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Mingels C, Nalbant H, Sari H, Godinez F, Sen F, Spencer B, Esteghamat NS, Tuscano JM, Nardo L. Long-Axial Field-of-View PET Imaging in Patients with Lymphoma: Challenges and Opportunities. PET Clin 2024; 19:495-504. [PMID: 38969563 DOI: 10.1016/j.cpet.2024.05.005] [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: 07/07/2024]
Abstract
[18F]fluoro-2-deoxy-d-glucose PET/computed tomography has been implemented in the management of patients with lymphoma, offering real-time metabolic information on lymphoma with the promise of more accurate staging, treatment response assessment, prognostication, and early detection of disease recurrence. The clinical management of lymphoproliferative disease has recently, rapidly evolved from initial chemotherapeutic to the use of immunotherapy, targeted agents, and to the use of chimeric antigen receptor T-cell therapies. The implementation of these new systems and imaging protocols together with new tracer development creates, in the field of lymphoproliferative disease, both opportunities and challenges that will be detailed in this comprehensive literature review.
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Affiliation(s)
- Clemens Mingels
- Department of Radiology, University of California Davis, Sacramento, CA, USA; Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
| | - Hande Nalbant
- Department of Radiology, University of California Davis, Sacramento, CA, USA
| | - Hasan Sari
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Siemens Healthineers International AG, Zurich, Switzerland
| | - Felipe Godinez
- Department of Radiology, University of California Davis, Sacramento, CA, USA; UC Cavis Comprehensive Cancer Center, University of California Davis, Sacramento, CA, USA
| | - Fatma Sen
- Department of Radiology, University of California Davis, Sacramento, CA, USA
| | - Benjamin Spencer
- Department of Radiology, University of California Davis, Sacramento, CA, USA
| | - Naseem S Esteghamat
- Division of Malignant Hematology, Cellular Therapy & Transplantation, Department of Internal Medicine, University of California Davis, Sacramento, CA, USA
| | - Joseph M Tuscano
- Division of Malignant Hematology, Cellular Therapy & Transplantation, Department of Internal Medicine, University of California Davis, Sacramento, CA, USA
| | - Lorenzo Nardo
- Department of Radiology, University of California Davis, Sacramento, CA, USA
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Scott PJH. Can we use PET to quantify mu opioid receptors across the monkey brain, spinal cord and peripheral organs at the same time? Totally! Eur J Nucl Med Mol Imaging 2024; 51:3267-3272. [PMID: 38822890 DOI: 10.1007/s00259-024-06778-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2024]
Affiliation(s)
- Peter J H Scott
- Department of Radiology, University of Michigan, Ann Arbor, MI, 48109, USA.
- Department of Pharmacology, University of Michigan, Ann Arbor, MI, 48109, USA.
- Department of Medicinal Chemistry, University of Michigan, Ann Arbor, MI, 48109, USA.
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Hsieh CJ, Hou C, Lee H, Tomita C, Schmitz A, Plakas K, Dubroff JG, Mach RH. Total-body imaging of mu-opioid receptors with [ 11C]carfentanil in non-human primates. Eur J Nucl Med Mol Imaging 2024; 51:3273-3283. [PMID: 38722383 PMCID: PMC11368985 DOI: 10.1007/s00259-024-06746-2] [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: 02/06/2024] [Accepted: 04/29/2024] [Indexed: 06/02/2024]
Abstract
PURPOSE Mu-opioid receptors (MORs) are widely expressed in the central nervous system (CNS), peripheral organs, and immune system. This study measured the whole body distribution of MORs in rhesus macaques using the MOR selective radioligand [11C]carfentanil ([11C]CFN) on the PennPET Explorer. Both baseline and blocking studies were conducted using either naloxone or GSK1521498 to measure the effect of the antagonists on MOR binding in both CNS and peripheral organs. METHODS The PennPET Explorer was used for MOR total-body PET imaging in four rhesus macaques using [11C]CFN under baseline, naloxone pretreatment, and naloxone or GSK1521498 displacement conditions. Logan distribution volume ratio (DVR) was calculated by using a reference model to quantitate brain regions, and the standard uptake value ratios (SUVRs) were calculated for peripheral organs. The percent receptor occupancy (%RO) was calculated to establish the blocking effect of 0.14 mg/kg naloxone or GSK1521498. RESULTS The %RO in MOR-abundant brain regions was 75-90% for naloxone and 72-84% for GSK1521498 in blocking studies. A higher than 90% of %RO were observed in cervical spinal cord for both naloxone and GSK1521498. It took approximately 4-6 min for naloxone or GSK1521498 to distribute to CNS and displace [11C]CFN from the MOR. A smaller effect was observed in heart wall in the naloxone and GSK1521498 blocking studies. CONCLUSION [11C]CFN total-body PET scans could be a useful approach for studying mechanism of action of MOR drugs used in the treatment of acute and chronic opioid use disorder and their effect on the biodistribution of synthetic opioids such as CFN. GSK1521498 could be a potential naloxone alternative to reverse opioid overdose.
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Affiliation(s)
- Chia-Ju Hsieh
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, 19104, USA
| | - Catherine Hou
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, 19104, USA
| | - Hsiaoju Lee
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, 19104, USA
| | - Cosette Tomita
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, 19104, USA
| | - Alexander Schmitz
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, 19104, USA
| | - Konstantinos Plakas
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, 19104, USA
| | - Jacob G Dubroff
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, 19104, USA
| | - Robert H Mach
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, 19104, USA.
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Lan W, Sari H, Rominger A, Fougère CL, Schmidt FP. Optimization and impact of sensitivity mode on abbreviated scan protocols with population-based input function for parametric imaging of [ 18F]-FDG for a long axial FOV PET scanner. Eur J Nucl Med Mol Imaging 2024; 51:3346-3359. [PMID: 38763962 PMCID: PMC11368996 DOI: 10.1007/s00259-024-06745-3] [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: 02/05/2024] [Accepted: 04/28/2024] [Indexed: 05/21/2024]
Abstract
BACKGROUND The long axial field of view, combined with the high sensitivity of the Biograph Vision Quadra PET/CT scanner enables the precise deviation of an image derived input function (IDIF) required for parametric imaging. Traditionally, this requires an hour-long dynamic PET scan for [18F]-FDG, which can be significantly reduced by using a population-based input function (PBIF). In this study, we expand these examinations and include the scanner's ultra-high sensitivity (UHS) mode in comparison to the high sensitivity (HS) mode and evaluate the potential for further shortening of the scan time. METHODS Patlak Ki and DV estimates were determined by the indirect and direct Patlak methods using dynamic [18F]-FDG data of 6 oncological patients with 26 lesions (0-65 min p.i.). Both sensitivity modes for different number/duration of PET data frames were compared, together with the potential of using abbreviated scan durations of 20, 15 and 10 min by using a PBIF. The differences in parametric images and tumour-to-background ratio (TBR) due to the shorter scans using the PBIF method and between the sensitivity modes were assessed. RESULTS A difference of 3.4 ± 7.0% (Ki) and 1.2 ± 2.6% (DV) was found between both sensitivity modes using indirect Patlak and the full IDIF (0-65 min). For the abbreviated protocols and indirect Patlak, the UHS mode resulted in a lower bias and higher precision, e.g., 45-65 min p.i. 3.8 ± 4.4% (UHS) and 6.4 ± 8.9% (HS), allowing shorter scan protocols, e.g. 50-65 min p.i. 4.4 ± 11.2% (UHS) instead of 7.3 ± 20.0% (HS). The variation of Ki and DV estimates for both Patlak methods was comparable, e.g., UHS mode 3.8 ± 4.4% and 2.7 ± 3.4% (Ki) and 14.4 ± 2.7% and 18.1 ± 7.5% (DV) for indirect and direct Patlak, respectively. Only a minor impact of the number of Patlak frames was observed for both sensitivity modes and Patlak methods. The TBR obtained with direct Patlak and PBIF was not affected by the sensitivity mode, was higher than that derived from the SUV image (6.2 ± 3.1) and degraded from 20.2 ± 12.0 (20 min) to 10.6 ± 5.4 (15 min). Ki and DV estimate images showed good agreement (UHS mode, RC: 6.9 ± 2.3% (Ki), 0.1 ± 3.1% (DV), peak signal-to-noise ratio (PSNR): 64.5 ± 3.3 dB (Ki), 61.2 ± 10.6 dB (DV)) even for abbreviated scan protocols of 50-65 min p.i. CONCLUSIONS Both sensitivity modes provide comparable results for the full 65 min dynamic scans and abbreviated scans using the direct Patlak reconstruction method, with good Ki and DV estimates for 15 min short scans. For the indirect Patlak approach the UHS mode improved the Ki estimates for the abbreviated scans.
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Affiliation(s)
- W Lan
- Department of Nuclear Medicine and Clinical Molecular Imaging, University Hospital Tuebingen, Tuebingen, Germany
| | - H Sari
- Advanced Clinical Imaging Technology, Siemens Healthineers International AG, Lausanne, Switzerland
| | - A Rominger
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - C la Fougère
- Department of Nuclear Medicine and Clinical Molecular Imaging, University Hospital Tuebingen, Tuebingen, Germany
- Cluster of Excellence iFIT (EXC 2180) "Image Guided and Functionally Instructed Tumor Therapies", University of Tuebingen, Tuebingen, Germany
| | - F P Schmidt
- Department of Nuclear Medicine and Clinical Molecular Imaging, University Hospital Tuebingen, Tuebingen, Germany.
- Werner Siemens Imaging Center, Department of Preclinical Imaging and Radiopharmacy, University of Tuebingen, Tuebingen, Germany.
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Mingels C, Spencer BA, Nalbant H, Omidvari N, Rokni M, Rominger A, Sen F, Cherry SR, Badawi RD, Abdelhafez YG, Nardo L. Dose Reduction in Pediatric Oncology Patients with Delayed Total-Body [ 18F]FDG PET/CT. J Nucl Med 2024; 65:1101-1106. [PMID: 38664017 PMCID: PMC11218730 DOI: 10.2967/jnumed.124.267521] [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: 01/29/2024] [Accepted: 03/25/2024] [Indexed: 07/03/2024] Open
Abstract
Our aim was to define a lower limit of reduced injected activity in delayed [18F]FDG total-body (TB) PET/CT in pediatric oncology patients. Methods: In this single-center prospective study, children were scanned for 20 min with TB PET/CT, 120 min after intravenous administration of a 4.07 ± 0.49 MBq/kg dose of [18F]FDG. Five randomly subsampled low-count reconstructions were generated using ¼, ⅛, [Formula: see text], and [Formula: see text] of the counts in the full-dose list-mode reference standard acquisition (20 min), to simulate dose reduction. For the 2 lowest-count reconstructions, smoothing was applied. Background uptake was measured with volumes of interest placed on the ascending aorta, right liver lobe, and third lumbar vertebra body (L3). Tumor lesions were segmented using a 40% isocontour volume-of-interest approach. Signal-to-noise ratio, tumor-to-background ratio, and contrast-to-noise ratio were calculated. Three physicians identified malignant lesions independently and assessed the image quality using a 5-point Likert scale. Results: In total, 113 malignant lesions were identified in 18 patients, who met the inclusion criteria. Of these lesions, 87.6% were quantifiable. Liver SUVmean did not change significantly, whereas a lower signal-to-noise ratio was observed in all low-count reconstructions compared with the reference standard (P < 0.0001) because of higher noise rates. Tumor uptake (SUVmax), tumor-to-background ratio, and total lesion count were significantly lower in the reconstructions with [Formula: see text] and [Formula: see text] of the counts of the reference standard (P < 0.001). Contrast-to-noise ratio and clinical image quality were significantly lower in all low-count reconstructions than with the reference standard. Conclusion: Dose reduction for delayed [18F]FDG TB PET/CT imaging in children is possible without loss of image quality or lesion conspicuity. However, our results indicate that to maintain comparable tumor uptake and lesion conspicuity, PET centers should not reduce the injected [18F]FDG activity below 0.5 MBq/kg when using TB PET/CT in pediatric imaging at 120 min after injection.
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Affiliation(s)
- Clemens Mingels
- Department of Radiology, University of California Davis, Sacramento, California;
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Benjamin A Spencer
- Department of Radiology, University of California Davis, Sacramento, California
| | - Hande Nalbant
- Department of Radiology, University of California Davis, Sacramento, California
| | - Negar Omidvari
- Department of Biomedical Engineering, University of California Davis, Davis, California; and
| | - Mehrad Rokni
- Department of Radiology, University of California Davis, Sacramento, California
| | - Axel Rominger
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Fatma Sen
- Department of Radiology, University of California Davis, Sacramento, California
| | - Simon R Cherry
- Department of Radiology, University of California Davis, Sacramento, California
- Department of Biomedical Engineering, University of California Davis, Davis, California; and
| | - Ramsey D Badawi
- Department of Radiology, University of California Davis, Sacramento, California
- Department of Biomedical Engineering, University of California Davis, Davis, California; and
| | - Yasser G Abdelhafez
- Department of Radiology, University of California Davis, Sacramento, California
- Nuclear Medicine Unit, South Egypt Cancer Institute, Assiut University, Assiut, Egypt
| | - Lorenzo Nardo
- Department of Radiology, University of California Davis, Sacramento, California
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Mingels C, Weissenrieder L, Zeimpekis K, Sari H, Nardo L, Caobelli F, Alberts I, Rominger A, Pyka T. FDG imaging with long-axial field-of-view PET/CT in patients with high blood glucose-a matched pair analysis. Eur J Nucl Med Mol Imaging 2024; 51:2036-2046. [PMID: 38383743 PMCID: PMC11139721 DOI: 10.1007/s00259-024-06646-5] [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: 12/19/2023] [Accepted: 02/05/2024] [Indexed: 02/23/2024]
Abstract
PURPOSE High blood glucose (hBG) in patients undergoing [18F]FDG PET/CT scans often results in rescheduling the examination, which may lead to clinical delay for the patient and decrease productivity for the department. The aim of this study was to evaluate whether long-axial field-of-view (LAFOV) PET/CT can minimize the effect of altered bio-distribution in hBG patients and is able to provide diagnostic image quality in hBG situations. MATERIALS AND METHODS Oncologic patients with elevated blood glucose (≥ 8.0 mmol/l) and normal blood glucose (< 8.0 mmol/l, nBG) levels were matched for tumor entity, gender, age, and BMI. hBG patients were further subdivided into two groups (BG 8-11 mmol/l and BG > 11 mmol/l). Tracer uptake in the liver, muscle, and tumor was evaluated. Furthermore, image quality was compared between long acquisitions (ultra-high sensitivity mode, 360 s) on a LAFOV PET/CT and routine acquisitions equivalent to a short-axial field-of-view scanner (simulated (sSAFOV), obtained with high sensitivity mode, 120 s). Tumor-to-background ratio (TBR) and contrast-to-noise ratio (CNR) were used as the main image quality criteria. RESULTS Thirty-one hBG patients met the inclusion criteria and were matched with 31 nBG patients. Overall, liver uptake was significantly higher in hBG patients (SUVmean, 3.07 ± 0.41 vs. 2.37 ± 0.33; p = 0.03), and brain uptake was significantly lower (SUVmax, 7.58 ± 0.74 vs. 13.38 ± 3.94; p < 0.001), whereas muscle (shoulder/gluteal) uptake showed no statistically significant difference. Tumor uptake was lower in hBG patients, resulting in a significantly lower TBR in the hBG cohort (3.48 ± 0.74 vs. 5.29 ± 1.48, p < 0.001). CNR was higher in nBG compared to hBG patients (12.17 ± 4.86 vs. 23.31 ± 12.22, p < 0.001). However, subgroup analysis of nBG 8-11 mmol/l on sSAFOV PET/CT compared to hBG (> 11 mmol/l) patients examined with LAFOV PET/CT showed no statistical significant difference in CNR (19.84 ± 8.40 vs. 17.79 ± 9.3, p = 0.08). CONCLUSION While elevated blood glucose (> 11 mmol) negatively affected TBR and CNR in our cohort, the images from a LAFOV PET-scanner had comparable CNR to PET-images acquired from nBG patients using sSAFOV PET/CT. Therefore, we argue that oncologic patients with increased blood sugar levels might be imaged safely with LAFOV PET/CT when rescheduling is not feasible.
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Affiliation(s)
- Clemens Mingels
- Department of Nuclear Medicine, Inselspital, University Hospital Bern, University of Bern, Freiburgstr. 18, 3010, Bern, Switzerland.
| | - Luis Weissenrieder
- Department of Nuclear Medicine, Inselspital, University Hospital Bern, University of Bern, Freiburgstr. 18, 3010, Bern, Switzerland
| | - Konstantinos Zeimpekis
- Department of Nuclear Medicine, Inselspital, University Hospital Bern, University of Bern, Freiburgstr. 18, 3010, Bern, Switzerland
| | - Hasan Sari
- Department of Nuclear Medicine, Inselspital, University Hospital Bern, University of Bern, Freiburgstr. 18, 3010, Bern, Switzerland
- Advanced Clinical Imaging Technology, Siemens Healthcare AG, Lausanne, Switzerland
| | - Lorenzo Nardo
- Department of Radiology, University of California Davis, Sacramento, CA, USA
| | - Federico Caobelli
- Department of Nuclear Medicine, Inselspital, University Hospital Bern, University of Bern, Freiburgstr. 18, 3010, Bern, Switzerland
| | - Ian Alberts
- Molecular Imaging and Therapy, BC Cancer Agency, Vancouver, BC, Canada
| | - Axel Rominger
- Department of Nuclear Medicine, Inselspital, University Hospital Bern, University of Bern, Freiburgstr. 18, 3010, Bern, Switzerland
| | - Thomas Pyka
- Department of Nuclear Medicine, Inselspital, University Hospital Bern, University of Bern, Freiburgstr. 18, 3010, Bern, Switzerland
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Huang B, Li T, Arino-Estrada G, Dulski K, Shopa RY, Moskal P, Stepien E, Qi J. SPLIT: Statistical Positronium Lifetime Image Reconstruction via Time-Thresholding. IEEE TRANSACTIONS ON MEDICAL IMAGING 2024; 43:2148-2158. [PMID: 38261489 PMCID: PMC11409919 DOI: 10.1109/tmi.2024.3357659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Abstract
Positron emission tomography (PET) is a widely utilized medical imaging modality that uses positron-emitting radiotracers to visualize biochemical processes in a living body. The spatiotemporal distribution of a radiotracer is estimated by detecting the coincidence photon pairs generated through positron annihilations. In human tissue, about 40% of the positrons form positroniums prior to the annihilation. The lifetime of these positroniums is influenced by the microenvironment in the tissue and could provide valuable information for better understanding of disease progression and treatment response. Currently, there are few methods available for reconstructing high-resolution lifetime images in practical applications. This paper presents an efficient statistical image reconstruction method for positronium lifetime imaging (PLI). We also analyze the random triple-coincidence events in PLI and propose a correction method for random events, which is essential for real applications. Both simulation and experimental studies demonstrate that the proposed method can produce lifetime images with high numerical accuracy, low variance, and resolution comparable to that of the activity images generated by a PET scanner with currently available time-of-flight resolution.
