 8:e11499. [PMID: 36411898 PMCID: PMC9674511 DOI: 10.1016/j.heliyon.2022.e11499] [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: 05/08/2022] [Revised: 08/12/2022] [Accepted: 11/01/2022] [Indexed: 11/13/2022] Open
Abstract
Animal robots have remarkable advantages over traditional mechatronic ones in terms of energy supply, self-orientation, and natural concealment and can provide remarkable theoretical and practical values for scientific investigation, community service, military detection and other fields. Given these features, animal robots have become high-profile research objects and have recently attracted extensive attention. Herein, we have defined animal robots, reviewed the main types of animal robots, and discussed the potential developing directions. We have also detailed the mechanisms underlying the regulation of animal robots and introduced key methods for manipulating them. We have further proposed several application prospects for different types of animal robots. Finally, we have presented research directions for their further improvement.
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Affiliation(s)
- Zhengyue Zhou
- Institute of Bio-inspired Structure and Surface Engineering, Nanjing University of Aeronautics and Astronautics, Nanjing, Jiangsu, China
| | - Hao Mei
- Institute of Bio-inspired Structure and Surface Engineering, Nanjing University of Aeronautics and Astronautics, Nanjing, Jiangsu, China
| | - Rongxun Li
- Institute of Bio-inspired Structure and Surface Engineering, Nanjing University of Aeronautics and Astronautics, Nanjing, Jiangsu, China
| | - Chenyuan Wang
- Institute of Bio-inspired Structure and Surface Engineering, Nanjing University of Aeronautics and Astronautics, Nanjing, Jiangsu, China
| | - Ke Fang
- Institute of Bio-inspired Structure and Surface Engineering, Nanjing University of Aeronautics and Astronautics, Nanjing, Jiangsu, China
| | - Wenbo Wang
- Institute of Bio-inspired Structure and Surface Engineering, Nanjing University of Aeronautics and Astronautics, Nanjing, Jiangsu, China
| | - Yezhong Tang
- Institute of Bio-inspired Structure and Surface Engineering, Nanjing University of Aeronautics and Astronautics, Nanjing, Jiangsu, China
- Chengdu Institute of Biology, Chinese Academy of Sciences. No.9 Section 4, Renmin Nan Road, 610041, Chengdu, Sichuan, China
| | - Zhendong Dai
- Institute of Bio-inspired Structure and Surface Engineering, Nanjing University of Aeronautics and Astronautics, Nanjing, Jiangsu, China
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18
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Tzortzakakis A, Papathomas T, Gustafsson O, Gabrielson S, Trpkov K, Ekström-Ehn L, Arvanitis A, Holstensson M, Karlsson M, Kokaraki G, Axelsson R. 99mTc-Sestamibi SPECT/CT and histopathological features of oncocytic renal neoplasia. Scand J Urol 2022; 56:375-382. [PMID: 36065481 DOI: 10.1080/21681805.2022.2119273] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND 99mTc-Sestamibi Single Photon Emission Computed Tomography/Computed Tomography (SPECT/CT) contributes to the non-invasive differentiation of renal oncocytoma (RO) from renal cell carcinoma (RCC) by characterising renal tumours as Sestamibi positive or Sestamibi negative regarding their 99mTc-Sestamibi uptake compared to the non-tumoral renal parenchyma. PURPOSE To determine whether 99mTc- Sestamibi uptake in renal tumour and the non-tumoral renal parenchyma measured using Standard Uptake Value (SUV) SPECT, has a beneficial role in differentiating RO from RCC. MATERIAL AND METHODS Fifty-seven renal tumours from 52 patients were evaluated. In addition to visual evaluation of 99mTc-Sestamibi uptake, SUVmax measurements were performed in the renal tumour and the ipsilateral non-tumoral renal parenchyma. Analysis of the area under the receiver operating characteristic curve identified an optimal cut-off value for detecting RO, based on the relative ratio of 99mTc- Sestamibi uptake. RESULTS Semiquantitative evaluation of 99mTc-Sestamibi uptake did not improve the performance of 99mTc- Sestamibi SPECT/CT in detecting RO. 99mTc- Sestamibi SPECT/CT identifies a group of mostly indolent Sestamibi-positive tumours with low malignant potential containing RO, Low-Grade Oncocytic Tumours, Hybrid Oncocytic Tumours, and a subset of chromophobe RCCs. CONCLUSION The imaging limitations for accurate differentiation of Sestamibi-positive renal tumours mirror the recognised diagnostic complexities of the histopathologic evaluation of oncocytic neoplasia. Patients with Sestamibi-positive renal tumours could be better suited for biopsy and follow-up, according to the current active surveillance protocols.
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Affiliation(s)
- Antonios Tzortzakakis
- Division of Radiology, Department for Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Solna, Sweden.,Medical Radiation Physics and Nuclear Medicine, Functional Unit of Nuclear Medicine, Karolinska University Hospital, Huddinge, Sweden
| | - Thomas Papathomas
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, United Kingdom.,Gloucestershire Cellular Pathology Laboratory, Cheltenham General Hospital, Gloucestershire Hospitals NHS Foundation Trust, Cheltenham, United Kingdom
| | - Ove Gustafsson
- Division of Urology, Karolinska University Hospital, Huddinge, Sweden
| | - Stefan Gabrielson
- Division of Radiology, Department for Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Solna, Sweden.,Medical Radiation Physics and Nuclear Medicine, Functional Unit of Nuclear Medicine, Karolinska University Hospital, Huddinge, Sweden
| | - Kiril Trpkov
- Department of Pathology and Laboratory Medicine, Alberta Precision Labs, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | | | - Alexandros Arvanitis
- Department of Clinical Pathology and Cytology, Karolinska University Hospital, Huddinge, Stockholm, Sweden
| | - Maria Holstensson
- Medical Radiation Physics and Nuclear Medicine, Functional Unit of Nuclear Medicine, Karolinska University Hospital, Huddinge, Sweden.,Division of Function and Technology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet
| | - Mattias Karlsson
- Medical Radiation Physics and Nuclear Medicine, Functional Unit of Nuclear Medicine, Karolinska University Hospital, Huddinge, Sweden
| | - Georgia Kokaraki
- Division of Radiology, Department for Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Solna, Sweden.,Department of Clinical Pathology and Cytology, Karolinska University Hospital, Huddinge, Stockholm, Sweden
| | - Rimma Axelsson
- Division of Radiology, Department for Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Solna, Sweden.,Medical Radiation Physics and Nuclear Medicine, Functional Unit of Nuclear Medicine, Karolinska University Hospital, Huddinge, Sweden
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19
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Gillen R, Erlandsson K, Denis-Bacelar AM, Thielemans K, Hutton BF, McQuaid SJ. Towards accurate partial volume correction in 99mTc oncology SPECT: perturbation for case-specific resolution estimation. EJNMMI Phys 2022; 9:59. [PMID: 36064882 PMCID: PMC9445108 DOI: 10.1186/s40658-022-00489-5] [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: 02/02/2022] [Accepted: 08/22/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Currently, there is no consensus on the optimal partial volume correction (PVC) algorithm for oncology imaging. Several existing PVC methods require knowledge of the reconstructed resolution, usually as the point spread function (PSF)-often assumed to be spatially invariant. However, this is not the case for SPECT imaging. This work aimed to assess the accuracy of SPECT quantification when PVC is applied using a case-specific PSF. METHODS Simulations of SPECT [Formula: see text]Tc imaging were performed for a range of activity distributions, including those replicating typical clinical oncology studies. Gaussian PSFs in reconstructed images were estimated using perturbation with a small point source. Estimates of the PSF were made in situations which could be encountered in a patient study, including; different positions in the field of view, different lesion shapes, sizes and contrasts, noise-free and noisy data. Ground truth images were convolved with the perturbation-estimated PSF, and with a PSF reflecting the resolution at the centre of the field of view. Both were compared with reconstructed images and the root-mean-square error calculated to assess the accuracy of the estimated PSF. PVC was applied using Single Target Correction, incorporating the perturbation-estimated PSF. Corrected regional mean values were assessed for quantitative accuracy. RESULTS Perturbation-estimated PSF values demonstrated dependence on the position in the Field of View and the number of OSEM iterations. A lower root mean squared error was observed when convolution of the ground truth image was performed with the perturbation-estimated PSF, compared with convolution using a different PSF. Regional mean values following PVC using the perturbation-estimated PSF were more accurate than uncorrected data, or data corrected with PVC using an unsuitable PSF. This was the case for both simple and anthropomorphic phantoms. For the simple phantom, regional mean values were within 0.7% of the ground truth values. Accuracy improved after 5 or more OSEM iterations (10 subsets). For the anthropomorphic phantoms, post-correction regional mean values were within 1.6% of the ground truth values for noise-free uniform lesions. CONCLUSION Perturbation using a simulated point source could potentially improve quantitative SPECT accuracy via the application of PVC, provided that sufficient reconstruction iterations are used.
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Affiliation(s)
- Rebecca Gillen
- Institute of Nuclear Medicine, University College London, London, UK.
- National Physical Laboratory, Teddington, UK.
- Department of Clinical Physics and Bioengineering, Nuclear Medicine, North East Sector, NHS Greater Glasgow and Clyde, Glasgow, UK.
| | - Kjell Erlandsson
- Institute of Nuclear Medicine, University College London, London, UK
| | | | - Kris Thielemans
- Institute of Nuclear Medicine, University College London, London, UK
- Centre for Medical Image Computing, University College London, London, UK
| | - Brian F Hutton
- Institute of Nuclear Medicine, University College London, London, UK
| | - Sarah J McQuaid
- Institute of Nuclear Medicine, University College London, London, UK
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20
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Study of 99mTc absorption on micro-sized ion exchange resins to achieve high activity for SPECT. Appl Radiat Isot 2022; 186:110256. [DOI: 10.1016/j.apradiso.2022.110256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 04/20/2022] [Accepted: 04/21/2022] [Indexed: 11/30/2022]
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21
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Volumetric analysis of mandibular lesions with SPECT/CT: a pilot clinical study of maximum standardized uptake value. Pol J Radiol 2022; 87:e311-e315. [PMID: 35892069 PMCID: PMC9288195 DOI: 10.5114/pjr.2022.117569] [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: 07/30/2021] [Accepted: 08/09/2021] [Indexed: 11/18/2022] Open
Abstract
Purpose This study was designed to investigate mandibular lesions using volumetric analysis with bone single-photon emission computed tomography/computed tomography (SPECT/CT). Material and methods Eight patients with mandibular lesions underwent SPECT/CT scan acquisition 4 hours after injection of Tc-99m hydroxymethylene diphosphonate (HMDP). Regarding volumetric analysis, maximum standar-dized uptake value (SUV) was obtained using software and a workstation (Q.Volumetrix MI and GEniE-Xeleris 4 DR, respectively). The localization and size of the volume of interest (VOI) can be drawn over the lesion, mesial, distal, and opposite side as normal using the CT, SPECT, and SPECT/CT transaxials, coronals, and sagittals as the anatomical reference. Q.Volumetrix MI can analyse SUV of lesions by organ segmentation using optional pan and zoom imaging. Then, the dosimetry software provided multiple quantitative data for a given VOI. Statistical analyses for the maximum SUV were performed by Mann-Whitney U test. A p-value lower than 0.05 was considered as statistically significant. Results Maximum SUVs for medication-related osteonecrosis of the jaw (n = 4, 25.4 ± 4.9), chronic osteomyelitis (n = 3, 14.6 ± 3.1), and squamous cell carcinoma (n = 1, 31.7) were significantly higher than those of the opposite side as normal mandible (3.8 ± 0.7, 4.6 ± 1.8, and 7.4, respectively; p = 0.000). Conclusions Volumetric analysis with SPECT/CT could be useful for the evaluation of mandibular lesions, such as detecting and surgical planning.
