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Baldassi B, Poladyan H, Shahi A, Maa-Hacquoil H, Rapley M, Komarov B, Stiles J, Freitas V, Waterston M, Aseyev O, Reznik A, Bubon O. Image quality evaluation for a clinical organ-targeted PET camera. Front Oncol 2024; 14:1268991. [PMID: 38590664 PMCID: PMC10999605 DOI: 10.3389/fonc.2024.1268991] [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: 07/28/2023] [Accepted: 03/12/2024] [Indexed: 04/10/2024] Open
Abstract
Introduction A newly developed clinical organ-targeted Positron Emission Tomography (PET) system (also known as Radialis PET) is tested with a set of standardized and custom tests previously used to evaluate the performance of Positron Emission Mammography (PEM) systems. Methods Imaging characteristics impacting standardized uptake value (SUV) and detectability of small lesions, namely spatial resolution, linearity, uniformity, and recovery coefficients, are evaluated. Results In-plane spatial resolution was measured as 2.3 mm ± 0.1 mm, spatial accuracy was 0.1 mm, and uniformity measured with flood field and NEMA NU-4 phantom was 11.7% and 8.3% respectively. Selected clinical images are provided as reference to the imaging capabilities under different clinical conditions such as reduced activity of 2-[fluorine-18]-fluoro-2-deoxy-D-glucose (18F-FDG) and time-delayed acquisitions. SUV measurements were performed for selected clinical acquisitions to demonstrate a capability for quantitative image assessment of different types of cancer including for invasive lobular carcinoma with comparatively low metabolic activity. Quantitative imaging performance assessment with phantoms demonstrates improved contrast recovery and spill-over ratio for this PET technology when compared to other commercial organ-dedicated PET systems with similar spatial resolution. Recovery coefficients were measured to be 0.21 for the 1 mm hot rod and up to 0.89 for the 5 mm hot rod of NEMA NU-4 Image Quality phantom. Discussion Demonstrated ability to accurately reconstruct activity in tumors as small as 5 mm suggests that the Radialis PET technology may be well suited for emerging clinical applications such as image guided assessment of response to neoadjuvant systemic treatment (NST) in lesions smaller than 2 cm. Also, our results suggest that, while spatial resolution greatly influences the partial volume effect which degrades contrast recovery, optimized count rate performance and image reconstruction workflow may improve recovery coefficients for systems with comparable spatial resolution. We emphasize that recovery coefficient should be considered as a primary performance metric when a PET system is used for accurate lesion size or radiotracer uptake assessments.
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Affiliation(s)
- Brandon Baldassi
- Department of Physics, Lakehead University, Thunder Bay, ON, Canada
| | | | - Anirudh Shahi
- Department of Physics, Lakehead University, Thunder Bay, ON, Canada
| | | | - Madeline Rapley
- Department of Physics, Lakehead University, Thunder Bay, ON, Canada
| | | | - Justin Stiles
- Department of Physics, Lakehead University, Thunder Bay, ON, Canada
| | - Vivianne Freitas
- Department of Medical Imaging, University Health Network, Sinai Health System, Women’s College Hospital, Toronto, ON, Canada
- Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
| | | | - Olexiy Aseyev
- Department of Medical Oncology, Thunder Bay Regional Health Sciences Center, Thunder Bay, ON, Canada
| | - Alla Reznik
- Department of Physics, Lakehead University, Thunder Bay, ON, Canada
- Radialis Inc., Thunder Bay, ON, Canada
| | - Oleksandr Bubon
- Department of Physics, Lakehead University, Thunder Bay, ON, Canada
- Radialis Inc., Thunder Bay, ON, Canada
- Thunder Bay Regional Health Research Institute, Thunder Bay, ON, Canada
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Barreto DS, Rapelyea JA. Low-Dose Positron Emission Mammography: A Novel, Promising Technique for Breast Cancer Detection. Radiol Imaging Cancer 2024; 6:e240006. [PMID: 38334472 PMCID: PMC10988329 DOI: 10.1148/rycan.240006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 01/17/2024] [Accepted: 01/22/2024] [Indexed: 02/10/2024]
Affiliation(s)
- David S. Barreto
- From the Department of Radiology, The George Washington University School of Medicine and Health Sciences, 2150 Pennsylvania Ave NW, Washington, DC 20037
| | - Jocelyn A. Rapelyea
- From the Department of Radiology, The George Washington University School of Medicine and Health Sciences, 2150 Pennsylvania Ave NW, Washington, DC 20037
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Abstract
Breast-specific positron imaging systems provide higher sensitivity than whole-body PET for breast cancer detection. The clinical applications for breast-specific positron imaging are similar to breast MRI including preoperative local staging and neoadjuvant therapy response assessment. Breast-specific positron imaging may be an alternative for patients who cannot undergo breast MRI. Further research is needed in expanding the field-of-view for posterior breast lesions, increasing biopsy capability, and reducing radiation dose. Efforts are also necessary for developing appropriate use criteria, increasing availability, and advancing insurance coverage.