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Sachpekidis C, Dimitrakopoulou-Strauss A. Long Axial Field-of-View (LAFOV) PET/CT in Prostate Cancer. Semin Nucl Med 2024:S0001-2998(24)00045-X. [PMID: 38825439 DOI: 10.1053/j.semnuclmed.2024.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2024] [Accepted: 05/16/2024] [Indexed: 06/04/2024]
Abstract
PSMA-targeted PET/CT is currently considered the most effective non-invasive diagnostic technique for imaging PSMA-positive lesions in prostate cancer (PC), and its introduction has significantly enhanced the role of nuclear medicine in both the diagnosis and therapy (theranostics) of this oncological entity. In line with developments in radiopharmaceuticals, significant progress has been made in the development of PET/CT systems. In particular, the advent of long axial field-of-view (LAFOV) PET/CT scanners has represented a major leap forward in molecular imaging, with early results from clinical applications of these systems showing significant improvements over previous standard axial field-of-view systems in terms of sensitivity, image quality and lesion quantification, while enabling whole-body dynamic PET imaging. In this context, the introduction of the new LAFOV scanners may further enhance the use and potential of PSMA-ligand PET/CT in the diagnosis and management of PC. The initial but steadily growing literature on the application of the new technology in the field of PSMA-ligand PET/CT has already yielded encouraging results regarding the detection of PC lesions with high sensitivity while providing the possibility of ultra-fast or ultra-low dose examinations. Moreover, whole-body dynamic PET has rendered for the first time feasible to capture the pharmacokinetics PSMA-ligands in all major organs and most tumor lesions with high temporal resolution. The main results of these studies are presented in this review.
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Affiliation(s)
- Christos Sachpekidis
- Clinical Cooperation Unit Nuclear Medicine, German Cancer Research Center (DKFZ), Heidelberg, Germany.
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Feng X, Muhashi A, Onishi Y, Ota R, Liu H. Transformer-CNN hybrid network for improving PET time of flight prediction. Phys Med Biol 2024; 69:115047. [PMID: 38749457 DOI: 10.1088/1361-6560/ad4c4d] [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: 01/09/2024] [Accepted: 05/15/2024] [Indexed: 05/31/2024]
Abstract
Objective.In positron emission tomography (PET) reconstruction, the integration of time-of-flight (TOF) information, known as TOF-PET, has been a major research focus. Compared to traditional reconstruction methods, the introduction of TOF enhances the signal-to-noise ratio of images. Precision in TOF is measured by full width at half maximum (FWHM) and the offset from ground truth, referred to as coincidence time resolution (CTR) and bias.Approach.This study proposes a network combining transformer and convolutional neural network (CNN) to utilize TOF information from detector waveforms, using event waveform pairs as inputs. This approach integrates the global self-attention mechanism of Transformer, which focuses on temporal relationships, with the local receptive field of CNN. The combination of global and local information allows the network to assign greater weight to the rising edges of waveforms, thereby extracting valuable temporal information for precise TOF predictions. Experiments were conducted using lutetium yttrium oxyorthosilicate (LYSO) scintillators and silicon photomultiplier (SiPM) detectors. The network was trained and tested using the waveform datasets after cropping.Main results.Compared to the constant fraction discriminator (CFD), CNN, CNN with attention, long short-term memory (LSTM) and Transformer, our network achieved an average CTR of 189 ps, reducing it by 82 ps (more than 30%), 13 ps (6.4%), 12 ps (6.0%), 16 ps (7.8%) and 9 ps (4.6%), respectively. Additionally, a reduction of 10.3, 8.7, 6.7 and 4 ps in average bias was achieved compared to CNN, CNN with attention, LSTM and Transformer.Significance.This work demonstrates the potential of applying the Transformer for PET TOF estimation using real experimental data. Through the integration of both CNN and Transformer with local and global attention, it achieves optimal performance, thereby presenting a novel direction for future research in this field.
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Affiliation(s)
- Xuhui Feng
- The State Key Laboratory of Modern Optical Instrumentation, College of Optical Science and Engineering, Zhejiang University, Hangzhou 310027, People's Republic of China
| | - Amanjule Muhashi
- The State Key Laboratory of Modern Optical Instrumentation, College of Optical Science and Engineering, Zhejiang University, Hangzhou 310027, People's Republic of China
| | - Yuya Onishi
- The Central Research Laboratory, Hamamatsu Photonics K.K., 5000 Hirakuchi, Hamakita-ku, Hamamatsu 434-8601, Japan
| | - Ryosuke Ota
- The Central Research Laboratory, Hamamatsu Photonics K.K., 5000 Hirakuchi, Hamakita-ku, Hamamatsu 434-8601, Japan
| | - Huafeng Liu
- The State Key Laboratory of Modern Optical Instrumentation, College of Optical Science and Engineering, Zhejiang University, Hangzhou 310027, People's Republic of China
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Dadgar M, Maebe J, Vandenberghe S. Evaluation of lesion contrast in the walk-through long axial FOV PET scanner simulated with XCAT anthropomorphic phantoms. EJNMMI Phys 2024; 11:44. [PMID: 38722428 PMCID: PMC11082126 DOI: 10.1186/s40658-024-00645-z] [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: 02/05/2024] [Accepted: 05/02/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND This study evaluates the lesion contrast in a cost-effective long axial field of view (FOV) PET scanner, called the walk-through PET (WT-PET). The scanner consists of two flat detector panels covering the entire torso and head, scanning patients in an upright position for increased throughput. High-resolution, depth-of-interaction capable, monolithic detector technology is used to provide good spatial resolution and enable detection of smaller lesions. METHODS Monte Carlo GATE simulations are used in conjunction with XCAT anthropomorphic phantoms to evaluate lesion contrast in lung, liver and breast for various lesion diameters (10, 7 and 5 mm), activity concentration ratios (8:1, 4:1 and 2:1) and patient BMIs (18-37). Images were reconstructed iteratively with listmode maximum likelihood expectation maximization, and contrast recovery coefficients (CRCs) were obtained for the reconstructed lesions. RESULTS Results shows notable variations in contrast recovery coefficients (CRC) across different lesion sizes and organ locations within the XCAT phantoms. Specifically, our findings reveal that 10 mm lesions consistently exhibit higher CRC compared to 7 mm and 5 mm lesions, with increases of approximately 54% and 330%, respectively, across all investigated organs. Moreover, high contrast recovery is observed in most liver lesions regardless of diameter or activity ratio (average CRC = 42%), as well as in the 10 mm lesions in the lung. Notably, for the 10 mm lesions, the liver demonstrates 42% and 62% higher CRC compared to the lung and breast, respectively. This trend remains consistent across lesion sizes, with the liver consistently exhibiting higher CRC values compared to the lung and breast: 7 mm lesions show an increase of 96% and 41%, while 5 mm lesions exhibit approximately 294% and 302% higher CRC compared to the lung and breast, respectively. CONCLUSION A comparison with a conventional pixelated LSO long axial FOV PET shows similar performance, achieved at a reduced cost for the WT-PET due to a reduction in required number of detectors.
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Affiliation(s)
- Meysam Dadgar
- Department of Electronics and Information Systems, Medical Image and Signal Processing, Ghent University, C. Heymanslaan 10, Ghent, Belgium.
| | - Jens Maebe
- Department of Electronics and Information Systems, Medical Image and Signal Processing, Ghent University, C. Heymanslaan 10, Ghent, Belgium
| | - Stefaan Vandenberghe
- Department of Electronics and Information Systems, Medical Image and Signal Processing, Ghent University, C. Heymanslaan 10, Ghent, Belgium
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Mei R, Pyka T, Sari H, Fanti S, Afshar-Oromieh A, Giger R, Caobelli F, Rominger A, Alberts I. The clinical acceptability of short versus long duration acquisitions for head and neck cancer using long-axial field-of-view PET/CT: a retrospective evaluation. Eur J Nucl Med Mol Imaging 2024; 51:1436-1443. [PMID: 38095670 PMCID: PMC10957684 DOI: 10.1007/s00259-023-06516-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 11/06/2023] [Indexed: 03/22/2024]
Abstract
PURPOSE To evaluate the utility of long duration (10 min) acquisitions compared to standard 4 min scans in the evaluation of head and neck cancer (HNC) using a long-axial field-of-view (LAFOV) system in 2-[18F]FDG PET/CT. METHODS HNC patients undergoing LAFOV PET/CT were included retrospectively according to a predefined sample size calculation. For each acquisition, FDG avid lymph nodes (LN) which were highly probable or equivocal for malignancy were identified by two board certified nuclear medicine physicians in consensus. The aim of this study was to establish the clinical acceptability of short-duration (4 min, C40%) acquisitions compared to full-count (10 min, C100%) in terms of the detection of LN metastases in HNC. Secondary endpoints were the positive predictive value for LN status (PPV) and comparison of SUVmax at C40% and C100%. Histology reports or confirmatory imaging were the reference standard. RESULTS A total of 1218 records were screened and target recruitment was met with n = 64 HNC patients undergoing LAFOV. Median age was 65 years (IQR: 59-73). At C40%, a total of 387 lesions were detected (highly probable LN n = 274 and equivocal n = 113. The total number of lesions detected at C100% acquisition was 439, of them 291 (66%) highly probable LN and 148 (34%) equivocal. Detection rate between the two acquisitions did not demonstrate any significant differences (Pearson's Chi-Square test, p = 0.792). Sensitivity, specificity, PPV, NPV and accuracy for C40% were 83%, 44%, 55%, 76% and 36%, whilst for C100% were 85%, 56%, 55%, 85% and 43%, respectively. The improved accuracy reached borderline significance (p = 0.057). At the ROC analysis, lower SUVmax was identified for C100% (3.5) compared to C40% (4.5). CONCLUSION In terms of LN detection, C40% acquisitions showed no significant difference compared to the C100% acquisitions. There was some improvement for lesions detection at C100%, with a small increment in accuracy reaching borderline significance, suggestive that the higher sensitivity afforded by LAFOV might translate to improved clinical performance in some patients.
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Affiliation(s)
- Riccardo Mei
- Nuclear Medicine Department, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstr. 18, 3010, Bern, Switzerland
| | - Thomas Pyka
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstr. 18, 3010, Bern, Switzerland.
| | - Hasan Sari
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstr. 18, 3010, Bern, Switzerland
- Advanced Clinical Imaging Technology, Siemens Healthcare AG, Lausanne, Switzerland
| | - Stefano Fanti
- Nuclear Medicine Department, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy
| | - Ali Afshar-Oromieh
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstr. 18, 3010, Bern, Switzerland
| | - Roland Giger
- Department of Head and Neck Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Federico Caobelli
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstr. 18, 3010, Bern, Switzerland
| | - Axel Rominger
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstr. 18, 3010, Bern, Switzerland
| | - Ian Alberts
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstr. 18, 3010, Bern, Switzerland
- Molecular Imaging and Therapy, BC Cancer Agency, Vancouver, BC, Canada
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12
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El Ouaridi A, Ait Elcadi Z, Mkimel M, Bougteb M, El Baydaoui R. The detection instrumentation and geometric design of clinical PET scanner: towards better performance and broader clinical applications. Biomed Phys Eng Express 2024; 10:032002. [PMID: 38412520 DOI: 10.1088/2057-1976/ad2d61] [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: 11/03/2023] [Accepted: 02/27/2024] [Indexed: 02/29/2024]
Abstract
Positron emission tomography (PET) is a powerful medical imaging modality used in nuclear medicine to diagnose and monitor various clinical diseases in patients. It is more sensitive and produces a highly quantitative mapping of the three-dimensional biodistribution of positron-emitting radiotracers inside the human body. The underlying technology is constantly evolving, and recent advances in detection instrumentation and PET scanner design have significantly improved the medical diagnosis capabilities of this imaging modality, making it more efficient and opening the way to broader, innovative, and promising clinical applications. Some significant achievements related to detection instrumentation include introducing new scintillators and photodetectors as well as developing innovative detector designs and coupling configurations. Other advances in scanner design include moving towards a cylindrical geometry, 3D acquisition mode, and the trend towards a wider axial field of view and a shorter diameter. Further research on PET camera instrumentation and design will be required to advance this technology by improving its performance and extending its clinical applications while optimising radiation dose, image acquisition time, and manufacturing cost. This article comprehensively reviews the various parameters of detection instrumentation and PET system design. Firstly, an overview of the historical innovation of the PET system has been presented, focusing on instrumental technology. Secondly, we have characterised the main performance parameters of current clinical PET and detailed recent instrumental innovations and trends that affect these performances and clinical practice. Finally, prospects for this medical imaging modality are presented and discussed. This overview of the PET system's instrumental parameters enables us to draw solid conclusions on achieving the best possible performance for the different needs of different clinical applications.
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Affiliation(s)
- Abdallah El Ouaridi
- Hassan First University of Settat, High Institute of Health Sciences, Laboratory of Health Sciences and Technologies, Settat, Morocco
| | - Zakaria Ait Elcadi
- Hassan First University of Settat, High Institute of Health Sciences, Laboratory of Health Sciences and Technologies, Settat, Morocco
- Electrical and Computer Engineering, Texas A&M University at Qatar, Doha, 23874, Qatar
| | - Mounir Mkimel
- Hassan First University of Settat, High Institute of Health Sciences, Laboratory of Health Sciences and Technologies, Settat, Morocco
| | - Mustapha Bougteb
- Hassan First University of Settat, High Institute of Health Sciences, Laboratory of Health Sciences and Technologies, Settat, Morocco
| | - Redouane El Baydaoui
- Hassan First University of Settat, High Institute of Health Sciences, Laboratory of Health Sciences and Technologies, Settat, Morocco
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Mingels C, Caobelli F, Alavi A, Sachpekidis C, Wang M, Nalbant H, Pantel AR, Shi H, Rominger A, Nardo L. Total-body PET/CT or LAFOV PET/CT? Axial field-of-view clinical classification. Eur J Nucl Med Mol Imaging 2024; 51:951-953. [PMID: 38040932 DOI: 10.1007/s00259-023-06534-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 11/17/2023] [Indexed: 12/03/2023]
Affiliation(s)
- Clemens Mingels
- Department of Nuclear Medicine, Inselspital, University Hospital Bern, University of Bern, Freiburgstr. 18, 3010, Bern, Switzerland.
- Department of Radiology, University of California Davis, Sacramento, CA, USA.
| | - Federico Caobelli
- Department of Nuclear Medicine, Inselspital, University Hospital Bern, University of Bern, Freiburgstr. 18, 3010, Bern, Switzerland
| | - Abass Alavi
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Christos Sachpekidis
- Clinical Cooperation Unit Nuclear Medicine, German Cancer Research Centre, Heidelberg, Germany
| | - Meiyun Wang
- Medical Imaging Institute, Henan Provincial People's Hospital & People's Hospital of Zhengzhou, Zhengzhou, China
| | - Hande Nalbant
- Department of Radiology, University of California Davis, Sacramento, CA, USA
| | - Austin R Pantel
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Hongcheng Shi
- Department of Nuclear Medicine, Zhongshan Hospital Fudan University, Shanghai, China
| | - Axel Rominger
- Department of Nuclear Medicine, Inselspital, University Hospital Bern, University of Bern, Freiburgstr. 18, 3010, Bern, Switzerland
| | - Lorenzo Nardo
- Department of Radiology, University of California Davis, Sacramento, CA, USA
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14
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Spencer BA, McBride K, Hunt H, Jones T, Cherry SR, Badawi RD. Practical Considerations for Total-Body PET Acquisition and Imaging. Methods Mol Biol 2024; 2729:371-389. [PMID: 38006507 DOI: 10.1007/978-1-0716-3499-8_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2023]
Abstract
The world's first total-body PET/CT system has been in routine clinical and research use at UC Davis since 2019. The uEXPLORER total-body PET scanner has been designed with an axial field-of-view long enough to completely encompass most human subjects (194 cm or 76 inches long), allowing for a 15-68-fold gain in the PET signal collection efficiency over conventional PET scanners. A high-sensitivity PET scanner that can image the entire subject with a single bed position comes with new benefits and challenges to consider for efficient and practical use. In this chapter, we discuss the common clinical and research imaging protocols implemented at our institution, along with the appropriate technical and practical considerations of total-body PET imaging.
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Affiliation(s)
- Benjamin A Spencer
- Department of Radiology, University of California-Davis, Sacramento, CA, USA.
