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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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2
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Wang Q, Abdelhafez YG, Nalbant H, Spencer BA, Bayerlein R, Qi J, Cherry SR, Nardo L, Badawi RD. Refining penalty parameter selection in whole-body PET image reconstruction for lung cancer patients using the cross-validation log-likelihood method. Phys Med Biol 2024; 69:185002. [PMID: 39168154 DOI: 10.1088/1361-6560/ad7222] [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: 05/31/2024] [Accepted: 08/21/2024] [Indexed: 08/23/2024]
Abstract
Objective.Penalty parameters in penalized likelihood positron emission tomography (PET) reconstruction are typically determined empirically. The cross-validation log-likelihood (CVLL) method has been introduced to optimize these parameters by maximizing a CVLL function, which assesses the likelihood of reconstructed images using one subset of a list-mode dataset based on another subset. This study aims to validate the efficacy of the CVLL method in whole-body imaging for cancer patients using a conventional clinical PET scanner.Approach.Fifteen lung cancer patients were injected with 243.7 ± 23.8 MBq of [18F]FDG and underwent a 22 min PET scan on a Biograph mCT PET/CT scanner, starting at 60 ± 5 min post-injection. The PET list-mode data were partitioned by subsampling without replacement, with 20 minutes of data for image reconstruction using an in-house ordered subset expectation maximization algorithm and the remaining 2 minutes of data for cross-validation. Two penalty parameters, penalty strengthβand Fair penalty function parameterδ, were subjected to optimization. Whole-body images were reconstructed, and CVLL values were computed across various penalty parameter combinations. The optimal image corresponding to the maximum CVLL value was selected by a grid search for each patient.Main results.Theδvalue required to maximize the CVLL value was notably small (⩽10-6in this study). The influences of voxel size and scan duration on image optimization were investigated. A correlation analysis revealed a significant inverse relationship between optimalβand scan count level, with a correlation coefficient of -0.68 (p-value = 3.5 × 10-5). The optimal images selected by the CVLL method were compared with those chosen by two radiologists based on their diagnostic preferences. Differences were observed in the selection of optimal images.Significance.This study demonstrates the feasibility of incorporating the CVLL method into routine imaging protocols, potentially allowing for a wide range of combinations of injected radioactivity amounts and scan durations in modern PET imaging.
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Affiliation(s)
- Qian Wang
- Department of Biomedical Engineering, University of California, Davis, CA, United States of America
- Department of Radiology, University of California, Davis, CA, United States of America
| | - Yasser G Abdelhafez
- Department of Radiology, University of California, Davis, CA, United States of America
- Department of Radiotherapy and Nuclear Medicine, South Egypt Cancer Institute, Assiut University, Assiut, Egypt
| | - Hande Nalbant
- Department of Radiology, University of California, Davis, CA, United States of America
| | - Benjamin A Spencer
- Department of Biomedical Engineering, University of California, Davis, CA, United States of America
- Department of Radiology, University of California, Davis, CA, United States of America
| | - Reimund Bayerlein
- Department of Biomedical Engineering, University of California, Davis, CA, United States of America
- Department of Radiology, University of California, Davis, CA, United States of America
| | - Jinyi Qi
- Department of Biomedical Engineering, University of California, Davis, CA, United States of America
| | - Simon R Cherry
- Department of Biomedical Engineering, University of California, Davis, CA, United States of America
- Department of Radiology, University of California, Davis, CA, United States of America
| | - Lorenzo Nardo
- Department of Radiology, University of California, Davis, CA, United States of America
| | - Ramsey D Badawi
- Department of Biomedical Engineering, University of California, Davis, CA, United States of America
- Department of Radiology, University of California, Davis, CA, United States of America
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3
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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 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] [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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4
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Slart RHJA, Martinez-Lucio TS, Boersma HH, Borra RH, Cornelissen B, Dierckx RAJO, Dobrolinska M, Doorduin J, Erba PA, Glaudemans AWJM, Giacobbo BL, Luurtsema G, Noordzij W, van Sluis J, Tsoumpas C, Lammertsma AA. [ 15O]H 2O PET: Potential or Essential for Molecular Imaging? Semin Nucl Med 2024; 54:761-773. [PMID: 37640631 DOI: 10.1053/j.semnuclmed.2023.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 08/14/2023] [Accepted: 08/14/2023] [Indexed: 08/31/2023]
Abstract
Imaging water pathways in the human body provides an excellent way of measuring accurately the blood flow directed to different organs. This makes it a powerful diagnostic tool for a wide range of diseases that are related to perfusion and oxygenation. Although water PET has a long history, its true potential has not made it into regular clinical practice. The article highlights the potential of water PET in molecular imaging and suggests its prospective role in becoming an essential tool for the 21st century precision medicine in different domains ranging from preclinical to clinical research and practice. The recent technical advances in high-sensitivity PET imaging can play a key accelerating role in empowering this technique, though there are still several challenges to overcome.
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Affiliation(s)
- Riemer H J A Slart
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; Department of Biomedical Photonic Imaging, Faculty of Science and Technology, University of Twente, Enschede, The Netherlands.
| | - T Samara Martinez-Lucio
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Hendrikus H Boersma
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Ronald H Borra
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Bart Cornelissen
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Rudi A J O Dierckx
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Magdalena Dobrolinska
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
| | - Janine Doorduin
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Paola A Erba
- Department of Medicine and Surgery, University of Milan Bicocca, and Nuclear Medicine Unit ASST Ospedale Papa Giovanni XXIII, Bergamo, Italy
| | - Andor W J M Glaudemans
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Bruno Lima Giacobbo
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Gert Luurtsema
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Walter Noordzij
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Joyce van Sluis
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Charalampos Tsoumpas
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Adriaan A Lammertsma
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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5
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Gu T, Liu S, Hou X, Zhao L, Ng YL, Wang J, Shi H. Low dose optimization for total-body 2-[ 18F]FDG PET/CT imaging: a single-center study on feasibility based on body mass index stratification. Eur Radiol 2024:10.1007/s00330-024-11039-1. [PMID: 39214892 DOI: 10.1007/s00330-024-11039-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Revised: 06/13/2024] [Accepted: 08/11/2024] [Indexed: 09/04/2024]
Abstract
OBJECTIVES Implementing personalization protocol in clinical routine necessitates diverse low-dose PET/CT scan protocols. This study explores the clinical feasibility of one-third (1/3) dose regimen and evaluates the diagnostic image quality and lesion detectability of BMI-based 1/3-injection doses for 2-[18F]FDG PET/CT imaging. METHODS Seventy-four cancer patients underwent total-body 2-[18F]FDG PET/CT examination, with 37 retrospectively enrolled as full-dose group (3.7 MBq/kg) and 37 prospectively enrolled as the 1/3-dose group (1.23 MBq/kg). The 1/3-dose group was stratified by BMI, with an acquisition time of 5 min (G5), 6 min (G6), and 8 min (G8) for BMI < 25, 25 ≤ BMI ≤ 29, and BMI > 29, respectively. Image quality was subjectively and objectively assessed, and lesion detectability was quantitatively analyzed. RESULTS Subjective assessments of 1/3-dose and full-dose PET images showed strong agreement among readers (κ > 0.88). In the 1/3-dose group, the Likert scores were above 4. G5, G6, and G8 showed comparable image quality, with G5 demonstrating higher lesion conspicuity than G6 and G8 (p = 0.045). Objective evaluation showed no significant differences in SUVmax, liver SUVmean and TBR between 1/3- and full-dose groups (p > 0.05). No statistical differences were observed in the SUVmax of primary tumor, SUVmean of liver and TBR across all BMI categories between the 1/3-dose and full-dose groups. Lesion detection rates showed no significant difference between the 1/3-dose (93.24%, 193/207) and full-dose groups (94.73%, 198/209) (p = 0.520). CONCLUSION A BMI-stratified 1/3-dose regimen is a feasible low-dose alternative with clinically acceptable lesion detectability equivalent to full-dose protocol, potentially expanding the applicability of personalized protocols. CLINICAL RELEVANCE STATEMENT This study demonstrated that BMI-stratified 1/3-dose regimens for [18F]FDG total-body PET/CT yielded equivalent outputs compared to the full-dose regimen, which aligns with clinical needs for personalization in dose and BMI. KEY POINTS Currently, limited personalized low-dose total-body PET/CT protocols are available, particularly for patients with varied BMI. Reducing the radiotracer dose to 1/3 the standard demonstrated comparable image quality and lesion detectability equivalent to full dose. BMI-stratified 1/3-dose regimen is a clinically feasible low-dose alternative.
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Affiliation(s)
- Taoying Gu
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Road, 200032, Shanghai, People's Republic of China
- Nuclear Medicine Institute of Fudan University, 200032, Shanghai, China
- Shanghai Institute of Medical Imaging, 200032, Shanghai, China
- Cancer Prevention and Treatment Center, Zhongshan Hospital, Fudan University, 200032, Shanghai, China
| | - Siwei Liu
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Road, 200032, Shanghai, People's Republic of China
- Nuclear Medicine Institute of Fudan University, 200032, Shanghai, China
- Shanghai Institute of Medical Imaging, 200032, Shanghai, China
- Cancer Prevention and Treatment Center, Zhongshan Hospital, Fudan University, 200032, Shanghai, China
| | - Xiaoguang Hou
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Road, 200032, Shanghai, People's Republic of China
- Nuclear Medicine Institute of Fudan University, 200032, Shanghai, China
- Shanghai Institute of Medical Imaging, 200032, Shanghai, China
- Cancer Prevention and Treatment Center, Zhongshan Hospital, Fudan University, 200032, Shanghai, China
| | - Liwei Zhao
- United Imaging Healthcare Co., Ltd., Shanghai, China
| | - Yee Ling Ng
- United Imaging Healthcare Co., Ltd., Shanghai, China
| | - Jingyi Wang
- United Imaging Healthcare Co., Ltd., Shanghai, China
| | - Hongcheng Shi
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Road, 200032, Shanghai, People's Republic of China.
- Nuclear Medicine Institute of Fudan University, 200032, Shanghai, China.
- Shanghai Institute of Medical Imaging, 200032, Shanghai, China.
- Cancer Prevention and Treatment Center, Zhongshan Hospital, Fudan University, 200032, Shanghai, China.
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6
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Li C, Zhang A, Xue Z, Qiu P, Zhang Z, Zhao S, Ding D. Efficient and Ultrafast Oxyorthosilicate Scintillator by Activator Valence State Manipulation. ACS APPLIED MATERIALS & INTERFACES 2024; 16:45197-45206. [PMID: 39150429 DOI: 10.1021/acsami.4c09739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/17/2024]
Abstract
There is an urgent need for faster, brighter, and more controllable scintillation materials in advanced nuclear medicine, high-energy physical experiments, and dark matter particle detection. Nevertheless, the trade-off between high emission efficiency and fast timing characteristics remains a common challenge in the entire optical field. To address this issue, we develop a composition engineering strategy that involves multisite selective doping. This strategy aims to transform nearly all Ce3+ into fast-emitting Ce4+ while synergistically suppressing the electron traps. Even at very low doping concentrations, the designed Ca2+, Al3+, and Ce3+ tridoped oxyorthosilicate exhibits a scintillation decay (τd) acceleration of 20%, accompanied by a 25% increase in light yield (LY). The ratio of emission efficiency and timing characteristics (LY/τd) can be enhanced by 56%, which realizes the perfect balance of high LY and fast τd. Our work provides a method for designing efficient, ultrafast, and controllable scintillators in multicomponent systems, thus paving the way for high-resolution radiation detection and imaging applications.
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Affiliation(s)
- Chengyi Li
- Shanghai Institute of Ceramics, Chinese Academy of Sciences, No. 585 Heshuo Road, Shanghai 201899, China
- Center of Materials Science and Optoelectronics Engineering, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Aochen Zhang
- Shanghai Institute of Ceramics, Chinese Academy of Sciences, No. 585 Heshuo Road, Shanghai 201899, China
- Center of Materials Science and Optoelectronics Engineering, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Zhongjun Xue
- Shanghai Institute of Ceramics, Chinese Academy of Sciences, No. 585 Heshuo Road, Shanghai 201899, China
| | - Peng Qiu
- Shanghai Institute of Ceramics, Chinese Academy of Sciences, No. 585 Heshuo Road, Shanghai 201899, China
- Center of Materials Science and Optoelectronics Engineering, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Zhe Zhang
- Shanghai Institute of Ceramics, Chinese Academy of Sciences, No. 585 Heshuo Road, Shanghai 201899, China
| | - Shuwen Zhao
- Shanghai Institute of Ceramics, Chinese Academy of Sciences, No. 585 Heshuo Road, Shanghai 201899, China
| | - Dongzhou Ding
- Shanghai Institute of Ceramics, Chinese Academy of Sciences, No. 585 Heshuo Road, Shanghai 201899, China
- Center of Materials Science and Optoelectronics Engineering, University of Chinese Academy of Sciences, Beijing 100049, China
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7
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Abdelhafez YG, Wang G, Li S, Pellegrinelli V, Chaudhari AJ, Ramirez A, Sen F, Vidal-Puig A, Sidossis LS, Klein S, Badawi RD, Chondronikola M. The role of brown adipose tissue in branched-chain amino acid clearance in people. iScience 2024; 27:110559. [PMID: 39175781 PMCID: PMC11340589 DOI: 10.1016/j.isci.2024.110559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 06/24/2024] [Accepted: 07/17/2024] [Indexed: 08/24/2024] Open
Abstract
Brown adipose tissue (BAT) in rodents appears to be an important tissue for the clearance of plasma branched-chain amino acids (BCAAs) contributing to improved metabolic health. However, the role of human BAT in plasma BCAA clearance is poorly understood. Here, we evaluate patients with prostate cancer who underwent positron emission tomography-computed tomography imaging after an injection of 18F-fluciclovine (L-leucine analog). Supraclavicular adipose tissue (AT; primary location of human BAT) has a higher net uptake rate for 18F-fluciclovine compared to subcutaneous abdominal and upper chest AT. Supraclavicular AT 18F-fluciclovine net uptake rate is lower in patients with obesity and type 2 diabetes. Finally, the expression of genes involved in BCAA catabolism is higher in the supraclavicular AT of healthy people with high BAT volume compared to those with low BAT volume. These findings support the notion that BAT can potentially function as a metabolic sink for plasma BCAA clearance in people.
