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Kim JT, Chang SJC, Haghdel A, Ramakrishna RR, Pannullo SC, Schwartz TH, Osborne JR, Magge RS, Fine HA, Cisse B, Stieg P, Lin E, Roytman M, Palmer JD, Karakatsanis NA, Pisapia D, Liechty B, Knisely JPS, Ivanidze J. DOTATATE PET/MR Imaging Differentiates Secondary-Progressive from de Novo World Health Organization Grade 3 Meningiomas. AJNR Am J Neuroradiol 2024:ajnr.A8219. [PMID: 38604734 DOI: 10.3174/ajnr.a8219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 02/02/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND AND PURPOSE WHO grade 3 meningiomas are rare and poorly understood and have a higher propensity for recurrence, metastasis, and worsened clinical outcomes compared with lower-grade meningiomas. The purpose of our study was to prospectively evaluate the molecular profile, PET characteristics, and outcomes of patients with World Health Organization grade 3 meningiomas who were imaged with gallium 68 (68Ga) DOTATATE PET/MR imaging. MATERIALS AND METHODS Patients with World Health Organization grade 3 meningiomas enrolled in our prospective observational cohort evaluating the utility of (68Ga) DOTATATE PET/MR imaging in somatostatin receptor positive brain tumors were included. We stratified patients by de novo-versus-secondary-progressive status and evaluated the differences in the PET standard uptake value, molecular profiles, and clinical outcomes. RESULTS Patients met the inclusion criteria (secondary-progressive: 7/14; de novo: 7/14). The secondary-progressive cohort had a significantly higher per-patient number of surgeries (4.1 versus 1.6; P = .011) and trended toward a higher number of radiation therapy courses (2.4 versus 1.6; P = .23) and cumulative radiation therapy doses (106Gy versus 68.3Gy; P = .31). The secondary-progressive cohort had a significantly lower progression-free survival compared with the de novo cohort (4.8 versus 37.7 months; P = .004). Secondary-progressive tumors had distinct molecular pathology profiles with higher numbers of mutations (3.5 versus 1.2; P = .024). Secondary-progressive tumors demonstrated higher PET standard uptake values (17.1 versus 12.4; P = .0021). CONCLUSIONS Our study confirms prior work illustrating distinct clinical outcomes in secondary-progressive and de novo World Health Organization grade 3 meningiomas. Furthermore, our findings support (68Ga) DOTATATE PET/MR imaging as a useful management strategy in World Health Organization grade 3 meningiomas and provide insight into meningioma biology, as well as clinical management implications.
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Affiliation(s)
- Joon Tae Kim
- From the Weill Cornell Medical College (J.T.K., S.J.C.C., A.H.), Weill Cornell Medicine/NewYork-Presbyterian Hospital, New York, New York
| | - Se Jung Chris Chang
- From the Weill Cornell Medical College (J.T.K., S.J.C.C., A.H.), Weill Cornell Medicine/NewYork-Presbyterian Hospital, New York, New York
| | - Arsalan Haghdel
- From the Weill Cornell Medical College (J.T.K., S.J.C.C., A.H.), Weill Cornell Medicine/NewYork-Presbyterian Hospital, New York, New York
| | - Rohan R Ramakrishna
- Department of Neurological Surgery (R.R.R., S.C.P., T.H.S., B.C., P.S.), Weill Cornell Medicine/NewYork-Presbyterian Hospital, New York, New York
| | - Susan C Pannullo
- Department of Neurological Surgery (R.R.R., S.C.P., T.H.S., B.C., P.S.), Weill Cornell Medicine/NewYork-Presbyterian Hospital, New York, New York
| | - Theodore H Schwartz
- Department of Neurological Surgery (R.R.R., S.C.P., T.H.S., B.C., P.S.), Weill Cornell Medicine/NewYork-Presbyterian Hospital, New York, New York
| | - Joseph R Osborne
- Departments of Radiology (J.R.O., E.L., M.R., N.A.K., J.I.), Weill Cornell Medicine/NewYork-Presbyterian Hospital, New York, New York
| | - Rajiv S Magge
- Department of Neurology (R.S.M., H.A.F.), Weill Cornell Medicine/NewYork-Presbyterian Hospital, New York, New York
| | - Howard A Fine
- Department of Neurology (R.S.M., H.A.F.), Weill Cornell Medicine/NewYork-Presbyterian Hospital, New York, New York
| | - Babacar Cisse
- Department of Neurological Surgery (R.R.R., S.C.P., T.H.S., B.C., P.S.), Weill Cornell Medicine/NewYork-Presbyterian Hospital, New York, New York
| | - Philip Stieg
- Department of Neurological Surgery (R.R.R., S.C.P., T.H.S., B.C., P.S.), Weill Cornell Medicine/NewYork-Presbyterian Hospital, New York, New York
| | - Eaton Lin
- Departments of Radiology (J.R.O., E.L., M.R., N.A.K., J.I.), Weill Cornell Medicine/NewYork-Presbyterian Hospital, New York, New York
| | - Michelle Roytman
- Departments of Radiology (J.R.O., E.L., M.R., N.A.K., J.I.), Weill Cornell Medicine/NewYork-Presbyterian Hospital, New York, New York
| | - Joshua D Palmer
- Department of Neuro-Oncology (J.D.P.), Ohio State University, Columbus, Ohio
| | - Nicolas A Karakatsanis
- Departments of Radiology (J.R.O., E.L., M.R., N.A.K., J.I.), Weill Cornell Medicine/NewYork-Presbyterian Hospital, New York, New York
| | - David Pisapia
- Department of Pathology and Laboratory Medicine (D.P., B.L.), Weill Cornell Medicine/NewYork-Presbyterian Hospital, New York, New York
| | - Benjamin Liechty
- Department of Pathology and Laboratory Medicine (D.P., B.L.), Weill Cornell Medicine/NewYork-Presbyterian Hospital, New York, New York
| | - Jonathan P S Knisely
- Department of Radiation Oncology (J.P.S.K.), Weill Cornell Medicine/NewYork-Presbyterian Hospital, New York, New York
| | - Jana Ivanidze
- Departments of Radiology (J.R.O., E.L., M.R., N.A.K., J.I.), Weill Cornell Medicine/NewYork-Presbyterian Hospital, New York, New York
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Mehta NH, Wang X, Keil SA, Xi K, Zhou L, Lee K, Tan W, Spector E, Goldan A, Kelly J, Karakatsanis NA, Mozley PD, Nehmeh S, Chazen JL, Morin S, Babich J, Ivanidze J, Pahlajani S, Tanzi EB, Saint-Louis L, Butler T, Chen K, Rusinek H, Carare RO, Li Y, Chiang GC, de Leon MJ. [1- 11C]-Butanol Positron Emission Tomography reveals an impaired brain to nasal turbinates pathway in aging amyloid positive subjects. Fluids Barriers CNS 2024; 21:30. [PMID: 38566110 PMCID: PMC10985958 DOI: 10.1186/s12987-024-00530-y] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 03/11/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Reduced clearance of cerebrospinal fluid (CSF) has been suggested as a pathological feature of Alzheimer's disease (AD). With extensive documentation in non-human mammals and contradictory human neuroimaging data it remains unknown whether the nasal mucosa is a CSF drainage site in humans. Here, we used dynamic PET with [1-11C]-Butanol, a highly permeable radiotracer with no appreciable brain binding, to test the hypothesis that tracer drainage from the nasal pathway reflects CSF drainage from brain. As a test of the hypothesis, we examined whether brain and nasal fluid drainage times were correlated and affected by brain amyloid. METHODS 24 cognitively normal subjects (≥ 65 years) were dynamically PET imaged for 60 min. using [1-11C]-Butanol. Imaging with either [11C]-PiB or [18F]-FBB identified 8 amyloid PET positive (Aβ+) and 16 Aβ- subjects. MRI-determined regions of interest (ROI) included: the carotid artery, the lateral orbitofrontal (LOF) brain, the cribriform plate, and an All-turbinate region comprised of the superior, middle, and inferior turbinates. The bilateral temporalis muscle and jugular veins served as control regions. Regional time-activity were used to model tracer influx, egress, and AUC. RESULTS LOF and All-turbinate 60 min AUC were positively associated, thus suggesting a connection between the brain and the nose. Further, the Aβ+ subgroup demonstrated impaired tracer kinetics, marked by reduced tracer influx and slower egress. CONCLUSION The data show that tracer kinetics for brain and nasal turbinates are related to each other and both reflect the amyloid status of the brain. As such, these data add to evidence that the nasal pathway is a potential CSF drainage site in humans. These data warrant further investigation of brain and nasal contributions to protein clearance in neurodegenerative disease.
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Affiliation(s)
- Neel H Mehta
- Department of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, 407 East 61 Street, 10065, New York, NY, USA
- Harvard Medical School, Boston, MA, USA
| | - Xiuyuan Wang
- Department of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, 407 East 61 Street, 10065, New York, NY, USA
| | - Samantha A Keil
- Department of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, 407 East 61 Street, 10065, New York, NY, USA
| | - Ke Xi
- Department of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, 407 East 61 Street, 10065, New York, NY, USA
| | - Liangdong Zhou
- Department of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, 407 East 61 Street, 10065, New York, NY, USA
| | - Kevin Lee
- Department of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, 407 East 61 Street, 10065, New York, NY, USA
- Weill Cornell Medicine, School of Medicine New York, New York, NY, USA
| | - Wanbin Tan
- Department of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, 407 East 61 Street, 10065, New York, NY, USA
| | - Edward Spector
- Department of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, 407 East 61 Street, 10065, New York, NY, USA
- University of Michigan, Ann Arbor, MI, USA
| | - Amirhossein Goldan
- Department of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, 407 East 61 Street, 10065, New York, NY, USA
- Department of Radiology, Weill Cornell Medicine, New York, NY, USA
| | - James Kelly
- Department of Radiology, Molecule Imaging Innovations Institute, Weill Cornell Medicine, New York, NY, USA
| | | | - P David Mozley
- Department of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, 407 East 61 Street, 10065, New York, NY, USA
- Radiopharm Theranostics, New York, NY, USA
| | - Sadek Nehmeh
- Department of Radiology, Weill Cornell Medicine, New York, NY, USA
| | - J Levi Chazen
- Department of Radiology, Hospital for Special Surgery, New York, NY, USA
| | - Simon Morin
- Department of Radiology, Weill Cornell Medicine, New York, NY, USA
| | | | - Jana Ivanidze
- Department of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, 407 East 61 Street, 10065, New York, NY, USA
- Department of Radiology, Weill Cornell Medicine, New York, NY, USA
| | - Silky Pahlajani
- Department of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, 407 East 61 Street, 10065, New York, NY, USA
| | - Emily B Tanzi
- Department of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, 407 East 61 Street, 10065, New York, NY, USA
| | | | - Tracy Butler
- Department of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, 407 East 61 Street, 10065, New York, NY, USA
| | - Kewei Chen
- College of Health Solutions, Arizona State University, Downtown Phoenix Campus, Arizona, USA
| | - Henry Rusinek
- Department of Radiology, NYU Langone Health, New York, NY, USA
| | - Roxana O Carare
- Faculty of Medicine, University of Southampton, Southampton, UK
| | - Yi Li
- Department of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, 407 East 61 Street, 10065, New York, NY, USA
| | - Gloria C Chiang
- Department of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, 407 East 61 Street, 10065, New York, NY, USA
- Department of Radiology, Weill Cornell Medicine, New York, NY, USA
| | - Mony J de Leon
- Department of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, 407 East 61 Street, 10065, New York, NY, USA.
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Trivieri MG, Robson PM, Vergani V, LaRocca G, Romero-Daza AM, Abgral R, Devesa A, Azoulay LD, Karakatsanis NA, Parikh A, Panagiota C, Palmisano A, DePalo L, Chang HL, Rothstein JH, Fayad RA, Miller MA, Fuster V, Narula J, Dweck MR, Morgenthau A, Jacobi A, Padilla M, Kovacic JC, Fayad ZA. Hybrid Magnetic Resonance Positron Emission Tomography Is Associated With Cardiac-Related Outcomes in Cardiac Sarcoidosis. JACC Cardiovasc Imaging 2024; 17:411-424. [PMID: 38300202 DOI: 10.1016/j.jcmg.2023.11.010] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 11/14/2023] [Accepted: 11/20/2023] [Indexed: 02/02/2024]
Abstract
BACKGROUND Imaging with late gadolinium enhancement (LGE) magnetic resonance (MR) and 18F-fluorodeoxyglucose (18F-FDG) PET allows complementary assessment of myocardial injury and disease activity and has shown promise for improved characterization of active cardiac sarcoidosis (CS) based on the combined positive imaging outcome, MR(+)PET(+). OBJECTIVES This study aims to evaluate qualitative and quantitative assessments of hybrid MR/PET imaging in CS and to evaluate its association with cardiac-related outcomes. METHODS A total of 148 patients with suspected CS underwent hybrid MR/PET imaging. Patients were classified based on the presence/absence of LGE (MR+/MR-), presence/absence of 18F-FDG (PET+/PET-), and pattern of 18F-FDG uptake (focal/diffuse) into the following categories: MR(+)PET(+)FOCAL, MR(+)PET(+)DIFFUSE, MR(+)PET(-), MR(-)PET(+)FOCAL, MR(-)PET(+)DIFFUSE, MR(-)PET(-). Further analysis classified MR positivity based on %LGE exceeding 5.7% as MR(+/-)5.7%. Quantitative values of standard uptake value, target-to-background ratio, target-to-normal-myocardium ratio (TNMRmax), and T2 were measured. The primary clinical endpoint was met by the occurrence of cardiac arrest, ventricular tachycardia, or secondary prevention implantable cardioverter-defibrillator (ICD) before the end of the study. The secondary endpoint was met by any of the primary endpoint criteria plus heart failure or heart block. MR/PET imaging results were compared between those meeting or not meeting the clinical endpoints. RESULTS Patients designated MR(+)5.7%PET(+)FOCAL had increased odds of meeting the primary clinical endpoint compared to those with all other imaging classifications (unadjusted OR: 9.2 [95% CI: 3.0-28.7]; P = 0.0001), which was higher than the odds based on MR or PET alone. TNMRmax achieved an area under the receiver-operating characteristic curve of 0.90 for separating MR(+)PET(+)FOCAL from non-MR(+)PET(+)FOCAL, and 0.77 for separating those reaching the clinical endpoint from those not reaching the clinical endpoint. CONCLUSIONS Hybrid MR/PET image-based classification of CS was statistically associated with clinical outcomes in CS. TNMRmax had modest sensitivity and specificity for quantifying the imaging-based classification MR(+)PET(+)FOCAL and was associated with outcomes. Use of combined MR and PET image-based classification may have use in prognostication and treatment management in CS.