- Department of Biomedical Engineering, University of California-Davis, Davis, CA, USA.
| | - Kristin McBride
- Department of Radiology, University of California-Davis, Sacramento, CA, USA
| | - Heather Hunt
- Department of Radiology, University of California-Davis, Sacramento, CA, USA
| | - Terry Jones
- Department of Radiology, University of California-Davis, Sacramento, CA, USA
| | - Simon R Cherry
- Department of Radiology, University of California-Davis, Sacramento, CA, USA
- Department of Biomedical Engineering, University of California-Davis, Davis, CA, USA
| | - Ramsey D Badawi
- Department of Radiology, University of California-Davis, Sacramento, CA, USA
- Department of Biomedical Engineering, University of California-Davis, Davis, CA, USA
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Singh MK. A review of digital PET-CT technology: Comparing performance parameters in SiPM integrated digital PET-CT systems. Radiography (Lond) 2024; 30:13-20. [PMID: 37864986 DOI: 10.1016/j.radi.2023.10.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 09/29/2023] [Accepted: 10/03/2023] [Indexed: 10/23/2023]
Abstract
OBJECTIVE The objective of this study was to perform a narrative review of digital Positron emission tomography-computed tomography (PET-CT) scanners, focussing on the current development in the technology of optimized crystal size and design, the time of flight (ToF) resolution, sensitivity, and axial field of view (AFOV). KEY FINDINGS It was observed that significant developments were carried out on the optimization of scintillation crystal size which results in the improvement of spatial resolution. such developments include the upgrade in the AFOV after the integration of SiPM technology, which results in dynamic parametric imaging acquisition in PET and sensitivity boost. The improvement in ToF resolution and the better ToF resolution values, which result in a boost in adequate sensitivity and signal-to-noise ratio (SNR). Other upgrades include the use of the smallest crystal size of 2.76 × 2.76 mm, and the use of the lowest ToF resolution of 214 ps. The use of the largest AFOV of 194 cm with the highest observed NEMA sensitivity of 225 cps/kBq for the total body PET-CT system. CONCLUSION Digital PET-CT systems offer various advantages such as a reduction in radiation dose from injected radiopharmaceuticals doses and the overall PET acquisition time with an improved diagnostic certainty. This is because of the better performance of the SiPM detector. Digital PET-CT also has added benefits of the dynamic acquisition and Patlak modeling capabilities into routine clinical practice with the advancement in higher AFOV PET systems. IMPLICATION This will help the users choose the best system during the evaluation of the PET-CT for purchase in clinical and research applications. This review will further help in teaching the latest technology and developments in PET-CT systems.
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Affiliation(s)
- M K Singh
- AECC University College, Parkwood Road, Bournemouth, UK.
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16
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McQuaid SJ. The impact of total body PET. Nucl Med Commun 2023; 44:1184-1186. [PMID: 37901931 DOI: 10.1097/mnm.0000000000001772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Affiliation(s)
- Sarah J McQuaid
- Institute of Nuclear Medicine, University College London Hospitals, London, UK
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17
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Rezaei H, Sheikhzadeh P, Ghafarian P, Zaidi H, Ay MR. Accurate modeling and performance evaluation of a total-body pet scanner using Monte Carlo simulations. Med Phys 2023; 50:6815-6827. [PMID: 37665768 DOI: 10.1002/mp.16707] [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: 02/28/2022] [Revised: 08/22/2023] [Accepted: 08/22/2023] [Indexed: 09/06/2023] Open
Abstract
BACKGROUND The limited axial field-of-view (FOV) of conventional clinical positron emission tomography (PET) scanners (∼15 to 26 cm) allows detecting only 1% of all coincidence photons, hence limiting significantly their sensitivity. To overcome this limitation, the EXPLORER consortium developed the world's first total-body PET/CT scanner that significantly increased the sensitivity, thus enabling to decrease the scan duration or injected dose. PURPOSE The purpose of this study is to perform and validate Monte Carlo simulations of the uEXPLORER PET scanner, which can be used to devise novel conceptual designs and geometrical configurations through obtaining features that are difficult to obtain experimentally. METHODS The total-body uEXPLORER PET scanner was modeled using GATE Monte Carlo (MC) platform. The model was validated through comparison with experimental measurements of various performance parameters, including spatial resolution, sensitivity, count rate performance, and image quality, according to NEMA-NU2 2018 standards. Furthermore, the effects of the time coincidence window and maximum ring difference on the count rate and noise equivalent count rate (NECR) were evaluated. RESULTS Overall, the validation study showed that there was a good agreement between the simulation and experimental results. The differences between the simulated and experimental total sensitivity for the NEMA and extended phantoms at the center of the FOV were 2.3% and 0.0%, respectively. The difference in peak NECR was 9.9% for the NEMA phantom and 1.0% for the extended phantom. The average bias between the simulated and experimental results of the full-width-at-half maximum (FWHM) for six different positions and three directions was 0.12 mm. The simulations showed that using a variable coincidence time window based on the maximum ring difference can reduce the effect of random coincidences and improve the NECR compared to a constant time coincidence window. The NECR corresponding to 252-ring difference was 2.11 Mcps, which is larger than the NECR corresponding to 336-ring difference (2.04 Mcps). CONCLUSION The developed MC model of the uEXPLORER PET scanner was validated against experimental measurements and can be used for further assessment and design optimization of the scanner.
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Affiliation(s)
- Hadi Rezaei
- Department of Medical Physics and Biomedical Engineering, Tehran University of Medical Science, Tehran, Iran
- Research Center for Molecular and Cellular Imaging (RCMCI), Advanced Medical Technologies and Equipment Institute (AMTEI), Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Peyman Sheikhzadeh
- Department of Medical Physics and Biomedical Engineering, Tehran University of Medical Science, Tehran, Iran
- Department of Nuclear Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Pardis Ghafarian
- Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
- PET/CT and Cyclotron Center, Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Habib Zaidi
- Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospital, Geneva, Switzerland
- Geneva University Neurocenter, Geneva University, Geneva, Switzerland
- Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University, Medical Center Groningen, Groningen, Netherlands
- Department of Nuclear Medicine, University of Southern Denmark, Odense, Denmark
| | - Mohammad Reza Ay
- Department of Medical Physics and Biomedical Engineering, Tehran University of Medical Science, Tehran, Iran
- Research Center for Molecular and Cellular Imaging (RCMCI), Advanced Medical Technologies and Equipment Institute (AMTEI), Tehran University of Medical Sciences (TUMS), Tehran, Iran
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18
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Alberts I, Seibel S, Xue S, Viscione M, Mingels C, Sari H, Afshar-Oromieh A, Limacher A, Rominger A. Investigating the influence of long-axial versus short-axial field of view PET/CT on stage migration in lymphoma and non-small cell lung cancer. Nucl Med Commun 2023; 44:988-996. [PMID: 37578376 PMCID: PMC10566597 DOI: 10.1097/mnm.0000000000001745] [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: 05/17/2023] [Accepted: 07/27/2023] [Indexed: 08/15/2023]
Abstract
OBJECTIVES The objective of this study was to evaluate the influence of a long-axial field-of-view (LAFOV) on stage migration using a large single-centre retrospective cohort in lymphoma and non-small cell lung cancer (NSCLC). METHODS A retrospective study is performed for patients undergoing PET/computed tomography (CT) on either a short-axial field-of-view (SAFOV) or LAFOV PET/CT system for the staging of known or suspected NSCLC or for therapeutic response in lymphoma. The primary endpoint was the Deauville therapy response score for patients with lymphoma for the two systems. Secondary endpoints were the American Joint Committee on Cancer stage for NSCLC, the frequency of cN3 and cM1 findings, the probability for a positive nodal staging (cN1-3) for NSCLC and the diagnostic accuracy for nodal staging in NSCLC. RESULTS One thousand two hundred eighteen records were screened and 597 patients were included for analysis ( N = 367 for lymphoma and N = 291 for NSCLC). For lymphoma, no significant differences were found in the proportion of patients with complete metabolic response versus non-complete metabolic response Deauville response scores ( P = 0.66). For NSCLC no significant differences were observed between the two scanners for the frequency of cN3 and cM1 findings, for positive nodal staging, neither the sensitivity nor the specificity. CONCLUSIONS In this study use of a LAFOV system was neither associated with upstaging in lymphoma nor NSCLC compared to a digital SAFOV system. Diagnostic accuracy was comparable between the two systems in NSCLC despite shorter acquisition times for LAFOV.
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Affiliation(s)
- Ian Alberts
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Bern
| | - Sigrid Seibel
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Bern
| | - Song Xue
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Bern
| | - Marco Viscione
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Bern
| | - Clemens Mingels
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Bern
| | - Hasan Sari
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Bern
- Advanced Clinical Imaging Technology, Siemens Healthcare AG, Lausanne
| | - Ali Afshar-Oromieh
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Bern
| | | | - Axel Rominger
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Bern
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19
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Roya M, Mostafapour S, Mohr P, Providência L, Li Z, van Snick JH, Brouwers AH, Noordzij W, Willemsen ATM, Dierckx RAJO, Lammertsma AA, Glaudemans AWJM, Tsoumpas C, Slart RHJA, van Sluis J. Current and Future Use of Long Axial Field-of-View Positron Emission Tomography/Computed Tomography Scanners in Clinical Oncology. Cancers (Basel) 2023; 15:5173. [PMID: 37958347 PMCID: PMC10648837 DOI: 10.3390/cancers15215173] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 10/23/2023] [Accepted: 10/24/2023] [Indexed: 11/15/2023] Open
Abstract
The latest technical development in the field of positron emission tomography/computed tomography (PET/CT) imaging has been the extension of the PET axial field-of-view. As a result of the increased number of detectors, the long axial field-of-view (LAFOV) PET systems are not only characterized by a larger anatomical coverage but also by a substantially improved sensitivity, compared with conventional short axial field-of-view PET systems. In clinical practice, this innovation has led to the following optimization: (1) improved overall image quality, (2) decreased duration of PET examinations, (3) decreased amount of radioactivity administered to the patient, or (4) a combination of any of the above. In this review, novel applications of LAFOV PET in oncology are highlighted and future directions are discussed.
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Affiliation(s)
- Mostafa Roya
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, P.O. Box 30001, 9700 RB Groningen, The Netherlands; (S.M.); (P.M.); (L.P.); (Z.L.); (J.H.v.S.); (A.H.B.); (W.N.); (A.T.M.W.); (R.A.J.O.D.); (A.A.L.); (A.W.J.M.G.); (C.T.); (J.v.S.)
| | - Samaneh Mostafapour
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, P.O. Box 30001, 9700 RB Groningen, The Netherlands; (S.M.); (P.M.); (L.P.); (Z.L.); (J.H.v.S.); (A.H.B.); (W.N.); (A.T.M.W.); (R.A.J.O.D.); (A.A.L.); (A.W.J.M.G.); (C.T.); (J.v.S.)
| | - Philipp Mohr
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, P.O. Box 30001, 9700 RB Groningen, The Netherlands; (S.M.); (P.M.); (L.P.); (Z.L.); (J.H.v.S.); (A.H.B.); (W.N.); (A.T.M.W.); (R.A.J.O.D.); (A.A.L.); (A.W.J.M.G.); (C.T.); (J.v.S.)
| | - Laura Providência
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, P.O. Box 30001, 9700 RB Groningen, The Netherlands; (S.M.); (P.M.); (L.P.); (Z.L.); (J.H.v.S.); (A.H.B.); (W.N.); (A.T.M.W.); (R.A.J.O.D.); (A.A.L.); (A.W.J.M.G.); (C.T.); (J.v.S.)
| | - Zekai Li
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, P.O. Box 30001, 9700 RB Groningen, The Netherlands; (S.M.); (P.M.); (L.P.); (Z.L.); (J.H.v.S.); (A.H.B.); (W.N.); (A.T.M.W.); (R.A.J.O.D.); (A.A.L.); (A.W.J.M.G.); (C.T.); (J.v.S.)
| | - Johannes H. van Snick
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, P.O. Box 30001, 9700 RB Groningen, The Netherlands; (S.M.); (P.M.); (L.P.); (Z.L.); (J.H.v.S.); (A.H.B.); (W.N.); (A.T.M.W.); (R.A.J.O.D.); (A.A.L.); (A.W.J.M.G.); (C.T.); (J.v.S.)
| | - Adrienne H. Brouwers
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, P.O. Box 30001, 9700 RB Groningen, The Netherlands; (S.M.); (P.M.); (L.P.); (Z.L.); (J.H.v.S.); (A.H.B.); (W.N.); (A.T.M.W.); (R.A.J.O.D.); (A.A.L.); (A.W.J.M.G.); (C.T.); (J.v.S.)
| | - Walter Noordzij
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, P.O. Box 30001, 9700 RB Groningen, The Netherlands; (S.M.); (P.M.); (L.P.); (Z.L.); (J.H.v.S.); (A.H.B.); (W.N.); (A.T.M.W.); (R.A.J.O.D.); (A.A.L.); (A.W.J.M.G.); (C.T.); (J.v.S.)
| | - Antoon T. M. Willemsen
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, P.O. Box 30001, 9700 RB Groningen, The Netherlands; (S.M.); (P.M.); (L.P.); (Z.L.); (J.H.v.S.); (A.H.B.); (W.N.); (A.T.M.W.); (R.A.J.O.D.); (A.A.L.); (A.W.J.M.G.); (C.T.); (J.v.S.)
| | - Rudi A. J. O. Dierckx
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, P.O. Box 30001, 9700 RB Groningen, The Netherlands; (S.M.); (P.M.); (L.P.); (Z.L.); (J.H.v.S.); (A.H.B.); (W.N.); (A.T.M.W.); (R.A.J.O.D.); (A.A.L.); (A.W.J.M.G.); (C.T.); (J.v.S.)
| | - Adriaan A. Lammertsma
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, P.O. Box 30001, 9700 RB Groningen, The Netherlands; (S.M.); (P.M.); (L.P.); (Z.L.); (J.H.v.S.); (A.H.B.); (W.N.); (A.T.M.W.); (R.A.J.O.D.); (A.A.L.); (A.W.J.M.G.); (C.T.); (J.v.S.)
| | - Andor W. J. M. Glaudemans
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, P.O. Box 30001, 9700 RB Groningen, The Netherlands; (S.M.); (P.M.); (L.P.); (Z.L.); (J.H.v.S.); (A.H.B.); (W.N.); (A.T.M.W.); (R.A.J.O.D.); (A.A.L.); (A.W.J.M.G.); (C.T.); (J.v.S.)
| | - Charalampos Tsoumpas
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, P.O. Box 30001, 9700 RB Groningen, The Netherlands; (S.M.); (P.M.); (L.P.); (Z.L.); (J.H.v.S.); (A.H.B.); (W.N.); (A.T.M.W.); (R.A.J.O.D.); (A.A.L.); (A.W.J.M.G.); (C.T.); (J.v.S.)
| | - Riemer H. J. A. Slart
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, P.O. Box 30001, 9700 RB Groningen, The Netherlands; (S.M.); (P.M.); (L.P.); (Z.L.); (J.H.v.S.); (A.H.B.); (W.N.); (A.T.M.W.); (R.A.J.O.D.); (A.A.L.); (A.W.J.M.G.); (C.T.); (J.v.S.)
- Department of Biomedical Photonic Imaging, Faculty of Science and Technology, University of Twente, 7522 NB Enchede, The Netherlands
| | - Joyce van Sluis
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, P.O. Box 30001, 9700 RB Groningen, The Netherlands; (S.M.); (P.M.); (L.P.); (Z.L.); (J.H.v.S.); (A.H.B.); (W.N.); (A.T.M.W.); (R.A.J.O.D.); (A.A.L.); (A.W.J.M.G.); (C.T.); (J.v.S.)
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Cherry SR, Diekmann J, Bengel FM. Total-Body Positron Emission Tomography: Adding New Perspectives to Cardiovascular Research. JACC Cardiovasc Imaging 2023; 16:1335-1347. [PMID: 37676207 DOI: 10.1016/j.jcmg.2023.06.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 06/26/2023] [Accepted: 06/27/2023] [Indexed: 09/08/2023]
Abstract
The recent advent of positron emission tomography (PET) scanners that can image the entire human body opens up intriguing possibilities for cardiovascular research and future clinical applications. These new systems permit radiotracer kinetics to be measured in all organs simultaneously. They are particularly well suited to study cardiovascular disease and its effects on the entire body. They could also play a role in quantitatively measuring physiologic, metabolic, and immunologic responses in healthy individuals to a variety of stressors and lifestyle interventions, and may ultimately be instrumental for evaluating novel therapeutic agents and their molecular effects across different tissues. In this review, we summarize recent progress in PET technology and methodology, discuss several emerging cardiovascular applications for total-body PET, and place this in the context of multiorgan and systems medicine. Finally, we discuss opportunities that will be enabled by the technology, while also pointing to some of the challenges that still need to be addressed.
