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Tan Z, Mei H, Qin C, Zhang X, Yang M, Zhang L, Wang J. The diagnostic value of dual-layer CT in the assessment of lymph nodes in lymphoma patients with PET/CT as a reference standard. Sci Rep 2023; 13:18323. [PMID: 37884597 PMCID: PMC10603090 DOI: 10.1038/s41598-023-45198-w] [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: 04/05/2023] [Accepted: 10/17/2023] [Indexed: 10/28/2023] Open
Abstract
This study aimed to evaluate the diagnostic performances of dual-layer CT (DLCT) for the identification of positive lymph nodes (LNs) in patients with lymphoma and retrospectively included 1165 LNs obtained by biopsy from 78 patients with histologically proven lymphoma, who underwent both pretreatment DLCT and 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT). According to 18F-FDG PET/CT findings as a reference standard, cases were categorized into the LN-negative and LN-positive groups. LNs were then randomly divided at a ratio of 7:3 into the training (n = 809) and validation (n = 356) cohorts. The patients' clinical characteristics and quantitative parameters including spectral curve slope (λHU), iodine concentration (IC) on arterial phase (AP) and venous phase (VP) images were compared between the LN-negative and LN-positive groups using Chi-square test, t-test or Mann-Whitney U test for categorical variables or quantitative parameters. Multivariate logistic regression analysis with tenfold cross-validation was performed to establish the most efficient predictive model in the training cohort. The area under the curve (AUC) was used to evaluate the diagnostic value of the predictive model, and differences in AUC were determined by the DeLong test. Moreover, the predictive model was validated in the validation cohort. Repeatability analysis was performed for LNs using intraclass correlation coefficients (ICCs). In the training cohort, long diameter (LD) had the highest AUC as an independent factors compared to other parameter in differentiating LN positivity from LN negativity (p = 0.006 to p < 0.001), and the AUC of predictive model jointly involving LD and λHU-AP was significantly elevated (AUC of 0.816, p < 0.001). While the AUC of predictive model in the validation cohort was 0.786. Good to excellent repeatability was observed for all parameters (ICC > 0.75). The combination of DLCT with morphological and functional parameters may represent a potential imaging biomarker for detecting LN positivity in lymphoma.
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Affiliation(s)
- Zhengwu Tan
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, No 1277, Jiefang Avenue, Wuhan, Hubei, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, Hubei, China
| | - Heng Mei
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Chunxia Qin
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
- Hubei Key Laboratory of Molecular Imaging, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Xiao Zhang
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
- Hubei Key Laboratory of Molecular Imaging, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Ming Yang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, No 1277, Jiefang Avenue, Wuhan, Hubei, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, Hubei, China
| | - Lan Zhang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, No 1277, Jiefang Avenue, Wuhan, Hubei, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, Hubei, China
| | - Jing Wang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, No 1277, Jiefang Avenue, Wuhan, Hubei, China.
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, Hubei, China.
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Ju N, Nie L, Wang Y, Hou L, Li C, Ding X, Luo Q, Shen C. Predicting 18F-FDG SUVs of metastatic pulmonary nodes from CT images in patients with differentiated thyroid cancer by using a convolutional neural network. Front Endocrinol (Lausanne) 2023; 14:1127741. [PMID: 37214240 PMCID: PMC10194030 DOI: 10.3389/fendo.2023.1127741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 04/04/2023] [Indexed: 05/24/2023] Open
Abstract
Purpose The aim of this study was to predict standard uptake values (SUVs) from computed tomography (CT) images of patients with lung metastases from differentiated thyroid cancer (DTC-LM). Methods We proposed a novel SUVs prediction model using 18-layer Residual Network for generating SUVmax, SUVmean, SUVmin of metastatic pulmonary nodes from CT images of patients with DTC-LM. Nuclear medicine specialists outlined the metastatic pulmonary as primary set. The best model parameters were obtained after five-fold cross-validation on the training and validation set, further evaluated in independent test set. Mean absolute error (MAE), mean squared error (MSE), and mean relative error (MRE) were used to assess the performance of regression task. Specificity, sensitivity, F1 score, positive predictive value, negative predictive value and accuracy were used for classification task. The correlation between predicted and actual SUVs was analyzed. Results A total of 3407 nodes from 74 patients with DTC-LM were collected in this study. On the independent test set, the average MAE, MSE and MRE was 0.3843, 1.0133, 0.3491 respectively, and the accuracy was 88.26%. Our proposed model achieved high metric scores (MAE=0.3843, MSE=1.0113, MRE=34.91%) compared with other backbones. The predicted SUVmax (R2 = 0.8987), SUVmean (R2 = 0.8346), SUVmin (R2 = 0.7373) were all significantly correlated with actual SUVs. Conclusion The novel approach proposed in this study provides new ideas for the application of predicting SUVs for metastatic pulmonary nodes in DTC patients.
