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van de Burgt A, van Velden FHP, Kwakkenbos K, Smit F, de Geus-Oei LF, Dekkers IA. Dynamic rubidium-82 PET/CT as a novel tool for quantifying hemodynamic differences in renal blood flow using a one-tissue compartment model. Med Phys 2024. [PMID: 38709908 DOI: 10.1002/mp.17080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 03/01/2024] [Accepted: 04/04/2024] [Indexed: 05/08/2024] Open
Abstract
PURPOSE Assessing renal perfusion in-vivo is challenging and quantitative information regarding renal hemodynamics is hardly incorporated in medical decision-making while abnormal renal hemodynamics might play a crucial role in the onset and progression of renal disease. Combining physiological stimuli with rubidium-82 positron emission tomography/computed tomography (82Rb PET/CT) offers opportunities to test the kidney perfusion under various conditions. The aim of this study is: (1) to investigate the application of a one-tissue compartment model for measuring renal hemodynamics with dynamic 82Rb PET/CT imaging, and (2) to evaluate whether dynamic PET/CT is sensitive to detect differences in renal hemodynamics in stress conditions compared to resting state. METHODS A one-tissue compartment model for the kidney was applied to cardiac 82Rb PET/CT scans that were obtained for ischemia detection as part of clinical care. Retrospective data, collected from 17 patients undergoing dynamic myocardial 82Rb PET/CT imaging in rest, were used to evaluate various CT-based volumes of interest (VOIs) of the kidney. Subsequently, retrospective data, collected from 10 patients (five impaired kidney functions and five controls) undergoing dynamic myocardial 82Rb PET/CT imaging, were used to evaluate image-derived input functions (IDIFs), PET-based VOIs of the kidney, extraction fractions, and whether dynamic 82Rb PET/CT can measure renal hemodynamics differences using the renal blood flow (RBF) values in rest and after exposure to adenosine pharmacological stress. RESULTS The delivery rate (K1) values showed no significant (p = 0.14) difference between the mean standard deviation (SD) K1 values using one CT-based VOI and the use of two, three, and four CT-based VOIs, respectively 2.01(0.32), 1.90(0.40), 1.93(0.39), and 1.94(0.40) mL/min/mL. The ratio between RBF in rest and RBF in pharmacological stress for the controls were overall significantly lower compared to the impaired kidney function group for both PET-based delineation methods (region growing and iso-contouring), with the smallest median interquartile range (IQR) of 0.40(0.28-0.66) and 0.96(0.62-1.15), respectively (p < 0.05). The K1 of the impaired kidney function group were close to 1.0 mL/min/mL. CONCLUSIONS This study demonstrated that obtaining renal K1 and RBF values using 82Rb PET/CT was feasible using a one-tissue compartment model. Applying iso-contouring as the PET-based VOI of the kidney and using AA as an IDIF is suggested for consideration in further studies. Dynamic 82Rb PET/CT imaging showed significant differences in renal hemodynamics in rest compared to when exposed to adenosine. This indicates that dynamic 82Rb PET/CT has potential to detect differences in renal hemodynamics in stress conditions compared to the resting state, and might be useful as a novel diagnostic tool for assessing renal perfusion.
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Affiliation(s)
- Alina van de Burgt
- Department of Nuclear Medicine, Alrijne hospital, Leiderdorp, The Netherlands
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Koen Kwakkenbos
- Department of Nuclear Medicine, Alrijne hospital, Leiderdorp, The Netherlands
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Frits Smit
- Department of Nuclear Medicine, Alrijne hospital, Leiderdorp, The Netherlands
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Lioe-Fee de Geus-Oei
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
- Biomedical Photonic Imaging Group, University of Twente, Enschede, The Netherlands
- Department of Radiation Science & Technology, Delft University of Technology, Delft, The Netherlands
| | - Ilona A Dekkers
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
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Hendriks P, Rietbergen DDD, van Erkel AR, Coenraad MJ, Arntz MJ, Bennink RJ, Braat AE, Crobach S, van Delden OM, Dibbets-Schneider P, van der Hulle T, Klümpen HJ, van der Meer RW, Nijsen JFW, van Rijswijk CSP, Roosen J, Ruijter BN, Smit F, Stam MK, Takkenberg RB, Tushuizen ME, van Velden FHP, de Geus-Oei LF, Burgmans MC. Adjuvant holmium-166 radioembolization after radiofrequency ablation in early-stage hepatocellular carcinoma patients: a dose-finding study (HORA EST HCC trial). Eur J Nucl Med Mol Imaging 2024:10.1007/s00259-024-06630-z. [PMID: 38329507 DOI: 10.1007/s00259-024-06630-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 01/27/2024] [Indexed: 02/09/2024]
Abstract
PURPOSE The aim of this study was to investigate the biodistribution of (super-)selective trans-arterial radioembolization (TARE) with holmium-166 microspheres (166Ho-MS), when administered as adjuvant therapy after RFA of HCC 2-5 cm. The objective was to establish a treatment volume absorbed dose that results in an absorbed dose of ≥ 120 Gy on the hyperemic zone around the ablation necrosis (i.e., target volume). METHODS In this multicenter, prospective dose-escalation study in BCLC early stage HCC patients with lesions 2-5 cm, RFA was followed by (super-)selective infusion of 166Ho-MS on day 5-10 after RFA. Dose distribution within the treatment volume was based on SPECT-CT. Cohorts of up to 10 patients were treated with an incremental dose (60 Gy, 90 Gy, 120 Gy) of 166Ho-MS to the treatment volume. The primary endpoint was to obtain a target volume dose of ≥ 120 Gy in 9/10 patients within a cohort. RESULTS Twelve patients were treated (male 10; median age, 66.5 years (IQR, [64.3-71.7])) with a median tumor diameter of 2.7 cm (IQR, [2.1-4.0]). At a treatment volume absorbed dose of 90 Gy, the primary endpoint was met with a median absorbed target volume dose of 138 Gy (IQR, [127-145]). No local recurrences were found within 1-year follow-up. CONCLUSION Adjuvant (super-)selective infusion of 166Ho-MS after RFA for the treatment of HCC can be administered safely at a dose of 90 Gy to the treatment volume while reaching a dose of ≥ 120 Gy to the target volume and may be a favorable adjuvant therapy for HCC lesions 2-5 cm. TRIAL REGISTRATION Clinicaltrials.gov NCT03437382 . (registered: 19-02-2018).
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Affiliation(s)
- Pim Hendriks
- Interventional Radiology Research (IR2) Group, Department of Radiology, Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, The Netherlands.
| | - Daphne D D Rietbergen
- Section of Nuclear Medicine, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Arian R van Erkel
- Interventional Radiology Research (IR2) Group, Department of Radiology, Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, The Netherlands
| | - Minneke J Coenraad
- Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, The Netherlands
| | - Mark J Arntz
- Department of Medical Imaging, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Roel J Bennink
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Andries E Braat
- Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Stijn Crobach
- Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands
| | - Otto M van Delden
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Petra Dibbets-Schneider
- Section of Nuclear Medicine, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Tom van der Hulle
- Department of Medical Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - Heinz-Josef Klümpen
- Department of Medical Oncology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Rutger W van der Meer
- Interventional Radiology Research (IR2) Group, Department of Radiology, Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, The Netherlands
| | - J Frank W Nijsen
- Department of Medical Imaging, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Catharina S P van Rijswijk
- Interventional Radiology Research (IR2) Group, Department of Radiology, Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, The Netherlands
| | - Joey Roosen
- Department of Medical Imaging, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Bastian N Ruijter
- Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, The Netherlands
| | - Frits Smit
- Section of Nuclear Medicine, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Mette K Stam
- Section of Nuclear Medicine, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - R Bart Takkenberg
- Department of Gastroenterology and Hepatology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Maarten E Tushuizen
- Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, The Netherlands
| | - Floris H P van Velden
- Section of Nuclear Medicine, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Lioe-Fee de Geus-Oei
- Section of Nuclear Medicine, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
- Biomedical Photonic Imaging Group, TechMed Center, University of Twente, Enschede, The Netherlands
- Department of Radiation Sciences & Technology, Delft University of Technology, Delft, The Netherlands
| | - Mark C Burgmans
- Interventional Radiology Research (IR2) Group, Department of Radiology, Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, The Netherlands
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Pullen LCE, Noortman WA, Triemstra L, de Jongh C, Rademaker FJ, Spijkerman R, Kalisvaart GM, Gertsen EC, de Geus-Oei LF, Tolboom N, de Steur WO, Dantuma M, Slart RHJA, van Hillegersberg R, Siersema PD, Ruurda JP, van Velden FHP, Vegt E. Prognostic Value of [ 18F]FDG PET Radiomics to Detect Peritoneal and Distant Metastases in Locally Advanced Gastric Cancer-A Side Study of the Prospective Multicentre PLASTIC Study. Cancers (Basel) 2023; 15:cancers15112874. [PMID: 37296837 DOI: 10.3390/cancers15112874] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 05/13/2023] [Accepted: 05/14/2023] [Indexed: 06/12/2023] Open
Abstract
AIM To improve identification of peritoneal and distant metastases in locally advanced gastric cancer using [18F]FDG-PET radiomics. METHODS [18F]FDG-PET scans of 206 patients acquired in 16 different Dutch hospitals in the prospective multicentre PLASTIC-study were analysed. Tumours were delineated and 105 radiomic features were extracted. Three classification models were developed to identify peritoneal and distant metastases (incidence: 21%): a model with clinical variables, a model with radiomic features, and a clinicoradiomic model, combining clinical variables and radiomic features. A least absolute shrinkage and selection operator (LASSO) regression classifier was trained and evaluated in a 100-times repeated random split, stratified for the presence of peritoneal and distant metastases. To exclude features with high mutual correlations, redundancy filtering of the Pearson correlation matrix was performed (r = 0.9). Model performances were expressed by the area under the receiver operating characteristic curve (AUC). In addition, subgroup analyses based on Lauren classification were performed. RESULTS None of the models could identify metastases with low AUCs of 0.59, 0.51, and 0.56, for the clinical, radiomic, and clinicoradiomic model, respectively. Subgroup analysis of intestinal and mixed-type tumours resulted in low AUCs of 0.67 and 0.60 for the clinical and radiomic models, and a moderate AUC of 0.71 in the clinicoradiomic model. Subgroup analysis of diffuse-type tumours did not improve the classification performance. CONCLUSION Overall, [18F]FDG-PET-based radiomics did not contribute to the preoperative identification of peritoneal and distant metastases in patients with locally advanced gastric carcinoma. In intestinal and mixed-type tumours, the classification performance of the clinical model slightly improved with the addition of radiomic features, but this slight improvement does not outweigh the laborious radiomic analysis.
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Affiliation(s)
- Lieke C E Pullen
- Biomedical Photonic Imaging Group, University of Twente, 7522 NB Enschede, The Netherlands
| | - Wyanne A Noortman
- Biomedical Photonic Imaging Group, University of Twente, 7522 NB Enschede, The Netherlands
- Department of Radiology, Leiden University Medical Center, 2333 ZD Leiden, The Netherlands
| | - Lianne Triemstra
- Department of Surgery, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
| | - Cas de Jongh
- Department of Surgery, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
| | - Fenna J Rademaker
- TechMed Centre, University of Twente, 7522 NB Enschede, The Netherlands
| | - Romy Spijkerman
- TechMed Centre, University of Twente, 7522 NB Enschede, The Netherlands
| | - Gijsbert M Kalisvaart
- Department of Radiology, Leiden University Medical Center, 2333 ZD Leiden, The Netherlands
| | - Emma C Gertsen
- Department of Surgery, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
| | - Lioe-Fee de Geus-Oei
- Biomedical Photonic Imaging Group, University of Twente, 7522 NB Enschede, The Netherlands
- Department of Radiology, Leiden University Medical Center, 2333 ZD Leiden, The Netherlands
| | - Nelleke Tolboom
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
| | - Wobbe O de Steur
- Department of Surgery, Leiden University Medical Center, 2333 ZD Leiden, The Netherlands
| | - Maura Dantuma
- Multi-Modality Medical Imaging Group, TechMed Centre, University of Twente, 7522 NB Enschede, The Netherlands
| | - Riemer H J A Slart
- Biomedical Photonic Imaging Group, University of Twente, 7522 NB Enschede, The Netherlands
- Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands
| | | | - Peter D Siersema
- Department of Gastroenterology, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
| | - Jelle P Ruurda
- Department of Surgery, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
| | - Floris H P van Velden
- Department of Radiology, Leiden University Medical Center, 2333 ZD Leiden, The Netherlands
| | - Erik Vegt
- Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Center Rotterdam, 3015 GD Rotterdam, The Netherlands
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de Vries BM, Zwezerijnen GJC, Burchell GL, van Velden FHP, Menke-van der Houven van Oordt CW, Boellaard R. Explainable artificial intelligence (XAI) in radiology and nuclear medicine: a literature review. Front Med (Lausanne) 2023; 10:1180773. [PMID: 37250654 PMCID: PMC10213317 DOI: 10.3389/fmed.2023.1180773] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 04/17/2023] [Indexed: 05/31/2023] Open
Abstract
Rational Deep learning (DL) has demonstrated a remarkable performance in diagnostic imaging for various diseases and modalities and therefore has a high potential to be used as a clinical tool. However, current practice shows low deployment of these algorithms in clinical practice, because DL algorithms lack transparency and trust due to their underlying black-box mechanism. For successful employment, explainable artificial intelligence (XAI) could be introduced to close the gap between the medical professionals and the DL algorithms. In this literature review, XAI methods available for magnetic resonance (MR), computed tomography (CT), and positron emission tomography (PET) imaging are discussed and future suggestions are made. Methods PubMed, Embase.com and Clarivate Analytics/Web of Science Core Collection were screened. Articles were considered eligible for inclusion if XAI was used (and well described) to describe the behavior of a DL model used in MR, CT and PET imaging. Results A total of 75 articles were included of which 54 and 17 articles described post and ad hoc XAI methods, respectively, and 4 articles described both XAI methods. Major variations in performance is seen between the methods. Overall, post hoc XAI lacks the ability to provide class-discriminative and target-specific explanation. Ad hoc XAI seems to tackle this because of its intrinsic ability to explain. However, quality control of the XAI methods is rarely applied and therefore systematic comparison between the methods is difficult. Conclusion There is currently no clear consensus on how XAI should be deployed in order to close the gap between medical professionals and DL algorithms for clinical implementation. We advocate for systematic technical and clinical quality assessment of XAI methods. Also, to ensure end-to-end unbiased and safe integration of XAI in clinical workflow, (anatomical) data minimization and quality control methods should be included.
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Affiliation(s)
- Bart M. de Vries
- Department of Radiology and Nuclear Medicine, Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Gerben J. C. Zwezerijnen
- Department of Radiology and Nuclear Medicine, Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | | | | | | | - Ronald Boellaard
- Department of Radiology and Nuclear Medicine, Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
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5
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Noortman WA, Aide N, Vriens D, Arkes LS, Slump CH, Boellaard R, Goeman JJ, Deroose CM, Machiels JP, Licitra LF, Lhommel R, Alessi A, Woff E, Goffin K, Le Tourneau C, Gal J, Temam S, Delord JP, van Velden FHP, de Geus-Oei LF. Development and External Validation of a PET Radiomic Model for Prognostication of Head and Neck Cancer. Cancers (Basel) 2023; 15:2681. [PMID: 37345017 DOI: 10.3390/cancers15102681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 04/30/2023] [Accepted: 05/03/2023] [Indexed: 06/23/2023] Open
Abstract
AIM To build and externally validate an [18F]FDG PET radiomic model to predict overall survival in patients with head and neck squamous cell carcinoma (HNSCC). METHODS Two multicentre datasets of patients with operable HNSCC treated with preoperative afatinib who underwent a baseline and evaluation [18F]FDG PET/CT scan were included (EORTC: n = 20, Unicancer: n = 34). Tumours were delineated, and radiomic features were extracted. Each cohort served once as a training and once as an external validation set for the prediction of overall survival. Supervised feature selection was performed using variable hunting with variable importance, selecting the top two features. A Cox proportional hazards regression model using selected radiomic features and clinical characteristics was fitted on the training dataset and validated in the external validation set. Model performances are expressed by the concordance index (C-index). RESULTS In both models, the radiomic model surpassed the clinical model with validation C-indices of 0.69 and 0.79 vs. 0.60 and 0.67, respectively. The model that combined the radiomic features and clinical variables performed best, with validation C-indices of 0.71 and 0.82. CONCLUSION Although assessed in two small but independent cohorts, an [18F]FDG-PET radiomic signature based on the evaluation scan seems promising for the prediction of overall survival for HNSSC treated with preoperative afatinib. The robustness and clinical applicability of this radiomic signature should be assessed in a larger cohort.
