1
|
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.
Collapse
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
| |
Collapse
|
2
|
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.
Collapse
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.
| |
Collapse
|
3
|
Zhao Y, Lv T, Xu Y, Yin J, Wang X, Xue Y, Zhu G, Yu W, Wang H, Li X. Application of Dynamic [ 18F]FDG PET/CT Multiparametric Imaging Leads to an Improved Differentiation of Benign and Malignant Lung Lesions. Mol Imaging Biol 2024:10.1007/s11307-024-01942-w. [PMID: 39174787 DOI: 10.1007/s11307-024-01942-w] [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: 04/05/2024] [Revised: 07/18/2024] [Accepted: 07/24/2024] [Indexed: 08/24/2024]
Abstract
PURPOSE To evaluate the potential of whole-body dynamic (WBD) 2-deoxy-2-[18F]fluoro-D-glucose positron emission tomography/computed tomography ([18F]FDG PET/CT) multiparametric imaging in the differential diagnosis between benign and malignant lung lesions. PROCEDURES We retrospectively analyzed WBD PET/CT scans from patients with lung lesions performed between April 2020 and March 2023. Multiparametric images including standardized uptake value (SUV), metabolic rate (MRFDG) and distribution volume (DVFDG) were visually interpreted and compared. We adopted SUVmax, metabolic tumor volume (MTV) and total lesion glycolysis (TLG) for semi-quantitative analysis, MRmax and DVmax values for quantitative analysis. We also collected the patients' clinical characteristics. The variables above with P-value < 0.05 in the univariate analysis were entered into a multivariate logistic regression. The statistically significant metrics were plotted on receiver-operating characteristic (ROC) curves. RESULTS A total of 60 patients were included for data evaluation. We found that most malignant lesions showed high uptake on MRFDG and SUV images, and low or absent uptake on DVFDG images, while benign lesions showed low uptake on MRFDG images and high uptake on DVFDG images. Most malignant lesions showed a characteristic pattern of gradually increasing FDG uptake, whereas benign lesions presented an initial rise with rapid fall, then kept stable at a low level. The AUC values of MRmax and SUVmax are 0.874 (95% CI: 0.763-0.946) and 0.792 (95% CI: 0.667-0.886), respectively. DeLong's test showed the difference between the areas is statistically significant (P < 0.001). CONCLUSIONS Our study demonstrated that dynamic [18F]FDG PET/CT imaging based on the Patlak analysis was a more accurate method of distinguishing malignancies from benign lesions than conventional static PET/CT scans.
Collapse
Affiliation(s)
- Yihan Zhao
- Department of Nuclear Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Tao Lv
- Department of Nuclear Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Yue Xu
- Department of Nuclear Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Jiankang Yin
- Department of Nuclear Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Xin Wang
- Department of Nuclear Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Yangyang Xue
- Department of Nuclear Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Gan Zhu
- Department of Nuclear Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Wenjing Yu
- Department of Nuclear Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Hui Wang
- Department of Nuclear Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Xiaohu Li
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Research Center of Clinical Medical Imaging, Anhui Province Clinical Image Quality Control Center, Hefei, China.
| |
Collapse
|
4
|
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.
Collapse
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
| |
Collapse
|
5
|
Wu Y, Sun T, Ng YL, Liu J, Zhu X, Cheng Z, Xu B, Meng N, Zhou Y, Wang M. Clinical Implementation of Total-Body PET in China. J Nucl Med 2024; 65:64S-71S. [PMID: 38719242 DOI: 10.2967/jnumed.123.266977] [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: 11/04/2023] [Revised: 02/13/2024] [Indexed: 07/16/2024] Open
Abstract
Total-body (TB) PET/CT is a groundbreaking tool that has brought about a revolution in both clinical application and scientific research. The transformative impact of TB PET/CT in the realms of clinical practice and scientific exploration has been steadily unfolding since its introduction in 2018, with implications for its implementation within the health care landscape of China. TB PET/CT's exceptional sensitivity enables the acquisition of high-quality images in significantly reduced time frames. Clinical applications have underscored its effectiveness across various scenarios, emphasizing the capacity to personalize dosage, scan duration, and image quality to optimize patient outcomes. TB PET/CT's ability to perform dynamic scans with high temporal and spatial resolution and to perform parametric imaging facilitates the exploration of radiotracer biodistribution and kinetic parameters throughout the body. The comprehensive TB coverage offers opportunities to study interconnections among organs, enhancing our understanding of human physiology and pathology. These insights have the potential to benefit applications requiring holistic TB assessments. The standard topics outlined in The Journal of Nuclear Medicine were used to categorized the reviewed articles into 3 sections: current clinical applications, scan protocol design, and advanced topics. This article delves into the bottleneck that impedes the full use of TB PET in China, accompanied by suggested solutions.
Collapse
Affiliation(s)
- Yaping Wu
- Department of Medical Imaging, Henan Provincial People's Hospital, Zhengzhou, China
- People's Hospital of Zhengzhou University, Zhengzhou, China
- Institute for Integrated Medical Science and Engineering, Henan Academy of Sciences, Zhengzhou, China
| | - Tao Sun
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Yee Ling Ng
- Central Research Institute, United Imaging Healthcare Group Co., Ltd., Shanghai, China
| | - Jianjun Liu
- Department of Nuclear Medicine, RenJi Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xiaohua Zhu
- Department of Nuclear Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhaoping Cheng
- Department of Nuclear Medicine, First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Jinan, China; and
| | - Baixuan Xu
- Department of Nuclear Medicine, Chinese PLA General Hospital, Beijing, China
| | - Nan Meng
- Department of Medical Imaging, Henan Provincial People's Hospital, Zhengzhou, China
- People's Hospital of Zhengzhou University, Zhengzhou, China
- Institute for Integrated Medical Science and Engineering, Henan Academy of Sciences, Zhengzhou, China
| | - Yun Zhou
- Central Research Institute, United Imaging Healthcare Group Co., Ltd., Shanghai, China
| | - Meiyun Wang
- Department of Medical Imaging, Henan Provincial People's Hospital, Zhengzhou, China;
- People's Hospital of Zhengzhou University, Zhengzhou, China
- Institute for Integrated Medical Science and Engineering, Henan Academy of Sciences, Zhengzhou, China
| |
Collapse
|
6
|
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.
Collapse
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.
| |
Collapse
|
7
|
Mei R, Pyka T, Sari H, Fanti S, Afshar-Oromieh A, Giger R, Caobelli F, Rominger A, Alberts I. The clinical acceptability of short versus long duration acquisitions for head and neck cancer using long-axial field-of-view PET/CT: a retrospective evaluation. Eur J Nucl Med Mol Imaging 2024; 51:1436-1443. [PMID: 38095670 PMCID: PMC10957684 DOI: 10.1007/s00259-023-06516-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 11/06/2023] [Indexed: 03/22/2024]
Abstract
PURPOSE To evaluate the utility of long duration (10 min) acquisitions compared to standard 4 min scans in the evaluation of head and neck cancer (HNC) using a long-axial field-of-view (LAFOV) system in 2-[18F]FDG PET/CT. METHODS HNC patients undergoing LAFOV PET/CT were included retrospectively according to a predefined sample size calculation. For each acquisition, FDG avid lymph nodes (LN) which were highly probable or equivocal for malignancy were identified by two board certified nuclear medicine physicians in consensus. The aim of this study was to establish the clinical acceptability of short-duration (4 min, C40%) acquisitions compared to full-count (10 min, C100%) in terms of the detection of LN metastases in HNC. Secondary endpoints were the positive predictive value for LN status (PPV) and comparison of SUVmax at C40% and C100%. Histology reports or confirmatory imaging were the reference standard. RESULTS A total of 1218 records were screened and target recruitment was met with n = 64 HNC patients undergoing LAFOV. Median age was 65 years (IQR: 59-73). At C40%, a total of 387 lesions were detected (highly probable LN n = 274 and equivocal n = 113. The total number of lesions detected at C100% acquisition was 439, of them 291 (66%) highly probable LN and 148 (34%) equivocal. Detection rate between the two acquisitions did not demonstrate any significant differences (Pearson's Chi-Square test, p = 0.792). Sensitivity, specificity, PPV, NPV and accuracy for C40% were 83%, 44%, 55%, 76% and 36%, whilst for C100% were 85%, 56%, 55%, 85% and 43%, respectively. The improved accuracy reached borderline significance (p = 0.057). At the ROC analysis, lower SUVmax was identified for C100% (3.5) compared to C40% (4.5). CONCLUSION In terms of LN detection, C40% acquisitions showed no significant difference compared to the C100% acquisitions. There was some improvement for lesions detection at C100%, with a small increment in accuracy reaching borderline significance, suggestive that the higher sensitivity afforded by LAFOV might translate to improved clinical performance in some patients.
Collapse
Affiliation(s)
- Riccardo Mei
- Nuclear Medicine Department, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstr. 18, 3010, Bern, Switzerland
| | - Thomas Pyka
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstr. 18, 3010, Bern, Switzerland.
| | - Hasan Sari
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstr. 18, 3010, Bern, Switzerland
- Advanced Clinical Imaging Technology, Siemens Healthcare AG, Lausanne, Switzerland
| | - Stefano Fanti
- Nuclear Medicine Department, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy
| | - Ali Afshar-Oromieh
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstr. 18, 3010, Bern, Switzerland
| | - Roland Giger
- Department of Head and Neck Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Federico Caobelli
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstr. 18, 3010, Bern, Switzerland
| | - Axel Rominger
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstr. 18, 3010, Bern, Switzerland
| | - Ian Alberts
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstr. 18, 3010, Bern, Switzerland
- Molecular Imaging and Therapy, BC Cancer Agency, Vancouver, BC, Canada
| |
Collapse
|
8
|
Liu G, Shi Y, Hou X, Yu H, Hu Y, Zhang Y, Shi H. Dynamic total-body PET/CT imaging with reduced acquisition time shows acceptable performance in quantification of [ 18F]FDG tumor kinetic metrics. Eur J Nucl Med Mol Imaging 2024; 51:1371-1382. [PMID: 38078950 DOI: 10.1007/s00259-023-06526-4] [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: 05/06/2023] [Accepted: 11/14/2023] [Indexed: 03/22/2024]
Abstract
PURPOSE To investigate the feasibility of reducing the acquisition time for continuous dynamic positron emission tomography (PET) while retaining acceptable performance in quantifying kinetic metrics of 2-[18F]-fluoro-2-deoxy-D-glucose ([18F]FDG) in tumors. METHODS In total, 78 oncological patients underwent total-body dynamic PET imaging for ≥ 60 min, with 8, 20, and 50 patients receiving full activity (3.7 MBq/kg), half activity (1.85 MBq/kg), and ultra-low activity (0.37 MBq/kg) of [18F]FDG, respectively. The dynamic data were divided into 21-, 30-, 45- and ≥ 60-min groups. The kinetic analysis involved model fitting to derive constant rates (VB, K1 to k3, and Ki) for both tumors and normal tissues, using both reversible and irreversible two-tissue-compartment models. One-way ANOVA with repeated measures or the Freidman test compared the kinetic metrics among groups, while the Deming regression assessed the correlation of kinetic metrics among groups. RESULTS All kinetic metrics in the 30-min and 45-min groups were statistically comparable to those in the ≥ 60-min group. The relative differences between the 30-min and ≥ 60-min groups ranged from 12.3% ± 15.1% for K1 to 29.8% ± 30.0% for VB, and those between the 45-min and ≥ 60-min groups ranged from 7.5% ± 8.7% for Ki to 24.0% ± 24.3% for VB. However, this comparability was not observed between the 21-min and ≥ 60-min groups. The significance trend of these comparisons remained consistent across different models (reversible or irreversible), administrated activity levels, and partial volume corrections for lesions. Significant correlations in tumor kinetic metrics were identified between the 30-/45-min and ≥ 60-min groups, with Deming regression slopes > 0.813. In addition, the comparability of kinetic metrics between the 30-min and ≥ 60-min groups were established for normal tissues. CONCLUSION The acquisition time for dynamic PET imaging can be reduced to 30 min without compromising the ability to reveal tumor kinetic metrics of [18F]FDG, using the total-body PET/CT system.