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Affiliation(s)
- Nianting Ju
- Department of Nuclear Medicine, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Liangbing Nie
- School of Computer Engineering and Science, Shanghai University, Shanghai, China
| | - Yang Wang
- Department of Nuclear Medicine, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Liying Hou
- Department of Nuclear Medicine, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chengfan Li
- School of Computer Engineering and Science, Shanghai University, Shanghai, China
| | - Xuehai Ding
- School of Computer Engineering and Science, Shanghai University, Shanghai, China
| | - Quanyong Luo
- Department of Nuclear Medicine, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chentian Shen
- Department of Nuclear Medicine, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Wang Y, Chen Y, Liu P, Lv W, Wu J, Wei M, Shi D, Wu X, Liu W, Tao X, Hu H, Ma X, Yang X, Xue H, Jin Z. Clinical effectiveness of contrast medium injection protocols for 80-kV coronary and craniocervical CT angiography-a prospective multicenter observational study. Eur Radiol 2022; 32:3808-3818. [PMID: 35103828 DOI: 10.1007/s00330-021-08505-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 10/22/2021] [Accepted: 12/04/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND OBJECTIVE Decreasing X-ray tube voltage is an effective way to reduce radiation and contrast dose, especially in non-obese patients. The current study focuses on CTA in non-obese patients to evaluate image quality and feasibility of 80-kV acquisition protocols with varying iodine delivery rates (IDR) and contrast concentrations in routine clinical practice. METHODS A prospective observational study in patients ≥ 18 years and ≤ 90 kg referred for coronary or craniocervical CTA at 10 centers in China (ClinicalTrials.gov: NCT02840903). Patients were divided into four groups: a standard 100-kV protocol (370 mgI/ml, IDR 1.48 gI/s), and three 80-kV protocols (370 mgI/ml, IDR 1.2 gI/s; 300 mgI/ml, IDR 1.2 gI/s; 300 mgI/ml, IDR 0.96gI/s). The primary outcome was contrast opacification of target vascular segments. Secondary outcomes were image quality (contrast-to-noise ratio, signal-to-noise ratio, visual image quality, and diagnostic confidence assessment), radiation, and iodine dose. RESULTS From July 2016 to July 2017, 1213 patients were enrolled: 614 coronary and 599 craniocervical CTA. The mean contrast opacification was ≥ 300 HU for 80-kV 1.2 gI/s IDR scanned segments; IDR 0.96 gI/s led to lower opacification. Image quality and diagnostic confidence were fair to excellent (≥ 98% of images), despite lower contrast-to-noise ratios and signal-to-noise ratios in 80-kV images. Compared to the standard protocol, 80-kV protocols led to 44-52% radiation dose reductions (p < 0.001) and 19% iodine dose reductions (p < 0.001). CONCLUSION Eighty-kilovolt 1.2 gI/s IDR protocols can be recommended for coronary and craniocervical CTA in non-obese patients, reducing radiation and iodine dose without compromising image quality. KEY POINTS • Using low-voltage scanning CTA protocols, in which tube voltage and iodine delivery rate are reduced proportionally (voltage: 80 kV, IDR: 1.2 gI/s), reduces radiation and contrast dose without compromising image quality in routine clinical practice. • Reducing iodine delivery rate beyond direct proportionality to tube voltage is not beneficial.