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Affiliation(s)
- Yasser G. Abdelhafez
- Department of Radiology, University of California Davis, Sacramento, CA 95817, USA
- Nuclear Medicine Unit, South Egypt Cancer Institute, Assiut University, El Fateh 71111, Egypt
| | - Guobao Wang
- Department of Radiology, University of California Davis, Sacramento, CA 95817, USA
| | - Siqi Li
- Department of Radiology, University of California Davis, Sacramento, CA 95817, USA
| | - Vanessa Pellegrinelli
- Institute of Metabolic Science-Metabolic Research Laboratories, Medical Research Council Metabolic Diseases Unit, University of Cambridge, Cambridge CB2 0QQ, UK
| | - Abhijit J. Chaudhari
- Department of Radiology, University of California Davis, Sacramento, CA 95817, USA
| | - Anthony Ramirez
- Department of Nutrition, University of California Davis, Davis, CA 95616, USA
| | - Fatma Sen
- Department of Radiology, University of California Davis, Sacramento, CA 95817, USA
| | - Antonio Vidal-Puig
- Institute of Metabolic Science-Metabolic Research Laboratories, Medical Research Council Metabolic Diseases Unit, University of Cambridge, Cambridge CB2 0QQ, UK
| | - Labros S. Sidossis
- Department of Kinesiology and Health, Rutgers University, New Brunswick, NJ 08901, USA
| | - Samuel Klein
- Center for Human Nutrition, Washington University School of Medicine, Saint Louis, MO 63110, USA
| | - Ramsey D. Badawi
- Department of Radiology, University of California Davis, Sacramento, CA 95817, USA
| | - Maria Chondronikola
- Department of Radiology, University of California Davis, Sacramento, CA 95817, USA
- Institute of Metabolic Science-Metabolic Research Laboratories, Medical Research Council Metabolic Diseases Unit, University of Cambridge, Cambridge CB2 0QQ, UK
- Department of Nutrition, University of California Davis, Davis, CA 95616, USA
- Department of Nutrition and Dietetics, Harokopio University of Athens, 17778 Athens, Greece
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8
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Li H, Badawi RD, Cherry SR, Fontaine K, He L, Henry S, Hillmer AT, Hu L, Khattar N, Leung EK, Li T, Li Y, Liu C, Liu P, Lu Z, Majewski S, Matuskey D, Morris ED, Mulnix T, Omidvari N, Samanta S, Selfridge A, Sun X, Toyonaga T, Volpi T, Zeng T, Jones T, Qi J, Carson RE. Performance Characteristics of the NeuroEXPLORER, a Next-Generation Human Brain PET/CT Imager. J Nucl Med 2024; 65:1320-1326. [PMID: 38871391 PMCID: PMC11294061 DOI: 10.2967/jnumed.124.267767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 05/13/2024] [Indexed: 06/15/2024] Open
Abstract
The collaboration of Yale, the University of California, Davis, and United Imaging Healthcare has successfully developed the NeuroEXPLORER, a dedicated human brain PET imager with high spatial resolution, high sensitivity, and a built-in 3-dimensional camera for markerless continuous motion tracking. It has high depth-of-interaction and time-of-flight resolutions, along with a 52.4-cm transverse field of view (FOV) and an extended axial FOV (49.5 cm) to enhance sensitivity. Here, we present the physical characterization, performance evaluation, and first human images of the NeuroEXPLORER. Methods: Measurements of spatial resolution, sensitivity, count rate performance, energy and timing resolution, and image quality were performed adhering to the National Electrical Manufacturers Association (NEMA) NU 2-2018 standard. The system's performance was demonstrated through imaging studies of the Hoffman 3-dimensional brain phantom and the mini-Derenzo phantom. Initial 18F-FDG images from a healthy volunteer are presented. Results: With filtered backprojection reconstruction, the radial and tangential spatial resolutions (full width at half maximum) averaged 1.64, 2.06, and 2.51 mm, with axial resolutions of 2.73, 2.89, and 2.93 mm for radial offsets of 1, 10, and 20 cm, respectively. The average time-of-flight resolution was 236 ps, and the energy resolution was 10.5%. NEMA sensitivities were 46.0 and 47.6 kcps/MBq at the center and 10-cm offset, respectively. A sensitivity of 11.8% was achieved at the FOV center. The peak noise-equivalent count rate was 1.31 Mcps at 58.0 kBq/mL, and the scatter fraction at 5.3 kBq/mL was 36.5%. The maximum count rate error at the peak noise-equivalent count rate was less than 5%. At 3 iterations, the NEMA image-quality contrast recovery coefficients varied from 74.5% (10-mm sphere) to 92.6% (37-mm sphere), and background variability ranged from 3.1% to 1.4% at a contrast of 4.0:1. An example human brain 18F-FDG image exhibited very high resolution, capturing intricate details in the cortex and subcortical structures. Conclusion: The NeuroEXPLORER offers high sensitivity and high spatial resolution. With its long axial length, it also enables high-quality spinal cord imaging and image-derived input functions from the carotid arteries. These performance enhancements will substantially broaden the range of human brain PET paradigms, protocols, and thereby clinical research applications.
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Affiliation(s)
- Hongdi Li
- United Imaging Healthcare North America, Houston, Texas
| | | | | | | | - Liuchun He
- United Imaging Healthcare, Shanghai, China
| | | | | | - Lingzhi Hu
- United Imaging Healthcare North America, Houston, Texas
| | | | - Edwin K Leung
- United Imaging Healthcare North America, Houston, Texas
- University of California, Davis, Davis, California
| | - Tiantian Li
- United Imaging Healthcare North America, Houston, Texas
- University of California, Davis, Davis, California
| | - Yusheng Li
- United Imaging Healthcare North America, Houston, Texas
| | - Chi Liu
- Yale University, New Haven, Connecticut; and
| | - Peng Liu
- United Imaging Healthcare, Shanghai, China
| | - Zhenrui Lu
- United Imaging Healthcare, Shanghai, China
| | | | | | | | - Tim Mulnix
- Yale University, New Haven, Connecticut; and
| | | | | | - Aaron Selfridge
- United Imaging Healthcare North America, Houston, Texas
- University of California, Davis, Davis, California
| | - Xishan Sun
- United Imaging Healthcare North America, Houston, Texas
| | | | | | - Tianyi Zeng
- Yale University, New Haven, Connecticut; and
| | - Terry Jones
- University of California, Davis, Davis, California
| | - Jinyi Qi
- University of California, Davis, Davis, California
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9
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Chung KJ, Abdelhafez YG, Spencer BA, Jones T, Tran Q, Nardo L, Chen MS, Sarkar S, Medici V, Lyo V, Badawi RD, Cherry SR, Wang G. Quantitative PET imaging and modeling of molecular blood-brain barrier permeability. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.07.26.24311027. [PMID: 39108503 PMCID: PMC11302722 DOI: 10.1101/2024.07.26.24311027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 08/12/2024]
Abstract
Blood-brain barrier (BBB) disruption is involved in the pathogenesis and progression of many neurological and systemic diseases. Non-invasive assessment of BBB permeability in humans has mainly been performed with dynamic contrast-enhanced magnetic resonance imaging, evaluating the BBB as a structural barrier. Here, we developed a novel non-invasive positron emission tomography (PET) method in humans to measure the BBB permeability of molecular radiotracers that cross the BBB through different transport mechanisms. Our method uses high-temporal resolution dynamic imaging and kinetic modeling to jointly estimate cerebral blood flow and tracer-specific BBB transport rate from a single dynamic PET scan and measure the molecular permeability-surface area (PS) product of the radiotracer. We show our method can resolve BBB PS across three PET radiotracers with greatly differing permeabilities, measure reductions in BBB PS of 18F-fluorodeoxyglucose (FDG) in healthy aging, and demonstrate a possible brain-body association between decreased FDG BBB PS in patients with metabolic dysfunction-associated steatotic liver inflammation. Our method opens new directions to efficiently study the molecular permeability of the human BBB in vivo using the large catalogue of available molecular PET tracers.
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Affiliation(s)
- Kevin J Chung
- Department of Radiology, University of California Davis Health, Sacramento, CA
| | - Yasser G Abdelhafez
- Department of Radiology, University of California Davis Health, Sacramento, CA
| | - Benjamin A Spencer
- Department of Radiology, University of California Davis Health, Sacramento, CA
| | - Terry Jones
- Department of Radiology, University of California Davis Health, Sacramento, CA
| | - Quyen Tran
- Department of Radiology, University of California Davis Health, Sacramento, CA
| | - Lorenzo Nardo
- Department of Radiology, University of California Davis Health, Sacramento, CA
| | - Moon S Chen
- Department of Internal Medicine, University of California Davis Health, Sacramento, CA
| | - Souvik Sarkar
- Department of Internal Medicine, University of California Davis Health, Sacramento, CA
| | - Valentina Medici
- Department of Internal Medicine, University of California Davis Health, Sacramento, CA
- Division of Gastroenterology and Hepatology, University of California Davis Health, Sacramento, CA
| | - Victoria Lyo
- Department of Surgery, University of California Davis Health, Sacramento, CA
- Center for Alimentary and Metabolic Sciences, University of California Davis Health, Sacramento, CA
| | - Ramsey D Badawi
- Department of Radiology, University of California Davis Health, Sacramento, CA
- Department of Biomedical Engineering, University of California at Davis, Davis, CA
| | - Simon R Cherry
- Department of Biomedical Engineering, University of California at Davis, Davis, CA
- Department of Radiology, University of California Davis Health, Sacramento, CA
| | - Guobao Wang
- Department of Radiology, University of California Davis Health, Sacramento, CA
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10
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Piccardo A, Bottoni G, Puppo C, Massollo M, Ugolini M, Shoushtari Zadeh Naseri M, Melani E, Tomasello L, Boitano M, DeCensi A, Sambucco B, Campodonico F, Altrinetti V, Ennas M, Urru A, Negro CLA, Timossi L, Treglia G, Introini C, Fiz F. Role of 64CuCl 2 PET/CT in Detecting and Staging Muscle-Invasive Bladder Cancer: Comparison with Contrast-Enhanced CT and 18F-FDG PET/CT. J Nucl Med 2024:jnumed.124.267474. [PMID: 39054284 DOI: 10.2967/jnumed.124.267474] [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: 01/28/2024] [Accepted: 05/13/2024] [Indexed: 07/27/2024] Open
Abstract
Molecular imaging of muscle-invasive bladder cancer (MBC) is restricted to its locoregional and distant metastases, since most radiopharmaceuticals have a urinary excretion that limits the visualization of the primary tumor. 64CuCl2 , a positron-emitting radiotracer with nearly exclusive biliary elimination, could be well suited to exploring urinary tract neoplasms. In this study, we evaluated the feasibility of 64CuCl2-based staging of patients with MBC; furthermore, we compared the diagnostic capability of this method with those of the current gold standards, that is, contrast-enhanced CT (ceCT) and 18F-FDG PET/CT. Methods: We prospectively enrolled patients referred to our institution for pathology-confirmed MBC staging/restaging between September 2021 and January 2023. All patients underwent ceCT, 18F-FDG, and 64CuCl2 PET/CT within 2 wk. Patient-based analysis and lesion-based analysis were performed for all of the potentially affected districts (overall, bladder wall, lymph nodes, skeleton, liver, lung, and pelvic soft tissue). Results: Forty-two patients (9 women) were enrolled. Thirty-six (86%) had evidence of disease, with a total of 353 disease sites. On patient-based analysis, ceCT and 64CuCl2 PET/CT showed higher sensitivity than 18F-FDG PET/CT in detecting the primary tumor (P < 0.001); moreover, 64CuCl2 PET/CT was slightly more sensitive than 18F-FDG PET/CT in disclosing soft-tissue lesions (P < 0.05). Both PET methods were more specific and accurate than ceCT in classifying nodal lesions (P < 0.05). On lesion-based analysis, 64CuCl2 PET/CT outperformed 18F-FDG PET/CT and ceCT in detecting disease localizations overall (P < 0.001), in the lymph nodes (P < 0.01), in the skeleton (P < 0.001), and in the soft tissue (P < 0.05). Conclusion: 64CuCl2 PET/CT appears to be a sensitive modality for staging/restaging of MBC and might represent a "one-stop shop" diagnostic method in these scenarios.
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Affiliation(s)
- Arnoldo Piccardo
- S.C. di Medicina Nucleare, E.O. Ospedali Galliera, Genova, Italy
| | - Gianluca Bottoni
- S.C. di Medicina Nucleare, E.O. Ospedali Galliera, Genova, Italy
| | - Cristina Puppo
- S.C. Radiodiagnostica, E.O. Ospedali Galliera, Genova, Italy
| | - Michela Massollo
- S.C. di Medicina Nucleare, E.O. Ospedali Galliera, Genova, Italy
| | - Martina Ugolini
- S.C. di Medicina Nucleare, E.O. Ospedali Galliera, Genova, Italy
| | | | - Enrico Melani
- S.C. Radiodiagnostica, E.O. Ospedali Galliera, Genova, Italy
| | - Laura Tomasello
- U.O. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Monica Boitano
- S.C. Oncologia Medica, E.O. Ospedali Galliera, Genova, Italy
| | - Andrea DeCensi
- S.C. Oncologia Medica, E.O. Ospedali Galliera, Genova, Italy
| | - Beatrice Sambucco
- Department of Health Sciences (DISSAL)-Radiology Section, University of Genoa, Genoa, Italy
| | | | - Vania Altrinetti
- S.C. di Medicina Nucleare, E.O. Ospedali Galliera, Genova, Italy
| | - Marco Ennas
- S.C. di Urologia, E.O. Ospedali Galliera, Genova, Italy
| | - Alessia Urru
- Diagnostic Imaging Department, Villa Scassi Hospital-ASL 3, Genoa, Italy
| | | | - Luca Timossi
- S.S.A. Urologia dell'Ospedale Evangelico Internazionale, Genova, Italy
| | - Giorgio Treglia
- Faculty of Biomedical Sciences, Università della Svizzera Italiana (USI), Lugano, Switzerland
- Clinic of Nuclear Medicine, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland; and
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | | | - Francesco Fiz
- S.C. di Medicina Nucleare, E.O. Ospedali Galliera, Genova, Italy;
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11
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Liu G, Gu T, Chen S, Gu Y, Yu H, Shi H. Total-body dynamic PET/CT imaging reveals kinetic distribution of [ 13N]NH 3 in normal organs. Eur J Nucl Med Mol Imaging 2024:10.1007/s00259-024-06826-3. [PMID: 38976037 DOI: 10.1007/s00259-024-06826-3] [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: 04/18/2024] [Accepted: 06/30/2024] [Indexed: 07/09/2024]
Abstract
PURPOSE To systematically investigate kinetic metrics and metabolic trapping of [13N]NH3 in organs. METHODS Eleven participants performed total-body [13N]NH3 dynamic positron emission tomography (PET). Regions of interest were drawn in organs to obtain time-to-activity curves (TACs), which were fitted with an irreversible two-tissue compartment model (2TC) to investigate constant rates K1, k2 and k3, and to calculate Ki. Additionally, one-tissue compartment model using full data (1TCfull) and the first four minutes of data (1TC4min) were fitted to TAC data. K1 and k2 were compared among different models to assess [13N]NH3 trapping in organs. RESULTS Kinetic rates of [13N]NH3 varied significantly among organs. The mean K1 ranged from 0.049 mL/cm3/min in the muscle to 2.936 mL/cm3/min in the kidney. The k2 and k3 were lowest in the liver (0.001 min- 1) and in the pituitary (0.009 min- 1), while highest in the kidney (0.587 min- 1) and in the liver (0.800 min- 1), respectively. The Ki was largest in the myocardium (0.601 ± 0.259 mL/cm3/min) while smallest in the bone marrow (0.028 ± 0.022 mL/cm3/min). Three groups of organs with similar kinetic characteristics were revealed: (1) the thyroid, the lung, the spleen, the pancreas, and the kidney; (2) the liver and the muscle; and (3) the cortex, the white matter, the cerebellum, the pituitary, the parotid, the submandibular gland, the myocardium, the bone, and the bone marrow. Obvious k3 was identified in multiple organs, and significant changes of K1 in multiple organs and k2 in most organs were found between 2TC and 1TCfull, but both K1 and k2 were comparable between 2TC and 1TC4min. CONCLUSION The kinetic rates of [13N]NH3 differed among organs with some have obvious 13N-anmmonia trapping. The normal distribution of kinetic metrics of 13N-anmmonia in organs can serve as a reference for its potential use in tumor imaging.
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Affiliation(s)
- Guobing Liu
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, No. 180 in Fenglin Road, Shanghai, 200032, P.R. China
- Institute of Nuclear Medicine, Fudan University, Shanghai, China
- Shanghai Institute of Medical Imaging, Shanghai, China
- Cancer Prevention and Treatment Center, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Taoying Gu
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, No. 180 in Fenglin Road, Shanghai, 200032, P.R. China
- Institute of Nuclear Medicine, Fudan University, Shanghai, China
- Shanghai Institute of Medical Imaging, Shanghai, China
- Cancer Prevention and Treatment Center, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Shuguang Chen
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, No. 180 in Fenglin Road, Shanghai, 200032, P.R. China
- Institute of Nuclear Medicine, Fudan University, Shanghai, China
- Shanghai Institute of Medical Imaging, Shanghai, China
- Cancer Prevention and Treatment Center, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yushen Gu
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, No. 180 in Fenglin Road, Shanghai, 200032, P.R. China
- Institute of Nuclear Medicine, Fudan University, Shanghai, China
- Shanghai Institute of Medical Imaging, Shanghai, China
- Cancer Prevention and Treatment Center, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Haojun Yu
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, No. 180 in Fenglin Road, Shanghai, 200032, P.R. China
- Institute of Nuclear Medicine, Fudan University, Shanghai, China
- Shanghai Institute of Medical Imaging, Shanghai, China
- Cancer Prevention and Treatment Center, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Hongcheng Shi
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, No. 180 in Fenglin Road, Shanghai, 200032, P.R. China.