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Affiliation(s)
- Wyanne A Noortman
- Section of Nuclear Medicine, Department of Radiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
- TechMed Centre, University of Twente, 7522 NB Enschede, The Netherlands
| | - Nicolas Aide
- Nuclear Medicine Department, Centre Hospitalier Universitaire de Caen, 14000 Caen, France
| | - Dennis Vriens
- Section of Nuclear Medicine, Department of Radiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Lisa S Arkes
- Section of Nuclear Medicine, Department of Radiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
- Technical Medicine, Delft University of Technology, 2628 CD Delft, The Netherlands
| | - Cornelis H Slump
- TechMed Centre, University of Twente, 7522 NB Enschede, The Netherlands
| | - Ronald Boellaard
- Amsterdam University Medical Center, 1081 HV Amsterdam, The Netherlands
| | - Jelle J Goeman
- Department of Biomedical Data Sciences, Leiden University Medical Center, 2300 RC Leiden, The Netherlands
| | - Christophe M Deroose
- Nuclear Medicine and Molecular Imaging, Department of Imaging & Pathology, University Hospitals Leuven, KU Leuven, 3000 Leuven, Belgium
| | - Jean-Pascal Machiels
- Department of Medical Oncology, Institut Roi Albert II, Cliniques Universitaires Saint-Luc, 1200 Brussels, Belgium
- Institute for Experimental and Clinical Research (IREC, pôle MIRO), Université Catholique de Louvain (UCLouvain), 1200 Brussels, Belgium
| | - Lisa F Licitra
- Department of Head and Neck Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, University of Milan, 20133 Milan, Italy
| | - Renaud Lhommel
- Division of Nuclear Medicine, Institut de Recherche Clinique, Cliniques Universitaires Saint Luc, 1200 Brussels, Belgium
| | - Alessandra Alessi
- Department of Nuclear Medicine-PET Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy
| | - Erwin Woff
- Nuclear Medicine Department, Institut Jules Bordet, Université Libre de Bruxelles (ULB), Hôpital Universitaire de Bruxelles (H.U.B.), 1070 Bruxelles, Belgium
| | - Karolien Goffin
- Nuclear Medicine and Molecular Imaging, Department of Imaging & Pathology, University Hospitals Leuven, KU Leuven, 3000 Leuven, Belgium
| | - Christophe Le Tourneau
- Department of Drug Development and Innovation, Institut Curie, Paris-Saclay University, 75005 Paris, France
| | - Jocelyn Gal
- Epidemiology and Biostatistics Department, Centre Antoine Lacassagne, University Côte d'Azur, 06100 Nice, France
| | - Stéphane Temam
- Department of Head and Neck Surgery Gustave Roussy, 94805 Villejuif, France
| | | | - Floris H P van Velden
- Section of Nuclear Medicine, Department of Radiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Lioe-Fee de Geus-Oei
- Section of Nuclear Medicine, Department of Radiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
- TechMed Centre, University of Twente, 7522 NB Enschede, The Netherlands
- Department of Radiation Science & Technology, Delft University of Technology, 2628 CD Delft, The Netherlands
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Straat ME, Hoekx CA, van Velden FHP, Pereira Arias-Bouda LM, Dumont L, Blondin DP, Boon MR, Martinez-Tellez B, Rensen PCN. Stimulation of the beta-2-adrenergic receptor with salbutamol activates human brown adipose tissue. Cell Rep Med 2023; 4:100942. [PMID: 36812890 PMCID: PMC9975328 DOI: 10.1016/j.xcrm.2023.100942] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 11/30/2022] [Accepted: 01/20/2023] [Indexed: 02/23/2023]
Abstract
While brown adipose tissue (BAT) is activated by the beta-3-adrenergic receptor (ADRB3) in rodents, in human brown adipocytes, the ADRB2 is dominantly present and responsible for noradrenergic activation. Therefore, we performed a randomized double-blinded crossover trial in young lean men to compare the effects of single intravenous bolus of the ADRB2 agonist salbutamol without and with the ADRB1/2 antagonist propranolol on glucose uptake by BAT, assessed by dynamic 2-[18F]fluoro-2-deoxy-D-glucose positron emission tomography-computed tomography scan (i.e., primary outcome). Salbutamol, compared with salbutamol with propranolol, increases glucose uptake by BAT, without affecting the glucose uptake by skeletal muscle and white adipose tissue. The salbutamol-induced glucose uptake by BAT positively associates with the increase in energy expenditure. Notably, participants with high salbutamol-induced glucose uptake by BAT have lower body fat mass, waist-hip ratio, and serum LDL-cholesterol concentration. In conclusion, specific ADRB2 agonism activates human BAT, which warrants investigation of ADRB2 activation in long-term studies (EudraCT: 2020-004059-34).
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Affiliation(s)
- Maaike E Straat
- Division of Endocrinology, Department of Medicine, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands; Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands
| | - Carlijn A Hoekx
- Division of Endocrinology, Department of Medicine, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands; Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands
| | - Floris H P van Velden
- Section of Nuclear Medicine, Department of Radiology, Leiden University Medical Center, 2333 ZA Leiden, the Netherlands
| | - Lenka M Pereira Arias-Bouda
- Section of Nuclear Medicine, Department of Radiology, Leiden University Medical Center, 2333 ZA Leiden, the Netherlands
| | - Lauralyne Dumont
- Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada; Department of Physiology-Pharmacology, Université de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada
| | - Denis P Blondin
- Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada; Department of Medicine, Division of Neurology, Université de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada
| | - Mariëtte R Boon
- Division of Endocrinology, Department of Medicine, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands; Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands
| | - Borja Martinez-Tellez
- Division of Endocrinology, Department of Medicine, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands; Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands
| | - Patrick C N Rensen
- Division of Endocrinology, Department of Medicine, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands; Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands.
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7
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Boekestijn I, van Oosterom MN, Dell'Oglio P, van Velden FHP, Pool M, Maurer T, Rietbergen DDD, Buckle T, van Leeuwen FWB. The current status and future prospects for molecular imaging-guided precision surgery. Cancer Imaging 2022; 22:48. [PMID: 36068619 PMCID: PMC9446692 DOI: 10.1186/s40644-022-00482-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 08/21/2022] [Indexed: 01/19/2023] Open
Abstract
Molecular imaging technologies are increasingly used to diagnose, monitor, and guide treatment of i.e., cancer. In this review, the current status and future prospects of the use of molecular imaging as an instrument to help realize precision surgery is addressed with focus on the main components that form the conceptual basis of intraoperative molecular imaging. Paramount for successful interventions is the relevance and accessibility of surgical targets. In addition, selection of the correct combination of imaging agents and modalities is critical to visualize both microscopic and bulk disease sites with high affinity and specificity. In this context developments within engineering/imaging physics continue to drive the growth of image-guided surgery. Particularly important herein is enhancement of sensitivity through improved contrast and spatial resolution, features that are critical if sites of cancer involvement are not to be overlooked during surgery. By facilitating the connection between surgical planning and surgical execution, digital surgery technologies such as computer-aided visualization nicely complement these technologies. The complexity of image guidance, combined with the plurality of technologies that are becoming available, also drives the need for evaluation mechanisms that can objectively score the impact that technologies exert on the performance of healthcare professionals and outcome improvement for patients.
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Affiliation(s)
- Imke Boekestijn
- Interventional Molecular Imaging Laboratory, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands.,Section of Nuclear Medicine, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Matthias N van Oosterom
- Interventional Molecular Imaging Laboratory, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Paolo Dell'Oglio
- Interventional Molecular Imaging Laboratory, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands.,Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Floris H P van Velden
- Medical Physics, Department of Radiology , Leiden University Medical Center, Leiden, the Netherlands
| | - Martin Pool
- Department of Clinical Farmacy and Toxicology, Leiden University Medical Center, Leiden, the Netherlands
| | - Tobias Maurer
- Martini-Klinik Prostate Cancer Centre Hamburg, Hamburg, Germany
| | - Daphne D D Rietbergen
- Interventional Molecular Imaging Laboratory, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands.,Section of Nuclear Medicine, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Tessa Buckle
- Interventional Molecular Imaging Laboratory, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Fijs W B van Leeuwen
- Interventional Molecular Imaging Laboratory, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands.
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8
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Noortman WA, Vriens D, de Geus-Oei LF, Slump CH, Aarntzen EH, van Berkel A, Timmers HJLM, van Velden FHP. [ 18F]FDG-PET/CT radiomics for the identification of genetic clusters in pheochromocytomas and paragangliomas. Eur Radiol 2022; 32:7227-7236. [PMID: 36001126 PMCID: PMC9474528 DOI: 10.1007/s00330-022-09034-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 06/15/2022] [Accepted: 07/16/2022] [Indexed: 11/04/2022]
Abstract
Objectives Based on germline and somatic mutation profiles, pheochromocytomas and paragangliomas (PPGLs) can be classified into different clusters. We investigated the use of [18F]FDG-PET/CT radiomics, SUVmax and biochemical profile for the identification of the genetic clusters of PPGLs. Methods In this single-centre cohort, 40 PPGLs (13 cluster 1, 18 cluster 2, 9 sporadic) were delineated using a 41% adaptive threshold of SUVpeak ([18F]FDG-PET) and manually (low-dose CT; ldCT). Using PyRadiomics, 211 radiomic features were extracted. Stratified 5-fold cross-validation for the identification of the genetic cluster was performed using multinomial logistic regression with dimensionality reduction incorporated per fold. Classification performances of biochemistry, SUVmax and PET(/CT) radiomic models were compared and presented as mean (multiclass) test AUCs over the five folds. Results were validated using a sham experiment, randomly shuffling the outcome labels. Results The model with biochemistry only could identify the genetic cluster (multiclass AUC 0.60). The three-factor PET model had the best classification performance (multiclass AUC 0.88). A simplified model with only SUVmax performed almost similarly. Addition of ldCT features and biochemistry decreased the classification performances. All sham AUCs were approximately 0.50. Conclusion PET radiomics achieves a better identification of PPGLs compared to biochemistry, SUVmax, ldCT radiomics and combined approaches, especially for the differentiation of sporadic PPGLs. Nevertheless, a model with SUVmax alone might be preferred clinically, weighing model performances against laborious radiomic analysis. The limited added value of radiomics to the overall classification performance for PPGL should be validated in a larger external cohort. Key Points • Radiomics derived from [18F]FDG-PET/CT has the potential to improve the identification of the genetic clusters of pheochromocytomas and paragangliomas. • A simplified model with SUVmaxonly might be preferred clinically, weighing model performances against the laborious radiomic analysis. • Cluster 1 and 2 PPGLs generally present distinctive characteristics that can be captured using [18F]FDG-PET imaging. Sporadic PPGLs appear more heterogeneous, frequently resembling cluster 2 PPGLs and occasionally resembling cluster 1 PPGLs. Supplementary Information The online version contains supplementary material available at 10.1007/s00330-022-09034-5.
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Affiliation(s)
- Wyanne A Noortman
- Department of Radiology, Section of Nuclear Medicine, Leiden University Medical Center, Leiden, the Netherlands. .,TechMed Centre, University of Twente, Enschede, the Netherlands.
| | - Dennis Vriens
- Department of Radiology, Section of Nuclear Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - Lioe-Fee de Geus-Oei
- Department of Radiology, Section of Nuclear Medicine, Leiden University Medical Center, Leiden, the Netherlands.,TechMed Centre, University of Twente, Enschede, the Netherlands.,Department of Medical Imaging, Radboud University Medical Center, Nijmegen, the Netherlands
| | | | - Erik H Aarntzen
- Department of Medical Imaging, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Anouk van Berkel
- Division of Endocrinology, Department of Internal Medicine, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Henri J L M Timmers
- Division of Endocrinology, Department of Internal Medicine, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Floris H P van Velden
- Department of Radiology, Section of Nuclear Medicine, Leiden University Medical Center, Leiden, the Netherlands
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9
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Hendriks P, Rietbergen DDD, van Erkel AR, Coenraad MJ, Arntz MJ, Bennink RJ, Braat AE, Crobach ASLP, van Delden OM, van der Hulle T, Klümpen HJ, van der Meer RW, Nijsen JFW, van Rijswijk CSP, Roosen J, Ruijter BN, Smit F, Stam MK, Takkenberg RB, Tushuizen ME, van Velden FHP, de Geus-Oei LF, Burgmans MC. Study Protocol: Adjuvant Holmium-166 Radioembolization After Radiofrequency Ablation in Early-Stage Hepatocellular Carcinoma Patients-A Dose-Finding Study (HORA EST HCC Trial). Cardiovasc Intervent Radiol 2022; 45:1057-1063. [PMID: 35618860 PMCID: PMC9307549 DOI: 10.1007/s00270-022-03162-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 04/23/2022] [Indexed: 12/07/2022]
Abstract
PURPOSE To investigate the biodistribution of holmium-166 microspheres (166Ho-MS) when administered after radiofrequency ablation (RFA) of early-stage hepatocellular carcinoma (HCC). The aim is to establish a perfused liver administration dose that results in a tumoricidal dose of holmium-166 on the hyperaemic zone around the ablation necrosis (i.e. target volume). MATERIALS AND METHODS This is a multicentre, prospective, dose-escalation study in HCC patients with a solitary lesion 2-5 cm, or a maximum of 3 lesions of ≤ 3 cm each. The day after RFA patients undergo angiography and cone-beam CT (CBCT) with (super)selective infusion of technetium-99 m labelled microalbumin aggregates (99mTc-MAA). The perfused liver volume is segmented from the CBCT and 166Ho-MS is administered to this treatment volume 5-10 days later. The dose of holmium-166 is escalated in a maximum of 3 patient cohorts (60 Gy, 90 Gy and 120 Gy) until the endpoint is reached. SPECT/CT is used to determine the biodistribution of holmium-166. The endpoint is met when a dose of ≥ 120 Gy has been reached on the target volume in 9/10 patients of a cohort. Secondary endpoints include toxicity, local recurrence, disease-free and overall survival. DISCUSSION This study aims to find the optimal administration dose of adjuvant radioembolization with 166Ho-MS after RFA. Ultimately, the goal is to bring the efficacy of thermal ablation up to par with surgical resection for early-stage HCC patients. TRIAL REGISTRATION Clinicaltrials.gov identifier: NCT03437382.
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Affiliation(s)
- Pim Hendriks
- Department of Radiology, Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, The Netherlands.
| | - Daphne D D Rietbergen
- Department of Radiology, Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, The Netherlands
| | - Arian R van Erkel
- Department of Radiology, Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, The Netherlands
| | - Minneke J Coenraad
- Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, The Netherlands
| | - Mark J Arntz
- Department of Medical Imaging, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Roel J Bennink
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, Location AMC, Amsterdam, The Netherlands
| | - Andries E Braat
- Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - A Stijn L P Crobach
- Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands
| | - Otto M van Delden
- Department of Medical Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - Tom van der Hulle
- Department of Medical Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - Heinz-Josef Klümpen
- Department of Medical Oncology, Amsterdam University Medical Center, Location AMC, Amsterdam, The Netherlands
| | - Rutger W van der Meer
- Department of Radiology, Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, The Netherlands
| | - J Frank W Nijsen
- Department of Medical Imaging, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Carla S P van Rijswijk
- Department of Radiology, Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, The Netherlands
| | - Joey Roosen
- Department of Medical Imaging, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Bastian N Ruijter
- Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, The Netherlands
| | - Frits Smit
- Department of Radiology, Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, The Netherlands
| | - Mette K Stam
- Department of Radiology, Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, The Netherlands
| | - R Bart Takkenberg
- Department of Gastroenterology and Hepatology, Amsterdam University Medical Center, Location AMC, Amsterdam, The Netherlands
| | - Maarten E Tushuizen
- Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, The Netherlands
| | - Floris H P van Velden
- Department of Radiology, Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, The Netherlands
| | - Lioe-Fee de Geus-Oei
- Department of Radiology, Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, The Netherlands
| | - Mark C Burgmans
- Department of Radiology, Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, The Netherlands
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10
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Kalisvaart GM, van Velden FHP, Hernández-Girón I, Meijer KM, Ghesquiere-Dierickx LMH, Brink WM, Webb A, de Geus-Oei LF, Slump CH, Kuznetsov DV, Schaart DR, Grootjans W. Design and evaluation of a modular multimodality imaging phantom to simulate heterogeneous uptake and enhancement patterns for radiomic quantification in hybrid imaging; a feasibility study. Med Phys 2022; 49:3093-3106. [PMID: 35178781 PMCID: PMC9314050 DOI: 10.1002/mp.15537] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 01/31/2022] [Accepted: 02/02/2022] [Indexed: 11/21/2022] Open
Abstract
Background Accuracy and precision assessment in radiomic features is important for the determination of their potential to characterize cancer lesions. In this regard, simulation of different imaging conditions using specialized phantoms is increasingly being investigated. In this study, the design and evaluation of a modular multimodality imaging phantom to simulate heterogeneous uptake and enhancement patterns for radiomics quantification in hybrid imaging is presented. Methods A modular multimodality imaging phantom was constructed that could simulate different patterns of heterogeneous uptake and enhancement patterns in positron emission tomography (PET), single‐photon emission computed tomography (SPECT), computed tomography (CT), and magnetic resonance (MR) imaging. The phantom was designed to be used as an insert in the standard NEMA‐NU2 IEC body phantom casing. The entire phantom insert is composed of three segments, each containing three separately fillable compartments. The fillable compartments between segments had different sizes in order to simulate heterogeneous patterns at different spatial scales. The compartments were separately filled with different ratios of 99mTc‐pertechnetate, 18F‐fluorodeoxyglucose ([18F]FDG), iodine‐ and gadolinium‐based contrast agents for SPECT, PET, CT, and T1‐weighted MR imaging respectively. Image acquisition was performed using standard oncological protocols on all modalities and repeated five times for repeatability assessment. A total of 93 radiomic features were calculated. Variability was assessed by determining the coefficient of quartile variation (CQV) of the features. Comparison of feature repeatability at different modalities and spatial scales was performed using Kruskal‐Wallis‐, Mann‐Whitney U‐, one‐way ANOVA‐ and independent t‐tests. Results Heterogeneous uptake and enhancement could be simulated on all four imaging modalities. Radiomic features in SPECT were significantly less stable than in all other modalities. Features in PET were significantly less stable than in MR and CT. A total of 20 features, particularly in the gray‐level co‐occurrence matrix (GLCM) and gray‐level run‐length matrix (GLRLM) class, were found to be relatively stable in all four modalities for all three spatial scales of heterogeneous patterns (with CQV < 10%). Conclusion The phantom was suitable for simulating heterogeneous uptake and enhancement patterns in [18F]FDG‐PET, 99mTc‐SPECT, CT, and T1‐weighted MR images. The results of this work indicate that the phantom might be useful for the further development and optimization of imaging protocols for radiomic quantification in hybrid imaging modalities.