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Affiliation(s)
- Amy M Fowler
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, Madison, WI 53792-3252, USA; Department of Medical Physics, University of Wisconsin-Madison; University of Wisconsin Carbone Cancer Center, Madison, WI, USA.
| | - Kanae K Miyake
- Department of Advanced Medical Imaging Research, Graduate School of Medicine Kyoto University, Kyoto, Japan
| | - Yuji Nakamoto
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine Kyoto University, Kyoto, Japan
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Patel MM, Adrada BE, Fowler AM, Rauch GM. Molecular Breast Imaging and Positron Emission Mammography. PET Clin 2023; 18:487-501. [PMID: 37258343 DOI: 10.1016/j.cpet.2023.04.005] [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] [Indexed: 06/02/2023]
Abstract
There is growing interest in application of functional imaging modalities for adjunct breast imaging due to their unique ability to evaluate molecular/pathophysiologic changes, not visible by standard anatomic breast imaging. This has led to increased use of nuclear medicine dedicated breast-specific single photon and coincidence imaging systems for multiple indications, such as supplemental screening, staging of newly diagnosed breast cancer, evaluation of response to neoadjuvant treatment, diagnosis of local disease recurrence in the breast, and problem solving. Studies show that these systems maybe especially useful for specific subsets of patients, not well served by available anatomic breast imaging modalities.
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Affiliation(s)
- Miral M Patel
- Department of Breast Imaging, The University of Texas MD Anderson Cancer Center, 1515 Holcombe, CPB5.3208, Houston, TX 77030, USA.
| | - Beatriz Elena Adrada
- Department of Breast Imaging, The University of Texas MD Anderson Cancer Center, 1515 Holcombe, CPB5.3208, Houston, TX 77030, USA
| | - Amy M Fowler
- Department of Radiology, Section of Breast Imaging and Intervention, University of Wisconsin - Madison, 600 Highland Avenue, Madison, WI 53792-3252, USA; Department of Medical Physics, University of Wisconsin Carbone Cancer Center, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI 53792-3252, USA
| | - Gaiane M Rauch
- Department of Abdominal Imaging, The University of Texas MD Anderson Cancer Center, 1515 Holcombe, Unit 1473, Houston, TX 77030, USA; Department of Breast Imaging, The University of Texas MD Anderson Cancer Center, 1515 Holcombe, Unit 1473, Houston, TX 77030, USA
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Evaluation of a High-Sensitivity Organ-Targeted PET Camera. SENSORS 2022; 22:s22134678. [PMID: 35808181 PMCID: PMC9269056 DOI: 10.3390/s22134678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 06/16/2022] [Accepted: 06/17/2022] [Indexed: 02/05/2023]
Abstract
The aim of this study is to evaluate the performance of the Radialis organ-targeted positron emission tomography (PET) Camera with standardized tests and through assessment of clinical-imaging results. Sensitivity, count-rate performance, and spatial resolution were evaluated according to the National Electrical Manufacturers Association (NEMA) NU-4 standards, with necessary modifications to accommodate the planar detector design. The detectability of small objects was shown with micro hotspot phantom images. The clinical performance of the camera was also demonstrated through breast cancer images acquired with varying injected doses of 2-[fluorine-18]-fluoro-2-deoxy-D-glucose (18F-FDG) and qualitatively compared with sample digital full-field mammography, magnetic resonance imaging (MRI), and whole-body (WB) PET images. Micro hotspot phantom sources were visualized down to 1.35 mm-diameter rods. Spatial resolution was calculated to be 2.3 ± 0.1 mm for the in-plane resolution and 6.8 ± 0.1 mm for the cross-plane resolution using maximum likelihood expectation maximization (MLEM) reconstruction. The system peak noise equivalent count rate was 17.8 kcps at a 18F-FDG concentration of 10.5 kBq/mL. System scatter fraction was 24%. The overall efficiency at the peak noise equivalent count rate was 5400 cps/MBq. The maximum axial sensitivity achieved was 3.5%, with an average system sensitivity of 2.4%. Selected results from clinical trials demonstrate capability of imaging lesions at the chest wall and identifying false-negative X-ray findings and false-positive MRI findings, even at up to a 10-fold dose reduction in comparison with standard 18F-FDG doses (i.e., at 37 MBq or 1 mCi). The evaluation of the organ-targeted Radialis PET Camera indicates that it is a promising technology for high-image-quality, low-dose PET imaging. High-efficiency radiotracer detection also opens an opportunity to reduce administered doses of radiopharmaceuticals and, therefore, patient exposure to radiation.