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Piwowarska-Bilska H, Kurkowska S, Birkenfeld B. Individualization of Radionuclide Therapies: Challenges and Prospects. Cancers (Basel) 2022; 14:cancers14143418. [PMID: 35884478 PMCID: PMC9316481 DOI: 10.3390/cancers14143418] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 07/04/2022] [Accepted: 07/12/2022] [Indexed: 02/01/2023] Open
Abstract
Simple Summary Currently, patient-specific treatment plans and dosimetry calculations are not routinely performed for radionuclide therapies. In external beam radiotherapy, it is quite the opposite. As a result, a small fraction of patients receives optimal radioactivity. This conservative approach provides “radiation safety” to healthy tissues but delivers a lower than indicated absorbed dose to the tumors, resulting in a lower response rate and a higher disease relapse rate. Evidence shows that better and more predictable outcomes can be achieved with patient-individualized dose assessment. Therefore, the incorporation of individual planning into radionuclide therapies is a high priority for nuclear medicine physicians and medical physicists alike. Internal dosimetry is used in tumor therapy to optimize the absorbed dose to the target tissue. The main reasons for the difficulties in incorporating patients’ internal dosimetry into routine clinical practice are discussed. The article presents the prospects for the routine implementation of personalized radionuclide therapies. Abstract The article presents the problems of clinical implementation of personalized radioisotope therapy. The use of radioactive drugs in the treatment of malignant and benign diseases is rapidly expanding. Currently, in the majority of nuclear medicine departments worldwide, patients receive standard activities of therapeutic radiopharmaceuticals. Intensively conducted clinical trials constantly provide more evidence of a close relationship between the dose of radiopharmaceutical absorbed in pathological tissues and the therapeutic effect of radioisotope therapy. Due to the lack of individual internal dosimetry (based on the quantitative analysis of a series of diagnostic images) before or during the treatment, only a small fraction of patients receives optimal radioactivity. The vast majority of patients receive too-low doses of ionizing radiation to the target tissues. This conservative approach provides “radiation safety” to healthy tissues, but also delivers lower radiopharmaceutical activity to the neoplastic tissue, resulting in a low level of response and a higher relapse rate. The article presents information on the currently used radionuclides in individual radioisotope therapies and on radionuclides newly introduced to the therapeutic market. It discusses the causes of difficulties with the implementation of individualized radioisotope therapies as well as possible changes in the current clinical situation.
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Zainudin NA, Zulkifli N, Hamid K, Hashim H, Mansor S. Experimental evaluation of absolute quantification in 99m Tc-TRODAT-1 SPECT/CT brain dopamine transporter (DAT) studies. J Appl Clin Med Phys 2022; 23:e13723. [PMID: 35833589 PMCID: PMC9359040 DOI: 10.1002/acm2.13723] [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: 04/08/2022] [Revised: 06/05/2022] [Accepted: 06/23/2022] [Indexed: 11/10/2022] Open
Abstract
Objective To evaluate the quantitative accuracy of clinical brain dopamine transporters (DAT) investigations utilizing 99mTc‐TRODAT‐1 single‐photon emission computed tomography (SPECT)/computed tomography (CT) in experimental and clinical settings. Materials and methods The study used an experimental phantom evaluation and a clinical dataset. Three‐dimensional‐ordered subsets expectation–maximization reconstructed the original and resampled datasets using attenuation correction, scatter correction, and resolution recovery. The reconstructed data were analyzed and reported as percentage difference, standardized uptake value reference (SUVr), and a coefficient of variation (CoV). The Taguchi method tested the impact of the three different parameters on signal‐to‐noise ratio (SNR) and SUVr, including number iteration, Poisson resampling, and phantom setup, with and without the plaster of Paris (POP). Six 99mTc‐TRODAT‐1 SPECT/CT scans were acquired in healthy subjects for verification purposes. Results The percentage activity difference between the phantom with and without POP is 20% and 5%, respectively. The SUVr reveals a 10% underestimate for both with and without POP. When it comes to the influence of Poisson resampling, the SUVr value for 75% Poisson resampling indicates 10% underestimation on both sides of the caudate and putamen area, with and without POP. When 25% of Poisson resampling is applied, the SUVr value is overestimated (±35%). In the Taguchi analysis, iteration numbers were the most dominant factor with the F‐value of 9.41 and the contribution rate of 52.66% (p < 0.05) for SNR. In comparison, F‐value of 9.1 for Poisson resampled with contribution rate of 58.91% (p < 0.05) for SUVr. Reducing counts by 25% from the original dataset resulted in a minimal bias in SUVr, compared to 50% and 75%. Conclusion The optimal absolute SPECT/CT quantification of brain DAT studies using 99mTc‐TRODAT‐1 appears achievable with at least 4i10s and SUVr as the surrogate parameter. In clinical investigations, it is possible to reduce the recommended administered dose by up to 25% while maintaining accurate measurement.
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Affiliation(s)
- Norasma Amira Zainudin
- Departmen of Biomedical Imaging, Advanced Medical and Dental Institute, Universiti Sains Malaysia, Kepala Batas, Penang, 13200, Malaysia
| | - Nadiah Zulkifli
- Departmen of Biomedical Imaging, Advanced Medical and Dental Institute, Universiti Sains Malaysia, Kepala Batas, Penang, 13200, Malaysia
| | - Khadijah Hamid
- Departmen of Biomedical Imaging, Advanced Medical and Dental Institute, Universiti Sains Malaysia, Kepala Batas, Penang, 13200, Malaysia.,Nuclear Medicine Unit, Advanced Medical and Dental Institute, Universiti Sains Malaysia, Kepala Batas, Penang, 13200, Malaysia
| | - Hazlin Hashim
- Departmen of Biomedical Imaging, Advanced Medical and Dental Institute, Universiti Sains Malaysia, Kepala Batas, Penang, 13200, Malaysia.,Nuclear Medicine Unit, Advanced Medical and Dental Institute, Universiti Sains Malaysia, Kepala Batas, Penang, 13200, Malaysia
| | - Syahir Mansor
- Departmen of Biomedical Imaging, Advanced Medical and Dental Institute, Universiti Sains Malaysia, Kepala Batas, Penang, 13200, Malaysia.,Nuclear Medicine Unit, Advanced Medical and Dental Institute, Universiti Sains Malaysia, Kepala Batas, Penang, 13200, Malaysia
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Impact of patient body habitus on image quality and quantitative value in bone SPECT/CT. Ann Nucl Med 2022; 36:586-595. [PMID: 35543916 DOI: 10.1007/s12149-022-01746-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 04/19/2022] [Indexed: 11/01/2022]
Abstract
OBJECTIVE The first edition of guidelines for standardization of bone single photon emission computed tomography (SPECT) imaging was published in 2017, and the optimization and standardization are widely promoted. To the purpose, clarification of the factors related to image quality and quantitative values and their influence are required. The present study aimed to clarify and optimize the influence of patient body habitus on image quality and quantitative values in bone SPECT/CT. METHODS National Electrical Manufacturers Association body phantom (S-size) and custom-made large body phantoms (M-size and L-size) that simulate the abdomens of Japanese patients weighing 60, 80, and 100 kg, were used. Each phantom was filled with 99mTc-solutions of 108 and 18 kBq/mL for the hot spheres and background, respectively. Dynamic SPECT acquisition was performed for 6000 s (150 s /rotation × 40 rotation). The data were divided into six projection data and reconstructed each acquisition time (150, 300, 450, 600, 750, 900 s, and single projection 6000 s). Image quality was evaluated for contrast (QH, 17 mm), background noise (NB, 17 mm), contrast-to-noise ratio (CNR), maximum standardized uptake value (SUVmax, 17 mm), and visual assessment for a 17 mm hot sphere. RESULTS Image quality in the 300 s acquisition showed that values of QH, 17 mm, CNR, and SUVmax, 17 mm decreased (-16.7%, -11.8%, and -11.3%) for M-size and (-28.2%, -30.1%, and -21.7%) for L-size compared with S-size, respectively. No significant difference was observed in NB, 17 mm values. M-size and L-size required 1.2 and 2.3 times longer acquisition, to achieve same CNR as S-size. In visual assessment, 17 mm hot sphere could not be detected only in the L-size. When the Japanese bone SPECT guidelines criteria were applied in 600 s, the sphere could be detected between all phantoms. CONCLUSIONS Patient body habitus significantly affects image quality and decreases the quantitative value in bone SPECT/CT. For the optimization, extend acquisition time according to the patient body habitus is effective for image quality. And for the standardization, it is important to achieve imaging conditions that meet the Japanese bone SPECT guidelines criteria to ensure adequate detectability.