- Institute of Nuclear Medicine, Fudan University, Shanghai, China.
- Shanghai Institute of Medical Imaging, Shanghai, China.
- Cancer Prevention and Treatment Center, Zhongshan Hospital, Fudan University, Shanghai, China.
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12
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Li S, Zhu Y, Spencer BA, Wang G. Single-Subject Deep-Learning Image Reconstruction With a Neural Optimization Transfer Algorithm for PET-Enabled Dual-Energy CT Imaging. IEEE TRANSACTIONS ON IMAGE PROCESSING : A PUBLICATION OF THE IEEE SIGNAL PROCESSING SOCIETY 2024; 33:4075-4089. [PMID: 38941203 DOI: 10.1109/tip.2024.3418347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/30/2024]
Abstract
Combining dual-energy computed tomography (DECT) with positron emission tomography (PET) offers many potential clinical applications but typically requires expensive hardware upgrades or increases radiation doses on PET/CT scanners due to an extra X-ray CT scan. The recent PET-enabled DECT method allows DECT imaging on PET/CT without requiring a second X-ray CT scan. It combines the already existing X-ray CT image with a 511 keV γ -ray CT (gCT) image reconstructed from time-of-flight PET emission data. A kernelized framework has been developed for reconstructing gCT image but this method has not fully exploited the potential of prior knowledge. Use of deep neural networks may explore the power of deep learning in this application. However, common approaches require a large database for training, which is impractical for a new imaging method like PET-enabled DECT. Here, we propose a single-subject method by using neural-network representation as a deep coefficient prior to improving gCT image reconstruction without population-based pre-training. The resulting optimization problem becomes the tomographic estimation of nonlinear neural-network parameters from gCT projection data. This complicated problem can be efficiently solved by utilizing the optimization transfer strategy with quadratic surrogates. Each iteration of the proposed neural optimization transfer algorithm includes: PET activity image update; gCT image update; and least-square neural-network learning in the gCT image domain. This algorithm is guaranteed to monotonically increase the data likelihood. Results from computer simulation, real phantom data and real patient data have demonstrated that the proposed method can significantly improve gCT image quality and consequent multi-material decomposition as compared to other methods.
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13
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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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Xin M, Wang Y, Yang X, Li L, Wang C, Gu Y, Zhang C, Huang G, Zhou Y, Liu J. Exploring the nigrostriatal and digestive interplays in Parkinson's disease using dynamic total-body [ 11C]CFT PET/CT. Eur J Nucl Med Mol Imaging 2024; 51:2271-2282. [PMID: 38393375 DOI: 10.1007/s00259-024-06638-5] [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: 09/08/2023] [Accepted: 02/04/2024] [Indexed: 02/25/2024]
Abstract
PURPOSE Dynamic total-body imaging enables new perspectives to investigate the potential relationship between the central and peripheral regions. Employing uEXPLORER dynamic [11C]CFT PET/CT imaging with voxel-wise simplified reference tissue model (SRTM) kinetic modeling and semi-quantitative measures, we explored how the correlation pattern between nigrostriatal and digestive regions differed between the healthy participants as controls (HC) and patients with Parkinson's disease (PD). METHODS Eleven participants (six HCs and five PDs) underwent 75-min dynamic [11C]CFT scans on a total-body PET/CT scanner (uEXPLORER, United Imaging Healthcare) were retrospectively enrolled. Time activity curves for four nigrostriatal nuclei (caudate, putamen, pallidum, and substantia nigra) and three digestive organs (pancreas, stomach, and duodenum) were obtained. Total-body parametric images of relative transporter rate constant (R1) and distribution volume ratio (DVR) were generated using the SRTM with occipital lobe as the reference tissue and a linear regression with spatial-constraint algorithm. Standardized uptake value ratio (SUVR) at early (1-3 min, SUVREP) and late (60-75 min, SUVRLP) phases were calculated as the semi-quantitative substitutes for R1 and DVR, respectively. RESULTS Significant differences in estimates between the HC and PD groups were identified in DVR and SUVRLP of putamen (DVR: 4.82 ± 1.58 vs. 2.58 ± 0.53; SUVRLP: 4.65 ± 1.36 vs. 2.84 ± 0.67; for HC and PD, respectively, both p < 0.05) and SUVREP of stomach (1.12 ± 0.27 vs. 2.27 ± 0.65 for HC and PD, respectively; p < 0.01). In the HC group, negative correlations were observed between stomach and substantia nigra in both the R1 and SUVREP values (r=-0.83, p < 0.05 for R1; r=-0.94, p < 0.01 for SUVREP). Positive correlations were identified between pancreas and putamen in both DVR and SUVRLP values (r = 0.94, p < 0.01 for DVR; r = 1.00, p < 0.001 for SUVRLP). By contrast, in the PD group, no correlations were found between the aforementioned target nigrostriatal and digestive areas. CONCLUSIONS The parametric images of R1 and DVR generated from the SRTM model, along with SUVREP and SUVRLP, were proposed to quantify dynamic total-body [11C]CFT PET/CT in HC and PD groups. The distinction in correlation patterns of nigrostriatal and digestive regions between HC and PD groups identified by R1 and DVR, or SUVRs, may provide new insights into the disease mechanism.
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Affiliation(s)
- Mei Xin
- Department of Nuclear Medicine, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, 160 Pujian Road, Shanghai, 200127, China
| | - Yihan Wang
- Central Research Institute, United Imaging Healthcare Group Co, Ltd, 2258 Chengbei Road, Shanghai, 201807, China
| | - Xinlan Yang
- Central Research Institute, United Imaging Healthcare Group Co, Ltd, 2258 Chengbei Road, Shanghai, 201807, China
| | - Lianghua Li
- Department of Nuclear Medicine, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, 160 Pujian Road, Shanghai, 200127, China
| | - Cheng Wang
- Department of Nuclear Medicine, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, 160 Pujian Road, Shanghai, 200127, China
| | - Yue Gu
- Central Research Institute, United Imaging Healthcare Group Co, Ltd, 2258 Chengbei Road, Shanghai, 201807, China
| | - Chenpeng Zhang
- Department of Nuclear Medicine, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, 160 Pujian Road, Shanghai, 200127, China
| | - Gang Huang
- Department of Nuclear Medicine, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, 160 Pujian Road, Shanghai, 200127, China
- Shanghai Key Laboratory of Molecular Imaging, Shanghai University of Medicine and Health Sciences, Shanghai, 201318, China
| | - Yun Zhou
- Central Research Institute, United Imaging Healthcare Group Co, Ltd, 2258 Chengbei Road, Shanghai, 201807, China.
| | - Jianjun Liu
- Department of Nuclear Medicine, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, 160 Pujian Road, Shanghai, 200127, China.
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15
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Lamba M, Singh PR, Bandyopadhyay A, Goswami A. Synthetic 18F labeled biomolecules that are selective and promising for PET imaging: major advances and applications. RSC Med Chem 2024; 15:1899-1920. [PMID: 38911154 PMCID: PMC11187557 DOI: 10.1039/d4md00033a] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 04/14/2024] [Indexed: 06/25/2024] Open
Abstract
The concept of positron emission tomography (PET) based imaging was developed more than 40 years ago. It has been a widely adopted technique for detecting and staging numerous diseases in clinical settings, particularly cancer, neuro- and cardio-diseases. Here, we reviewed the evolution of PET and its advantages over other imaging modalities in clinical settings. Primarily, this review discusses recent advances in the synthesis of 18F radiolabeled biomolecules in light of the widely accepted performance for effective PET. The discussion particularly emphasizes the 18F-labeling chemistry of carbohydrates, lipids, amino acids, oligonucleotides, peptides, and protein molecules, which have shown promise for PET imaging in recent decades. In addition, we have deliberated on how 18F-labeled biomolecules enable the detection of metabolic changes at the cellular level and the selective imaging of gross anatomical localization via PET imaging. In the end, the review discusses the future perspective of PET imaging to control disease in clinical settings. We firmly believe that collaborative multidisciplinary research will further widen the comprehensive applications of PET approaches in the clinical management of cancer and other pathological outcomes.
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Affiliation(s)
- Manisha Lamba
- Department of Chemistry, Indian Institute of Technology Birla Farms Ropar Punjab-140001 India
| | - Prasoon Raj Singh
- Department of Chemistry, Indian Institute of Technology Birla Farms Ropar Punjab-140001 India
| | - Anupam Bandyopadhyay
- Department of Chemistry, Indian Institute of Technology Birla Farms Ropar Punjab-140001 India
| | - Avijit Goswami
- Department of Chemistry, Indian Institute of Technology Birla Farms Ropar Punjab-140001 India
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16
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Zeimpekis KG, Mercolli L, Conti M, Sari H, Rominger A, Rathke H. 90Y post-radioembolization clinical assessment with whole-body Biograph Vision Quadra PET/CT: image quality, tumor, liver and lung dosimetry. Eur J Nucl Med Mol Imaging 2024; 51:2100-2113. [PMID: 38347299 PMCID: PMC11139701 DOI: 10.1007/s00259-024-06650-9] [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: 10/31/2023] [Accepted: 02/07/2024] [Indexed: 05/31/2024]
Abstract
PURPOSE Evaluation of 90Y liver radioembolization post-treatment clinical data using a whole-body Biograph Vision Quadra PET/CT to investigate the potential of protocol optimization in terms of scan time and dosimetry. METHODS 17 patients with hepatocellular carcinoma with median (IQR) injected activity 2393 (1348-3298) MBq were included. Pre-treatment dosimetry plan was based on 99mTc-MAA SPECT/CT with Simplicit90Y™ and post-treatment validation with Quadra using Simplicit90Y™ and HERMIA independently. Regarding the image analysis, mean and peak SNR, the coefficient of variation (COV) and lesion-to-background ratio (LBR) were evaluated. For the post-treatment dosimetry validation, the mean tumor, whole liver and lung absorbed dose evaluation was performed using Simplicit90Y and HERMES. Images were reconstructed with 20-, 15-, 10-, 5- and 1- min sinograms with 2, 4, 6 and 8 iterations. Wilcoxon signed rank test was used to show statistical significance (p < 0.05). RESULTS There was no difference of statistical significance between 20- and 5- min reconstructed times for the peak SNR, COV and LBR. In addition, there was no difference of statistical significance between 20- and 1- min reconstructed times for all dosimetry metrics. Lung dosimetry showed consistently lower values than the expected. Tumor absorbed dose based on Simplicit90Y™ was similar to the expected while HERMES consistently underestimated significantly the measured tumor absorbed dose. Finally, there was no difference of statistical significance between expected and measured tumor, whole liver and lung dose for all reconstruction times. CONCLUSION In this study we evaluated, in terms of image quality and dosimetry, whole-body PET clinical images of patients after having been treated with 90Y microspheres radioembolization for liver cancer. Compared to the 20-min standard scan, the simulated 5-min reconstructed images provided equal image peak SNR and noise behavior, while performing also similarly for post-treatment dosimetry of tumor, whole liver and lung absorbed doses.
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Affiliation(s)
- Konstantinos G Zeimpekis
- Department of Nuclear Medicine, Bern University Hospital, Inselspital, University of Bern, Freiburgstrasse 18, Bern, 3010, Switzerland.
| | - Lorenzo Mercolli
- Department of Nuclear Medicine, Bern University Hospital, Inselspital, University of Bern, Freiburgstrasse 18, Bern, 3010, Switzerland
| | - Maurizio Conti
- Molecular Imaging, Siemens Healthineers, Knoxville, TN, USA
| | - Hasan Sari
- Advanced Clinical Imaging Technology, Siemens Healthcare AG, Lausanne, Switzerland
| | - Axel Rominger
- Department of Nuclear Medicine, Bern University Hospital, Inselspital, University of Bern, Freiburgstrasse 18, Bern, 3010, Switzerland
| | - Hendrik Rathke
- Department of Nuclear Medicine, Bern University Hospital, Inselspital, University of Bern, Freiburgstrasse 18, Bern, 3010, Switzerland
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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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Dong Y, Huang S, Wu H, Cao M, Huang Y, Tang G, Zhou W. Superiority of 18F-FAPI-42 PET/CT in the detection of primary tumor and management of appendiceal neoplasm to 18F-FDG PET/CT and CE-CT. Cancer Imaging 2024; 24:58. [PMID: 38715096 PMCID: PMC11077780 DOI: 10.1186/s40644-024-00706-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 04/27/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND In the present study, we investigated the value of 18F-fibroblast-activation protein inhibitor (FAPI) positron emission tomography/computed tomography (18F-FAPI-42 PET/CT) to preoperative evaluations of appendiceal neoplasms and management for patients. METHODS This single-center retrospective clinical study, including 16 untreated and 6 treated patients, was performed from January 2022 to May 2023 at Southern Medical University Nanfang Hospital. Histopathologic examination and imaging follow-up served as the reference standard. 18F-FAPI-42 PET/CT was compared to 18F-fluorodeoxyglucose (18F-FDG) PET/CT and contrast-enhanced CT (CE-CT) in terms of maximal standardized uptake value (SUVmax), diagnostic efficacy and impact on treatment decisions. RESULTS The accurate detection of primary tumors and peritoneal metastases were improved from 28.6% (4/14) and 50% (8/16) for CE-CT, and 43.8% (7/16) and 85.0% (17/20) for 18F-FDG PET/CT, to 87.5% (14/16) and 100% (20/20) for 18F-FAPI-42 PET/CT. Compared to 18F-FDG PET/CT, 18F-FAPI-42 PET/CT detected more regions infiltrated by peritoneal metastases (108 vs. 43), thus produced a higher peritoneal cancer index (PCI) score (median PCI: 12 vs. 5, P < 0.01). 18F-FAPI-42 PET/CT changed the intended treatment plans in 35.7% (5/14) of patients compared to CE-CT and 25% (4/16) of patients compared to 18F-FDG PET/CT but did not improve the management of patients with recurrent tumors. CONCLUSIONS The present study revealed that 18F-FAPI-42 PET/CT can supplement CE-CT and 18F-FDG PET/CT to provide a more accurate detection of appendiceal neoplasms and improved treatment decision making for patients.
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Affiliation(s)
- Ye Dong
- NanFang PET Center, NanFang Hospital, Southern Medical University, Guangzhou, Guangdong Province, 510515, China
- GDMPA Key Laboratory for Quality Control and Evaluation of Radiopharmaceuticals, Department of Nuclear Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, 510515, China
| | - Shun Huang
- Department of Nuclear Medicine, PET Center, The Tenth Affiliated Hospital of Southern Medical University (Dongguan People's Hospital), Dongguan, 523059, P. R. China
| | - Hubing Wu
- NanFang PET Center, NanFang Hospital, Southern Medical University, Guangzhou, Guangdong Province, 510515, China
- GDMPA Key Laboratory for Quality Control and Evaluation of Radiopharmaceuticals, Department of Nuclear Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, 510515, China
| | - Min Cao
- NanFang PET Center, NanFang Hospital, Southern Medical University, Guangzhou, Guangdong Province, 510515, China
- GDMPA Key Laboratory for Quality Control and Evaluation of Radiopharmaceuticals, Department of Nuclear Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, 510515, China
| | - Yanchao Huang
- NanFang PET Center, NanFang Hospital, Southern Medical University, Guangzhou, Guangdong Province, 510515, China
- GDMPA Key Laboratory for Quality Control and Evaluation of Radiopharmaceuticals, Department of Nuclear Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, 510515, China
| | - Ganghua Tang
- NanFang PET Center, NanFang Hospital, Southern Medical University, Guangzhou, Guangdong Province, 510515, China.
- GDMPA Key Laboratory for Quality Control and Evaluation of Radiopharmaceuticals, Department of Nuclear Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, 510515, China.
| | - Wenlan Zhou
- NanFang PET Center, NanFang Hospital, Southern Medical University, Guangzhou, Guangdong Province, 510515, China.
- GDMPA Key Laboratory for Quality Control and Evaluation of Radiopharmaceuticals, Department of Nuclear Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, 510515, China.