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Affiliation(s)
- Yining Wang
- Peking Union Medical College Hospital, Shuaifuyan Wangfujing District, Beijing, 100730, China
| | - Yu Chen
- Peking Union Medical College Hospital, Shuaifuyan Wangfujing District, Beijing, 100730, China
| | - Peijun Liu
- Peking Union Medical College Hospital, Shuaifuyan Wangfujing District, Beijing, 100730, China
| | - Wan Lv
- The First People's Hospital of Yulin, # 495, JiaoYu Central Road, Yulin, 537000, Guangxi, China
| | - Jianlin Wu
- Affiliated Zhongshan Hospital of Dalian University, # 6, Jiefang Road Zhongshan District, Dalian, 116001, Liaoning, China
| | - Mengqi Wei
- The First Affiliated Hospital of Air Force Medical University, # 15 Changle West Road, Xian, 710032, Shanxi, China
| | - Dapeng Shi
- Henan Provincial People's Hospital, # 7, Weiwu Road, Zhengzhou, 450000, Henan, China
| | - Xianheng Wu
- The Second People's Hospital of Shantou, # 28, Waimalu Road, Shantou, 515031, Guangdong, China
| | - Wenya Liu
- The First Affiliated Hospital of Xinjiang Medical University, # 137, Liyushan South Road, Urumqi, 830054, Xinjiang, China
| | - Xiaofeng Tao
- Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, # 639, Zaoju Road, Shanghai, 200011, China
| | - Hongjie Hu
- Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, 3 Qinchun East Road, Hangzhou, 310016, Zhejiang, China
| | - Xiangxing Ma
- Qilu Hospital of Shandong University (Qingdao), North District, # 758, Hefei Road, Qingdao, 266035, Shandong, China
| | - Xiaozheng Yang
- Medical Affairs, Bayer Healthcare Co. Ltd, Dongshanhuan Central Road, Beijing, 100010, China
| | - Huadan Xue
- Peking Union Medical College Hospital, Shuaifuyan Wangfujing District, Beijing, 100730, China
| | - Zhengyu Jin
- Peking Union Medical College Hospital, Shuaifuyan Wangfujing District, Beijing, 100730, China.
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Gee AD, Andersson J, Bhalla R, Choe YS, Dick DW, Herth MM, Hostetler ED, Jáuregui-Haza UJ, Huang YY, James ML, Jeong JM, Korde A, Kuge Y, Kung HF, Lapi SE, Osso JA, Parent E, Patt M, Pricile EF, Riss PJ, Santos-Oliveira R, Taylor S, Vasdev N, Vercouillie J, Wadsak W, Yang Z, Zhu H, Scott PJH. Training the next generation of radiopharmaceutical scientists. Nucl Med Biol 2020; 88-89:10-13. [PMID: 32650289 DOI: 10.1016/j.nucmedbio.2020.06.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 06/04/2020] [Accepted: 06/10/2020] [Indexed: 10/24/2022]
Affiliation(s)
- Antony D Gee
- Department of Imaging Chemistry and Biology, School of Biomedical Engineering and Imaging Sciences, King's College London, Lambeth Palace Rd, London SE1 7EH, UK.