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Affiliation(s)
- Maria Giovanna Trivieri
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA; Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
| | - Philip M Robson
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Vittoria Vergani
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Gina LaRocca
- Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | | | - Ronan Abgral
- Department of Nuclear Medicine, University Hospital of Brest, European University of Brittany, Brest, France
| | - Ana Devesa
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Levi-Dan Azoulay
- Sorbonne Université, INSERM, CNRS, Laboratoire d'Imagerie Biomédicale (LIB), Paris, France
| | - Nicolas A Karakatsanis
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA; Division of Radiopharmaceutical Sciences, Department of Radiology, Weill Cornell Medical College, New York, New York, USA
| | - Aditya Parikh
- Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Christia Panagiota
- Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Anna Palmisano
- Experimental Imaging Center, Department of Radiology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Louis DePalo
- Division of Pulmonary, Critical Care and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Helena L Chang
- International Center for Health Outcomes and Innovation Research, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Joseph H Rothstein
- International Center for Health Outcomes and Innovation Research, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Rima A Fayad
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Marc A Miller
- Helmsley Electrophysiology Center, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Valentin Fuster
- Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Jagat Narula
- Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Marc R Dweck
- British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, Scotland, UK
| | - Adam Morgenthau
- Division of Pulmonary, Critical Care and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Adam Jacobi
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Maria Padilla
- Division of Pulmonary, Critical Care and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Jason C Kovacic
- Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA; Victor Chang Cardiac Research Institute and St Vincent's Clinical School, University of NSW, Darlinghurst, New South Wales, Australia
| | - Zahi A Fayad
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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4
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Vandenberghe S, Karakatsanis NA, Akl MA, Maebe J, Surti S, Dierckx RA, Pryma DA, Nehmeh SA, Bouhali O, Karp JS. The potential of a medium-cost long axial FOV PET system for nuclear medicine departments. Eur J Nucl Med Mol Imaging 2023; 50:652-660. [PMID: 36178535 DOI: 10.1007/s00259-022-05981-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 09/19/2022] [Indexed: 01/24/2023]
Abstract
PURPOSE Total body positron emission tomography (TB-PET) has recently been introduced in nuclear medicine departments. There is a large interest in these systems, but for many centers, the high acquisition cost makes it very difficult to justify their current operational budget. Here, we propose medium-cost long axial FOV scanners as an alternative. METHODS Several medium-cost long axial FOV designs are described with their advantages and drawbacks. We describe their potential for higher throughput, more cost-effective scanning, a larger group of indications, and novel research opportunities. The wider spread of TB-PET can also lead to the fast introduction of new tracers (at a low dose), new methodologies, and optimized workflows. CONCLUSIONS A medium-cost TB-PET would be positioned between the current standard PET-CT and the full TB-PET systems in investment but recapitulate most advantages of full TB-PET. These systems could be more easily justified financially in a standard academic or large private nuclear medicine department and still have ample research options.
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Affiliation(s)
- Stefaan Vandenberghe
- Medical Image and Signal Processing, Ghent University, Corneel Heymans Laan 10, 9000, Ghent, Belgium.
| | | | - Maya Abi Akl
- Medical Image and Signal Processing, Ghent University, Corneel Heymans Laan 10, 9000, Ghent, Belgium
- Science Program, Texas A&M University at Qatar, Doha, Qatar
| | - Jens Maebe
- Medical Image and Signal Processing, Ghent University, Corneel Heymans Laan 10, 9000, Ghent, Belgium
| | - Suleman Surti
- Department of Radiology, University of Pennsylvania, Philadelphia, USA
| | - Rudi A Dierckx
- Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Daniel A Pryma
- Department of Radiology, University of Pennsylvania, Philadelphia, USA
| | - Sadek A Nehmeh
- Weill Cornell Medical College, Cornell University, NY, USA
| | | | - Joel S Karp
- Department of Radiology, University of Pennsylvania, Philadelphia, USA
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5
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Robson PM, Kaufman A, Pruzan A, Dweck MR, Trivieri MG, Abgral R, Karakatsanis NA, Brunner PM, Guttman E, Fayad ZA, Mani V. Scan-rescan measurement repeatability of 18F-FDG PET/MR imaging of vascular inflammation. J Nucl Cardiol 2022; 29:1660-1670. [PMID: 34046803 DOI: 10.1007/s12350-021-02627-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 03/07/2021] [Indexed: 12/27/2022]
Abstract
Non-invasive positron emission tomography (PET) of vascular inflammation and atherosclerotic plaque by identifying increased uptake of 18F-fluordeoxyglucose (18F-FDG) is a powerful tool for monitoring disease activity, progression, and its response to therapy. 18F-FDG PET/computed tomography (PET/CT) of the aorta and carotid arteries has become widely used to assess changes in inflammation in clinical trials. However, the recent advent of hybrid PET/magnetic resonance (PET/MR) scanners has advantages for vascular imaging due to the reduction in radiation exposure and improved soft tissue contrast of MR compared to CT. Important for research and clinical use is an understanding of the scan-rescan repeatability of the PET measurement. While this has been studied for PET/CT, no data is currently available for vascular PET/MR imaging. In this study, we determined the scan-rescan measurement repeatability of 18F-FDG PET/MR in the aorta and carotid arteries was less than 5%, comparable to similar findings for 18F-FDG PET/CT.
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Affiliation(s)
- Philip M Robson
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Audrey Kaufman
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Alison Pruzan
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Marc R Dweck
- British Heart Foundation/University Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, EH16 4SB, UK
| | - Maria-Giovanna Trivieri
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ronan Abgral
- Department of Nuclear Medicine, European University of Brittany, EA3878 GETBO, IFR 148, CHRU Brest, Brest, France
| | - Nicolas A Karakatsanis
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Patrick M Brunner
- Laboratory for Investigative Dermatology, The Rockefeller University, New York, NY, USA
| | - Emma Guttman
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Zahi A Fayad
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Venkatesh Mani
- BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Kang Y, Jamison K, Jaywant A, Dams-O’Connor K, Kim N, Karakatsanis NA, Butler T, Schiff ND, Kuceyeski A, Shah SA. Longitudinal alterations in gamma-aminobutyric acid (GABAA) receptor availability over ∼ 1 year following traumatic brain injury. Brain Commun 2022; 4:fcac159. [PMID: 35794871 PMCID: PMC9253887 DOI: 10.1093/braincomms/fcac159] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [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: 11/22/2021] [Revised: 03/24/2022] [Accepted: 06/14/2022] [Indexed: 11/25/2022] Open
Abstract
Longitudinal alterations of gamma-aminobutyric acid (GABAA) receptor availability following traumatic brain injury have remained uncharacterized and may reflect changes in neuronal structure and function linked to cognitive recovery. We measured GABAA receptor availability using the tracer [11C]flumazenil in nine adults with traumatic brain injury (3–6 months after injury, subacute scan) and in 20 non-brain-injured individuals. A subset of subjects with traumatic brain injury (n = 7) were scanned at a second chronic time-point, 7–13 months after their first scan; controls (n = 9) were scanned for a second time, 5–11 months after the first scan. After accounting for atrophy in subjects with traumatic brain injury, we find broad decreases in GABAA receptor availability predominantly within the frontal lobes, striatum, and posterior-medial thalami; focal reductions were most pronounced in the right insula and anterior cingulate cortex (p < 0.05). Greater relative increase, compared to controls, in global GABAA receptor availability appeared between subacute and chronic scans. At chronic scan (>1 year post-injury), we find increased pallidal receptor availability compared to controls. Conversely, receptor availability remained depressed across the frontal cortices. Longitudinal improvement in executive attention correlated with increases in receptor availability across bilateral fronto-parietal cortical regions and the anterior-lateral aspects of the thalami. The specific observations of persistent bi-frontal lobe reductions and bilateral pallidal elevation are consistent with the anterior forebrain mesocircuit hypothesis for recovery of consciousness following a wide range of brain injuries; our results provide novel correlative data in support of specific cellular mechanisms underlying persistent cognitive deficits. Collectively, these measurements support the use of [11C]flumazenil to track recovery of large-scale network function following brain injuries and measure response to therapeutics.
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Affiliation(s)
- Y Kang
- Department of Mathematics, Howard University , Washington, DC 20059 , USA
| | - K Jamison
- Department of Radiology, Weill Cornell Medicine , 407 E. 61 St., Rm 208, New York, NY 10065 , USA
| | - A Jaywant
- Department of Rehabilitation Medicine, Weill Cornell Medicine , New York, NY 10065 , USA
- Department of Psychiatry, Weill Cornell Medicine , New York, NY 10065 , USA
| | - K Dams-O’Connor
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai , New York, NY 10029 , USA
- Department of Neurology, Icahn School of Medicine at Mount Sinai , New York, NY 10029 , USA
| | - N Kim
- Department of Radiology, Weill Cornell Medicine , 407 E. 61 St., Rm 208, New York, NY 10065 , USA
| | - N A Karakatsanis
- Department of Radiology, Weill Cornell Medicine , 407 E. 61 St., Rm 208, New York, NY 10065 , USA
| | - T Butler
- Department of Radiology, Weill Cornell Medicine , 407 E. 61 St., Rm 208, New York, NY 10065 , USA
| | - N D Schiff
- Department of BMRI & Neurology, Weill Cornell Medicine , New York, NY 10065 , USA
| | - A Kuceyeski
- Department of Radiology, Weill Cornell Medicine , 407 E. 61 St., Rm 208, New York, NY 10065 , USA
| | - S A Shah
- Department of Radiology, Weill Cornell Medicine , 407 E. 61 St., Rm 208, New York, NY 10065 , USA
- Department of BMRI & Neurology, Weill Cornell Medicine , New York, NY 10065 , USA
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Karakatsanis NA, Nehmeh MH, Conti M, Bal G, González AJ, Nehmeh SA. Physical performance of adaptive axial FOV PET scanners with a sparse detector block rings or a checkerboard configuration. Phys Med Biol 2022; 67. [DOI: 10.1088/1361-6560/ac6aa1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 04/26/2022] [Indexed: 11/12/2022]
Abstract
Abstract
Objective. Using Monte-Carlo simulations, we evaluated the physical performance of a hypothetical state-of-the-art clinical PET scanner with adaptive axial field-of-view (AFOV) based on the validated GATE model of the Siemens Biograph VisionTM PET/CT scanner. Approach. Vision consists of 16 compact PET rings, each consisting of 152 mini-blocks of 5 × 5 Lutetium Oxyorthosilicate crystals (3.2 × 3.2 × 20 mm3). The Vision 25.6 cm AFOV was extended by adopting (i) a sparse mini-block ring (SBR) configuration of 49.6 cm AFOV, with all mini-block rings interleaved with 16 mm axial gaps, or (ii) a sparse mini-block checkerboard (SCB) configuration of 51.2 cm AFOV, with all mini-blocks interleaved with gaps of 16 mm (transaxial) × 16 mm (axial) width in checkerboard pattern. For sparse configurations, a ‘limited’ continuous bed motion (limited-CBM) acquisition was employed to extend AFOVs by 2.9 cm. Spatial resolution, sensitivity, image quality (IQ), NECR and scatter fraction were assessed per NEMA NU2-2012. Main Results. All IQ phantom spheres were distinguishable with all configurations. SBR and SCB percent contrast recovery (% CR) and background variability (% BV) were similar (p-value > 0.05). Compared to Vision, SBR and SCB %CRs were similar (p-values > 0.05). However, SBR and SCB %BVs were deteriorated by 30% and 26% respectively (p-values < 0.05). SBR, SCB and Vision exhibited system sensitivities of 16.6, 16.8, and 15.8 kcps MBq−1, NECRs of 311 kcps @35 kBq cc−1, 266 kcps @25.8 kBq cc−1, and 260 kcps @27.8 kBq cc−1, and scatter fractions of 31.2%, 32.4%, and 32.6%, respectively. SBR and SCB exhibited a smoother sensitivity reduction and noise enhancement rate from AFOV center to its edges. SBR and SCB attained comparable spatial resolution in all directions (p-value > 0.05), yet, up to 1.5 mm worse than Vision (p-values < 0.05). Significance. The proposed sparse configurations may offer a clinically adoptable solution for cost-effective adaptive AFOV PET with either highly-sensitive or long-AFOV acquisitions.
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Ivanidze J, Roytman M, Skafida M, Kim S, Glynn S, Osborne JR, Pannullo SC, Nehmeh S, Ramakrishna R, Schwartz TH, Knisely JPS, Lin E, Karakatsanis NA. Dynamic 68Ga-DOTATATE PET/MRI in the Diagnosis and Management of Intracranial Meningiomas. Radiol Imaging Cancer 2022; 4:e210067. [PMID: 35275019 DOI: 10.1148/rycan.210067] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Purpose To evaluate dynamic gallium 68 (68Ga) tetraazacyclododecane tetraacetic acid octreotate (DOTATATE) brain PET/MRI as an adjunct modality in meningioma, enabling multiparametric standardized uptake value (SUV) and Patlak net binding rate constant (Ki) imaging, and to optimize static acquisition period. Materials and Methods In this prospective study (ClinicalTrials.gov no. NCT04081701, DOMINO-START), 68Ga-DOTATATE PET/MRI-derived time-activity curves (TACs) were measured in 84 volumes of interest in 19 participants (mean age, 63 years; range, 36-89 years; 13 women; 2019-2021) with meningiomas. Region- and voxel-specific Ki were determined using Patlak analysis with a validated population-based reference tissue TAC model built from an independent data set of nine participants. Mean and maximum absolute and relative-to-superior-sagittal-sinus SUVs were extracted from the entire 50 minutes (SUV50) and last 10 minutes (SUV10) of acquisition. SUV versus Ki Spearman correlation, SUV and Ki meningioma versus posttreatment-change Mann-Whitney U tests, and SUV50 versus SUV10 Wilcoxon matched-pairs signed rank tests were performed. Results Absolute and relative maximum SUV50 demonstrated a strong positive correlation with Patlak Ki in meningioma (r = 0.82, P < .001 and r = 0.85, P < .001, respectively) and posttreatment-change lesions (r = 0.88, P = .007 and r = 0.83, P = .02, respectively). Patlak Ki images yielded higher lesion contrast by mitigating nonspecific background signal. All SUV50 and SUV10 metrics differed between meningioma and posttreatment-change regions (P < .001). Within the meningioma group, SUV10 attained higher mean scores than SUV50 (P < .001). Conclusion Combined SUV and Patlak K i 68Ga-DOTATATE PET/MRI enabled multiparametric evaluation of meningioma, offering the potential to enhance lesion contrast with Ki imaging and optimize the SUV measurement postinjection window. Keywords: Molecular Imaging-Clinical Translation, Neuro-Oncology, PET/MRI, Dynamic, Patlak ClinicalTrials.gov registration no. NCT04081701 © RSNA, 2022.