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20
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Meng X, Kong X, Xia L, Wu R, Zhu H, Yang Z. The Role of Total-Body PET in Drug Development and Evaluation: Status and Outlook. J Nucl Med 2024; 65:46S-53S. [PMID: 38719239 DOI: 10.2967/jnumed.123.266978] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 01/23/2024] [Indexed: 07/16/2024] Open
Abstract
Total-body PET, an emerging technique, enables high-quality simultaneous total-body dynamic PET acquisition and accurate kinetic analysis. It has the potential to facilitate the study of multiple tracers while minimizing radiation dose and improving tracer-specific imaging. This advancement holds promise for enhancing the development and clinical evaluation of drugs, particularly radiopharmaceuticals. Multiple clinical trials are using a total-body PET scanner to explore existing and innovative radiopharmaceuticals. However, challenges persist, along with the opportunities, with regard to the use of total-body PET in drug development and evaluation. Specifically, considerations relate to the role of total-body PET in clinical pharmacologic evaluations and its integration into the theranostic paradigm. In this review, state-of-the-art total-body PET and its potential roles in pharmaceutical research are explored.
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Affiliation(s)
- Xiangxi Meng
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), National Medical Products Association, Key Laboratory for Research and Evaluation of Radiopharmaceuticals, National Medical Products Association, Department of Nuclear Medicine, Peking University Cancer Hospital & Institute, Beijing, China; and
| | - Xiangxing Kong
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), National Medical Products Association, Key Laboratory for Research and Evaluation of Radiopharmaceuticals, National Medical Products Association, Department of Nuclear Medicine, Peking University Cancer Hospital & Institute, Beijing, China; and
| | - Lei Xia
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), National Medical Products Association, Key Laboratory for Research and Evaluation of Radiopharmaceuticals, National Medical Products Association, Department of Nuclear Medicine, Peking University Cancer Hospital & Institute, Beijing, China; and
| | - Runze Wu
- Beijing United Imaging Research Institute of Intelligent Imaging, Beijing, China
| | - Hua Zhu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), National Medical Products Association, Key Laboratory for Research and Evaluation of Radiopharmaceuticals, National Medical Products Association, Department of Nuclear Medicine, Peking University Cancer Hospital & Institute, Beijing, China; and
| | - Zhi Yang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), National Medical Products Association, Key Laboratory for Research and Evaluation of Radiopharmaceuticals, National Medical Products Association, Department of Nuclear Medicine, Peking University Cancer Hospital & Institute, Beijing, China; and
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21
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Chen W, Li Y, Li Z, Jiang Y, Cui Y, Zeng J, Mo Y, Tang S, Li S, Liu L, Zhao Y, Hu Y, Fan W. Advantages and Challenges of Total-Body PET/CT at a Tertiary Cancer Center: Insights from Sun Yat-sen University Cancer Center. J Nucl Med 2024; 65:54S-63S. [PMID: 38719233 DOI: 10.2967/jnumed.123.266948] [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: 10/25/2023] [Revised: 01/31/2024] [Indexed: 07/16/2024] Open
Abstract
In recent decades, researchers worldwide have directed their efforts toward enhancing the quality of PET imaging. The detection sensitivity and image resolution of conventional PET scanners with a short axial field of view have been constrained, leading to a suboptimal signal-to-noise ratio. The advent of long-axial-field-of-view PET scanners, exemplified by the uEXPLORER system, marked a significant advancement. Total-body PET imaging possesses an extensive scan range of 194 cm and an ultrahigh detection sensitivity, and it has emerged as a promising avenue for improving image quality while reducing the administered radioactivity dose and shortening acquisition times. In this review, we elucidate the application of the uEXPLORER system at the Sun Yat-sen University Cancer Center, including the disease distribution, patient selection workflow, scanning protocol, and several enhanced clinical applications, along with encountered challenges. We anticipate that this review will provide insights into routine clinical practice and ultimately improve patient care.
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Affiliation(s)
- Wanqi Chen
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, China
- Department of Nuclear Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China; and
| | - Yinghe Li
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, China
- Department of Nuclear Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China; and
| | - Zhijian Li
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, China
- Department of Nuclear Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China; and
| | - Yongluo Jiang
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, China
- Department of Nuclear Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China; and
| | - Yingpu Cui
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, China
- Department of Nuclear Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China; and
| | - Jiling Zeng
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, China
- Department of Nuclear Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China; and
| | - Yiwen Mo
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, China
- Department of Nuclear Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China; and
| | - Si Tang
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, China
- Department of Nuclear Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China; and
| | - Shatong Li
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, China
- Department of Nuclear Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China; and
| | - Lei Liu
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, China
- Department of Nuclear Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China; and
| | - Yumo Zhao
- United Imaging Healthcare Co. Ltd., Shanghai, China
| | - Yingying Hu
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, China;
- Department of Nuclear Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China; and
| | - Wei Fan
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, China;
- Department of Nuclear Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China; and
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22
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Wang Y, Abdelhafez YG, Spencer BA, Verma R, Parikh M, Stollenwerk N, Nardo L, Jones T, Badawi RD, Cherry SR, Wang G. High-Temporal-Resolution Kinetic Modeling of Lung Tumors with Dual-Blood Input Function Using Total-Body Dynamic PET. J Nucl Med 2024; 65:714-721. [PMID: 38548347 PMCID: PMC11064825 DOI: 10.2967/jnumed.123.267036] [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: 11/09/2023] [Revised: 02/21/2024] [Indexed: 05/03/2024] Open
Abstract
The lungs are supplied by both the pulmonary arteries carrying deoxygenated blood originating from the right ventricle and the bronchial arteries carrying oxygenated blood downstream from the left ventricle. However, this effect of dual blood supply has never been investigated using PET, partially because the temporal resolution of conventional dynamic PET scans is limited. The advent of PET scanners with a long axial field of view, such as the uEXPLORER total-body PET/CT system, permits dynamic imaging with high temporal resolution (HTR). In this work, we modeled the dual-blood input function (DBIF) and studied its impact on the kinetic quantification of normal lung tissue and lung tumors using HTR dynamic PET imaging. Methods: Thirteen healthy subjects and 6 cancer subjects with lung tumors underwent a dynamic 18F-FDG scan with the uEXPLORER for 1 h. Data were reconstructed into dynamic frames of 1 s in the early phase. Regional time-activity curves of lung tissue and tumors were analyzed using a 2-tissue compartmental model with 3 different input functions: the right ventricle input function, left ventricle input function, and proposed DBIF, all with time delay and dispersion corrections. These models were compared for time-activity curve fitting quality using the corrected Akaike information criterion and for differentiating lung tumors from lung tissue using the Mann-Whitney U test. Voxelwise multiparametric images by the DBIF model were further generated to verify the regional kinetic analysis. Results: The effect of dual blood supply was pronounced in the high-temporal-resolution time-activity curves of lung tumors. The DBIF model achieved better time-activity curve fitting than the other 2 single-input models according to the corrected Akaike information criterion. The estimated fraction of left ventricle input was low in normal lung tissue of healthy subjects but much higher in lung tumors (∼0.04 vs. ∼0.3, P < 0.0003). The DBIF model also showed better robustness in the difference in 18F-FDG net influx rate [Formula: see text] and delivery rate [Formula: see text] between lung tumors and normal lung tissue. Multiparametric imaging with the DBIF model further confirmed the differences in tracer kinetics between normal lung tissue and lung tumors. Conclusion: The effect of dual blood supply in the lungs was demonstrated using HTR dynamic imaging and compartmental modeling with the proposed DBIF model. The effect was small in lung tissue but nonnegligible in lung tumors. HTR dynamic imaging with total-body PET can offer a sensitive tool for investigating lung diseases.
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Affiliation(s)
- Yiran Wang
- Department of Radiology, University of California Davis Medical Center, Sacramento, California
- Department of Biomedical Engineering, University of California, Davis, Davis, California
| | - Yasser G Abdelhafez
- Department of Radiology, University of California Davis Medical Center, Sacramento, California
- Nuclear Medicine Unit, South Egypt Cancer Institute, Assiut University, Assiut, Egypt; and
| | - Benjamin A Spencer
- Department of Radiology, University of California Davis Medical Center, Sacramento, California
| | - Rashmi Verma
- Comprehensive Cancer Center, University of California Davis Medical Center, Sacramento, California
| | - Mamta Parikh
- Comprehensive Cancer Center, University of California Davis Medical Center, Sacramento, California
| | - Nicholas Stollenwerk
- Comprehensive Cancer Center, University of California Davis Medical Center, Sacramento, California
| | - Lorenzo Nardo
- Department of Radiology, University of California Davis Medical Center, Sacramento, California
| | - Terry Jones
- Department of Radiology, University of California Davis Medical Center, Sacramento, California
| | - Ramsey D Badawi
- Department of Radiology, University of California Davis Medical Center, Sacramento, California
- Department of Biomedical Engineering, University of California, Davis, Davis, California
| | - Simon R Cherry
- Department of Radiology, University of California Davis Medical Center, Sacramento, California
- Department of Biomedical Engineering, University of California, Davis, Davis, California
| | - Guobao Wang
- Department of Radiology, University of California Davis Medical Center, Sacramento, California;
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23
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Holy EN, Li E, Bhattarai A, Fletcher E, Alfaro ER, Harvey DJ, Spencer BA, Cherry SR, DeCarli CS, Fan AP. Non-invasive quantification of 18F-florbetaben with total-body EXPLORER PET. EJNMMI Res 2024; 14:39. [PMID: 38625413 PMCID: PMC11021392 DOI: 10.1186/s13550-024-01104-7] [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: 12/20/2023] [Accepted: 03/02/2024] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND Kinetic modeling of 18F-florbetaben provides important quantification of brain amyloid deposition in research and clinical settings but its use is limited by the requirement of arterial blood data for quantitative PET. The total-body EXPLORER PET scanner supports the dynamic acquisition of a full human body simultaneously and permits noninvasive image-derived input functions (IDIFs) as an alternative to arterial blood sampling. This study quantified brain amyloid burden with kinetic modeling, leveraging dynamic 18F-florbetaben PET in aorta IDIFs and the brain in an elderly cohort. METHODS 18F-florbetaben dynamic PET imaging was performed on the EXPLORER system with tracer injection (300 MBq) in 3 individuals with Alzheimer's disease (AD), 3 with mild cognitive impairment, and 9 healthy controls. Image-derived input functions were extracted from the descending aorta with manual regions of interest based on the first 30 s after injection. Dynamic time-activity curves (TACs) for 110 min were fitted to the two-tissue compartment model (2TCM) using population-based metabolite corrected IDIFs to calculate total and specific distribution volumes (VT, Vs) in key brain regions with early amyloid accumulation. Non-displaceable binding potential ([Formula: see text] was also calculated from the multi-reference tissue model (MRTM). RESULTS Amyloid-positive (AD) patients showed the highest VT and VS in anterior cingulate, posterior cingulate, and precuneus, consistent with [Formula: see text] analysis. [Formula: see text]and VT from kinetic models were correlated (r² = 0.46, P < 2[Formula: see text] with a stronger positive correlation observed in amyloid-positive participants, indicating reliable model fits with the IDIFs. VT from 2TCM was highly correlated ([Formula: see text]= 0.65, P < 2[Formula: see text]) with Logan graphical VT estimation. CONCLUSION Non-invasive quantification of amyloid binding from total-body 18F-florbetaben PET data is feasible using aorta IDIFs with high agreement between kinetic distribution volume parameters compared to [Formula: see text]in amyloid-positive and amyloid-negative older individuals.
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Affiliation(s)
- Emily Nicole Holy
- Department of Neurology, University of California (UC) Davis Health, 1590 Drew Avenue, Davis, CA, 95618, USA.
- Department of Biomedical Engineering, UC Davis, Davis, USA.
| | - Elizabeth Li
- Department of Biomedical Engineering, UC Davis, Davis, USA
| | - Anjan Bhattarai
- Department of Neurology, University of California (UC) Davis Health, 1590 Drew Avenue, Davis, CA, 95618, USA
- Department of Biomedical Engineering, UC Davis, Davis, USA
| | - Evan Fletcher
- Department of Neurology, University of California (UC) Davis Health, 1590 Drew Avenue, Davis, CA, 95618, USA
| | - Evelyn R Alfaro
- Department of Neurology, University of California (UC) Davis Health, 1590 Drew Avenue, Davis, CA, 95618, USA
| | | | - Benjamin A Spencer
- Department of Biomedical Engineering, UC Davis, Davis, USA
- Department of Radiology, UC Davis Health, Davis, USA
| | - Simon R Cherry
- Department of Biomedical Engineering, UC Davis, Davis, USA
- Department of Radiology, UC Davis Health, Davis, USA
| | - Charles S DeCarli
- Department of Neurology, University of California (UC) Davis Health, 1590 Drew Avenue, Davis, CA, 95618, USA
| | - Audrey P Fan
- Department of Neurology, University of California (UC) Davis Health, 1590 Drew Avenue, Davis, CA, 95618, USA
- Department of Biomedical Engineering, UC Davis, Davis, USA
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24
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Sun Y, Cheng Z, Qiu J, Lu W. Performance and application of the total-body PET/CT scanner: a literature review. EJNMMI Res 2024; 14:38. [PMID: 38607510 PMCID: PMC11014840 DOI: 10.1186/s13550-023-01059-1] [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: 10/08/2023] [Accepted: 12/14/2023] [Indexed: 04/13/2024] Open
Abstract
BACKGROUND The total-body positron emission tomography/computed tomography (PET/CT) system, with a long axial field of view, represents the state-of-the-art PET imaging technique. Recently, the total-body PET/CT system has been commercially available. The total-body PET/CT system enables high-resolution whole-body imaging, even under extreme conditions such as ultra-low dose, extremely fast imaging speed, delayed imaging more than 10 h after tracer injection, and total-body dynamic scan. The total-body PET/CT system provides a real-time picture of the tracers of all organs across the body, which not only helps to explain normal human physiological process, but also facilitates the comprehensive assessment of systemic diseases. In addition, the total-body PET/CT system may play critical roles in other medical fields, including cancer imaging, drug development and immunology. MAIN BODY Therefore, it is of significance to summarize the existing studies of the total-body PET/CT systems and point out its future direction. This review collected research literatures from the PubMed database since the advent of commercially available total-body PET/CT systems to the present, and was divided into the following sections: Firstly, a brief introduction to the total-body PET/CT system was presented, followed by a summary of the literature on the performance evaluation of the total-body PET/CT. Then, the research and clinical applications of the total-body PET/CT were discussed. Fourthly, deep learning studies based on total-body PET imaging was reviewed. At last, the shortcomings of existing research and future directions for the total-body PET/CT were discussed. CONCLUSION Due to its technical advantages, the total-body PET/CT system is bound to play a greater role in clinical practice in the future.
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Affiliation(s)
- Yuanyuan Sun
- Department of Radiology, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, 271016, China
| | - Zhaoping Cheng
- Department of PET-CT, The First Affiliated Hospital of Shandong First Medical University, Shandong Provincial Qianfoshan Hospital Affiliated to Shandong University, Jinan, 250014, China
| | - Jianfeng Qiu
- Department of Radiology, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, 271016, China
| | - Weizhao Lu
- Department of Radiology, The Second Affiliated Hospital of Shandong First Medical University, No. 366 Taishan Street, Taian, 271000, China.
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25
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Shiyam Sundar LK, Gutschmayer S, Maenle M, Beyer T. Extracting value from total-body PET/CT image data - the emerging role of artificial intelligence. Cancer Imaging 2024; 24:51. [PMID: 38605408 PMCID: PMC11010281 DOI: 10.1186/s40644-024-00684-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 03/03/2024] [Indexed: 04/13/2024] Open
Abstract
The evolution of Positron Emission Tomography (PET), culminating in the Total-Body PET (TB-PET) system, represents a paradigm shift in medical imaging. This paper explores the transformative role of Artificial Intelligence (AI) in enhancing clinical and research applications of TB-PET imaging. Clinically, TB-PET's superior sensitivity facilitates rapid imaging, low-dose imaging protocols, improved diagnostic capabilities and higher patient comfort. In research, TB-PET shows promise in studying systemic interactions and enhancing our understanding of human physiology and pathophysiology. In parallel, AI's integration into PET imaging workflows-spanning from image acquisition to data analysis-marks a significant development in nuclear medicine. This review delves into the current and potential roles of AI in augmenting TB-PET/CT's functionality and utility. We explore how AI can streamline current PET imaging processes and pioneer new applications, thereby maximising the technology's capabilities. The discussion also addresses necessary steps and considerations for effectively integrating AI into TB-PET/CT research and clinical practice. The paper highlights AI's role in enhancing TB-PET's efficiency and addresses the challenges posed by TB-PET's increased complexity. In conclusion, this exploration emphasises the need for a collaborative approach in the field of medical imaging. We advocate for shared resources and open-source initiatives as crucial steps towards harnessing the full potential of the AI/TB-PET synergy. This collaborative effort is essential for revolutionising medical imaging, ultimately leading to significant advancements in patient care and medical research.