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Bellevre D, Bailliez A, Delelis F, Blaire T, Agostini D, Mouquet F, Maréchaux S, Manrique A. Quantitation of myocardial 99mTc-HMDP uptake with new SPECT/CT cadmium zinc telluride (CZT) camera in patients with transthyretin-related cardiac amyloidosis: Ready for clinical use? J Nucl Cardiol 2022; 29:506-514. [PMID: 32715418 DOI: 10.1007/s12350-020-02274-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 06/14/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND The aim of this study was to investigate the feasibility of assessing absolute myocardial 99mTc-HMDP uptake in patients with suspected cardiac ATTR using SUV with a whole-body CZT SPECT-CT camera (DNM670CZT). METHODS Fifteen patients with suspected cardiac ATTR (Perugini ≥ 2) underwent a conventional 99mTc-HMDP planar imaging and a thoracic SPECT/CT using a DNM 670CZT. A control group consisted of 15 patients with negative scintigraphy (Perugini < 2). SUVmax (mg·L-1) and percentage of injected dose (%ID) were calculated in a cardiac volume of interest (VOI) encompassing the left ventricle. VOIs were also placed in the lung, the right pectoris major, and the sternum. A heart-to-lung SUVmax ratio (HLR) was calculated. RESULTS All ATTR patients demonstrated an increased cardiac HMDP SUVmax (12.2 ± 3.7 mg·L-1) vs controls (3.5 ± 1.2, P < .0001). Percentage of ID, pectoral uptake and HLR were significantly higher in the ATTR group (1.1 ± 0.3 vs 0.15 ± 0.8, P < .0001; 1.5 ± 0.3 vs 0.9 ± 0.3, P < .0001; 9.7 ± 3 vs 4.3 ± 2.2, P < .0001). Bone uptake was not statistically different between the two groups. CONCLUSION This study demonstrated the feasibility of quantitative 99mTc-HMDP SUVmax measurement using a whole-body SPECT/CT CZT camera in patients with suspected cardiac ATTR.
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Affiliation(s)
- Dimitri Bellevre
- Normandie Univ, UNICAEN, Signalisation, électrophysiologie et imagerie des lésions d'ischémie-reperfusion myocardique, FHU REMOD-VHF, Caen, France.
- Department of Nuclear Medicine, UF 5881, Groupement des Hôpitaux de l'Institut Catholique de Lille, Lomme, France.
- Department of Nuclear Medicine, IRIS, Hôpital Privé Le Bois, Lille, France.
| | - Alban Bailliez
- Department of Nuclear Medicine, UF 5881, Groupement des Hôpitaux de l'Institut Catholique de Lille, Lomme, France
- Department of Nuclear Medicine, IRIS, Hôpital Privé Le Bois, Lille, France
| | - François Delelis
- Department of Cardiology, Groupement des Hopitaux de l'instituts catholiques de Lille, Lomme, France
| | - Tanguy Blaire
- Department of Nuclear Medicine, UF 5881, Groupement des Hôpitaux de l'Institut Catholique de Lille, Lomme, France
- Department of Nuclear Medicine, IRIS, Hôpital Privé Le Bois, Lille, France
| | - Denis Agostini
- Normandie Univ, UNICAEN, Signalisation, électrophysiologie et imagerie des lésions d'ischémie-reperfusion myocardique, FHU REMOD-VHF, Caen, France
- Department of Nuclear Medicine, CHU Cote de Nacre, Normandy University, Caen, France
| | | | - Sylvestre Maréchaux
- Department of Cardiology, Groupement des Hopitaux de l'instituts catholiques de Lille, Lomme, France
| | - Alain Manrique
- Normandie Univ, UNICAEN, Signalisation, électrophysiologie et imagerie des lésions d'ischémie-reperfusion myocardique, FHU REMOD-VHF, Caen, France
- Department of Nuclear Medicine, CHU Cote de Nacre, Normandy University, Caen, France
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Piwowarska-Bilska H, Supińska A, Birkenfeld B. What validation tests can be done by the clinical medical physicist while waiting for the standardization of quantitative SPECT/CT imaging? EJNMMI Phys 2022; 9:8. [PMID: 35122533 PMCID: PMC8817961 DOI: 10.1186/s40658-022-00434-6] [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: 11/27/2020] [Accepted: 01/24/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE The aim of the study was to assess the accuracy of quantitative SPECT/CT imaging in a clinical setting and to compare test results from two nuclear medicine departments. METHODS Phantom studies were carried out with two gamma cameras manufactured by GE Healthcare: Discovery NM/CT 670 and NM/CT 850, used in two nuclear medicine departments. The data were collected using a cylindrical uniform phantom and a NEMA/IEC NU2 Body Phantom, filled with 99mTc-pertechnetate. RESULTS The convergence of activity concentration recovery was validated for the two gamma cameras operating in two medical centers using the cylindrical uniform phantom. The comparison of results revealed a 5% difference in the background calibration factor Bg. cal; 6% difference in COV, and a 0.6% difference in total activity deviation ∆Atot. Recovery coefficients (RCmax) for activity concentration in spheres of the NEMA/IEC NU2 Body Phantom were measured for different image reconstruction techniques. RCmax was in the range of 0.2-0.4 for the smallest sphere (ϕ 10 mm), and 1.3-1.4 for the largest sphere (ϕ 37 mm). Conversion factors for SUVmax and SUVmean for the gamma camera systems used were 0.99 and 1.13, respectively. CONCLUSIONS (1) Measurements taken in our study confirmed the clinical suitability of 5 parameters of image quality (Bg. cal-background calibration factor, ∆Atot-total activity deviation, COV-coefficient of variation used for image noise assessment, QH-hot contrast, AM-accuracy of measurements, or RC-recovery coefficient) for the validation of SPECT/CT system performance in terms of correct quantitative acquisitions of images. (2) This work shows that absolute SPECT/CT quantification is achievable in clinical nuclear medicine centers. Results variation of quantitative analyses between centers is mainly related to the use of different reconstruction methods. (3) It is necessary to standardize the technique of measuring the SUV conversion factor obtained with different SPECT/CT scanners.
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Affiliation(s)
| | - Aleksandra Supińska
- Clinical Nuclear Medicine Department, University of Zielona Gora, Multi-Specialist Regional Hospital, Gorzow Wielkopolski, Poland
| | - Bożena Birkenfeld
- Nuclear Medicine Department, Pomeranian Medical University, Szczecin, Poland
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Lim CH, Kim HS, Lee KA, Kim J, Park SB. Clinical significance of quantitative bone SPECT/CT in the evaluation of hand and wrist pain in patients with rheumatic disease. Sci Rep 2022; 12:327. [PMID: 35013365 PMCID: PMC8748937 DOI: 10.1038/s41598-021-03874-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 12/13/2021] [Indexed: 01/19/2023] Open
Abstract
We investigated the diagnostic value of the maximum standardized uptake value (SUV) at hand and wrist joints for differentiating rheumatic diseases via bone single-photon emission computed tomography (SPECT)/computed tomography (CT). A total of 84 patients manifesting hand and wrist pain (58 women; age, 49.8 ± 15.4 years) were finally diagnosed with rheumatoid arthritis (RA, n = 42), osteoarthritis (OA, n = 16), fibromyalgia (FM, n = 2), and other rheumatic diseases (n = 24). The SUV of each patient was measured in 32 joints including the distal interphalangeal (DIP), proximal interphalangeal (PIP), metacarpophalangeal (MCP), and wrist joints bilaterally. Differences in pain and SUVs between specific rheumatic diseases were assessed using the chi-squared test or one-way analysis of variance. Using the highest SUV (hSUV) in each patient, the diagnostic performance in differentiating specific diseases was evaluated by receiver operating characteristic (ROC) curve analysis. Pain symptoms were present in 886 (33.0%) sites in a total of 2688 joints. In four joint groups (DIP, PIP, MCP, and wrist), the SUVs of joints with pain were significantly higher than those of pain-free joints (all P < 0.001). Active joint sites with higher SUVs than the median value of each joint group were the most common in RA (55.1%). RA showed the greatest hSUV in the PIP (3.0 ± 2.4), MCP (3.5 ± 3.4), and wrist (3.3 ± 1.9) joint groups. FM was characterized by the lowest hSUV of all joint groups. In ROC curve analysis, the cumulative hSUV of the PIP, MCP, and wrist joint groups showed good performance for evaluating RA (area under the curve (AUC), 0.668; P = 0.005). The summation of the hSUVs at all joint groups had an excellent predictive performance for FM (AUC, 0.878; P < 0.001). Consequently, the arthritic activity of the hand and wrist joints based on SUV differed according to specific rheumatic diseases. Quantitative SPECT/CT may provide objective information related to arthritic activity for differentiating specific rheumatic diseases.
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Affiliation(s)
- Chae Hong Lim
- Department of Nuclear Medicine, Soonchunhyang University Hospital Seoul, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Hyun-Sook Kim
- Department of Rheumatology, Soonchunhyang University Hospital Seoul, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Kyung-Ann Lee
- Department of Rheumatology, Soonchunhyang University Hospital Seoul, Soonchunhyang University College of Medicine, Seoul, Korea
| | - JongSun Kim
- Department of Rheumatology, Soonchunhyang University Hospital Seoul, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Soo Bin Park
- Department of Nuclear Medicine, Soonchunhyang University Hospital Seoul, Soonchunhyang University College of Medicine, Seoul, Korea.
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Yamashita K, Miyaji N, Motegi K, Terauchi T, Ito S. Development of a new quantification method using partial volume effect correction for individual energy peaks in 111In-pentetreotide SPECT/CT. ASIA OCEANIA JOURNAL OF NUCLEAR MEDICINE & BIOLOGY 2022; 10:126-137. [PMID: 35800427 PMCID: PMC9205847 DOI: 10.22038/aojnmb.2022.61394.1430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 01/08/2022] [Accepted: 01/23/2022] [Indexed: 11/20/2022]
Abstract
Objectives Somatostatin receptor scintigraphy (SRS) using 111In-pentetreotide has no established quantification method. The purpose of this study was to develop a new quantitative method to correct the partial volume effect (PVE) for individual energy peaks in 111In-pentetreotide single-photon emission computed tomography (SPECT). Methods Phantom experiments were performed to construct a new quantitative method. In the phantom experiments, a NEMA IEC body phantom was used. Acquisition was performed using two energy peaks (171 keV and 245 keV) on the SPECT/CT system. The volume of interest was set at each hot sphere and lung insert in the SPECT images of each energy peak, and the recovery coefficient (RC) was calculated to understand the PVE. A new quantitative index, the indium uptake index (IUI), was calculated using the RC to correct the PVE. The quantitative accuracy of the IUI in the hot sphere was confirmed. Case studies were performed to clarify the quantitative accuracy. In a case study, the relationship between the IUI and the Krenning score, which is used as a visual assessment, was evaluated for each lesion. Results The obtained RCs showed that the energy peak at 171 keV was faster in recovering the effect of PVE than that at 245 keV. The IUI in the 17-mm-diameter hot sphere was overestimated by 4.8% and 8.3% at 171 keV and 245 keV, respectively, compared to the actual IUIs. The relationship between IUI and Krenning score was rs=0.773 (p<0.005) at sum, rs=0.739 (p<0.005) at 171 keV, and rs=0.773 (p<0.005) at 245 keV. Conclusion We have developed a new quantification method for 111In-pentetreotide SPECT/CT using RC-based PVE correction for an individual energy peak of 171 keV. The quantitative accuracy of this method was high even for accumulations of less than 20 mm, and it showed a good relationship with the Krenning score; therefore, the clinical usefulness of IUI was demonstrated.