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Affiliation(s)
- Jana Ivanidze
- From the Departments of Radiology (J.I., M.R., M.S., J.R.O., S.N., E.L., N.A.K.), Neurologic Surgery (S.C.P., R.R., T.H.S.), and Radiation Oncology (J.P.S.K.), NewYork-Presbyterian/Weill Cornell Medical Center, 515 E 71st St, S-120, New York, NY 10021; Weill Cornell Medical College, New York, NY (S.K., S.G.); and Department of Biomedical Engineering, Cornell University, Ithaca, NY (S.C.P.)
| | - Michelle Roytman
- From the Departments of Radiology (J.I., M.R., M.S., J.R.O., S.N., E.L., N.A.K.), Neurologic Surgery (S.C.P., R.R., T.H.S.), and Radiation Oncology (J.P.S.K.), NewYork-Presbyterian/Weill Cornell Medical Center, 515 E 71st St, S-120, New York, NY 10021; Weill Cornell Medical College, New York, NY (S.K., S.G.); and Department of Biomedical Engineering, Cornell University, Ithaca, NY (S.C.P.)
| | - Myrto Skafida
- From the Departments of Radiology (J.I., M.R., M.S., J.R.O., S.N., E.L., N.A.K.), Neurologic Surgery (S.C.P., R.R., T.H.S.), and Radiation Oncology (J.P.S.K.), NewYork-Presbyterian/Weill Cornell Medical Center, 515 E 71st St, S-120, New York, NY 10021; Weill Cornell Medical College, New York, NY (S.K., S.G.); and Department of Biomedical Engineering, Cornell University, Ithaca, NY (S.C.P.)
| | - Sean Kim
- From the Departments of Radiology (J.I., M.R., M.S., J.R.O., S.N., E.L., N.A.K.), Neurologic Surgery (S.C.P., R.R., T.H.S.), and Radiation Oncology (J.P.S.K.), NewYork-Presbyterian/Weill Cornell Medical Center, 515 E 71st St, S-120, New York, NY 10021; Weill Cornell Medical College, New York, NY (S.K., S.G.); and Department of Biomedical Engineering, Cornell University, Ithaca, NY (S.C.P.)
| | - Shannon Glynn
- From the Departments of Radiology (J.I., M.R., M.S., J.R.O., S.N., E.L., N.A.K.), Neurologic Surgery (S.C.P., R.R., T.H.S.), and Radiation Oncology (J.P.S.K.), NewYork-Presbyterian/Weill Cornell Medical Center, 515 E 71st St, S-120, New York, NY 10021; Weill Cornell Medical College, New York, NY (S.K., S.G.); and Department of Biomedical Engineering, Cornell University, Ithaca, NY (S.C.P.)
| | - Joseph R Osborne
- From the Departments of Radiology (J.I., M.R., M.S., J.R.O., S.N., E.L., N.A.K.), Neurologic Surgery (S.C.P., R.R., T.H.S.), and Radiation Oncology (J.P.S.K.), NewYork-Presbyterian/Weill Cornell Medical Center, 515 E 71st St, S-120, New York, NY 10021; Weill Cornell Medical College, New York, NY (S.K., S.G.); and Department of Biomedical Engineering, Cornell University, Ithaca, NY (S.C.P.)
| | - Susan C Pannullo
- From the Departments of Radiology (J.I., M.R., M.S., J.R.O., S.N., E.L., N.A.K.), Neurologic Surgery (S.C.P., R.R., T.H.S.), and Radiation Oncology (J.P.S.K.), NewYork-Presbyterian/Weill Cornell Medical Center, 515 E 71st St, S-120, New York, NY 10021; Weill Cornell Medical College, New York, NY (S.K., S.G.); and Department of Biomedical Engineering, Cornell University, Ithaca, NY (S.C.P.)
| | - Sadek Nehmeh
- From the Departments of Radiology (J.I., M.R., M.S., J.R.O., S.N., E.L., N.A.K.), Neurologic Surgery (S.C.P., R.R., T.H.S.), and Radiation Oncology (J.P.S.K.), NewYork-Presbyterian/Weill Cornell Medical Center, 515 E 71st St, S-120, New York, NY 10021; Weill Cornell Medical College, New York, NY (S.K., S.G.); and Department of Biomedical Engineering, Cornell University, Ithaca, NY (S.C.P.)
| | - Rohan Ramakrishna
- From the Departments of Radiology (J.I., M.R., M.S., J.R.O., S.N., E.L., N.A.K.), Neurologic Surgery (S.C.P., R.R., T.H.S.), and Radiation Oncology (J.P.S.K.), NewYork-Presbyterian/Weill Cornell Medical Center, 515 E 71st St, S-120, New York, NY 10021; Weill Cornell Medical College, New York, NY (S.K., S.G.); and Department of Biomedical Engineering, Cornell University, Ithaca, NY (S.C.P.)
| | - Theodore H Schwartz
- From the Departments of Radiology (J.I., M.R., M.S., J.R.O., S.N., E.L., N.A.K.), Neurologic Surgery (S.C.P., R.R., T.H.S.), and Radiation Oncology (J.P.S.K.), NewYork-Presbyterian/Weill Cornell Medical Center, 515 E 71st St, S-120, New York, NY 10021; Weill Cornell Medical College, New York, NY (S.K., S.G.); and Department of Biomedical Engineering, Cornell University, Ithaca, NY (S.C.P.)
| | - Jonathan P S Knisely
- From the Departments of Radiology (J.I., M.R., M.S., J.R.O., S.N., E.L., N.A.K.), Neurologic Surgery (S.C.P., R.R., T.H.S.), and Radiation Oncology (J.P.S.K.), NewYork-Presbyterian/Weill Cornell Medical Center, 515 E 71st St, S-120, New York, NY 10021; Weill Cornell Medical College, New York, NY (S.K., S.G.); and Department of Biomedical Engineering, Cornell University, Ithaca, NY (S.C.P.)
| | - Eaton Lin
- From the Departments of Radiology (J.I., M.R., M.S., J.R.O., S.N., E.L., N.A.K.), Neurologic Surgery (S.C.P., R.R., T.H.S.), and Radiation Oncology (J.P.S.K.), NewYork-Presbyterian/Weill Cornell Medical Center, 515 E 71st St, S-120, New York, NY 10021; Weill Cornell Medical College, New York, NY (S.K., S.G.); and Department of Biomedical Engineering, Cornell University, Ithaca, NY (S.C.P.)
| | - Nicolas A Karakatsanis
- From the Departments of Radiology (J.I., M.R., M.S., J.R.O., S.N., E.L., N.A.K.), Neurologic Surgery (S.C.P., R.R., T.H.S.), and Radiation Oncology (J.P.S.K.), NewYork-Presbyterian/Weill Cornell Medical Center, 515 E 71st St, S-120, New York, NY 10021; Weill Cornell Medical College, New York, NY (S.K., S.G.); and Department of Biomedical Engineering, Cornell University, Ithaca, NY (S.C.P.)
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9
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Akerele MI, Mushari NA, Forsythe RO, Syed M, Karakatsanis NA, Newby DE, Dweck MR, Tsoumpas C. Assessment of different quantification metrics of [ 18F]-NaF PET/CT images of patients with abdominal aortic aneurysm. J Nucl Cardiol 2022; 29:251-261. [PMID: 32557152 PMCID: PMC8873073 DOI: 10.1007/s12350-020-02220-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 05/26/2020] [Indexed: 01/22/2023]
Abstract
BACKGROUND We aim to assess the spill-in effect and the benefit in quantitative accuracy for [18F]-NaF PET/CT imaging of abdominal aortic aneurysms (AAA) using the background correction (BC) technique. METHODS Seventy-two datasets of patients diagnosed with AAA were reconstructed with ordered subset expectation maximization algorithm incorporating point spread function (PSF). Spill-in effect was investigated for the entire aneurysm (AAA), and part of the aneurysm excluding the region close to the bone (AAAexc). Quantifications of PSF and PSF+BC images using different thresholds (% of max. SUV in target regions-of-interest) to derive target-to-background (TBR) values (TBRmax, TBR90, TBR70 and TBR50) were compared at 3 and 10 iterations. RESULTS TBR differences were observed between AAA and AAAexc due to spill-in effect from the bone into the aneurysm. TBRmax showed the highest sensitivity to the spill-in effect while TBR50 showed the least. The spill-in effect was reduced at 10 iterations compared to 3 iterations, but at the expense of reduced contrast-to-noise ratio (CNR). TBR50 yielded the best trade-off between increased CNR and reduced spill-in effect. PSF+BC method reduced TBR sensitivity to spill-in effect, especially at 3 iterations, compared to PSF (P-value ≤ 0.05). CONCLUSION TBR50 is robust metric for reduced spill-in and increased CNR.
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Affiliation(s)
- Mercy I. Akerele
- Biomedical Imaging Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, LS2 9NL UK
| | - Nouf A. Mushari
- Biomedical Imaging Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, LS2 9NL UK
| | - Rachael O. Forsythe
- British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
- Edinburgh Imaging Facility, Queen’s Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Maaz Syed
- British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
- Edinburgh Imaging Facility, Queen’s Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Nicolas A. Karakatsanis
- Division of Radiopharmaceutical Sciences, Department of Radiology, Weil Cornell Medical College of Cornell University, New York, NY USA
- Biomedical Engineering & Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY USA
| | - David E. Newby
- Edinburgh Imaging Facility, Queen’s Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Marc R. Dweck
- British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
- Edinburgh Imaging Facility, Queen’s Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Charalampos Tsoumpas
- Biomedical Imaging Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, LS2 9NL UK
- Biomedical Engineering & Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY USA
- Invicro, London, UK
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10
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Roytman M, Kim S, Glynn S, Thomas C, Lin E, Feltus W, Magge RS, Liechty B, Schwartz TH, Ramakrishna R, Karakatsanis NA, Pannullo SC, Osborne JR, Knisely JPS, Ivanidze J. PET/MR Imaging of Somatostatin Receptor Expression and Tumor Vascularity in Meningioma: Implications for Pathophysiology and Tumor Outcomes. Front Oncol 2022; 11:820287. [PMID: 35155210 PMCID: PMC8832502 DOI: 10.3389/fonc.2021.820287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 12/21/2021] [Indexed: 11/13/2022] Open
Abstract
Background and Purpose Meningiomas, the most common primary intracranial tumor, are vascular neoplasms that express somatostatin receptor-2 (SSTR2). The purpose of this investigation was to evaluate if a relationship exists between tumor vascularity and SSTR2 expression, which may play a role in meningioma prognostication and clinical management. Materials and Methods Gallium-68-DOTATATE PET/MRI with dynamic contrast-enhanced (DCE) perfusion was prospectively performed. Clinical and demographic patient characteristics were recorded. Tumor volumes were segmented and superimposed onto parametric DCE maps including flux rate constant (Kep), transfer constant (Ktrans), extravascular volume fraction (Ve), and plasma volume fraction (Vp). Meningioma PET standardized uptake value (SUV) and SUV ratio to superior sagittal sinus (SUVRSSS) were recorded. Pearson correlation analyses were performed. In a random subset, analysis was repeated by a second investigator, and intraclass correlation coefficients (ICCs) were determined. Results Thirty-six patients with 60 meningiomas (20 WHO-1, 27 WHO-2, and 13 WHO-3) were included. Mean Kep demonstrated a strong significant positive correlation with SUV (r = 0.84, p < 0.0001) and SUVRSSS (r = 0.81, p < 0.0001). When stratifying by WHO grade, this correlation persisted in WHO-2 (r = 0.91, p < 0.0001) and WHO-3 (r = 0.92, p = 0.0029) but not WHO-1 (r = 0.26, p = 0.4, SUVRSSS). ICC was excellent (0.97–0.99). Conclusion DOTATATE PET/MRI demonstrated a strong significant correlation between tumor vascularity and SSTR2 expression in WHO-2 and WHO-3, but not WHO-1 meningiomas, suggesting biological differences in the relationship between tumor vascularity and SSTR2 expression in higher-grade meningiomas, the predictive value of which will be tested in future work.