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Affiliation(s)
| | | | | | - Karin M Meijer
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Laura M H Ghesquiere-Dierickx
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.,Mechanical, Maritime, and Materials Engineering, Delft University of Technology, Delft, The Netherlands.,Department of Medical Physics in Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Wyger M Brink
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Andrew Webb
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Lioe-Fee de Geus-Oei
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.,Biomedical Photonic Imaging Group, University of Twente, Enschede, The Netherlands
| | - Cornelis H Slump
- Robotics and Mechatronics, University of Twente, Enschede, The Netherlands
| | - Dimitri V Kuznetsov
- Electronic and mechanical support division, Delft University of Technology, Delft, The Netherlands
| | - Dennis R Schaart
- Radiation Science and Technology, Delft University of Technology, Delft, The Netherlands.,Holland Proton Therapy Center (HollandPTC), Delft, The Netherlands
| | - Willem Grootjans
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
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11
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de Koster EJ, Noortman WA, Mostert JM, Booij J, Brouwer CB, de Keizer B, de Klerk JMH, Oyen WJG, van Velden FHP, de Geus-Oei LF, Vriens D. Quantitative classification and radiomics of [ 18F]FDG-PET/CT in indeterminate thyroid nodules. Eur J Nucl Med Mol Imaging 2022; 49:2174-2188. [PMID: 35138444 PMCID: PMC9165273 DOI: 10.1007/s00259-022-05712-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 01/26/2022] [Indexed: 12/12/2022]
Abstract
PURPOSE To evaluate whether quantitative [18F]FDG-PET/CT assessment, including radiomic analysis of [18F]FDG-positive thyroid nodules, improved the preoperative differentiation of indeterminate thyroid nodules of non-Hürthle cell and Hürthle cell cytology. METHODS Prospectively included patients with a Bethesda III or IV thyroid nodule underwent [18F]FDG-PET/CT imaging. Receiver operating characteristic (ROC) curve analysis was performed for standardised uptake values (SUV) and SUV-ratios, including assessment of SUV cut-offs at which a malignant/borderline neoplasm was reliably ruled out (≥ 95% sensitivity). [18F]FDG-positive scans were included in radiomic analysis. After segmentation at 50% of SUVpeak, 107 radiomic features were extracted from [18F]FDG-PET and low-dose CT images. Elastic net regression classifiers were trained in a 20-times repeated random split. Dimensionality reduction was incorporated into the splits. Predictive performance of radiomics was presented as mean area under the ROC curve (AUC) across the test sets. RESULTS Of 123 included patients, 84 (68%) index nodules were visually [18F]FDG-positive. The malignant/borderline rate was 27% (33/123). SUV-metrices showed AUCs ranging from 0.705 (95% CI, 0.601-0.810) to 0.729 (0.633-0.824), 0.708 (0.580-0.835) to 0.757 (0.650-0.864), and 0.533 (0.320-0.747) to 0.700 (0.502-0.898) in all (n = 123), non-Hürthle (n = 94), and Hürthle cell (n = 29) nodules, respectively. At SUVmax, SUVpeak, SUVmax-ratio, and SUVpeak-ratio cut-offs of 2.1 g/mL, 1.6 g/mL, 1.2, and 0.9, respectively, sensitivity of [18F]FDG-PET/CT was 95.8% (95% CI, 78.9-99.9%) in non-Hürthle cell nodules. In Hürthle cell nodules, cut-offs of 5.2 g/mL, 4.7 g/mL, 3.4, and 2.8, respectively, resulted in 100% sensitivity (95% CI, 66.4-100%). Radiomic analysis of 84 (68%) [18F]FDG-positive nodules showed a mean test set AUC of 0.445 (95% CI, 0.290-0.600) for the PET model. CONCLUSION Quantitative [18F]FDG-PET/CT assessment ruled out malignancy in indeterminate thyroid nodules. Distinctive, higher SUV cut-offs should be applied in Hürthle cell nodules to optimize rule-out ability. Radiomic analysis did not contribute to the additional differentiation of [18F]FDG-positive nodules. TRIAL REGISTRATION NUMBER This trial is registered with ClinicalTrials.gov: NCT02208544 (5 August 2014), https://clinicaltrials.gov/ct2/show/NCT02208544 .
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Affiliation(s)
- Elizabeth J de Koster
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, the Netherlands.
| | - Wyanne A Noortman
- Department of Radiology, Section of Nuclear Medicine, Leiden University Medical Center, Leiden, the Netherlands
- Biomedical Photonic Imaging Group, University of Twente, Enschede, the Netherlands
| | - Jacob M Mostert
- Department of Radiology, Section of Nuclear Medicine, Leiden University Medical Center, Leiden, the Netherlands
- Delft University of Technology, Delft, the Netherlands
| | - Jan Booij
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, Location Academic Medical Center, Amsterdam, the Netherlands
| | | | - Bart de Keizer
- Department of Radiology and Nuclear Medicine, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - John M H de Klerk
- Department of Nuclear Medicine, Meander Medical Centre, Amersfoort, the Netherlands
| | - Wim J G Oyen
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, the Netherlands
- Department of Radiology and Nuclear Medicine, Rijnstate Hospital, Arnhem, the Netherlands
- Department of Biomedical Sciences and Humanitas Clinical and Research Centre, Department of Nuclear Medicine, Humanitas University, Milan, Italy
| | - Floris H P van Velden
- Department of Radiology, Section of Nuclear Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - Lioe-Fee de Geus-Oei
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, the Netherlands
- Department of Radiology, Section of Nuclear Medicine, Leiden University Medical Center, Leiden, the Netherlands
- Biomedical Photonic Imaging Group, University of Twente, Enschede, the Netherlands
| | - Dennis Vriens
- Department of Radiology, Section of Nuclear Medicine, Leiden University Medical Center, Leiden, the Netherlands
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12
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Schalbroeck R, de Geus-Oei LF, Selten JP, Yaqub M, Schrantee A, van Amelsvoort T, Booij J, van Velden FHP. Cerebral [ 18F]-FDOPA Uptake in Autism Spectrum Disorder and Its Association with Autistic Traits. Diagnostics (Basel) 2021; 11:diagnostics11122404. [PMID: 34943640 PMCID: PMC8700159 DOI: 10.3390/diagnostics11122404] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 12/07/2021] [Accepted: 12/17/2021] [Indexed: 11/16/2022] Open
Abstract
Dopaminergic signaling is believed to be related to autistic traits. We conducted an exploratory 3,4-dihydroxy-6-[18F]-fluoro-L-phenylalanine positron emission tomography/computed tomography ([18F]-FDOPA PET/CT) study, to examine cerebral [18F]-FDOPA influx constant (kicer min−1), reflecting predominantly striatal dopamine synthesis capacity and a mixed monoaminergic innervation in extrastriatal neurons, in 44 adults diagnosed with autism spectrum disorder (ASD) and 22 controls, aged 18 to 30 years. Autistic traits were assessed with the Autism Spectrum Quotient (AQ). Region-of-interest and voxel-based analyses showed no statistically significant differences in kicer between autistic adults and controls. In autistic adults, striatal kicer was significantly, negatively associated with AQ attention to detail subscale scores, although Bayesian analyses did not support this finding. In conclusion, among autistic adults, specific autistic traits can be associated with reduced striatal dopamine synthesis capacity. However, replication of this finding is necessary.
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Affiliation(s)
- Rik Schalbroeck
- School for Mental Health and Neuroscience, Maastricht University, 6229 ER Maastricht, The Netherlands; (J.-P.S.); (T.v.A.)
- Rivierduinen Institute for Mental Healthcare, 2333 ZZ Leiden, The Netherlands
- Section of Nuclear Medicine, Department of Radiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (L.-F.d.G.-O.); (F.H.P.v.V.)
- Correspondence:
| | - Lioe-Fee de Geus-Oei
- Section of Nuclear Medicine, Department of Radiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (L.-F.d.G.-O.); (F.H.P.v.V.)
- Biomedical Photonic Imaging Group, University of Twente, 7522 NB Enschede, The Netherlands
| | - Jean-Paul Selten
- School for Mental Health and Neuroscience, Maastricht University, 6229 ER Maastricht, The Netherlands; (J.-P.S.); (T.v.A.)
- Rivierduinen Institute for Mental Healthcare, 2333 ZZ Leiden, The Netherlands
| | - Maqsood Yaqub
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, Location VU Medical Center, 1081 HV Amsterdam, The Netherlands;
| | - Anouk Schrantee
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, Location Academic Medical Center, 1105 AZ Amsterdam, The Netherlands; (A.S.); (J.B.)
| | - Therese van Amelsvoort
- School for Mental Health and Neuroscience, Maastricht University, 6229 ER Maastricht, The Netherlands; (J.-P.S.); (T.v.A.)
| | - Jan Booij
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, Location Academic Medical Center, 1105 AZ Amsterdam, The Netherlands; (A.S.); (J.B.)
| | - Floris H. P. van Velden
- Section of Nuclear Medicine, Department of Radiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (L.-F.d.G.-O.); (F.H.P.v.V.)
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13
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Kalisvaart GM, Grootjans W, Bovée JVMG, Gelderblom H, van der Hage JA, van de Sande MAJ, van Velden FHP, Bloem JL, de Geus-Oei LF. Prognostic Value of Quantitative [18F]FDG-PET Features in Patients with Metastases from Soft Tissue Sarcoma. Diagnostics (Basel) 2021; 11:diagnostics11122271. [PMID: 34943508 PMCID: PMC8700088 DOI: 10.3390/diagnostics11122271] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 11/30/2021] [Accepted: 12/02/2021] [Indexed: 02/03/2023] Open
Abstract
Background: Prognostic biomarkers are pivotal for adequate treatment decision making. The objective of this study was to determine the added prognostic value of quantitative [18F]FDG-PET features in patients with metastases from soft tissue sarcoma (STS). Methods: Patients with metastases from STS, detected by (re)staging [18F]FDG-PET/CT at Leiden University Medical Centre, were retrospectively included. Clinical and histopathological patient characteristics and [18F]FDG-PET features (SUVmax, SUVpeak, SUVmean, total lesion glycolysis, and metabolic tumor volume) were analyzed as prognostic factors for overall survival using a Cox proportional hazards model and Kaplan–Meier methods. Results: A total of 31 patients were included. SUVmax and SUVpeak were significantly predictive for overall survival (OS) in a univariate analysis (p = 0.004 and p = 0.006, respectively). Hazard ratios (HRs) were 1.16 per unit increase for SUVmax and 1.20 per unit for SUVpeak. SUVmax and SUVpeak remained significant predictors for overall survival after correction for the two strongest predictive clinical characteristics (number of lesions and performance status) in a multivariate analysis (p = 0.02 for both). Median SUVmax and SUVpeak were 5.7 and 4.9 g/mL, respectively. The estimated mean overall survival in patients with SUVmax > 5.7 g/mL was 14 months; otherwise, it was 39 months (p < 0.001). For patients with SUVpeak > 4.9 g/mL, the estimated mean overall survival was 18 months; otherwise, it was 33 months (p = 0.04). Conclusions: In this study, SUVmax and SUVpeak were independent prognostic factors for overall survival in patients with metastases from STS. These results warrant further investigation of metabolic imaging with [18F]FDG-PET/CT in patients with metastatic STS.
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Affiliation(s)
- Gijsbert M. Kalisvaart
- Department of Radiology, Leiden University Medical Centre, 2333 ZA Leiden, The Netherlands; (W.G.); (F.H.P.v.V.); (J.L.B.); (L.-F.d.G.-O.)
- Correspondence:
| | - Willem Grootjans
- Department of Radiology, Leiden University Medical Centre, 2333 ZA Leiden, The Netherlands; (W.G.); (F.H.P.v.V.); (J.L.B.); (L.-F.d.G.-O.)
| | - Judith V. M. G. Bovée
- Department of Pathology, Leiden University Medical Centre, 2333 ZA Leiden, The Netherlands;
| | - Hans Gelderblom
- Department of Medical Oncology, Leiden University Medical Centre, 2333 ZA Leiden, The Netherlands;
| | - Jos A. van der Hage
- Department of Surgical Oncology, Leiden University Medical Centre, 2333 ZA Leiden, The Netherlands;
| | | | - Floris H. P. van Velden
- Department of Radiology, Leiden University Medical Centre, 2333 ZA Leiden, The Netherlands; (W.G.); (F.H.P.v.V.); (J.L.B.); (L.-F.d.G.-O.)
| | - Johan L. Bloem
- Department of Radiology, Leiden University Medical Centre, 2333 ZA Leiden, The Netherlands; (W.G.); (F.H.P.v.V.); (J.L.B.); (L.-F.d.G.-O.)
| | - Lioe-Fee de Geus-Oei
- Department of Radiology, Leiden University Medical Centre, 2333 ZA Leiden, The Netherlands; (W.G.); (F.H.P.v.V.); (J.L.B.); (L.-F.d.G.-O.)
- Biomedical Photonic Imaging Group, University of Twente, 7522 NB Enschede, The Netherlands
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14
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Peters SMB, Meyer Viol SL, van der Werf NR, de Jong N, van Velden FHP, Meeuwis A, Konijnenberg MW, Gotthardt M, de Jong HWAM, Segbers M. Correction to: Variability in lutetium-177 SPECT quantification between different state-of-the-art SPECT/CT systems. EJNMMI Phys 2021; 8:59. [PMID: 34406512 PMCID: PMC8374010 DOI: 10.1186/s40658-021-00399-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Steffie M B Peters
- Department of Radiology and Nuclear Medicine, Department of Radiology and Nuclear Medicine, Radboud University Medical Center, P.O. Box 9101, 6500, HB, Nijmegen, The Netherlands.
| | - Sebastiaan L Meyer Viol
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Niels R van der Werf
- Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Nick de Jong
- Department of Radiology, Section of Medical Technology, Leiden University Medical Center, Leiden, The Netherlands
| | - Floris H P van Velden
- Department of Radiology, Section of Medical Technology, Leiden University Medical Center, Leiden, The Netherlands
| | - Antoi Meeuwis
- Department of Radiology and Nuclear Medicine, Department of Radiology and Nuclear Medicine, Radboud University Medical Center, P.O. Box 9101, 6500, HB, Nijmegen, The Netherlands
| | - Mark W Konijnenberg
- Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Martin Gotthardt
- Department of Radiology and Nuclear Medicine, Department of Radiology and Nuclear Medicine, Radboud University Medical Center, P.O. Box 9101, 6500, HB, Nijmegen, The Netherlands
| | - Hugo W A M de Jong
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Marcel Segbers
- Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
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15
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Noortman WA, Vriens D, Mooij CDY, Slump CH, Aarntzen EH, van Berkel A, Timmers HJLM, Bussink J, Meijer TWH, de Geus-Oei LF, van Velden FHP. The Influence of the Exclusion of Central Necrosis on [ 18F]FDG PET Radiomic Analysis. Diagnostics (Basel) 2021. [PMID: 34359379 DOI: 10.3390/diagnostics] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Central necrosis can be detected on [18F]FDG PET/CT as a region with little to no tracer uptake. Currently, there is no consensus regarding the inclusion of regions of central necrosis during volume of interest (VOI) delineation for radiomic analysis. The aim of this study was to assess how central necrosis affects radiomic analysis in PET. METHODS Forty-three patients, either with non-small cell lung carcinomas (NSCLC, n = 12) or with pheochromocytomas or paragangliomas (PPGL, n = 31), were included retrospectively. VOIs were delineated with and without central necrosis. From all VOIs, 105 radiomic features were extracted. Differences in radiomic features between delineation methods were assessed using a paired t-test with Benjamini-Hochberg multiple testing correction. In the PPGL cohort, performances of the radiomic models to predict the noradrenergic biochemical profile were assessed by comparing the areas under the receiver operating characteristic curve (AUC) for both delineation methods. RESULTS At least 65% of the features showed significant differences between VOIvital-tumour and VOIgross-tumour (65%, 79% and 82% for the NSCLC, PPGL and combined cohort, respectively). The AUCs of the radiomic models were not significantly different between delineation methods. CONCLUSION In both tumour types, almost two-third of the features were affected, demonstrating that the impact of whether or not to include central necrosis in the VOI on the radiomic feature values is significant. Nevertheless, predictive performances of both delineation methods were comparable. We recommend that radiomic studies should report whether or not central necrosis was included during delineation.