Collapse
Affiliation(s)
- Guobing Liu
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, P.R. China
- Department of Nuclear Medicine, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, 361015, China
- Institute of Nuclear Medicine, Fudan University, Shanghai, 200032, China
- Shanghai Institute of Medical Imaging, Shanghai, 200032, China
- Cancer Prevention and Treatment Center, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
- Xiamen Municipal Clinical Research Center for Medical Imaging, Xiamen, 361015, China
| | - Yimeng Shi
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, P.R. China
- Institute of Nuclear Medicine, Fudan University, Shanghai, 200032, China
- Shanghai Institute of Medical Imaging, Shanghai, 200032, China
- Cancer Prevention and Treatment Center, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Xiaoguang Hou
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, P.R. China
- Institute of Nuclear Medicine, Fudan University, Shanghai, 200032, China
- Shanghai Institute of Medical Imaging, Shanghai, 200032, China
- Cancer Prevention and Treatment Center, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Haojun Yu
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, P.R. China
- Institute of Nuclear Medicine, Fudan University, Shanghai, 200032, China
- Shanghai Institute of Medical Imaging, Shanghai, 200032, China
- Cancer Prevention and Treatment Center, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Yan Hu
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, P.R. China
- Institute of Nuclear Medicine, Fudan University, Shanghai, 200032, China
- Shanghai Institute of Medical Imaging, Shanghai, 200032, China
- Cancer Prevention and Treatment Center, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Yiqiu Zhang
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, P.R. China
- Institute of Nuclear Medicine, Fudan University, Shanghai, 200032, China
- Shanghai Institute of Medical Imaging, Shanghai, 200032, China
- Cancer Prevention and Treatment Center, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Hongcheng Shi
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, P.R. China.
- Department of Nuclear Medicine, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, 361015, China.
- Institute of Nuclear Medicine, Fudan University, Shanghai, 200032, China.
- Shanghai Institute of Medical Imaging, Shanghai, 200032, China.
- Cancer Prevention and Treatment Center, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.
- Xiamen Municipal Clinical Research Center for Medical Imaging, Xiamen, 361015, China.
| |
Collapse
|
9
|
Li M, Cui X, Yue H, Ma C, Li K, Chai L, Ge M, Li H, Ng YL, Zhou Y, Shi J, Duan Y, Cheng Z. The efficacy of short acquisition time using 18F-FDG total-body PET/CT for the identification of pediatric epileptic foci. EJNMMI Res 2024; 14:21. [PMID: 38409511 PMCID: PMC10897067 DOI: 10.1186/s13550-024-01081-x] [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: 03/06/2023] [Accepted: 02/14/2024] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND 18F-FDG positron emission tomography (PET) plays a crucial part in the evaluation for pediatric epileptic patients prior to therapy. Short-term scanning holds significant importance, especially for pediatrics epileptic individuals who exhibited involuntary movements. The aim was to evaluate the effects of short acquisition time on image quality and lesion detectability in pediatric epileptic patients using total-body (TB) PET/CT. A total of 25 pediatric patients who underwent TB PET/CT using uEXPLORER scanner with an 18F-FDG administered dose of 3.7 MBq/kg and an acquisition time of 600 s were retrospectively enrolled. Short acquisition times (60 s, 150 and 300 s) were simulated by truncating PET data in list mode to reduce count density. Subjective image quality was scored on a 5-point scale. Regions of interest analysis of suspected epileptogenic zones (EZs), corresponding locations contralateral to EZs, and healthy cerebellar cortex were used to compare the semi-quantitative uptake indices of short-time images and then were compared with 600 s images. The comparison of EZs detectability based on time-dependent PET images was performed. RESULTS Our study demonstrated that a short acquisition time of 150 s is sufficient to maintain subjective image quality and lesion significance. Statistical analysis revealed no significant difference in subjective PET image quality between imaging at 300 s and 150 s (P > 0.05). The overall impression scores of image quality and lesion conspicuity in G60s were both greater than 3 (overall quality, 3.21 ± 0.46; lesion conspicuity, 4.08 ± 0.74). As acquisition time decreased, the changes of SUVmax and SD in the cerebellar cortex gradually increased (P < 0.01). There was no significant difference in asymmetry index (AI) difference between the groups and the AIs of EZs were > 15% in all groups. In 26 EZs of 25 patients, the lesion detection rate was still 100% when the time was reduced to 60 s. CONCLUSIONS This study proposed that TB PET/CT acquisition time could be reduced to 60 s with acceptable lesion detectability. Furthermore, it was suggested that a 150 s acquisition time would be sufficient to achieve diagnostic performance and image quality for children with epilepsy.
Collapse
Affiliation(s)
- Min Li
- Postgraduate Department, Shandong First Medical University, Shandong Academy of Medical Sciences), Jinan, China
- Department of Nuclear Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, China
| | - Xiao Cui
- Department of Nuclear Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, China
| | - Huixin Yue
- Postgraduate Department, Shandong First Medical University, Shandong Academy of Medical Sciences), Jinan, China
- Department of Nuclear Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, China
| | - Chao Ma
- Postgraduate Department, Shandong First Medical University, Shandong Academy of Medical Sciences), Jinan, China
- Department of Nuclear Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, China
| | - Kun Li
- Department of Nuclear Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, China
| | - Leiying Chai
- Department of Nuclear Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, China
| | - Min Ge
- Department of Nuclear Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, China
| | - Hui Li
- Department of Nuclear Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, China
| | - Yee Ling Ng
- Central Research Institute, United Imaging Healthcare Group Co., Ltd, Shanghai, China
| | - Yun Zhou
- Central Research Institute, United Imaging Healthcare Group Co., Ltd, Shanghai, China
| | - Jianguo Shi
- Department of Epilepsy Center, Children's Hospital Affiliated to Shandong University, Jinan Children's Hospital, Jinan, China.
| | - Yanhua Duan
- Department of Nuclear Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, China.
| | - Zhaoping Cheng
- Department of Nuclear Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, China.
| |
Collapse
|
10
|
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.
Collapse
Affiliation(s)
- M K Singh
- AECC University College, Parkwood Road, Bournemouth, UK.
| |
Collapse
|
11
|
Huang Z, Li W, Wu Y, Guo N, Yang L, Zhang N, Pang Z, Yang Y, Zhou Y, Shang Y, Zheng H, Liang D, Wang M, Hu Z. Short-axis PET image quality improvement based on a uEXPLORER total-body PET system through deep learning. Eur J Nucl Med Mol Imaging 2023; 51:27-39. [PMID: 37672046 DOI: 10.1007/s00259-023-06422-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 08/30/2023] [Indexed: 09/07/2023]
Abstract
PURPOSE The axial field of view (AFOV) of a positron emission tomography (PET) scanner greatly affects the quality of PET images. Although a total-body PET scanner (uEXPLORER) with a large AFOV is more sensitive, it is more expensive and difficult to widely use. Therefore, we attempt to utilize high-quality images generated by uEXPLORER to optimize the quality of images from short-axis PET scanners through deep learning technology while controlling costs. METHODS The experiments were conducted using PET images of three anatomical locations (brain, lung, and abdomen) from 335 patients. To simulate PET images from different axes, two protocols were used to obtain PET image pairs (each patient was scanned once). For low-quality PET (LQ-PET) images with a 320-mm AFOV, we applied a 300-mm FOV for brain reconstruction and a 500-mm FOV for lung and abdomen reconstruction. For high-quality PET (HQ-PET) images, we applied a 1940-mm AFOV during the reconstruction process. A 3D Unet was utilized to learn the mapping relationship between LQ-PET and HQ-PET images. In addition, the peak signal-to-noise ratio (PSNR) and structural similarity index measure (SSIM) were employed to evaluate the model performance. Furthermore, two nuclear medicine doctors evaluated the image quality based on clinical readings. RESULTS The generated PET images of the brain, lung, and abdomen were quantitatively and qualitatively compatible with the HQ-PET images. In particular, our method achieved PSNR values of 35.41 ± 5.45 dB (p < 0.05), 33.77 ± 6.18 dB (p < 0.05), and 38.58 ± 7.28 dB (p < 0.05) for the three beds. The overall mean SSIM was greater than 0.94 for all patients who underwent testing. Moreover, the total subjective quality levels of the generated PET images for three beds were 3.74 ± 0.74, 3.69 ± 0.81, and 3.42 ± 0.99 (the highest possible score was 5, and the minimum score was 1) from two experienced nuclear medicine experts. Additionally, we evaluated the distribution of quantitative standard uptake values (SUV) in the region of interest (ROI). Both the SUV distribution and the peaks of the profile show that our results are consistent with the HQ-PET images, proving the superiority of our approach. CONCLUSION The findings demonstrate the potential of the proposed technique for improving the image quality of a PET scanner with a 320 mm or even shorter AFOV. Furthermore, this study explored the potential of utilizing uEXPLORER to achieve improved short-axis PET image quality at a limited economic cost, and computer-aided diagnosis systems that are related can help patients and radiologists.
Collapse
Affiliation(s)
- Zhenxing Huang
- Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
| | - Wenbo Li
- Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
| | - Yaping Wu
- Department of Medical Imaging, Henan Provincial People's Hospital & People's Hospital of Zhengzhou University, Zhengzhou, 450003, China
| | - Nannan Guo
- Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
- School of Mathematics and Statistics, Henan University, Kaifeng, 475004, China
| | - Lin Yang
- Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
- School of Mathematics and Statistics, Henan University, Kaifeng, 475004, China
| | - Na Zhang
- Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
| | - Zhifeng Pang
- School of Mathematics and Statistics, Henan University, Kaifeng, 475004, China
| | - Yongfeng Yang
- Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
| | - Yun Zhou
- Central Research Institute, United Imaging Healthcare Group, Shanghai, 201807, China
| | - Yue Shang
- Performance Strategy & Analytics, UCLA Health, Los Angeles, CA, 90001, USA
| | - Hairong Zheng
- Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
| | - Dong Liang
- Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
| | - Meiyun Wang
- School of Mathematics and Statistics, Henan University, Kaifeng, 475004, China.
| | - Zhanli Hu
- Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China.
| |
Collapse
|
12
|
Cumming P, Dias AH, Gormsen LC, Hansen AK, Alberts I, Rominger A, Munk OL, Sari H. Single time point quantitation of cerebral glucose metabolism by FDG-PET without arterial sampling. EJNMMI Res 2023; 13:104. [PMID: 38032409 PMCID: PMC10689590 DOI: 10.1186/s13550-023-01049-3] [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: 03/17/2023] [Accepted: 11/01/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND Until recently, quantitation of the net influx of 2-[18F]fluorodeoxyglucose (FDG) to brain (Ki) and the cerebrometabolic rate for glucose (CMRglc) required serial arterial blood sampling in conjunction with dynamic positron emission tomography (PET) recordings. Recent technical innovations enable the identification of an image-derived input function (IDIF) from vascular structures, but are frequently still encumbered by the need for interrupted sequences or prolonged recordings that are seldom available outside of a research setting. In this study, we tested simplified methods for quantitation of FDG-Ki by linear graphic analysis relative to the descending aorta IDIF in oncology patients examined using a Biograph Vision 600 PET/CT with continuous bed motion (Aarhus) or using a recently installed Biograph Vision Quadra long-axial field-of-view (FOV) scanner (Bern). RESULTS Correlation analysis of the coefficients of a tri-exponential decomposition of the IDIFs measured during 67 min revealed strong relationships among the total area under the curve (AUC), the terminal normalized arterial integral (theta(52-67 min)), and the terminal image-derived arterial FDG concentration (Ca(52-67 min)). These relationships enabled estimation of the missing AUC from late recordings of the IDIF, from which we then calculated FDG-Ki in brain by two-point linear graphic analysis using a population mean ordinate intercept and the single late frame. Furthermore, certain aspects of the IDIF data from Aarhus showed a marked age-dependence, which was not hitherto reported for the case of FDG pharmacokinetics. CONCLUSIONS The observed interrelationships between pharmacokinetic parameters in the IDIF measured during the PET recording support quantitation of FDG-Ki in brain using a single averaged frame from the interval 52-67 min post-injection, with minimal error relative to calculation from the complete dynamic sequences.