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Affiliation(s)
- Michelle Roytman
- Departments of Radiology, Weill Cornell Medicine/NewYork-Presbyterian Hospital, New York, NY, United States
| | - Sean Kim
- Weill Cornell Medical College, Weill Cornell Medicine/NewYork-Presbyterian Hospital, New York, NY, United States
| | - Shannon Glynn
- Weill Cornell Medical College, Weill Cornell Medicine/NewYork-Presbyterian Hospital, New York, NY, United States
| | - Charlene Thomas
- Weill Cornell Medical College, Weill Cornell Medicine/NewYork-Presbyterian Hospital, New York, NY, United States
| | - Eaton Lin
- Departments of Radiology, Weill Cornell Medicine/NewYork-Presbyterian Hospital, New York, NY, United States
| | - Whitney Feltus
- Departments of Radiology, New York-Presbyterian Hospital/Columbia University Medical Center, New York, NY, United States
| | - Rajiv S. Magge
- Department of Neurology, Weill Cornell Medicine/NewYork-Presbyterian Hospital, New York, NY, United States
| | - Benjamin Liechty
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine/NewYork-Presbyterian Hospital, New York, NY, United States
| | - Theodore H. Schwartz
- Department of Neurological Surgery, Weill Cornell Medicine/NewYork-Presbyterian Hospital, New York, NY, United States
| | - Rohan Ramakrishna
- Department of Neurological Surgery, Weill Cornell Medicine/NewYork-Presbyterian Hospital, New York, NY, United States
| | - Nicolas A. Karakatsanis
- Departments of Radiology, Weill Cornell Medicine/NewYork-Presbyterian Hospital, New York, NY, United States
| | - Susan C. Pannullo
- Department of Neurological Surgery, Weill Cornell Medicine/NewYork-Presbyterian Hospital, New York, NY, United States
| | - Joseph R. Osborne
- Departments of Radiology, Weill Cornell Medicine/NewYork-Presbyterian Hospital, New York, NY, United States
| | - Jonathan P. S. Knisely
- Department of Radiation Oncology, Weill Cornell Medicine/NewYork-Presbyterian Hospital, New York, NY, United States
| | - Jana Ivanidze
- Departments of Radiology, Weill Cornell Medicine/NewYork-Presbyterian Hospital, New York, NY, United States
- *Correspondence: Jana Ivanidze,
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11
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Karakatsanis NA, Arleo EK. Dr. Edith H. Quimby: A pioneering medical physicist and educator with outstanding contributions in radiation dosimetry. Clin Imaging 2021; 81:118-121. [PMID: 34700174 DOI: 10.1016/j.clinimag.2021.09.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 09/01/2021] [Accepted: 09/21/2021] [Indexed: 11/28/2022]
Affiliation(s)
| | - Elizabeth K Arleo
- Department of Radiology, Weill Cornell Medical College, United States of America
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12
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Robson PM, Vergani V, Benkert T, Trivieri MG, Karakatsanis NA, Abgral R, Dweck MR, Moreno PR, Kovacic JC, Block KT, Fayad ZA. Assessing the qualitative and quantitative impacts of simple two-class vs multiple tissue-class MR-based attenuation correction for cardiac PET/MR. J Nucl Cardiol 2021; 28:2194-2204. [PMID: 31898004 PMCID: PMC7329599 DOI: 10.1007/s12350-019-02002-5] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 11/01/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Hybrid PET/MR imaging has significant potential in cardiology due to its combination of molecular PET imaging and cardiac MR. Multi-tissue-class MR-based attenuation correction (MRAC) is necessary for accurate PET quantification. Moreover, for thoracic PET imaging, respiration is known to lead to misalignments of MRAC and PET data that result in PET artifacts. These factors can be addressed by using multi-echo MR for tissue segmentation and motion-robust or motion-gated acquisitions. However, the combination of these strategies is not routinely available and can be prone to errors. In this study, we examine the qualitative and quantitative impacts of multi-class MRAC compared to a more widely available simple two-class MRAC for cardiac PET/MR. METHODS AND RESULTS In a cohort of patients with cardiac sarcoidosis, we acquired MRAC data using multi-echo radial gradient-echo MR imaging. Water-fat separation was used to produce attenuation maps with up to 4 tissue classes including water-based soft tissue, fat, lung, and background air. Simultaneously acquired 18F-fluorodeoxyglucose PET data were subsequently reconstructed using each attenuation map separately. PET uptake values were measured in the myocardium and compared between different PET images. The inclusion of lung and subcutaneous fat in the MRAC maps significantly affected the quantification of 18F-fluorodeoxyglucose activity in the myocardium but only moderately altered the appearance of the PET image without introduction of image artifacts. CONCLUSION Optimal MRAC for cardiac PET/MR applications should include segmentation of all tissues in combination with compensation for the respiratory-related motion of the heart. Simple two-class MRAC is adequate for qualitative clinical assessment.
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Affiliation(s)
- Philip M Robson
- Translational and Molecular Imaging Institute, Leon and Norma Hess Center for Science and Medicine, Icahn School of Medicine at Mount Sinai, One Gustave Levy Pl, 1470 Madison Ave, TMII - 1st floor, New York, NY, 10029, USA.
| | - Vittoria Vergani
- Translational and Molecular Imaging Institute, Leon and Norma Hess Center for Science and Medicine, Icahn School of Medicine at Mount Sinai, One Gustave Levy Pl, 1470 Madison Ave, TMII - 1st floor, New York, NY, 10029, USA
- Cardiothoracic and Vascular Department, Vita-Salute University and San Raffaele Hospital, Milan, Italy
| | - Thomas Benkert
- Center for Advanced Imaging Innovation and Research, Department of Radiology, New York University School of Medicine, New York, NY, USA
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY, USA
| | - Maria Giovanna Trivieri
- Translational and Molecular Imaging Institute, Leon and Norma Hess Center for Science and Medicine, Icahn School of Medicine at Mount Sinai, One Gustave Levy Pl, 1470 Madison Ave, TMII - 1st floor, New York, NY, 10029, USA
- Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, One Gustave Levy Pl, New York, NY, 10029, USA
| | - Nicolas A Karakatsanis
- Translational and Molecular Imaging Institute, Leon and Norma Hess Center for Science and Medicine, Icahn School of Medicine at Mount Sinai, One Gustave Levy Pl, 1470 Madison Ave, TMII - 1st floor, New York, NY, 10029, USA
- Division of Radiopharmaceutical Sciences, Department of Radiology, Weill Cornell Medical College, Cornell University, New York, NY, USA
| | - Ronan Abgral
- Department of Nuclear Medicine, University Hospital of Brest, European University of Brittany, EA3878 GETBO, Brest, France
| | - Marc R Dweck
- British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - Pedro R Moreno
- Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, One Gustave Levy Pl, New York, NY, 10029, USA
| | - Jason C Kovacic
- Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, One Gustave Levy Pl, New York, NY, 10029, USA
| | - Kai Tobias Block
- Center for Advanced Imaging Innovation and Research, Department of Radiology, New York University School of Medicine, New York, NY, USA
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY, USA
| | - Zahi A Fayad
- Translational and Molecular Imaging Institute, Leon and Norma Hess Center for Science and Medicine, Icahn School of Medicine at Mount Sinai, One Gustave Levy Pl, 1470 Madison Ave, TMII - 1st floor, New York, NY, 10029, USA
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13
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Akerele MI, Karakatsanis NA, Forsythe RO, Dweck MR, Syed M, Aykroyd RG, Sourbron S, Newby DE, Tsoumpas C. Iterative reconstruction incorporating background correction improves quantification of [ 18F]-NaF PET/CT images of patients with abdominal aortic aneurysm. J Nucl Cardiol 2021; 28:1875-1886. [PMID: 31721093 PMCID: PMC8648624 DOI: 10.1007/s12350-019-01940-4] [Citation(s) in RCA: 9] [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] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 10/16/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND A confounding issue in [18F]-NaF PET/CT imaging of abdominal aortic aneurysms (AAA) is the spill in contamination from the bone into the aneurysm. This study investigates and corrects for this spill in contamination using the background correction (BC) technique without the need to manually exclude the part of the AAA region close to the bone. METHODS Seventy-two (72) datasets of patients with AAA were reconstructed with the standard ordered subset expectation maximization (OSEM) algorithm incorporating point spread function (PSF) modelling. The spill in effect in the aneurysm was investigated using two target regions of interest (ROIs): one covering the entire aneurysm (AAA), and the other covering the aneurysm but excluding the part close to the bone (AAAexc). ROI analysis was performed by comparing the maximum SUV in the target ROI (SUVmax(T)), the corrected cSUVmax (SUVmax(T) - SUVmean(B)) and the target-to-blood ratio (TBR = SUVmax(T)/SUVmean(B)) with respect to the mean SUV in the right atrium region. RESULTS There is a statistically significant higher [18F]-NaF uptake in the aneurysm than normal aorta and this is not correlated with the aneurysm size. There is also a significant difference in aneurysm uptake for OSEM and OSEM + PSF (but not OSEM + PSF + BC) when quantifying with AAA and AAAexc due to the spill in from the bone. This spill in effect depends on proximity of the aneurysms to the bone as close aneurysms suffer more from spill in than farther ones. CONCLUSION The background correction (OSEM + PSF + BC) technique provided more robust AAA quantitative assessments regardless of the AAA ROI delineation method, and thus it can be considered as an effective spill in correction method for [18F]-NaF AAA studies.
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Affiliation(s)
- Mercy I Akerele
- Biomedical Imaging Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, LS2 9NL, UK
| | - Nicolas A Karakatsanis
- Division of Radiopharmaceutical Sciences, Department of Radiology, Weil Cornell Medical College of Cornell University, New York, NY, USA
| | - Rachael O Forsythe
- British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
- Edinburgh Imaging Facility, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Marc R Dweck
- British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
- Edinburgh Imaging Facility, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Maaz Syed
- British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
- Edinburgh Imaging Facility, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | | | - Steven Sourbron
- Biomedical Imaging Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, LS2 9NL, UK
| | - David E Newby
- Edinburgh Imaging Facility, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Charalampos Tsoumpas
- Biomedical Imaging Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, LS2 9NL, UK.
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Zein SA, Karakatsanis NA, Conti M, Nehmeh SA. Monte Carlo Simulation of the Siemens Biograph Vision PET With Extended Axial Field of View Using Sparse Detector Module Rings Configuration. IEEE Trans Radiat Plasma Med Sci 2021. [DOI: 10.1109/trpms.2020.3034676] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Akerele MI, Zein SA, Pandya S, Nikolopoulou A, Gauthier SA, Raj A, Henchcliffe C, Mozley PD, Karakatsanis NA, Gupta A, Babich J, Nehmeh SA. Population-based input function for TSPO quantification and kinetic modeling with [ 11C]-DPA-713. EJNMMI Phys 2021; 8:39. [PMID: 33914185 PMCID: PMC8085191 DOI: 10.1186/s40658-021-00381-8] [Citation(s) in RCA: 3] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 03/29/2021] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Quantitative positron emission tomography (PET) studies of neurodegenerative diseases typically require the measurement of arterial input functions (AIF), an invasive and risky procedure. This study aims to assess the reproducibility of [11C]DPA-713 PET kinetic analysis using population-based input function (PBIF). The final goal is to possibly eliminate the need for AIF. MATERIALS AND METHODS Eighteen subjects including six healthy volunteers (HV) and twelve Parkinson disease (PD) subjects from two [11C]-DPA-713 PET studies were included. Each subject underwent 90 min of dynamic PET imaging. Five healthy volunteers underwent a test-retest scan within the same day to assess the repeatability of the kinetic parameters. Kinetic modeling was carried out using the Logan total volume of distribution (VT) model. For each data set, kinetic analysis was performed using a patient-specific AIF (PSAIF, ground-truth standard) and then repeated using the PBIF. PBIF was generated using the leave-one-out method for each subject from the remaining 17 subjects and after normalizing the PSAIFs by 3 techniques: (a) Weightsubject×DoseInjected, (b) area under AIF curve (AUC), and (c) Weightsubject×AUC. The variability in the VT measured with PSAIF, in the test-retest study, was determined for selected brain regions (white matter, cerebellum, thalamus, caudate, putamen, pallidum, brainstem, hippocampus, and amygdala) using the Bland-Altman analysis and for each of the 3 normalization techniques. Similarly, for all subjects, the variabilities due to the use of PBIF were assessed. RESULTS Bland-Altman analysis showed systematic bias between test and retest studies. The corresponding mean bias and 95% limits of agreement (LOA) for the studied brain regions were 30% and ± 70%. Comparing PBIF- and PSAIF-based VT estimate for all subjects and all brain regions, a significant difference between the results generated by the three normalization techniques existed for all brain structures except for the brainstem (P-value = 0.095). The mean % difference and 95% LOA is -10% and ±45% for Weightsubject×DoseInjected; +8% and ±50% for AUC; and +2% and ± 38% for Weightsubject×AUC. In all cases, normalizing by Weightsubject×AUC yielded the smallest % bias and variability (% bias = ±2%; LOA = ±38% for all brain regions). Estimating the reproducibility of PBIF-kinetics to PSAIF based on disease groups (HV/PD) and genotype (MAB/HAB), the average VT values for all regions obtained from PBIF is insignificantly higher than PSAIF (%difference = 4.53%, P-value = 0.73 for HAB; and %difference = 0.73%, P-value = 0.96 for MAB). PBIF also tends to overestimate the difference between PD and HV for HAB (% difference = 32.33% versus 13.28%) and underestimate it in MAB (%difference = 6.84% versus 20.92%). CONCLUSIONS PSAIF kinetic results are reproducible with PBIF, with variability in VT within that obtained for the test-retest studies. Therefore, VT assessed using PBIF-based kinetic modeling is clinically feasible and can be an alternative to PSAIF.