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Affiliation(s)
- Wyanne A Noortman
- Section of Nuclear Medicine, Department of Radiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
- TechMed Centre, University of Twente, 7522 NB Enschede, The Netherlands
| | - Dennis Vriens
- Section of Nuclear Medicine, Department of Radiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Charlotte D Y Mooij
- Section of Nuclear Medicine, Department of Radiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
- Technical Medicine, Delft University of Technology, 2628 CD Delft, The Netherlands
| | - Cornelis H Slump
- TechMed Centre, University of Twente, 7522 NB Enschede, The Netherlands
| | - Erik H Aarntzen
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
| | - Anouk van Berkel
- Division of Endocrinology, Department of Internal Medicine, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
| | - Henri J L M Timmers
- Division of Endocrinology, Department of Internal Medicine, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
| | - Johan Bussink
- Radiotherapy and OncoImmunology Laboratory, Department of Radiation Oncology, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
| | - Tineke W H Meijer
- Department of Radiation Oncology, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands
| | - Lioe-Fee de Geus-Oei
- Section of Nuclear Medicine, Department of Radiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
- TechMed Centre, University of Twente, 7522 NB Enschede, The Netherlands
| | - Floris H P van Velden
- Section of Nuclear Medicine, Department of Radiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
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16
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van de Burgt A, Dibbets-Schneider P, Slump CH, Scholte AJHA, Atsma DE, de Geus-Oei LF, van Velden FHP. Experimental validation of absolute SPECT/CT quantification for response monitoring in patients with coronary artery disease. EJNMMI Phys 2021; 8:48. [PMID: 34132918 PMCID: PMC8208344 DOI: 10.1186/s40658-021-00393-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 06/08/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Quantitative SPECT enables absolute quantification of uptake in perfusion defects. The aim of this experimental study is to assess quantitative accuracy and precision of a novel iterative reconstruction technique (Evolution; GE Healthcare) for the potential application of response monitoring using 99mTc-tetrofosmin SPECT/CT in patients with coronary artery disease (CAD). METHODS Acquisitions of an anthropomorphic torso phantom with cardiac insert containing defects (with varying sizes), filled with 99mTc-pertechnetate, were performed on a SPECT/CT (Discovery 670 Pro, GE Healthcare). Subsequently, volumes of interest of the defects were manually drawn on CT to assess the recovery coefficient (RC). Bull's eye plots were composed to evaluate the uptake per segment. Finally, 99mTc-tetrofosmin SPECT/CT scans of 10 CAD patients were used to illustrate clinical application. RESULTS The phantom study indicated that Evolution showed convergence after 7 iterations and 10 subsets. The average repeatability deviation of all configurations was 2.91% and 3.15% (%SD mean) for filtered (Butterworth) and unfiltered data, respectively. The accuracy after post-filtering was lower compared to the unfiltered data with a mean (SD) RC of 0.63 (0.05) and 0.70 (0.07), respectively (p < 0.05). More artificial defects were found on Bull's eye plots created with the unfiltered data compared to filtered data. Eight out of ten patients showed significant changes in uptake before and after treatment (p < 0.05). CONCLUSION Quantification of 99mTc-tetrofosmin SPECT/CT seems feasible for CAD patients when 7 iterations (10 subsets), Butterworth post-filtering (cut off frequency 0.52 in cycles/cm, order of 5) and manual CT-delineation are applied. However, future prospective patient studies are required for clinical application.
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Affiliation(s)
- Alina van de Burgt
- Department of Radiology, Section of Nuclear Medicine, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, The Netherlands.
| | - Petra Dibbets-Schneider
- Department of Radiology, Section of Nuclear Medicine, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, The Netherlands
| | - Cornelis H Slump
- Technical Medical Center, University of Twente, Enschede, The Netherlands
| | - Arthur J H A Scholte
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Douwe E Atsma
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Lioe-Fee de Geus-Oei
- Department of Radiology, Section of Nuclear Medicine, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, The Netherlands.,Biomedical Photonic Imaging Group, University of Twente, Enschede, The Netherlands
| | - Floris H P van Velden
- Department of Radiology, Section of Nuclear Medicine, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, The Netherlands
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Schalbroeck R, van Velden FHP, de Geus-Oei LF, Yaqub M, van Amelsvoort T, Booij J, Selten JP. Striatal dopamine synthesis capacity in autism spectrum disorder and its relation with social defeat: an [ 18F]-FDOPA PET/CT study. Transl Psychiatry 2021; 11:47. [PMID: 33441546 PMCID: PMC7806928 DOI: 10.1038/s41398-020-01174-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 12/14/2020] [Accepted: 12/15/2020] [Indexed: 01/29/2023] Open
Abstract
Alterations in dopamine signalling have been implied in autism spectrum disorder (ASD), and these could be associated with the risk of developing a psychotic disorder in ASD adults. Negative social experiences and feelings of social defeat might result in an increase in dopamine functioning. However, few studies examined dopamine functioning in vivo in ASD. Here we examine whether striatal dopamine synthesis capacity is increased in ASD and associated with social defeat. Forty-four unmedicated, non-psychotic adults diagnosed with ASD and 22 matched controls, aged 18-30 years, completed a dynamic 3,4-dihydroxy-6-[18F]-fluoro-L-phenylalanine positron emission tomography/computed tomography ([18F]-FDOPA PET/CT) scan to measure presynaptic dopamine synthesis capacity in the striatum. We considered unwanted loneliness, ascertained using the UCLA Loneliness Scale, as primary measure of social defeat. We found no statistically significant difference in striatal dopamine synthesis capacity between ASD and controls (F1,60 = 0.026, p = 0.87). In ASD, striatal dopamine synthesis capacity was not significantly associated with loneliness (β = 0.01, p = 0.96). Secondary analyses showed comparable results when examining the associative, limbic, and sensorimotor sub-regions of the striatum (all p-values > 0.05). Results were similar before and after adjusting for age, sex, smoking-status, and PET/CT-scanner-type. In conclusion, in unmedicated, non-psychotic adults with ASD, striatal dopamine synthesis capacity is not increased and not associated with social defeat.
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Affiliation(s)
- Rik Schalbroeck
- Rivierduinen Institute for Mental Healthcare, Leiden, The Netherlands. .,School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands. .,Section of Nuclear Medicine, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.
| | - Floris H. P. van Velden
- grid.10419.3d0000000089452978Section of Nuclear Medicine, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Lioe-Fee de Geus-Oei
- grid.10419.3d0000000089452978Section of Nuclear Medicine, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands ,grid.6214.10000 0004 0399 8953Biomedical Imaging Group, University of Twente, Enschede, The Netherlands
| | - Maqsood Yaqub
- grid.16872.3a0000 0004 0435 165XDepartment of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, location Vrije Universiteit Medical Center, Amsterdam, The Netherlands
| | - Therese van Amelsvoort
- grid.5012.60000 0001 0481 6099School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Jan Booij
- grid.5650.60000000404654431Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, location Academic Medical Center, Amsterdam, The Netherlands
| | - Jean-Paul Selten
- Rivierduinen Institute for Mental Healthcare, Leiden, The Netherlands ,grid.5012.60000 0001 0481 6099School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
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18
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Saldarriaga Vargas C, Bauwens M, Pooters INA, Pommé S, Peters SMB, Segbers M, Jentzen W, Vogg A, van Velden FHP, Meyer Viol SL, Gotthardt M, Mottaghy FM, Wildberger JE, Covens P, Wierts R. An international multi-center investigation on the accuracy of radionuclide calibrators in nuclear medicine theragnostics. EJNMMI Phys 2020; 7:69. [PMID: 33226485 PMCID: PMC7683758 DOI: 10.1186/s40658-020-00338-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 11/10/2020] [Indexed: 01/20/2023] Open
Abstract
Background Personalized molecular radiotherapy based on theragnostics requires accurate quantification of the amount of radiopharmaceutical activity administered to patients both in diagnostic and therapeutic applications. This international multi-center study aims to investigate the clinical measurement accuracy of radionuclide calibrators for 7 radionuclides used in theragnostics: 99mTc, 111In, 123I, 124I, 131I, 177Lu, and 90Y. Methods In total, 32 radionuclide calibrators from 8 hospitals located in the Netherlands, Belgium, and Germany were tested. For each radionuclide, a set of four samples comprising two clinical containers (10-mL glass vial and 3-mL syringe) with two filling volumes were measured. The reference value of each sample was determined by two certified radioactivity calibration centers (SCK CEN and JRC) using two secondary standard ionization chambers. The deviation in measured activity with respect to the reference value was determined for each radionuclide and each measurement geometry. In addition, the combined systematic deviation of activity measurements in a theragnostic setting was evaluated for 5 clinically relevant theragnostic pairs: 131I/123I, 131I/124I, 177Lu/111In, 90Y/99mTc, and 90Y/111In. Results For 99mTc, 131I, and 177Lu, a small minority of measurements were not within ± 5% range from the reference activity (percentage of measurements not within range: 99mTc, 6%; 131I, 14%; 177Lu, 24%) and almost none were outside ± 10% range. However, for 111In, 123I, 124I, and 90Y, more than half of all measurements were not accurate within ± 5% range (111In, 51%; 123I, 83%; 124I, 63%; 90Y, 61%) and not all were within ± 10% margin (111In, 22%; 123I, 35%; 124I, 15%; 90Y, 25%). A large variability in measurement accuracy was observed between radionuclide calibrator systems, type of sample container (vial vs syringe), and source-geometry calibration/correction settings used. Consequently, we observed large combined deviations (percentage deviation > ± 10%) for the investigated theragnostic pairs, in particular for 90Y/111In, 131I/123I, and 90Y/99mTc. Conclusions Our study shows that substantial over- or underestimation of therapeutic patient doses is likely to occur in a theragnostic setting due to errors in the assessment of radioactivity with radionuclide calibrators. These findings underline the importance of thorough validation of radionuclide calibrator systems for each clinically relevant radionuclide and sample geometry. Supplementary Information The online version contains supplementary material available at 10.1186/s40658-020-00338-3.
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Affiliation(s)
- Clarita Saldarriaga Vargas
- Radiation Protection Dosimetry and Calibrations, Belgian Nuclear Research Centre (SCK CEN), Mol, Belgium.,In vivo Cellular and Molecular Imaging, Vrije Universiteit Brussel, Jette, Belgium
| | - Matthias Bauwens
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, P.O. Box 5800, 6202, AZ, Maastricht, The Netherlands
| | - Ivo N A Pooters
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, P.O. Box 5800, 6202, AZ, Maastricht, The Netherlands
| | - Stefaan Pommé
- European Commission, Joint Research Centre (JRC), Geel, Belgium
| | - Steffie M B Peters
- Department of Radiology, Nuclear Medicine and Anatomy, Radboudumc, Nijmegen, The Netherlands
| | - Marcel Segbers
- Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Walter Jentzen
- Department of Nuclear Medicine, University of Duisburg-Essen, Essen, Germany
| | - Andreas Vogg
- Department of Nuclear Medicine, University Hospital RWTH Aachen University, Aachen, Germany
| | | | - Sebastiaan L Meyer Viol
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Martin Gotthardt
- Department of Radiology, Nuclear Medicine and Anatomy, Radboudumc, Nijmegen, The Netherlands
| | - Felix M Mottaghy
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, P.O. Box 5800, 6202, AZ, Maastricht, The Netherlands.,Department of Nuclear Medicine, University Hospital RWTH Aachen University, Aachen, Germany
| | - Joachim E Wildberger
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, P.O. Box 5800, 6202, AZ, Maastricht, The Netherlands
| | - Peter Covens
- In vivo Cellular and Molecular Imaging, Vrije Universiteit Brussel, Jette, Belgium
| | - Roel Wierts
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, P.O. Box 5800, 6202, AZ, Maastricht, The Netherlands.
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19
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Noortman WA, Vriens D, Slump CH, Bussink J, Meijer TWH, de Geus-Oei LF, van Velden FHP. Adding the temporal domain to PET radiomic features. PLoS One 2020; 15:e0239438. [PMID: 32966313 PMCID: PMC7510999 DOI: 10.1371/journal.pone.0239438] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 09/05/2020] [Indexed: 01/18/2023] Open
Abstract
Background Radiomic features, extracted from positron emission tomography, aim to characterize tumour biology based on tracer intensity, tumour geometry and/or tracer uptake heterogeneity. Currently, radiomic features are derived from static images. However, temporal changes in tracer uptake might reveal new aspects of tumour biology. This study aims to explore additional information of these novel dynamic radiomic features compared to those derived from static or metabolic rate images. Methods Thirty-five patients with non-small cell lung carcinoma underwent dynamic [18F]FDG PET/CT scans. Spatial intensity, shape and texture radiomic features were derived from volumes of interest delineated on static PET and parametric metabolic rate PET. Dynamic grey level cooccurrence matrix (GLCM) and grey level run length matrix (GLRLM) features, assessing the temporal domain unidirectionally, were calculated on eight and sixteen time frames of equal length. Spearman’s rank correlations of parametric and dynamic features with static features were calculated to identify features with potential additional information. Survival analysis was performed for the non-redundant temporal features and a selection of static features using Kaplan-Meier analysis. Results Three out of 90 parametric features showed moderate correlations with corresponding static features (ρ≥0.61), all other features showed high correlations (ρ>0.7). Dynamic features are robust independent of frame duration. Five out of 22 dynamic GLCM features showed a negligible to moderate correlation with any static feature, suggesting additional information. All sixteen dynamic GLRLM features showed high correlations with static features, implying redundancy. Log-rank analyses of Kaplan-Meier survival curves for all features dichotomised at the median were insignificant. Conclusion This study suggests that, compared to static features, some dynamic GLCM radiomic features show different information, whereas parametric features provide minimal additional information. Future studies should be conducted in larger populations to assess whether there is a clinical benefit of radiomics using the temporal domain over traditional radiomics.
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Affiliation(s)
- Wyanne A. Noortman
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
- Biomedical Photonic Imaging Group, University of Twente, Enschede, The Netherlands
- * E-mail:
| | - Dennis Vriens
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Cornelis H. Slump
- Robotics and Mechatronics, Technical Medical Centre, University of Twente, Enschede, The Netherlands
| | - Johan Bussink
- Department of Radiation Oncology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Tineke W. H. Meijer
- Department of Radiation Oncology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Lioe-Fee de Geus-Oei
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
- Biomedical Photonic Imaging Group, University of Twente, Enschede, The Netherlands
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20
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Janssen LGM, Nahon KJ, Bracké KFM, van den Broek D, Smit R, Sardjoe Mishre ASD, Koorneef LL, Martinez-Tellez B, Burakiewicz J, Kan HE, van Velden FHP, Pereira Arias-Bouda LM, de Geus-Oei LF, Berbée JFP, Jazet IM, Boon MR, Rensen PCN. Twelve weeks of exenatide treatment increases [ 18F]fluorodeoxyglucose uptake by brown adipose tissue without affecting oxidative resting energy expenditure in nondiabetic males. Metabolism 2020; 106:154167. [PMID: 31982480 DOI: 10.1016/j.metabol.2020.154167] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 01/18/2020] [Accepted: 01/21/2020] [Indexed: 12/30/2022]
Abstract
AIMS/HYPOTHESIS Brown adipose tissue (BAT) improves energy metabolism by combusting glucose and lipids into heat. Agonism of the glucagon-like peptide-1 receptor (GLP-1R) within the central nervous system activates BAT in mice. Moreover, in patients with type 2 diabetes, GLP-1R agonism lowers body weight and improves glucose and lipid levels, possibly involving BAT activation. Interestingly, people from South Asian descent are prone to develop cardiometabolic disease. We studied the effect of GLP-1R agonism on BAT in humans, specifically in South Asians and Europids without obesity or type 2 diabetes. METHODS Twelve Dutch South Asian and 12 age- and BMI-matched Europid nondiabetic men received 12 weeks extended-release exenatide (Bydureon) in this single-arm prospective study. Before and after treatment, BAT was visualized by a cold-induced [18F]FDG-PET/CT scan and a thermoneutral MRI scan, and resting energy expenditure (REE), substrate oxidation, body composition and fasting plasma glucose and serum lipids were determined. Appetite was rated using a visual analogue scale. RESULTS Since the effect of exenatide on metabolic parameters did not evidently differ between ethnicities, data of all participants were pooled. Exenatide decreased body weight (-1.5 ± 0.4 kg, p < 0.01), without affecting REE or substrate oxidation, and transiently decreased appetite ratings during the first weeks. Exenatide also lowered triglycerides (-15%, p < 0.05) and total cholesterol (-5%, p < 0.05), and tended to lower glucose levels. Notably, exenatide increased BAT metabolic volume (+28%, p < 0.05) and mean standardized uptake value (+11%, p < 0.05) ([18F]FDG-PET/CT), without affecting supraclavicular adipose tissue fat fraction (MRI). CONCLUSIONS/INTERPRETATION We show for the first time that GLP-1R agonism increases [18F]FDG uptake by BAT in South Asian and Europid men without obesity or type 2 diabetes. TRIAL REGISTRY Clinicaltrials.gov NCT03002675.