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Affiliation(s)
| | - Sebastian Gutschmayer
- Quantitative Imaging and Medical Physics (QIMP) Team, Medical University of Vienna, Vienna, Austria
| | - Marcel Maenle
- Quantitative Imaging and Medical Physics (QIMP) Team, Medical University of Vienna, Vienna, Austria
| | - Thomas Beyer
- Quantitative Imaging and Medical Physics (QIMP) Team, Medical University of Vienna, Vienna, Austria
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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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Fiz F, Cirone A, Righi S, Massollo M, Amoroso L, Bottoni G, Conte M, Gambaro M, Massone F, Orengo S, Bruzzone GS, Sorrentino S, Garaventa A, Piccardo A. Reaching the target dose with one single 131 I-mIBG administration in high-risk neuroblastoma: The determinant impact of the primary tumour. Pediatr Blood Cancer 2024; 71:e30806. [PMID: 38082548 DOI: 10.1002/pbc.30806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 11/13/2023] [Accepted: 11/19/2023] [Indexed: 01/24/2024]
Abstract
BACKGROUND 131 I-metaiodobenzylguanidine (131 I-mIBG) effectiveness in children with metastasised neuroblastoma (NB) is linked to the effective dose absorbed by the target; a target of 4 Gy whole-body dose threshold has been proposed. Achieving this dose often requires administering 131 I-mIBG twice back-to-back, which may cause haematological toxicity. In this study, we tried identifying the factors predicting the achievement of 4 Gy whole-body dose with a single radiopharmaceutical administration. MATERIALS AND METHODS Children affected by metastatic NB and treated with a high 131 I-mIBG activity (>450 MBq (megabecquerel)/kg) were evaluated retrospectively. Kinetics measurements were carried out at multiple time points to estimate the whole-body dose, which was compared with clinical and activity-related parameters. RESULTS Seventeen children (12 females, median age 3 years, age range: 1.5-6.9 years) were included. Eleven of them still bore the primary tumour. The median whole-body dose was 2.88 Gy (range: 1.63-4.22 Gy). Children with a 'bulky' primary (>30 mL) received a higher whole-body dose than those with smaller or surgically removed primaries (3.42 ± 0.74 vs. 2.48 ± 0.65 Gy, respectively, p = .016). Conversely, the correlation between activity/kg and the whole-body dose was moderate (R: 0.42, p = .093). In the multivariate analysis, the volume of the primary tumour was the most relevant predictor of the whole-body dose (p = .002). CONCLUSIONS These data suggest that the presence of a bulky primary tumour can significantly prolong the 131 I-mIBG biological half-life, effectively increasing the absorbed whole-body dose. This information could be used to model the administered activity, allowing to attain the target dose without needing a two-step radiopharmaceutical administration.
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Affiliation(s)
- Francesco Fiz
- Department of Nuclear Medicine, Galliera Hospital, Genoa, Italy
- Department of Nuclear Medicine and Clinical Molecular Imaging, University Hospital, Tübingen, Germany
| | - Alessio Cirone
- Department of Medical Physics, Galliera Hospital, Genoa, Italy
| | - Sergio Righi
- Department of Medical Physics, Galliera Hospital, Genoa, Italy
| | | | | | | | - Massimo Conte
- Oncology Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Monica Gambaro
- Department of Medical Physics, Galliera Hospital, Genoa, Italy
| | | | - Stefano Orengo
- Department of Medical Physics, Galliera Hospital, Genoa, Italy
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Wang F, Kao CM, Zhang X, Liu L, Hua Y, Kim H, Choong WS, Xie Q. DOI- and TOF-capable PET array detector using double-ended light readout and stripline-based row and column electronic readout. IEEE TRANSACTIONS ON RADIATION AND PLASMA MEDICAL SCIENCES 2024; 8:269-276. [PMID: 38654812 PMCID: PMC11034922 DOI: 10.1109/trpms.2024.3360942] [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] [Indexed: 04/26/2024]
Abstract
We investigate a highly multiplexing readout for depth-of-interaction (DOI) and time-of-flight PET detector consisting of an N×N crystals whose light outputs at the front and back ends are detected by using silicon photomultipliers (SiPM). The front N×N SiPM array is read by using a stripline (SL) configured to support discrimination of the row position of the signal-producing crystal. The back N×N SiPM array is similarly read by an SL for column discrimination. Hence, the detector has only four outputs. We built 4×4 and 8×8 detector modules (DM) by using 3.0×3.0×20 mm3 lutetium-yttrium oxyorthosilicates. The outputs were sampled and processed offline. For both DMs, crystal discrimination was successful. For the 4×4 DM, we obtained an average energy resolution (ER) of 14.1%, an average DOI resolution of 2.5 mm, a non DOI-corrected coincidence resolving time (CRT), measured in coincidence with a single-pixel reference detector, of about 495 ps. For the 8×8 DM, the average ER, average DOI resolution and average CRT were 16.4%, 2.9 mm, and 641 ps, respectively. We identified the intercrystal scattering as a probable cause for the CRT deterioration when the DM was increased from 4×4 to 8×8.
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Affiliation(s)
- Fei Wang
- College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, China
| | | | - Xiaoyu Zhang
- Wuhan National Laboratory for Optoelectronics, Huazhong University of Science and Technology, Wuhan, China
| | - Linfeng Liu
- College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, China
| | | | - Heejong Kim
- The University of Chicago, Chicago, Illinois, USA
| | - Woon-Seng Choong
- Lawrence Berkeley National Laboratory, Berkeley, California, USA
| | - Qingguo Xie
- College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, China
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Li G, Ma W, Li X, Yang W, Quan Z, Ma T, Wang J, Wang Y, Kang F, Wang J. Performance Evaluation of the uMI Panorama PET/CT System in Accordance with the National Electrical Manufacturers Association NU 2-2018 Standard. J Nucl Med 2024:jnumed.123.265929. [PMID: 38388513 DOI: 10.2967/jnumed.123.265929] [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: 04/24/2023] [Accepted: 01/11/2024] [Indexed: 02/24/2024] Open
Abstract
The uMI Panorama is a novel PET/CT system using silicon photomultiplier and application-specific integrated circuit technologies and providing exceptional spatial and time-of-flight (TOF) resolutions. The objective of this study was to assess the physical performance of the uMI Panorama in accordance with the National Electrical Manufacturers Association (NEMA) NU 2-2018 standard. Methods: Spatial resolution, sensitivity, count rate performance, accuracy, image quality, and TOF resolution were evaluated in accordance with the guidelines outlined in the NEMA NU 2-2018 standard. Energy resolution was determined using the same dataset acquired for the count rate performance evaluation. Images from a Hoffman brain phantom, a mini-Derenzo phantom, and 3 patient studies were evaluated to demonstrate system performance. Results: The transaxial spatial resolution at full width at half maximum was measured as 2.88 mm with a 1-cm offset from the center axial field of view. The sensitivity at the center axial field of view was 20.1 kcps/MBq. At an activity concentration of 73.0 kBq/mL, the peak noise-equivalent count rate (NECR) reached 576 kcps with a scatter fraction of approximately 33.2%. For activity concentrations at or below the peak NECR, the maximum relative count rate error among all slices remained consistently below 3%. When assessed using the NEMA image quality phantom, overall image contrast recovery ranged from 63.2% to 88.4%, whereas background variability ranged from 4.2% to 1.1%. TOF resolution was 189 ps at 5.3 kBq/mL and was consistently lower than 200 ps for activity concentrations at or below the peak NECR. The patient studies demonstrated that scans at 2 min/bed produced images characterized by low noise and high contrast. Clear delineation of nuclei, spinal cords, and other substructures of the brain was observed in the brain PET images. Conclusion: uMI Panorama, the world's first commercial PET system with sub-200-ps TOF resolution, demonstrated fine spatial and fast TOF resolutions, robust count rate performance, and high quantification accuracy across a wide range of activity levels. This advanced technology offers enhanced diagnostic capability for detecting small and low-contrast lesions while showing promising potential under high-count-rate imaging scenarios.
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Affiliation(s)
- Guiyu Li
- Department of Nuclear Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Wenhui Ma
- Department of Nuclear Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Xiang Li
- Department of Nuclear Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Weidong Yang
- Department of Nuclear Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Zhiyong Quan
- Department of Nuclear Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Taoqi Ma
- Department of Nuclear Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Junling Wang
- Department of Nuclear Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Yunya Wang
- Department of Nuclear Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Fei Kang
- Department of Nuclear Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Jing Wang
- Department of Nuclear Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, China
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Bayerlein R, Spencer BA, Leung EK, Omidvari N, Abdelhafez YG, Wang Q, Nardo L, Cherry SR, Badawi RD. Development of a Monte Carlo-based scatter correction method for total-body PET using the uEXPLORER PET/CT scanner. Phys Med Biol 2024; 69:045033. [PMID: 38266297 DOI: 10.1088/1361-6560/ad2230] [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: 09/25/2023] [Accepted: 01/24/2024] [Indexed: 01/26/2024]
Abstract
Objective.This study presents and evaluates a robust Monte Carlo-based scatter correction (SC) method for long axial field of view (FOV) and total-body positron emission tomography (PET) using the uEXPLORER total-body PET/CT scanner.Approach.Our algorithm utilizes the Monte Carlo (MC) tool SimSET to compute SC factors in between individual image reconstruction iterations within our in-house list-mode and time-of-flight-based image reconstruction framework. We also introduced a unique scatter scaling technique at the detector block-level for optimal estimation of the scatter contribution in each line of response. First image evaluations were derived from phantom data spanning the entire axial FOV along with image data from a human subject with a large body mass index. Data was evaluated based on qualitative inspections, and contrast recovery, background variability, residual scatter removal from cold regions, biases and axial uniformity were quantified and compared to non-scatter-corrected images.Main results.All reconstructed images demonstrated qualitative and quantitative improvements compared to non-scatter-corrected images: contrast recovery coefficients improved by up to 17.2% and background variability was reduced by up to 34.3%, and the residual lung error was between 1.26% and 2.08%. Low biases throughout the axial FOV indicate high quantitative accuracy and axial uniformity of the corrections. Up to 99% of residual activity in cold areas in the human subject was removed, and the reliability of the method was demonstrated in challenging body regions like in the proximity of a highly attenuating knee prosthesis.Significance.The MC SC method employed was demonstrated to be accurate and robust in TB-PET. The results of this study can serve as a benchmark for optimizing the quantitative performance of future SC techniques.
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Affiliation(s)
- Reimund Bayerlein
- Departments of Radiology and Biomedical Engineering, University of California-Davis, Davis, CA, United States of America
| | - Benjamin A Spencer
- Biomedical Engineering, University of California-Davis, Davis, CA, United States of America
| | | | - Negar Omidvari
- Biomedical Engineering, University of California-Davis, Davis, CA, United States of America
| | - Yasser G Abdelhafez
- Departments of Radiology and Biomedical Engineering, University of California-Davis, Davis, CA, United States of America
| | - Qian Wang
- Biomedical Engineering, University of California-Davis, Davis, CA, United States of America
| | - Lorenzo Nardo
- Departments of Radiology and Biomedical Engineering, University of California-Davis, Davis, CA, United States of America
| | - Simon R Cherry
- Departments of Radiology and Biomedical Engineering, University of California-Davis, Davis, CA, United States of America
- Biomedical Engineering, University of California-Davis, Davis, CA, United States of America
| | - Ramsey D Badawi
- Departments of Radiology and Biomedical Engineering, University of California-Davis, Davis, CA, United States of America
- Biomedical Engineering, University of California-Davis, Davis, CA, United States of America
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Tatsumi M, Tanaka H, Takenaka Y, Suzuki M, Fukusumi T, Eguchi H, Watabe T, Kato H, Yachida S, Inohara H, Tomiyama N. Association of circulating tumor HPV16DNA levels and quantitative PET parameters in patients with HPV-positive head and neck squamous cell carcinoma. Sci Rep 2024; 14:3278. [PMID: 38332246 PMCID: PMC10853198 DOI: 10.1038/s41598-024-53894-4] [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: 10/06/2023] [Accepted: 02/06/2024] [Indexed: 02/10/2024] Open
Abstract
Circulating tumor DNA (ctDNA), which circulates in the blood after being shed from cancer cells in the body, has recently gained attention as an excellent tumor marker. The purpose of this study was to evaluate whether ct human papillomavirus (HPV) 16 DNA (ctHPV16DNA) levels were associated with quantitative PET parameters in patients with HPV-positive head and neck (HN) squamous cell carcinoma (SCC). Fifty patients with oropharyngeal SCC (OPSCC) and 5 with SCC of unknown primary (SCCUP) before treatment were included. They all underwent blood sampling to test ctHPV16DNA levels and FDG PET-CT examinations. Quantitative PET parameters included SUVmax, metabolic tumor volume (MTV), MTV of whole-body lesions (wbMTV), and 56 texture features. ctHPV16DNA levels were compared to texture features of primary tumors in OPSCC patients (Group A) or the largest primary or metastatic lymph node lesions in OPSCC and SCCUP patients (Group B) and to other PET parameters. Spearman rank correlation test and multiple regression analysis were used to confirm the associations between ctHPV16DNA levels and PET parameters. ctHPV16DNA levels moderately correlated with wbMTV, but not with SUVmax or MTV in Groups A and B. ctHPV16DNA levels exhibited a weak negative correlation with low gray-level zone emphasis in Groups A and B. Multiple regression analysis revealed that wbMTV and high gray-level zone emphasis were the significant factors for ctHPV16DNA levels in Group B. These results were not observed in Group A. This study demonstrated that ctHPV16DNA levels correlated with the whole-body tumor burden and tumor heterogeneity visualized on FDG PET-CT in patients with HPV-positive HNSCC.
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Affiliation(s)
- Mitsuaki Tatsumi
- Department of Radiology, Osaka University Hospital, 2-2-D1 Yamadaoka, Suita, Osaka, 565-0871, Japan.
| | - Hidenori Tanaka
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Yukinori Takenaka
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Motoyuki Suzuki
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Takahito Fukusumi
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Hirotaka Eguchi
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Tadashi Watabe
- Department of Nuclear Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Hiroki Kato
- Department of Nuclear Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Shinichi Yachida
- Department of Cancer Genome Informatics, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Hidenori Inohara
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Noriyuki Tomiyama
- Department of Radiology, Osaka University Hospital, 2-2-D1 Yamadaoka, Suita, Osaka, 565-0871, Japan
- Department of Radiology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
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Yu X, Xu L, Huang G, Liu J, Chen R, Chen Y. The image quality and feasibility of solitary delayed [ 68 Ga]Ga-PSMA-11 PET/CT using long field-of-view scanning in patients with prostate cancer. EJNMMI Res 2024; 14:14. [PMID: 38319452 PMCID: PMC10847078 DOI: 10.1186/s13550-024-01076-8] [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: 12/20/2023] [Accepted: 01/30/2024] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND Previous studies have demonstrated that delayed [68 Ga]Ga-PSMA PET/CT imaging improves lesion detection compared to early [68 Ga]Ga-PSMA PET/CT in patients with prostate cancer. However, the sole use of delayed [68 Ga]Ga-PSMA PET/CT has been limited due to the insufficient number of photons obtained with standard PET/CT scanners. The combination of early and delayed [68 Ga]Ga-PSMA standard PET/CT may be considered, and it is challenging to incorporate into a high-demand clinical setting. Long field-of-view (LFOV) PET/CT scanners have higher sensitivity compared to standard PET/CT. However, it remains unknown whether the image quality of solitary delayed [68 Ga]Ga-PSMA LFOV PET/CT imaging is adequate to satisfy clinical diagnostic requirements. Therefore, the purpose of this study was to evaluate the image quality of delayed [68 Ga]Ga-PSMA LFOV PET/CT and examine the feasibility of utilizing delayed [68 Ga]Ga-PSMA LFOV PET/CT imaging alone in patients with prostate cancer. METHODS The study sample consisted of 56 prostate cancer patients who underwent [68 Ga]Ga-PSMA-11 LFOV PET/CT scanning between December 2020 and July 2021. All patients were subjected to early LFOV PET/CT imaging at 1-h post-injection as well as delayed LFOV PET/CT imaging at 3-h post-injection using [68 Ga]Ga-PSMA-11. The image quality and diagnostic efficiency of solitary delayed [68 Ga]Ga-PSMA-11 LFOV PET/CT imaging was analyzed. RESULTS The results showed that delayed [68 Ga]Ga-PSMA-11 LFOV PET/CT yielded satisfactory image quality that fulfilled clinical diagnostic benchmarks. Compared to early imaging, delayed [68 Ga]Ga-PSMA-11 LFOV PET/CT demonstrated heightened lesion SUVmax values (11.0 [2.3-193.6] vs. 7.0 [2.0-124.3], P < 0.001) and superior tumor-to-background ratios (3.3 [0.5-62.2] vs. 1.7 [0.3-30.7], P < 0.001). Additionally, delayed [68 Ga]Ga-PSMA-11 LFOV PET/CT detected supplementary lesions in 14 patients (25%) compared to early imaging, resulting in modifications to disease staging and management plans. CONCLUSIONS In summary, the findings indicate that the image quality of delayed [68 Ga]Ga-PSMA-11 LFOV PET/CT is satisfactory for meeting clinical diagnostic prerequisites. The use of solitary delayed [68 Ga]Ga-PSMA-11 LFOV PET/CT imaging in prostate cancer simplifies the examination protocol and improves patient compliance, compared to [68 Ga]Ga-PSMA-11 standard PET/CT which necessitates both early and delayed imaging.