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Affiliation(s)
- Simon R Cherry
- Departments of Biomedical Engineering and Radiology, University of California, Davis, California, USA.
| | - Johanna Diekmann
- Departments of Biomedical Engineering and Radiology, University of California, Davis, California, USA; Department of Nuclear Medicine, Hannover Medical School, Hannover, Germany
| | - Frank M Bengel
- Department of Nuclear Medicine, Hannover Medical School, Hannover, Germany
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21
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Vandenberghe S, Muller FM, Withofs N, Dadgar M, Maebe J, Vervenne B, Akl MA, Xue S, Shi K, Sportelli G, Belcari N, Hustinx R, Vanhove C, Karp JS. Walk-through flat panel total-body PET: a patient-centered design for high throughput imaging at lower cost using DOI-capable high-resolution monolithic detectors. Eur J Nucl Med Mol Imaging 2023; 50:3558-3571. [PMID: 37466650 PMCID: PMC10547652 DOI: 10.1007/s00259-023-06341-x] [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: 05/23/2023] [Accepted: 07/07/2023] [Indexed: 07/20/2023]
Abstract
PURPOSE Long axial field-of-view (LAFOV) systems have a much higher sensitivity than standard axial field-of-view (SAFOV) PET systems for imaging the torso or full body, which allows faster and/or lower dose imaging. Despite its very high sensitivity, current total-body PET (TB-PET) throughput is limited by patient handling (positioning on the bed) and often a shortage of available personnel. This factor, combined with high system costs, makes it hard to justify the implementation of these systems for many academic and nearly all routine nuclear medicine departments. We, therefore, propose a novel, cost-effective, dual flat panel TB-PET system for patients in upright standing positions to avoid the time-consuming positioning on a PET-CT table; the walk-through (WT) TB-PET. We describe a patient-centered, flat panel PET design that offers very efficient patient throughput and uses monolithic detectors (with BGO or LYSO) with depth-of-interaction (DOI) capabilities and high intrinsic spatial resolution. We compare system sensitivity, component costs, and patient throughput of the proposed WT-TB-PET to a SAFOV (= 26 cm) and a LAFOV (= 106 cm) LSO PET systems. METHODS Patient width, height (= top head to start of thighs) and depth (= distance from the bed to front of patient) were derived from 40 randomly selected PET-CT scans to define the design dimensions of the WT-TB-PET. We compare this new PET system to the commercially available Siemens Biograph Vision 600 (SAFOV) and Siemens Quadra (LAFOV) PET-CT in terms of component costs, system sensitivity, and patient throughput. System cost comparison was based on estimating the cost of the two main components in the PET system (Silicon Photomultipliers (SiPMs) and scintillators). Sensitivity values were determined using Gate Monte Carlo simulations. Patient throughput times (including CT and scout scan, patient positioning on bed and transfer) were recorded for 1 day on a Siemens Vision 600 PET. These timing values were then used to estimate the expected patient throughput (assuming an equal patient radiotracer injected activity to patients and considering differences in system sensitivity and time-of-flight information) for WT-TB-PET, SAFOV and LAFOV PET. RESULTS The WT-TB-PET is composed of two flat panels; each is 70 cm wide and 106 cm high, with a 50-cm gap between both panels. These design dimensions were justified by the patient sizes measured from the 40 random PET-CT scans. Each panel consists of 14 × 20 monolithic BGO detector blocks that are 50 × 50 × 16 mm in size and are coupled to a readout with 6 × 6 mm SiPMs arrays. For the WT-TB-PET, the detector surface is reduced by a factor of 1.9 and the scintillator volume by a factor of 2.2 compared to LAFOV PET systems, while demonstrating comparable sensitivity and much better uniform spatial resolution (< 2 mm in all directions over the FOV). The estimated component cost for the WT-TB-PET is 3.3 × lower than that of a 106 cm LAFOV system and only 20% higher than the PET component costs of a SAFOV. The estimated maximum number of patients scanned on a standard 8-h working day increases from 28 (for SAFOV) to 53-60 (for LAFOV in limited/full acceptance) to 87 (for the WT-TB-PET). By scanning faster (more patients), the amount of ordered activity per patient can be reduced drastically: the WT-TB-PET requires 66% less ordered activity per patient than a SAFOV. CONCLUSIONS We propose a monolithic BGO or LYSO-based WT-TB-PET system with DOI measurements that departs from the classical patient positioning on a table and allows patients to stand upright between two flat panels. The WT-TB-PET system provides a solution to achieve a much lower cost TB-PET approaching the cost of a SAFOV system. High patient throughput is increased by fast patient positioning between two vertical flat panel detectors of high sensitivity. High spatial resolution (< 2 mm) uniform over the FOV is obtained by using DOI-capable monolithic scintillators.
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Affiliation(s)
- Stefaan Vandenberghe
- Medical Image and Signal Processing, Department of Electronics and Information Systems, Faculty of Engineering and Architecture, Ghent University, Corneel Heymanslaan 10, 9000, Ghent, Belgium.
| | - Florence M Muller
- Medical Image and Signal Processing, Department of Electronics and Information Systems, Faculty of Engineering and Architecture, Ghent University, Corneel Heymanslaan 10, 9000, Ghent, Belgium
| | - Nadia Withofs
- Division of Nuclear Medicine and Oncological Imaging, Department of Medical Physics, CHU of Liege, Quartier Hôpital, Avenue de Hôpital, 1, 4000, Liège 1, Belgium
| | - Meysam Dadgar
- Medical Image and Signal Processing, Department of Electronics and Information Systems, Faculty of Engineering and Architecture, Ghent University, Corneel Heymanslaan 10, 9000, Ghent, Belgium
| | - Jens Maebe
- Medical Image and Signal Processing, Department of Electronics and Information Systems, Faculty of Engineering and Architecture, Ghent University, Corneel Heymanslaan 10, 9000, Ghent, Belgium
| | - Boris Vervenne
- Medical Image and Signal Processing, Department of Electronics and Information Systems, Faculty of Engineering and Architecture, Ghent University, Corneel Heymanslaan 10, 9000, Ghent, Belgium
| | - Maya Abi Akl
- Medical Image and Signal Processing, Department of Electronics and Information Systems, Faculty of Engineering and Architecture, Ghent University, Corneel Heymanslaan 10, 9000, Ghent, Belgium
| | - Song Xue
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Kuangyu Shi
- Division of Nuclear Medicine and Oncological Imaging, Department of Medical Physics, CHU of Liege, Quartier Hôpital, Avenue de Hôpital, 1, 4000, Liège 1, Belgium
| | - Giancarlo Sportelli
- Dipartimento Di Fisica "E. Fermi", Università Di Pisa, Italy and with the Instituto Nazionale Di Fisica Nucleare, Sezione Di Pisa, 56127, Pisa, Italy
| | - Nicola Belcari
- Dipartimento Di Fisica "E. Fermi", Università Di Pisa, Italy and with the Instituto Nazionale Di Fisica Nucleare, Sezione Di Pisa, 56127, Pisa, Italy
| | - Roland Hustinx
- Division of Nuclear Medicine and Oncological Imaging, Department of Medical Physics, CHU of Liege, Quartier Hôpital, Avenue de Hôpital, 1, 4000, Liège 1, Belgium
| | - Christian Vanhove
- Medical Image and Signal Processing, Department of Electronics and Information Systems, Faculty of Engineering and Architecture, Ghent University, Corneel Heymanslaan 10, 9000, Ghent, Belgium
| | - Joel S Karp
- Physics and Instrumentation, Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
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22
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Abi-Akl M, Dadgar M, Toufique Y, Bouhali O, Vandenberghe S. Monte Carlo simulation of the system performance of a long axial field-of-view PET based on monolithic LYSO detectors. EJNMMI Phys 2023; 10:37. [PMID: 37311926 PMCID: PMC10264335 DOI: 10.1186/s40658-023-00559-2] [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: 02/02/2023] [Accepted: 06/05/2023] [Indexed: 06/15/2023] Open
Abstract
BACKGROUND In light of the milestones achieved in PET design so far, further sensitivity improvements aim to optimise factors such as the dose, throughput, and detection of small lesions. While several longer axial field-of-view (aFOV) PET systems based on pixelated detectors have been installed, continuous monolithic scintillation detectors recently gained increased attention due to their depth of interaction capability and superior intrinsic resolution. As a result, the aim of this work is to present and evaluate the performance of two long aFOV, monolithic LYSO-based PET scanner designs. METHODS Geant4 Application for Tomographic Emission (GATE) v9.1 was used to perform the simulations. Scanner designs A and B have an aFOV of 36.2 cm (7 rings) and 72.6 cm (14 rings), respectively, with 40 detector modules per ring each and a bore diameter of 70 cm. Each module is a 50 × 50 × 16 mm3 monolithic LYSO crystal. Sensitivity, noise equivalent count rate (NECR), scatter fraction, spatial resolution, and image quality tests were performed based on NEMA NU-2018 standards. RESULTS The sensitivity of design A was calculated to be 29.2 kcps/MBq at the centre and 27 kcps/MBq at 10 cm radial offset; similarly, the sensitivity of design B was found to be 106.8 kcps/MBq and 98.3 kcps/MBq at 10 cm radial offset. NECR peaks were reached at activity concentrations beyond the range of activities used for clinical studies. In terms of spatial resolution, the values for the point sources were below 2 mm for the radial, tangential, and axial full width half maximum. The contrast recovery coefficient ranged from 53% for design B and 4:1 contrast ratio to 90% for design A and 8:1 ratio, with a reasonably low background variability. CONCLUSIONS Longer aFOV PET designs using monolithic LYSO have superior spatial resolution compared to current pixelated total-body PET (TB-PET) scanners. These systems combine high sensitivity with improved contrast recovery.
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Affiliation(s)
- Maya Abi-Akl
- Department of Electronics and Information Systems, Medical Image and Signal Processing, Ghent University, Ghent, Belgium.
- Division of Arts and Sciences, Texas A&M University at Qatar, Doha, Qatar.
| | - Meysam Dadgar
- Department of Electronics and Information Systems, Medical Image and Signal Processing, Ghent University, Ghent, Belgium
| | - Yassine Toufique
- Energy, Materials, Numerical Physics, Ecole Normal Supérieur (ENS), Abdelmalek Essaadi University, Tétouan, Morocco
| | - Othmane Bouhali
- Division of Arts and Sciences, Texas A&M University at Qatar, Doha, Qatar
| | - Stefaan Vandenberghe
- Department of Electronics and Information Systems, Medical Image and Signal Processing, Ghent University, Ghent, Belgium
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Surti S, Werner ME, Karp JS. Evaluation of cost-effective system designs for long axial field-of-view PET scanners. Phys Med Biol 2023; 68:10.1088/1361-6560/accf5d. [PMID: 37084744 PMCID: PMC10231377 DOI: 10.1088/1361-6560/accf5d] [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: 12/20/2022] [Accepted: 04/21/2023] [Indexed: 04/23/2023]
Abstract
Objective. Current commercial positron emission tomography (PET) scanners have excellent performance and diagnostic image quality primarily due to improvements in scanner sensitivity and time-of-flight (TOF) resolution. Recent years have seen the development of total-body PET scanners with longer axial field-of-view (AFOV) that increase sensitivity for single organ imaging, and also image more of the patient in a single bed position thereby enabling multi-organ dynamic imaging. While studies have shown significant capabilities of these systems, cost will be a major factor in their widespread adoption in the clinic. Here we evaluate alternative designs that achieve many advantages of long AFOV PET while utilizing cost-effective detector hardware.Approach. We utilize Monte Carlo simulations and clinically relevant lesion detectability metric to study the impact of scintillator type lutetium oxyorthosilicate or bismuth germanate (LSO or BGO), scintillator thickness (10-20 mm), and TOF resolution on resultant image quality in a 72 cm long scanner. Detector TOF resolution was varied based on current scanner performance, as well as expected future performance from detector designs that currently hold most promise for scaling into a scanner.Main results. Results indicate that BGO is competitive with LSO (both 20 mm thick) if we assume that it uses TOF (e.g. Cerenkov timing with 450 ps fwhm and Lorentzian distribution) and the LSO scanner has TOF resolution similar to the latest PMT-based scanners (∼500-650 ps). Alternatively, a system using 10 mm thick LSO with 150 ps TOF resolution can also provide similar performance. Both these alternative systems can provide cost savings (25%-33%) relative to a scanner using 20 mm LSO with ∼50% of effective sensitivity, but still 500%-700% higher than a conventional AFOV scanner.Significance. Our results have relevance to the development of long AFOV PET, where reduced cost of these alternative designs can provide wider accessibility for use in situations requiring imaging of multiple organs simultaneously.
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Affiliation(s)
- Suleman Surti
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Matthew E Werner
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Joel S Karp
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, United States of America
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Karimi H, Moskal P, Żak A, Stępień EŁ. 3D melanoma spheroid model for the development of positronium biomarkers. Sci Rep 2023; 13:7648. [PMID: 37169794 PMCID: PMC10175546 DOI: 10.1038/s41598-023-34571-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Accepted: 05/03/2023] [Indexed: 05/13/2023] Open
Abstract
It was recently demonstrated that newly invented positronium imaging may be used for improving cancer diagnostics by providing additional information about tissue pathology with respect to the standardized uptake value currently available in positron emission tomography (PET). Positronium imaging utilizes the properties of positronium atoms, which are built from the electrons and positrons produced in the body during PET examinations. We hypothesized that positronium imaging would be sensitive to the in vitro discrimination of tumor-like three-dimensional structures (spheroids) built of melanoma cell lines with different cancer activities and biological properties. The lifetime of ortho-positronium (o-Ps) was evaluated in melanoma spheroids from two cell lines (WM266-4 and WM115) differing in the stage of malignancy. Additionally, we considered parameters such as the cell number, spheroid size and melanoma malignancy to evaluate their relationship with the o-Ps lifetime. We demonstrate pilot results for o-Ps lifetime measurement in extracellular matrix-free spheroids. With the statistical significance of two standard deviations, we demonstrated that the higher the degree of malignancy and the rate of proliferation of neoplastic cells, the shorter the lifetime of ortho-positronium. In particular, we observed the following indications encouraging further research: (i) WM266-4 spheroids characterized by a higher proliferation rate and malignancy showed a shorter o-Ps lifetime than WM115 spheroids characterized by a lower growth rate. (ii) Both cell lines showed a decrease in the lifetime of o-Ps after spheroid generation on day 8 compared to day 4 in culture, and the mean o-Ps lifetime was longer for spheroids formed from WM115 cells than for those formed from WM266-4 cells, regardless of spheroid age. The results of this study revealed that positronium is a promising biomarker that may be applied in PET diagnostics for the assessment of the degree of cancer malignancy.
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Affiliation(s)
- Hanieh Karimi
- Department of Medical Physics, M. Smoluchowski Institute of Physics, Faculty of Physics, Astronomy and Applied Computer Science, Jagiellonian University, Łojasiewicza 11 Street, 30-348, Kraków, Poland
- Department of Biochemistry, University of Missouri, Columbia, USA
| | - Paweł Moskal
- Department of Experimental Particle Physics and Applications, M. Smoluchowski Institute of Physics, Faculty of Physics, Astronomy and Applied Computer Science, Jagiellonian University, Kraków, Poland
- Center for Theranostics, Jagiellonian University, Kraków, Poland
| | - Agata Żak
- Faculty of Chemistry, Jagiellonian University, Kraków, Poland
| | - Ewa Ł Stępień
- Department of Medical Physics, M. Smoluchowski Institute of Physics, Faculty of Physics, Astronomy and Applied Computer Science, Jagiellonian University, Łojasiewicza 11 Street, 30-348, Kraków, Poland.
- Center for Theranostics, Jagiellonian University, Kraków, Poland.
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Triumbari EKA, Rufini V, Mingels C, Rominger A, Alavi A, Fanfani F, Badawi RD, Nardo L. Long Axial Field-of-View PET/CT Could Answer Unmet Needs in Gynecological Cancers. Cancers (Basel) 2023; 15:2407. [PMID: 37173874 PMCID: PMC10177015 DOI: 10.3390/cancers15092407] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 04/15/2023] [Accepted: 04/21/2023] [Indexed: 05/15/2023] Open
Abstract
Gynecological malignancies currently affect about 3.5 million women all over the world. Imaging of uterine, cervical, vaginal, ovarian, and vulvar cancer still presents several unmet needs when using conventional modalities such as ultrasound, computed tomography (CT), magnetic resonance, and standard positron emission tomography (PET)/CT. Some of the current diagnostic limitations are represented by differential diagnosis between inflammatory and cancerous findings, detection of peritoneal carcinomatosis and metastases <1 cm, detection of cancer-associated vascular complications, effective assessment of post-therapy changes, as well as bone metabolism and osteoporosis assessment. As a result of recent advances in PET/CT instrumentation, new systems now offer a long-axial field-of-view (LAFOV) to image between 106 cm and 194 cm (i.e., total-body PET) of the patient's body simultaneously and feature higher physical sensitivity and spatial resolution compared to standard PET/CT systems. LAFOV PET could overcome the forementioned limitations of conventional imaging and provide valuable global disease assessment, allowing for improved patient-tailored care. This article provides a comprehensive overview of these and other potential applications of LAFOV PET/CT imaging for patients with gynecological malignancies.
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Affiliation(s)
- Elizabeth Katherine Anna Triumbari
- Nuclear Medicine Unit, G-STeP Radiopharmacy Research Core Facility, Department of Radiology, Radiotherapy and Haematology, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Vittoria Rufini
- Nuclear Medicine Unit, Department of Radiology, Radiotherapy and Haematology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli, 8, 00168 Rome, Italy
- Section of Nuclear Medicine, Department of Radiological Sciences, Radiotherapy and Haematology, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Clemens Mingels
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland
| | - Axel Rominger
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland
| | - Abass Alavi
- Department of Radiology, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Francesco Fanfani
- Woman, Child and Public Health Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
- Section of Obstetrics and Gynaecology, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Roma, Italy
| | - Ramsey D. Badawi
- Department of Radiology, University of California Davis, Sacramento, CA 95819, USA
- Department of Biomedical Engineering, University of California Davis, Davis, CA 95616, USA
| | - Lorenzo Nardo
- Department of Radiology, University of California Davis, Sacramento, CA 95819, USA
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26
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Dai B, Daube-Witherspoon ME, McDonald S, Werner ME, Parma MJ, Geagan MJ, Viswanath V, Karp JS. Performance evaluation of the PennPET explorer with expanded axial coverage. Phys Med Biol 2023; 68:095007. [PMID: 36958051 PMCID: PMC10450774 DOI: 10.1088/1361-6560/acc722] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 03/13/2023] [Accepted: 03/23/2023] [Indexed: 03/25/2023]
Abstract
Objective.This work evaluated the updated PennPET Explorer total-body (TB) PET scanner, which was extended to 6 rings with updated readout firmware to achieve a 142 cm axial field of view (AFOV) without 7.6 cm inter-ring axial gaps.Approach.National Electrical Manufacturers Association (NEMA) NU 2-2018 measurements were performed with modifications including longer phantoms for sensitivity and count-rate measurements and additional positions for spatial resolution and image quality. A long uniform phantom and the clinical trials network (CTN) phantom were also used.Main results.The total sensitivity increased to 140 kcps MBq-1for a 70 cm line, a gain of 1.8x compared to the same system with axial gaps; an additional 47% increase in total counts was observed with a 142 cm line at the same activity per cm. The noise equivalent count rate (NECR) increased by 1.8x without axial gaps. The peak NECR is 1550 kcps at 25 kBq cc-1for a 140 cm phantom; due to increased randoms, the NECR is lower than with a 70 cm phantom, for which NECR is 2156 kcps cc-1at 25 kBq cc-1and continues increasing. The time-of-flight resolution is 250 ps, increasing by <10 ps at the highest activity. The axial spatial resolution degrades by 0.6 mm near the center of the AFOV, compared to 4 mm resolution near the end. The NEMA image quality phantom showed consistent contrast recovery throughout the AFOV. A long uniform phantom demonstrated axial uniformity of uptake and noise, and the CTN phantom demonstrated quantitative accuracy for both18F and89Zr.Significance. The performance evaluation of the updated PennPET Explorer demonstrates significant gains compared to conventional scanners and shows where the current NEMA standard needs to be updated for TB-PET systems. The comparisons of systems with and without inter-ring gaps demonstrate the performance trade-offs of a more cost-effective TB-PET system with incomplete detector coverage.