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Affiliation(s)
- Laura G M Janssen
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, the Netherlands; Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - Kimberly J Nahon
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, the Netherlands; Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - Katrien F M Bracké
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, the Netherlands; Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - Dennis van den Broek
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, the Netherlands; Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - Renée Smit
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, the Netherlands; Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - Aashley S D Sardjoe Mishre
- Department of Radiology, C.J. Gorter Center for High Field MRI, Leiden University Medical Center, Leiden, the Netherlands
| | - Lisa L Koorneef
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, the Netherlands; Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - Borja Martinez-Tellez
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, the Netherlands; Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, the Netherlands; PROFITH (PROmoting FITness and Health Through Physical Activity) Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Jedrzej Burakiewicz
- Department of Radiology, C.J. Gorter Center for High Field MRI, Leiden University Medical Center, Leiden, the Netherlands
| | - Hermien E Kan
- Department of Radiology, C.J. Gorter Center for High Field MRI, Leiden University Medical Center, Leiden, the Netherlands
| | - Floris H P van Velden
- Department of Radiology, Division of Nuclear Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - Lenka M Pereira Arias-Bouda
- Department of Radiology, Division of Nuclear Medicine, Leiden University Medical Center, Leiden, the Netherlands; Department of Nuclear Medicine, Alrijne Hospital, Leiderdorp, the Netherlands
| | - Lioe-Fee de Geus-Oei
- Department of Radiology, Division of Nuclear Medicine, Leiden University Medical Center, Leiden, the Netherlands; Biomedical Photonic Imaging Group, University of Twente, Enschede, the Netherlands
| | - Jimmy F P Berbée
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, the Netherlands; Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - Ingrid M Jazet
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, the Netherlands
| | - Mariëtte R Boon
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, the Netherlands; Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, the Netherlands.
| | - Patrick C N Rensen
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, the Netherlands; Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, the Netherlands
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21
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Peters SMB, Meyer Viol SL, van der Werf NR, de Jong N, van Velden FHP, Meeuwis A, Konijnenberg MW, Gotthardt M, de Jong HWAM, Segbers M. Variability in lutetium-177 SPECT quantification between different state-of-the-art SPECT/CT systems. EJNMMI Phys 2020; 7:9. [PMID: 32048097 PMCID: PMC7013023 DOI: 10.1186/s40658-020-0278-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 01/27/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Quantitative SPECT imaging in targeted radionuclide therapy with lutetium-177 holds great potential for individualized treatment based on dose assessment. The establishment of dose-effect relations requires a standardized method for SPECT quantification. The purpose of this multi-center study is to evaluate quantitative accuracy and inter-system variations of different SPECT/CT systems with corresponding commercially available quantitative reconstruction algorithms. This is an important step towards a vendor-independent standard for quantitative lutetium-177 SPECT. METHODS Four state-of-the-art SPECT/CT systems were included: Discovery™ NM/CT 670Pro (GE Healthcare), Symbia Intevo™, and two Symbia™ T16 (Siemens Healthineers). Quantitative accuracy and inter-system variations were evaluated by repeatedly scanning a cylindrical phantom with 6 spherical inserts (0.5 - 113 ml). A sphere-to-background activity concentration ratio of 10:1 was used. Acquisition settings were standardized: medium energy collimator, body contour trajectory, photon energy window of 208 keV (± 10%), adjacent 20% lower scatter window, 2 × 64 projections, 128 × 128 matrix size, and 40 s projection time. Reconstructions were performed using GE Evolution with Q.Metrix™, Siemens xSPECT Quant™, Siemens Broad Quantification™ or Siemens Flash3D™ algorithms using vendor recommended settings. In addition, projection data were reconstructed using Hermes SUV SPECT™ with standardized reconstruction settings to obtain a vendor-neutral quantitative reconstruction for all systems. Volumes of interest (VOI) for the spheres were obtained by applying a 50% threshold of the sphere maximum voxel value corrected for background activity. For each sphere, the mean and maximum recovery coefficient (RCmean and RCmax) of three repeated measurements was calculated, defined as the imaged activity concentration divided by the actual activity concentration. Inter-system variations were defined as the range of RC over all systems. RESULTS RC decreased with decreasing sphere volume. Inter-system variations with vendor-specific reconstructions were between 0.06 and 0.41 for RCmean depending on sphere size (maximum 118% quantification difference), and improved to 0.02-0.19 with vendor-neutral reconstructions (maximum 38% quantification difference). CONCLUSION This study shows that eliminating sources of possible variation drastically reduces inter-system variation in quantification. This means that absolute SPECT quantification for 177Lu is feasible in a multi-center and multi-vendor setting; however, close agreement between vendors and sites is key for multi-center dosimetry and quantitative biomarker studies.
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Affiliation(s)
- Steffie M B Peters
- Department of Radiology and Nuclear Medicine, Department of Radiology and Nuclear Medicine, Radboud University Medical Center, P.O. Box 9101, 6500, HB, Nijmegen, The Netherlands.
| | - Sebastiaan L Meyer Viol
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Niels R van der Werf
- Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Nick de Jong
- Department of Radiology, Section of Medical Technology, Leiden University Medical Center, Leiden, The Netherlands
| | - Floris H P van Velden
- Department of Radiology, Section of Medical Technology, Leiden University Medical Center, Leiden, The Netherlands
| | - Antoi Meeuwis
- Department of Radiology and Nuclear Medicine, Department of Radiology and Nuclear Medicine, Radboud University Medical Center, P.O. Box 9101, 6500, HB, Nijmegen, The Netherlands
| | - Mark W Konijnenberg
- Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Martin Gotthardt
- Department of Radiology and Nuclear Medicine, Department of Radiology and Nuclear Medicine, Radboud University Medical Center, P.O. Box 9101, 6500, HB, Nijmegen, The Netherlands
| | - Hugo W A M de Jong
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Marcel Segbers
- Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
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Peters SMB, van der Werf NR, Segbers M, van Velden FHP, Wierts R, Blokland KJAK, Konijnenberg MW, Lazarenko SV, Visser EP, Gotthardt M. Towards standardization of absolute SPECT/CT quantification: a multi-center and multi-vendor phantom study. EJNMMI Phys 2019; 6:29. [PMID: 31879813 PMCID: PMC6933042 DOI: 10.1186/s40658-019-0268-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 12/05/2019] [Indexed: 11/29/2022] Open
Abstract
Abstract Absolute quantification of radiotracer distribution using SPECT/CT imaging is of great importance for dosimetry aimed at personalized radionuclide precision treatment. However, its accuracy depends on many factors. Using phantom measurements, this multi-vendor and multi-center study evaluates the quantitative accuracy and inter-system variability of various SPECT/CT systems as well as the effect of patient size, processing software and reconstruction algorithms on recovery coefficients (RC). Methods Five SPECT/CT systems were included: Discovery™ NM/CT 670 Pro (GE Healthcare), Precedence™ 6 (Philips Healthcare), Symbia Intevo™, and Symbia™ T16 (twice) (Siemens Healthineers). Three phantoms were used based on the NEMA IEC body phantom without lung insert simulating body mass indexes (BMI) of 25, 28, and 47 kg/m2. Six spheres (0.5–26.5 mL) and background were filled with 0.1 and 0.01 MBq/mL 99mTc-pertechnetate, respectively. Volumes of interest (VOI) of spheres were obtained by a region growing technique using a 50% threshold of the maximum voxel value corrected for background activity. RC, defined as imaged activity concentration divided by actual activity concentration, were determined for maximum (RCmax) and mean voxel value (RCmean) in the VOI for each sphere diameter. Inter-system variability was expressed as median absolute deviation (MAD) of RC. Acquisition settings were standardized. Images were reconstructed using vendor-specific 3D iterative reconstruction algorithms with institute-specific settings used in clinical practice and processed using a standardized, in-house developed processing tool based on the SimpleITK framework. Additionally, all data were reconstructed with a vendor-neutral reconstruction algorithm (Hybrid Recon™; Hermes Medical Solutions). Results RC decreased with decreasing sphere diameter for each system. Inter-system variability (MAD) was 16 and 17% for RCmean and RCmax, respectively. Standardized reconstruction decreased this variability to 4 and 5%. High BMI hampers quantification of small lesions (< 10 ml). Conclusion Absolute SPECT quantification in a multi-center and multi-vendor setting is feasible, especially when reconstruction protocols are standardized, paving the way for a standard for absolute quantitative SPECT.
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Affiliation(s)
- Steffie M B Peters
- Department of Radiology and Nuclear Medicine, Radboudumc, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.
| | - Niels R van der Werf
- Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands.,Department of Medical Physics, Albert Schweitzer Hospital, Dordrecht, The Netherlands
| | - Marcel Segbers
- Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Floris H P van Velden
- Department of Radiology, Section of Medical Physics, Leiden University Medical Center, Leiden, The Netherlands
| | - Roel Wierts
- Department of Radiology and Nuclear Medicine, Maastricht UMC+, Maastricht, The Netherlands
| | - Koos J A K Blokland
- Department of Radiology, Section of Medical Physics, Leiden University Medical Center, Leiden, The Netherlands
| | - Mark W Konijnenberg
- Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Sergiy V Lazarenko
- Department of Nuclear Medicine, Noordwest Ziekenhuisgroep, Alkmaar, The Netherlands
| | - Eric P Visser
- Department of Radiology and Nuclear Medicine, Radboudumc, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Martin Gotthardt
- Department of Radiology and Nuclear Medicine, Radboudumc, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
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Pfaehler E, van Sluis J, Merema BBJ, van Ooijen P, Berendsen RCM, van Velden FHP, Boellaard R. Experimental Multicenter and Multivendor Evaluation of the Performance of PET Radiomic Features Using 3-Dimensionally Printed Phantom Inserts. J Nucl Med 2019; 61:469-476. [PMID: 31420497 DOI: 10.2967/jnumed.119.229724] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 07/24/2019] [Indexed: 01/27/2023] Open
Abstract
The sensitivity of radiomic features to several confounding factors, such as reconstruction settings, makes clinical use challenging. To investigate the impact of harmonized image reconstructions on feature consistency, a multicenter phantom study was performed using 3-dimensionally printed phantom inserts reflecting realistic tumor shapes and heterogeneity uptakes. Methods: Tumors extracted from real PET/CT scans of patients with non-small cell lung cancer served as model for three 3-dimensionally printed inserts. Different heterogeneity pattern were realized by printing separate compartments that could be filled with different activity solutions. The inserts were placed in the National Electrical Manufacturers Association image-quality phantom and scanned various times. First, a list-mode scan was acquired and 5 statistically equal replicates were reconstructed. Second, the phantom was scanned 4 times on the same scanner. Third, the phantom was scanned on 6 PET/CT systems. All images were reconstructed using EANM Research Ltd. (EARL)-compliant and locally clinically preferred reconstructions. EARL-compliant reconstructions were performed without (EARL1) or with (EARL2) point-spread function. Images were analyzed with and without resampling to 2-mm cubic voxels. Images were discretized with a fixed bin width (FBW) of 0.25 and a fixed bin number (FBN) of 64. The intraclass correlation coefficient (ICC) of each scan setup was calculated and compared across reconstruction settings. An ICC above 0.75 was regarded as high. Results: The percentage of features yielding a high ICC was largest for the statistically equal replicates (70%-91% for FBN; 90%-96% for FBW discretization). For scans acquired on the same system, the percentage decreased, but most features still resulted in a high ICC (FBN, 52%-63%; FBW, 75%-85%). The percentage of features yielding a high ICC decreased more in the multicenter setting. In this case, the percentage of features yielding a high ICC was larger for images reconstructed with EARL-compliant reconstructions: for example, 40% for EARL1 and 60% for EARL2 versus 21% for the clinically preferred setting for FBW discretization. When discretized with FBW and resampled to isotropic voxels, this benefit was more pronounced. Conclusion: EARL-compliant reconstructions harmonize a wide range of radiomic features. FBW discretization and a sampling to isotropic voxels enhances the benefits of EARL-compliant reconstructions.
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Affiliation(s)
- Elisabeth Pfaehler
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, Groningen, The Netherlands
| | - Joyce van Sluis
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, Groningen, The Netherlands
| | - Bram B J Merema
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, Groningen, The Netherlands
| | - Peter van Ooijen
- Department of Radiology, University Medical Center Groningen, Groningen, The Netherlands
| | - Ralph C M Berendsen
- Department of Medical Physics, Zuyderland Medical Center, Heerlen, The Netherlands
| | - Floris H P van Velden
- Section of Nuclear Medicine, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands; and
| | - Ronald Boellaard
- Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, Groningen, The Netherlands.,Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands
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Nahon KJ, Doornink F, Straat ME, Botani K, Martinez-Tellez B, Abreu-Vieira G, van Klinken JB, Voortman GJ, Friesema ECH, Ruiz JR, van Velden FHP, de Geus-Oei LF, Smit F, Pereira Arias-Bouda LM, Berbée JFP, Jazet IM, Boon MR, Rensen PCN. Effect of sitagliptin on energy metabolism and brown adipose tissue in overweight individuals with prediabetes: a randomised placebo-controlled trial. Diabetologia 2018; 61:2386-2397. [PMID: 30145664 PMCID: PMC6182651 DOI: 10.1007/s00125-018-4716-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Accepted: 07/09/2018] [Indexed: 01/12/2023]
Abstract
AIMS/HYPOTHESIS The aim of this study was to evaluate the effect of sitagliptin on glucose tolerance, plasma lipids, energy expenditure and metabolism of brown adipose tissue (BAT), white adipose tissue (WAT) and skeletal muscle in overweight individuals with prediabetes (impaired glucose tolerance and/or impaired fasting glucose). METHODS We performed a randomised, double-blinded, placebo-controlled trial in 30 overweight, Europid men (age 45.9 ± 6.2 years; BMI 28.8 ± 2.3 kg/m2) with prediabetes in the Leiden University Medical Center and the Alrijne Hospital between March 2015 and September 2016. Participants were initially randomly allocated to receive sitagliptin (100 mg/day) (n = 15) or placebo (n = 15) for 12 weeks, using a randomisation list that was set up by an unblinded pharmacist. All people involved in the study as well as participants were blinded to group assignment. Two participants withdrew from the study prior to completion (both in the sitagliptin group) and were subsequently replaced with two new participants that were allocated to the same treatment. Before and after treatment, fasting venous blood samples and skeletal muscle biopsies were obtained, OGTT was performed and body composition, resting energy expenditure and [18F] fluorodeoxyglucose ([18F]FDG) uptake by metabolic tissues were assessed. The primary study endpoint was the effect of sitagliptin on BAT volume and activity. RESULTS One participant from the sitagliptin group was excluded from analysis, due to a distribution error, leaving 29 participants for further analysis. Sitagliptin, but not placebo, lowered glucose excursion (-40%; p < 0.003) during OGTT, accompanied by an improved insulinogenic index (+38%; p < 0.003) and oral disposition index (+44%; p < 0.003). In addition, sitagliptin lowered serum concentrations of triacylglycerol (-29%) and very large (-46%), large (-35%) and medium-sized (-24%) VLDL particles (all p < 0.05). Body weight, body composition and energy expenditure did not change. In skeletal muscle, sitagliptin increased mRNA expression of PGC1β (also known as PPARGC1B) (+117%; p < 0.05), a main controller of mitochondrial oxidative energy metabolism. Although the primary endpoint of change in BAT volume and activity was not met, sitagliptin increased [18F] FDG uptake in subcutaneous WAT (sWAT; +53%; p < 0.05). Reported side effects were mild and transient and not necessarily related to the treatment. CONCLUSIONS/INTERPRETATION Twelve weeks of sitagliptin in overweight, Europid men with prediabetes improves glucose tolerance and lipid metabolism, as related to increased [18F] FDG uptake by sWAT, rather than BAT, and upregulation of the mitochondrial gene PGC1β in skeletal muscle. Studies on the effect of sitagliptin on preventing or delaying the progression of prediabetes into type 2 diabetes are warranted. TRIAL REGISTRATION ClinicalTrials.gov NCT02294084. FUNDING This study was funded by Merck Sharp & Dohme Corp, Dutch Heart Foundation, Dutch Diabetes Research Foundation, Ministry of Economic Affairs and the University of Granada.
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Affiliation(s)
- Kimberly J Nahon
- Division of Endocrinology, Department of Medicine, Leiden University Medical Center, post zone C7Q, P. O. Box 9600, 2300 RC, Leiden, the Netherlands
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - Fleur Doornink
- Division of Endocrinology, Department of Medicine, Leiden University Medical Center, post zone C7Q, P. O. Box 9600, 2300 RC, Leiden, the Netherlands
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - Maaike E Straat
- Division of Endocrinology, Department of Medicine, Leiden University Medical Center, post zone C7Q, P. O. Box 9600, 2300 RC, Leiden, the Netherlands
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - Kani Botani
- Division of Endocrinology, Department of Medicine, Leiden University Medical Center, post zone C7Q, P. O. Box 9600, 2300 RC, Leiden, the Netherlands
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - Borja Martinez-Tellez
- Division of Endocrinology, Department of Medicine, Leiden University Medical Center, post zone C7Q, P. O. Box 9600, 2300 RC, Leiden, the Netherlands
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, the Netherlands
- PROFITH 'Promoting Fitness and Health through Physical Activity' research group, Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Gustavo Abreu-Vieira
- Division of Endocrinology, Department of Medicine, Leiden University Medical Center, post zone C7Q, P. O. Box 9600, 2300 RC, Leiden, the Netherlands
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - Jan B van Klinken
- Department of Human Genetics, Leiden University Medical Center, Leiden, the Netherlands
| | - Gardi J Voortman
- Division of Vascular Medicine, Department of Internal Medicine, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Edith C H Friesema
- Division of Vascular Medicine, Department of Internal Medicine, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Jonatan R Ruiz
- PROFITH 'Promoting Fitness and Health through Physical Activity' research group, Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Floris H P van Velden
- Division of Nuclear Medicine, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Lioe-Fee de Geus-Oei
- Division of Nuclear Medicine, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Frits Smit
- Division of Nuclear Medicine, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
- Department of Nuclear Medicine, Alrijne Hospital, Leiderdorp, the Netherlands
| | - Lenka M Pereira Arias-Bouda
- Division of Nuclear Medicine, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
- Department of Nuclear Medicine, Alrijne Hospital, Leiderdorp, the Netherlands
| | - Jimmy F P Berbée
- Division of Endocrinology, Department of Medicine, Leiden University Medical Center, post zone C7Q, P. O. Box 9600, 2300 RC, Leiden, the Netherlands
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - Ingrid M Jazet
- Division of Endocrinology, Department of Medicine, Leiden University Medical Center, post zone C7Q, P. O. Box 9600, 2300 RC, Leiden, the Netherlands
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - Mariëtte R Boon
- Division of Endocrinology, Department of Medicine, Leiden University Medical Center, post zone C7Q, P. O. Box 9600, 2300 RC, Leiden, the Netherlands.