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Affiliation(s)
- Mercy I Akerele
- Department of Radiology, Weill Cornell Medical College, New York, NY, 10021, USA.
| | - Sara A Zein
- Department of Radiology, Weill Cornell Medical College, New York, NY, 10021, USA
| | - Sneha Pandya
- Department of Radiology, Weill Cornell Medical College, New York, NY, 10021, USA
| | | | - Susan A Gauthier
- Department of Radiology, Weill Cornell Medical College, New York, NY, 10021, USA
- Department of Neurology, Weill Cornell Medical College, New York, NY, 10021, USA
- Feil Family Brain and Mind Institute, Weill Cornell Medical College, New York, NY, 10021, USA
| | - Ashish Raj
- Department of Radiology, Weill Cornell Medical College, New York, NY, 10021, USA
| | - Claire Henchcliffe
- Department of Radiology, Weill Cornell Medical College, New York, NY, 10021, USA
- Department of Neurology, Weill Cornell Medical College, New York, NY, 10021, USA
| | - P David Mozley
- Department of Radiology, Weill Cornell Medical College, New York, NY, 10021, USA
| | | | - Ajay Gupta
- Department of Radiology, Weill Cornell Medical College, New York, NY, 10021, USA
| | - John Babich
- Department of Radiology, Weill Cornell Medical College, New York, NY, 10021, USA
| | - Sadek A Nehmeh
- Department of Radiology, Weill Cornell Medical College, New York, NY, 10021, USA
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Rowe SP, Solnes LB, Yin Y, Kitchen G, Lodge MA, Karakatsanis NA, Rahmim A, Pomper MG, Leal JP. Imager-4D: New Software for Viewing Dynamic PET Scans and Extracting Radiomic Parameters from PET Data. J Digit Imaging 2021; 32:1071-1080. [PMID: 31388864 DOI: 10.1007/s10278-019-00255-7] [Citation(s) in RCA: 3] [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] [Indexed: 12/17/2022] Open
Abstract
Extensive research is currently being conducted into dynamic positron emission tomography (PET) acquisitions (including dynamic whole-body imaging) as well as extraction of radiomic features from imaging modalities. We describe a new PET viewing software known as Imager-4D that provides a facile means of viewing and analyzing dynamic PET data and obtaining associated quantitative metrics including radiomic parameters. The Imager-4D was programmed in the Java language utilizing the FX extensions. It is executable on any system for which a Java w/FX compliant virtual machine is available. The software incorporates the ability to view and analyze dynamic data acquired with different types of dynamic protocols. For image display, the program maintains a built-in library of 62 different lookup tables with monochromatic and full-color distributions. The Imager-4D provides multiple display layouts and can display fused images. Multiple methods of volume-of-interest (VOI) selection are available. Dynamic analysis features, such as image summation and full Patlak analysis, are also available. The user interface includes window width and level, blending, and zoom functionality. VOI sizes are adjustable and data from VOIs can either be displayed numerically or graphically within the software or exported. An example case of a 50-year-old woman with metastatic colorectal cancer and thyroiditis is included and demonstrates the steps for a user to obtain standard PET parameters, dynamic data, and radiomic features using selected VOIs. The Imager-4D represents a novel PET viewer that allows the user to view dynamic PET data, to derive dynamic and radiomic parameters from that data, and to combine dynamic data with radiomics ("dynomics"). The Imager-4D is available as a free download. This software has the potential to speed the adoption of advanced analysis of dynamic PET data into routine clinical use.
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Affiliation(s)
- Steven P Rowe
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 550 N. Broadway Suite 300, Baltimore, MD, 21205, USA. .,The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 N. Caroline JHOC 3233, Baltimore, MD, 21287, USA.
| | - Lilja B Solnes
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 550 N. Broadway Suite 300, Baltimore, MD, 21205, USA
| | - Yafu Yin
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 550 N. Broadway Suite 300, Baltimore, MD, 21205, USA.,Department of Nuclear Medicine, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Grant Kitchen
- Institute for NanoBioTechnology, Johns Hopkins University, Baltimore, MD, USA
| | - Martin A Lodge
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 550 N. Broadway Suite 300, Baltimore, MD, 21205, USA
| | - Nicolas A Karakatsanis
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 550 N. Broadway Suite 300, Baltimore, MD, 21205, USA.,Department of Radiology, Weill Cornell Medical College of Cornell University, New York, NY, USA
| | - Arman Rahmim
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 550 N. Broadway Suite 300, Baltimore, MD, 21205, USA.,Departments of Radiology and Physics, University of British Columbia, Vancouver, BC, Canada
| | - Martin G Pomper
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 550 N. Broadway Suite 300, Baltimore, MD, 21205, USA
| | - Jeffrey P Leal
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 550 N. Broadway Suite 300, Baltimore, MD, 21205, USA.
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Mahase SS, Roth O'Brien DA, No D, Roytman M, Skafida ME, Lin E, Karakatsanis NA, Osborne JR, Brandmaier A, Pannullo SC, Ramakrishna R, Stieg PE, Knisely JPS, Ivanidze J. [ 68Ga]-DOTATATE PET/MRI as an adjunct imaging modality for radiation treatment planning of meningiomas. Neurooncol Adv 2021; 3:vdab012. [PMID: 33738446 PMCID: PMC7954102 DOI: 10.1093/noajnl/vdab012] [Citation(s) in RCA: 9] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Background Meningiomas express high levels of somatostatin receptor 2 (SSTR2). SSTR2-targeted PET imaging with [68Ga]-DOTATATE can aid with distinguishing residual meningioma from reactive changes in the postoperative setting. We present initial dosimetric analyses, acute events, and local control data utilizing [68Ga]-DOTATATE PET/MRI-assisted target delineation for prospectively-treated intermediate-risk meningiomas. Methods Twenty-nine patients underwent DOTATATE PET/MRI meningioma evaluation in 2019. Eight patients with 9 postoperative meningiomas met RTOG 0539 intermediate-risk criteria (recurrent WHO grade I, 1/9; WHO grade II, 8/9). Target volumes were created using DOTATATE PET/MRI to determine residual disease and received a nominal dose of 35.0 Gy over 5 fractions. For comparison, cases were recontoured and planned with MRI alone per RTOG 0539 guidelines. Mean and maximum equivalent 2 Gy doses were generated for target volumes and organs at risk (OAR) within 1 cm of the PTV and compared using Wilcoxon matched pairs signed rank test. Results DOTATATE PET/MRI-guided planning significantly reduced mean PTV (11.12 cm3 compared to 71.39 cm3 based on MRI alone, P < .05) and mean and max dose to the whole brain, optic nerves, and scalp. PET/MRI plans resulted in at least 50% reduction of mean and max doses to the lens, eyes, chiasm, cochlea, brainstem, and hippocampi. One patient experienced focal alopecia. There were no local recurrences at 6 months. Conclusion Incorporating DOTATATE-PET/MRI for postoperative target delineation in patients with intermediate-risk intracranial meningiomas results in PTV reduction and decreased OAR dose. Our findings warrant larger studies evaluating DOTATATE-PET/MRI in the radiotherapeutic planning of postoperative meningiomas.
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Affiliation(s)
- Sean S Mahase
- Department of Radiation Oncology, Weill Cornell Medicine, New York, New York, USA
| | - Diana A Roth O'Brien
- Department of Radiation Oncology, Weill Cornell Medicine, New York, New York, USA
| | - Diana No
- Department of Radiation Oncology, Weill Cornell Medicine, New York, New York, USA
| | - Michelle Roytman
- Department of Radiology, Weill Cornell Medicine, New York, New York, USA
| | - Myrto E Skafida
- Department of Radiology, Weill Cornell Medicine, New York, New York, USA
| | - Eaton Lin
- Department of Radiology, Weill Cornell Medicine, New York, New York, USA
| | | | - Joseph R Osborne
- Department of Radiology, Weill Cornell Medicine, New York, New York, USA
| | - Andrew Brandmaier
- Department of Radiation Oncology, Weill Cornell Medicine, New York, New York, USA
| | - Susan C Pannullo
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA
| | - Rohan Ramakrishna
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA
| | - Philip E Stieg
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA
| | - Jonathan P S Knisely
- Department of Radiation Oncology, Weill Cornell Medicine, New York, New York, USA
| | - Jana Ivanidze
- Department of Radiology, Weill Cornell Medicine, New York, New York, USA
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18
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Karakatsanis NA, Abgral R, Trivieri MG, Dweck MR, Robson PM, Calcagno C, Boeykens G, Senders ML, Mulder WJM, Tsoumpas C, Fayad ZA. Hybrid PET- and MR-driven attenuation correction for enhanced 18F-NaF and 18F-FDG quantification in cardiovascular PET/MR imaging. J Nucl Cardiol 2020; 27:1126-1141. [PMID: 31667675 PMCID: PMC7190435 DOI: 10.1007/s12350-019-01928-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 10/02/2019] [Accepted: 10/02/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND The standard MR Dixon-based attenuation correction (AC) method in positron emission tomography/magnetic resonance (PET/MR) imaging segments only the air, lung, fat and soft-tissues (4-class), thus neglecting the highly attenuating bone tissues and affecting quantification in bones and adjacent vessels. We sought to address this limitation by utilizing the distinctively high bone uptake rate constant Ki expected from 18F-Sodium Fluoride (18F-NaF) to segment bones from PET data and support 5-class hybrid PET/MR-driven AC for 18F-NaF and 18F-Fluorodeoxyglucose (18F-FDG) PET/MR cardiovascular imaging. METHODS We introduce 5-class Ki/MR-AC for (i) 18F-NaF studies where the bones are segmented from Patlak Ki images and added as the 5th tissue class to the MR Dixon 4-class AC map. Furthermore, we propose two alternative dual-tracer protocols to permit 5-class Ki/MR-AC for (ii) 18F-FDG-only data, with a streamlined simultaneous administration of 18F-FDG and 18F-NaF at 4:1 ratio (R4:1), or (iii) for 18F-FDG-only or both 18F-FDG and 18F-NaF dual-tracer data, by administering 18F-NaF 90 minutes after an equal 18F-FDG dosage (R1:1). The Ki-driven bone segmentation was validated against computed tomography (CT)-based segmentation in rabbits, followed by PET/MR validation on 108 vertebral bone and carotid wall regions in 16 human volunteers with and without prior indication of carotid atherosclerosis disease (CAD). RESULTS In rabbits, we observed similar (< 1.2% mean difference) vertebral bone 18F-NaF SUVmean scores when applying 5-class AC with Ki-segmented bone (5-class Ki/CT-AC) vs CT-segmented bone (5-class CT-AC) tissue. Considering the PET data corrected with continuous CT-AC maps as gold-standard, the percentage SUVmean bias was reduced by 17.6% (18F-NaF) and 15.4% (R4:1) with 5-class Ki/CT-AC vs 4-class CT-AC. In humans without prior CAD indication, we reported 17.7% and 20% higher 18F-NaF target-to-background ratio (TBR) at carotid bifurcations wall and vertebral bones, respectively, with 5- vs 4-class AC. In the R4:1 human cohort, the mean 18F-FDG:18F-NaF TBR increased by 12.2% at carotid bifurcations wall and 19.9% at vertebral bones. For the R1:1 cohort of subjects without CAD indication, mean TBR increased by 15.3% (18F-FDG) and 15.5% (18F-NaF) at carotid bifurcations and 21.6% (18F-FDG) and 22.5% (18F-NaF) at vertebral bones. Similar TBR enhancements were observed when applying the proposed AC method to human subjects with prior CAD indication. CONCLUSIONS Ki-driven bone segmentation and 5-class hybrid PET/MR-driven AC is feasible and can significantly enhance 18F-NaF and 18F-FDG contrast and quantification in bone tissues and carotid walls.
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Affiliation(s)
- Nicolas A Karakatsanis
- Biomedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, 1470 Madison Ave, New York, NY, 10029, USA.
- Department of Radiology, Weill Cornell Medical College, Cornell University, 515 E 71st Street, S-120, New York, NY, 10021, USA.
| | - Ronan Abgral
- Biomedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, 1470 Madison Ave, New York, NY, 10029, USA
- Department of Nuclear Medicine, University Hospital of Brest, Brest, France
| | - Maria Giovanna Trivieri
- Biomedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, 1470 Madison Ave, New York, NY, 10029, USA
| | - Marc R Dweck
- Biomedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, 1470 Madison Ave, New York, NY, 10029, USA
- British Heart Foundation, Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - Philip M Robson
- Biomedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, 1470 Madison Ave, New York, NY, 10029, USA
| | - Claudia Calcagno
- Biomedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, 1470 Madison Ave, New York, NY, 10029, USA
| | - Gilles Boeykens
- Biomedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, 1470 Madison Ave, New York, NY, 10029, USA
- Department of Medical Biochemistry, Academic Medical Center, Amsterdam, The Netherlands
| | - Max L Senders
- Biomedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, 1470 Madison Ave, New York, NY, 10029, USA
- Department of Medical Biochemistry, Academic Medical Center, Amsterdam, The Netherlands
| | - Willem J M Mulder
- Biomedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, 1470 Madison Ave, New York, NY, 10029, USA
- Department of Medical Biochemistry, Academic Medical Center, Amsterdam, The Netherlands
| | - Charalampos Tsoumpas
- Biomedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, 1470 Madison Ave, New York, NY, 10029, USA
- Biomedical Imaging Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
| | - Zahi A Fayad
- Biomedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, 1470 Madison Ave, New York, NY, 10029, USA
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19
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Akerele MI, Karakatsanis NA, Deidda D, Cal-Gonzalez J, Forsythe RO, Dweck MR, Syed M, Newby DE, Aykroyd RG, Sourbron S, Tsoumpas C. Comparison of Correction Techniques for the Spill in Effect in Emission Tomography. IEEE Trans Radiat Plasma Med Sci 2020; 4:422-432. [PMID: 33542967 DOI: 10.1109/trpms.2020.2980443] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
In positron emission tomography (PET) imaging, accurate clinical assessment is often affected by the partial volume effect (PVE) leading to overestimation (spill-in) or underestimation (spill-out) of activity in various small regions. The spill-in correction, in particular, can be very challenging when the target region is close to a hot background region. Therefore, this study evaluates and compares the performance of various recently developed spill-in correction techniques, namely: background correction (BC), local projection (LP), and hybrid kernelized (HKEM) methods. We used a simulated digital phantom and [18F]-NaF PET data of three patients with abdominal aortic aneurysms (AAA) acquired with Siemens Biograph mMR™ and mCT™ scanners respectively. Region of Interest (ROI) analysis was performed and the extracted SUV mean , SUV max and target-to-background ratio (TBR) scores were compared. Results showed substantial spill-in effects from hot regions to targeted regions, which are more prominent in small structures. The phantom experiment demonstrated the feasibility of spill-in correction with all methods. For the patient data, large differences in SUV mean , SUV max and TBR max scores were observed between the ROIs drawn over the entire aneurysm and ROIs excluding some regions close to the bone. Overall, BC yielded the best performance in spill-in correction in both phantom and patient studies.