| | - Jan Andersson
- Edmonton Radiopharmaceutical Centre & Cyclotron, Diagnostic Imaging, Alberta Health Services, Canada
| | - Rajiv Bhalla
- Centre for Advanced Imaging, The University of Queensland, St Lucia, Brisbane, Queensland 4072, Australia
| | - Yearn Seong Choe
- Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea
| | - David W Dick
- Department of Radiology, University of Iowa, Iowa City, IA 52242, USA
| | - Matthias M Herth
- Department of Drug Design and Pharmacology, University of Copenhagen, Jagtvej 162, 2100 Copenhagen, Denmark; Department of Clinical Physiology, Nuclear Medicine & PET, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | | | - Ulises J Jáuregui-Haza
- Instituto Tecnológico de Santo Domingo, Av. de Los Próceres #49,10602, Santo Domingo, Dominican Republic
| | - Ya-Yao Huang
- Institute of Medical Device and Imaging, National Taiwan University College of Medicine, No.1, Jen Ai Road Section 1, Taipei 100, Taiwan
| | - Michelle L James
- Department of Radiology, Molecular Imaging Program at Stanford, Stanford University, 1201 Welch Rd, Palo Alto, CA 94305, USA; Department of Neurology and Neurological Sciences, Stanford University, 1201 Welch Rd, Palo Alto, CA 94305, USA
| | - Jae Min Jeong
- Department of Nuclear Medicine, Institute of Radiation Medicine, Seoul National University College of Medicine, Republic of Korea; Cancer Research Institute, Seoul National University College of Medicine, Republic of Korea; Department of Nuclear Medicine, Seoul National University Hospital, Republic of Korea
| | - Aruna Korde
- Radioisotope Products and Radiation Technology Section, Division of Physical and Chemical Sciences, Department of Nuclear Sciences and Applications, International Atomic Energy Agency, Vienna International Centre, PO Box 100, 1400 Vienna, Austria
| | - Yuji Kuge
- Central Institute of Isotope Science, Hokkaido University, Kita-15, Nishi-7, Kita-ku, Sapporo 060-0815, Japan
| | - Hank F Kung
- Department of Radiology, University of Pennsylvania, Philadelphia, PA 19104, USA; Beijing Institute for Brain Disorders, Capital Medical University, Beijing 100069, China
| | - Suzanne E Lapi
- University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Joao Alberto Osso
- Radioisotope Products and Radiation Technology Section, Division of Physical and Chemical Sciences, Department of Nuclear Sciences and Applications, International Atomic Energy Agency, Vienna International Centre, PO Box 100, 1400 Vienna, Austria
| | - Ephraim Parent
- Department of Radiology, Mayo Clinic, Jacksonville, FL 32224, USA
| | - Marianne Patt
- Department of Nuclear Medicine, University Hospital Leipzig, Leipzig, Germany
| | | | - Patrick J Riss
- Department of Chemistry, University of Oslo, Oslo, Norway
| | - Ralph Santos-Oliveira
- Presidency, Brazilian Association of Radiopharmacy, Rio de Janeiro 243480945, Brazil
| | - Stephen Taylor
- Department of Molecular Imaging, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia
| | - Neil Vasdev
- Azrieli Centre for Neuro-Radiochemistry, Brain Health Imaging Centre, Centre for Addiction and Mental Health & Department of Psychiatry, University of Toronto, 250 College St., Toronto M5T 1R8, ON, Canada
| | - Johnny Vercouillie
- UMR Inserm U1253, iBrain, Université de Tours, UFR de Médecine, 10 Boulevard Tonnellé, 37032 Tours Cedex 01, France; INSERM CIC 1415, University Hospital, Tours, France
| | - Wolfgang Wadsak
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Zhi Yang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Nuclear Medicine, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - Hua Zhu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Nuclear Medicine, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - Peter J H Scott
- Department of Radiology, University of Michigan, Ann Arbor, MI 48109, USA.