Collapse
Affiliation(s)
- Paul Cumming
- Department of Nuclear Medicine, Bern University Hospital, Freiburgstrasse 18, INO B 214.C, 3010, Bern, Switzerland.
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, Australia.
| | - André H Dias
- Department of Nuclear Medicine and PET Centre, Aarhus University Hospital, Aarhus, Denmark
| | - Lars C Gormsen
- Department of Nuclear Medicine and PET Centre, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Allan K Hansen
- Department of Nuclear Medicine and PET Centre, Aarhus University Hospital, Aarhus, Denmark
| | - Ian Alberts
- Department of Nuclear Medicine, Bern University Hospital, Freiburgstrasse 18, INO B 214.C, 3010, Bern, Switzerland
| | - Axel Rominger
- Department of Nuclear Medicine, Bern University Hospital, Freiburgstrasse 18, INO B 214.C, 3010, Bern, Switzerland
| | - Ole L Munk
- Department of Nuclear Medicine and PET Centre, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Hasan Sari
- Department of Nuclear Medicine, Bern University Hospital, Freiburgstrasse 18, INO B 214.C, 3010, Bern, Switzerland
- Advanced Clinical Imaging Technology, Siemens Healthcare AG, Lausanne, Switzerland
| |
Collapse
|
13
|
Alberts I, Seibel S, Xue S, Viscione M, Mingels C, Sari H, Afshar-Oromieh A, Limacher A, Rominger A. Investigating the influence of long-axial versus short-axial field of view PET/CT on stage migration in lymphoma and non-small cell lung cancer. Nucl Med Commun 2023; 44:988-996. [PMID: 37578376 PMCID: PMC10566597 DOI: 10.1097/mnm.0000000000001745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 07/27/2023] [Indexed: 08/15/2023]
Abstract
OBJECTIVES The objective of this study was to evaluate the influence of a long-axial field-of-view (LAFOV) on stage migration using a large single-centre retrospective cohort in lymphoma and non-small cell lung cancer (NSCLC). METHODS A retrospective study is performed for patients undergoing PET/computed tomography (CT) on either a short-axial field-of-view (SAFOV) or LAFOV PET/CT system for the staging of known or suspected NSCLC or for therapeutic response in lymphoma. The primary endpoint was the Deauville therapy response score for patients with lymphoma for the two systems. Secondary endpoints were the American Joint Committee on Cancer stage for NSCLC, the frequency of cN3 and cM1 findings, the probability for a positive nodal staging (cN1-3) for NSCLC and the diagnostic accuracy for nodal staging in NSCLC. RESULTS One thousand two hundred eighteen records were screened and 597 patients were included for analysis ( N = 367 for lymphoma and N = 291 for NSCLC). For lymphoma, no significant differences were found in the proportion of patients with complete metabolic response versus non-complete metabolic response Deauville response scores ( P = 0.66). For NSCLC no significant differences were observed between the two scanners for the frequency of cN3 and cM1 findings, for positive nodal staging, neither the sensitivity nor the specificity. CONCLUSIONS In this study use of a LAFOV system was neither associated with upstaging in lymphoma nor NSCLC compared to a digital SAFOV system. Diagnostic accuracy was comparable between the two systems in NSCLC despite shorter acquisition times for LAFOV.
Collapse
Affiliation(s)
- Ian Alberts
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Bern
| | - Sigrid Seibel
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Bern
| | - Song Xue
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Bern
| | - Marco Viscione
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Bern
| | - Clemens Mingels
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Bern
| | - Hasan Sari
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Bern
- Advanced Clinical Imaging Technology, Siemens Healthcare AG, Lausanne
| | - Ali Afshar-Oromieh
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Bern
| | | | - Axel Rominger
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Bern
| |
Collapse
|
14
|
Hirata K, Kamagata K, Ueda D, Yanagawa M, Kawamura M, Nakaura T, Ito R, Tatsugami F, Matsui Y, Yamada A, Fushimi Y, Nozaki T, Fujita S, Fujioka T, Tsuboyama T, Fujima N, Naganawa S. From FDG and beyond: the evolving potential of nuclear medicine. Ann Nucl Med 2023; 37:583-595. [PMID: 37749301 DOI: 10.1007/s12149-023-01865-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 09/09/2023] [Indexed: 09/27/2023]
Abstract
The radiopharmaceutical 2-[fluorine-18]fluoro-2-deoxy-D-glucose (FDG) has been dominantly used in positron emission tomography (PET) scans for over 20 years, and due to its vast utility its applications have expanded and are continuing to expand into oncology, neurology, cardiology, and infectious/inflammatory diseases. More recently, the addition of artificial intelligence (AI) has enhanced nuclear medicine diagnosis and imaging with FDG-PET, and new radiopharmaceuticals such as prostate-specific membrane antigen (PSMA) and fibroblast activation protein inhibitor (FAPI) have emerged. Nuclear medicine therapy using agents such as [177Lu]-dotatate surpasses conventional treatments in terms of efficacy and side effects. This article reviews recently established evidence of FDG and non-FDG drugs and anticipates the future trajectory of nuclear medicine.
Collapse
Affiliation(s)
- Kenji Hirata
- Department of Diagnostic Imaging, Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan.
| | - Koji Kamagata
- Department of Radiology, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Daiju Ueda
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3 Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan
| | - Masahiro Yanagawa
- Department of Radiology, Osaka University Graduate School of Medicine, Suita, Osaka, 565-0871, Japan
| | - Mariko Kawamura
- Department of Radiology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan
| | - Takeshi Nakaura
- Department of Diagnostic Radiology, Kumamoto University Graduate School of Medicine, 1-1-1 Honjo Chuo-ku, Kumamoto, 860-8556, Japan
| | - Rintaro Ito
- Department of Radiology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan
| | - Fuminari Tatsugami
- Department of Diagnostic Radiology, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Yusuke Matsui
- Department of Radiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Akira Yamada
- Department of Radiology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-2621, Japan
| | - Yasutaka Fushimi
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Taiki Nozaki
- Department of Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-0016, Japan
| | - Shohei Fujita
- Department of Radiology, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Tomoyuki Fujioka
- Department of Diagnostic Radiology, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Takahiro Tsuboyama
- Department of Radiology, Osaka University Graduate School of Medicine, Suita, Osaka, 565-0871, Japan
| | - Noriyuki Fujima
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, N15, W5, Kita-ku, Sapporo, 060-8638, Japan
| | - Shinji Naganawa
- Department of Radiology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan
| |
Collapse
|
15
|
Roya M, Mostafapour S, Mohr P, Providência L, Li Z, van Snick JH, Brouwers AH, Noordzij W, Willemsen ATM, Dierckx RAJO, Lammertsma AA, Glaudemans AWJM, Tsoumpas C, Slart RHJA, van Sluis J. Current and Future Use of Long Axial Field-of-View Positron Emission Tomography/Computed Tomography Scanners in Clinical Oncology. Cancers (Basel) 2023; 15:5173. [PMID: 37958347 PMCID: PMC10648837 DOI: 10.3390/cancers15215173] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 10/23/2023] [Accepted: 10/24/2023] [Indexed: 11/15/2023] Open
Abstract
The latest technical development in the field of positron emission tomography/computed tomography (PET/CT) imaging has been the extension of the PET axial field-of-view. As a result of the increased number of detectors, the long axial field-of-view (LAFOV) PET systems are not only characterized by a larger anatomical coverage but also by a substantially improved sensitivity, compared with conventional short axial field-of-view PET systems. In clinical practice, this innovation has led to the following optimization: (1) improved overall image quality, (2) decreased duration of PET examinations, (3) decreased amount of radioactivity administered to the patient, or (4) a combination of any of the above. In this review, novel applications of LAFOV PET in oncology are highlighted and future directions are discussed.
Collapse
Affiliation(s)
- Mostafa Roya
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, P.O. Box 30001, 9700 RB Groningen, The Netherlands; (S.M.); (P.M.); (L.P.); (Z.L.); (J.H.v.S.); (A.H.B.); (W.N.); (A.T.M.W.); (R.A.J.O.D.); (A.A.L.); (A.W.J.M.G.); (C.T.); (J.v.S.)
| | - Samaneh Mostafapour
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, P.O. Box 30001, 9700 RB Groningen, The Netherlands; (S.M.); (P.M.); (L.P.); (Z.L.); (J.H.v.S.); (A.H.B.); (W.N.); (A.T.M.W.); (R.A.J.O.D.); (A.A.L.); (A.W.J.M.G.); (C.T.); (J.v.S.)
| | - Philipp Mohr
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, P.O. Box 30001, 9700 RB Groningen, The Netherlands; (S.M.); (P.M.); (L.P.); (Z.L.); (J.H.v.S.); (A.H.B.); (W.N.); (A.T.M.W.); (R.A.J.O.D.); (A.A.L.); (A.W.J.M.G.); (C.T.); (J.v.S.)
| | - Laura Providência
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, P.O. Box 30001, 9700 RB Groningen, The Netherlands; (S.M.); (P.M.); (L.P.); (Z.L.); (J.H.v.S.); (A.H.B.); (W.N.); (A.T.M.W.); (R.A.J.O.D.); (A.A.L.); (A.W.J.M.G.); (C.T.); (J.v.S.)
| | - Zekai Li
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, P.O. Box 30001, 9700 RB Groningen, The Netherlands; (S.M.); (P.M.); (L.P.); (Z.L.); (J.H.v.S.); (A.H.B.); (W.N.); (A.T.M.W.); (R.A.J.O.D.); (A.A.L.); (A.W.J.M.G.); (C.T.); (J.v.S.)
| | - Johannes H. van Snick
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, P.O. Box 30001, 9700 RB Groningen, The Netherlands; (S.M.); (P.M.); (L.P.); (Z.L.); (J.H.v.S.); (A.H.B.); (W.N.); (A.T.M.W.); (R.A.J.O.D.); (A.A.L.); (A.W.J.M.G.); (C.T.); (J.v.S.)
| | - Adrienne H. Brouwers
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, P.O. Box 30001, 9700 RB Groningen, The Netherlands; (S.M.); (P.M.); (L.P.); (Z.L.); (J.H.v.S.); (A.H.B.); (W.N.); (A.T.M.W.); (R.A.J.O.D.); (A.A.L.); (A.W.J.M.G.); (C.T.); (J.v.S.)
| | - Walter Noordzij
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, P.O. Box 30001, 9700 RB Groningen, The Netherlands; (S.M.); (P.M.); (L.P.); (Z.L.); (J.H.v.S.); (A.H.B.); (W.N.); (A.T.M.W.); (R.A.J.O.D.); (A.A.L.); (A.W.J.M.G.); (C.T.); (J.v.S.)