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Affiliation(s)
- Mercy I Akerele
- Biomedical Imaging Science Department, Faculty of Medicine and Health, University of Leeds, UK; Department of Radiology, Weil Cornell Medical College of Cornell University, NY, USA
| | - Nicolas A Karakatsanis
- Department of Radiology, Weil Cornell Medical College of Cornell University, NY, USA; Biomedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, NY
| | - Daniel Deidda
- Biomedical Imaging Science Department, Faculty of Medicine and Health, University of Leeds, UK; Department of Statistics, University of Leeds, UK; Nuclear Medicine Imaging, Medical Radiation Physics, National Physical Laboratory, London, UK
| | | | | | | | | | | | | | - Steven Sourbron
- Biomedical Imaging Science Department, Faculty of Medicine and Health, University of Leeds, UK
| | - Charalampos Tsoumpas
- Biomedical Imaging Science Department, Faculty of Medicine and Health, University of Leeds, UK; Biomedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, NY
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Zein SA, Karakatsanis NA, Issa M, Haj‐Ali AA, Nehmeh SA. Physical performance of a long axial field‐of‐view PET scanner prototype with sparse rings configuration: A Monte Carlo simulation study. Med Phys 2020; 47:1949-1957. [DOI: 10.1002/mp.14046] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 12/26/2019] [Accepted: 01/11/2020] [Indexed: 01/22/2023] Open
Affiliation(s)
- Sara A. Zein
- Department of Radiology Weill Cornell Medical College New York NY 10021USA
| | | | - Mohammad Issa
- School of Engineering Lebanese International University Beirut Lebanon
| | - Amin A. Haj‐Ali
- School of Engineering Lebanese International University Beirut Lebanon
| | - Sadek A. Nehmeh
- Department of Radiology Weill Cornell Medical College New York NY 10021USA
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21
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Zhuang M, Karakatsanis NA, Dierckx RAJO, Zaidi H. Impact of Tissue Classification in MRI-Guided Attenuation Correction on Whole-Body Patlak PET/MRI. Mol Imaging Biol 2019; 21:1147-1156. [PMID: 30838550 DOI: 10.1007/s11307-019-01338-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE The aim of this work is to investigate the impact of tissue classification in magnetic resonance imaging (MRI)-guided positron emission tomography (PET) attenuation correction (AC) for whole-body (WB) Patlak net uptake rate constant (Ki) imaging in PET/MRI studies. PROCEDURES WB dynamic PET/CT data were acquired for 14 patients. The CT images were utilized to generate attenuation maps (μ-mapCTAC) of continuous attenuation coefficient values (Acoeff). The μ-mapCTAC were then segmented into four tissue classes (μ-map4-classes), namely background (air), lung, fat, and soft tissue, where a predefined Acoeff was assigned to each class. To assess the impact of bone for AC, the bones in the μ-mapCTAC were then assigned a predefined soft tissue Acoeff (0.1 cm-1) to produce an AC μ-map without bones (μ-mapno-bones). Thereafter, both WB static SUV and dynamic PET images were reconstructed using μ-mapCTAC, μ-map4-classes, and μ-mapno-bones (PETCTAC, PET4-classes, and PETno-bones), respectively. WB indirect and direct parametric Ki images were generated using Patlak graphical analysis. Malignant lesions were delineated on PET images with an automatic segmentation method that uses an active contour model (MASAC). Then, the quantitative metrics of the metabolically active tumor volume (MATV), target-to-background (TBR), contrast-to-noise ratio (CNR), peak region-of-interest (ROIpeak), maximum region-of-interest (ROImax), mean region-of-interest (ROImean), and metabolic volume product (MVP) were analyzed. The Wilcoxon test was conducted to assess the difference between PET4-classes and PETno-bones against PETCTAC for all images. The same test was also adopted to compare the differences between SUV, indirect Ki, and direct Ki images for each evaluated AC method. RESULTS No significant differences in MATV, TBR, and CNR were observed between PET4-classes and PETCTAC for either SUV or Ki images. PET4-classes significantly overestimated ROIpeak, ROImax, ROImean, as well as MVP scores compared with PETCTAC in both SUV and Ki images. SUV images exhibited the highest median relative errors for PET4-classes with respect to PETCTAC (RE4-classes): 6.91 %, 6.55 %, 5.90 %, and 6.56 % for ROIpeak, ROImax, ROImean, and MVP, respectively. On the contrary, Ki images showed slightly reduced RE4-classes (indirect 5.52 %, 5.95 %, 4.43 %, and 5.70 %, direct 6.61 %, 6.33 %, 5.53 %, and 4.96 %) for ROIpeak, ROImax, ROImean, and MVP, respectively. A higher TBR was observed on indirect and direct Ki images relative to SUV, while direct Ki images demonstrated the highest CNR. CONCLUSIONS Four-tissue class AC may impact SUV and Ki parameter estimation but only to a limited extent, thereby suggesting that WB Patlak Ki imaging for dynamic WB PET/MRI studies is feasible. Patlak Ki imaging can enhance TBR, thereby facilitating lesion segmentation and quantification. However, patient-specific Acoeff for each tissue class should be used when possible to address the high inter-patient variability of Acoeff distributions.
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Affiliation(s)
- Mingzan Zhuang
- Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center, 9700 RB, Groningen, The Netherlands.,Department of Radiation Oncology, Affiliated Hospital of Yangzhou University, Yangzhou, 225012, Jiangsu, China
| | - Nicolas A Karakatsanis
- Division of Radiopharmaceutical Sciences, Department of Radiology, Weill Cornell Medical College, Cornell University, New York, NY, 10021, USA
| | - Rudi A J O Dierckx
- Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center, 9700 RB, Groningen, The Netherlands
| | - Habib Zaidi
- Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center, 9700 RB, Groningen, The Netherlands. .,Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospital, 1211, Geneva, Switzerland. .,Geneva University Neurocenter, University of Geneva, 1205, Geneva, Switzerland. .,Department of Nuclear Medicine, University of Southern Denmark, 500, Odense, Denmark.
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22
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Fahrni G, Karakatsanis NA, Di Domenicantonio G, Garibotto V, Zaidi H. Does whole-body Patlak 18F-FDG PET imaging improve lesion detectability in clinical oncology? Eur Radiol 2019; 29:4812-4821. [PMID: 30689031 DOI: 10.1007/s00330-018-5966-1] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [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: 08/27/2018] [Revised: 11/07/2018] [Accepted: 12/11/2018] [Indexed: 11/28/2022]
Abstract
PURPOSE Single-pass whole-body (WB) 18F-FDG PET/CT imaging is routinely employed for the clinical assessment of malignant, infectious, and inflammatory diseases. Our aim in this study is the systematic clinical assessment of lesion detectability in multi-pass WB parametric imaging enabling direct imaging of the highly quantitative 18F-FDG influx rate constant Ki, as a complement to standard-of-care standardized uptake value (SUV) imaging for a range of oncologic studies. METHODS We compared SUV and Ki images of 18 clinical studies of different oncologic indications (lesion characterization and staging) including standard-of-care SUV and dynamic WB PET protocols in a single session. The comparison involved both the visual assessment and the quantitative evaluation of SUVmean, SUVmax, Kimean, Kimax, tumor-to-background ratio (TBRSUV, TBRKi), and contrast-to-noise ratio (CNRSUV, CNRKi) quality metrics. RESULTS Overall, both methods provided good-quality images suitable for visual interpretation. A total of 118 lesions were detected, including 40 malignant (proven) and 78 malignant (unproven) lesions. Of those, 111 were detected on SUV and 108 on Ki images. One proven malignant lesion was detected only on Ki images whereas none of the proven malignant lesions was visible only on SUV images. The proven malignant lesions had overall higher Ki TBR and CNR scores. One unproven lesion, which was later confirmed as benign, was detected only on the SUV images (false-positive). Overall, our results from 40 proven malignant lesions suggested improved sensitivity (from 92.5 to 95%) and accuracy (from 90.24 to 95.12%) and potentially enhanced specificity with Ki over SUV imaging. CONCLUSION Oncologic WB Patlak Ki imaging may achieve equivalent or superior lesion detectability with reduced false-positive rates when complementing standard-of-care SUV imaging. KEY POINTS • The whole-body spatio-temporal distribution of 18 F-FDG uptake may reveal clinically useful information on oncologic diseases to complement the standard-of-care SUV metric. • Parametric imaging resulted in less false-positive indications of non-specific 18 F-FDG uptake relative to SUV. • Parametric imaging may achieve equivalent or superior 18 F-FDG lesion detectability than standard-of-care SUV imaging in oncology.
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Affiliation(s)
- Guillaume Fahrni
- Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospital, CH-1211, Geneva, Switzerland
| | - Nicolas A Karakatsanis
- Division of Radiopharmaceutical Sciences, Department of Radiology, Weill Cornell Medical College of Cornell University, New York, NY, 10021, USA.
| | - Giulia Di Domenicantonio
- Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospital, CH-1211, Geneva, Switzerland
| | - Valentina Garibotto
- Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospital, CH-1211, Geneva, Switzerland.,Faculty of Medicine, University of Geneva, 1205, Geneva, Switzerland
| | - Habib Zaidi
- Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospital, CH-1211, Geneva, Switzerland. .,Geneva University Neurocenter, University of Geneva, 1205, Geneva, Switzerland. .,Department of Nuclear Medicine and Molecular Imaging, University of Groningen, 9700 RB, Groningen, Netherlands. .,Department of Nuclear Medicine, University of Southern Denmark, DK-500, Odense, Denmark.
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Deidda D, Karakatsanis NA, Robson PM, Calcagno C, Senders ML, Mulder WJM, Fayad ZA, Aykroyd RG, Tsoumpas C. Hybrid PET/MR Kernelised Expectation Maximisation Reconstruction for Improved Image-Derived Estimation of the Input Function from the Aorta of Rabbits. Contrast Media Mol Imaging 2019; 2019:3438093. [PMID: 30800014 PMCID: PMC6360049 DOI: 10.1155/2019/3438093] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 11/15/2018] [Accepted: 11/21/2018] [Indexed: 11/30/2022]
Abstract
Positron emission tomography (PET) provides simple noninvasive imaging biomarkers for multiple human diseases which can be used to produce quantitative information from single static images or to monitor dynamic processes. Such kinetic studies often require the tracer input function (IF) to be measured but, in contrast to direct blood sampling, the image-derived input function (IDIF) provides a noninvasive alternative technique to estimate the IF. Accurate estimation can, in general, be challenging due to the partial volume effect (PVE), which is particularly important in preclinical work on small animals. The recently proposed hybrid kernelised ordered subsets expectation maximisation (HKEM) method has been shown to improve accuracy and contrast across a range of different datasets and count levels and can be used on PET/MR or PET/CT data. In this work, we apply the method with the purpose of providing accurate estimates of the aorta IDIF for rabbit PET studies. In addition, we proposed a method for the extraction of the aorta region of interest (ROI) using the MR and the HKEM image, to minimise the PVE within the rabbit aortic region-a method which can be directly transferred to the clinical setting. A realistic simulation study was performed with ten independent noise realisations while two, real data, rabbit datasets, acquired with the Biograph Siemens mMR PET/MR scanner, were also considered. For reference and comparison, the data were reconstructed using OSEM, OSEM with Gaussian postfilter and KEM, as well as HKEM. The results across the simulated datasets and different time frames show reduced PVE and accurate IDIF values for the proposed method, with 5% average bias (0.8% minimum and 16% maximum bias). Consistent results were obtained with the real datasets. The results of this study demonstrate that HKEM can be used to accurately estimate the IDIF in preclinical PET/MR studies, such as rabbit mMR data, as well as in clinical human studies. The proposed algorithm is made available as part of an open software library, and it can be used equally successfully on human or animal data acquired from a variety of PET/MR or PET/CT scanners.
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Affiliation(s)
- Daniel Deidda
- Biomedical Imaging Science Department, University of Leeds, Leeds, UK
- Department of Statistics, University of Leeds, Leeds, UK
| | - Nicolas A. Karakatsanis
- Translational and Molecular Imaging Institute (TMII), Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Division of Radiopharmaceutical Sciences, Department of Radiology, Weill Cornell Medical College, Cornell University, New York, NY, USA
| | - Philip M. Robson
- Translational and Molecular Imaging Institute (TMII), Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Claudia Calcagno
- Translational and Molecular Imaging Institute (TMII), Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Max L. Senders
- Translational and Molecular Imaging Institute (TMII), Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Willem J. M. Mulder
- Translational and Molecular Imaging Institute (TMII), Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Zahi A. Fayad
- Translational and Molecular Imaging Institute (TMII), Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Charalampos Tsoumpas
- Biomedical Imaging Science Department, University of Leeds, Leeds, UK
- Translational and Molecular Imaging Institute (TMII), Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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24
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Robson PM, Trivieri M, Karakatsanis NA, Padilla M, Abgral R, Dweck MR, Kovacic JC, Fayad ZA. Correction of respiratory and cardiac motion in cardiac PET/MR using MR-based motion modeling. Phys Med Biol 2018; 63:225011. [PMID: 30426968 DOI: 10.1088/1361-6560/aaea97] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Cardiac positron emission tomography (PET) imaging suffers from image blurring due to the constant motion of the heart that can impact interpretation. Hybrid PET/magnetic resonance (MR) has the potential to use radiation-free MR imaging to correct for the effects of cardio-respiratory motion in the PET data, improving qualitative and quantitative PET imaging in the heart. The purpose of this study was (i) to implement a MR image-based motion-corrected PET/MR method and (ii) to perform a proof-of-concept study of quantitative myocardial PET data in patients. The proposed method takes reconstructions of respiratory and cardiac gated PET data and applies spatial transformations to a single reference frame before averaging to form a single motion-corrected PET (MC-PET) image. Motion vector fields (MVFs) describing the transformations were derived from affine or non-rigid registration of respiratory and cardiac gated MR data. Eight patients with suspected cardiac sarcoidosis underwent cardiac PET/MR imaging after injection of 5 MBq kg-1 of 18F-fluorodeoxyglucose (18F-FDG). Myocardial regions affected by motion were identified by expert readers within which target-to-background ratios (TBR) and contrast-to-noise ratios (CNR) were measured on non-MC-non-gated, MC-PET, and double respiratory and cardiac gated PET images. Paired t-tests were used to determine statistical differences in quantitative uptake-measures between the different types of PET images. MC-PET images showed less blurring compared to non-MC-non-gated PET and tracer activity qualitatively aligned better with the underlying myocardial anatomy when fused with MR. TBR and CNR were significantly greater for MC-PET (2.8 ± 0.9; 21 ± 22) compared to non-MC-non-gated PET (2.4 ± 0.9, p = 0.0001; 15 ± 13, p = 0.02), while TBR was lower and CNR greater compared to double-gated PET (3.2 ± 0.9, p = 0.04; 6 ± 3, p = 0.004). This study demonstrated in a patient cohort that motion-corrected (MC) cardiac PET/MR is feasible using a retrospective MR image-based method and that improvement in TBR and CNR are achievable. MC PET/MR holds promise for improving interpretation and quantification in cardiac PET imaging.