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Affiliation(s)
- Xiaofeng Yu
- Department of Nuclear Medicine, Renji Hospital, School of Medicine, Shanghai Jiaotong University, No.160 Pujian Road, Pudong District, Shanghai, 200127, People's Republic of China
| | - Lian Xu
- Department of Nuclear Medicine, Renji Hospital, School of Medicine, Shanghai Jiaotong University, No.160 Pujian Road, Pudong District, Shanghai, 200127, People's Republic of China
| | - Gang Huang
- Department of Nuclear Medicine, Renji Hospital, School of Medicine, Shanghai Jiaotong University, No.160 Pujian Road, Pudong District, Shanghai, 200127, People's Republic of China
| | - Jianjun Liu
- Department of Nuclear Medicine, Renji Hospital, School of Medicine, Shanghai Jiaotong University, No.160 Pujian Road, Pudong District, Shanghai, 200127, People's Republic of China
| | - Ruohua Chen
- Department of Nuclear Medicine, Renji Hospital, School of Medicine, Shanghai Jiaotong University, No.160 Pujian Road, Pudong District, Shanghai, 200127, People's Republic of China.
| | - Yumei Chen
- Department of Nuclear Medicine, Renji Hospital, School of Medicine, Shanghai Jiaotong University, No.160 Pujian Road, Pudong District, Shanghai, 200127, People's Republic of China.
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Zhu Y, Spencer BA, Xie Z, Leung EK, Bayerlein R, Omidvari N, Cherry SR, Qi J, Badawi RD, Wang G. Super-resolution reconstruction of γ-ray CT images for PET-enabled dual-energy CT imaging. PROCEEDINGS OF SPIE--THE INTERNATIONAL SOCIETY FOR OPTICAL ENGINEERING 2024; 12463:124631F. [PMID: 38500666 PMCID: PMC10947795 DOI: 10.1117/12.2654431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/20/2024]
Abstract
Dual-energy computed tomography (DECT) enables material decomposition for tissues and produces additional information for PET/CT imaging to potentially improve the characterization of diseases. PET-enabled DECT (PDECT) allows the generation of PET and DECT images simultaneously with a conventional PET/CT scanner without the need for a second x-ray CT scan. In PDECT, high-energy γ -ray CT (GCT) images at 511 keV are obtained from time-of-flight (TOF) PET data and are combined with the existing x-ray CT images to form DECT imaging. We have developed a kernel-based maximum-likelihood attenuation and activity (MLAA) method that uses x-ray CT images as a priori information for noise suppression. However, our previous studies focused on GCT image reconstruction at the PET image resolution which is coarser than the image resolution of the x-ray CT. In this work, we explored the feasibility of generating super-resolution GCT images at the corresponding CT resolution. The study was conducted using both phantom and patient scans acquired with the uEXPLORER total-body PET/CT system. GCT images at the PET resolution with a pixel size of 4.0 mm × 4.0 mm and at the CT resolution with a pixel size of 1.2 mm × 1.2 mm were reconstructed using both the standard MLAA and kernel MLAA methods. The results indicated that the GCT images at the CT resolution had sharper edges and revealed more structural details compared to the images reconstructed at the PET resolution. Furthermore, images from the kernel MLAA method showed substantially improved image quality compared to those obtained with the standard MLAA method.
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Affiliation(s)
- Yansong Zhu
- Department of Radiology, University of California Davis Medical Center, Sacramento, CA, 95817, USA
| | - Benjamin A. Spencer
- Department of Radiology, University of California Davis Medical Center, Sacramento, CA, 95817, USA
- Department of Biomedical Engineering, University of California Davis, Davis, CA, 95616, USA
| | - Zhaoheng Xie
- Department of Biomedical Engineering, University of California Davis, Davis, CA, 95616, USA
| | | | - Reimund Bayerlein
- Department of Radiology, University of California Davis Medical Center, Sacramento, CA, 95817, USA
| | - Negar Omidvari
- Department of Biomedical Engineering, University of California Davis, Davis, CA, 95616, USA
| | - Simon R. Cherry
- Department of Radiology, University of California Davis Medical Center, Sacramento, CA, 95817, USA
- Department of Biomedical Engineering, University of California Davis, Davis, CA, 95616, USA
| | - Jinyi Qi
- Department of Biomedical Engineering, University of California Davis, Davis, CA, 95616, USA
| | - Ramsey D. Badawi
- Department of Radiology, University of California Davis Medical Center, Sacramento, CA, 95817, USA
- Department of Biomedical Engineering, University of California Davis, Davis, CA, 95616, USA
| | - Guobao Wang
- Department of Radiology, University of California Davis Medical Center, Sacramento, CA, 95817, USA
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Mercolli L, Zeimpekis K, Prenosil GA, Sari H, Rathke HG, Rominger A, Shi K. Phantom study for 90Y liver radioembolization dosimetry with a long axial field-of-view PET/CT. Phys Med 2024; 118:103296. [PMID: 38281409 DOI: 10.1016/j.ejmp.2024.103296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 11/20/2023] [Accepted: 01/23/2024] [Indexed: 01/30/2024] Open
Abstract
PURPOSE The physical properties of yttrium-90 (90Y) allow for imaging with positron emission tomography/computed tomography (PET/CT). The increased sensitivity of long axial field-of-view (LAFOV) PET/CT scanners possibly allows to overcome the small branching ratio for positron production from 90Y decays and to improve for the post-treatment dosimetry of 90Y of selective internal radiation therapy. METHODS For the challenging case of an image quality body phantom, we compare a full Monte Carlo (MC) dose calculation with the results from the two commercial software packages Simplicit90Y and Hermes. The voxel dosimetry module of Hermes relies on the 90Y images taken with a LAFOV PET/CT, while the MC and Simplicit90Y dose calculations are image independent. RESULTS The resulting doses from the MC calculation and Simplicit90Y agree well within the error margins. The image-based dose calculation with Hermes, however, consistently underestimates the dose. This is due to the mismatch of the activity distribution in the PET images and the size of the volume of interest. We found that only for the smallest phantom sphere there is a statistically significant dependence of the Hermes dose on the image reconstruction parameters and scan time. CONCLUSION Our study shows that Simplicit90Y's local deposition model can provide a reliable dose estimate. On the other hand, the image based dose calculation suffers from the suboptimal reconstruction of the 90Y distribution in small structures.
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Affiliation(s)
- Lorenzo Mercolli
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 18, CH-3010 Bern, Switzerland.
| | - Konstantinos Zeimpekis
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 18, CH-3010 Bern, Switzerland
| | - George A Prenosil
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 18, CH-3010 Bern, Switzerland
| | - Hasan Sari
- Advanced Clinical Imaging Technology, Siemens Healthcare AG, Lausanne, Switzerland
| | - Hendrik G Rathke
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 18, CH-3010 Bern, Switzerland
| | - Axel Rominger
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 18, CH-3010 Bern, Switzerland
| | - Kunagyu Shi
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 18, CH-3010 Bern, Switzerland
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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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Liu Y, Li L, Qin Y, Chen Z, Zhao H, Wang X, Chen R. Total-body PET/CT with half-dose [ 68 Ga]Ga-PSMA-11 for biochemical recurrent prostate cancer: comparable diagnostic value to short axial field-of-view PET/CT with full-dose [ 68 Ga]Ga-PSMA-11. Eur J Nucl Med Mol Imaging 2024; 51:581-589. [PMID: 37819451 DOI: 10.1007/s00259-023-06466-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 10/01/2023] [Indexed: 10/13/2023]
Abstract
PURPOSE The objective of this study was to evaluate the diagnostic performance and image quality of total-body positron emission tomography/computed tomography (PET/CT) imaging using a half-dose of [68 Ga]Ga-prostate specific membrane antigen ([68 Ga]Ga-PSMA) radiotracer, compared to conventional short axial field-of-view PET/CT imaging using a full dose of [68 Ga]Ga-PSMA. METHODS This retrospective study enrolled 52 patients with biochemical recurrent (BCR) prostate cancer after radical prostatectomy who underwent total-body PET/CT with a half-dose (0.9-1.1 MBq/kg) of [68 Ga]Ga-PSMA. These patients were matched by baseline characteristics to another 52 BCR patients after prostatectomy who underwent conventional PET/CT with a full dose (1.8-2.2 MBq/kg) of [68 Ga]Ga-PSMA. The half-dose group was further divided into 5-min (G5) and 2-min (G2) acquisition subgroups. Image quality was assessed through subjective analysis using a 5-point scale and objective measurements of standard uptake value maximum (SUVmax), standard uptake value mean (SUVmean), background variation (BV) of the liver, blood pool, and parotid glands. Additionally, SUVmax and tumor-to-background ratio (TBR) were calculated for lesions. RESULTS No significant difference in subjective image quality was found between the G2 and full-dose groups (p > 0.05). PET/CT image quality was significantly higher for the G5 versus G2 (p < 0.001) and full-dose groups (p < 0.001). TBR did not differ between the G2 and full-dose groups (4.23 ± 5.21 vs 4.22 ± 3.97, p = 0.99). Liver BV was significantly lower for G2 versus full-dose groups (0.16 ± 0.03 vs 0.20 ± 0.05, p < 0.001). CONCLUSIONS Total-body PET/CT with a half-dose [68 Ga]Ga-PSMA yields image quality superior or comparable to that of conventional PET/CT. The utilization of total-body [68 Ga]Ga-PSMA PET/CT meets the diagnostic demands of BCR patients, particularly those who exhibit reduced tolerance to prolonged horizontal positioning and scan durations, while simultaneously reducing radiation exposure for the subjects.
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Affiliation(s)
- Yuheng Liu
- Department of Nuclear Medicine, the First Affiliated Hospital of Guangzhou Medical University, 151 Yanjiangxi Road, Guangzhou, 510120, Guangdong Province, China
| | - Lianghua Li
- Department of Nuclear Medicine, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, 160 Pujian Road, Shanghai, 200127, China
| | - Yanyu Qin
- Department of Nuclear Medicine, the First Affiliated Hospital of Guangzhou Medical University, 151 Yanjiangxi Road, Guangzhou, 510120, Guangdong Province, China
| | - Zijun Chen
- Department of Nuclear Medicine, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, 160 Pujian Road, Shanghai, 200127, China
| | - Haitao Zhao
- Department of Nuclear Medicine, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, 160 Pujian Road, Shanghai, 200127, China
| | - Xinlu Wang
- Department of Nuclear Medicine, the First Affiliated Hospital of Guangzhou Medical University, 151 Yanjiangxi Road, Guangzhou, 510120, Guangdong Province, China.
| | - Ruohua Chen
- Department of Nuclear Medicine, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, 160 Pujian Road, Shanghai, 200127, China.
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Holy EN, Li E, Bhattarai A, Fletcher E, Alfaro ER, Harvey DJ, Spencer BA, Cherry SR, DeCarli CS, Fan AP. Non-invasive quantification of 18F-florbetaben with total-body EXPLORER PET. RESEARCH SQUARE 2023:rs.3.rs-3764930. [PMID: 38234716 PMCID: PMC10793501 DOI: 10.21203/rs.3.rs-3764930/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
Purpose Kinetic modeling of 18F-florbetaben provides important quantification of brain amyloid deposition in research and clinical settings but its use is limited by the requirement of arterial blood data for quantitative PET. The total-body EXPLORER PET scanner supports the dynamic acquisition of a full human body simultaneously and permits noninvasive image-derived input functions (IDIFs) as an alternative to arterial blood sampling. This study quantified brain amyloid burden with kinetic modeling, leveraging dynamic 18F-florbetaben PET in aorta IDIFs and the brain in an elderly cohort. Methods 18F-florbetaben dynamic PET imaging was performed on the EXPLORER system with tracer injection (300 MBq) in 3 individuals with Alzheimer's disease (AD), 3 with mild cognitive impairment, and 9 healthy controls. Image-derived input functions were extracted from the descending aorta with manual regions of interest based on the first 30 seconds after injection. Dynamic time-activity curves (TACs) for 110 minutes were fitted to the two-tissue compartment model (2TCM) using population-based metabolite corrected IDIFs to calculate total and specific distribution volumes (VT, Vs) in key brain regions with early amyloid accumulation. Non-displaceable binding potential (BPND) was also calculated from the multi-reference tissue model (MRTM). Results Amyloid-positive (AD) patients showed the highest VT and VS in anterior cingulate, posterior cingulate, and precuneus, consistent with BPND analysis. BPND and VT from kinetic models were correlated (r2 = 0.46, P<2e-16) with a stronger positive correlation observed in amyloid-positive participants, indicating reliable model fits with the IDIFs. VT from 2TCM was highly correlated (r2 = 0.65, P< 2e-16) with Logan graphical VT estimation. Conclusion Non-invasive quantification of amyloid binding from total-body 18F-florbetaben PET data is feasible using aorta IDIFs with high agreement between kinetic distribution volume parameters compared to BPND in amyloid-positive and negative older individuals.
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Affiliation(s)
- Emily N Holy
- Department of Neurology, University of California (UC) Davis Health
- Department of Biomedical Engineering, UC Davis
| | | | - Anjan Bhattarai
- Department of Neurology, University of California (UC) Davis Health
- Department of Biomedical Engineering, UC Davis
| | - Evan Fletcher
- Department of Neurology, University of California (UC) Davis Health
| | - Evelyn R Alfaro
- Department of Neurology, University of California (UC) Davis Health
| | | | - Benjamin A Spencer
- Department of Biomedical Engineering, UC Davis
- Department of Radiology, UC Davis Health
| | - Simon R Cherry
- Department of Biomedical Engineering, UC Davis
- Department of Radiology, UC Davis Health
| | | | - Audrey P Fan
- Department of Neurology, University of California (UC) Davis Health
- Department of Biomedical Engineering, UC Davis
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Tingen HSA, van Praagh GD, Nienhuis PH, Tubben A, van Rijsewijk ND, ten Hove D, Mushari NA, Martinez-Lucio TS, Mendoza-Ibañez OI, van Sluis J, Tsoumpas C, Glaudemans AW, Slart RH. The clinical value of quantitative cardiovascular molecular imaging: a step towards precision medicine. Br J Radiol 2023; 96:20230704. [PMID: 37786997 PMCID: PMC10646628 DOI: 10.1259/bjr.20230704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 09/05/2023] [Accepted: 09/05/2023] [Indexed: 10/04/2023] Open
Abstract
Cardiovascular diseases (CVD) are the leading cause of death worldwide and have an increasing impact on society. Precision medicine, in which optimal care is identified for an individual or a group of individuals rather than for the average population, might provide significant health benefits for this patient group and decrease CVD morbidity and mortality. Molecular imaging provides the opportunity to assess biological processes in individuals in addition to anatomical context provided by other imaging modalities and could prove to be essential in the implementation of precision medicine in CVD. New developments in single-photon emission computed tomography (SPECT) and positron emission tomography (PET) systems, combined with rapid innovations in promising and specific radiopharmaceuticals, provide an impressive improvement of diagnostic accuracy and therapy evaluation. This may result in improved health outcomes in CVD patients, thereby reducing societal impact. Furthermore, recent technical advances have led to new possibilities for accurate image quantification, dynamic imaging, and quantification of radiotracer kinetics. This potentially allows for better evaluation of disease activity over time and treatment response monitoring. However, the clinical implementation of these new methods has been slow. This review describes the recent advances in molecular imaging and the clinical value of quantitative PET and SPECT in various fields in cardiovascular molecular imaging, such as atherosclerosis, myocardial perfusion and ischemia, infiltrative cardiomyopathies, systemic vascular diseases, and infectious cardiovascular diseases. Moreover, the challenges that need to be overcome to achieve clinical translation are addressed, and future directions are provided.