| | - Antoon T. M. Willemsen
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, P.O. Box 30001, 9700 RB Groningen, The Netherlands; (S.M.); (P.M.); (L.P.); (Z.L.); (J.H.v.S.); (A.H.B.); (W.N.); (A.T.M.W.); (R.A.J.O.D.); (A.A.L.); (A.W.J.M.G.); (C.T.); (J.v.S.)
| | - Rudi A. J. O. Dierckx
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, P.O. Box 30001, 9700 RB Groningen, The Netherlands; (S.M.); (P.M.); (L.P.); (Z.L.); (J.H.v.S.); (A.H.B.); (W.N.); (A.T.M.W.); (R.A.J.O.D.); (A.A.L.); (A.W.J.M.G.); (C.T.); (J.v.S.)
| | - Adriaan A. Lammertsma
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, P.O. Box 30001, 9700 RB Groningen, The Netherlands; (S.M.); (P.M.); (L.P.); (Z.L.); (J.H.v.S.); (A.H.B.); (W.N.); (A.T.M.W.); (R.A.J.O.D.); (A.A.L.); (A.W.J.M.G.); (C.T.); (J.v.S.)
| | - Andor W. J. M. Glaudemans
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, P.O. Box 30001, 9700 RB Groningen, The Netherlands; (S.M.); (P.M.); (L.P.); (Z.L.); (J.H.v.S.); (A.H.B.); (W.N.); (A.T.M.W.); (R.A.J.O.D.); (A.A.L.); (A.W.J.M.G.); (C.T.); (J.v.S.)
| | - Charalampos Tsoumpas
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, P.O. Box 30001, 9700 RB Groningen, The Netherlands; (S.M.); (P.M.); (L.P.); (Z.L.); (J.H.v.S.); (A.H.B.); (W.N.); (A.T.M.W.); (R.A.J.O.D.); (A.A.L.); (A.W.J.M.G.); (C.T.); (J.v.S.)
| | - Riemer H. J. A. Slart
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, P.O. Box 30001, 9700 RB Groningen, The Netherlands; (S.M.); (P.M.); (L.P.); (Z.L.); (J.H.v.S.); (A.H.B.); (W.N.); (A.T.M.W.); (R.A.J.O.D.); (A.A.L.); (A.W.J.M.G.); (C.T.); (J.v.S.)
- Department of Biomedical Photonic Imaging, Faculty of Science and Technology, University of Twente, 7522 NB Enchede, The Netherlands
| | - Joyce van Sluis
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, P.O. Box 30001, 9700 RB Groningen, The Netherlands; (S.M.); (P.M.); (L.P.); (Z.L.); (J.H.v.S.); (A.H.B.); (W.N.); (A.T.M.W.); (R.A.J.O.D.); (A.A.L.); (A.W.J.M.G.); (C.T.); (J.v.S.)
| |
Collapse
|
16
|
Gu F, Wu Q. Quantitation of dynamic total-body PET imaging: recent developments and future perspectives. Eur J Nucl Med Mol Imaging 2023; 50:3538-3557. [PMID: 37460750 PMCID: PMC10547641 DOI: 10.1007/s00259-023-06299-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 06/05/2023] [Indexed: 10/04/2023]
Abstract
BACKGROUND Positron emission tomography (PET) scanning is an important diagnostic imaging technique used in disease diagnosis, therapy planning, treatment monitoring, and medical research. The standardized uptake value (SUV) obtained at a single time frame has been widely employed in clinical practice. Well beyond this simple static measure, more detailed metabolic information can be recovered from dynamic PET scans, followed by the recovery of arterial input function and application of appropriate tracer kinetic models. Many efforts have been devoted to the development of quantitative techniques over the last couple of decades. CHALLENGES The advent of new-generation total-body PET scanners characterized by ultra-high sensitivity and long axial field of view, i.e., uEXPLORER (United Imaging Healthcare), PennPET Explorer (University of Pennsylvania), and Biograph Vision Quadra (Siemens Healthineers), further stimulates valuable inspiration to derive kinetics for multiple organs simultaneously. But some emerging issues also need to be addressed, e.g., the large-scale data size and organ-specific physiology. The direct implementation of classical methods for total-body PET imaging without proper validation may lead to less accurate results. CONCLUSIONS In this contribution, the published dynamic total-body PET datasets are outlined, and several challenges/opportunities for quantitation of such types of studies are presented. An overview of the basic equation, calculation of input function (based on blood sampling, image, population or mathematical model), and kinetic analysis encompassing parametric (compartmental model, graphical plot and spectral analysis) and non-parametric (B-spline and piece-wise basis elements) approaches is provided. The discussion mainly focuses on the feasibilities, recent developments, and future perspectives of these methodologies for a diverse-tissue environment.
Collapse
Affiliation(s)
- Fengyun Gu
- School of Mathematics and Physics, North China Electric Power University, 102206, Beijing, China.
- School of Mathematical Sciences, University College Cork, T12XF62, Cork, Ireland.
| | - Qi Wu
- School of Mathematical Sciences, University College Cork, T12XF62, Cork, Ireland
| |
Collapse
|
17
|
Ye Q, Zeng H, Zhao Y, Zhang W, Dong Y, Fan W, Lu Y. Framing protocol optimization in oncological Patlak parametric imaging with uKinetics. EJNMMI Phys 2023; 10:54. [PMID: 37698773 PMCID: PMC10497476 DOI: 10.1186/s40658-023-00577-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 09/05/2023] [Indexed: 09/13/2023] Open
Abstract
PURPOSE Total-body PET imaging with ultra-high sensitivity makes high-temporal-resolution framing protocols possible for the first time, which allows to capture rapid tracer dynamic changes. However, whether protocols with higher number of temporal frames can justify the efficacy with substantially added computation burden for clinical application remains unclear. We have developed a kinetic modeling software package (uKinetics) with the advantage of practical, fast, and automatic workflow for dynamic total-body studies. The aim of this work is to verify the uKinetics with PMOD and to perform framing protocol optimization for the oncological Patlak parametric imaging. METHODS Six different protocols with 100, 61, 48, 29, 19 and 12 temporal frames were applied to analyze 60-min dynamic 18F-FDG PET scans of 10 patients, respectively. Voxel-based Patlak analysis coupled with automatically extracted image-derived input function was applied to generate parametric images. Normal tissues and lesions were segmented manually or automatically to perform correlation analysis and Bland-Altman plots. Different protocols were compared with the protocol of 100 frames as reference. RESULTS Minor differences were found between uKinetics and PMOD in the Patlak parametric imaging. Compared with the protocol with 100 frames, the relative difference of the input function and quantitative kinetic parameters remained low for protocols with at least 29 frames, but increased for the protocols with 19 and 12 frames. Significant difference of lesion Ki values was found between the protocols with 100 frames and 12 frames. CONCLUSION uKinetics was proved providing equivalent oncological Patlak parametric imaging comparing to PMOD. Minor differences were found between protocols with 100 and 29 frames, which indicated that 29-frame protocol is sufficient and efficient for the oncological 18F-FDG Patlak applications, and the protocols with more frames are not needed. The protocol with 19 frames yielded acceptable results, while that with 12 frames is not recommended.
Collapse
Affiliation(s)
- Qing Ye
- Shanghai United Imaging Healthcare Co., Ltd, Shanghai, China
| | - Hao Zeng
- Shanghai United Imaging Healthcare Co., Ltd, Shanghai, China
| | - Yizhang Zhao
- Shanghai United Imaging Healthcare Co., Ltd, Shanghai, China
| | | | - Yun Dong
- Shanghai United Imaging Healthcare Co., Ltd, Shanghai, China
| | - Wei Fan
- Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - Yihuan Lu
- Shanghai United Imaging Healthcare Co., Ltd, Shanghai, China.
| |
Collapse
|
18
|
Meng N, Zhang M, Ren J, Fu F, Xie B, Wu Y, Li Z, Dai B, Li Y, Feng T, Xu T, Wang M. Quantitative parameters of static imaging and fast kinetics imaging in 18F-FDG total-body PET/CT for the assessment of histological feature of pulmonary lesions. Quant Imaging Med Surg 2023; 13:5579-5592. [PMID: 37711783 PMCID: PMC10498229 DOI: 10.21037/qims-23-186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 06/30/2023] [Indexed: 09/16/2023]
Abstract
Background To investigate the value of quantitative parameters related to static imaging and fast kinetics imaging of total-body (TB) 2-[18F]-fluoro-2-deoxy-D-glucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) in differentiating benign from malignant pulmonary lesions and squamous cell carcinoma (SCC) from adenocarcinoma (AC) and to analyze the correlation of each parameter with the Ki-67 index. Methods A total of 108 patients with pulmonary lesions from July 2021 to May 2022 in the Henan Provincial People's Hospital, China, were consecutively recruited for TB 18F-FDG PET/CT in this prospective study. Static imaging parameters maximum standardized uptake value (SUVmax) and fast kinetics imaging parameters transport constant (K1), rate constants (k2), time delay (td), and fractional blood volume (vb) were calculated and compared. The area under the receiver operating characteristic (ROC) curve (AUC), Delong test, Logistic regression analyses, and Pearson correlation were used to assess diagnostic efficacy, find independent predictors and analyse correlations respectively. Results Malignant lesions had higher SUVmax and K1 and lower vb than benign lesions, and SCC had higher SUVmax and K1 and lower td and vb than AC (all P<0.05). For the differentiation of benign and malignant lesions, SUVmax, K1, and vb were independent predictors, and AUC (SUVmax + K1+ vb) =0.909 (95% CI: 0.839-0.956), AUC (SUVmax) =0.883 (95% CI: 0.807-0.937), AUC (K1) =0.810 (95% CI: 0.723-0.879), and AUC (vb) =0.746 (95% CI: 0.653-0.825), where AUC (SUVmax + K1+ vb) was significantly different from AUC (K1), AUC (vb) (Z=3.006, 3.965, all P<0.05). For the differentiation of SCC and AC, SUVmax, K1, td, and vb were independent predictors, and AUC (SUVmax + K1+ td + vb) =0.946 (95% CI: 0.840-0.991), AUC (SUVmax) =0.818 (95% CI: 0.680-0.914), AUC (K1) =0.770 (95% CI: 0.626-0.879), AUC (vb) =0.737 (95% CI: 0.590-0.853), and AUC (td) =0.669 (95% CI: 0.510-0.791), where AUC (SUVmax + K1+ td + vb) was significantly different from AUC (SUVmax), AUC (K1), AUC (vb), and AUC (td) (Z=2.269, 2.821, 2.848, and 3.276, all P<0.05). SUVmax and K1 were moderately and mildly positively correlated with the Ki-67 index (r=0.541, 0.452, all P<0.05), respectively. Conclusions Quantitative parameters of static imaging and fast kinetics imaging in 18F-FDG total-body PET/CT can be used to differentiate benign from malignant pulmonary lesions and SCC from AC and to assess Ki-67 expression.