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Affiliation(s)
- Philip M Robson
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, One Gustave Levy Pl, New York, NY 10029, United States of America. Author to whom any correspondence should be addressed
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Senders ML, Hernot S, Carlucci G, van de Voort JC, Fay F, Calcagno C, Tang J, Alaarg A, Zhao Y, Ishino S, Palmisano A, Boeykens G, Meerwaldt AE, Sanchez-Gaytan BL, Baxter S, Zendman L, Lobatto ME, Karakatsanis NA, Robson PM, Broisat A, Raes G, Lewis JS, Tsimikas S, Reiner T, Fayad ZA, Devoogdt N, Mulder WJM, Pérez-Medina C. Nanobody-Facilitated Multiparametric PET/MRI Phenotyping of Atherosclerosis. JACC Cardiovasc Imaging 2018; 12:2015-2026. [PMID: 30343086 PMCID: PMC6461528 DOI: 10.1016/j.jcmg.2018.07.027] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [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: 12/06/2017] [Revised: 06/11/2018] [Accepted: 07/12/2018] [Indexed: 12/13/2022]
Abstract
OBJECTIVES This study sought to develop an integrative positron emission tomography (PET) with magnetic resonance imaging (MRI) procedure for accurate atherosclerotic plaque phenotyping, facilitated by clinically approved and nanobody radiotracers. BACKGROUND Noninvasive characterization of atherosclerosis remains a challenge in clinical practice. The limitations of current diagnostic methods demonstrate that, in addition to atherosclerotic plaque morphology and composition, disease activity needs to be evaluated. METHODS We screened 3 nanobody radiotracers targeted to different biomarkers of atherosclerosis progression, namely vascular cell adhesion molecule (VCAM)-1, lectin-like oxidized low-density lipoprotein receptor (LOX)-1, and macrophage mannose receptor (MMR). The nanobodies, initially radiolabeled with copper-64 (64Cu), were extensively evaluated in Apoe–/– mice and atherosclerotic rabbits using a combination of in vivo PET/MRI readouts and ex vivo radioactivity counting, autoradiography, and histological analyses. RESULTS The 3 nanobody radiotracers accumulated in atherosclerotic plaques and displayed short circulation times due to fast renal clearance. The MMR nanobody was selected for labeling with gallium-68 (68Ga), a short-lived radioisotope with high clinical relevance, and used in an ensuing atherosclerosis progression PET/MRI study. Macrophage burden was longitudinally studied by 68Ga-MMR–PET, plaque burden by T2-weighted MRI, and neovascularization by dynamic contrast-enhanced (DCE) MRI. Additionally, inflammation and microcalcifications were evaluated by fluorine-18 (18F)-labeled fluorodeoxyglucose (18F-FDG) and 18F-sodium fluoride (18F-NaF) PET, respectively. We observed an increase in all the aforementioned measures as disease progressed, and the imaging signatures correlated with histopathological features. CONCLUSIONS We have evaluated nanobody-based radiotracers in rabbits and developed an integrative PET/MRI protocol that allows noninvasive assessment of different processes relevant to atherosclerosis progression. This approach allows the multiparametric study of atherosclerosis and can aid in early stage anti-atherosclerosis drug trials.
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Affiliation(s)
- Max L Senders
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Medical Biochemistry, Academic Medical Center, Amsterdam, the Netherlands
| | - Sophie Hernot
- In Vivo Cellular and Molecular Imaging Laboratory, Vrije Universiteit Brussel, Brussels, Belgium
| | - Giuseppe Carlucci
- Bernard and Irene Schwarz Center for Biomedical Imaging, New York University, New York, New York; Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Jan C van de Voort
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Francois Fay
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Chemistry, York College of The City University of New York, New York, New York
| | - Claudia Calcagno
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Jun Tang
- Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Amr Alaarg
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Biomaterials Science and Technology, Technical Medical Centre. University of Twente, Enschede, the Netherlands
| | - Yiming Zhao
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Seigo Ishino
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Anna Palmisano
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York; Unit of Clinical Research in Radiology, Experimental Imaging Center, San Raffaele Scientific Institute, Milan, Italy
| | - Gilles Boeykens
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Anu E Meerwaldt
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Brenda L Sanchez-Gaytan
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Samantha Baxter
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Laura Zendman
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Mark E Lobatto
- Department of Radiology, Academic Medical Center, Amsterdam, the Netherlands
| | - Nicolas A Karakatsanis
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Philip M Robson
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Alexis Broisat
- Bioclinic Radiopharmaceutics Laboratory, Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche S 1039, Grenoble, France
| | - Geert Raes
- Research Group of Cellular and Molecular Immunology, Vrije Universiteit Brussel, Brussels, Belgium; Laboratory of Myeloid Cell Immunology, Vlaams Instituut voor Biotechnologie Inflammation Research Center, Ghent, Belgium
| | - Jason S Lewis
- Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, New York; Department of Radiology, Weill Cornell Medical College, New York, New York; Molecular Pharmacology Program, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Sotirios Tsimikas
- Division of Cardiovascular Diseases, Sulpizio Cardiovascular Center, Department of Medicine, University of California-La Jolla, San Diego, California
| | - Thomas Reiner
- Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, New York; Department of Radiology, Weill Cornell Medical College, New York, New York
| | - Zahi A Fayad
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Nick Devoogdt
- In Vivo Cellular and Molecular Imaging Laboratory, Vrije Universiteit Brussel, Brussels, Belgium
| | - Willem J M Mulder
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Medical Biochemistry, Academic Medical Center, Amsterdam, the Netherlands.
| | - Carlos Pérez-Medina
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York.
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Rahmim A, Lodge MA, Karakatsanis NA, Panin VY, Zhou Y, McMillan A, Cho S, Zaidi H, Casey ME, Wahl RL. Dynamic whole-body PET imaging: principles, potentials and applications. Eur J Nucl Med Mol Imaging 2018; 46:501-518. [PMID: 30269154 DOI: 10.1007/s00259-018-4153-6] [Citation(s) in RCA: 108] [Impact Index Per Article: 18.0] [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: 04/26/2018] [Accepted: 08/28/2018] [Indexed: 02/07/2023]
Abstract
PURPOSE In this article, we discuss dynamic whole-body (DWB) positron emission tomography (PET) as an imaging tool with significant clinical potential, in relation to conventional standard uptake value (SUV) imaging. BACKGROUND DWB PET involves dynamic data acquisition over an extended axial range, capturing tracer kinetic information that is not available with conventional static acquisition protocols. The method can be performed within reasonable clinical imaging times, and enables generation of multiple types of PET images with complementary information in a single imaging session. Importantly, DWB PET can be used to produce multi-parametric images of (i) Patlak slope (influx rate) and (ii) intercept (referred to sometimes as "distribution volume"), while also providing (iii) a conventional 'SUV-equivalent' image for certain protocols. RESULTS We provide an overview of ongoing efforts (primarily focused on FDG PET) and discuss potential clinically relevant applications. CONCLUSION Overall, the framework of DWB imaging [applicable to both PET/CT(computed tomography) and PET/MRI (magnetic resonance imaging)] generates quantitative measures that may add significant value to conventional SUV image-derived measures, with limited pitfalls as we also discuss in this work.
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Affiliation(s)
- Arman Rahmim
- Department of Radiology and Radiological Science, Johns Hopkins University, JHOC Building Room 3245, 601 N. Caroline St, Baltimore, MD, 21287, USA. .,Departments of Radiology and Physics & Astronomy, University of British Columbia, Vancouver, BC, V5Z 1M9, Canada.
| | - Martin A Lodge
- Department of Radiology and Radiological Science, Johns Hopkins University, JHOC Building Room 3245, 601 N. Caroline St, Baltimore, MD, 21287, USA
| | | | | | - Yun Zhou
- Department of Radiology and Radiological Science, Johns Hopkins University, JHOC Building Room 3245, 601 N. Caroline St, Baltimore, MD, 21287, USA
| | - Alan McMillan
- Department of Radiology, University of Wisconsin, Madison, WI, 53705, USA
| | - Steve Cho
- Department of Radiology, University of Wisconsin, Madison, WI, 53705, USA
| | - Habib Zaidi
- Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospital, CH-1211, Geneva, Switzerland
| | | | - Richard L Wahl
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, 63110, USA
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Wang X, Yang B, Adams MP, Gao X, Karakatsanis NA, Tang J. Improved myocardial perfusion PET imaging with MRI assisted reconstruction incorporating multi-resolution joint entropy. ACTA ACUST UNITED AC 2018; 63:175017. [DOI: 10.1088/1361-6560/aad8f9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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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Trivieri MG, Dweck MR, Abgral R, Robson PM, Karakatsanis NA, Lala A, Contreras J, Sahni G, Gopalan R, Gorevic P, Fuster V, Narula J, Fayad ZA. 18F-Sodium Fluoride PET/MR for the Assessment of Cardiac Amyloidosis. J Am Coll Cardiol 2018; 68:2712-2714. [PMID: 27978955 DOI: 10.1016/j.jacc.2016.09.953] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Revised: 08/26/2016] [Accepted: 09/28/2016] [Indexed: 01/15/2023]
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Zhuang M, Karakatsanis NA, Dierckx RAJO, Zaidi H. Quantitative Analysis of Heterogeneous [18F]FDG Static (SUV) vs. Patlak (Ki) Whole-body PET Imaging Using Different Segmentation Methods: a Simulation Study. Mol Imaging Biol 2018; 21:317-327. [DOI: 10.1007/s11307-018-1241-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Kundel V, Trivieri MG, Karakatsanis NA, Robson PM, Mani V, Kizer JR, Kaplan R, Fayad Z, Shah N. Assessment of atherosclerotic plaque activity in patients with sleep apnea using hybrid positron emission tomography/magnetic resonance imaging (PET/MRI): a feasibility study. Sleep Breath 2018; 22:1125-1135. [PMID: 29508121 DOI: 10.1007/s11325-018-1646-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [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: 12/21/2017] [Revised: 02/05/2018] [Accepted: 02/19/2018] [Indexed: 02/04/2023]
Abstract
PURPOSE Evidence suggests that the inflammatory state of an atherosclerotic plaque is important in predicting future risk of plaque rupture. This study aims to investigate the feasibility of measuring plaque inflammation in patients with obstructive sleep apnea (OSA) utilizing advanced vascular imaging - hybrid positron-emission tomography/magnetic resonance imaging (PET/MRI) with fluorodeoxyglucose (FDG) tracer-before and after continuous positive airway pressure (CPAP). METHODS Patients with newly diagnosed moderate to severe OSA underwent baseline PET/MRI for assessment of vascular inflammation of the carotid arteries and thoracic aorta prior to initiation of CPAP. Those adherent to CPAP returned for repeat imaging after 3-6 months of CPAP use. Atherosclerotic plaque activity, as measured by arterial wall FDG uptake, was calculated using target-to-background ratios (TBR) before and after CPAP. RESULTS Five patients were recruited as part of a focused project. Mean age was 52 years (80% male), and mean apnea-hypopnea index (AHI) was 33. Three patients were objectively adherent with CPAP. In the pre-CPAP phase, all patients had focal FDG uptake in the carotid arteries and aorta. After CPAP, there was an average reduction in TBR of 5.5% (TBRmean) and 6.2% (TBRmax) in carotid and aortic plaque inflammation, similar in magnitude to the reduction observed with statin therapy alone in non-OSA patients (previously reported by others). CONCLUSIONS We demonstrate the feasibility of using hybrid PET/MRI to assess atherosclerotic plaque inflammation in patients with OSA before and after CPAP. Use of the vascular PET/MRI platform in patients with OSA may provide better insight into the role of OSA and its treatment in reducing atherosclerotic inflammation.
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Affiliation(s)
- Vaishnavi Kundel
- Division of Pulmonary, Critical Care, and Sleep Medicine, Icahn School of Medicine at Mount Sinai, One Gustave L Levy Place, Box 1232, New York, NY, 10029, USA
| | - Maria Giovanna Trivieri
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Nicolas A Karakatsanis
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Division of Radiopharmaceutical Sciences, Department of Radiology, Weill Cornell Medical College, New York, NY, USA
| | - Phillip M Robson
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Venkatesh Mani
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jorge R Kizer
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Robert Kaplan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA.,Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Zahi Fayad
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Neomi Shah
- Division of Pulmonary, Critical Care, and Sleep Medicine, Icahn School of Medicine at Mount Sinai, One Gustave L Levy Place, Box 1232, New York, NY, 10029, USA. .,Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA.