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Affiliation(s)
- Bing Dai
- Department of Radiology, University
of Pennsylvania, Philadelphia, United States of
America
| | | | - Stephen McDonald
- Department of Radiology, University
of Pennsylvania, Philadelphia, United States of
America
| | - Matthew E Werner
- Department of Radiology, University
of Pennsylvania, Philadelphia, United States of
America
| | - Michael J Parma
- Department of Radiology, University
of Pennsylvania, Philadelphia, United States of
America
| | - Michael J Geagan
- Department of Radiology, University
of Pennsylvania, Philadelphia, United States of
America
| | - Varsha Viswanath
- Department of Radiology, University
of Pennsylvania, Philadelphia, United States of
America
| | - Joel S Karp
- Department of Radiology, University
of Pennsylvania, Philadelphia, United States of
America
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27
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Sharma S, Baran J, Chug N, Curceanu C, Czerwiński E, Dadgar M, Dulski K, Eliyan K, Gajos A, Gupta-Sharma N, Hiesmayr BC, Kacprzak K, Kapłon Ł, Klimaszewski K, Konieczka P, Korcyl G, Kozik T, Krzemień W, Kumar D, Niedźwiecki S, Panek D, Parzych S, Del Rio EP, Raczyński L, Choudhary S, Shopa RY, Skurzok M, Stępień EŁ, Tayefi F, Tayefi K, Wiślicki W, Moskal P. Efficiency determination of J-PET: first plastic scintillators-based PET scanner. EJNMMI Phys 2023; 10:28. [PMID: 37029849 PMCID: PMC10082891 DOI: 10.1186/s40658-023-00546-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 03/22/2023] [Indexed: 04/09/2023] Open
Abstract
BACKGROUND The Jagiellonian Positron Emission Tomograph is the 3-layer prototype of the first scanner based on plastic scintillators, consisting of 192 half-metre-long strips with readouts at both ends. Compared to crystal-based detectors, plastic scintillators are several times cheaper and could be considered as a more economical alternative to crystal scintillators in future PETs. JPET is also a first multi-photon PET prototype. For the development of multi-photon detection, with photon characterized by the continuous energy spectrum, it is important to estimate the efficiency of J-PET as a function of energy deposition. The aim of this work is to determine the registration efficiency of the J-PET tomograph as a function of energy deposition by incident photons and the intrinsic efficiency of the J-PET scanner in detecting photons of different incident energies. In this study, 3-hit events are investigated, where 2-hits are caused by 511 keV photons emitted in [Formula: see text] annihilations, while the third hit is caused by one of the scattered photons. The scattered photon is used to accurately measure the scattering angle and thus the energy deposition. Two hits by a primary and a scattered photon are sufficient to calculate the scattering angle of a photon, while the third hit ensures the precise labeling of the 511 keV photons. RESULTS By comparing experimental and simulated energy distribution spectra, the registration efficiency of the J-PET scanner was determined in the energy deposition range of 70-270 keV, where it varies between 20 and 100[Formula: see text]. In addition, the intrinsic efficiency of the J-PET was also determined as a function of the energy of the incident photons. CONCLUSION A method for determining registration efficiency as a function of energy deposition and intrinsic efficiency as a function of incident photon energy of the J-PET scanner was demonstrated. This study is crucial for evaluating the performance of the scanner based on plastic scintillators and its applications as a standard and multi-photon PET systems. The method may be also used in the calibration of Compton-cameras developed for the ion-beam therapy monitoring and simultaneous multi-radionuclide imaging in nuclear medicine.
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Affiliation(s)
- S Sharma
- Faculty of Physics, Astronomy and Applied Computer Science, Jagiellonian University, prof. Stanisława Łojasiewicza 11, 30-348, Cracow, Poland.
- Total-Body Jagiellonian-PET Laboratory, Jagiellonian University, 30-348, Cracow, Poland.
- Center for Theranostics, Jagiellonian University, 31-034, Cracow, Poland.
| | - J Baran
- Faculty of Physics, Astronomy and Applied Computer Science, Jagiellonian University, prof. Stanisława Łojasiewicza 11, 30-348, Cracow, Poland
- Total-Body Jagiellonian-PET Laboratory, Jagiellonian University, 30-348, Cracow, Poland
- Center for Theranostics, Jagiellonian University, 31-034, Cracow, Poland
| | - N Chug
- Faculty of Physics, Astronomy and Applied Computer Science, Jagiellonian University, prof. Stanisława Łojasiewicza 11, 30-348, Cracow, Poland
- Total-Body Jagiellonian-PET Laboratory, Jagiellonian University, 30-348, Cracow, Poland
- Center for Theranostics, Jagiellonian University, 31-034, Cracow, Poland
| | - C Curceanu
- INFN, Laboratori Nazionali di Frascati, 00044, Frascati, Italy
| | - E Czerwiński
- Faculty of Physics, Astronomy and Applied Computer Science, Jagiellonian University, prof. Stanisława Łojasiewicza 11, 30-348, Cracow, Poland
- Total-Body Jagiellonian-PET Laboratory, Jagiellonian University, 30-348, Cracow, Poland
- Center for Theranostics, Jagiellonian University, 31-034, Cracow, Poland
| | - M Dadgar
- Faculty of Physics, Astronomy and Applied Computer Science, Jagiellonian University, prof. Stanisława Łojasiewicza 11, 30-348, Cracow, Poland
- Total-Body Jagiellonian-PET Laboratory, Jagiellonian University, 30-348, Cracow, Poland
- Center for Theranostics, Jagiellonian University, 31-034, Cracow, Poland
| | - K Dulski
- Faculty of Physics, Astronomy and Applied Computer Science, Jagiellonian University, prof. Stanisława Łojasiewicza 11, 30-348, Cracow, Poland
- Total-Body Jagiellonian-PET Laboratory, Jagiellonian University, 30-348, Cracow, Poland
- Center for Theranostics, Jagiellonian University, 31-034, Cracow, Poland
| | - K Eliyan
- Faculty of Physics, Astronomy and Applied Computer Science, Jagiellonian University, prof. Stanisława Łojasiewicza 11, 30-348, Cracow, Poland
- Total-Body Jagiellonian-PET Laboratory, Jagiellonian University, 30-348, Cracow, Poland
- Center for Theranostics, Jagiellonian University, 31-034, Cracow, Poland
| | - A Gajos
- Faculty of Physics, Astronomy and Applied Computer Science, Jagiellonian University, prof. Stanisława Łojasiewicza 11, 30-348, Cracow, Poland
- Total-Body Jagiellonian-PET Laboratory, Jagiellonian University, 30-348, Cracow, Poland
- Center for Theranostics, Jagiellonian University, 31-034, Cracow, Poland
| | - N Gupta-Sharma
- Faculty of Physics, Astronomy and Applied Computer Science, Jagiellonian University, prof. Stanisława Łojasiewicza 11, 30-348, Cracow, Poland
- Total-Body Jagiellonian-PET Laboratory, Jagiellonian University, 30-348, Cracow, Poland
| | - B C Hiesmayr
- Faculty of Physics, University of Vienna, 1090, Vienna, Austria
| | - K Kacprzak
- Faculty of Physics, Astronomy and Applied Computer Science, Jagiellonian University, prof. Stanisława Łojasiewicza 11, 30-348, Cracow, Poland
- Total-Body Jagiellonian-PET Laboratory, Jagiellonian University, 30-348, Cracow, Poland
- Center for Theranostics, Jagiellonian University, 31-034, Cracow, Poland
| | - Ł Kapłon
- Faculty of Physics, Astronomy and Applied Computer Science, Jagiellonian University, prof. Stanisława Łojasiewicza 11, 30-348, Cracow, Poland
- Total-Body Jagiellonian-PET Laboratory, Jagiellonian University, 30-348, Cracow, Poland
- Center for Theranostics, Jagiellonian University, 31-034, Cracow, Poland
| | - K Klimaszewski
- Department of Complex Systems, National Centre for Nuclear Research, 05-400, Otwock-Świerk, Poland
| | - P Konieczka
- Department of Complex Systems, National Centre for Nuclear Research, 05-400, Otwock-Świerk, Poland
| | - G Korcyl
- Faculty of Physics, Astronomy and Applied Computer Science, Jagiellonian University, prof. Stanisława Łojasiewicza 11, 30-348, Cracow, Poland
- Total-Body Jagiellonian-PET Laboratory, Jagiellonian University, 30-348, Cracow, Poland
| | - T Kozik
- Faculty of Physics, Astronomy and Applied Computer Science, Jagiellonian University, prof. Stanisława Łojasiewicza 11, 30-348, Cracow, Poland
| | - W Krzemień
- High Energy Physics Division, National Centre for Nuclear Research, 05-400, Otwock-Świerk, Poland
| | - D Kumar
- Faculty of Physics, Astronomy and Applied Computer Science, Jagiellonian University, prof. Stanisława Łojasiewicza 11, 30-348, Cracow, Poland
- Total-Body Jagiellonian-PET Laboratory, Jagiellonian University, 30-348, Cracow, Poland
- Center for Theranostics, Jagiellonian University, 31-034, Cracow, Poland
| | - Sz Niedźwiecki
- Faculty of Physics, Astronomy and Applied Computer Science, Jagiellonian University, prof. Stanisława Łojasiewicza 11, 30-348, Cracow, Poland
- Total-Body Jagiellonian-PET Laboratory, Jagiellonian University, 30-348, Cracow, Poland
- Center for Theranostics, Jagiellonian University, 31-034, Cracow, Poland
| | - D Panek
- Faculty of Physics, Astronomy and Applied Computer Science, Jagiellonian University, prof. Stanisława Łojasiewicza 11, 30-348, Cracow, Poland
- Total-Body Jagiellonian-PET Laboratory, Jagiellonian University, 30-348, Cracow, Poland
- Center for Theranostics, Jagiellonian University, 31-034, Cracow, Poland
| | - S Parzych
- Faculty of Physics, Astronomy and Applied Computer Science, Jagiellonian University, prof. Stanisława Łojasiewicza 11, 30-348, Cracow, Poland
- Total-Body Jagiellonian-PET Laboratory, Jagiellonian University, 30-348, Cracow, Poland
- Center for Theranostics, Jagiellonian University, 31-034, Cracow, Poland
| | - E Perez Del Rio
- Faculty of Physics, Astronomy and Applied Computer Science, Jagiellonian University, prof. Stanisława Łojasiewicza 11, 30-348, Cracow, Poland
- Total-Body Jagiellonian-PET Laboratory, Jagiellonian University, 30-348, Cracow, Poland
- Center for Theranostics, Jagiellonian University, 31-034, Cracow, Poland
| | - L Raczyński
- Department of Complex Systems, National Centre for Nuclear Research, 05-400, Otwock-Świerk, Poland
| | - Shivani Choudhary
- Faculty of Physics, Astronomy and Applied Computer Science, Jagiellonian University, prof. Stanisława Łojasiewicza 11, 30-348, Cracow, Poland
- Total-Body Jagiellonian-PET Laboratory, Jagiellonian University, 30-348, Cracow, Poland
- Center for Theranostics, Jagiellonian University, 31-034, Cracow, Poland
| | - R Y Shopa
- Department of Complex Systems, National Centre for Nuclear Research, 05-400, Otwock-Świerk, Poland
| | - M Skurzok
- Faculty of Physics, Astronomy and Applied Computer Science, Jagiellonian University, prof. Stanisława Łojasiewicza 11, 30-348, Cracow, Poland
- Total-Body Jagiellonian-PET Laboratory, Jagiellonian University, 30-348, Cracow, Poland
- Center for Theranostics, Jagiellonian University, 31-034, Cracow, Poland
| | - E Ł Stępień
- Faculty of Physics, Astronomy and Applied Computer Science, Jagiellonian University, prof. Stanisława Łojasiewicza 11, 30-348, Cracow, Poland
- Total-Body Jagiellonian-PET Laboratory, Jagiellonian University, 30-348, Cracow, Poland
- Center for Theranostics, Jagiellonian University, 31-034, Cracow, Poland
| | - F Tayefi
- Faculty of Physics, Astronomy and Applied Computer Science, Jagiellonian University, prof. Stanisława Łojasiewicza 11, 30-348, Cracow, Poland
- Total-Body Jagiellonian-PET Laboratory, Jagiellonian University, 30-348, Cracow, Poland
- Center for Theranostics, Jagiellonian University, 31-034, Cracow, Poland
| | - K Tayefi
- Faculty of Physics, Astronomy and Applied Computer Science, Jagiellonian University, prof. Stanisława Łojasiewicza 11, 30-348, Cracow, Poland
- Total-Body Jagiellonian-PET Laboratory, Jagiellonian University, 30-348, Cracow, Poland
- Center for Theranostics, Jagiellonian University, 31-034, Cracow, Poland
| | - W Wiślicki
- High Energy Physics Division, National Centre for Nuclear Research, 05-400, Otwock-Świerk, Poland
| | - P Moskal
- Faculty of Physics, Astronomy and Applied Computer Science, Jagiellonian University, prof. Stanisława Łojasiewicza 11, 30-348, Cracow, Poland
- Total-Body Jagiellonian-PET Laboratory, Jagiellonian University, 30-348, Cracow, Poland
- Center for Theranostics, Jagiellonian University, 31-034, Cracow, Poland
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28
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Moskal P, Kubicz E, Grudzień G, Czerwiński E, Dulski K, Leszczyński B, Niedźwiecki S, Stępień EŁ. Developing a novel positronium biomarker for cardiac myxoma imaging. EJNMMI Phys 2023; 10:22. [PMID: 36959477 PMCID: PMC10036702 DOI: 10.1186/s40658-023-00543-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 03/10/2023] [Indexed: 03/25/2023] Open
Abstract
PURPOSE Cardiac myxoma (CM), the most common cardiac tumor in adults, accounts for 50-75% of benign cardiac tumors. The diagnosis of CM is often elusive, especially in young stroke survivors and transthoracic echocardiography (TTE) is the initial technique for the differential diagnostics of CM. Less invasive cardiac computed tomography (CT) and magnetic resonance imaging (MRI) are not available for the majority of cardiac patients. Here, a robust imaging approach, ortho-Positronium (o-Ps) imaging, is presented to determine cardiac myxoma extracted from patients undergoing urgent cardiac surgery due to unexpected atrial masses. We aimed to assess if the o-Ps atom, produced copiously in intramolecular voids during the PET imaging, serves as a biomarker for CM diagnosing. METHODS Six perioperative CM and normal (adipose) tissue samples from patients, with primary diagnosis confirmed by the histopathology examination, were examined using positron annihilation lifetime spectroscopy (PALS) and micro-CT. Additionally, cell cultures and confocal microscopy techniques were used to picture cell morphology and origin. RESULTS We observed significant shortening in the mean o-Ps lifetime in tumor with compare to normal tissues: an average value of 1.92(02) ns and 2.72(05) ns for CM and the adipose tissue, respectively. Microscopic differences between tumor samples, confirmed in histopathology examination and micro-CT, did not influenced the major positronium imaging results. CONCLUSIONS Our findings, combined with o-Ps lifetime analysis, revealed the novel emerging positronium imaging marker (o-PS) for cardiovascular imaging. This method opens the new perspective to facilitate the quantitative in vivo assessment of intracardiac masses on a molecular (nanoscale) level.
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Affiliation(s)
- Paweł Moskal
- Department of Experimental Particle Physics and Applications, Marian Smoluchowski Institute of Physics, Faculty of Physics, Astronomy and Applied Computer Science, Jagiellonian University, Łojasiewicza 11, 30-348, Kraków, Poland.
- Total-Body Jagiellonian-PET Laboratory, Jagiellonian University, Kraków, Poland.
- Center for Theranostics, Jagiellonian University, Kraków, Poland.
| | - Ewelina Kubicz
- Total-Body Jagiellonian-PET Laboratory, Jagiellonian University, Kraków, Poland.
- Center for Theranostics, Jagiellonian University, Kraków, Poland.
- Department of Medical Physics, Marian Smoluchowski Institute of Physics, Faculty of Physics, Astronomy and Applied Computer Science, Jagiellonian University, Łojasiewicza 11, 30-348, Kraków, Poland.
| | - Grzegorz Grudzień
- Department of Cardiovascular Surgery and Transplantology, John Paul II Hospital, Kraków, Poland
- Department of Cardiovascular Surgery and Transplantology, Jagiellonian University Medical College, Kraków, Poland
| | - Eryk Czerwiński
- Department of Experimental Particle Physics and Applications, Marian Smoluchowski Institute of Physics, Faculty of Physics, Astronomy and Applied Computer Science, Jagiellonian University, Łojasiewicza 11, 30-348, Kraków, Poland
- Total-Body Jagiellonian-PET Laboratory, Jagiellonian University, Kraków, Poland
| | - Kamil Dulski
- Department of Experimental Particle Physics and Applications, Marian Smoluchowski Institute of Physics, Faculty of Physics, Astronomy and Applied Computer Science, Jagiellonian University, Łojasiewicza 11, 30-348, Kraków, Poland
- Total-Body Jagiellonian-PET Laboratory, Jagiellonian University, Kraków, Poland
| | - Bartosz Leszczyński
- Department of Medical Physics, Marian Smoluchowski Institute of Physics, Faculty of Physics, Astronomy and Applied Computer Science, Jagiellonian University, Łojasiewicza 11, 30-348, Kraków, Poland
| | - Szymon Niedźwiecki
- Department of Experimental Particle Physics and Applications, Marian Smoluchowski Institute of Physics, Faculty of Physics, Astronomy and Applied Computer Science, Jagiellonian University, Łojasiewicza 11, 30-348, Kraków, Poland
- Total-Body Jagiellonian-PET Laboratory, Jagiellonian University, Kraków, Poland
| | - Ewa Ł Stępień
- Total-Body Jagiellonian-PET Laboratory, Jagiellonian University, Kraków, Poland.