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Affiliation(s)
- Hendrea Sanne Aletta Tingen
- Department of Nuclear Medicine and Molecular Imaging, University Medical Centre Groningen, Groningen, The Netherlands
| | - Gijs D. van Praagh
- Department of Nuclear Medicine and Molecular Imaging, University Medical Centre Groningen, Groningen, The Netherlands
| | - Pieter H. Nienhuis
- Department of Nuclear Medicine and Molecular Imaging, University Medical Centre Groningen, Groningen, The Netherlands
| | - Alwin Tubben
- Department of Cardiology, University Medical Centre Groningen, Groningen, The Netherlands
| | - Nick D. van Rijsewijk
- Department of Nuclear Medicine and Molecular Imaging, University Medical Centre Groningen, Groningen, The Netherlands
| | - Derk ten Hove
- Department of Nuclear Medicine and Molecular Imaging, University Medical Centre Groningen, Groningen, The Netherlands
| | - Nouf A. Mushari
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, United Kingdom
| | - T. Samara Martinez-Lucio
- Department of Nuclear Medicine and Molecular Imaging, University Medical Centre Groningen, Groningen, The Netherlands
| | - Oscar I. Mendoza-Ibañez
- Department of Nuclear Medicine and Molecular Imaging, University Medical Centre Groningen, Groningen, The Netherlands
| | - Joyce van Sluis
- Department of Nuclear Medicine and Molecular Imaging, University Medical Centre Groningen, Groningen, The Netherlands
| | | | - Andor W.J.M. Glaudemans
- Department of Nuclear Medicine and Molecular Imaging, University Medical Centre Groningen, Groningen, The Netherlands
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Fu L, Huang J, Liu Q, Xie F, Han Y, Sun P, Cao M, Huang Y, Hu K, Tang G. Radiosynthesis, preclinical evaluation and pilot clinical PET imaging study of a 18F-labeled tracer targeting fibroblast activation protein. Bioorg Chem 2023; 141:106878. [PMID: 37774434 DOI: 10.1016/j.bioorg.2023.106878] [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: 07/04/2023] [Revised: 09/16/2023] [Accepted: 09/20/2023] [Indexed: 10/01/2023]
Abstract
Fibroblast activation protein (FAP) is a promising molecular target for imaging in various types of cancers. Several 18F-labeled FAP inhibitor (FAPI) tracers have been evaluated in clinical study. However, these tracers display high physiological uptake in gallbladder and bile duct system. To overcome the limitation, we herein designed a novel radiotracer named 18F-FAPTG. 18F-FAPTG was produced with a non-decay-corrected radiochemical yield of 24.0 ± 6.0% and 22.0 ± 7.0% for manual and automatic synthesis, respectively. 18F-FAPTG exhibited high hydrophilicity and stability in vitro. The studies of cellular uptake, internalization, efflux properties and competitive binding to FAP of 18F-FAPTG indicated that the tracer showed high specificity, rapid internalization and low cellular efflux in FAP-positive cells. Biodistribution studies and microPET in mice bearing FAP-positive xenografts demonstrated extremely low uptake in the majority of other organs and main excretion of 18F-FAPTG through the urinary system. Furthermore, compared to 18F-FAPI-42, 18F-FAPTG showed significantly lower uptake in gallbladder, higher tumor uptake and longer tumor retention. In the pilot clinical study, 18F-FAPTG PET/CT demonstrated favorable tumor-to-background ratios in most organs and clearly displayed the malignant lesions. Our findings indicated that 18F-FAPTG had an advantage over 18F-FAPI-42 in PET imaging for cancers located in gallbladder the bile duct system. Thus, 18F-FAPTG could be an alternative to the currently available FAPI tracers.
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Affiliation(s)
- Lilan Fu
- Department of Nuclear Medicine, Nanfang Hospital, Southern Medical University, GDMPA Key Laboratory for Quality Control and Evaluation of Radiopharmaceuticals, Guangzhou, Guangdong Province 510515, China
| | - Jiawen Huang
- Department of Nuclear Medicine, Nanfang Hospital, Southern Medical University, GDMPA Key Laboratory for Quality Control and Evaluation of Radiopharmaceuticals, Guangzhou, Guangdong Province 510515, China
| | - Qingxing Liu
- Department of Nuclear Medicine, Nanfang Hospital, Southern Medical University, GDMPA Key Laboratory for Quality Control and Evaluation of Radiopharmaceuticals, Guangzhou, Guangdong Province 510515, China
| | - Fei Xie
- Department of Nuclear Medicine, Nanfang Hospital, Southern Medical University, GDMPA Key Laboratory for Quality Control and Evaluation of Radiopharmaceuticals, Guangzhou, Guangdong Province 510515, China
| | - Yanjiang Han
- Department of Nuclear Medicine, Nanfang Hospital, Southern Medical University, GDMPA Key Laboratory for Quality Control and Evaluation of Radiopharmaceuticals, Guangzhou, Guangdong Province 510515, China
| | - Penghui Sun
- Department of Nuclear Medicine, Nanfang Hospital, Southern Medical University, GDMPA Key Laboratory for Quality Control and Evaluation of Radiopharmaceuticals, Guangzhou, Guangdong Province 510515, China
| | - Min Cao
- Department of Nuclear Medicine, Nanfang Hospital, Southern Medical University, GDMPA Key Laboratory for Quality Control and Evaluation of Radiopharmaceuticals, Guangzhou, Guangdong Province 510515, China
| | - Yanchao Huang
- Department of Nuclear Medicine, Nanfang Hospital, Southern Medical University, GDMPA Key Laboratory for Quality Control and Evaluation of Radiopharmaceuticals, Guangzhou, Guangdong Province 510515, China
| | - Kongzhen Hu
- Department of Nuclear Medicine, Nanfang Hospital, Southern Medical University, GDMPA Key Laboratory for Quality Control and Evaluation of Radiopharmaceuticals, Guangzhou, Guangdong Province 510515, China.
| | - Ganghua Tang
- Department of Nuclear Medicine, Nanfang Hospital, Southern Medical University, GDMPA Key Laboratory for Quality Control and Evaluation of Radiopharmaceuticals, Guangzhou, Guangdong Province 510515, China.
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Chaudhari AJ, Abdelhafez YG, Nardo L, Raychaudhuri SP. EXPLORing Arthritis with Total-body Positron Emission Tomography. Semin Musculoskelet Radiol 2023; 27:632-640. [PMID: 37935209 PMCID: PMC10689025 DOI: 10.1055/s-0043-1775746] [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] [Indexed: 11/09/2023]
Abstract
Arthritis has significant adverse consequences on musculoskeletal tissues and often other organs of the body. Current methods for clinical evaluation of arthritis are suboptimal, and biomarkers that are objective and measurable indicators for monitoring of arthritis disease activity are in critical demand. Recently, total-body positron emission tomography (PET) has been developed that can collect imaging signals synchronously from the entire body at ultra-low doses and reduced scan times. These scanners have increased signal collection efficiency that overcomes several limitations of standard PET scanners in the evaluation of arthritis, and they may potentially provide biomarkers to assess local and systemic impact of the arthritis disease process. This article reviews current results from using total-body PET in the assessment of common arthritic conditions, and it outlines future opportunities and challenges.
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Affiliation(s)
| | - Yasser G. Abdelhafez
- Department of Radiology, University of California, Davis, Davis, California
- Nuclear Medicine Unit, South Egypt Cancer Institute, Assiut University, Assiut, Egypt
| | - Lorenzo Nardo
- Department of Radiology, University of California, Davis, Davis, California
| | - Siba P. Raychaudhuri
- Department of Internal Medicine – Rheumatology, University of California, Davis, Davis, California
- Northern California Veterans Affairs Medical Center, Mather, California
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Zhao M, Zan K, Cui X, Chai L, Ge M, Cheng Z, Sun H, Duan Y. Investigation of the quarter-dose 18 F-FDG total-body PET in routine clinical practice and its clinical value. Nucl Med Commun 2023; 44:1176-1183. [PMID: 37901913 DOI: 10.1097/mnm.0000000000001777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Abstract
OBJECTIVE The purpose of the study was to evaluate the routine clinical application of total-body PET with quarter-dose 18 F-FDG. METHODS The contrast recovery coefficient (CRC) and coefficient of variation (COV) were evaluated among full-, half-, and quarter-dose groups with an acquisition duration of 10-, 5-, 3-, and 1-min in the NEMA (IQ) phantom test. Fifty patients undergoing total-body PET/CT with quarter-dose (0.925MBq/kg) of 18 F-FDG were included in the prospective study. The acquisition time was 10 min, divided into duration groups of 5-, 3-, and 1-min, referred to as G10, G5, G3, and G1. Visual scores were assessed based on overall visual assessment, noise scoring, and lesion conspicuity. Lesion SUV max and TBR were evaluated in semi-quantitative analysis. G10 was used as the gold reference to evaluate lesion detectability. RESULTS In the phantom study, the COV value of the images with quarter-dose 18 F-FDG and 10-min acquisition time was 11.52%. For spheres with 10 mm diameter, the CRC of quarter-dose PET images was relatively stable compared to that of full-dose groups with all acquisition durations. In the human study, the visual score in G10, G5, and G3 was significantly higher than that in G1. The differences in lesion SUV max and TBR for G1-G10 were significantly higher than that for G5-G10 and G3-G10. All lesions in G10 could be identified in G5 and G3. CONCLUSION The phantom and human findings demonstrated the feasibility of quarter-dose 18 F-FDG PET with 3-min acquisition time, which can maintain image quality with reduced radiation dose.
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Affiliation(s)
- Minjie Zhao
- Department of Nuclear Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan and
| | - Keyu Zan
- Department of Nuclear Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan and
| | - Xiao Cui
- Department of Nuclear Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan and
| | - Leiying Chai
- Department of Nuclear Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan and
| | - Min Ge
- Department of Nuclear Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan and
| | - Zhaoping Cheng
- Department of Nuclear Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan and
| | | | - Yanhua Duan
- Department of Nuclear Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan and
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Duan Y, Zan K, Zhao M, Ng YL, Li H, Ge M, Chai L, Cui X, Quan W, Li K, Zhou Y, Chen L, Wang X, Cheng Z. The feasibility of quantitative assessment of dynamic 18F-fluorodeoxyglucose PET in Takayasu's arteritis: a pilot study. Eur J Nucl Med Mol Imaging 2023; 51:81-92. [PMID: 37691022 DOI: 10.1007/s00259-023-06429-4] [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: 04/18/2023] [Accepted: 09/04/2023] [Indexed: 09/12/2023]
Abstract
PURPOSE PET has been demonstrated to be sensitive for detecting active inflammation in Takayasu's arteritis (TAK) patients, but semi-quantitative-based assessment may be susceptible to various biological and technical factors. Absolute quantification via dynamic PET (dPET) may provide a more reliable and quantitative assessment of TAK-active arteries. The purpose of this study was to investigate the feasibility and efficacy of dPET in quantifying TAK-active arteries compared to static PET. MATERIALS AND METHODS This prospective study enrolled 10 TAK-active patients (fulfilled the NIH criteria) and 5 control participants from March to October 2022. One-hour dPET scan (all TAK and control participants) and delayed static PET scan at 2-h (all TAK patients) were acquired. For 1-h static PET, summed images from 50 to 60 min of the dPET were extracted. PET parameters derived from 1- and 2-h static PET including SUV (SUV1H and SUV2H), target-to-background ratio (TBR) (TBR1H and TBR2H), net influx rate (Ki), and TBRKi extracted from dPET were obtained. The detectability of TAK-active arteries was compared among different scanning methods using the generalized estimating equation (GEE) with a logistic regression with repeated measures, and the GEE with gamma distribution and log link function was used to evaluate the different study groups or scanning methods. RESULTS Based on the disease states, 5 cases of TAK were classified as untreated and relapsed, respectively. The SUVmax on 2-h PET was higher than that on 1-h PET in the untreated patients (P < 0.05). However, no significant differences were observed in the median SUVmax between 1-h PET and 2-h PET in the relapsed patients (P > 0.05). The TBRKi was significantly higher than both TBR1H and TBR2H (all P < 0.001). Moreover, the detectability of TAK-active arteries by dPET-derived Ki was significantly higher than 1-h and 2-h PET (all P < 0.001). Significant differences were observed in Kimax, SUVmax-1H, TBR1H, and TBRKi among untreated, relapsed, and control groups (all P < 0.05). CONCLUSIONS Absolute quantitative assessment by dPET provides an improved sensitivity and detectability in both visualization and quantification of TAK-active arteries. This elucidates the clinical significance of dPET in the early detection of active inflammation and monitoring recurrence.
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Affiliation(s)
- Yanhua Duan
- Department of Nuclear Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, 250014, China
| | - Keyu Zan
- Department of Nuclear Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, 250014, China
- Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, 250117, China
| | - Minjie Zhao
- Department of Nuclear Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, 250014, China
- Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, 250117, China
| | - Yee Ling Ng
- Central Research Institute, United Imaging Healthcare Group Co., Ltd, Shanghai, China
| | - Hui Li
- Department of Nuclear Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, 250014, China
| | - Min Ge
- Department of Nuclear Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, 250014, China
| | - Leiying Chai
- Department of Nuclear Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, 250014, China
| | - Xiao Cui
- Department of Nuclear Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, 250014, China
| | - Wenjin Quan
- Department of Nuclear Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, 250014, China
| | - Kun Li
- Department of Nuclear Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, 250014, China
| | - Yun Zhou
- Central Research Institute, United Imaging Healthcare Group Co., Ltd, Shanghai, China
| | - Li Chen
- Department of Ultrasound, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China, 250021.
| | - Ximing Wang
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China, 250021.
| | - Zhaoping Cheng
- Department of Nuclear Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, 250014, China.
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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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Dadgar M, Maebe J, Abi Akl M, Vervenne B, Vandenberghe S. A simulation study of the system characteristics for a long axial FOV PET design based on monolithic BGO flat panels compared with a pixelated LSO cylindrical design. EJNMMI Phys 2023; 10:75. [PMID: 38036794 PMCID: PMC10689648 DOI: 10.1186/s40658-023-00593-0] [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: 03/30/2023] [Accepted: 11/07/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND Although a new generation of tomographs with a longer axial field-of-view called total-body PET have been developed, they are not widely utilized due to their high cost compared to conventional scanners. The newly designed walk-through total-body PET scanner is introduced as a high-throughput and cost-efficient alternative to total-body PET scanners, by making use of a flat panel geometry and lower cost, depth-of-interaction capable, monolithic BGO detectors. The main aim of the presented study is to evaluate through Monte Carlo simulation the system characteristics of the walk-through total-body PET scanner by comparing it with a Quadra-like total-body PET of similar attributes to the Siemens Biograph Vision Quadra. METHODS The walk-through total-body PET is comprised of two flat detector panels, spaced 50 cm apart. Each panel, 70 [Formula: see text] 106 cm[Formula: see text] in size, consists of 280 BGO-based monolithic detectors. The Quadra-like TB-PET has been simulated based on the characteristics of the Biograph Vision Quadra, one of the most common total-body PET scanners with 106 cm of axial field-of-view, which is constructed with pixelated LSO scintillation crystals. The spatial resolution, sensitivity, count rate performance, scatter fractions, and image quality of both scanners are simulated in the GATE simulation toolkit for comparison. RESULTS Due to the DOI-capable detectors used in the walk-through total-body PET, the values of the spatial resolution of this scanner were all below 2 mm along directions parallel to the panels, and reached a maximum of 3.36 mm in the direction perpendicular to the panels. This resolution is a large improvement compared to the values of the Quadra-like TB-PET. The walk-through total-body PET uses its maximum sensitivity (154 cps/kBq) for data acquisition and image reconstruction. CONCLUSION Based on the combination of very good spatial resolution and high sensitivity of the walk-through total-body PET, along with a 2.2 times lower scintillation crystal volume and 1.8 times lower SiPM surface, this scanner can be a very cost-efficient alternative for total-body PET scanners in cases where concomitant CT is not required.