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, the Netherlands.
| | - Patrick C N Rensen
- Division of Endocrinology, Department of Medicine, Leiden University Medical Center, post zone C7Q, P. O. Box 9600, 2300 RC, Leiden, the Netherlands
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, the Netherlands
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Pfaehler E, De Jong JR, Dierckx RAJO, van Velden FHP, Boellaard R. SMART (SiMulAtion and ReconsTruction) PET: an efficient PET simulation-reconstruction tool. EJNMMI Phys 2018; 5:16. [PMID: 30225675 PMCID: PMC6141406 DOI: 10.1186/s40658-018-0215-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 04/25/2018] [Indexed: 01/28/2023] Open
Abstract
Background Positron-emission tomography (PET) simulators are frequently used for development and performance evaluation of segmentation methods or quantitative uptake metrics. To date, most PET simulation tools are based on Monte Carlo simulations, which are computationally demanding. Other analytical simulation tools lack the implementation of time of flight (TOF) or resolution modelling (RM). In this study, a fast and easy-to-use PET simulation-reconstruction package, SiMulAtion and ReconsTruction (SMART)-PET, is developed and validated, which includes both TOF and RM. SMART-PET, its documentation and instructions to calibrate the tool to a specific PET/CT system are available on Zenodo. SMART-PET allows the fast generation of 3D PET images. As input, it requires one image representing the activity distribution and one representing the corresponding CT image/attenuation map. It allows the user to adjust different parameters, such as reconstruction settings (TOF/RM), noise level or scan duration. Furthermore, a random spatial shift can be included, representing patient repositioning. To evaluate the tool, simulated images were compared with real scan data of the NEMA NU 2 image quality phantom. The scan was acquired as a 60-min list-mode scan and reconstructed with and without TOF and/or RM. For every reconstruction setting, ten statistically equivalent images, representing 30, 60, 120 and 300 s scan duration, were generated. Simulated and real-scan data were compared regarding coefficient of variation in the phantom background and activity recovery coefficients (RCs) of the spheres. Furthermore, standard deviation images of each of the ten statistically equivalent images were compared. Results SMART-PET produces images comparable to actual phantom data. The image characteristics of simulated and real PET images varied in similar ways as function of reconstruction protocols and noise levels. The change in image noise with variation of simulated TOF settings followed the theoretically expected behaviour. RC as function of sphere size agreed within 0.3–11% between simulated and actual phantom data. Conclusions SMART-PET allows for rapid and easy simulation of PET data. The user can change various acquisition and reconstruction settings (including RM and TOF) and noise levels. The images obtained show similar image characteristics as those seen in actual phantom data. Electronic supplementary material The online version of this article (10.1186/s40658-018-0215-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Elisabeth Pfaehler
- Departments of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Johan R De Jong
- Departments of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Rudi A J O Dierckx
- Departments of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Floris H P van Velden
- Department of Radiology, Section of Nuclear Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - Ronald Boellaard
- Departments of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. .,Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands.
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Martinez-Tellez B, Nahon KJ, Sanchez-Delgado G, Abreu-Vieira G, Llamas-Elvira JM, van Velden FHP, Pereira Arias-Bouda LM, Rensen PCN, Boon MR, Ruiz JR. The impact of using BARCIST 1.0 criteria on quantification of BAT volume and activity in three independent cohorts of adults. Sci Rep 2018; 8:8567. [PMID: 29867076 PMCID: PMC5986766 DOI: 10.1038/s41598-018-26878-4] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 05/08/2018] [Indexed: 12/16/2022] Open
Abstract
Human brown adipose tissue (BAT) is commonly assessed by cold-induced 18F-fluorodeoxyglucose (FDG) PET-CT using several quantification criteria. Uniform criteria for data analysis became available recently (BARCIST 1.0). We compared BAT volume and activity following BARCIST 1.0 criteria against the most commonly used criteria [Hounsfield Units (HU):-250, -50, standardized uptake value (SUV):2.0; HU: Not applied, SUV:2.0 and HU:-180, -10, SUV:1.5] in a prospective study using three independent cohorts of men including young lean adults, young overweight/obese adults and middle-aged overweight/obese adults. BAT volume was the most variable outcome between criteria. While BAT volume calculated using the HU: NA; SUV: 2.0 criteria was up to 207% higher than the BAT volume calculated based on BARCIST 1.0 criteria, it was up to 57% lower using the HU: -250, -50; SUV: 2.0 criteria compared to the BARCIST 1.0. Similarly, BAT activity (expressed as SUVmean) also differed between different thresholds mainly because SUVmean depends on BAT volume. SUVpeak was the most consistent BAT outcome across the four study criteria. Of note, we replicated these findings in three independent cohorts. In conclusion, BAT volume and activity as determined by 18F-FDG-PET/CT highly depend on the quantification criteria used. Future human BAT studies should conduct sensitivity analysis with different thresholds in order to understand whether results are driven by the selected HU and/or SUV thresholds. The design of the present study precludes providing any conclusive threshold, but before more definitive thresholds for HU and SUV are available, we support the use of BARCIST 1.0 criteria to facilitate interpretation of BAT characteristics between research groups.
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Affiliation(s)
- Borja Martinez-Tellez
- PROFITH "PROmoting FITness and Health through physical activity" research Group, Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain.
- Department of Medicine, Division of Endocrinology, and Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, The Netherlands.
| | - Kimberly J Nahon
- Department of Medicine, Division of Endocrinology, and Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - Guillermo Sanchez-Delgado
- PROFITH "PROmoting FITness and Health through physical activity" research Group, Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Gustavo Abreu-Vieira
- Department of Medicine, Division of Endocrinology, and Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - Jose M Llamas-Elvira
- Servicio de Medicina Nuclear, Hospital Universitario Virgen de las Nieves, Granada, Spain
- Instituto de Investigación Biosanitaria (ibs. GRANADA), Servicio de Medicina Nuclear, Granada, Spain
| | - Floris H P van Velden
- Department of Radiology (Division of Nuclear Medicine), Leiden University Medical Center, Leiden, The Netherlands
| | - Lenka M Pereira Arias-Bouda
- Department of Radiology (Division of Nuclear Medicine), Leiden University Medical Center, Leiden, The Netherlands
- Department of Nuclear Medicine, Alrijne hospital, Leiderdorp, The Netherlands
| | - Patrick C N Rensen
- Department of Medicine, Division of Endocrinology, and Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - Mariëtte R Boon
- Department of Medicine, Division of Endocrinology, and Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - Jonatan R Ruiz
- PROFITH "PROmoting FITness and Health through physical activity" research Group, Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain
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Collarino A, Pereira Arias-Bouda LM, Valdés Olmos RA, van der Tol P, Dibbets-Schneider P, de Geus-Oei LF, van Velden FHP. Experimental validation of absolute SPECT/CT quantification for response monitoring in breast cancer. Med Phys 2018; 45:2143-2153. [PMID: 29572848 DOI: 10.1002/mp.12880] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Revised: 03/02/2018] [Accepted: 03/08/2018] [Indexed: 01/01/2023] Open
Abstract
PURPOSE Recent developments in iterative image reconstruction enable absolute quantification of SPECT/CT studies by incorporating compensation for collimator-detector response, attenuation, and scatter as well as resolution recovery into the reconstruction process (Evolution; Q.Metrix package; GE Healthcare, Little Chalfont, UK). The aim of this experimental study is to assess its quantitative accuracy for potential clinical 99m Tc-sestamibi (MIBI)-related SPECT/CT application in neoadjuvant chemotherapy response studies in breast cancer. METHODS Two phantoms were filled with MIBI and acquired on a SPECT/CT gamma camera (Discovery 670 Pro; GE Healthcare), that is, a water cylinder and a NEMA body phantom containing six spheres that were filled with an activity concentration reflecting clinical MIBI uptake. Subsequently, volumes-of-interest (VOI) of each sphere were drawn (semi)automatically on SPECT using various isocontour methods or manually on CT. Finally, prone MIBI SPECT/CT scans were acquired 5 and 90 min p.i. in a locally advanced breast cancer patient. RESULTS Activity concentration in the four largest spheres converged after nine iterations of evolution. Depending on the count statistics, the accuracy of the reconstructed activity concentration varied between -4.7 and -0.16% (VOI covering the entire phantom) and from 6.9% to 10% (8.8 cm ⌀ cylinder VOI placed in the center of the phantom). Recovery coefficients of SUVmax were 1.89 ± 0.18, 1.76 ± 0.17, 2.00 ± 0.38, 1.89 ± 0.35, and 0.90 ± 0.26 for spheres with 37, 28, 22, 17, and 13 mm ⌀, respectively. Recovery coefficients of SUVmean were 1.07 ± 0.06, 1.03 ± 0.09, 1.17 ± 0.21, 1.10 ± 0.20, and 0.52 ± 0.14 (42% isocontour); 1.10 ± 0.07, 1.02 ± 0.09, 1.13 ± 0.19, 1.06 ± 0.19, and 0.51 ± 0.13 (36% isocontour with local background correction); and 0.96, 1.09, 1.03, 1.03, and 0.29 (CT). Patient study results were concordant with the phantom validation. CONCLUSIONS Absolute SPECT/CT quantification of breast studies using MIBI seems feasible (<17% deviation) when a 42% isocontour is used for delineation for tumors of at least 17 mm diameter. However, with tumor shrinkage, response evaluation should be handled with caution, especially when using SUVmax .
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Affiliation(s)
- Angela Collarino
- Section of Nuclear Medicine, Department of Radiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands.,Biomedical Photonic Imaging Group, MIRA Institute University of Twente, PO Box 217, 7500 AE, Enschede, The Netherlands
| | - Lenka M Pereira Arias-Bouda
- Section of Nuclear Medicine, Department of Radiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands.,Department of Nuclear Medicine, Alrijne Ziekenhuis, Simon Smitweg 1, 2353 GA, Leiderdorp, The Netherlands
| | - Renato A Valdés Olmos
- Section of Nuclear Medicine, Department of Radiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands.,Interventional Molecular Imaging Laboratory, Department of Radiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands.,Department of Nuclear Medicine, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
| | - Pieternel van der Tol
- Medical Physics, Department of Radiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands
| | - Petra Dibbets-Schneider
- Section of Nuclear Medicine, Department of Radiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands
| | - Lioe-Fee de Geus-Oei
- Section of Nuclear Medicine, Department of Radiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands.,Biomedical Photonic Imaging Group, MIRA Institute University of Twente, PO Box 217, 7500 AE, Enschede, The Netherlands
| | - Floris H P van Velden
- Section of Nuclear Medicine, Department of Radiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands.,Medical Physics, Department of Radiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands
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Mansor S, Boellaard R, Huisman MC, van Berckel BNM, Schuit RC, Windhorst AD, Lammertsma AA, van Velden FHP. Impact of New Scatter Correction Strategies on High-Resolution Research Tomograph Brain PET Studies. Mol Imaging Biol 2016; 18:627-35. [PMID: 26728160 PMCID: PMC4927607 DOI: 10.1007/s11307-015-0921-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE The aim of this study is to evaluate the impact of different scatter correction strategies on quantification of high-resolution research tomograph (HRRT) data for three tracers covering a wide range in kinetic profiles. PROCEDURES Healthy subjects received dynamic HRRT scans using either (R)-[(11)C]verapamil (n = 5), [(11)C]raclopride (n = 5) or [(11)C]flumazenil (n = 5). To reduce the effects of patient motion on scatter scaling factors, a margin in the attenuation correction factor (ACF) sinogram was applied prior to 2D or 3D single scatter simulation (SSS). RESULTS Some (R)-[(11)C]verapamil studies showed prominent artefacts that disappeared with an ACF-margin of 10 mm or more. Use of 3D SSS for (R)-[(11)C]verapamil showed a statistically significant increase in volume of distribution compared with 2D SSS (p < 0.05), but not for [(11)C]raclopride and [(11)C]flumazenil studies (p > 0.05). CONCLUSIONS When there is a patient motion-induced mismatch between transmission and emission scans, applying an ACF-margin resulted in more reliable scatter scaling factors but did not change (and/or deteriorate) quantification.
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Affiliation(s)
- Syahir Mansor
- Department of Radiology and Nuclear Medicine, VU University Medical Center, PO Box 7057, 1007 MB, Amsterdam, The Netherlands
| | - Ronald Boellaard
- Department of Radiology and Nuclear Medicine, VU University Medical Center, PO Box 7057, 1007 MB, Amsterdam, The Netherlands.
- Department of Nuclear Medicine and Molecular Imaging, University Medical Centre Groningen, Groningen, The Netherlands.
| | - Marc C Huisman
- Department of Radiology and Nuclear Medicine, VU University Medical Center, PO Box 7057, 1007 MB, Amsterdam, The Netherlands
| | - Bart N M van Berckel
- Department of Radiology and Nuclear Medicine, VU University Medical Center, PO Box 7057, 1007 MB, Amsterdam, The Netherlands
| | - Robert C Schuit
- Department of Radiology and Nuclear Medicine, VU University Medical Center, PO Box 7057, 1007 MB, Amsterdam, The Netherlands
| | - Albert D Windhorst
- Department of Radiology and Nuclear Medicine, VU University Medical Center, PO Box 7057, 1007 MB, Amsterdam, The Netherlands
| | - Adriaan A Lammertsma
- Department of Radiology and Nuclear Medicine, VU University Medical Center, PO Box 7057, 1007 MB, Amsterdam, The Netherlands
| | - Floris H P van Velden
- Department of Radiology and Nuclear Medicine, VU University Medical Center, PO Box 7057, 1007 MB, Amsterdam, The Netherlands
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
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van Velden FHP, Mansor SM, van Assema DME, van Berckel BNM, Froklage FE, Wang S, Schuit RC, Asselin MC, Lammertsma AA, Boellaard R, Huisman MC. Comparison of HRRT and HR+ scanners for quantitative (R)-[11C]verapamil, [11C]raclopride and [11C]flumazenil brain studies. Mol Imaging Biol 2015; 17:129-39. [PMID: 25028091 DOI: 10.1007/s11307-014-0766-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE This study was conducted to directly compare the high-resolution research tomograph (HRRT) (high-resolution brain) and HR+ (standard whole-body) positron emission tomography (PET) only scanners for quantitative brain studies using three tracers with vastly different tracer distributions. PROCEDURES Healthy volunteers underwent successive scans on HR+ and HRRT scanners (in random order) using either (R)-[(11)C]verapamil (n = 6), [(11)C]raclopride (n = 7) or [(11)C]flumazenil (n = 7). For all tracers, metabolite-corrected plasma-input functions were generated. RESULTS After resolution matching, HRRT-derived kinetic parameter values correlated well with those of HR+ for all tracers (intraclass correlation coefficients ≥0.78), having a good absolute interscanner test-retest variability (≤15 %). However, systematic differences can be seen for HRRT-derived kinetic parameter values (range -13 to +15 %). CONCLUSION Quantification of kinetic parameters based on plasma-input models leads to comparable results when spatial resolution between HRRT and HR+ data is matched. When using reference-tissue models, differences remain that are likely caused by differences in attenuation and scatter corrections and/or image reconstruction.
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Affiliation(s)
- Floris H P van Velden
- Department of Radiology & Nuclear Medicine, VU University Medical Center, PO Box 7057, 1007 MB, Amsterdam, The Netherlands,
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Cheung A, van Velden FHP, Lagerburg V, Minderman N. The organizational and clinical impact of integrating bedside equipment to an information system: a systematic literature review of patient data management systems (PDMS). Int J Med Inform 2015; 84:155-65. [PMID: 25601332 DOI: 10.1016/j.ijmedinf.2014.12.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2013] [Revised: 09/30/2014] [Accepted: 12/28/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVE The introduction of an information system integrated to bedside equipment requires significant financial and resource investment; therefore understanding the potential impact is beneficial for decision-makers. However, no systematic literature reviews (SLRs) focus on this topic. This SLR aims to gather evidence on the impact of the aforementioned system, also known as a patient data management system (PDMS) on both organizational and clinical outcomes. MATERIALS AND METHODS A literature search was performed using the databases Medline/PubMed and CINHAL for English articles published between January 2000 and December 2012. A quality assessment was performed on articles deemed relevant for the SLR. RESULTS Eighteen articles were included in the SLR. Sixteen articles investigated the impact of a PDMS on the organizational outcomes, comprising descriptive, quantitative and qualitative studies. A PDMS was found to reduce the charting time, increase the time spent on direct patient care and reduce the occurrence of errors. Only two articles investigated the clinical impact of a PDMS. Both reported an improvement in clinical outcomes when a PDMS was integrated with a clinical decision support system (CDSS). CONCLUSIONS A PDMS has shown to offer many advantages in both the efficiency and the quality of care delivered to the patient. In addition, a PDMS integrated to a CDSS may improve clinical outcomes, although further studies are required for validation.