- Center for Theranostics, Jagiellonian University, Kraków, Poland.
- Department of Medical Physics, Marian Smoluchowski Institute of Physics, Faculty of Physics, Astronomy and Applied Computer Science, Jagiellonian University, Łojasiewicza 11, 30-348, Kraków, Poland.
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29
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Alberts I, Sari H, Mingels C, Afshar-Oromieh A, Pyka T, Shi K, Rominger A. Long-axial field-of-view PET/CT: perspectives and review of a revolutionary development in nuclear medicine based on clinical experience in over 7000 patients. Cancer Imaging 2023; 23:28. [PMID: 36934273 PMCID: PMC10024603 DOI: 10.1186/s40644-023-00540-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 02/25/2023] [Indexed: 03/20/2023] Open
Abstract
Recently introduced long-axial field-of-view (LAFOV) PET/CT systems represent one of the most significant advancements in nuclear medicine since the advent of multi-modality PET/CT imaging. The higher sensitivity exhibited by such systems allow for reductions in applied activity and short duration scans. However, we consider this to be just one small part of the story: Instead, the ability to image the body in its entirety in a single FOV affords insights which standard FOV systems cannot provide. For example, we now have the ability to capture a wider dynamic range of a tracer by imaging it over multiple half-lives without detrimental image noise, to leverage lower radiopharmaceutical doses by using dual-tracer techniques and with improved quantification. The potential for quantitative dynamic whole-body imaging using abbreviated protocols potentially makes these techniques viable for routine clinical use, transforming PET-reporting from a subjective analysis of semi-quantitative maps of radiopharmaceutical uptake at a single time-point to an accurate and quantitative, non-invasive tool to determine human function and physiology and to explore organ interactions and to perform whole-body systems analysis. This article will share the insights obtained from 2 years' of clinical operation of the first Biograph Vision Quadra (Siemens Healthineers) LAFOV system. It will also survey the current state-of-the-art in PET technology. Several technologies are poised to furnish systems with even greater sensitivity and resolution than current systems, potentially with orders of magnitude higher sensitivity. Current barriers which remain to be surmounted, such as data pipelines, patient throughput and the hindrances to implementing kinetic analysis for routine patient care will also be discussed.
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Affiliation(s)
- Ian Alberts
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstr. 18, 3010, Bern, Switzerland
| | - Hasan Sari
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstr. 18, 3010, Bern, Switzerland
- Advanced Clinical Imaging Technology, Siemens Healthcare AG, Lausanne, Switzerland
| | - Clemens Mingels
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstr. 18, 3010, Bern, Switzerland
| | - Ali Afshar-Oromieh
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstr. 18, 3010, Bern, Switzerland
| | - Thomas Pyka
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstr. 18, 3010, Bern, Switzerland
| | - Kuangyu Shi
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstr. 18, 3010, Bern, Switzerland
| | - Axel Rominger
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstr. 18, 3010, Bern, Switzerland.
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30
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Zatcepin A, Ziegler SI. Detectors in positron emission tomography. Z Med Phys 2023; 33:4-12. [PMID: 36208967 PMCID: PMC10082375 DOI: 10.1016/j.zemedi.2022.08.004] [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: 07/11/2022] [Accepted: 08/25/2022] [Indexed: 11/05/2022]
Abstract
Positron emission tomography is a highly sensitive molecular imaging modality, based on the coincident detection of annihilation photons after positron decay. The most used detector is based on dense, fast, and luminous scintillators read out by light sensors. This review covers the various detector concepts for clinical and preclinical systems.
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Affiliation(s)
- Artem Zatcepin
- Department of Nuclear Medicine, University Hospital, LMU Munich, Munich, Germany; German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Sibylle I Ziegler
- Department of Nuclear Medicine, University Hospital, LMU Munich, Munich, Germany.
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31
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Sundar LKS, Hacker M, Beyer T. Whole-Body PET Imaging: A Catalyst for Whole-Person Research? J Nucl Med 2023; 64:197-199. [PMID: 36460342 PMCID: PMC9902855 DOI: 10.2967/jnumed.122.264555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 11/17/2022] [Accepted: 11/17/2022] [Indexed: 12/03/2022] Open
Affiliation(s)
| | - Marcus Hacker
- Division of Nuclear Medicine, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Thomas Beyer
- Quantitative Imaging and Medical Physics Team, Medical University of Vienna, Vienna, Austria; and
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32
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Vandenberghe S, Karakatsanis NA, Akl MA, Maebe J, Surti S, Dierckx RA, Pryma DA, Nehmeh SA, Bouhali O, Karp JS. The potential of a medium-cost long axial FOV PET system for nuclear medicine departments. Eur J Nucl Med Mol Imaging 2023; 50:652-660. [PMID: 36178535 DOI: 10.1007/s00259-022-05981-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 09/19/2022] [Indexed: 01/24/2023]
Abstract
PURPOSE Total body positron emission tomography (TB-PET) has recently been introduced in nuclear medicine departments. There is a large interest in these systems, but for many centers, the high acquisition cost makes it very difficult to justify their current operational budget. Here, we propose medium-cost long axial FOV scanners as an alternative. METHODS Several medium-cost long axial FOV designs are described with their advantages and drawbacks. We describe their potential for higher throughput, more cost-effective scanning, a larger group of indications, and novel research opportunities. The wider spread of TB-PET can also lead to the fast introduction of new tracers (at a low dose), new methodologies, and optimized workflows. CONCLUSIONS A medium-cost TB-PET would be positioned between the current standard PET-CT and the full TB-PET systems in investment but recapitulate most advantages of full TB-PET. These systems could be more easily justified financially in a standard academic or large private nuclear medicine department and still have ample research options.
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Affiliation(s)
- Stefaan Vandenberghe
- Medical Image and Signal Processing, Ghent University, Corneel Heymans Laan 10, 9000, Ghent, Belgium.
| | | | - Maya Abi Akl
- Medical Image and Signal Processing, Ghent University, Corneel Heymans Laan 10, 9000, Ghent, Belgium
- Science Program, Texas A&M University at Qatar, Doha, Qatar
| | - Jens Maebe
- Medical Image and Signal Processing, Ghent University, Corneel Heymans Laan 10, 9000, Ghent, Belgium
| | - Suleman Surti
- Department of Radiology, University of Pennsylvania, Philadelphia, USA
| | - Rudi A Dierckx
- Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Daniel A Pryma
- Department of Radiology, University of Pennsylvania, Philadelphia, USA
| | - Sadek A Nehmeh
- Weill Cornell Medical College, Cornell University, NY, USA
| | | | - Joel S Karp
- Department of Radiology, University of Pennsylvania, Philadelphia, USA
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33
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van Sluis J, Borra R, Tsoumpas C, van Snick JH, Roya M, ten Hove D, Brouwers AH, Lammertsma AA, Noordzij W, Dierckx RA, Slart RH, Glaudemans AW. Extending the clinical capabilities of short- and long-lived positron-emitting radionuclides through high sensitivity PET/CT. Cancer Imaging 2022; 22:69. [PMID: 36527149 PMCID: PMC9755796 DOI: 10.1186/s40644-022-00507-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 12/07/2022] [Indexed: 12/23/2022] Open
Abstract
This review describes the main benefits of using long axial field of view (LAFOV) PET in clinical applications. As LAFOV PET is the latest development in PET instrumentation, many studies are ongoing that explore the potentials of these systems, which are characterized by ultra-high sensitivity. This review not only provides an overview of the published clinical applications using LAFOV PET so far, but also provides insight in clinical applications that are currently under investigation. Apart from the straightforward reduction in acquisition times or administered amount of radiotracer, LAFOV PET also allows for other clinical applications that to date were mostly limited to research, e.g., dual tracer imaging, whole body dynamic PET imaging, omission of CT in serial PET acquisition for repeat imaging, and studying molecular interactions between organ systems. It is expected that this generation of PET systems will significantly advance the field of nuclear medicine and molecular imaging.
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Affiliation(s)
- Joyce van Sluis
- grid.4494.d0000 0000 9558 4598Medical Imaging Center, Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713GZ Groningen, the Netherlands
| | - Ronald Borra
- grid.4494.d0000 0000 9558 4598Medical Imaging Center, Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713GZ Groningen, the Netherlands
| | - Charalampos Tsoumpas
- grid.4494.d0000 0000 9558 4598Medical Imaging Center, Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713GZ Groningen, the Netherlands
| | - Johannes H. van Snick
- grid.4494.d0000 0000 9558 4598Medical Imaging Center, Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713GZ Groningen, the Netherlands
| | - Mostafa Roya
- grid.4494.d0000 0000 9558 4598Medical Imaging Center, Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713GZ Groningen, the Netherlands
| | - Dik ten Hove
- grid.4494.d0000 0000 9558 4598Medical Imaging Center, Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713GZ Groningen, the Netherlands
| | - Adrienne H. Brouwers
- grid.4494.d0000 0000 9558 4598Medical Imaging Center, Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713GZ Groningen, the Netherlands
| | - Adriaan A. Lammertsma
- grid.4494.d0000 0000 9558 4598Medical Imaging Center, Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713GZ Groningen, the Netherlands
| | - Walter Noordzij
- grid.4494.d0000 0000 9558 4598Medical Imaging Center, Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713GZ Groningen, the Netherlands
| | - Rudi A.J.O. Dierckx
- grid.4494.d0000 0000 9558 4598Medical Imaging Center, Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713GZ Groningen, the Netherlands
| | - Riemer H.J.A. Slart
- grid.4494.d0000 0000 9558 4598Medical Imaging Center, Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713GZ Groningen, the Netherlands
| | - Andor W.J.M. Glaudemans
- grid.4494.d0000 0000 9558 4598Medical Imaging Center, Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713GZ Groningen, the Netherlands
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34
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Rausch I, Mannheim JG, Kupferschläger J, la Fougère C, Schmidt FP. Image quality assessment along the one metre axial field-of-view of the total-body Biograph Vision Quadra PET/CT system for 18F-FDG. EJNMMI Phys 2022; 9:87. [PMID: 36513949 PMCID: PMC9747988 DOI: 10.1186/s40658-022-00516-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 12/02/2022] [Indexed: 12/15/2022] Open
Abstract
AIM Recently, total-body PET/CT systems with an extended axial field-of-view (aFOV) became commercially available which allow acquiring physiologic information of multiple organs simultaneously. However, the nominal aFOV may clinically not be used effectively due to the inherently reduced sensitivity at the distal ends of the aFOV. The aim of this study was to assess the extent of the useful aFOV of the Biograph Vision Quadra PET/CT system. METHODS A NEMA image quality (IQ) phantom mimicking a standard [18F]FDG examination was used. Image contrast and noise were assessed across the 106 cm aFOV of the Biograph Vision Quadra PET/CT system (Siemens Healthineers). Phantom acquisitions were performed at different axial positions. PET data were rebinned to simulate different acquisition times for a standard injected activity and reconstructed using different filter settings to evaluate the noise and images along the axial direction. RESULTS Image noise and contrast were stable within the central 80 cm of the aFOV. Outside this central area, image contrast variability as well as image noise increased. This degradation of IQ was in particular evident for short acquisition times of less than 30 s. At 10 min acquisition time and in the absence of post-reconstruction filtering, the useful aFOV was 100 cm. For a 2 min acquisition time, a useful aFOV with image noise below 15% was only achievable using Gaussian filtering with axial extents of between 83 and 103 cm when going from 2 to 6 mm full-width-half-maximum, respectively. CONCLUSION Image noise increases substantially towards the ends of the aFOV. However, good IQ in compliance with generally accepted benchmarks is achievable for an aFOV of > 90 cm. When accepting higher image noise or using dedicated protocol settings such as stronger filtering a useful aFOV of around 1 m can be achieved for a 2 min acquisition time.
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Affiliation(s)
- Ivo Rausch
- grid.22937.3d0000 0000 9259 8492QIMP Team, Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Waehringer Guertel 18-20/4L, 1090 Vienna, Austria
| | - Julia G. Mannheim
- grid.10392.390000 0001 2190 1447Werner Siemens Imaging Center, Department of Preclinical Imaging and Radiopharmacy, Eberhard-Karls University Tuebingen, Tübingen, Germany ,grid.10392.390000 0001 2190 1447Cluster of Excellence iFIT (EXC 2180) “Image Guided and Functionally Instructed Tumor Therapies”, University of Tuebingen, Tübingen, Germany
| | - Jürgen Kupferschläger
- grid.411544.10000 0001 0196 8249Department of Nuclear Medicine and Clinical Molecular Imaging, University Hospital Tuebingen, Otfried-Mueller-Strasse 14, 72076 Tübingen, Germany
| | - Christian la Fougère
- grid.10392.390000 0001 2190 1447Cluster of Excellence iFIT (EXC 2180) “Image Guided and Functionally Instructed Tumor Therapies”, University of Tuebingen, Tübingen, Germany ,grid.411544.10000 0001 0196 8249Department of Nuclear Medicine and Clinical Molecular Imaging, University Hospital Tuebingen, Otfried-Mueller-Strasse 14, 72076 Tübingen, Germany
| | - Fabian P. Schmidt
- grid.10392.390000 0001 2190 1447Werner Siemens Imaging Center, Department of Preclinical Imaging and Radiopharmacy, Eberhard-Karls University Tuebingen, Tübingen, Germany ,grid.411544.10000 0001 0196 8249Department of Nuclear Medicine and Clinical Molecular Imaging, University Hospital Tuebingen, Otfried-Mueller-Strasse 14, 72076 Tübingen, Germany
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Sundar LKS, Yu J, Muzik O, Kulterer OC, Fueger B, Kifjak D, Nakuz T, Shin HM, Sima AK, Kitzmantl D, Badawi RD, Nardo L, Cherry SR, Spencer BA, Hacker M, Beyer T. Fully Automated, Semantic Segmentation of Whole-Body 18F-FDG PET/CT Images Based on Data-Centric Artificial Intelligence. J Nucl Med 2022; 63:1941-1948. [PMID: 35772962 PMCID: PMC9730926 DOI: 10.2967/jnumed.122.264063] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 05/16/2022] [Indexed: 01/26/2023] Open
Abstract
We introduce multiple-organ objective segmentation (MOOSE) software that generates subject-specific, multiorgan segmentation using data-centric artificial intelligence principles to facilitate high-throughput systemic investigations of the human body via whole-body PET imaging. Methods: Image data from 2 PET/CT systems were used in training MOOSE. For noncerebral structures, 50 whole-body CT images were used, 30 of which were acquired from healthy controls (14 men and 16 women), and 20 datasets were acquired from oncology patients (14 men and 6 women). Noncerebral tissues consisted of 13 abdominal organs, 20 bone segments, subcutaneous fat, visceral fat, psoas muscle, and skeletal muscle. An expert panel manually segmented all noncerebral structures except for subcutaneous fat, visceral fat, and skeletal muscle, which were semiautomatically segmented using thresholding. A majority-voting algorithm was used to generate a reference-standard segmentation. From the 50 CT datasets, 40 were used for training and 10 for testing. For cerebral structures, 34 18F-FDG PET/MRI brain image volumes were used from 10 healthy controls (5 men and 5 women imaged twice) and 14 nonlesional epilepsy patients (7 men and 7 women). Only 18F-FDG PET images were considered for training: 24 and 10 of 34 volumes were used for training and testing, respectively. The Dice score coefficient (DSC) was used as the primary metric, and the average symmetric surface distance as a secondary metric, to evaluate the automated segmentation performance. Results: An excellent overlap between the reference labels and MOOSE-derived organ segmentations was observed: 92% of noncerebral tissues showed DSCs of more than 0.90, whereas a few organs exhibited lower DSCs (e.g., adrenal glands [0.72], pancreas [0.85], and bladder [0.86]). The median DSCs of brain subregions derived from PET images were lower. Only 29% of the brain segments had a median DSC of more than 0.90, whereas segmentation of 60% of regions yielded a median DSC of 0.80-0.89. The results of the average symmetric surface distance analysis demonstrated that the average distance between the reference standard and the automatically segmented tissue surfaces (organs, bones, and brain regions) lies within the size of image voxels (2 mm). Conclusion: The proposed segmentation pipeline allows automatic segmentation of 120 unique tissues from whole-body 18F-FDG PET/CT images with high accuracy.