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Affiliation(s)
- Kosuke Yamashita
- Department of Nuclear Medicine, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan,Graduate School of Health Sciences, Kumamoto University, Kumamoto, Japan ,Corresponding author: Kosuke Yamashita. Department of Nuclear Medicine, Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo 135-8550, Japan. Tel: +81-3-3520-0111;
| | - Noriaki Miyaji
- Department of Nuclear Medicine, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Kazuki Motegi
- Department of Nuclear Medicine, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Takashi Terauchi
- Department of Nuclear Medicine, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Shigeki Ito
- Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
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Havel M, Dedek V, Kolacek M, Formanek M. Quantitative analysis in parathyroid adenoma scintigraphy. Nucl Med Commun 2022; 43:1-7. [PMID: 34406145 DOI: 10.1097/mnm.0000000000001474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Surgery is the only curative treatment for primary hyperparathyroidism. Parathyroid scintigraphy is one method used to preoperatively localize the lesion. We examined time-related changes in radiopharmaceutical uptake in parathyroid adenomas (PTAs) and thyroid gland by quantitative single-photon-emission computed tomography (SPECT) imaging to assess differences between rapid and delayed washout patterns. PATIENTS AND METHODS The study group consisted of 35 histologically verified PTAs after radio-guided surgery extirpation in 33 patients with primary hyperparathyroidism. Patients underwent a three-phase SPECT/CT study of the neck and upper thorax post 99mTc-methoxyisobutylisonitrile (MIBI) injection. Images were reconstructed using a proprietary ordered-subset-conjugate-gradient-maximization algorithm (Siemens xSPECT Quant). PTAs were divided into those with a rapid (group A) and those with a slow (group B) washout pattern. SUVmax values of PTAs and thyroid gland tissue at 10, 90 and 180 min post 99mTc-MIBI injection were recorded and statistically assessed. Retention indexes related to the early examination were calculated for PTA and thyroid gland (RI-PTA and RI-TG). RESULTS There were 11 PTAs in group A and 24 in group B. Significant between-group differences in PTA SUVmax and PTA/thyroid gland ratios were observed only at 180 min postinjection (P = 0.0297, P = 0.0222, respectively). RI-PTAs differed significantly at 90 and 180 min postinjection (P = 0.0298, P = 0.0431). No differences in PTA volumes, thyroid gland SUVmax values or RI-TG were observed between the groups. CONCLUSION PTAs with rapid and slow washout patterns have different characteristics on quantitative analysis in later phases. No significant differences in directly measurable quantitative values (SUVmax, PTA/thyroid gland ratio) at the early stages of multi-phase examination were observed.
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Affiliation(s)
| | | | | | - Martin Formanek
- Department of Otorhinolaryngology, University Hospital Ostrava and Medical Faculty, University Ostrava, Ostrava, Czech Republic
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Massari R, D’Elia A, Soluri A. Hybrid SPECT/CT. Nucl Med Mol Imaging 2022. [DOI: 10.1016/b978-0-12-822960-6.00134-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Yamane T, Takahashi M, Matsusaka Y, Fukushima K, Seto A, Kuji I, Matsunari I. Satisfied quantitative value can be acquired by short-time bone SPECT/CT using a whole-body cadmium-zinc-telluride gamma camera. Sci Rep 2021; 11:24320. [PMID: 34934145 PMCID: PMC8692318 DOI: 10.1038/s41598-021-03853-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 12/10/2021] [Indexed: 11/15/2022] Open
Abstract
The aim of this study was to evaluate the quantitative values of short-time scan (STS) of metastatic lesions compared with a standard scan (SS) when acquired by whole-body bone SPECT/CT with cadmium-zinc-telluride (CZT) detectors. We retrospectively reviewed 13 patients with bone metastases from prostate cancer, who underwent SPECT/CT performed on whole-body CZT gamma cameras. STSs were obtained using 75, 50, 25, 10, and 5% of the list-mode data for SS, respectively. Regions of interest (ROIs) were set on the increased uptake areas diagnosed as metastases. Intraclass correlation coefficients (ICCs) of standardized uptake values (SUVs) for the ROIs were calculated between the SS and each STS, and ICC ≥ 0.8 was set as a perfect correlation. Moreover, the repeatability coefficient (RC) was calculated, and RC ≤ 20% was defined as acceptable. A total of 152 metastatic lesions were included in the analysis. The ICCs between the SS vs. 75%-STS, 50%-STS, 25%-STS, 10%-STS, and 5%-STS were 0.999, 0.997, 0.994, 0.983, and 0.955, respectively. The RCs of the SS vs. 75%-STS, 50%-STS, 25%-STS, 10%-STS, and 5%-STS were 7.9, 12.4, 19.8, 30.8, and 41.3%, respectively. When evaluating the quality of CZT bone SPECT/CT acquired by a standard protocol, 25%-STS may provide adequate quantitative values.
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Affiliation(s)
- Tomohiko Yamane
- Division of Nuclear Medicine, Department of Radiology, Saitama Medical University Hospital, 38 Moro-Hongo, Moroyama, 350-0495, Japan.
- Department of Nuclear Medicine, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, 350-0491, Japan.
| | - Masafumi Takahashi
- Department of Central Radiological Technology, Saitama Medical University Hospital, 38 Moro-Hongo, Moroyama, 350-0495, Japan
| | - Yohji Matsusaka
- Department of Nuclear Medicine, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, 350-0491, Japan
| | - Kenji Fukushima
- Department of Nuclear Medicine, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, 350-0491, Japan
| | - Akira Seto
- Department of Nuclear Medicine, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, 350-0491, Japan
| | - Ichiei Kuji
- Department of Nuclear Medicine, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, 350-0491, Japan
| | - Ichiro Matsunari
- Division of Nuclear Medicine, Department of Radiology, Saitama Medical University Hospital, 38 Moro-Hongo, Moroyama, 350-0495, Japan
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Absolute Quantification in Diagnostic SPECT/CT: The Phantom Premise. Diagnostics (Basel) 2021; 11:diagnostics11122333. [PMID: 34943570 PMCID: PMC8700635 DOI: 10.3390/diagnostics11122333] [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: 11/22/2021] [Revised: 12/03/2021] [Accepted: 12/06/2021] [Indexed: 02/07/2023] Open
Abstract
The application of absolute quantification in SPECT/CT has seen increased interest in the context of radionuclide therapies where patient-specific dosimetry is a requirement within the European Union (EU) legislation. However, the translation of this technique to diagnostic nuclear medicine outside this setting is rather slow. Clinical research has, in some examples, already shown an association between imaging metrics and clinical diagnosis, but the applications, in general, lack proper validation because of the absence of a ground truth measurement. Meanwhile, additive manufacturing or 3D printing has seen rapid improvements, increasing its uptake in medical imaging. Three-dimensional printed phantoms have already made a significant impact on quantitative imaging, a trend that is likely to increase in the future. In this review, we summarize the data of recent literature to underpin our premise that the validation of diagnostic applications in nuclear medicine using application-specific phantoms is within reach given the current state-of-the-art in additive manufacturing or 3D printing.
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Ichikawa H, Onoguchi M, Shibutani T, Kato T, Ito T, Shimada H. Optimization of cross-calibration factor for quantitative bone SPECT without attenuation and scatter correction in the lumbar spine: head-to-head comparison with attenuation and scatter correction. Nucl Med Commun 2021; 42:1404-1416. [PMID: 34456319 DOI: 10.1097/mnm.0000000000001480] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVES Quantitative single-photon emission computed tomography (SPECT) with computed tomography (SPECT/CT) is known to improve diagnostic performance. Although SPECT-alone systems are used widely, accurate quantitative SPECT using these systems is challenging. This study aimed to improve the accuracy of quantitative bone SPECT of the lumbar spine with the SPECT-alone system. METHODS The cross-calibration factor (CCF) was measured using three kinds of phantoms and the optimal values were determined. The recovery coefficient with and without attenuation and scatter correction (ACSC) were compared. Bone SPECT/CT was performed on 93 consecutive patients with prostate cancer, and the standardized uptake values (SUVs) were compared using the respective CCFs. The first 60 patients were classified according to body weight, and the correlation coefficient between SUVs with and without ACSC were calculated; the slopes were defined as body weight-based coefficients (BWCs). In the remaining 33 patients, the SUV was adjusted according to BWC, and the accuracy of the adjustment was verified. RESULTS The quantitative SPECT values obtained from the CCF using SIM2 bone phantom showed nearly accurate radioactivity concentrations, even without ACSC. The recovery coefficients with and without ACSC were similar. Unadjusted SUVs with and without ACSC were strongly correlated; however, SUVs without ACSC were significantly higher than those with ACSC (P < 0.0001). The mean difference between the SUVs with and without ACSC disappeared when the SUVs without ACSC were adjusted by BWC (P = 0.9814). CONCLUSIONS Our cross-calibration method for quantitative bone SPECT enables interpretation with a harmonized SUV even in SPECT-alone systems.