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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
| | - Maya Abi Akl
- Department of Electronics and Information Systems, Medical Image and Signal Processing, Ghent University, C. Heymanslaan 10, Ghent, Belgium
- Division of Arts and Sciences, Texas A&M University at Qatar, Doha, Qatar
| | - Boris Vervenne
- 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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Yamagishi S, Miwa K, Kamitaki S, Anraku K, Sato S, Yamao T, Kubo H, Miyaji N, Oguchi K. Performance Characteristics of a New-Generation Digital Bismuth Germanium Oxide PET/CT System, Omni Legend 32, According to NEMA NU 2-2018 Standards. J Nucl Med 2023; 64:1990-1997. [PMID: 37857503 DOI: 10.2967/jnumed.123.266140] [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: 06/07/2023] [Revised: 09/27/2023] [Indexed: 10/21/2023] Open
Abstract
The Omni Legend 32 PET/CT system features silicon photomultiplier (SiPM)-based detectors with bismuth germanium oxide crystals and a 32-cm axial field of view (FOV). The present study aimed to determine the performance characteristics of the Omni Legend 32 PET/CT system according to National Electrical Manufacturers Association (NEMA) NU 2-2018 standards. Methods: The PET component of this system comprises 22 detector modules; each module contains 24 detector blocks with 72 bismuth germanium oxide crystals with a volume of 4.1 × 4.1 × 30 mm coupled to 18 SiPM devices with a 6 × 6 mm area, resulting in an axial FOV of 32 cm. The spatial resolution, sensitivity, count rate performance, and image quality delivered by PET were evaluated using the NEMA NU 2-2018 standard. PET images of 2 patients were evaluated to get a visual first impression of the Omni Legend 32 PET/CT system together with Precision DL. Results: The average spatial resolution at 1, 10, and 20 cm from the central axis was 4.3, 5.3, and 6.2 mm, respectively, for filtered backprojection and 3.7, 4.3, and 5.1 mm, respectively, for ordered-subset expectation maximization. The NEMA sensitivity was 47.30 and 47.05 cps/kBq at the axial center of the FOV and at a 10-cm radial offset, respectively. The scatter fraction, count rate accuracy, and peak noise-equivalent count rates were 35.4%, 1.7%, and 501.7 kcps, respectively, at 15.7 kBq/mL. Contrast recovery for the NEMA body phantom from the smallest to the largest sphere ranged from 61.3% to 93.0%, with a background variability of 5.4%-11.7% and a lung error of 5.1% for Q.Clear (β-value, 50). Good patient image quality was obtained with the Omni Legend 32. Conclusion: The Omni Legend 32 has class-leading sensitivity and count rates within the category of whole-body PET systems while maintaining spatial resolution broadly comparable to that of other current SiPM-based PET/CT systems. This combination of properties results in a very good image quality.
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Affiliation(s)
- Shin Yamagishi
- Center of Radiology and Diagnostic Imaging, Aizawa Hospital, Nagano, Japan; and
| | - Kenta Miwa
- Department of Radiological Sciences, School of Health Sciences, Fukushima Medical University, Fukushima, Japan
| | - Shun Kamitaki
- Center of Radiology and Diagnostic Imaging, Aizawa Hospital, Nagano, Japan; and
| | - Kouichi Anraku
- Center of Radiology and Diagnostic Imaging, Aizawa Hospital, Nagano, Japan; and
| | - Shun Sato
- Center of Radiology and Diagnostic Imaging, Aizawa Hospital, Nagano, Japan; and
| | - Tensho Yamao
- Department of Radiological Sciences, School of Health Sciences, Fukushima Medical University, Fukushima, Japan
| | - Hitoshi Kubo
- Department of Radiological Sciences, School of Health Sciences, Fukushima Medical University, Fukushima, Japan
| | - Noriaki Miyaji
- Department of Radiological Sciences, School of Health Sciences, Fukushima Medical University, Fukushima, Japan
| | - Kazuhiro Oguchi
- Center of Radiology and Diagnostic Imaging, Aizawa Hospital, Nagano, Japan; and
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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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Wang Y, Nardo L, Spencer BA, Abdelhafez YG, Li EJ, Omidvari N, Chaudhari AJ, Badawi RD, Jones T, Cherry SR, Wang G. Total-Body Multiparametric PET Quantification of 18F-FDG Delivery and Metabolism in the Study of Coronavirus Disease 2019 Recovery. J Nucl Med 2023; 64:1821-1830. [PMID: 37591539 PMCID: PMC10626370 DOI: 10.2967/jnumed.123.265723] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 07/05/2023] [Indexed: 08/19/2023] Open
Abstract
Conventional whole-body static 18F-FDG PET imaging provides a semiquantitative evaluation of overall glucose metabolism without insight into the specific transport and metabolic steps. Here we demonstrate the ability of total-body multiparametric 18F-FDG PET to quantitatively evaluate glucose metabolism using macroparametric quantification and assess specific glucose delivery and phosphorylation processes using microparametric quantification for studying recovery from coronavirus disease 2019 (COVID-19). Methods: The study included 13 healthy subjects and 12 recovering COVID-19 subjects within 8 wk of confirmed diagnosis. Each subject had a 1-h dynamic 18F-FDG scan on the uEXPLORER total-body PET/CT system. Semiquantitative SUV and the SUV ratio relative to blood (SUVR) were calculated for different organs to measure glucose utilization. Tracer kinetic modeling was performed to quantify the microparametric blood-to-tissue 18F-FDG delivery rate [Formula: see text] and the phosphorylation rate k 3, as well as the macroparametric 18F-FDG net influx rate ([Formula: see text]). Statistical tests were performed to examine differences between healthy subjects and recovering COVID-19 subjects. The effect of COVID-19 vaccination was also investigated. Results: We detected no significant difference in lung SUV but significantly higher lung SUVR and [Formula: see text] in COVID-19 recovery, indicating improved sensitivity of kinetic quantification for detecting the difference in glucose metabolism. A significant difference was also observed in the lungs with the phosphorylation rate k 3 but not with [Formula: see text], which suggests that glucose phosphorylation, rather than glucose delivery, drives the observed difference of glucose metabolism. Meanwhile, there was no or little difference in bone marrow 18F-FDG metabolism measured with SUV, SUVR, and [Formula: see text] but a significantly higher bone marrow [Formula: see text] in the COVID-19 group, suggesting a difference in glucose delivery. Vaccinated COVID-19 subjects had a lower lung [Formula: see text] and a higher spleen [Formula: see text] than unvaccinated COVID-19 subjects. Conclusion: Higher lung glucose metabolism and bone marrow glucose delivery were observed with total-body multiparametric 18F-FDG PET in recovering COVID-19 subjects than in healthy subjects, implying continued inflammation during recovery. Vaccination demonstrated potential protection effects. Total-body multiparametric PET of 18F-FDG can provide a more sensitive tool and more insights than conventional whole-body static 18F-FDG imaging to evaluate metabolic changes in systemic diseases such as COVID-19.
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Affiliation(s)
- Yiran Wang
- Department of Radiology, Davis Medical Center, University of California, Sacramento, California;
- Department of Biomedical Engineering, University of California, Davis, Davis, California; and
| | - Lorenzo Nardo
- Department of Radiology, Davis Medical Center, University of California, Sacramento, California
| | - Benjamin A Spencer
- Department of Radiology, Davis Medical Center, University of California, Sacramento, California
- Department of Biomedical Engineering, University of California, Davis, Davis, California; and
| | - Yasser G Abdelhafez
- Department of Radiology, Davis Medical Center, University of California, Sacramento, California
- Nuclear Medicine Unit, South Egypt Cancer Institute, Assiut University, Assiut, Egypt
| | - Elizabeth J Li
- Department of Biomedical Engineering, University of California, Davis, Davis, California; and
| | - Negar Omidvari
- Department of Biomedical Engineering, University of California, Davis, Davis, California; and
| | - Abhijit J Chaudhari
- Department of Radiology, Davis Medical Center, University of California, Sacramento, California
| | - Ramsey D Badawi
- Department of Radiology, Davis Medical Center, University of California, Sacramento, California
- Department of Biomedical Engineering, University of California, Davis, Davis, California; and
| | - Terry Jones
- Department of Radiology, Davis Medical Center, University of California, Sacramento, California
| | - Simon R Cherry
- Department of Radiology, Davis Medical Center, University of California, Sacramento, California
- Department of Biomedical Engineering, University of California, Davis, Davis, California; and
| | - Guobao Wang
- Department of Radiology, Davis Medical Center, University of California, Sacramento, California
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Dong Y, Sun P, Wu H, Zhong J, Cao M, Tang G, Zhou W. PET/CT imaging fibroblast activation protein in initial colorectal cancer: compared to 18 F-FDG PET/CT. Nucl Med Commun 2023; 44:1011-1019. [PMID: 37661771 DOI: 10.1097/mnm.0000000000001751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/05/2023]
Abstract
OBJECTIVE In this study, the potential advantage of FAPI over 18 F-labelled deoxyglucose ( 18 F-FDG) in evaluation of the initial staging colorectal cancer (CRC) was investigated. MATERIALS AND METHODS Thirty-two patients with histopathologically confirmed primary CRC were included in our study. They all underwent both 18 F-FDG and FAPI PET/CT. Lesion detectability and tracer uptakes, mainly quantified by maximum standardized uptake value (SUVmax) and target-to-background ratio (TBR), were compared for paired lesions between both modalities using the Wilcoxon signed-rank test and paired t-test. RESULTS Thirty-five CRC lesions in 32 patients were diagnosed. The sensitivity of FAPI PET/CT in diagnosis of the CRC lesions was 100% while 93.8% of 18 F-FDG PET/CT. FAPI and 18 F-FDG had a similar uptake in CRC lesion (mean SUVmax: 14.3 ± 8.6 vs. 15.4 ± 9.8, P = 0.604), but lesions contained mucus and/or signet-ring cell carcinoma seemed to have a trend of higher FAPI uptake although there was no statistical difference (mean SUVmax: 12.7 ± 5.6 vs. 8.5 ± 4.1, P = 0.152) and higher TBR (13.4 ± 6.2 vs. 4.9 ± 2.2, P = 0.004) than those of 18 F-FDG. For regional lymph node metastases, both FAPI and FDG PET/CTs showed high sensitivity (7/8 vs. 7/8), specificity (7/8 vs. 6/8) and accuracy (14/16 vs. 13/16) (all P > 0.05). For distant metastasis, FAPI PET/CT depicted more positive lesions in distant lymph node (46 vs. 26), liver (13 vs. 7) and peritoneum (107 vs. 45) than 18 F-FDG PET/CT. FAPI PET/CT also had a higher peritoneal cancer index score (median 11 vs 4; P < 0.001) than 18 F-FDG PET/CT in evaluation of peritoneal metastases. CONCLUSION FAPI PET/CT showed high sensitivity in detection of primary CRC and superiority to 18 F-FDG PET/CT in detection of metastases to distant lymph node, liver and peritoneum.
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Chen X, Hu P, Yu H, Tan H, He Y, Cao S, Zhou Y, Shi H. Head-to-head intra-individual comparison of total-body 2-[ 18F]FDG PET/CT and digital PET/CT in patients with malignant tumor: how sensitive could it be? Eur Radiol 2023; 33:7890-7898. [PMID: 37338551 DOI: 10.1007/s00330-023-09825-4] [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: 07/29/2022] [Revised: 03/14/2023] [Accepted: 03/26/2023] [Indexed: 06/21/2023]
Abstract
OBJECTIVES To comparatively evaluate the lesion-detecting ability of 2-[18F]FDG total-body PET/CT (TB PET/CT) and conventional digital PET/CT. METHODS This study enrolled 67 patients (median age, 65 years; 24 female and 43 male patients) who underwent a TB PET/CT scan and a conventional digital PET/CT scan after a single 2-[18F]FDG injection (3.7 MBq/kg). Raw PET data for TB PET/CT were acquired over the course of 5 min, and images were reconstructed using data from the first 1, 2, 3, and 4 min and the entire 5 min (G1, G2, G3, G4, and G5, respectively). The conventional digital PET/CT scan acquired in 2-3 min per bed (G0). Two nuclear medicine physicians independently assessed subjective image quality using a 5-point Likert scale and recorded the number of 2-[18F]FDG-avid lesions. RESULTS A total of 241 lesions (69 primary lesions; 32 liver, lung, and peritoneum metastases; and 140 regional lymph nodes) among 67 patients with various types of cancer were analyzed. The subjective image quality score and SNR (signal-to-noise ratio) increased gradually from G1 to G5, and these values were significantly higher than the values at G0 (all p < 0.05). Compared to conventional PET/CT, G4 and G5 of TB PET/CT detected an additional 15 lesions (2 primary lesions; 5 liver, lung, and peritoneum lesions; and 8 lymph node metastases). CONCLUSION TB PET/CT was more sensitive than conventional whole-body PET/CT in detecting small (4.3 mm, maximum standardized uptake value (SUVmax) of 1.0) or low-uptake (tumor-to-liver ratio of 1.6, SUVmax of 4.1) lesions. CLINICAL RELEVANCE STATEMENT This study explored the gain of the image quality and lesion detectability of TB PET/CT, compared to conventional PET/CT, and recommended the appropriate acquisition time for TB PET/CT in clinical practice with an ordinary 2-[18F] FDG dose. KEY POINTS • TB PET/CT increases the effective sensitivity to approximately 40 times that of conventional PET scanners. • The subjective image quality score and signal-to-noise ratio of TB PET/CT from G1 to G5 were better than those of conventional PET/CT. • 2-[18F]FDG TB PET/CT with a 4-min acquisition time at a regular tracer dose detected an additional 15 lesions compared to conventional PET/CT.
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Affiliation(s)
- Xueqi Chen
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China
- Nuclear Medicine Institute of Fudan University, Shanghai, 200032, China
- Shanghai Institute of Medical Imaging, Shanghai, 200032, China
| | - Pengcheng Hu
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China
- Nuclear Medicine Institute of Fudan University, Shanghai, 200032, China
- Shanghai Institute of Medical Imaging, Shanghai, 200032, China
| | - Haojun Yu
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China
- Nuclear Medicine Institute of Fudan University, Shanghai, 200032, China
- Shanghai Institute of Medical Imaging, Shanghai, 200032, China
| | - Hui Tan
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China
- Nuclear Medicine Institute of Fudan University, Shanghai, 200032, China
- Shanghai Institute of Medical Imaging, Shanghai, 200032, China
| | - Yibo He
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China
- Nuclear Medicine Institute of Fudan University, Shanghai, 200032, China
- Shanghai Institute of Medical Imaging, Shanghai, 200032, China
| | - Shuangliang Cao
- Central Research Institute, United Imaging Healthcare Group Co., Ltd., Shanghai, 201807, China
| | - Yun Zhou
- Central Research Institute, United Imaging Healthcare Group Co., Ltd., Shanghai, 201807, China
- School of Biomedical Engineering, Shanghai Tech University, Shanghai, China
| | - Hongcheng Shi
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.
- Nuclear Medicine Institute of Fudan University, Shanghai, 200032, China.
- Shanghai Institute of Medical Imaging, Shanghai, 200032, China.
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