Collapse
Affiliation(s)
- Nan Meng
- Department of Medical Imaging, Henan Provincial People’s Hospital & Zhengzhou University People’s Hospital, Zhengzhou, China
- Laboratory of Brain Science and Brain-Like Intelligence Technology, Biomedical Research Institute, Henan Academy of Sciences, Zhengzhou, China
| | - Meng Zhang
- Department of MR, The First Affiliated Hospital, Xinxiang Medical University, Weihui, China
| | - Jipeng Ren
- Department of MR, The First Affiliated Hospital, Xinxiang Medical University, Weihui, China
| | - Fangfang Fu
- Department of Medical Imaging, Henan Provincial People’s Hospital & Zhengzhou University People’s Hospital, Zhengzhou, China
| | - Beichen Xie
- Department of MR, The First Affiliated Hospital, Xinxiang Medical University, Weihui, China
| | - Yaping Wu
- Department of Medical Imaging, Henan Provincial People’s Hospital & Zhengzhou University People’s Hospital, Zhengzhou, China
| | - Zhong Li
- Department of MR, The First Affiliated Hospital, Xinxiang Medical University, Weihui, China
| | - Bo Dai
- Department of Medical Imaging, Henan Provincial People’s Hospital & Zhengzhou University People’s Hospital, Zhengzhou, China
| | - Yuxia Li
- Department of MR, The First Affiliated Hospital, Xinxiang Medical University, Weihui, China
| | - Tao Feng
- United Imaging Healthcare America Inc. TX, USA
| | - Tianyi Xu
- United Imaging Healthcare, Shanghai, China
| | - Meiyun Wang
- Department of Medical Imaging, Henan Provincial People’s Hospital & Zhengzhou University People’s Hospital, Zhengzhou, China
- Laboratory of Brain Science and Brain-Like Intelligence Technology, Biomedical Research Institute, Henan Academy of Sciences, Zhengzhou, China
| |
Collapse
|
19
|
Li J, Ni B, Yu X, Wang C, Li L, Zhou Y, Gu Y, Huang G, Hou J, Liu J, Chen Y. Metabolic kinetic modeling of [ 11C]methionine based on total-body PET in multiple myeloma. Eur J Nucl Med Mol Imaging 2023; 50:2683-2691. [PMID: 37039900 DOI: 10.1007/s00259-023-06219-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 04/02/2023] [Indexed: 04/12/2023]
Abstract
PURPOSE Multiple myeloma (MM) is a malignant disease characterized by the secretion of monoclonal immunoglobulins and has a high demand for amino acids. [11C]methionine total-body PET is capable of noninvasive dynamic monitoring of radiotracer in vivo, thus providing a way to reveal the dynamic changes of myeloma metabolism. This study aims to analyze the metabolic process of [11C]methionine based on kinetic modeling, and to preliminary reveal its application value in MM. METHODS Dynamic total-body [11C]methionine PET/CT was conducted with uEXPLORER in 12 subjects (9 MM patients and 3 controls). The tissue time activity curves (TACs) of organs and bone marrows were extracted. Model fitting of TACs was operated using PMOD Kinetic Modeling. After validation by Goodness of fit (GOF), the reversible two-tissue compartment model (2T4k) was used to further analysis. R software was used to analyze the correlation between kinetic parameters and clinical indicators. RESULTS The 2T4k has passed the criterion of GOF and was used to fit the data of 0-20 minutes. The [11C]methionine net uptake rate (Ki) was significantly higher in the MM lesions than in the non-myeloma controls (control: 0.040±0.007 mL/g/min, MM: 0.171±0.108 mL/g/min, p=0.009). The Ki values were found to be correlated with M protein levels in MM patients. MM patients with t(4;14) translocations had an elevated k4 value compared with t(4;14) negative patients. CONCLUSION MM lesions have a propensity for uptake of [11C]methionine. The serum levels of M protein are correlated with [11C]methionine uptake rate in myeloma. Metabolic classification based on the k4 value may be a promising strategy for risk stratification in MM.
Collapse
Affiliation(s)
- Jiajin Li
- Department of Nuclear Medicine, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200127, China
| | - Beiwen Ni
- Department of Hematology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200127, China
| | - Xiaofeng Yu
- Department of Nuclear Medicine, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200127, China
| | - Cheng Wang
- Department of Nuclear Medicine, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200127, China
| | - Lianghua Li
- Department of Nuclear Medicine, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200127, China
| | - Yun Zhou
- Central Research Institute, United Imaging Healthcare Group Co., Ltd, Shanghai, 200032, China
| | - Yue Gu
- Central Research Institute, United Imaging Healthcare Group Co., Ltd, Shanghai, 200032, China
| | - Gang Huang
- Department of Nuclear Medicine, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200127, China
- Shanghai Key Laboratory of Molecular Imaging, Shanghai University of Medicine and Health Sciences, Shanghai, 201318, China
| | - Jian Hou
- Department of Hematology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200127, China.
| | - Jianjun Liu
- Department of Nuclear Medicine, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200127, China.
| | - Yumei Chen
- Department of Nuclear Medicine, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200127, China.
| |
Collapse
|
20
|
Hou X, Guo P, Wang P, Liu P, Lin DDM, Fan H, Li Y, Wei Z, Lin Z, Jiang D, Jin J, Kelly C, Pillai JJ, Huang J, Pinho MC, Thomas BP, Welch BG, Park DC, Patel VM, Hillis AE, Lu H. Deep-learning-enabled brain hemodynamic mapping using resting-state fMRI. NPJ Digit Med 2023; 6:116. [PMID: 37344684 PMCID: PMC10284915 DOI: 10.1038/s41746-023-00859-y] [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: 10/10/2022] [Accepted: 06/09/2023] [Indexed: 06/23/2023] Open
Abstract
Cerebrovascular disease is a leading cause of death globally. Prevention and early intervention are known to be the most effective forms of its management. Non-invasive imaging methods hold great promises for early stratification, but at present lack the sensitivity for personalized prognosis. Resting-state functional magnetic resonance imaging (rs-fMRI), a powerful tool previously used for mapping neural activity, is available in most hospitals. Here we show that rs-fMRI can be used to map cerebral hemodynamic function and delineate impairment. By exploiting time variations in breathing pattern during rs-fMRI, deep learning enables reproducible mapping of cerebrovascular reactivity (CVR) and bolus arrival time (BAT) of the human brain using resting-state CO2 fluctuations as a natural "contrast media". The deep-learning network is trained with CVR and BAT maps obtained with a reference method of CO2-inhalation MRI, which includes data from young and older healthy subjects and patients with Moyamoya disease and brain tumors. We demonstrate the performance of deep-learning cerebrovascular mapping in the detection of vascular abnormalities, evaluation of revascularization effects, and vascular alterations in normal aging. In addition, cerebrovascular maps obtained with the proposed method exhibit excellent reproducibility in both healthy volunteers and stroke patients. Deep-learning resting-state vascular imaging has the potential to become a useful tool in clinical cerebrovascular imaging.
Collapse
Affiliation(s)
- Xirui Hou
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Pengfei Guo
- Department of Computer Science, Johns Hopkins University, Baltimore, MD, USA
| | - Puyang Wang
- Department of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Peiying Liu
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Doris D M Lin
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Hongli Fan
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Yang Li
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Zhiliang Wei
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Zixuan Lin
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Dengrong Jiang
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jin Jin
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Catherine Kelly
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jay J Pillai
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Judy Huang
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Marco C Pinho
- Department of Radiology, UT Southwestern Medical Center, Dallas, TX, USA
| | - Binu P Thomas
- Department of Radiology, UT Southwestern Medical Center, Dallas, TX, USA
| | - Babu G Welch
- Department of Neurologic Surgery, UT Southwestern Medical Center, Dallas, TX, USA
- Center for Vital Longevity, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, TX, USA
| | - Denise C Park
- Center for Vital Longevity, School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, TX, USA
| | - Vishal M Patel
- Department of Computer Science, Johns Hopkins University, Baltimore, MD, USA
- Department of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Argye E Hillis
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Hanzhang Lu
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA.
| |
Collapse
|
21
|
Wang H, Wu Y, Huang Z, Li Z, Zhang N, Fu F, Meng N, Wang H, Zhou Y, Yang Y, Liu X, Liang D, Zheng H, Mok GSP, Wang M, Hu Z. Deep learning-based dynamic PET parametric K i image generation from lung static PET. Eur Radiol 2023; 33:2676-2685. [PMID: 36399164 DOI: 10.1007/s00330-022-09237-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 09/30/2022] [Accepted: 10/12/2022] [Indexed: 11/19/2022]
Abstract
OBJECTIVES PET/CT is a first-line tool for the diagnosis of lung cancer. The accuracy of quantification may suffer from various factors throughout the acquisition process. The dynamic PET parametric Ki provides better quantification and improve specificity for cancer detection. However, parametric imaging is difficult to implement clinically due to the long acquisition time (~ 1 h). We propose a dynamic parametric imaging method based on conventional static PET using deep learning. METHODS Based on the imaging data of 203 participants, an improved cycle generative adversarial network incorporated with squeeze-and-excitation attention block was introduced to learn the potential mapping relationship between static PET and Ki parametric images. The image quality of the synthesized images was qualitatively and quantitatively evaluated by using several physical and clinical metrics. Statistical analysis of correlation and consistency was also performed on the synthetic images. RESULTS Compared with those of other networks, the images synthesized by our proposed network exhibited superior performance in both qualitative and quantitative evaluation, statistical analysis, and clinical scoring. Our synthesized Ki images had significant correlation (Pearson correlation coefficient, 0.93), consistency, and excellent quantitative evaluation results with the Ki images obtained in standard dynamic PET practice. CONCLUSIONS Our proposed deep learning method can be used to synthesize highly correlated and consistent dynamic parametric images obtained from static lung PET. KEY POINTS • Compared with conventional static PET, dynamic PET parametric Ki imaging has been shown to provide better quantification and improved specificity for cancer detection. • The purpose of this work was to develop a dynamic parametric imaging method based on static PET images using deep learning. • Our proposed network can synthesize highly correlated and consistent dynamic parametric images, providing an additional quantitative diagnostic reference for clinicians.
Collapse
Affiliation(s)
- Haiyan Wang
- Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China.,Biomedical Imaging Laboratory (BIG), Department of Electrical and Computer Engineering, Faculty of Science and Technology, University of Macau, Avenida da Universidade, Macau, 999078, SAR, China
| | - Yaping Wu
- Department of Medical Imaging, Henan Provincial People's Hospital & People's Hospital of Zhengzhou University, Zhengzhou, 450003, China
| | - Zhenxing Huang
- Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
| | - Zhicheng Li
- Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
| | - Na Zhang
- Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
| | - Fangfang Fu
- Department of Medical Imaging, Henan Provincial People's Hospital & People's Hospital of Zhengzhou University, Zhengzhou, 450003, China
| | - Nan Meng
- Department of Medical Imaging, Henan Provincial People's Hospital & People's Hospital of Zhengzhou University, Zhengzhou, 450003, China
| | - Haining Wang
- Shenzhen United Imaging Research Institute of Innovative Medical Equipment, Shenzhen, 518045, China
| | - Yun Zhou
- Central Research Institute, United Imaging Healthcare Group, Shanghai, 201807, China
| | - Yongfeng Yang
- Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
| | - Xin Liu
- Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
| | - Dong Liang
- Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
| | - Hairong Zheng
- Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
| | - Greta S P Mok
- Biomedical Imaging Laboratory (BIG), Department of Electrical and Computer Engineering, Faculty of Science and Technology, University of Macau, Avenida da Universidade, Macau, 999078, SAR, China
| | - Meiyun Wang
- Department of Medical Imaging, Henan Provincial People's Hospital & People's Hospital of Zhengzhou University, Zhengzhou, 450003, China.
| | - Zhanli Hu
- Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China.
| |
Collapse
|
22
|
Alberts I, Schepers R, Zeimpekis K, Sari H, Rominger A, Afshar-Oromieh A. Authors' reply to Dr. Paolo Duarte: Combined [68Ga]Ga-PSMA-11 and low-dose [18F]FDG PET/CT using a long-axial field of view scanner for patients referred for [177Lu]-PSMA-radioligand therapy. Eur J Nucl Med Mol Imaging 2023; 50:644-647. [PMID: 36543899 DOI: 10.1007/s00259-022-06071-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 11/29/2022] [Indexed: 12/24/2022]
Affiliation(s)
- Ian Alberts
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
| | - Robin Schepers
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Konstantinos Zeimpekis
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Hasan Sari
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.,Advanced Clinical Imaging Technology, Siemens Healthcare AG, Lausanne, Switzerland
| | - Axel Rominger
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Ali Afshar-Oromieh
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| |
Collapse
|
23
|
Du J, Jones T. Technical opportunities and challenges in developing total-body PET scanners for mice and rats. EJNMMI Phys 2023; 10:2. [PMID: 36592266 PMCID: PMC9807733 DOI: 10.1186/s40658-022-00523-6] [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: 12/09/2021] [Accepted: 12/20/2022] [Indexed: 01/03/2023] Open
Abstract
Positron emission tomography (PET) is the most sensitive in vivo molecular imaging technique available. Small animal PET has been widely used in studying pharmaceutical biodistribution and disease progression over time by imaging a wide range of biological processes. However, it remains true that almost all small animal PET studies using mouse or rat as preclinical models are either limited by the spatial resolution or the sensitivity (especially for dynamic studies), or both, reducing the quantitative accuracy and quantitative precision of the results. Total-body small animal PET scanners, which have axial lengths longer than the nose-to-anus length of the mouse/rat and can provide high sensitivity across the entire body of mouse/rat, can realize new opportunities for small animal PET. This article aims to discuss the technical opportunities and challenges in developing total-body small animal PET scanners for mice and rats.