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Affiliation(s)
- Lalith Kumar Shiyam Sundar
- Quantitative Imaging and Medical Physics Team, Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Josef Yu
- Quantitative Imaging and Medical Physics Team, Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria;,Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Otto Muzik
- Department of Pediatrics, Wayne State University School of Medicine, Children’s Hospital of Michigan, Detroit, Michigan
| | - Oana C. Kulterer
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Barbara Fueger
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Daria Kifjak
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria;,Department of Radiology, University of Massachusetts Chan Medical School/UMass Memorial Health Care, Worcester, Massachusetts
| | - Thomas Nakuz
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Hyung Min Shin
- Division of General Surgery, Department of Surgery, Medical University of Vienna, Vienna, Austria; and
| | - Annika Katharina Sima
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Daniela Kitzmantl
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Ramsey D. Badawi
- Department of Biomedical Engineering and Radiology, University of California–Davis, Davis, California
| | - Lorenzo Nardo
- Department of Biomedical Engineering and Radiology, University of California–Davis, Davis, California
| | - Simon R. Cherry
- Department of Biomedical Engineering and Radiology, University of California–Davis, Davis, California
| | - Benjamin A. Spencer
- Department of Biomedical Engineering and Radiology, University of California–Davis, Davis, California
| | - Marcus Hacker
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Thomas Beyer
- Quantitative Imaging and Medical Physics Team, Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
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Daube-Witherspoon ME, Pantel AR, Pryma DA, Karp JS. Total-body PET: a new paradigm for molecular imaging. Br J Radiol 2022; 95:20220357. [PMID: 35993615 PMCID: PMC9733603 DOI: 10.1259/bjr.20220357] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 06/25/2022] [Accepted: 08/12/2022] [Indexed: 11/05/2022] Open
Abstract
Total body (TB) positron emission tomography (PET) instruments have dramatically changed the paradigm of PET clinical and research studies due to their very high sensitivity and capability to image dynamic radiopharmaceutical distributions in the major organs of the body simultaneously. In this manuscript, we review the design of these systems and discuss general challenges and trade-offs to maximize the performance gains of current TB-PET systems. We then describe new concepts and technology that may impact future TB-PET systems. The manuscript summarizes what has been learned from the initial sites with TB-PET and explores potential research and clinical applications of TB-PET. The current generation of TB-PET systems range in axial field-of-view (AFOV) from 1 to 2 m and serve to illustrate the benefits and opportunities of a longer AFOV for various applications in PET. In only a few years of use these new TB-PET systems have shown that they will play an important role in expanding the field of molecular imaging and benefiting clinical practice.
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Affiliation(s)
| | - Austin R Pantel
- Department of Radiology, University of Pennsylvania, Philadelphia, United States
| | - Daniel A Pryma
- Department of Radiology, University of Pennsylvania, Philadelphia, United States
| | - Joel S Karp
- Department of Radiology, University of Pennsylvania, Philadelphia, United States
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van Sluis J, van Snick JH, Brouwers AH, Noordzij W, Dierckx RAJO, Borra RJH, Lammertsma AA, Glaudemans AWJM, Slart RHJA, Yaqub M, Tsoumpas C, Boellaard R. Shortened duration whole body 18F-FDG PET Patlak imaging on the Biograph Vision Quadra PET/CT using a population-averaged input function. EJNMMI Phys 2022; 9:74. [PMID: 36308568 PMCID: PMC9618000 DOI: 10.1186/s40658-022-00504-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 10/21/2022] [Indexed: 11/13/2022] Open
Abstract
Background Excellent performance characteristics of the Vision Quadra PET/CT, e.g. a substantial increase in sensitivity, allow for precise measurements of image-derived input functions (IDIF) and tissue time activity curves. Previously we have proposed a method for a reduced 30 min (as opposed to 60 min) whole body 18F-FDG Patlak PET imaging procedure using a previously published population-averaged input function (PIF) scaled to IDIF values at 30–60 min post-injection (p.i.). The aim of the present study was to apply this method using the Vision Quadra PET/CT, including the use of a PIF to allow for shortened scan durations. Methods Twelve patients with suspected lung malignancy were included and received a weight-based injection of 18F-FDG. Patients underwent a 65-min dynamic PET acquisition which were reconstructed using European Association of Nuclear Medicine Research Ltd. (EARL) standards 2 reconstruction settings. A volume of interest (VOI) was placed in the ascending aorta (AA) to obtain the IDIF. An external PIF was scaled to IDIF values at 30–60, 40–60, and 50–60 min p.i., respectively, and parametric 18F-FDG influx rate constant (Ki) images were generated using a t* of 30, 40 or 50 min, respectively. Herein, tumour lesions as well as healthy tissues, i.e. liver, muscle tissue, spleen and grey matter, were segmented. Results Good agreement between the IDIF and corresponding PIF scaled to 30–60 min p.i. and 40–60 min p.i. was obtained with 7.38% deviation in Ki. Bland–Altman plots showed excellent agreement in Ki obtained using the PIF scaled to the IDIF at 30–60 min p.i. and at 40–60 min p.i. as all data points were within the limits of agreement (LOA) (− 0.004–0.002, bias: − 0.001); for the 50–60 min p.i. Ki, all except one data point fell in between the LOA (− 0.021–0.012, bias: − 0.005). Conclusions Parametric whole body 18F-FDG Patlak Ki images can be generated non-invasively on a Vision Quadra PET/CT system. In addition, using a scaled PIF allows for a substantial (factor 2 to 3) reduction in scan time without substantial loss of accuracy (7.38% bias) and precision (image quality and noise interference). Supplementary Information The online version contains supplementary material available at 10.1186/s40658-022-00504-9.
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38
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Stępień EŁ, Rząca C, Moskal P. Radiovesicolomics-new approach in medical imaging. Front Physiol 2022; 13:996985. [DOI: 10.3389/fphys.2022.996985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 09/20/2022] [Indexed: 11/13/2022] Open
Abstract
This review introduce extracellular vesicles (EVs) to a molecular imaging field. The idea of modern analyses based on the use of omics studies, using high-throughput methods to characterize the molecular content of a single biological system, vesicolomics seems to be the new approach to collect molecular data about EV content, to find novel biomarkers or therapeutic targets. The use of various imaging techniques, including those based on radionuclides as positron emission tomography (PET) or single photon emission computed tomography (SPECT), combining molecular data on EVs, opens up the new space for radiovesicolomics—a new approach to be used in theranostics.
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Qi J, Huang B. Positronium Lifetime Image Reconstruction for TOF PET. IEEE TRANSACTIONS ON MEDICAL IMAGING 2022; 41:2848-2855. [PMID: 35584079 PMCID: PMC9829407 DOI: 10.1109/tmi.2022.3174561] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Positron emission tomography is widely used in clinical and preclinical applications. Positronium lifetime carries information about the tissue microenvironment where positrons are emitted, but such information has not been captured because of two technical challenges. One challenge is the low sensitivity in detecting triple coincidence events. This problem has been mitigated by the recent developments of PET scanners with long (1-2 m) axial field of view. The other challenge is the low spatial resolution of the positronium lifetime images formed by existing methods that is determined by the time-of-flight (TOF) resolution (200-500 ps) of existing PET scanners. This paper solves the second challenge by developing a new image reconstruction method to generate high-resolution positronium lifetime images using existing TOF PET. Simulation studies demonstrate that the proposed method can reconstruct positronium lifetime images at much better spatial resolution than the limit set by the TOF resolution of the PET scanner. The proposed method opens up the possibility of performing positronium lifetime imaging using existing TOF PET scanners. The lifetime information can be used to understand the tissue microenvironment in vivo which could facilitate the study of disease mechanism and selection of proper treatments.
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Hicks RJ, Van den Abbeele AD. Will ultra-extended field-of-view scanners be an expensive folly or the next clinical standard for PET/CT? Cancer Imaging 2022; 22:49. [PMID: 36068626 PMCID: PMC9450327 DOI: 10.1186/s40644-022-00486-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Accepted: 08/23/2022] [Indexed: 11/24/2022] Open
Affiliation(s)
| | - Annick D Van den Abbeele
- Dana-Farber Cancer Institute and Mass General Brigham Hospitals, Harvard Medical School, Boston, MA, USA
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41
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Zhang Y, Nordstrom R. Celebrating Contributions of Imaging Technology to Fight against Cancer at the 50th NCA Anniversary. Radiol Imaging Cancer 2022; 4:e220085. [PMID: 35960178 PMCID: PMC9530755 DOI: 10.1148/rycan.220085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 07/04/2022] [Accepted: 07/15/2022] [Indexed: 06/15/2023]
Affiliation(s)
- Yantian Zhang
- From the Cancer Imaging Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute, 9609 Medical Center Dr, Bethesda, MD 20892
| | - Robert Nordstrom
- From the Cancer Imaging Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute, 9609 Medical Center Dr, Bethesda, MD 20892
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42
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Sari H, Teimoorisichani M, Mingels C, Alberts I, Panin V, Bharkhada D, Xue S, Prenosil G, Shi K, Conti M, Rominger A. Quantitative evaluation of a deep learning-based framework to generate whole-body attenuation maps using LSO background radiation in long axial FOV PET scanners. Eur J Nucl Med Mol Imaging 2022; 49:4490-4502. [PMID: 35852557 PMCID: PMC9606046 DOI: 10.1007/s00259-022-05909-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 07/10/2022] [Indexed: 12/19/2022]
Abstract
Purpose Attenuation correction is a critically important step in data correction in positron emission tomography (PET) image formation. The current standard method involves conversion of Hounsfield units from a computed tomography (CT) image to construct attenuation maps (µ-maps) at 511 keV. In this work, the increased sensitivity of long axial field-of-view (LAFOV) PET scanners was exploited to develop and evaluate a deep learning (DL) and joint reconstruction-based method to generate µ-maps utilizing background radiation from lutetium-based (LSO) scintillators. Methods Data from 18 subjects were used to train convolutional neural networks to enhance initial µ-maps generated using joint activity and attenuation reconstruction algorithm (MLACF) with transmission data from LSO background radiation acquired before and after the administration of 18F-fluorodeoxyglucose (18F-FDG) (µ-mapMLACF-PRE and µ-mapMLACF-POST respectively). The deep learning-enhanced µ-maps (µ-mapDL-MLACF-PRE and µ-mapDL-MLACF-POST) were compared against MLACF-derived and CT-based maps (µ-mapCT). The performance of the method was also evaluated by assessing PET images reconstructed using each µ-map and computing volume-of-interest based standard uptake value measurements and percentage relative mean error (rME) and relative mean absolute error (rMAE) relative to CT-based method. Results No statistically significant difference was observed in rME values for µ-mapDL-MLACF-PRE and µ-mapDL-MLACF-POST both in fat-based and water-based soft tissue as well as bones, suggesting that presence of the radiopharmaceutical activity in the body had negligible effects on the resulting µ-maps. The rMAE values µ-mapDL-MLACF-POST were reduced by a factor of 3.3 in average compared to the rMAE of µ-mapMLACF-POST. Similarly, the average rMAE values of PET images reconstructed using µ-mapDL-MLACF-POST (PETDL-MLACF-POST) were 2.6 times smaller than the average rMAE values of PET images reconstructed using µ-mapMLACF-POST. The mean absolute errors in SUV values of PETDL-MLACF-POST compared to PETCT were less than 5% in healthy organs, less than 7% in brain grey matter and 4.3% for all tumours combined. Conclusion We describe a deep learning-based method to accurately generate µ-maps from PET emission data and LSO background radiation, enabling CT-free attenuation and scatter correction in LAFOV PET scanners. Supplementary Information The online version contains supplementary material available at 10.1007/s00259-022-05909-3.
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Affiliation(s)
- Hasan Sari
- Advanced Clinical Imaging Technology, Siemens Healthcare AG, Lausanne, Switzerland.
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, Bern, Switzerland.
| | | | - Clemens Mingels
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Ian Alberts
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, Bern, Switzerland
| | | | | | - Song Xue
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, Bern, Switzerland
| | - George Prenosil
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Kuangyu Shi
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, Bern, Switzerland
| | | | - Axel Rominger
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, Bern, Switzerland
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Costa G, Spencer B, Omidvari N, Foster C, Rusnak M, Hunt H, Caudle DT, Pillai RT, Vu CT, Roncali E. Radioembolization Dosimetry with Total-Body 90Y PET. J Nucl Med 2022; 63:1101-1107. [PMID: 34795015 PMCID: PMC9258581 DOI: 10.2967/jnumed.121.263145] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 11/08/2021] [Indexed: 01/26/2023] Open
Abstract
Transarterial radioembolization (TARE) is a locoregional radiopharmaceutical therapy based on the delivery of radioactive 90Y microspheres to liver tumors. The importance of personalized dosimetry to make TARE safer and more effective has been demonstrated in recent clinical studies, stressing the need for quantification of the dose-response relationship to ultimately optimize the administered activity before treatment and image it after treatment. 90Y dosimetric studies are challenging because of the lack of accurate and precise methods but are best realized with PET combined with Monte Carlo simulations and other image modalities to calculate a segmental dose distribution. The aim of this study was to assess the suitability of imaging 90Y PET patients with the total-body PET/CT uEXPLORER and to investigate possible improvements in TARE 90Y PET-based dosimetry. The uEXPLORER is the first commercially available ultra-high-resolution (171 cps/kBq) total-body digital PET/CT device with a 194-cm axial PET field of view that enables the whole body to be scanned at a single bed position. Methods: Two PET/CT scanners were evaluated in this study: the Biograph mCT and the total-body uEXPLORER. Images of a National Electrical Manufacturers Association (NEMA) image-quality phantom and 2 patients were reconstructed using our standard clinical oncology protocol. A late portal phase contrast-enhanced CT scan was used to contour the liver segments and create corresponding volumes of interest. To calculate the absorbed dose, Monte Carlo simulations were performed using Geant4 Application for Tomographic Emission (GATE). The absorbed dose and dose-volume histograms were calculated for all 6 spheres (diameters ranging from 10 to 37 mm) of the NEMA phantom, the liver segments, and the entire liver. Differences between the phantom doses and an analytic ground truth were quantified through the root mean squared error. Results: The uEXPLORER showed a higher signal-to-noise ratio at 10- and 13-mm diameters, consistent with its high spatial resolution and system sensitivity. The total liver-absorbed dose showed excellent agreement between the uEXPLORER and the mCT for both patients, with differences lower than 0.2%. Larger differences of up to 60% were observed when comparing the liver segment doses. All dose-volume histograms were in good agreement, with narrower tails for the uEXPLORER in all segments, indicating lower image noise. Conclusion: This patient study is compelling for the use of total-body 90Y PET for liver dosimetry. The uEXPLORER scanner showed a better signal-to-noise ratio than mCT, especially in lower-count regions of interest, which is expected to improve dose quantification and tumor dosimetry.
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Affiliation(s)
- Gustavo Costa
- Department of Biomedical Engineering, University of California–Davis, Davis, California; and
| | - Benjamin Spencer
- Department of Biomedical Engineering, University of California–Davis, Davis, California; and
| | - Negar Omidvari
- Department of Biomedical Engineering, University of California–Davis, Davis, California; and
| | - Cameron Foster
- Department of Radiology, University of California–Davis, Davis, California
| | - Michael Rusnak
- Department of Radiology, University of California–Davis, Davis, California
| | - Heather Hunt
- Department of Radiology, University of California–Davis, Davis, California
| | - Denise T. Caudle
- Department of Radiology, University of California–Davis, Davis, California
| | - Rex T. Pillai
- Department of Radiology, University of California–Davis, Davis, California
| | - Catherine Tram Vu
- Department of Radiology, University of California–Davis, Davis, California
| | - Emilie Roncali
- Department of Biomedical Engineering, University of California–Davis, Davis, California; and,Department of Radiology, University of California–Davis, Davis, California
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Yu H, Gu Y, Fan W, Gao Y, Wang M, Zhu X, Wu Z, Liu J, Li B, Wu H, Cheng Z, Wang S, Zhang Y, Xu B, Li S, Shi H. Expert consensus on oncological [ 18F]FDG total-body PET/CT imaging (version 1). Eur Radiol 2022; 33:615-626. [PMID: 35751696 DOI: 10.1007/s00330-022-08960-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 06/04/2022] [Accepted: 06/09/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND [18F]FDG imaging on total-body PET/CT (TB PET/CT) scanners, with improved sensitivity, offers new potentials for cancer diagnosis, staging, and radiation treatment planning. This consensus provides the protocols for clinical practices with a goal of paving the way for future studies with the total-body scanners in oncological [18F]FDG TB PET/CT imaging. METHODS The consensus was summarized based on the published guidelines and peer-reviewed articles of TB PET/CT in the literature, along with the opinions of the experts from major research institutions with a total of 40,000 cases performed on the TB PET/CT scanners. RESULTS This consensus describes the protocols for routine and dynamic [18F]FDG TB PET/CT scanning focusing on the reduction of imaging acquisition time and FDG injected activity, which may serve as a reference for research and clinic oncological PET/CT studies. CONCLUSION This expert consensus focuses on the reduction of acquisition time and FDG injected activity with a TB PET/CT scanner, which may improve the patient throughput or reduce the radiation exposure in daily clinical oncologic imaging. KEY POINTS • [18F]FDG-imaging protocols for oncological total-body PET/CT with reduced acquisition time or with different FDG activity levels have been summarized from multicenter studies. • Total-body PET/CT provides better image quality and improved diagnostic insights. • Clinical workflow and patient management have been improved.