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Affiliation(s)
- Amy Cheung
- Department of Information, Communication and Medical Technology (ICMT), Catharina Hospital, PO Box 1350, 5602ZA Eindhoven, The Netherlands
| | - Floris H P van Velden
- Department of Information, Communication and Medical Technology (ICMT), Catharina Hospital, PO Box 1350, 5602ZA Eindhoven, The Netherlands; Department of Radiology & Nuclear Medicine, VU University Medical Center, PO Box 7057, 1007MB Amsterdam, The Netherlands.
| | - Vera Lagerburg
- Department of Information, Communication and Medical Technology (ICMT), Catharina Hospital, PO Box 1350, 5602ZA Eindhoven, The Netherlands
| | - Niels Minderman
- Department of, Medical Spectrum Twente, PO Box 50000, 7500 KA, Enschede, The Netherlands
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Van Slambrouck K, Stute S, Comtat C, Sibomana M, van Velden FHP, Boellaard R, Nuyts J. Bias reduction for low-statistics PET: maximum likelihood reconstruction with a modified Poisson distribution. IEEE Trans Med Imaging 2015; 34:126-136. [PMID: 25137726 PMCID: PMC4465546 DOI: 10.1109/tmi.2014.2347810] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Positron emission tomography data are typically reconstructed with maximum likelihood expectation maximization (MLEM). However, MLEM suffers from positive bias due to the non-negativity constraint. This is particularly problematic for tracer kinetic modeling. Two reconstruction methods with bias reduction properties that do not use strict Poisson optimization are presented and compared to each other, to filtered backprojection (FBP), and to MLEM. The first method is an extension of NEGML, where the Poisson distribution is replaced by a Gaussian distribution for low count data points. The transition point between the Gaussian and the Poisson regime is a parameter of the model. The second method is a simplification of ABML. ABML has a lower and upper bound for the reconstructed image whereas AML has the upper bound set to infinity. AML uses a negative lower bound to obtain bias reduction properties. Different choices of the lower bound are studied. The parameter of both algorithms determines the effectiveness of the bias reduction and should be chosen large enough to ensure bias-free images. This means that both algorithms become more similar to least squares algorithms, which turned out to be necessary to obtain bias-free reconstructions. This comes at the cost of increased variance. Nevertheless, NEGML and AML have lower variance than FBP. Furthermore, randoms handling has a large influence on the bias. Reconstruction with smoothed randoms results in lower bias compared to reconstruction with unsmoothed randoms or randoms precorrected data. However, NEGML and AML yield both bias-free images for large values of their parameter.
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Affiliation(s)
- Katrien Van Slambrouck
- Department of Imaging and Pathology, Division of Nuclear Medicine and Medical Imaging Research Center, K.U. Leuven, B-3000 Leuven, Belgium
| | - Simon Stute
- CEA, DSV, I2BM, SHFJ, Orsay, F-91401, France
| | | | | | - Floris H. P. van Velden
- Department of Radiology and Nuclear Medicine, VU University Medical Center, 1007MB Amsterdam, The Netherlands
| | - Ronald Boellaard
- Department of Radiology and Nuclear Medicine, VU University Medical Center, 1007MB Amsterdam, The Netherlands
| | - Johan Nuyts
- Department of Imaging and Pathology, Division of Nuclear Medicine and Medical Imaging Research Center, K.U. Leuven, B-3000 Leuven, Belgium
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Frings V, van Velden FHP, Velasquez LM, Hayes W, van de Ven PM, Hoekstra OS, Boellaard R. Repeatability of metabolically active tumor volume measurements with FDG PET/CT in advanced gastrointestinal malignancies: a multicenter study. Radiology 2014; 273:539-48. [PMID: 24865311 DOI: 10.1148/radiol.14132807] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
PURPOSE To evaluate the feasibility and repeatability of various metabolically active tumor volume ( MATV metabolically active tumor volume ) quantification methods in fluorine 18 fluorodeoxyglucose ( FDG fluorine 18 fluorodeoxyglucose ) positron emission tomography (PET)/computed tomography (CT) in a multicenter setting and propose the optimal MATV metabolically active tumor volume method together with the minimal threshold for future response evaluation studies. MATERIALS AND METHODS The study was approved by the institutional review board of all four participating centers, and patients provided written informed consent. Thirty-four patients with advanced gastrointestinal malignancies underwent two FDG fluorine 18 fluorodeoxyglucose PET/CT examinations within 1 week. MATV metabolically active tumor volume s were defined semiautomatically with 27 variations of tumor delineation methods with different reference values. Feasibility was determined as the percentage of successful tumor segmentations per MATV metabolically active tumor volume method. Repeatability was determined with intraclass correlation coefficients, Bland-Altman plots, and limits of agreement ( LOA limit of agreement s) of the percentage difference between the test and repeat test measurements. In addition, LOA limit of agreement variability per center was investigated. RESULTS In total, 136 lesions were identified. Feasibility of tumor segmentation ranged from 54% to 100% (74-136 of 136 lesions); repeatability was evaluated for 19 MATV metabolically active tumor volume methods with feasibility of greater than 95%. The median MATV metabolically active tumor volume derived with 50% threshold of mean standardized uptake value ( SUV standardized uptake value ) of a sphere of 12-mm diameter with highest local intensity ( SUVhp mean SUV of a sphere of 12-mm diameter with highest local intensity ), which may not include the voxel with highest SUV standardized uptake value corrected for local background, was 5.7 and 6.1 mL for test and retest scans, respectively, with a relative LOA limit of agreement of 36.1%. Comparable repeatability was found between centers. A difference in uptake time between scan 1 and 2 of 15 minutes or longer had a minor negative influence on repeatability. CONCLUSION MATV metabolically active tumor volume measured with 50% of SUVhp mean SUV of a sphere of 12-mm diameter with highest local intensity corrected for local background is recommended in multicenter FDG fluorine 18 fluorodeoxyglucose PET/CT studies on the basis of a high feasibility (96%) and repeatability ( LOA limit of agreement of 36.1%).
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Affiliation(s)
- Virginie Frings
- From the Department of Radiology and Nuclear Medicine (V.F., F.H.P.v.V., O.S.H., R.B.) and Department of Biostatistics and Epidemiology (P.M.v.d.V.), VU University Medical Center, PO Box 7057, 1007 MB Amsterdam, the Netherlands; and Bristol-Myers Squibb, Princeton, NJ (L.M.V., W.H.)
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Verwer EE, van Velden FHP, Bahce I, Yaqub M, Schuit RC, Windhorst AD, Raijmakers P, Lammertsma AA, Smit EF, Boellaard R. Pharmacokinetic analysis of [18F]FAZA in non-small cell lung cancer patients. Eur J Nucl Med Mol Imaging 2013; 40:1523-31. [PMID: 23740374 DOI: 10.1007/s00259-013-2462-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2013] [Accepted: 05/09/2013] [Indexed: 12/12/2022]
Abstract
PURPOSE [(18)F]Fluoroazomycin arabinoside (FAZA) is a positron emission tomography (PET) tracer developed to enable identification of hypoxic regions within a tumour. The aims of this study were to determine the optimal kinetic model along with validation of using alternatives to arterial blood sampling for analysing [(18)F]FAZA studies and to assess the validity of simplified analytical methods. METHODS Dynamic 70-min [(18)F]FAZA PET/CT scans were obtained from nine non-small cell lung cancer patients. Continuous arterial blood sampling, together with manual arterial and venous sampling, was performed to derive metabolite-corrected plasma input functions. Volumes of interest (VOIs) were defined for tumour, healthy lung muscle and adipose tissue generating [(18)F]FAZA time-activity curves (TACs). TACs were analysed using one- and two-tissue compartment models using both metabolite-corrected blood sampler plasma input functions (BSIF) and image-derived plasma input functions (IDIF). RESULTS The reversible two-tissue compartment model with blood volume parameter (2T4k+VB) best described kinetics of [(18)F]FAZA in tumours. Volumes of distribution (VT) obtained using IDIF correlated well with those derived using BSIF (R(2) = 0.82). Venous samples yielded the same radioactivity concentrations as arterial samples for times >50 min post-injection (p.i.). In addition, both plasma to whole blood ratios and parent fractions were essentially the same for venous and arterial samples. Both standardised uptake value (SUV), normalised to lean body mass, and tumour to blood ratio correlated well with VT (R(2) = 0.77 and R(2) = 0.87, respectively, at 50-60 min p.i.), although a bias was observed at low VT. CONCLUSION The 2T4k+VB model provided the best fit to the dynamic [(18)F]FAZA data. IDIF with venous blood samples can be used as input function. Further data are needed to validate the use of simplified methods.
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Affiliation(s)
- Eline E Verwer
- Department of Radiology & Nuclear Medicine, VU University Medical Center, PO Box 7057, 1007 MB, Amsterdam, The Netherlands,
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Cheebsumon P, Yaqub M, van Velden FHP, Hoekstra OS, Lammertsma AA, Boellaard R. Impact of [¹⁸F]FDG PET imaging parameters on automatic tumour delineation: need for improved tumour delineation methodology. Eur J Nucl Med Mol Imaging 2011; 38:2136-44. [PMID: 21858528 PMCID: PMC3228515 DOI: 10.1007/s00259-011-1899-5] [Citation(s) in RCA: 90] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2011] [Accepted: 08/02/2011] [Indexed: 11/27/2022]
Abstract
Purpose Delineation of tumour boundaries is important for quantification of [18F]fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) studies and for definition of biological target volumes in radiotherapy. Several (semi-)automatic tumour delineation methods have been proposed, but these methods differ substantially in estimating tumour volume and their performance may be affected by imaging parameters. The main purpose of this study was to explore the performance dependence of various (semi-)automatic tumour delineation methods on different imaging parameters, i.e. reconstruction parameters, noise levels and tumour characteristics, and thereby the need for standardization or inter-institute calibration. Methods Six different types of delineation methods were evaluated by assessing accuracy and precision in estimating tumour volume from simulations and phantom experiments. The evaluated conditions were various tumour sizes, iterative reconstruction algorithm settings and image filtering, tumour to background ratios (TBR), noise levels and region growing initializations. Results The accuracy of all automatic delineation methods was influenced when imaging parameters were varied. The performance of all tumour delineation methods depends on variation of TBR, image resolution and image noise level, and to a lesser extent on number of iterations during image reconstruction or the initialization method of the region generation. For sphere sizes larger than 20 mm diameter a contrast-oriented method provided the most accurate results, on average, over all simulated conditions. For threshold-based methods the accuracy of tumour delineation improved after image denoising/filtering. Conclusion The accuracy and precision of all studied tumour delineation methods was affected by physiological and imaging parameters. The latter illustrates the need for optimizing imaging parameters and/or for careful calibration and optimization of delineation methods. Electronic supplementary material The online version of this article (doi:10.1007/s00259-011-1899-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Patsuree Cheebsumon
- Department of Nuclear Medicine & PET Research, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands
| | - Maqsood Yaqub
- Department of Nuclear Medicine & PET Research, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands
| | - Floris H. P. van Velden
- Department of Nuclear Medicine & PET Research, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands
| | - Otto S. Hoekstra
- Department of Nuclear Medicine & PET Research, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands
| | - Adriaan A. Lammertsma
- Department of Nuclear Medicine & PET Research, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands
| | - Ronald Boellaard
- Department of Nuclear Medicine & PET Research, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands
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Cheebsumon P, van Velden FHP, Yaqub M, Frings V, de Langen AJ, Hoekstra OS, Lammertsma AA, Boellaard R. Effects of image characteristics on performance of tumor delineation methods: a test-retest assessment. J Nucl Med 2011; 52:1550-8. [PMID: 21849398 DOI: 10.2967/jnumed.111.088914] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
UNLABELLED PET can be used to monitor response during chemotherapy and assess biologic target volumes for radiotherapy. Previous simulation studies have shown that the performance of various automatic or semiautomatic tumor delineation methods depends on image characteristics. The purpose of this study was to assess test-retest variability of tumor delineation methods, with emphasis on the effects of several image characteristics (e.g., resolution and contrast). METHODS Baseline test-retest data from 19 non-small cell lung cancer patients were obtained using (18)F-FDG (n = 10) and 3'-deoxy-3'-(18)F-fluorothymidine ((18)F-FLT) (n = 9). Images were reconstructed with varying spatial resolution and contrast. Six different types of tumor delineation methods, based on various thresholds or on a gradient, were applied to all datasets. Test-retest variability of metabolic volume and standardized uptake value (SUV) was determined. RESULTS For both tracers, size of metabolic volume and test-retest variability of both metabolic volume and SUV were affected by the image characteristics and tumor delineation method used. The median volume test-retest variability ranged from 8.3% to 23% and from 7.4% to 29% for (18)F-FDG and (18)F-FLT, respectively. For all image characteristics studied, larger differences (≤10-fold higher) were seen in test-retest variability of metabolic volume than in SUV. CONCLUSION Test-retest variability of both metabolic volume and SUV varied with tumor delineation method, radiotracer, and image characteristics. The results indicate that a careful optimization of imaging and delineation method parameters is needed when metabolic volume is used, for example, as a response assessment parameter.
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Affiliation(s)
- Patsuree Cheebsumon
- Department of Nuclear Medicine and PET Research, VU University Medical Center, Amsterdam, The Netherlands
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Mourik JEM, Lubberink M, van Velden FHP, Lammertsma AA, Boellaard R. Off-line motion correction methods for multi-frame PET data. Eur J Nucl Med Mol Imaging 2011; 36:2002-13. [PMID: 19585116 PMCID: PMC2779434 DOI: 10.1007/s00259-009-1193-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2009] [Accepted: 06/08/2009] [Indexed: 11/28/2022]
Abstract
Purpose Patient motion during PET acquisition may affect measured time-activity curves, thereby reducing accuracy of tracer kinetic analyses. The aim of the present study was to evaluate different off-line frame-by-frame methods to correct patient motion, which is of particular interest when no optical motion tracking system is available or when older data sets have to be reanalysed. Methods Four different motion correction methods were evaluated. In the first method attenuation-corrected frames were realigned with the summed image of the first 3 min. The second method was identical, except that non-attenuation-corrected images were used. In the third and fourth methods non-attenuation-corrected images were realigned with standard and cupped transmission images, respectively. Two simulation studies were performed, based on [11C]flumazenil and (R)-[11C]PK11195 data sets, respectively. For both simulation studies different types (rotational, translational) and degrees of motion were added. Simulated PET scans were corrected for motion using all correction methods. The optimal method derived from these simulation studies was used to evaluate two (one with and one without visible movement) clinical data sets of [11C]flumazenil, (R)-[11C]PK11195 and [11C]PIB. For these clinical data sets, the volume of distribution (VT) was derived using Logan analysis and values were compared before and after motion correction. Results For both [11C]flumazenil and (R)-[11C]PK11195 simulation studies, optimal results were obtained when realignment was based on non-attenuation-corrected images. For the clinical data sets motion disappeared visually after motion correction. Regional differences of up to 433% in VT before and after motion correction were found for scans with visible movement. On the other hand, when no visual motion was present in the original data set, overall differences in VT before and after motion correction were <1.5 ± 1.3%. Conclusion Frame-by-frame motion correction using non-attenuation-corrected images improves the accuracy of tracer kinetic analysis compared to non-motion-corrected data. Electronic supplementary material The online version of this article (doi:10.1007/s00259-009-1193-y) contains supplementary material, which is available to authorised users.
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Affiliation(s)
- Jurgen E M Mourik
- Department of Nuclear Medicine & PET Research, VU University Medical Center, PO Box 7057, 1007 MB Amsterdam, The Netherlands.
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van Velden FHP, Cheebsumon P, Yaqub M, Smit EF, Hoekstra OS, Lammertsma AA, Boellaard R. Evaluation of a cumulative SUV-volume histogram method for parameterizing heterogeneous intratumoural FDG uptake in non-small cell lung cancer PET studies. Eur J Nucl Med Mol Imaging 2011; 38:1636-47. [PMID: 21617975 PMCID: PMC3151405 DOI: 10.1007/s00259-011-1845-6] [Citation(s) in RCA: 147] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2011] [Accepted: 05/09/2011] [Indexed: 11/26/2022]
Abstract
PURPOSE Standardized uptake values (SUV) are commonly used for quantification of whole-body [(18)F]fluoro-2-deoxy-D: -glucose (FDG) positron emission tomography (PET) studies. Changes in SUV following therapy, however, only provide a proper measure of response in case of homogeneous FDG uptake in the tumour. The purpose of this study was therefore to implement and characterize a method that enables quantification of heterogeneity in tumour FDG uptake. METHODS Cumulative SUV-volume histograms (CSH), describing % of total tumour volume above % threshold of maximum SUV (SUV(max)), were calculated. The area under a CSH curve (AUC) is a quantitative index of tumour uptake heterogeneity, with lower AUC corresponding to higher degrees of heterogeneity. Simulations of homogeneous and heterogeneous responses were performed to assess the value of AUC-CSH for measuring uptake and/or response heterogeneity. In addition, partial volume correction and image denoising was applied prior to calculating AUC-CSH. Finally, the method was applied to a number of human FDG scans. RESULTS Partial volume correction and noise reduction improved CSH curves. Both simulations and clinical examples showed that AUC-CSH values corresponded with level of tumour heterogeneity and/or heterogeneity in response. In contrast, this correspondence was not seen with SUV(max) alone. The results indicate that the main advantage of AUC-CSH above other measures, such as 1/COV (coefficient of variation), is the possibility to measure or normalize AUC-CSH in different ways. CONCLUSION AUC-CSH might be used as a quantitative index of heterogeneity in tracer uptake. In response monitoring studies it can be used to address heterogeneity in response.
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Affiliation(s)
- Floris H P van Velden
- Department of Nuclear Medicine & PET Research, VU University Medical Center, PO Box 7057, 1007 MB Amsterdam, The Netherlands.