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Affiliation(s)
- Hajime Ichikawa
- Department of Radiology, Toyohashi Municipal Hospital, Aichi
- Department of Quantum Medical Technology, Graduate School of Medical Sciences, Kanazawa University, Ishikawa
| | - Masahisa Onoguchi
- Department of Quantum Medical Technology, Graduate School of Medical Sciences, Kanazawa University, Ishikawa
| | - Takayuki Shibutani
- Department of Quantum Medical Technology, Graduate School of Medical Sciences, Kanazawa University, Ishikawa
| | - Toyohiro Kato
- Department of Quantum Medical Technology, Graduate School of Medical Sciences, Kanazawa University, Ishikawa
| | - Toshimune Ito
- Department of Radiological Technology, Faculty of Medical Technology, Teikyo University, Tokyo, Japan
| | - Hideki Shimada
- Department of Radiology, Toyohashi Municipal Hospital, Aichi
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Comparison between planar and single-photon computed tomography images for radiation intensity quantification in iodine-131 scintigraphy. Sci Rep 2021; 11:21858. [PMID: 34750482 PMCID: PMC8576011 DOI: 10.1038/s41598-021-01432-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 10/25/2021] [Indexed: 11/23/2022] Open
Abstract
This study aimed to evaluate the feasibility of quantifying iodine-131 (131I) accumulation in scintigraphy images and compare planar and single-photon emission computed tomography (SPECT) images to estimate 131I radioactivity in patients receiving radioactive iodine therapy for thyroid cancer. We evaluated 72 sets of planar and SPECT images acquired between February 2017 and December 2018. Simultaneously, we placed a reference 131I capsule next to the patient during image acquisition. We evaluated the correlation between the intensity of the capsule in the images and the capsule dose and estimated the radiation dose at the thyroid bed. The mean capsule dose was 2.14 MBq (range, 0.63–4.31 MBq). The correlation coefficients (p-value) between capsule dose and maximum and mean intensities in both planar and SPECT images were 0.93 (p < 0.01), 0.96 (p < 0.01), 0.60 (p < 0.01), and 0.47 (p < 0.01), respectively. The mean intensities of planar images show the highest correlation coefficients. Based on a regression equation, the average radiation dose in the thyroid bed was 5.9 MBq. In conclusion, planar images reflected the radiation dose more accurately than SPECT images. The regression equation allows to determine the dose in other regions, such as the thyroid bed or sites of distant metastasis.
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Chen EJ, Safwan Selvam HS, Tan TH, Chew MT. Quantitative analysis of xQuant reconstruction algorithm in SPECT/CT. Radiat Phys Chem Oxf Engl 1993 2021. [DOI: 10.1016/j.radphyschem.2021.109683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Doruyter AGG, Holness JL. Dual energy window imaging for optimisation of P/V ratios in VP SPECT. EJNMMI Phys 2021; 8:69. [PMID: 34655369 PMCID: PMC8520548 DOI: 10.1186/s40658-021-00417-z] [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: 01/13/2021] [Accepted: 10/01/2021] [Indexed: 11/21/2022] Open
Abstract
Purpose Ventilation–perfusion single-photon emission computed tomography (VP SPECT) plays an important role in pulmonary embolism diagnosis. Rapid results may be obtained using same-day ventilation followed by perfusion imaging, but generally requires careful attention to achieving an optimal count rate ratio (P/V ratio) of ≥ 3:1. This study investigated whether the ratio of counts simultaneously acquired in adjacent primary and Compton scatter energy windows (Eratio) on V SPECT was predictive of final normalised perfusion count rate (PCRnorm) on P SPECT using [99mTc]Tc-macroaggregated albumin (MAA), thus allowing for optimisation of P/V ratios. Methods Same-day VP SPECT studies acquired using standard protocols in adult patients during a 2-year period (training dataset) were assessed. Studies were included provided they were acquired with correct imaging parameters, and injection site imaging and laboratory records were available for quality control and normalised count rate corrections. Extraction of DICOM information, and linear regression were performed using custom Python and R scripts. A predictive tool was developed in Microsoft Excel. This tool was then validated using a second (validation) dataset of same-day studies acquired over a subsequent 7-month period. Accuracy of the prediction tool was assessed by calculating the mean absolute percentage error (MAPE). Results Of 643 studies performed, the scans of 342 participants (median age 30.4 years, 318 female) were included in the training dataset, the analysis of which yielded a significant regression equation (F(1,340) = 1057.3, p < 0.0001), with an adjusted R2 of 0.756 and MSE of 0.001089. A prediction tool designed for routine clinical use was developed for predicting final P/V ratio. Of an additional 285 studies, 198 were included in the second (validation) dataset (median age 29.7 years, 188 female). The Excel-based tool was shown to be 91% accurate (MAPE: 9%) in predicting P/V ratio. Conclusion The relationship between the ratio of simultaneously acquired counts in adjacent energy windows on V SPECT and perfusion count rate after administration of a known activity of [99mTc]Tc-MAA can be linearly approximated. A predictive tool based on this work may assist in optimising the dose and timing of [99mTc]Tc-MAA administration in same-day studies to the benefit of patients and workflows. Supplementary Information The online version contains supplementary material available at 10.1186/s40658-021-00417-z.
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Affiliation(s)
- A G G Doruyter
- NuMeRI Node for Infection Imaging, Central Analytical Facilities, Stellenbosch University, Cape Town, South Africa. .,Division of Nuclear Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
| | - J L Holness
- Nuclear Medicine Division, Department of Radiation Medicine, University of Cape Town, Cape Town, South Africa
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Nautiyal A, Jha AK, Mithun S, Sawant V, Jadhav R, Khairnar K, Rangarajan V. Normal Skeletal Standardized Uptake Values Obtained from Quantitative Single-Photon Emission Computed Tomography/Computed Tomography: Time-Dependent Study on Breast Cancer Patients. Indian J Nucl Med 2021; 36:398-411. [PMID: 35125758 PMCID: PMC8771070 DOI: 10.4103/ijnm.ijnm_47_21] [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: 04/08/2021] [Revised: 08/14/2021] [Accepted: 08/31/2021] [Indexed: 11/09/2022] Open
Abstract
Aim: To estimate the standard uptake values (SUVs) of Tc-99m methylene-diphosphonate (Tc-99m MDP) from normal skeletal sites in breast cancer patients using quantitative single-photon emission computed tomography (SPECT). Materials and Methods: A total of 60 breast cancer patients who underwent Tc-99m MDP SPECT/CT study at different postinjection acquisition times were included in this study. Based on postinjection acquisition time, patients were divided into four study groups (n_15 each), i.e. Ist (2 h), IInd (3 h), IIIrd (4 h), and IVth (5 h). Image quantification (SUVmax and SUVmean) was performed using Q.Metrix software. Delineation of volume of interest was shaped around different bones of the skeletal system. Results: The highest normal SUVmax and SUVmean values were observed in lumber and thoracic vertebra (8.89 ± 2.26 and 2.89 ± 0.58) for Group I and in pelvis and thoracic (9.6 ± 1.32 and 3.04 ± 0.64), (10.93 ± 3.91 and 3.65 ± 0.97), (11.33 ± 2.67 and 3.65 ± 0.22) for Group II, III and IV, respectively. Lowest normal SUVmax and SUVmean values were observed in humerus and ribs (3.22 ± 0.67 and 0.97 ± 0.18), (5.16 ± 1.82 and 1.18 ± 0.16) for Group I, IV, and in humerus (3.17 ± 0.58 and 0.85 ± 0.26), (3.98 ± 1.12 and 1.04 ± 0.28) for Group II and III, respectively. Significant difference (P < 0.05) noted in SUVmax for sternum, cervical, humerus, ribs, and pelvis with respect to time. However, significant difference (P < 0.05) noted in SUVmean for all skeletal sites with respect to time. Conclusions: Our study shows variability in normal SUV values for different skeletal sites in breast cancer patients. Vertebral bodies and pelvis contribute highest SUV values. Time dependency of SUVs emphasizes the usefulness of routinely acquired images at the same time after Tc-99m MDP injection, especially in follow-up studies.
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Affiliation(s)
- Amit Nautiyal
- Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Centre, Mumbai, Maharashtra, India.,Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Ashish Kumar Jha
- Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Centre, Mumbai, Maharashtra, India.,Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Sneha Mithun
- Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Centre, Mumbai, Maharashtra, India.,Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Viraj Sawant
- Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Centre, Mumbai, Maharashtra, India.,Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Raveena Jadhav
- Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Centre, Mumbai, Maharashtra, India.,Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Kranti Khairnar
- Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Centre, Mumbai, Maharashtra, India.,Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Venkatesh Rangarajan
- Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Centre, Mumbai, Maharashtra, India.,Homi Bhabha National Institute, Mumbai, Maharashtra, India
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Nakamura Y, Kangai Y, Abe T, Nakahara Y. [Improvement of Standardized Uptake Value Accuracy in the 99mTc Body SPECT and SPECT/CT: Optimization of the Phantom for Calculating Becquerel Calibration Factor and Correction Method]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2021; 77:921-931. [PMID: 34544916 DOI: 10.6009/jjrt.2021_jsrt_77.9.921] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE The purpose of this study was to evaluate the best phantom for calculating the becquerel calibration factor (BCF) and correction method to obtain the improvement of standardized uptake value (SUV) accuracy in both single photon emission computed tomography (SPECT) and SPECT/CT. METHOD A SPECT/CT scanner was used in this study. BCFs were calculated using four phantoms with different cross sections including National Electrical Manufacturers Association International Electrotechnical Commission body phantom (NEMA IEC body phantom) filled with 99mTcO4-, and five correction methods were used for reconstruction. SUVs were calculated by the NEMA IEC body phantom and pediatric phantom in house with these BCFs. We then measured SUVmean in the background region of the NEMA IEC body phantom, SUVmax and SUVpeak of the 37-mm-diameter sphere. RESULTS In the SPECT scanner, SUVmean and SUVmax measured 1.04 and 4.02, respectively, in the case of BCF calculation and SUV measurement using NEMA IEC body phantoms without corrections. In the SPECT/CT scanner, SUVmean with CT attenuation correction (AC) was in agreement with the theoretical values using each phantom. SUVmax showed the same trend. CONCLUSION In the SPECT scanner, it is possible to obtain a highly accurate SUV by using a phantom that matches the size of the subject for BCF calculation and without correction. In the SPECT/CT scanner, highly accurate SUVs can be obtained by using CT-based attenuation correction, and these values do not depend on the size of the BCF calculation phantom.