Collapse
Affiliation(s)
- Junwei Du
- grid.27860.3b0000 0004 1936 9684Department of Biomedical Engineering, University of California at Davis, Davis, CA 95616 USA
| | - Terry Jones
- grid.27860.3b0000 0004 1936 9684Department of Radiology, University of California at Davis, Davis, CA 95616 USA
| |
Collapse
|
24
|
Sari H, Eriksson L, Mingels C, Alberts I, Casey ME, Afshar-Oromieh A, Conti M, Cumming P, Shi K, Rominger A. Feasibility of using abbreviated scan protocols with population-based input functions for accurate kinetic modeling of [ 18F]-FDG datasets from a long axial FOV PET scanner. Eur J Nucl Med Mol Imaging 2023; 50:257-265. [PMID: 36192468 PMCID: PMC9816288 DOI: 10.1007/s00259-022-05983-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 09/20/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND Accurate kinetic modeling of 18F-fluorodeoxyglucose ([18F]-FDG) positron emission tomography (PET) data requires accurate knowledge of the available tracer concentration in the plasma during the scan time, known as the arterial input function (AIF). The gold standard method to derive the AIF requires collection of serial arterial blood samples, but the introduction of long axial field of view (LAFOV) PET systems enables the use of non-invasive image-derived input functions (IDIFs) from large blood pools such as the aorta without any need for bed movement. However, such protocols require a prolonged dynamic PET acquisition, which is impractical in a busy clinical setting. Population-based input functions (PBIFs) have previously shown potential in accurate Patlak analysis of [18F]-FDG datasets and can enable the use of shortened dynamic imaging protocols. Here, we exploit the high sensitivity and temporal resolution of a LAFOV PET system and explore the use of PBIF with abbreviated protocols in [18F]-FDG total body kinetic modeling. METHODS Dynamic PET data were acquired in 24 oncological subjects for 65 min following the administration of [18F]-FDG. IDIFs were extracted from the descending thoracic aorta, and a PBIF was generated from 16 datasets. Five different scaled PBIFs (sPBIFs) were generated by scaling the PBIF with the AUC of IDIF curve tails using various portions of image data (35-65, 40-65, 45-65, 50-65, and 55-65 min post-injection). The sPBIFs were compared with the IDIFs using the AUCs and Patlak Ki estimates in tumor lesions and cerebral gray matter. Patlak plot start time (t*) was also varied to evaluate the performance of shorter acquisitions on the accuracy of Patlak Ki estimates. Patlak Ki estimates with IDIF and t* = 35 min were used as reference, and mean bias and precision (standard deviation of bias) were calculated to assess the relative performance of different sPBIFs. A comparison of parametric images generated using IDIF and sPBIFs was also performed. RESULTS There was no statistically significant difference between AUCs of the IDIF and sPBIFs (Wilcoxon test: P > 0.05). Excellent agreement was shown between Patlak Ki estimates obtained using sPBIF and IDIF. Using the sPBIF55-65 with the Patlak model, 20 min of PET data (i.e., 45 to 65 min post-injection) achieved < 15% precision error in Ki estimates in tumor lesions compared to the estimates with the IDIF. Parametric images reconstructed using the IDIF and sPBIFs with and without an abbreviated protocol were visually comparable. Using Patlak Ki generated with an IDIF and 30 min of PET data as reference, Patlak Ki images generated using sPBIF55-65 with 20 min of PET data (t* = 45 min) provided excellent image quality with structural similarity index measure > 0.99 and peak signal-to-noise ratio > 55 dB. CONCLUSION We demonstrate the feasibility of performing accurate [18F]-FDG Patlak analysis using sPBIFs with only 20 min of PET data from a LAFOV PET scanner.
Collapse
Affiliation(s)
- Hasan Sari
- Advanced Clinical Imaging Technology, Siemens Healthcare AG, Lausanne, Switzerland.
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 18, 3010, Bern, Switzerland.
| | - Lars Eriksson
- Siemens Medical Solutions USA, Inc., Knoxville, TN, USA
- Department of Oncology and Pathology, Medical Radiation Physics, Karolinska Institutet, Stockholm, Sweden
| | - Clemens Mingels
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 18, 3010, Bern, Switzerland
| | - Ian Alberts
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 18, 3010, Bern, Switzerland
| | | | - Ali Afshar-Oromieh
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 18, 3010, Bern, Switzerland
| | | | - Paul Cumming
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 18, 3010, Bern, Switzerland
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, Australia
| | - Kuangyu Shi
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 18, 3010, Bern, Switzerland
| | - Axel Rominger
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 18, 3010, Bern, Switzerland
| |
Collapse
|
25
|
Combined [68 Ga]Ga-PSMA-11 and low-dose 2-[18F]FDG PET/CT using a long-axial field of view scanner for patients referred for [177Lu]-PSMA-radioligand therapy. Eur J Nucl Med Mol Imaging 2023; 50:951-956. [PMID: 36136102 PMCID: PMC9852199 DOI: 10.1007/s00259-022-05961-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 09/01/2022] [Indexed: 01/24/2023]
Abstract
PURPOSE Performing 2-[18F]FDG PET/CT in addition to a PSMA-ligand PET/CT can assist in the detection of lesions with low PSMA expression and may help in prognostication and identification of patients who likely benefit from PSMA-radioligand therapy (PSMA-RLT). However, the cost and time needed for a separate PET/CT examination might hinder its routine implementation. In this communication, we present our initial experiences with additional low-dose 2-[18F]FDG PET/CT as part of a dual-tracer and same-day imaging protocol which exploits the higher sensitivity exhibited by long-axial field-of-view (LAFOV) and total-body PET/CT systems and demonstrates its feasibility. METHODS Fourteen patients referred for evaluation for PSMA-RLT received [68 Ga]Ga-PSMA-11 PET/CT at 1 h p.i. with a standard activity of 150 MBq and an additional low-dose 2-[18F]FDG PET/CT with 40 MBq 1 h thereafter using a long-axial field-of-view PET/CT system in a single sitting and as per institutional protocol. Scans were scrutinized by two experienced nuclear medicine physicians for mismatch findings. RESULTS The combined protocol identified additional lesions with low or absent PSMA-expression but high FDG-avidity in 1/14 (7%) patients. The protocol was easily implemented and well tolerated by all patients. CONCLUSION Additional low-dose 2-[18F]FDG-PET/CT is feasible as part of a same-day imaging protocol and can help reveal lesions of low PSMA avidity as part of therapy assessment for [177Lu]-PSMA radioligand therapy and demonstrates higher sensitivity compared to [68 Ga]Ga-PSMA-11 PET/CT alone in some patients.
Collapse
|
26
|
Sun T, Wu Y, Wei W, Fu F, Meng N, Chen H, Li X, Bai Y, Wang Z, Ding J, Hu D, Chen C, Hu Z, Liang D, Liu X, Zheng H, Yang Y, Zhou Y, Wang M. Motion correction and its impact on quantification in dynamic total-body 18F-fluorodeoxyglucose PET. EJNMMI Phys 2022; 9:62. [PMID: 36104468 PMCID: PMC9474756 DOI: 10.1186/s40658-022-00493-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 09/01/2022] [Indexed: 12/17/2022] Open
Abstract
Background The total-body positron emission tomography (PET) scanner provides an unprecedented opportunity to scan the whole body simultaneously, thanks to its long axial field of view and ultrahigh temporal resolution. To fully utilize this potential in clinical settings, a dynamic scan would be necessary to obtain the desired kinetic information from scan data. However, in a long dynamic acquisition, patient movement can degrade image quality and quantification accuracy. Methods In this work, we demonstrated a motion correction framework and its importance in dynamic total-body FDG PET imaging. Dynamic FDG scans from 12 subjects acquired on a uEXPLORER PET/CT were included. In these subjects, 7 are healthy subjects and 5 are those with tumors in the thorax and abdomen. All scans were contaminated by motion to some degree, and for each the list-mode data were reconstructed into 1-min frames. The dynamic frames were aligned to a reference position by sequentially registering each frame to its previous neighboring frame. We parametrized the motion fields in-between frames as diffeomorphism, which can map the shape change of the object smoothly and continuously in time and space. Diffeomorphic representations of motion fields were derived by registering neighboring frames using large deformation diffeomorphic metric matching. When all pairwise registrations were completed, the motion field at each frame was obtained by concatenating the successive motion fields and transforming that frame into the reference position. The proposed correction method was labeled SyN-seq. The method that was performed similarly, but aligned each frame to a designated middle frame, was labeled as SyN-mid. Instead of SyN, the method that performed the sequential affine registration was labeled as Aff-seq. The original uncorrected images were labeled as NMC. Qualitative and quantitative analyses were performed to compare the performance of the proposed method with that of other correction methods and uncorrected images. Results The results indicated that visual improvement was achieved after correction of the SUV images for the motion present period, especially in the brain and abdomen. For subjects with tumors, the average improvement in tumor SUVmean was 5.35 ± 4.92% (P = 0.047), with a maximum improvement of 12.89%. An overall quality improvement in quantitative Ki images was also observed after correction; however, such improvement was less obvious in K1 images. Sampled time–activity curves in the cerebral and kidney cortex were less affected by the motion after applying the proposed correction. Mutual information and dice coefficient relative to the reference also demonstrated that SyN-seq improved the alignment between frames over non-corrected images (P = 0.003 and P = 0.011). Moreover, the proposed correction successfully reduced the inter-subject variability in Ki quantifications (11.8% lower in sampled organs). Subjective assessment by experienced radiologists demonstrated consistent results for both SUV images and Ki images. Conclusion To conclude, motion correction is important for image quality in dynamic total-body PET imaging. We demonstrated a correction framework that can effectively reduce the effect of random body movements on dynamic images and their associated quantification. The proposed correction framework can potentially benefit applications that require total-body assessment, such as imaging the brain-gut axis and systemic diseases.