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Affiliation(s)
- Haojun Yu
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.,Shanghai Institute of Medical Imaging, Shanghai, 200032, China.,Institute of Nuclear Medicine, Fudan University, Shanghai, 200032, China.,Cancer Prevention and Treatment Center, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Yushen Gu
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.,Shanghai Institute of Medical Imaging, Shanghai, 200032, China.,Institute of Nuclear Medicine, Fudan University, Shanghai, 200032, China.,Cancer Prevention and Treatment Center, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Wei Fan
- Department of Nuclear Medicine, Sun Yat-sen University Cancer Center, No. 651 Dongfendong Road, Guangzhou, 510060, China
| | - Yongju Gao
- Department of Nuclear Medicine, Henan Provincial People's Hospital, Henan Key Laboratory of Noval Molecular Probes and Clinical Translation in Nuclear Medicine, No. 7 Weiwu Road, Zhengzhou, 450003, China
| | - Meiyun Wang
- Department of Nuclear Medicine, Henan Provincial People's Hospital, Henan Key Laboratory of Noval Molecular Probes and Clinical Translation in Nuclear Medicine, No. 7 Weiwu Road, Zhengzhou, 450003, China
| | - Xiaohua Zhu
- Department of Nuclear Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Ave, Wuhan, 430030, China
| | - Zhifang Wu
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Collaborative Innovation Center for Molecular Imaging Precision Medicine, Taiyuan, 030001, China
| | - Jianjun Liu
- Department of Nuclear Medicine, RenJi Hospital, School of Medicine, Shanghai Jiao Tong University, No. 160 PuJian Road, Shanghai, 200127, China
| | - Biao Li
- Department of Nuclear Medicine, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, No. 197 Ruijin Er Road, Shanghai, 200025, China
| | - Hubing Wu
- Nanfang PET Center, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue North, Guangzhou, 510515, China
| | - Zhaoping Cheng
- Department of Nuclear Medicine, The First Affiliated Hospital of Shandong First Medical University, No. 16766 Jingshi Road, Jinan, 250014, Shandong, China
| | - Shuxia Wang
- Department of Nuclear Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, No. 106 Zhongshan Er Road, Guangzhou, 510080, China
| | - Yiqiu Zhang
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.,Shanghai Institute of Medical Imaging, Shanghai, 200032, China.,Institute of Nuclear Medicine, Fudan University, Shanghai, 200032, China.,Cancer Prevention and Treatment Center, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Baixuan Xu
- Department of Nuclear Medicine, Chinese PLA General Hospital, Beijing, 100853, China.
| | - Sijin Li
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Collaborative Innovation Center for Molecular Imaging Precision Medicine, Taiyuan, 030001, China.
| | - Hongcheng Shi
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China. .,Shanghai Institute of Medical Imaging, Shanghai, 200032, China. .,Institute of Nuclear Medicine, Fudan University, Shanghai, 200032, China. .,Cancer Prevention and Treatment Center, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.
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Karakatsanis NA, Nehmeh MH, Conti M, Bal G, González AJ, Nehmeh SA. Physical performance of adaptive axial FOV PET scanners with a sparse detector block rings or a checkerboard configuration. Phys Med Biol 2022; 67. [DOI: 10.1088/1361-6560/ac6aa1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 04/26/2022] [Indexed: 11/12/2022]
Abstract
Abstract
Objective. Using Monte-Carlo simulations, we evaluated the physical performance of a hypothetical state-of-the-art clinical PET scanner with adaptive axial field-of-view (AFOV) based on the validated GATE model of the Siemens Biograph VisionTM PET/CT scanner. Approach. Vision consists of 16 compact PET rings, each consisting of 152 mini-blocks of 5 × 5 Lutetium Oxyorthosilicate crystals (3.2 × 3.2 × 20 mm3). The Vision 25.6 cm AFOV was extended by adopting (i) a sparse mini-block ring (SBR) configuration of 49.6 cm AFOV, with all mini-block rings interleaved with 16 mm axial gaps, or (ii) a sparse mini-block checkerboard (SCB) configuration of 51.2 cm AFOV, with all mini-blocks interleaved with gaps of 16 mm (transaxial) × 16 mm (axial) width in checkerboard pattern. For sparse configurations, a ‘limited’ continuous bed motion (limited-CBM) acquisition was employed to extend AFOVs by 2.9 cm. Spatial resolution, sensitivity, image quality (IQ), NECR and scatter fraction were assessed per NEMA NU2-2012. Main Results. All IQ phantom spheres were distinguishable with all configurations. SBR and SCB percent contrast recovery (% CR) and background variability (% BV) were similar (p-value > 0.05). Compared to Vision, SBR and SCB %CRs were similar (p-values > 0.05). However, SBR and SCB %BVs were deteriorated by 30% and 26% respectively (p-values < 0.05). SBR, SCB and Vision exhibited system sensitivities of 16.6, 16.8, and 15.8 kcps MBq−1, NECRs of 311 kcps @35 kBq cc−1, 266 kcps @25.8 kBq cc−1, and 260 kcps @27.8 kBq cc−1, and scatter fractions of 31.2%, 32.4%, and 32.6%, respectively. SBR and SCB exhibited a smoother sensitivity reduction and noise enhancement rate from AFOV center to its edges. SBR and SCB attained comparable spatial resolution in all directions (p-value > 0.05), yet, up to 1.5 mm worse than Vision (p-values < 0.05). Significance. The proposed sparse configurations may offer a clinically adoptable solution for cost-effective adaptive AFOV PET with either highly-sensitive or long-AFOV acquisitions.
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Ng Q, Triumbari EKA, Omidvari N, Cherry SR, Badawi RD, Nardo L. Total-body PET/CT - First Clinical Experiences and Future Perspectives. Semin Nucl Med 2022; 52:330-339. [PMID: 35272853 PMCID: PMC9439875 DOI: 10.1053/j.semnuclmed.2022.01.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 01/04/2022] [Accepted: 01/06/2022] [Indexed: 01/26/2023]
Abstract
Total-body PET has come a long way from its first conception to today, with both total-body and long axial field of view (> 1m) scanners now being commercially available world-wide. The conspicuous signal collection efficiency gain, coupled with high spatial resolution, allows for higher sensitivity and improved lesion detection, enhancing several clinical applications not readily available on current conventional PET/CT scanners. This technology can provide (a) reduction in acquisition times with preservation of diagnostic quality images, benefitting specific clinical situations (i.e. pediatric patients) and the use of several existing radiotracers that present transient uptake over time and where small differences in acquisition time can greatly impact interpretation of images; (b) reduction in administered activity with minimal impact on image noise, thus reducing effective dose to the patient, improving staff safety, and helping with logistical concerns for short-lived radionuclides or long-lived radionuclides with poor dosimetry profiles that have had limited use on conventional PET scanners until now; (c) delayed scanning, that has shown to increase the detection of even small and previously occult malignant lesions by improved clearance in regions of significant background activity and by reduced visibility of coexisting inflammatory processes; (d) improvement in image quality, as a consequence of higher spatial resolution and sensitivity of total-body scanners, implying better appreciation of small structures and clinical implications with downstream prognostic consequences for patients; (e) simultaneous total-body dynamic imaging, that allows the measurement of full spatiotemporal distribution of radiotracers, kinetic modeling, and creation of multiparametric images, providing physiologic and biologically relevant data of the entire body at the same time. On the other hand, the higher physical and clinical sensitivity of total-body scanners bring along some limitations and challenges. The strong impact on clinical sensitivity potentially increases the number of false positive findings if the radiologist does not recalibrate interpretation considering the new technique. Delayed scanning causes logistical issues and introduces new interpretation questions for radiologists. Data storage capacity, longer processing and reconstruction time issues are other limitations, but they may be overcome in the near future by advancements in reconstruction algorithms and computing hardware.
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Affiliation(s)
- Quinn Ng
- Department of Radiology, UC Davis, Sacramento, CA, USA
| | - Elizabeth Katherine Anna Triumbari
- Department of Radiology, UC Davis, Sacramento, CA, USA,Section of Nuclear Medicine, University Department of Radiological Sciences and Hematology, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Negar Omidvari
- Department of Biomedical Engineering California Davis, CA, USA
| | - Simon R. Cherry
- Department of Radiology, UC Davis, Sacramento, CA, USA,Department of Biomedical Engineering California Davis, CA, USA
| | - Ramsey D. Badawi
- Department of Radiology, UC Davis, Sacramento, CA, USA,Department of Biomedical Engineering California Davis, CA, USA
| | - Lorenzo Nardo
- Department of Radiology, UC Davis, Sacramento, CA, USA
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Efthimiou N, Karp JS, Surti S. Data-driven, energy-based method for estimation of scattered events in positron emission tomography. Phys Med Biol 2022; 67:10.1088/1361-6560/ac62fc. [PMID: 35358957 PMCID: PMC9340671 DOI: 10.1088/1361-6560/ac62fc] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 03/31/2022] [Indexed: 11/11/2022]
Abstract
Objective.Scattered events add bias in the reconstructed positron emission tomography (PET) images. Our objective is the accurate estimation of the scatter distribution, required for an effective scatter correction.Approach.In this paper, we propose a practical energy-based (EB) scatter estimation method that uses the marked difference between the energy distribution of the non-scattered and scattered events in the presence of randoms. In contrast to previous EB methods, we model the unscattered events using data obtained from measured point sources.Main results.We demonstrate feasibility using Monte Carlo simulated as well as experimental data acquired on the long axial field-of-view (FOV) PennPET EXPLORER scanner. Simulations show that the EB scatter estimated sinograms, for all phantoms, are in excellent agreement with the ground truth scatter distribution, known from the simulated data. Using the standard NEMA image quality (IQ) phantom we find that both the EB and single scatter simulation (SSS) provide good contrast recovery values. However, the EB correction gives better lung residuals.Significance.Application of the EB method on measured data showed, that the proposed method can be successfully translated to real-world PET scanners. When applied to a 20 cm diameter ×20 cm long cylindrical phantom the EB and SSS algorithms demonstrated very similar performance. However, on a larger 35 cm × 30 cm long cylinder the EB can better account for increased multiple scattering and out-of-FOV activity, providing more uniform images with 12%-36% reduced background variability. In typical PET ring sizes, the EB estimation can be performed in a matter of a few seconds compared to the several minutes needed for SSS, leading to efficiency advantages over the SSS implementation. as well.
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Affiliation(s)
- Nikos Efthimiou
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, United States of America
| | - Joel S Karp
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, United States of America
| | - Suleman Surti
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, United States of America
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Pantel AR, Viswanath V, Muzi M, Doot RK, Mankoff DA. Principles of Tracer Kinetic Analysis in Oncology, Part II: Examples and Future Directions. J Nucl Med 2022; 63:514-521. [PMID: 35361713 PMCID: PMC8973282 DOI: 10.2967/jnumed.121.263519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 02/17/2022] [Indexed: 11/29/2022] Open
Abstract
Learning Objectives: On successful completion of this activity, participants should be able to (1) describe examples of the application of PET tracer kinetic analysis to oncology; (2) list applications research and possible clinical applications in oncology where kinetic analysis is helpful; and (3) discuss future applications of kinetic modeling to cancer research and possible clinical cancer imaging practice.Financial Disclosure: This work was supported by KL2 TR001879, R01 CA211337, R01 CA113941, R33 CA225310, Komen SAC130060, R50 CA211270, and K01 DA040023. Dr. Pantel is a consultant or advisor for Progenics and Blue Earth Diagnostics and is a meeting participant or lecturer for Blue Earth Diagnostics. Dr. Mankoff is on the scientific advisory boards of GE Healthcare, Philips Healthcare, Reflexion, and ImaginAb and is the owner of Trevarx; his wife is the chief executive officer of Trevarx. The authors of this article have indicated no other relevant relationships that could be perceived as a real or apparent conflict of interest.CME Credit: SNMMI is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to sponsor continuing education for physicians. SNMMI designates each JNM continuing education article for a maximum of 2.0 AMA PRA Category 1 Credits. Physicians should claim only credit commensurate with the extent of their participation in the activity. For CE credit, SAM, and other credit types, participants can access this activity through the SNMMI website (http://www.snmmilearningcenter.org) through April 2025.Kinetic analysis of dynamic PET imaging enables the estimation of biologic processes relevant to disease. Through mathematic analysis of the interactions of a radiotracer with tissue, information can be gleaned from PET imaging beyond static uptake measures. Part I of this 2-part continuing education paper reviewed the underlying principles and methodology of kinetic modeling. In this second part, the benefits of kinetic modeling for oncologic imaging are illustrated through representative case examples that demonstrate the principles and benefits of kinetic analysis in oncology. Examples of the model types discussed in part I are reviewed here: a 1-tissue-compartment model (15O-water), an irreversible 2-tissue-compartment model (18F-FDG), and a reversible 2-tissue-compartment model (3'-deoxy-3'-18F-fluorothymidine). Kinetic approaches are contrasted with static uptake measures typically used in the clinic. Overall, this 2-part review provides the reader with background in kinetic analysis to understand related research and improve the interpretation of clinical nuclear medicine studies with a focus on oncologic imaging.
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Affiliation(s)
- Austin R Pantel
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania; and
| | - Varsha Viswanath
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania; and
| | - Mark Muzi
- Department of Radiology, University of Washington, Seattle, Washington
| | - Robert K Doot
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania; and
| | - David A Mankoff
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania; and
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49
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Al-Sarhani H, Gottumukkala RV, Grasparil ADS, Tung EL, Gee MS, Greer MLC. Screening of cancer predisposition syndromes. Pediatr Radiol 2022; 52:401-417. [PMID: 33791839 DOI: 10.1007/s00247-021-05023-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 01/14/2021] [Accepted: 02/17/2021] [Indexed: 12/19/2022]
Abstract
Pediatric patients with cancer predisposition syndromes are at increased risk of developing malignancies compared with their age-matched peers, necessitating regular surveillance. Screening protocols differ among syndromes and are composed of a number of elements, imaging being one. Surveillance can be initiated in infants, children and adolescents with a tumor known or suspected of being related to a cancer predisposition syndrome or where genetic testing identifies a germline pathogenic gene variant in an asymptomatic child. Pre-symptomatic detection of malignant neoplasms offers potential to improve treatment options and survival outcomes, but the benefits and risks of screening need to be weighed, particularly with variable penetrance in many cancer predisposition syndromes. In this review we discuss the benefits and risks of surveillance imaging and the importance of integrating imaging and non-imaging screening elements. We explore the principles of surveillance imaging with particular reference to whole-body MRI, considering the strategies to minimize false-negative and manage false-positive whole-body MRI results, the value of standardized nomenclature when reporting risk stratification to better guide patient management, and the need for timely communication of results to allay anxiety. Cancer predisposition syndrome screening is a multimodality, multidisciplinary and longitudinal process, so developing formalized frameworks for surveillance imaging programs should enhance diagnostic performance while improving the patient experience.
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Affiliation(s)
- Haifa Al-Sarhani
- Department of Diagnostic Imaging, The Hospital for Sick Children, 555 University Ave., Toronto, ON, M5G 1X8, Canada.,Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
| | - Ravi V Gottumukkala
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Angelo Don S Grasparil
- Department of Radiological Sciences, Cardinal Santos Medical Center, San Juan City, Philippines
| | - Eric L Tung
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Michael S Gee
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Mary-Louise C Greer
- Department of Diagnostic Imaging, The Hospital for Sick Children, 555 University Ave., Toronto, ON, M5G 1X8, Canada. .,Department of Medical Imaging, University of Toronto, Toronto, ON, Canada.
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50
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Sari H, Mingels C, Alberts I, Hu J, Buesser D, Shah V, Schepers R, Caluori P, Panin V, Conti M, Afshar-Oromieh A, Shi K, Eriksson L, Rominger A, Cumming P. First results on kinetic modelling and parametric imaging of dynamic 18F-FDG datasets from a long axial FOV PET scanner in oncological patients. Eur J Nucl Med Mol Imaging 2022; 49:1997-2009. [PMID: 34981164 DOI: 10.1007/s00259-021-05623-6] [Citation(s) in RCA: 49] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 11/15/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE To investigate the kinetics of 18F-fluorodeoxyglucose (18F-FDG) by positron emission tomography (PET) in multiple organs and test the feasibility of total-body parametric imaging using an image-derived input function (IDIF). METHODS Twenty-four oncological patients underwent dynamic 18F-FDG scans lasting 65 min using a long axial FOV (LAFOV) PET/CT system. Time activity curves (TAC) were extracted from semi-automated segmentations of multiple organs, cerebral grey and white matter, and from vascular structures. The tissue and tumor lesion TACs were fitted using an irreversible two-tissue compartment (2TC) and a Patlak model. Parametric images were also generated using direct and indirect Patlak methods and their performances were evaluated. RESULTS We report estimates of kinetic parameters and metabolic rate of glucose consumption (MRFDG) for different organs and tumor lesions. In some organs, there were significant differences between MRFDG values estimated using 2TC and Patlak models. No statistically significant difference was seen between MRFDG values estimated using 2TC and Patlak methods in tumor lesions (paired t-test, P = 0.65). Parametric imaging showed that net influx (Ki) images generated using direct and indirect Patlak methods had superior tumor-to-background ratio (TBR) to standard uptake value (SUV) images (3.1- and 3.0-fold mean increases in TBRmean, respectively). Influx images generated using the direct Patlak method had twofold higher contrast-to-noise ratio in tumor lesions compared to images generated using the indirect Patlak method. CONCLUSION We performed pharmacokinetic modelling of multiple organs using linear and non-linear models using dynamic total-body 18F-FDG images. Although parametric images did not reveal more tumors than SUV images, the results confirmed that parametric imaging furnishes improved tumor contrast. We thus demonstrate the feasibility of total-body kinetic modelling and parametric imaging in basic research and oncological studies. LAFOV PET can enhance dynamic imaging capabilities by providing high sensitivity parametric images and allowing total-body pharmacokinetic analysis.
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Affiliation(s)
- Hasan Sari
- Advanced Clinical Imaging Technology, Siemens Healthcare AG, Lausanne, Switzerland.
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 18, 3010, Bern, Switzerland.
| | - Clemens Mingels
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 18, 3010, Bern, Switzerland
| | - Ian Alberts
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 18, 3010, Bern, Switzerland
| | - Jicun Hu
- Siemens Medical Solutions, USA Inc., Knoxville, TN, USA
| | - Dorothee Buesser
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 18, 3010, Bern, Switzerland
| | - Vijay Shah
- Siemens Medical Solutions, USA Inc., Knoxville, TN, USA
| | - Robin Schepers
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 18, 3010, Bern, Switzerland
| | - Patrik Caluori
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 18, 3010, Bern, Switzerland
| | | | | | - Ali Afshar-Oromieh
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 18, 3010, Bern, Switzerland
| | - Kuangyu Shi
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 18, 3010, Bern, Switzerland
| | - Lars Eriksson
- Siemens Medical Solutions, USA Inc., Knoxville, TN, USA
- Department of Oncology and Pathology, Medical Radiation Physics, Karolinska Institutet, Stockholm, Sweden
| | - Axel Rominger
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 18, 3010, Bern, Switzerland
| | - Paul Cumming
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 18, 3010, Bern, Switzerland
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, Australia
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