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Frings V, de Langen AJ, Smit EF, van Velden FHP, Hoekstra OS, van Tinteren H, Boellaard R. Repeatability of metabolically active volume measurements with 18F-FDG and 18F-FLT PET in non-small cell lung cancer. J Nucl Med 2010; 51:1870-7. [PMID: 21078791 DOI: 10.2967/jnumed.110.077255] [Citation(s) in RCA: 89] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
UNLABELLED In addition to tumor size measurements with CT, there is a need for quantitative measurements of metabolic active volumes, possibly adding to tracer uptake measurements in oncologic response evaluation with PET. The aim of this study was to evaluate the metabolic volume test-retest variability in (18)F-FDG and 3'-deoxy-3'-(18)F-fluorothymidine ((18)F-FLT) PET studies for various commonly used volumes of interest (VOIs) and the dependence of that variability on lesion size and relative radiotracer uptake. METHODS Twenty non-small cell lung cancer patients were scanned twice with (18)F-FDG (n = 11) or (18)F-FLT (n = 9). VOIs were defined on images reconstructed with normalization- and attenuation-weighted ordered-subset expectation maximization using 4 isocontours (A41%, A50%, and A70% thresholds, adapted for local background, and 50% threshold, uncorrected for background). Statistical analysis comprised intraclass correlation coefficients and Bland-Altman analysis. RESULTS In the (18)F-FDG and (18)F-FLT groups, 34 and 20 lesions, respectively, were analyzed. Median volumes at the A50% threshold were 3.31 and 2.19 mL (interquartile range, 1.91-8.90 and 1.52-7.27 mL) for (18)F-FDG and (18)F-FLT, respectively. Intraclass correlation coefficients were greater than 0.9, with the exception of the A70%-based metabolic volumes for (18)F-FLT. For lesions greater than 4.2 mL, repeatability coefficients (RCs = 1.96 × SD) of the percentage difference ranged from 22% to 37% for (18)F-FDG and from 39% to 73% for (18)F-FLT, depending on the VOI method being used. Repeatability was better for larger tumors, but there was no dependence on absolute uptake (standardized uptake value). CONCLUSION Results indicate that changes of greater than 37% for (18)F-FDG and greater than 73% for (18)F-FLT (1.96 × SD) for lesions with A50% metabolic volumes greater than 4.2 mL represent a biologic effect. For smaller lesions (A50% VOI < 4.2 mL), an absolute change of 1.0 and 0.9 mL for (18)F-FDG and (18)F-FLT, respectively, is biologically relevant. Considering the balance between the success rate of automatic tumor delineation and repeatability of metabolic volume, a 50% threshold with correction for local background activity (A50%) seems optimal among the VOI methods evaluated.
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Affiliation(s)
- Virginie Frings
- Department of Nuclear Medicine and PET Research, VU University Medical Centre, Amsterdam, The Netherlands
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Hoetjes NJ, van Velden FHP, Hoekstra OS, Hoekstra CJ, Krak NC, Lammertsma AA, Boellaard R. Partial volume correction strategies for quantitative FDG PET in oncology. Eur J Nucl Med Mol Imaging 2010; 37:1679-87. [PMID: 20422184 PMCID: PMC2918791 DOI: 10.1007/s00259-010-1472-7] [Citation(s) in RCA: 116] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2010] [Accepted: 04/06/2010] [Indexed: 11/24/2022]
Abstract
Purpose Quantitative accuracy of positron emission tomography (PET) is affected by partial volume effects resulting in increased underestimation of the standardized uptake value (SUV) with decreasing tumour volume. The purpose of the present study was to assess accuracy and precision of different partial volume correction (PVC) methods. Methods Three methods for PVC were evaluated: (1) inclusion of the point spread function (PSF) within the reconstruction, (2) iterative deconvolution of PET images and (3) calculation of spill-in and spill-out factors based on tumour masks. Simulations were based on a mathematical phantom with tumours of different sizes and shapes. Phantom experiments were performed in 2-D mode using the National Electrical Manufacturers Association (NEMA) NU2 image quality phantom containing six differently sized spheres. Clinical studies (2-D mode) included a test-retest study consisting of 10 patients with stage IIIB and IV non-small cell lung cancer and a response monitoring study consisting of 15 female breast cancer patients. In all studies tumour or sphere volumes of interest (VOI) were generated using VOI based on adaptive relative thresholds. Results Simulations and experiments provided similar results. All methods were able to accurately recover true SUV within 10% for spheres equal to and larger than 1 ml. Reconstruction-based recovery, however, provided up to twofold better precision than image-based methods. Clinical studies showed that PVC increased SUV by 5–80% depending on tumour size. Test-retest variability slightly worsened from 9.8 ± 6.5 without to 10.8 ± 7.9% with PVC. Finally, PVC resulted in slightly smaller SUV responses, i.e. from −30.5% without to −26.3% with PVC after the first cycle of treatment (p < 0.01). Conclusion PVC improves accuracy of SUV without decreasing (clinical) test-retest variability significantly and it has a small, but significant effect on observed tumour responses. Reconstruction-based PVC outperforms image-based methods, but requires dedicated reconstruction software. Image-based methods are good alternatives because of their ease of implementation and their similar performance in clinical studies.
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Affiliation(s)
- Nikie J Hoetjes
- Department of Nuclear Medicine & PET Research, VU University Medical Center, Amsterdam, The Netherlands.
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Mourik JEM, Lubberink M, van Velden FHP, Kloet RW, van Berckel BNM, Lammertsma AA, Boellaard R. In vivo validation of reconstruction-based resolution recovery for human brain studies. J Cereb Blood Flow Metab 2010; 30:381-9. [PMID: 19844240 PMCID: PMC2949117 DOI: 10.1038/jcbfm.2009.225] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The aim of this study was to validate in vivo the accuracy of a reconstruction-based partial volume correction (PVC), which takes into account the point spread function of the imaging system. The NEMA NU2 Image Quality phantom and five healthy volunteers (using [(11)C]flumazenil) were scanned on both HR+ and high-resolution research tomograph (HRRT) scanners. HR+ data were reconstructed using normalization and attenuation-weighted ordered subsets expectation maximization (NAW-OSEM) and a PVC algorithm (PVC-NAW-OSEM). HRRT data were reconstructed using 3D ordinary Poisson OSEM (OP-OSEM) and a PVC algorithm (PVC-OP-OSEM). For clinical studies, parametric volume of distribution (V(T)) images were generated. For phantom data, good recovery was found for both OP-OSEM (0.84 to 0.97) and PVC-OP-OSEM (0.91 to 0.98) HRRT reconstructions. In addition, for the HR+, good recovery was found for PVC-NAW-OSEM (0.84 to 0.94), corresponding well with OP-OSEM. Finally, for clinical data, good correspondence was found between PVC-NAW-OSEM and OP-OSEM-derived V(T) values (slope: 1.02+/-0.08). This study showed that HR+ image resolution using PVC-NAW-OSEM was comparable to that of the HRRT scanner. As the HRRT has a higher intrinsic resolution, this agreement validates reconstruction-based PVC as a means of improving the spatial resolution of the HR+ scanner and thereby improving the quantitative accuracy of positron emission tomography.
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Affiliation(s)
- Jurgen E M Mourik
- Department of Nuclear Medicine & PET Research, VU University Medical Center, Amsterdam, The Netherlands.
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van Velden FHP, Kloet RW, van Berckel BNM, Lammertsma AA, Boellaard R. Accuracy of 3-dimensional reconstruction algorithms for the high-resolution research tomograph. J Nucl Med 2008; 50:72-80. [PMID: 19091902 DOI: 10.2967/jnumed.108.052985] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
UNLABELLED The high-resolution research tomograph (HRRT) is a dedicated human brain PET scanner. At present, iterative reconstruction methods are preferred for reconstructing HRRT studies. However, these iterative reconstruction algorithms show bias in short-duration frames. New algorithms such as the shifted Poisson ordered-subsets expectation maximization (SP-OSEM) and ordered-subsets weighted least squares (OSWLS) showed promising results in bias reduction, compared with the recommended ordinary Poisson OSEM (OP-OSEM). The goal of this study was to evaluate quantitative accuracy of these iterative reconstruction algorithms, compared with 3-dimensional filtered backprojection (3D-FBP). METHODS The 3 above-mentioned 3D iterative reconstruction methods were implemented for the HRRT. To evaluate the various 3D iterative reconstruction techniques quantitatively, several phantom studies and a human brain study (n=5) were performed. RESULTS OSWLS showed a low and almost linearly increasing coefficient of variation (SD over average activity concentration), with decreasing noise-equivalent count rates. In decay studies, OSWLS showed good agreement with the 3D-FBP gray matter (GM)-to-white matter (WM) contrast ratio (<4%), and OP-OSEM and SP-OSEM showed agreement within 6% and 7%, respectively. For various frame durations, both SP-OSEM and OP-OSEM showed the fewest errors in GM-to-WM contrast ratios, varying 75% between different noise-equivalent count rates; this variability was much higher for other iterative methods (>92%). 3D-FBP showed the least variability (34%). Visually, OSWLS hardly showed any artifacts in parametric images and showed good agreement with 3D-FBP data for parametric images, especially in the case of reference-tissue kinetic methods (slope, 1.02; Pearson correlation coefficient, 0.99). CONCLUSION OP-OSEM, SP-OSEM, and OSWLS showed good performance for phantom studies. In addition, OSWLS showed better results for parametric analysis of clinical studies and is therefore recommended for quantitative HRRT brain PET studies.
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Affiliation(s)
- Floris H P van Velden
- Department of Nuclear Medicine & PET Research, VU University medical center, Amsterdam, The Netherlands.
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Mourik JEM, van Velden FHP, Lubberink M, Kloet RW, van Berckel BNM, Lammertsma AA, Boellaard R. Image derived input functions for dynamic High Resolution Research Tomograph PET brain studies. Neuroimage 2008; 43:676-86. [PMID: 18707007 DOI: 10.1016/j.neuroimage.2008.07.035] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2008] [Revised: 07/18/2008] [Accepted: 07/20/2008] [Indexed: 11/25/2022] Open
Abstract
The High Resolution Research Tomograph (HRRT) is a dedicated human brain positron emission tomography (PET) scanner. The aim of the present study was to validate the use of image derived input functions (IDIF) as an alternative for arterial sampling for HRRT human brain studies. To this end, IDIFs were extracted from 3D ordinary Poisson ordered subsets expectation maximization (OP-OSEM) and reconstruction based partial volume corrected (PVC) OP-OSEM images. IDIFs, either derived directly from regions of interest or further calibrated using manual samples taken during scans, were evaluated for dynamic [(11)C]flumazenil data (n=6). Results obtained with IDIFs were compared with those obtained using blood sampler input functions (BSIF). These comparisons included areas under the curve (AUC) for peak (0-3.3 min) and tail (3.3-55.0 min). In addition, slope, intercept and Pearson's correlation coefficient of tracer kinetic analysis results based on IDIF and BSIF were calculated for each subject. Good peak AUC ratios (0.83+/-0.21) between IDIF and BSIF were found for calibrated IDIFs extracted from OP-OSEM images. This combination of IDIFs and images also provided good slope values (1.07+/-0.11). Improved resolution, as obtained with PVC OP-OSEM, changed AUC ratios to 1.14+/-0.35 and, for tracer kinetic analysis, slopes changed to 0.95+/-0.13. For all reconstructions, non-calibrated IDIFs gave poorer results (>61+/-34% higher slopes) compared with calibrated IDIFs. The results of this study indicate that the use of IDIFs, extracted from OP-OSEM or PVC OP-OSEM images, is feasible for dynamic HRRT data, thereby obviating the need for online arterial sampling.
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Affiliation(s)
- Jurgen E M Mourik
- Department of Nuclear Medicine and PET Research, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.
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van Velden FHP, Kloet RW, van Berckel BNM, Wolfensberger SPA, Lammertsma AA, Boellaard R. Comparison of 3D-OP-OSEM and 3D-FBP reconstruction algorithms for High-Resolution Research Tomograph studies: effects of randoms estimation methods. Phys Med Biol 2008; 53:3217-30. [PMID: 18506070 DOI: 10.1088/0031-9155/53/12/010] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The High-Resolution Research Tomograph (HRRT) is a dedicated human brain positron emission tomography (PET) scanner. Recently, a 3D filtered backprojection (3D-FBP) reconstruction method has been implemented to reduce bias in short duration frames, currently observed in 3D ordinary Poisson OSEM (3D-OP-OSEM) reconstructions. Further improvements might be expected using a new method of variance reduction on randoms (VRR) based on coincidence histograms instead of using the delayed window technique (DW) to estimate randoms. The goal of this study was to evaluate VRR in combination with 3D-OP-OSEM and 3D-FBP reconstruction techniques. To this end, several phantom studies and a human brain study were performed. For most phantom studies, 3D-OP-OSEM showed higher accuracy of observed activity concentrations with VRR than with DW. However, both positive and negative deviations in reconstructed activity concentrations and large biases of grey to white matter contrast ratio (up to 88%) were still observed as a function of scan statistics. Moreover 3D-OP-OSEM+VRR also showed bias up to 64% in clinical data, i.e. in some pharmacokinetic parameters as compared with those obtained with 3D-FBP+VRR. In the case of 3D-FBP, VRR showed similar results as DW for both phantom and clinical data, except that VRR showed a better standard deviation of 6-10%. Therefore, VRR should be used to correct for randoms in HRRT PET studies.
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Affiliation(s)
- Floris H P van Velden
- Department of Nuclear Medicine & PET Research, VU University Medical Centre, PO Box 7057, 1007 MB Amsterdam, The Netherlands.
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van Velden FHP, Kloet RW, van Berckel BNM, Molthoff CFM, Lammertsma AA, Boellaard R. Gap filling strategies for 3-D-FBP reconstructions of High-Resolution Research Tomograph scans. IEEE Trans Med Imaging 2008; 27:934-942. [PMID: 18599399 DOI: 10.1109/tmi.2008.922702] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The High-Resolution Research Tomograph (HRRT) is a dedicated human brain positron emission tomography scanner. Currently available iterative reconstruction algorithms show bias due to nonnegativity constraints. Consequently, implementation of 3-D filtered backprojection (3-D-FBP) is of interest. To apply 3-D-FBP all missing data including those due to gaps between detector heads need to be estimated. The aim of this study was to evaluate various gap filling strategies for 3-D-FBP reconstructions of HRRT data, such as linear and bilinear interpolation or constraint Fourier space gap filling (confosp). Furthermore, missing planes were estimated using segment 0 image data only (noniterative) or by using reconstructed images based on all previous segments (iterative method). Use of bilinear interpolation showed worst correspondence between reconstructed and true activity concentration, especially for small structures. Moreover, phantom data indicated that use of linear interpolation resulted in artifacts in planes located near the edge of the field-of-view. Use of confosp did not show these artifacts. Iterative estimations of the missing planes for |segments| 0 improved image quality at the cost of more computation time. Therefore, use of confosp for filling sinogram gaps with both iterative and noniterative estimation of missing planes are recommended for quantitative 3-D-FBP of HRRT studies.
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Affiliation(s)
- Floris H P van Velden
- Department of Nuclear Medicine and PET Research, VU University Medical Center, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands.
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van Velden FHP, Kloet RW, van Berckel BNM, Molthoff CFM, de Jong HWAM, Lammertsma AA, Boellaard R. Impact of attenuation correction strategies on the quantification of High Resolution Research Tomograph PET studies. Phys Med Biol 2007; 53:99-118. [DOI: 10.1088/0031-9155/53/1/007] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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de Jong HWAM, van Velden FHP, Kloet RW, Buijs FL, Boellaard R, Lammertsma AA. Performance evaluation of the ECAT HRRT: an LSO-LYSO double layer high resolution, high sensitivity scanner. Phys Med Biol 2007; 52:1505-26. [PMID: 17301468 DOI: 10.1088/0031-9155/52/5/019] [Citation(s) in RCA: 216] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The ECAT high resolution research tomograph (HRRT) is a dedicated brain and small animal PET scanner, with design features that enable high image spatial resolution combined with high sensitivity. The HRRT is the first commercially available scanner that utilizes a double layer of LSO/LYSO crystals to achieve photon detection with depth-of-interaction information. In this study, the performance of the commercial LSO/LYSO HRRT was characterized, using the NEMA protocol as a guideline. Besides measurement of spatial resolution, energy resolution, sensitivity, scatter fraction, count rate performance, correction for attenuation and scatter, hot spot recovery and image quality, a clinical evaluation was performed by means of a HR+/HRRT human brain comparison study. Point source resolution varied across the field of view from approximately 2.3 to 3.2 mm (FWHM) in the transaxial direction and from 2.5 to 3.4 mm in the axial direction. Absolute line-source sensitivity ranged from 2.5 to 3.3% and the NEMA-2001 scatter fraction equalled 45%. Maximum NECR was 45 kcps and 148 kcps according to the NEMA-2001 and 1994 protocols, respectively. Attenuation and scatter correction led to a volume uniformity of 6.3% and a system uniformity of 3.1%. Reconstructed values deviated up to 15 and 8% in regions with high and low densities, respectively, which can possibly be assigned to inaccuracies in scatter estimation. Hot spot recovery ranged from 60 to 94% for spheres with diameters of 1 to 2.2 cm. A high quantitative agreement was met between HR+ and HRRT clinical data. In conclusion, the ECAT HRRT has excellent resolution and sensitivity properties, which is a crucial advantage in many research studies.
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Affiliation(s)
- Hugo W A M de Jong
- Department of Nuclear Medicine & PET Research, VU University Medical Centre, Amsterdam, The Netherlands.
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