Collapse
|
27
|
Wang Z, Wu Y, Li X, Bai Y, Chen H, Ding J, Shen C, Hu Z, Liang D, Liu X, Zheng H, Yang Y, Zhou Y, Wang M, Sun T. Comparison between a dual-time-window protocol and other simplified protocols for dynamic total-body 18F-FDG PET imaging. EJNMMI Phys 2022; 9:63. [PMID: 36104580 PMCID: PMC9474964 DOI: 10.1186/s40658-022-00492-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 08/29/2022] [Indexed: 11/10/2022] Open
Abstract
Purpose Efforts have been made both to avoid invasive blood sampling and to shorten the scan duration for dynamic positron emission tomography (PET) imaging. A total-body scanner, such as the uEXPLORER PET/CT, can relieve these challenges through the following features: First, the whole-body coverage allows for noninvasive input function from the aortic arteries; second, with a dramatic increase in sensitivity, image quality can still be maintained at a high level even with a shorter scan duration than usual. We implemented a dual-time-window (DTW) protocol for a dynamic total-body 18F-FDG PET scan to obtain multiple kinetic parameters. The DTW protocol was then compared to several other simplified quantification methods for total-body FDG imaging that were proposed for conventional setup. Methods The research included 28 patient scans performed on an uEXPLORER PET/CT. By discarding the corresponding data in the middle of the existing full 60-min dynamic scan, the DTW protocol was simulated. Nonlinear fitting was used to estimate the missing data in the interval. The full input function was obtained from 15 subjects using a hybrid approach with a population-based image-derived input function. Quantification was carried out in three areas: the cerebral cortex, muscle, and tumor lesion. Micro- and macro-kinetic parameters for different scan durations were estimated by assuming an irreversible two-tissue compartment model. The visual performance of parametric images and region of interest-based quantification in several parameters were evaluated. Furthermore, simplified quantification methods (DTW, Patlak, fractional uptake ratio [FUR], and standardized uptake value [SUV]) were compared for similarity to the reference net influx rate Ki. Results Ki and K1 derived from the DTW protocol showed overall good consistency (P < 0.01) with the reference from the 60-min dynamic scan with 10-min early scan and 5-min late scan (Ki correlation: 0.971, 0.990, and 0.990; K1 correlation: 0.820, 0.940, and 0.975 in the cerebral cortex, muscle, and tumor lesion, respectively). Similar correlationss were found for other micro-parameters. The DTW protocol had the lowest bias relative to standard Ki than any of the quantification methods, followed by FUR and Patlak. SUV had the weakest correlation with Ki. The whole-body Ki and K1 images generated by the DTW protocol were consistent with the reference parametric images. Conclusions Using the DTW protocol, the dynamic total-body FDG scan time can be reduced to 15 min while obtaining accurate Ki and K1 quantification and acceptable visual performance in parametric images. However, the trade-off between quantification accuracy and protocol implementation feasibility must be considered in practice. We recommend that the DTW protocol be used when the clinical task requires reliable visual assessment or quantifying multiple micro-parameters; FUR with a hybrid input function may be a more feasible approach to quantifying regional metabolic rate with a known lesion position or organs of interest. Supplementary Information The online version contains supplementary material available at 10.1186/s40658-022-00492-w.
Collapse
|
28
|
Viswanath V, Sari H, Pantel AR, Conti M, Daube-Witherspoon ME, Mingels C, Alberts I, Eriksson L, Shi K, Rominger A, Karp JS. Abbreviated scan protocols to capture 18F-FDG kinetics for long axial FOV PET scanners. Eur J Nucl Med Mol Imaging 2022; 49:3215-3225. [PMID: 35278108 PMCID: PMC10695012 DOI: 10.1007/s00259-022-05747-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 02/25/2022] [Indexed: 12/14/2022]
Abstract
PURPOSE Kinetic parameters from dynamic 18F-fluorodeoxyglucose (FDG) imaging offer complementary insights to the study of disease compared to static clinical imaging. However, dynamic imaging protocols are cumbersome due to the long acquisition time. Long axial field-of-view (LAFOV) PET scanners (> 70 cm) have two advantages for dynamic imaging over clinical PET scanners with a standard axial field-of-view (SAFOV; 16-30 cm). The large axial coverage enables multi-organ dynamic imaging in a single bed position, and the high sensitivity may enable clinically routine abbreviated dynamic imaging protocols. METHODS In this work, we studied two abbreviated protocols using data from a 65-min dynamic 18F-FDG scan: (A) dynamic imaging immediately post-injection (p.i.) for variable durations, and (B) dynamic imaging immediately p.i. for variable durations plus a 1-h p.i. (5-min-long) datapoint. Nine cancer patients were imaged on the Biograph Vision Quadra (Siemens Healthineers). Time-activity curves over the lesions (N = 39) were fitted using the Patlak graphical analysis and a 2-tissue-compartment (2C, k4 = 0) model for variable scan durations (5-60 min). Kinetic parameters from the complete dataset served as the reference. Lesions from all cancers were grouped into low, medium, and high flux groups, and bias and precision of Ki (Patlak) and Ki, K1, k2, and k3 (2C) were calculated for each group. RESULTS Using only early dynamic data with the 2C (or Patlak) model, accurate quantification of Ki required at least 50 (or 55) min of dynamic data for low flux lesions, at least 30 (or 40) min for medium flux lesions, and at least 15 (or 20) min for high flux lesions to achieve both 10% bias and precision. The addition of the final (5-min) datapoint allowed for accurate quantification of Ki with a bias and precision of 10% using only 10-15 min of early dynamic data for either model. CONCLUSION Dynamic imaging for 10-15 min immediately p.i. followed by a 5-min scan at 1-h p.i can accurately and precisely quantify 18F-FDG on a long axial FOV scanner, potentially allowing for more widespread use of dynamic 18F-FDG imaging.
Collapse
Affiliation(s)
- Varsha Viswanath
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Hasan Sari
- Advanced Clinical Imaging Technology, Siemens Healthcare AG, Lausanne, Switzerland
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, 18, 3010, Bern, Switzerland
| | - Austin R Pantel
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | | | | | - Clemens Mingels
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, 18, 3010, Bern, Switzerland
| | - Ian Alberts
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, 18, 3010, Bern, Switzerland
| | - Lars Eriksson
- Siemens Medical Solutions, USA Inc., Knoxville, TN, USA
- Department of Oncology and Pathology, Medical Radiation Physics, Karolinska Institutet, Stockholm, Sweden
| | - Kuangyu Shi
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, 18, 3010, Bern, Switzerland
| | - Axel Rominger
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, 18, 3010, Bern, Switzerland
| | - Joel S Karp
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| |
Collapse
|
29
|
Yu H, Gu Y, Fan W, Gao Y, Wang M, Zhu X, Wu Z, Liu J, Li B, Wu H, Cheng Z, Wang S, Zhang Y, Xu B, Li S, Shi H. Expert consensus on oncological [ 18F]FDG total-body PET/CT imaging (version 1). Eur Radiol 2022; 33:615-626. [PMID: 35751696 DOI: 10.1007/s00330-022-08960-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 06/04/2022] [Accepted: 06/09/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND [18F]FDG imaging on total-body PET/CT (TB PET/CT) scanners, with improved sensitivity, offers new potentials for cancer diagnosis, staging, and radiation treatment planning. This consensus provides the protocols for clinical practices with a goal of paving the way for future studies with the total-body scanners in oncological [18F]FDG TB PET/CT imaging. METHODS The consensus was summarized based on the published guidelines and peer-reviewed articles of TB PET/CT in the literature, along with the opinions of the experts from major research institutions with a total of 40,000 cases performed on the TB PET/CT scanners. RESULTS This consensus describes the protocols for routine and dynamic [18F]FDG TB PET/CT scanning focusing on the reduction of imaging acquisition time and FDG injected activity, which may serve as a reference for research and clinic oncological PET/CT studies. CONCLUSION This expert consensus focuses on the reduction of acquisition time and FDG injected activity with a TB PET/CT scanner, which may improve the patient throughput or reduce the radiation exposure in daily clinical oncologic imaging. KEY POINTS • [18F]FDG-imaging protocols for oncological total-body PET/CT with reduced acquisition time or with different FDG activity levels have been summarized from multicenter studies. • Total-body PET/CT provides better image quality and improved diagnostic insights. • Clinical workflow and patient management have been improved.
Collapse
Affiliation(s)
- Haojun Yu
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.,Shanghai Institute of Medical Imaging, Shanghai, 200032, China.,Institute of Nuclear Medicine, Fudan University, Shanghai, 200032, China.,Cancer Prevention and Treatment Center, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Yushen Gu
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.,Shanghai Institute of Medical Imaging, Shanghai, 200032, China.,Institute of Nuclear Medicine, Fudan University, Shanghai, 200032, China.,Cancer Prevention and Treatment Center, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Wei Fan
- Department of Nuclear Medicine, Sun Yat-sen University Cancer Center, No. 651 Dongfendong Road, Guangzhou, 510060, China
| | - Yongju Gao
- Department of Nuclear Medicine, Henan Provincial People's Hospital, Henan Key Laboratory of Noval Molecular Probes and Clinical Translation in Nuclear Medicine, No. 7 Weiwu Road, Zhengzhou, 450003, China
| | - Meiyun Wang
- Department of Nuclear Medicine, Henan Provincial People's Hospital, Henan Key Laboratory of Noval Molecular Probes and Clinical Translation in Nuclear Medicine, No. 7 Weiwu Road, Zhengzhou, 450003, China
| | - Xiaohua Zhu
- Department of Nuclear Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Ave, Wuhan, 430030, China
| | - Zhifang Wu
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Collaborative Innovation Center for Molecular Imaging Precision Medicine, Taiyuan, 030001, China
| | - Jianjun Liu
- Department of Nuclear Medicine, RenJi Hospital, School of Medicine, Shanghai Jiao Tong University, No. 160 PuJian Road, Shanghai, 200127, China
| | - Biao Li
- Department of Nuclear Medicine, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, No. 197 Ruijin Er Road, Shanghai, 200025, China
| | - Hubing Wu
- Nanfang PET Center, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue North, Guangzhou, 510515, China
| | - Zhaoping Cheng
- Department of Nuclear Medicine, The First Affiliated Hospital of Shandong First Medical University, No. 16766 Jingshi Road, Jinan, 250014, Shandong, China
| | - Shuxia Wang
- Department of Nuclear Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, No. 106 Zhongshan Er Road, Guangzhou, 510080, China
| | - Yiqiu Zhang
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.,Shanghai Institute of Medical Imaging, Shanghai, 200032, China.,Institute of Nuclear Medicine, Fudan University, Shanghai, 200032, China.,Cancer Prevention and Treatment Center, Zhongshan Hospital, Fudan University, Shanghai, 200032, China
| | - Baixuan Xu
- Department of Nuclear Medicine, Chinese PLA General Hospital, Beijing, 100853, China.
| | - Sijin Li
- Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Collaborative Innovation Center for Molecular Imaging Precision Medicine, Taiyuan, 030001, China.
| | - Hongcheng Shi
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China. .,Shanghai Institute of Medical Imaging, Shanghai, 200032, China. .,Institute of Nuclear Medicine, Fudan University, Shanghai, 200032, China. .,Cancer Prevention and Treatment Center, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.