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Affiliation(s)
- Yuto Nakamura
- Department of Radiological Technology, Yamaguchi University Hospital
| | - Yoshiharu Kangai
- Department of Radiological Technology, Yamaguchi University Hospital
| | - Toshinori Abe
- Department of Radiological Technology, Kawasaki Medical School Hospital
| | - Yuki Nakahara
- Department of Radiological Technology, Yamaguchi University Hospital
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Bahloul A, Verger A, Blum A, Chawki MB, Perrin M, Melki S, Karcher G, Marie PY, Imbert L. Bone Scintigraphy of Vertebral Fractures With a Whole-Body CZT Camera in a PET-Like Utilization. FRONTIERS IN NUCLEAR MEDICINE (LAUSANNE, SWITZERLAND) 2021; 1:740275. [PMID: 39355639 PMCID: PMC11440846 DOI: 10.3389/fnume.2021.740275] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 08/04/2021] [Indexed: 10/03/2024]
Abstract
Objective: An image display with a standardized uptake value (SUV) scale is recommended for analyzing PET exams, thus requiring the reconstruction of accurate images for both SUV measurement and visual analysis. This study aimed to determine whether such images may also be obtained with a high-speed CZT-SPECT/CT system, with a further application for the longitudinal monitoring of vertebral fractures. Materials and Methods: SPECT image reconstruction was optimized with an IEC phantom according to both image quality parameters and accuracy of measured activity. The optimized reconstruction process was applied to ≤15 min 99mTc-HDP SPECT spine recordings previously acquired from 25 patients (74 ± 12 years old) at both early (1.3 ± 1.1 months) and late (5.2 ± 2.3 months) stages after an acute vertebral fracture. Results: A SPECT reconstruction with 32 equivalent iterations was selected based on the association of high detectability for spheres down to 0.6 ml in volume, with accurate measured activity, although the latter was affected by partial volume effect for spheres ≤5.6 ml. Coherent measurements were obtained on these high-quality SPECT images for the SUVmax from the intact vertebrae of patients, which were stable between basal SPECT/CT and follow-up SPECT/CT (for T1 vertebrae: 5.7 ± 1.1 vs. 5.8 ± 1.1, p = 0.76), and from initially fractured vertebrae, which were dramatically higher on the basal compared with the follow-up SPECT (21.0 ± 8.5 vs. 11.2 ± 4.2, p < 0.001), whereas inverse changes in SUVmax were observed for newly compacted fractures identified on follow-up SPECT (74.4 ± 2.0 vs. 21.8 ± 10.3, p = 0.002). Finally, an image display with an SUV scale was shown to be advantageous for highlighting areas with >7.5 SUV, a level reached by 98% of vertebral fractures of <7 months and 4% of reference intact vertebrae. Conclusion: Bone scintigraphy of vertebral fractures may be obtained with this CZT-SPECT/CT system with fast 3D acquisitions and high-quality images displayed with a reliable SUV scale, approaching what is achieved and recommended for PET imaging.
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Affiliation(s)
- Achraf Bahloul
- Université de Lorraine, CHRU-Nancy, Department of Nuclear Medicine and Nancyclotep Imaging Platform, Nancy, France
| | - Antoine Verger
- Université de Lorraine, CHRU-Nancy, Department of Nuclear Medicine and Nancyclotep Imaging Platform, Nancy, France
- Université de Lorraine, INSERM U1254, IADI, Nancy, France
| | - Alain Blum
- Université de Lorraine, CHRU-Nancy, Department of Radiology Guilloz, Nancy, France
| | - Mohammad Bilal Chawki
- Université de Lorraine, CHRU-Nancy, Department of Nuclear Medicine and Nancyclotep Imaging Platform, Nancy, France
| | - Mathieu Perrin
- Université de Lorraine, CHRU-Nancy, Department of Nuclear Medicine and Nancyclotep Imaging Platform, Nancy, France
| | - Saifeddine Melki
- Université de Lorraine, CHRU-Nancy, Department of Nuclear Medicine and Nancyclotep Imaging Platform, Nancy, France
| | - Gilles Karcher
- Université de Lorraine, CHRU-Nancy, Department of Nuclear Medicine and Nancyclotep Imaging Platform, Nancy, France
- Université de Lorraine, INSERM U1254, IADI, Nancy, France
| | - Pierre-Yves Marie
- Université de Lorraine, CHRU-Nancy, Department of Nuclear Medicine and Nancyclotep Imaging Platform, Nancy, France
- Université de Lorraine, INSERM, UMR-1116 DCAC, Nancy, France
| | - Laetitia Imbert
- Université de Lorraine, CHRU-Nancy, Department of Nuclear Medicine and Nancyclotep Imaging Platform, Nancy, France
- Université de Lorraine, INSERM U1254, IADI, Nancy, France
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Kupitz D, Wissel H, Wuestemann J, Bluemel S, Pech M, Amthauer H, Kreissl MC, Grosser OS. Optimization of SPECT/CT imaging protocols for quantitative and qualitative 99mTc SPECT. EJNMMI Phys 2021; 8:57. [PMID: 34328565 PMCID: PMC8324619 DOI: 10.1186/s40658-021-00405-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 07/13/2021] [Indexed: 11/29/2022] Open
Abstract
Background The introduction of hybrid SPECT/CT devices enables quantitative imaging in SPECT, providing a methodological setup for quantitation using SPECT tracers comparable to PET/CT. We evaluated a specific quantitative reconstruction algorithm for SPECT data using a 99mTc-filled NEMA phantom. Quantitative and qualitative image parameters were evaluated for different parametrizations of the acquisition and reconstruction protocol to identify an optimized quantitative protocol. Results The reconstructed activity concentration (ACrec) and the signal-to-noise ratio (SNR) of all examined protocols (n = 16) were significantly affected by the parametrization of the weighting factor k used in scatter correction, the total number of iterations and the sphere volume (all, p < 0.0001). The two examined SPECT acquisition protocols (with 60 or 120 projections) had a minor impact on the ACrec and no significant impact on the SNR. In comparison to the known AC, the use of default scatter correction (k = 0.47) or object-specific scatter correction (k = 0.18) resulted in an underestimation of ACrec in the largest sphere volume (26.5 ml) by − 13.9 kBq/ml (− 16.3%) and − 7.1 kBq/ml (− 8.4%), respectively. An increase in total iterations leads to an increase in estimated AC and a decrease in SNR. The mean difference between ACrec and known AC decreased with an increasing number of total iterations (e.g., for 20 iterations (2 iterations/10 subsets) = − 14.6 kBq/ml (− 17.1%), 240 iterations (24i/10s) = − 8.0 kBq/ml (− 9.4%), p < 0.0001). In parallel, the mean SNR decreased significantly from 2i/10s to 24i/10s by 76% (p < 0.0001). Conclusion Quantitative SPECT imaging is feasible with the used reconstruction algorithm and hybrid SPECT/CT, and its consistent implementation in diagnostics may provide perspectives for quantification in routine clinical practice (e.g., assessment of bone metabolism). When combining quantitative analysis and diagnostic imaging, we recommend using two different reconstruction protocols with task-specific optimized setups (quantitative vs. qualitative reconstruction). Furthermore, individual scatter correction significantly improves both quantitative and qualitative results. Supplementary Information The online version contains supplementary material available at 10.1186/s40658-021-00405-3.
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Affiliation(s)
- Dennis Kupitz
- Department of Radiology and Nuclear Medicine, University Hospital Magdeburg, Magdeburg, Germany.
| | - Heiko Wissel
- Department of Radiology and Nuclear Medicine, University Hospital Magdeburg, Magdeburg, Germany
| | - Jan Wuestemann
- Department of Radiology and Nuclear Medicine, University Hospital Magdeburg, Magdeburg, Germany
| | - Stephanie Bluemel
- Department of Nuclear Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Maciej Pech
- Department of Radiology and Nuclear Medicine, University Hospital Magdeburg, Magdeburg, Germany.,Research Campus STIMULATE, Otto-von-Guericke University, Magdeburg, Germany
| | - Holger Amthauer
- Department of Nuclear Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Michael C Kreissl
- Department of Radiology and Nuclear Medicine, University Hospital Magdeburg, Magdeburg, Germany.,Research Campus STIMULATE, Otto-von-Guericke University, Magdeburg, Germany
| | - Oliver S Grosser
- Department of Radiology and Nuclear Medicine, University Hospital Magdeburg, Magdeburg, Germany.,Research Campus STIMULATE, Otto-von-Guericke University, Magdeburg, Germany
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Dotinga M, Vriens D, van Velden F, Heijmen L, Nagarajah J, Hicks R, Kapiteijn E, de Geus-Oei LF. Managing radioiodine refractory thyroid cancer: the role of dosimetry and redifferentiation on subsequent I-131 therapy. 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 RADIOPHARMACEUTICAL CHEMISTRY AND BIOLOGY 2021; 64:250-264. [PMID: 32744039 DOI: 10.23736/s1824-4785.20.03264-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Poor responses to iodine-131 (I-131) therapy can relate to either low iodine uptake and retention in thyroid cancer cells or to increased radioresistance. Both mechanisms are currently termed radioactive iodine (RAI)-refractory (RAI-R) thyroid cancer but the first reflects unsuitability for I-131 therapy that can be evaluated in advance of treatment, whereas the other can only be identified post hoc. Management of both represents a considerable challenge in clinical practice as failure of I-131 therapy, the most effective treatment of metastatic thyroid cancer, is associated with a poor overall prognosis. The development of targeted therapies has shown substantial promise in the treatment of RAI-R thyroid cancer in progressive patients. Recent studies show that selective tyrosine kinase inhibitors (TKIs) targeting B-type rapidly accelerated fibrosarcoma kinase (BRAF) and mitogen-activated protein kinase (MEK) can be used as redifferentiation agents to re-induce RAI uptake, thereby (re)enabling I-131 therapy. The use of dosimetry prior- and post-TKI treatment can assist in quantifying RAI uptake and improve identification of patients that will benefit from I-131 therapy. It also potentially offers the prospect of calculating individualized therapeutic administered activities to enhance efficacy and limit toxicity. In this review, we present an overview of the regulation of RAI uptake and clinically investigated redifferentiation agents, both reimbursed and in experimental setting, that induce renewed RAI uptake. We describe the role of dosimetry in redifferentiation and subsequent I-131 therapy in RAI-R thyroid cancer, explain different dosimetry approaches and discuss limitations and considerations in the field.