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Perini EA, Skopchenko M, Hong TT, Harianto R, Maître A, Rodríguez MRR, de Oliveira Santos N, Guo Y, Qin X, Zeituni CA, Starovoitova VN. Pre-feasibility Study for Establishing Radioisotope and Radiopharmaceutical Production Facilities in Developing Countries. Curr Radiopharm 2020; 12:187-200. [PMID: 30924426 DOI: 10.2174/1874471012666190328164253] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2018] [Revised: 03/01/2019] [Accepted: 03/03/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND A significant number of developing countries have no facilities to produce medical radioisotopes and radiopharmaceuticals. OBJECTIVE In this paper we show that access to life-saving radioisotopes and radiopharmaceuticals and the geographical distribution of corresponding infrastructure is highly unbalanced worldwide. METHODS We discuss the main issues which need to be addressed in order to establish the production of radioisotopes and radiopharmaceuticals, which are especially important for developing countries as newcomers in the field. The data was gathered from several sources, including databases maintained by the International Atomic Energy Agency (IAEA), World Health Organization (WHO), and other international organizations; personal interactions with representatives in the nuclear medicine field from different regions of the world; and relevant literature. RESULTS Developing radioisotope and radiopharmaceutical production program and installing corresponding infrastructure requires significant investments, both man-power and financial. Support already exists to help developing countries establish their medical radioisotope production installations from several organizations, such as IAEA. CONCLUSION This work clearly shows that access to life-saving radioisotopes and the geographical distribution of corresponding infrastructure is highly unbalanced. Technology transfer is important as it not only immediately benefits patients, but also provides employment, economic activity and general prosperity in the region to where the technology transfer is implemented.
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Affiliation(s)
- Efrain Araujo Perini
- Institute of Energy and Nuclear Research (IPEN), Av. Prof. Lineu Prestes 2242, Cidade Universitaria., 05508-000, Sao Paulo, SP, Brazil
| | - Mikhail Skopchenko
- National Nuclear Center, Institute of Radiation Safety and Ecology, 23 Building, 2 Krasnoarmeyskaya Street, 071100, Kurchatov, Kazakhstan
| | - Tran Thu Hong
- Nuclear Research Institute, 01 Nguyen Tu Luc St., Ward 9, Dalat City, Lam Dong, Vietnam
| | - Rahmat Harianto
- Nuclear Energy Regulatory Agency (BAPETEN), North Petojo, Jl. Gajah Mada 8, RT.1/RW.2, Krukut, Tamansari, Daerah Khusus Ibukota 11120, Jakarta, Indonesia
| | - Alexis Maître
- INVAP S.E., Avenida Comandante Luis Piedrabuena 4950, R8403CPV, Bariloche, Argentina
| | | | - Nathalia de Oliveira Santos
- Eckert & Ziegler Brasil Isotope Solution, Rua Miguel Nelsom Bechara, 480, Jardim Pereira Leite, ZIP 02712-130, Sao Paulo - SP, Brazil
| | | | | | - Carlos A Zeituni
- Institute of Energy and Nuclear Research (IPEN), Av. Prof. Lineu Prestes 2242, Cidade Universitaria., 05508-000, Sao Paulo, SP, Brazil
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Tang G. Nuclear cardiology in China: 2017. J Nucl Cardiol 2017; 24:1810-1813. [PMID: 28695407 PMCID: PMC5629245 DOI: 10.1007/s12350-017-0985-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2017] [Revised: 06/17/2017] [Indexed: 11/29/2022]
Abstract
This paper provides the current state of nuclear cardiology in China and contrasts it with the state of nuclear cardiology in the United States (US). The West China Hospital and New York-Presbyterian Hospital (NYPH) were used as representative hospitals to contrast nuclear cardiology in China and the US, respectively. In 2015, there were 101 medical cyclotrons, 774 SPECT or SPECT/CT, 240 PET/CT, and 6 PET/MR cameras in China. Most (~90%) of the nuclear cardiology studies are gated SPECT myocardial perfusion imaging (MPI), and ~10% are other types of studies including MUGA, PET/CT MPI, and viability studies. There are differences in nuclear cardiology between the West China Hospital and NYPH and these include those in cardiac stress tests, SPECT/CT acquisition protocols, PET/CT blood flow and viability studies, reimbursement, and fellowship training. In this paper, we aim to present status of nuclear cardiology in China and provide potential solutions.
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Affiliation(s)
- Gongshun Tang
- West China Hospital, Sichuan University, 37 Guoxuexiang Street, Wuhou District, Chengdu, 610041, China.
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