| |
Collapse
|
30
|
Wang H, Miao Y, Yu W, Zhu G, Wu T, Zhao X, Yuan G, Li B, Xu H. Improved Clinical Workflow for Whole-Body Patlak Parametric Imaging Using Two Short Dynamic Acquisitions. Front Oncol 2022; 12:822708. [PMID: 35574350 PMCID: PMC9097952 DOI: 10.3389/fonc.2022.822708] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 03/30/2022] [Indexed: 11/13/2022] Open
Abstract
Objective We sought to explore the feasibility of shorter acquisition times using two short dynamic scans for a multiparametric PET study and the influence of quantitative performance in shortened dynamic PET. Methods Twenty-one patients underwent whole-body dynamic 18F-FDG PET/CT examinations on a PET/CT (Siemens Biograph Vision) with a total scan time of 75 min using continuous bed motion for Patlak multiparametric imaging. Two sets of Patlak multiparametric images were produced: the standard MRFDG and DVFDG images (MRFDG-std and DVFDG-std) and two short dynamic MRFDG and DVFDG images (MRFDG-tsd and DVFDG-tsd), which were generated by a 0–75 min post injection (p.i.) dynamic PET series and a 0–6 min + 60–75 min p.i. dynamic PET series, respectively. The maximum, mean, and peak values of the standard and two short dynamic multiparametric acquisitions were obtained and compared using Passing–Bablok regression and Bland–Altman analysis. Results High correlations were obtained between MRFDG-tsd and MRFDG-std, and between DVFDG-tsd and DVFDG-std for both normal organs and all lesions (0.962 ≦ Spearman’s rho ≦ 0.982, p < 0.0001). The maximum, mean, and peak values of the standard and two short dynamic multiparametric acquisitions were also in agreement. For normal organs, the Bland–Altman plot showed that the mean bias of MRFDG-max, MRFDG-mean, and MRFDG-peak was -0.002 (95% CI: -0.032–0.027), -0.002 (95% CI: -0.026–0.023), and -0.002 (95% CI: -0.026–0.022), respectively. The mean bias of DVFDG-max, DVFDG-mean, and DVFDG-peak was -3.3 (95% CI: -24.8–18.2), -1.4 (95% CI: -12.1–9.2), and -2.3 (95% CI: -15–10.4), respectively. For lesions, the Bland–Altman plot showed that the mean bias of MRFDG-max, MRFDG-mean, and MRFDG-peak was -0.009 (95% CI: -0.056–0.038), -0.004 (95% CI: -0.039–0.031), and -0.004 (95% CI: -0.036–0.028), respectively. The mean bias of DVFDG-max, DVFDG-mean, and DVFDG-peak was -8.4 (95% CI: -42.6–25.9), -4.8 (95% CI: -20.2–10.6), and -4.0 (95% CI: -23.7–15.6), respectively. Conclusions This study demonstrates the feasibility of using two short dynamic scans that include the first 0–6 min and 60–75 min scans p.i. for Patlak multiparametric images, which can increase patient throughout for parametric analysis.
Collapse
Affiliation(s)
- Hui Wang
- Department of Nuclear Medicine, First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Ying Miao
- Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wenjing Yu
- Department of Nuclear Medicine, First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Gan Zhu
- Department of Nuclear Medicine, First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Tao Wu
- Department of Nuclear Medicine, First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Xuefeng Zhao
- Department of Nuclear Medicine, First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Guangjie Yuan
- Department of Nuclear Medicine, First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Biao Li
- Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Huiqin Xu
- Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| |
Collapse
|
31
|
Abdelhafez YG, McBride K, Leung EK, Hunt H, Spencer BA, Lopez JE, Atsina K, Li EJ, Wang G, Cherry SR, Badawi RD, Sen F, Nardo L. Blanching Defects at the Pressure Points: Observations from Dynamic Total-Body PET/CT Studies. J Nucl Med Technol 2022; 50:jnmt.122.263905. [PMID: 35440473 PMCID: PMC9745988 DOI: 10.2967/jnmt.122.263905] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 03/22/2022] [Accepted: 03/22/2022] [Indexed: 01/26/2023] Open
Abstract
Total-body PET/CT allows simultaneous acquisition of all the body parts in a single bed position during the radiotracer uptake phase. Dynamic imaging protocols employing total-body PET could demonstrate findings that may not have been previously visualized or described using conventional PET/CT scanners. We examined the characteristics of blanching defects, areas of markedly reduced (partial defect) or absent (complete defect) radiotracer uptake seen at the skin/subcutaneous tissues opposite the bony prominences at pressure points. Methods: In this observational study, 77 participants underwent dynamic total-body PET/CT imaging using 18F-FDG (Group 1, N = 47, 60-min dynamic, arms-down, divided into 3 subgroups according to the injected dose) or 18F-fluciclovine (Group 2, N = 30, 25-min dynamic, arms above the head). 40 out of 47 participants in Group 1 were re-imaged at 90 min after being allowed off the scanning table. Blanching defects, partial or complete, were characterized opposite the bony prominences at 7 pressure points (the skull, scapula, and calcaneus bilaterally, as well as the sacrum). Association of the blanching defects with different clinical and technical characteristics were analyzed using uni- and multi-variate analyses. Results: A total of 124 blanching defects were seen in 68 out of 77 (88%) participants at one or more pressure points. Blanching defects were higher, on average, in Group 2 participants (3.5±1.7) compared to Group 1 (2.1±1.4; P <0.001), but it did not vary within Group 1 for different 18F-FDG dose subgroups. All defects resumed normal pattern on delayed static (90-min) images except for 14 partial defects. No complete blanching defects were seen on the 90-min images. By multivariate analysis, arm positioning above the head was associated with skull defects; scapular and sacral defects were significantly more encountered in men and with lower BMI, while calcaneal defects could not be associated to any factor. Conclusion: Blanching defects opposite the bony pressure points are common on dynamic total-body PET/CT images using different radiopharmaceuticals and injection doses. Their appearance should not be immediately interpreted as an abnormality. The current findings warrant further exploration in a prospective setting and may be utilized to study various mechano-pathologic conditions, such as pressure ulcers.
Collapse
Affiliation(s)
- Yasser G. Abdelhafez
- Department of Radiology, University of California, Davis, California
- Nuclear Medicine Unit, South Egypt Cancer Institute, Assiut University, Assiut, Egypt
| | - Kristin McBride
- Department of Radiology, University of California, Davis, California
| | - Edwin K. Leung
- Department of Radiology, University of California, Davis, California
- Biomedical Engineering, University of California, Davis, California
- UIH America, Inc., Houston, Texas
| | - Heather Hunt
- Department of Radiology, University of California, Davis, California
| | | | - Javier E. Lopez
- Department of Internal Medicine, University of California, Davis, California; and
- Cardiovascular Research Institute, University of California, Davis, California
| | - Kwame Atsina
- Department of Internal Medicine, University of California, Davis, California; and
- Cardiovascular Research Institute, University of California, Davis, California
| | - Elizabeth J. Li
- Biomedical Engineering, University of California, Davis, California
| | - Guobao Wang
- Department of Radiology, University of California, Davis, California
| | - Simon R. Cherry
- Department of Radiology, University of California, Davis, California
- Biomedical Engineering, University of California, Davis, California
| | - Ramsey D. Badawi
- Department of Radiology, University of California, Davis, California
- Biomedical Engineering, University of California, Davis, California
| | - Fatma Sen
- Department of Radiology, University of California, Davis, California
| | - Lorenzo Nardo
- Department of Radiology, University of California, Davis, California
| |
Collapse
|
32
|
Wu Y, Feng T, Shen Y, Fu F, Meng N, Li X, Xu T, Sun T, Gu F, Wu Q, Zhou Y, Han H, Bai Y, Wang M. Total-body parametric imaging using the patlak model: Feasibility of reduced scan time. Med Phys 2022; 49:4529-4539. [PMID: 35394071 DOI: 10.1002/mp.15647] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 01/17/2022] [Accepted: 03/19/2022] [Indexed: 11/08/2022] Open
Abstract
PURPOSE This study explored the feasibility of reducing the scan time of Patlak parametric imaging on the uEXPLORER. METHODS A total of 65 patients (27 females and 38 males, age 56.1±10.4) were recruited in this study. 18 F-FDG was injected and its dose was adjusted by body weight (4.07 MBq / kg).Total-body dynamic scanning was performed on the uEXPLORER Total-Body PET/CT scanner with a total scan time of 60 minutes from the injection. The image derived input function (IDIF) was obtained from the aortic arch. The voxelwise Patlak analysis was applied to generate the Ki images designated as GIDIF with different acquisition times (20-60, 30-60, 40-60, and 44-60 min). The population-based input function (PBIF) was constructed from the mean value of the IDIF from the population, and Ki images designated as GPBIF were generated using the PBIF. Non-localmeans (NLM) denoising was applied to the generated images to get two extra groups of (NLM-designated) images: GIDIF+NLM and GPBIF+NLM . Two radiologists evaluated the overall image quality, noise, and lesion detectability of the Ki images from different groups. The 20-60 min scans in GIDIF were selected as the gold standard for each patient. We determined that image quality is at sufficient level if all the lesions can be recognized and meet the clinical criteria. Ki values in muscle and lesion were compared across different groups to evaluate the quantitative accuracy. RESULTS The overall image quality, image noise, and lesion conspicuity were significantly better in long time series than short time series in all 4 groups (all p<0.001). The Ki images in the GIDIF and GPBIF groups generated from 30-min scans showed diagnostic value equivalent to the 40-min scans of GIDIF . While the image quality of the 16-min scans was poor, all lesions could still be detected. No significant difference was found between Ki values estimated with GIDIF and GPBIF in muscle and lesion regions (all p>0.5). After applying the NLM filter, The coefficient of variation could be reduced on the order of [1%, 15%, 19%,37%] and [110%, 125%, 94%, 69%] with four acquisition time schemes for lesion and muscle. The reduction percentage did not have a substantial difference in IDIF and PBIF group. The Ki images in the GIDIF+NLM and GPBIF+NLM groups generated from the 20-min acquisitions showed acceptable quality. All lesions could be found on the NLM processed images of the 16-min scans. No significant difference was found between Ki values produced with GIDIF+NLM and GPBIF+NLM in muscle and lesion regions(all p>0.7). CONCLUSIONS The Ki images generated by the PBIF-based Patlak model using a 20-min dynamic scan with the NLM filter achieved a similar diagnostic efficiency to images with GIDIF from 40-min dynamic data, and there is no significant difference between Ki images generated using IDIF or PBIF (p>0.5). This article is protected by copyright. All rights reserved.
Collapse
Affiliation(s)
- Yaping Wu
- Department of Medical Imaging, Henan Provincial People's Hospital & People's Hospital of Zhengzhou University, Zhengzhou, Henan, 450003, China
| | - Tao Feng
- UIH America Inc., Houston, TX, 77054, USA
| | - Yu Shen
- Department of Medical Imaging, Henan Provincial People's Hospital & People's Hospital of Zhengzhou University, Zhengzhou, Henan, 450003, China
| | - Fangfang Fu
- Department of Medical Imaging, Henan Provincial People's Hospital & People's Hospital of Zhengzhou University, Zhengzhou, Henan, 450003, China
| | - Nan Meng
- Department of Medical Imaging, Henan Provincial People's Hospital & People's Hospital of Zhengzhou University, Zhengzhou, Henan, 450003, China
| | - Xiaochen Li
- Department of Medical Imaging, Henan Provincial People's Hospital & People's Hospital of Zhengzhou University, Zhengzhou, Henan, 450003, China
| | - Tianyi Xu
- United Imaging Healthcare Group, Shanghai, 201807, China
| | - Tao Sun
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
| | - Fengyun Gu
- United Imaging Healthcare Group, Shanghai, 201807, China.,Department of Statistics, School of Mathematical Sciences, University College Cork, Cork, T12XF62, Ireland
| | - Qi Wu
- United Imaging Healthcare Group, Shanghai, 201807, China.,Department of Statistics, School of Mathematical Sciences, University College Cork, Cork, T12XF62, Ireland
| | - Yun Zhou
- United Imaging Healthcare Group, Shanghai, 201807, China
| | - Hui Han
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA
| | - Yan Bai
- Department of Medical Imaging, Henan Provincial People's Hospital & People's Hospital of Zhengzhou University, Zhengzhou, Henan, 450003, China
| | - Meiyun Wang
- Department of Medical Imaging, Henan Provincial People's Hospital & People's Hospital of Zhengzhou University, Zhengzhou, Henan, 450003, China
| |
Collapse
|