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MacDonald LR, Lo JY, Sturgeon GM, Zeng C, Harrison RL, Kinahan PE, Segars WP. Impact of Using Uniform Attenuation Coefficients for Heterogeneously Dense Breasts in a Dedicated Breast PET/X-ray Scanner. IEEE TRANSACTIONS ON RADIATION AND PLASMA MEDICAL SCIENCES 2020; 4:585-593. [PMID: 33163753 DOI: 10.1109/trpms.2020.2991120] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
We investigated PET image quantification when using a uniform attenuation coefficient (μ) for attenuation correction (AC) of anthropomorphic density phantoms derived from high-resolution breast CT scans. A breast PET system was modeled with perfect data corrections except for AC. Using uniform μ for AC resulted in quantitative errors roughly proportional to the difference between μ used in AC (μ AC) and local μ, yielding approximately ± 5% bias, corresponding to the variation of μ for 511 keV photons in breast tissue. Global bias was lowest when uniform μ AC was equal to the phantom mean μ (μ mean). Local bias in 10-mm spheres increased as the sphere μ deviated from μ mean, but remained only 2-3% when the μ sphere was 6.5% higher than μ mean. Bias varied linearly with and was roughly proportional to local μ mismatch. Minimizing local bias, e.g., in a small sphere, required the use of a uniform μ value between the local μ and the μ mean. Thus, biases from using uniform-μ AC are low when local μ sphere is close to μ mean. As the μ sphere increasingly differs from the phantom μ mean, bias increases, and the optimal uniform μ is less predictable, having a value between μ sphere and the phantom μ mean.
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Affiliation(s)
| | - Joseph Y Lo
- Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology, Duke University Medical Center, Durham, NC 27705
| | - Gregory M Sturgeon
- Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology, Duke University Medical Center, Durham, NC 27705
| | - Chengeng Zeng
- University of Washington Radiology Department, Seattle, WA 98195
| | | | - Paul E Kinahan
- University of Washington Radiology Department, Seattle, WA 98195
| | - William Paul Segars
- Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology, Duke University Medical Center, Durham, NC 27705
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Narayanan D, Berg WA. Dedicated Breast Gamma Camera Imaging and Breast PET: Current Status and Future Directions. PET Clin 2018; 13:363-381. [PMID: 30100076 DOI: 10.1016/j.cpet.2018.02.008] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Recent advances in nuclear medicine instrumentation have led to the emergence of improved molecular imaging techniques to image breast cancer: dedicated gamma cameras using γ-emitting 99mTc-sestamibi and breast-specific PET cameras using 18F-fluorodeoxyglucose. This article focuses on the current role of such approaches in the clinical setting including diagnosis, assessing local extent of disease, monitoring response to therapy, and, for gamma camera imaging, possible supplemental screening in women with dense breasts. Barriers to clinical adoption and technologies and radiotracers under development are also discussed.
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Affiliation(s)
- Deepa Narayanan
- National Cancer Institute, 9609 Medical Center Drive, Rockville, MD 20850, USA.
| | - Wendie A Berg
- Department of Radiology, University of Pittsburgh School of Medicine, Magee-Womens Hospital of UPMC, 300 Halket Street, Pittsburgh, PA 15213
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Narayanan D, Berg WA. Use of Breast-Specific PET Scanners and Comparison with MR Imaging. Magn Reson Imaging Clin N Am 2018; 26:265-272. [PMID: 29622131 DOI: 10.1016/j.mric.2017.12.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The goals of this article are to discuss the role of breast-specific PET imaging of women with breast cancer, compare the clinical performance of positron emission mammography (PEM) and MR imaging for current indications, and provide recommendations for when women should undergo PEM instead of breast MR imaging.
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Affiliation(s)
- Deepa Narayanan
- SBIR Development Center, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD 20850, USA.
| | - Wendie A Berg
- Department of Radiology, University of Pittsburgh School of Medicine, Magee-Womens Hospital of UPMC, 300 Halket Street, Pittsburgh, PA 15213, USA
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Heller SL, Heacock L, Moy L. Developments in Breast Imaging: Update on New and Evolving MR Imaging and Molecular Imaging Techniques. Magn Reson Imaging Clin N Am 2018; 26:247-258. [PMID: 29622129 DOI: 10.1016/j.mric.2017.12.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
This article reviews new developments in breast imaging. There is growing interest in creating a shorter, less expensive MR protocol with broader applicability. There is an increasing focus on and consideration for the additive impact that functional analysis of breast pathology have on identifying and characterizing lesions. These developments apply to MR imaging and molecular imaging. This article reviews evolving breast imaging techniques with attention to strengths, weaknesses, and applications of these approaches. We aim to give the reader familiarity with the state of current developments in the field and to increase awareness of what to expect in breast imaging.
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Affiliation(s)
- Samantha Lynn Heller
- NYU School of Medicine, NYU Laura and Isaac Perlmutter Cancer Center, 3rd Floor, New York, NY 10016, USA
| | - Laura Heacock
- NYU School of Medicine, NYU Laura and Isaac Perlmutter Cancer Center, 3rd Floor, New York, NY 10016, USA
| | - Linda Moy
- NYU School of Medicine, NYU Laura and Isaac Perlmutter Cancer Center, 3rd Floor, New York, NY 10016, USA.
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