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Affiliation(s)
- Maaike Dotinga
- Section of Nuclear Medicine, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands -
| | - Dennis Vriens
- Section of Nuclear Medicine, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Floris van Velden
- Section of Nuclear Medicine, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Linda Heijmen
- Section of Nuclear Medicine, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - James Nagarajah
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, the Netherlands.,Department of Nuclear Medicine, Technical University Munich, Munich, Germany
| | - Rodney Hicks
- Department of Molecular Imaging, Peter MacCallum Cancer Center, Melbourne, VIC, Australia
| | - Ellen Kapiteijn
- Department of Medical Oncology, Leiden University Medical Center, Leiden, the Netherlands
| | - Lioe-Fee de Geus-Oei
- Section of Nuclear Medicine, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands.,Biomedical Photonic Imaging Group, University of Twente, Enschede, the Netherlands
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Abdelhafez YG, Godinez F, Sood K, Hagge RJ, Boutin RD, Raychaudhuri SP, Badawi RD, Chaudhari AJ. Feasibility of dual-phase 99mTc-MDP SPECT/CT imaging in rheumatoid arthritis evaluation. Quant Imaging Med Surg 2021; 11:2333-2343. [PMID: 34079705 DOI: 10.21037/qims-20-996] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Background To prospectively demonstrate the feasibility of performing dual-phase SPECT/CT for the assessment of the small joints of the hands of rheumatoid arthritis (RA) patients, and to evaluate the reliability of the quantitative and qualitative measures derived from the resulting images. Methods A SPECT/CT imaging protocol was developed in this pilot study to scan both hands simultaneously in participants with RA, in two phases of 99mTc-MDP radiotracer uptake, namely the soft-tissue blood pool phase (within 15 minutes after radiotracer injection) and osseous phase (after 3 hours). Joints were evaluated qualitatively (normal vs. abnormal uptake) and quantitatively [by measuring a newly developed metric, maximum corrected count ratio (MCCR)]. Qualitative and quantitative evaluations were repeated to assess reliability. Results Four participants completed seven studies (all four were imaged at baseline, and three of them at follow-up after 1-month of arthritis therapy). A total of 280 joints (20 per hand) were evaluated. The MCCR from soft-tissue phase scans was significantly higher for clinically abnormal joints compared to clinically normal ones; P<0.001, however the MCCR from the osseous phase scans were not different between the two joint groups. Intraclass Correlation Coefficient (ICC) for MCCR was excellent [0.9789, 95% confidence interval (CI): 0.9734-0.9833]. Intra-observer agreement for qualitative SPECT findings was substantial for both the soft-tissue phase (kappa =0.78, 95% CI: 0.72-0.83) and osseous-phase (kappa =0.70, 95% CI: 0.64-0.76) scans. Conclusions Extracting reliable quantitative and qualitative measures from dual-phase 99mTc-MDP SPECT/CT hand scans is feasible in RA patients. SPECT/CT may provide a unique means for assessing both synovitis and osseous involvement in RA joints using the same radiotracer injection.
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Affiliation(s)
- Yasser G Abdelhafez
- Department of Radiology, University of California Davis, Sacramento, CA, USA.,Nuclear Medicine Unit, South Egypt Cancer Institute, Assiut University, Assiut, Egypt
| | - Felipe Godinez
- Department of Radiology, University of California Davis, Sacramento, CA, USA.,School of Biomedical Engineering and Imaging Science, King's College, London, UK
| | - Kanika Sood
- Rheumatology Section, Sacramento Veterans Affairs Medical Center, Mather, CA, USA
| | - Rosalie J Hagge
- Department of Radiology, University of California Davis, Sacramento, CA, USA
| | - Robert D Boutin
- Department of Radiology, University of California Davis, Sacramento, CA, USA.,Department of Radiology, Stanford University, Stanford, CA, USA
| | - Siba P Raychaudhuri
- Rheumatology Section, Sacramento Veterans Affairs Medical Center, Mather, CA, USA.,Department of Internal Medicine, University of California Davis, Sacramento, CA, USA
| | - Ramsey D Badawi
- Department of Radiology, University of California Davis, Sacramento, CA, USA
| | - Abhijit J Chaudhari
- Department of Radiology, University of California Davis, Sacramento, CA, USA
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Miyaji N, Miwa K, Motegi K, Yamashita K, Terauchi T, Onoguchi M. Patient arm position during quantitative bone single-photon emission computed tomography/computed tomography acquisition can affect image quality and quantitative accuracy: a phantom study. Nucl Med Commun 2021; 42:267-275. [PMID: 33323866 DOI: 10.1097/mnm.0000000000001338] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE The present study used a phantom to determine the effects of various arm positions on bone SPECT/computed tomography (CT) images and the optimal arm position to acquire good-quality and quantitatively accurate images. MATERIALS AND METHODS We designed a phantom study of five simulated arm positions that are assumed during SPECT image acquisition. All SPECT data were acquired during a total of 120 projections of 10 and 100 s/view over 360° in a non-circular mode and reconstructed using Flash 3D (Siemens Healthineers). We evaluated contrast (QH,17 mm), image noise (NB,17 mm), contrast-to-noise ratios (QNRs), and visual scores according to the guidelines for bone SPECT acquisition protocols published by the Japanese Society of Nuclear Medicine Technology. The SUVmean, SUVmax, and SUVpeak were calculated and quantitative errors were evaluated using the recovery coefficient (RC) and the root means square error (RMSE). RESULTS The spatial resolution of SPECT images was better when the arms were down than raised with simulated shoulder disorders. Raised arms with shoulder disorders significantly increased the NB,17 mm and decreased the QH,17 mm, and the QNR in each image differed over a range from 2.2 to 5.2. The visual score was >1.5 with the arms down, raised normally, and raised with moderate shoulder disorders. The SUVmax and SUVpeak were overestimated compared with 100-min data for all images, whereas SUVmean was underestimated. Raised arms with a shoulder disorder decreased RCmax, and RCmean and RCpeak suppressed differences among arm positions. In addition, RMSE with the arms down and raised normally were close to that for 100-min data. CONCLUSION Bone SPECT images with good quality and quantitative accuracy can be acquired with patients holding their arms down by their sides. This will help patients with shoulder pain who have difficulties raising their arms.
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Affiliation(s)
- Noriaki Miyaji
- Department of Nuclear Medicine, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo
- Department of Quantum Medical Technology, Institute of Medical Pharmaceutical and Health Sciences, Kanazawa University, Ishikawa
| | - Kenta Miwa
- Department of Radiological Sciences, School of Health Science, International University of Health and Welfare, Tochigi, Japan
| | - Kazuki Motegi
- Department of Nuclear Medicine, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo
| | - Kosuke Yamashita
- Department of Nuclear Medicine, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo
| | - Takashi Terauchi
- Department of Nuclear Medicine, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo
| | - Masahisa Onoguchi
- Department of Quantum Medical Technology, Institute of Medical Pharmaceutical and Health Sciences, Kanazawa University, Ishikawa
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Hao G, Mastren T, Silvers W, Hassan G, Öz OK, Sun X. Copper-67 radioimmunotheranostics for simultaneous immunotherapy and immuno-SPECT. Sci Rep 2021; 11:3622. [PMID: 33574346 PMCID: PMC7878802 DOI: 10.1038/s41598-021-82812-1] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 01/22/2021] [Indexed: 02/01/2023] Open
Abstract
Copper-67 (t1/2 = 2.58 days) decays by β- ([Formula: see text]: 562 keV) and γ-rays (93 keV and 185 keV) rendering it with potential for both radionuclide therapy and single-photon emission computed tomography (SPECT) imaging. Prompted by the recent breakthrough of 67Cu production with high specific activity, high radionuclidic purity, and sufficient quantities, the interest in the theranostic potential of 67Cu has been rekindled. This work addresses the practicability of developing 67Cu-labeled antibodies with substantially improved quality for cancer radioimmunotheranostics. Proof of concept is demonstrated with pertuzumab, a US-FDA-approved monoclonal antibody for combination therapies of HER2-positive breast cancer. With an average number of 1.9 chelators coupled to each antibody, we achieved a two-order of magnitude increase in radiolabeling efficiency compared to literature reports. In a preclinical therapeutic study, mice (n = 4-7/group) bearing HER2+ xenografts exhibited a 67Cu-dose dependent tumor-growth inhibition from 67Cu-labeled-Pertuzumab co-administered with trastuzumab. Furthermore, greater tumor size reduction was observed with 67Cu-labeled-pertuzumab formulations of higher specific activity. The potential of SPECT imaging with 67Cu radiopharmaceuticals was tested after 67Cu-labeled-Pertuzumab administration. Impressively, all tumors were clearly visualized by SPECT imaging with 67Cu-labeled-Pertuzumab even at day 5 post injection. This work demonstrates it is practical to use 67Cu radioimmunoconjugates for cancer radioimmunotheranostics.
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Affiliation(s)
- Guiyang Hao
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, 75390, USA
| | - Tara Mastren
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, 75390, USA
| | - William Silvers
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, 75390, USA
| | - Gedaa Hassan
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, 75390, USA
| | - Orhan K Öz
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, 75390, USA
| | - Xiankai Sun
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, 75390, USA.
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX, 75390, USA.
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Picone V, Makris N, Boutevin F, Roy S, Playe M, Soussan M. Clinical validation of time reduction strategy in continuous step-and-shoot mode during SPECT acquisition. EJNMMI Phys 2021; 8:10. [PMID: 33532876 PMCID: PMC7855188 DOI: 10.1186/s40658-021-00354-x] [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: 02/28/2020] [Accepted: 01/05/2021] [Indexed: 12/02/2022] Open
Abstract
Background The SwiftScan solution (General Electric Healthcare) combines a new low-energy high-resolution sensitivity collimator and a tomographic step-and-shoot continuous (SSC) mode acquisition. The purpose of this study is to determine whether SSC mode can be used in clinical practice with shorter examination times, while preserving image quality and ensuring accurate semi-quantification. Twenty bone scan and 10 lung scan studies were randomly selected over a period of 2 months. Three sets of image datasets were produced: step-and-shoot (SS) acquisition, simulated 25% count reduction using the Poisson resampling method (SimSS), and SimSS continuous acquisition (SimSSC), where SimSS was summed with counts acquired during detector head rotation. Visual assessment (5-point Likert scale, 2 readers) and semi-quantitative evaluation (50 focal uptake from 10 bone studies), assessed by SUVmean, coefficient of variation (COV), and contrast-to-noise ratio (CNR), were performed using t test and Bland-Altman analysis. Results Intra-reader agreement was substantial for reader 1 (k = 0.71) and for reader 2 (k = 0.61). Inter-reader agreement was substantial for SS set (k = 0.93) and moderate for SimSSC (k = 0.52). Bland-Altman analysis showed a good interchangeability of SS and SimSSC SUV values. The mean CNR between SS and SimSSC was not significantly different: 42.9 ± 43.7 [23.7–62.1] vs. 43.1 ± 46 [22.9–63.3] (p = 0.46), respectively. COV values, assessing noise level, did not deviate significantly between SS and SimSSC: 0.20 ± 0.08 [0.18–0.23] vs. 0.21 ± 0.08, [0.18–0.23] (p = 0.15), respectively, whereas a significant difference was demonstrated between SS and SimSS: 0.20 ± 0.08 [0.18–0.23] vs. 0.23 ± 0.09 [0.20–0.25] (p < 0.0001), respectively. Conclusions SSC mode acquisition decreases examination time by approximately 25% in bone and lung SPECT/CT studies compared to SS mode (~ 2 min per single-bed SPECT), without compromising image quality and signal quantification. This SPECT sensitivity improvement also offers the prospect of more comfortable exams, with less motion artifacts, especially in painful or dyspneic patients.
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Affiliation(s)
| | | | - Fanny Boutevin
- GE Healthcare, 78530, 283 Rue de la Miniere, Buc, France
| | - Sarah Roy
- GE Healthcare, 78530, 283 Rue de la Miniere, Buc, France
| | - Margot Playe
- Department of Nuclear Medicine, Avicenne Hospital, HUPSSD, APHP, Paris, France
| | - Michael Soussan
- Department of Nuclear Medicine, Avicenne Hospital, HUPSSD, APHP, Paris, France. .,Inserm, Institut Curie, Laboratoire d'Imagerie Translationnelle en Oncologie, Orsay, France.
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46
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Aldridge MD, Peet C, Wan S, Shankar A, Gains JE, Bomanji JB, Gaze MN. Paediatric Molecular Radiotherapy: Challenges and Opportunities. Clin Oncol (R Coll Radiol) 2021; 33:80-91. [PMID: 33246658 DOI: 10.1016/j.clon.2020.11.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 09/17/2020] [Accepted: 11/12/2020] [Indexed: 12/18/2022]
Abstract
The common contemporary indications for paediatric molecular radiotherapy (pMRT) are differentiated thyroid cancer and neuroblastoma. It may also have value in neuroendocrine cancers, and it is being investigated in clinical trials for other diseases. pMRT is the prototypical biomarker-driven, precision therapy, with a unique mode of delivery and mechanism of action. It is safe and well tolerated, compared with other treatments. However, its full potential has not yet been achieved, and its wider use faces a number of challenges and obstacles. Paradoxically, the success of radioactive iodine as a curative treatment for metastatic thyroid cancer has led to a 'one size fits all' approach and limited academic enquiry into optimisation of the conventional treatment regimen, until very recently. Second, the specialised requirements for the delivery of pMRT are available in only a very limited number of centres. This limited capacity and geographical coverage results in reduced accessibility. With few enthusiastic advocates for this treatment modality, investment in research to improve treatments and broaden indications from both industry and national and charitable research funders has historically been suboptimal. Nonetheless, there is now an increasing interest in the opportunities offered by pMRT. Increased research funding has been allocated, and technical developments that will permit innovative approaches in pMRT are available for exploration. A new portfolio of clinical trials is being assembled. These studies should help to move at least some paediatric treatments from simply palliative use into potentially curative protocols. Therapeutic strategies require modification and optimisation to achieve this. The delivery should be personalised and tailored appropriately, with a comprehensive evaluation of tumour and organ-at-risk dosimetry, in alignment with the external beam model of radiotherapy. This article gives an overview of the current status of pMRT, indicating the barriers to progress and identifying ways in which these may be overcome.
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Affiliation(s)
- M D Aldridge
- Department of Oncology, University College London Hospitals NHS Foundation Trust, London, UK; Department of Nuclear Medicine, University College London Hospitals NHS Foundation Trust, London, UK
| | - C Peet
- Department of Oncology, University College London Hospitals NHS Foundation Trust, London, UK
| | - S Wan
- Department of Nuclear Medicine, University College London Hospitals NHS Foundation Trust, London, UK
| | - A Shankar
- Department of Paediatric and Adolescent Oncology, University College London Hospitals NHS Foundation Trust, London, UK
| | - J E Gains
- Department of Oncology, University College London Hospitals NHS Foundation Trust, London, UK
| | - J B Bomanji
- Department of Nuclear Medicine, University College London Hospitals NHS Foundation Trust, London, UK
| | - M N Gaze
- Department of Nuclear Medicine, University College London Hospitals NHS Foundation Trust, London, UK.
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47
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SPECT and SPECT/CT. Mol Imaging 2021. [DOI: 10.1016/b978-0-12-816386-3.00008-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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48
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Craig AJ, Rojas B, Wevrett JL, Hamer E, Fenwick A, Gregory R. IPEM topical report: current molecular radiotherapy service provision and guidance on the implications of setting up a dosimetry service. Phys Med Biol 2020; 65:245038. [PMID: 33142274 DOI: 10.1088/1361-6560/abc707] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Despite a growth in molecular radiotherapy treatment (MRT) and an increase in interest, centres still rarely perform MRT dosimetry. The aims of this report were to assess the main reasons why centres are not performing MRT dosimetry and provide advice on the resources required to set-up such a service. A survey based in the United Kingdom was developed to establish how many centres provide an MRT dosimetry service and the main reasons why it is not commonly performed. Twenty-eight per cent of the centres who responded to the survey performed some form of dosimetry, with 88% of those centres performing internal dosimetry. The survey showed that a 'lack of clinical evidence', a 'lack of guidelines' and 'not current UK practice' were the largest obstacles to setting up an MRT dosimetry service. More practical considerations, such as 'lack of software' and 'lack of staff training/expertise', were considered to be of lower significance by the respondents. Following on from the survey, this report gives an overview of the current guidelines, and the evidence available demonstrating the benefits of performing MRT dosimetry. The resources required to perform such techniques are detailed with reference to guidelines, training resources and currently available software. It is hoped that the information presented in this report will allow MRT dosimetry to be performed more frequently and in more centres, both in routine clinical practice and in multicentre trials. Such trials are required to harmonise dosimetry techniques between centres, build on the current evidence base, and provide the data necessary to establish the dose-response relationship for MRT.
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Affiliation(s)
- Allison J Craig
- Joint Department of Physics, Royal Marsden NHSFT, Sutton, United Kingdom. The Institute of Cancer Research, London, United Kingdom. Author to whom any correspondence should be addressed
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Davis KM, Ryan JL, Aaron VD, Sims JB. PET and SPECT Imaging of the Brain: History, Technical Considerations, Applications, and Radiotracers. Semin Ultrasound CT MR 2020; 41:521-529. [PMID: 33308491 DOI: 10.1053/j.sult.2020.08.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Advances in nuclear medicine have revolutionized our ability to accurately diagnose patients with a wide array of neurologic pathologies and provide appropriate therapy. The development of new radiopharmaceuticals has made possible the identification of regional differences in brain tissue composition and metabolism. In addition, the evolution of 3-dimensional molecular imaging followed by fusion with computed tomography and magnetic resonance imaging have allowed for more precise localization of pathologies. This review will introduce single photon emission computed tomography and positron emission tomographic imaging of the brain, including the history of their development, technical considerations, and a brief overview of pertinent radiopharmaceuticals and their applications.
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Affiliation(s)
- Korbin M Davis
- Indiana University School of Medicine, Department of Radiology and Imaging Sciences, Indianapolis, IN.
| | - Joshua L Ryan
- Indiana University School of Medicine, Department of Radiology and Imaging Sciences, Indianapolis, IN
| | - Vasantha D Aaron
- Indiana University School of Medicine, Department of Radiology and Imaging Sciences, Indianapolis, IN
| | - Justin B Sims
- Indiana University School of Medicine, Department of Radiology and Imaging Sciences, Indianapolis, IN
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50
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Zhang YD, Dong Z, Wang SH, Yu X, Yao X, Zhou Q, Hu H, Li M, Jiménez-Mesa C, Ramirez J, Martinez FJ, Gorriz JM. Advances in multimodal data fusion in neuroimaging: Overview, challenges, and novel orientation. AN INTERNATIONAL JOURNAL ON INFORMATION FUSION 2020; 64:149-187. [PMID: 32834795 PMCID: PMC7366126 DOI: 10.1016/j.inffus.2020.07.006] [Citation(s) in RCA: 121] [Impact Index Per Article: 30.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 07/06/2020] [Accepted: 07/14/2020] [Indexed: 05/13/2023]
Abstract
Multimodal fusion in neuroimaging combines data from multiple imaging modalities to overcome the fundamental limitations of individual modalities. Neuroimaging fusion can achieve higher temporal and spatial resolution, enhance contrast, correct imaging distortions, and bridge physiological and cognitive information. In this study, we analyzed over 450 references from PubMed, Google Scholar, IEEE, ScienceDirect, Web of Science, and various sources published from 1978 to 2020. We provide a review that encompasses (1) an overview of current challenges in multimodal fusion (2) the current medical applications of fusion for specific neurological diseases, (3) strengths and limitations of available imaging modalities, (4) fundamental fusion rules, (5) fusion quality assessment methods, and (6) the applications of fusion for atlas-based segmentation and quantification. Overall, multimodal fusion shows significant benefits in clinical diagnosis and neuroscience research. Widespread education and further research amongst engineers, researchers and clinicians will benefit the field of multimodal neuroimaging.
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Affiliation(s)
- Yu-Dong Zhang
- School of Informatics, University of Leicester, Leicester, LE1 7RH, Leicestershire, UK
- Department of Information Systems, Faculty of Computing and Information Technology, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Zhengchao Dong
- Department of Psychiatry, Columbia University, USA
- New York State Psychiatric Institute, New York, NY 10032, USA
| | - Shui-Hua Wang
- Department of Information Systems, Faculty of Computing and Information Technology, King Abdulaziz University, Jeddah 21589, Saudi Arabia
- School of Architecture Building and Civil engineering, Loughborough University, Loughborough, LE11 3TU, UK
- School of Mathematics and Actuarial Science, University of Leicester, LE1 7RH, UK
| | - Xiang Yu
- School of Informatics, University of Leicester, Leicester, LE1 7RH, Leicestershire, UK
| | - Xujing Yao
- School of Informatics, University of Leicester, Leicester, LE1 7RH, Leicestershire, UK
| | - Qinghua Zhou
- School of Informatics, University of Leicester, Leicester, LE1 7RH, Leicestershire, UK
| | - Hua Hu
- Department of Psychiatry, Columbia University, USA
- Department of Neurology, The Second Affiliated Hospital of Soochow University, China
| | - Min Li
- Department of Psychiatry, Columbia University, USA
- School of Internet of Things, Hohai University, Changzhou, China
| | - Carmen Jiménez-Mesa
- Department of Signal Theory, Networking and Communications, University of Granada, Granada, Spain
| | - Javier Ramirez
- Department of Signal Theory, Networking and Communications, University of Granada, Granada, Spain
| | - Francisco J Martinez
- Department of Signal Theory, Networking and Communications, University of Granada, Granada, Spain
| | - Juan Manuel Gorriz
- Department of Signal Theory, Networking and Communications, University of Granada, Granada, Spain
- Department of Psychiatry, University of Cambridge, Cambridge CB21TN, UK
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