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Karakatsanis NA, Tsoumpas C, Zaidi H. Quantitative PET image reconstruction employing nested expectation-maximization deconvolution for motion compensation. Comput Med Imaging Graph 2017; 60:11-21. [DOI: 10.1016/j.compmedimag.2016.11.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2016] [Revised: 09/13/2016] [Accepted: 11/11/2016] [Indexed: 12/20/2022]
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Ashrafinia S, Mohy-ud-Din H, Karakatsanis NA, Jha AK, Casey ME, Kadrmas DJ, Rahmim A. Generalized PSF modeling for optimized quantitation in PET imaging. Phys Med Biol 2017; 62:5149-5179. [DOI: 10.1088/1361-6560/aa6911] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Robson PM, Dweck MR, Trivieri MG, Abgral R, Karakatsanis NA, Contreras J, Gidwani U, Narula JP, Fuster V, Kovacic JC, Fayad ZA. Coronary Artery PET/MR Imaging: Feasibility, Limitations, and Solutions. JACC Cardiovasc Imaging 2017; 10:1103-1112. [PMID: 28109921 DOI: 10.1016/j.jcmg.2016.09.029] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [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] [Received: 06/27/2016] [Revised: 09/23/2016] [Accepted: 09/23/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVES The aims of this study were to describe the authors' initial experience with combined coronary artery positron emission tomographic (PET) and magnetic resonance (MR) imaging using 18F-fluorodeoxyglucose (18F-FDG) and 18F-sodium fluoride (18F-NaF) radiotracers, describe common problems and their solutions, and demonstrate the feasibility of coronary PET/MR imaging in appropriate patients. BACKGROUND Recently, PET imaging has been applied to the aortic valve and regions of atherosclerosis. 18F-FDG PET imaging has become established for imaging inflammation in atherosclerosis in the aorta and carotid arteries. Moreover, 18F-NaF has emerged as a novel tracer of active microcalcification in the aortic valve and coronary arteries. Coronary PET imaging remains challenging because of the small caliber of the vessels and their complex motion. Currently, most coronary imaging uses combined PET and computed tomographic imaging, but there is increasing enthusiasm for PET/MR imaging because of its reduced radiation, potential to correct for motion, and the complementary information available from cardiac MR in a single scan. METHODS Twenty-three patients with diagnosed or documented risk factors for coronary artery disease underwent either 18F-FDG or 18F-NaF PET/MR imaging. Standard breath-held MR-based attenuation correction was compared with a novel free-breathing approach. The impact on PET image artifacts and the interpretation of vascular uptake were evaluated semiquantitatively by expert readers. Moreover, PET reconstructions with more algorithm iterations were compared visually and by target-to-background ratio. RESULTS Image quality was significantly improved by novel free-breathing attenuation correction. Moreover, conspicuity of coronary uptake was improved by increasing the number of algorithm iterations from 3 to 6. Elevated radiotracer uptake could be localized to individual coronary lesions using both 18F-FDG (n = 1, maximal target-to-background ratio = 1.61) and 18F-NaF (n = 7, maximal target-to-background ratio = 1.55 ± 0.37), including in 1 culprit plaque post-myocardial infarction confirmed by myocardial late gadolinium enhancement. CONCLUSIONS The authors provide the first demonstration of successful, low-radiation (7.2 mSv) PET/MR imaging of inflammation and microcalcification activity in the coronary arteries. However, this requires specialized approaches tailored to coronary imaging for both attenuation correction and PET reconstruction.
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Affiliation(s)
- Philip M Robson
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York.
| | - Marc R Dweck
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York; British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom
| | - Maria Giovanna Trivieri
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York; Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Ronan Abgral
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Nuclear Medicine, University Hospital of Brest, European University of Brittany, EA3878 GETBO, Brest, France
| | - Nicolas A Karakatsanis
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Johanna Contreras
- Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Umesh Gidwani
- Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Jagat P Narula
- Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Valentin Fuster
- Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Jason C Kovacic
- Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Zahi A Fayad
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York; Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York
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Karakatsanis NA, Casey ME, Lodge MA, Rahmim A, Zaidi H. Whole-body direct 4D parametric PET imaging employing nested generalized Patlak expectation-maximization reconstruction. Phys Med Biol 2016; 61:5456-85. [PMID: 27383991 DOI: 10.1088/0031-9155/61/15/5456] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Whole-body (WB) dynamic PET has recently demonstrated its potential in translating the quantitative benefits of parametric imaging to the clinic. Post-reconstruction standard Patlak (sPatlak) WB graphical analysis utilizes multi-bed multi-pass PET acquisition to produce quantitative WB images of the tracer influx rate K i as a complimentary metric to the semi-quantitative standardized uptake value (SUV). The resulting K i images may suffer from high noise due to the need for short acquisition frames. Meanwhile, a generalized Patlak (gPatlak) WB post-reconstruction method had been suggested to limit K i bias of sPatlak analysis at regions with non-negligible (18)F-FDG uptake reversibility; however, gPatlak analysis is non-linear and thus can further amplify noise. In the present study, we implemented, within the open-source software for tomographic image reconstruction platform, a clinically adoptable 4D WB reconstruction framework enabling efficient estimation of sPatlak and gPatlak images directly from dynamic multi-bed PET raw data with substantial noise reduction. Furthermore, we employed the optimization transfer methodology to accelerate 4D expectation-maximization (EM) convergence by nesting the fast image-based estimation of Patlak parameters within each iteration cycle of the slower projection-based estimation of dynamic PET images. The novel gPatlak 4D method was initialized from an optimized set of sPatlak ML-EM iterations to facilitate EM convergence. Initially, realistic simulations were conducted utilizing published (18)F-FDG kinetic parameters coupled with the XCAT phantom. Quantitative analyses illustrated enhanced K i target-to-background ratio (TBR) and especially contrast-to-noise ratio (CNR) performance for the 4D versus the indirect methods and static SUV. Furthermore, considerable convergence acceleration was observed for the nested algorithms involving 10-20 sub-iterations. Moreover, systematic reduction in K i % bias and improved TBR were observed for gPatlak versus sPatlak. Finally, validation on clinical WB dynamic data demonstrated the clinical feasibility and superior K i CNR performance for the proposed 4D framework compared to indirect Patlak and SUV imaging.
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Affiliation(s)
- Nicolas A Karakatsanis
- Division of Nuclear Medicine and Molecular Imaging, School of Medicine, University of Geneva, Geneva, CH-1211, Switzerland
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Karakatsanis NA, Zhou Y, Lodge MA, Casey ME, Wahl RL, Zaidi H, Rahmim A. Generalized whole-body Patlak parametric imaging for enhanced quantification in clinical PET. Phys Med Biol 2015; 60:8643-73. [PMID: 26509251 DOI: 10.1088/0031-9155/60/22/8643] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
We recently developed a dynamic multi-bed PET data acquisition framework to translate the quantitative benefits of Patlak voxel-wise analysis to the domain of routine clinical whole-body (WB) imaging. The standard Patlak (sPatlak) linear graphical analysis assumes irreversible PET tracer uptake, ignoring the effect of FDG dephosphorylation, which has been suggested by a number of PET studies. In this work: (i) a non-linear generalized Patlak (gPatlak) model is utilized, including a net efflux rate constant kloss, and (ii) a hybrid (s/g)Patlak (hPatlak) imaging technique is introduced to enhance contrast to noise ratios (CNRs) of uptake rate Ki images. Representative set of kinetic parameter values and the XCAT phantom were employed to generate realistic 4D simulation PET data, and the proposed methods were additionally evaluated on 11 WB dynamic PET patient studies. Quantitative analysis on the simulated Ki images over 2 groups of regions-of-interest (ROIs), with low (ROI A) or high (ROI B) true kloss relative to Ki, suggested superior accuracy for gPatlak. Bias of sPatlak was found to be 16-18% and 20-40% poorer than gPatlak for ROIs A and B, respectively. By contrast, gPatlak exhibited, on average, 10% higher noise than sPatlak. Meanwhile, the bias and noise levels for hPatlak always ranged between the other two methods. In general, hPatlak was seen to outperform all methods in terms of target-to-background ratio (TBR) and CNR for all ROIs. Validation on patient datasets demonstrated clinical feasibility for all Patlak methods, while TBR and CNR evaluations confirmed our simulation findings, and suggested presence of non-negligible kloss reversibility in clinical data. As such, we recommend gPatlak for highly quantitative imaging tasks, while, for tasks emphasizing lesion detectability (e.g. TBR, CNR) over quantification, or for high levels of noise, hPatlak is instead preferred. Finally, gPatlak and hPatlak CNR was systematically higher compared to routine SUV values.
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Affiliation(s)
- Nicolas A Karakatsanis
- Division of Nuclear Medicine and Molecular Imaging, School of Medicine, University of Geneva, Geneva, CH-1211, Switzerland
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Karakatsanis NA, Fokou E, Tsoumpas C. Dosage optimization in positron emission tomography: state-of-the-art methods and future prospects. Am J Nucl Med Mol Imaging 2015; 5:527-547. [PMID: 26550543 PMCID: PMC4620179] [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] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Accepted: 09/04/2015] [Indexed: 06/05/2023]
Abstract
Positron emission tomography (PET) is widely used nowadays for tumor staging and therapy response in the clinic. However, average PET radiation exposure has increased due to higher PET utilization. This study aims to review state-of-the-art PET tracer dosage optimization methods after accounting for the effects of human body attenuation and scan protocol parameters on the counting rate. In particular, the relationship between the noise equivalent count rate (NECR) and the dosage (NECR-dosage curve) for a range of clinical PET systems and body attenuation sizes will be systematically studied to prospectively estimate the minimum dosage required for sufficiently high NECR. The optimization criterion can be determined either as a function of the peak of the NECR-dosage curve or as a fixed NECR score when NECR uniformity across a patient population is important. In addition, the systematic NECR assessments within a controllable environment of realistic simulations and phantom experiments can lead to a NECR-dosage response model, capable of predicting the optimal dosage for every individual PET scan. Unlike conventional guidelines suggesting considerably large dosage levels for obese patients, NECR-based optimization recommends: i) moderate dosage to achieve 90% of peak NECR for obese patients, ii) considerable dosage reduction for slimmer patients such that uniform NECR is attained across the patient population, and iii) prolongation of scans for PET/MR protocols, where longer PET acquisitions are affordable due to lengthy MR sequences, with motion compensation becoming important then. Finally, the need for continuous adaptation of dosage optimization to emerging technologies will be discussed.
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Affiliation(s)
- Nicolas A Karakatsanis
- Translational and Molecular Imaging Institute and Department of Radiology, Icahn School of Medicine at Mount SinaiNew York, USA
- Division of Nuclear Medicine and Molecular Imaging, School of Medicine, University of GenevaGeneva, Switzerland
| | - Eleni Fokou
- Division of Biomedical Imaging, University of LeedsLeeds, United Kingdom
| | - Charalampos Tsoumpas
- Translational and Molecular Imaging Institute and Department of Radiology, Icahn School of Medicine at Mount SinaiNew York, USA
- Division of Biomedical Imaging, University of LeedsLeeds, United Kingdom
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Efthimiou N, Loudos G, Karakatsanis NA, Panayiotakis GS. Effect of 176Lu intrinsic radioactivity on dual head PET system imaging and data acquisition, simulation, and experimental measurements. Med Phys 2014; 40:112505. [PMID: 24320464 DOI: 10.1118/1.4824694] [Citation(s) in RCA: 11] [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: 11/07/2022] Open
Abstract
PURPOSE In this work, the authors aim for the estimation of the effect of (176)Lu intrinsic radioactivity on the performance of a dual head PET system dedicated to small animal imaging. METHODS A prototype camera has been used as a reference system in order to validate two GATE simulation models, which were used for the investigation. The first model includes the (176)Lu intrinsic radioactivity, while the second does not. The two models have been designed in order to provide similar sensitivities, in terms of count rate performance and scatter fraction, in the linear range of activities. In addition, the model with the (176)Lu intrinsic radioactivity, has been validated in terms of background count rate. Different acquisition schemes have been examined in order to determine the optimum conditions to minimize the (176)Lu effects, while maintaining a high trues count rate. In addition, the effect on the image quality, in terms of spatial resolution, signal-to-noise ratio, and minimum detectable activity, was investigated. RESULTS Both models are in good agreement with the measured data. While, the presence of the (176)Lu altered the dead time of the model, it also affected the singles, trues, and randoms count rates. The noise equivalent count rate curves of the two models indicate that for low activities, the lack of (176)Lu radioactivity leads to better noise properties due to the underestimation of the randoms. Signal-to-noise ratio measurement on coincidence images confirm the aforementioned claim, since the model without the (176)Lu provides better less noisy images. Furthermore, the spatial resolution and the minimum detectable activity are overestimated. CONCLUSIONS It has been proven that the lack of the (176)Lu intrinsic radioactivity has an impact on the design of the simulation model's dead time. Even if there is an alignment with experimental results still the noise properties, for a wide range of activities, are overestimated. In addition, for low activities, better image quality, is presented, mainly due to the lack of the (176)Lu photons which blur the images. Furthermore, it was shown that the use of a high hardware threshold allows the application of a wide energy window, which improves the statistics without a significant compromise on the quality of the detected photons, mainly, due to the early rejection of the low energy photons and the low scatter factor.
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Affiliation(s)
- Nikos Efthimiou
- Department of Medical Physics, School of Medicine, University of Patras, Rion 26504, Greece
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Karakatsanis NA, Lodge MA, Tahari AK, Zhou Y, Wahl RL, Rahmim A. Dynamic whole-body PET parametric imaging: I. Concept, acquisition protocol optimization and clinical application. Phys Med Biol 2013; 58:7391-418. [PMID: 24080962 PMCID: PMC3941007 DOI: 10.1088/0031-9155/58/20/7391] [Citation(s) in RCA: 114] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Static whole-body PET/CT, employing the standardized uptake value (SUV), is considered the standard clinical approach to diagnosis and treatment response monitoring for a wide range of oncologic malignancies. Alternative PET protocols involving dynamic acquisition of temporal images have been implemented in the research setting, allowing quantification of tracer dynamics, an important capability for tumor characterization and treatment response monitoring. Nonetheless, dynamic protocols have been confined to single-bed-coverage limiting the axial field-of-view to ~15-20 cm, and have not been translated to the routine clinical context of whole-body PET imaging for the inspection of disseminated disease. Here, we pursue a transition to dynamic whole-body PET parametric imaging, by presenting, within a unified framework, clinically feasible multi-bed dynamic PET acquisition protocols and parametric imaging methods. We investigate solutions to address the challenges of: (i) long acquisitions, (ii) small number of dynamic frames per bed, and (iii) non-invasive quantification of kinetics in the plasma. In the present study, a novel dynamic (4D) whole-body PET acquisition protocol of ~45 min total length is presented, composed of (i) an initial 6 min dynamic PET scan (24 frames) over the heart, followed by (ii) a sequence of multi-pass multi-bed PET scans (six passes × seven bed positions, each scanned for 45 s). Standard Patlak linear graphical analysis modeling was employed, coupled with image-derived plasma input function measurements. Ordinary least squares Patlak estimation was used as the baseline regression method to quantify the physiological parameters of tracer uptake rate Ki and total blood distribution volume V on an individual voxel basis. Extensive Monte Carlo simulation studies, using a wide set of published kinetic FDG parameters and GATE and XCAT platforms, were conducted to optimize the acquisition protocol from a range of ten different clinically acceptable sampling schedules examined. The framework was also applied to six FDG PET patient studies, demonstrating clinical feasibility. Both simulated and clinical results indicated enhanced contrast-to-noise ratios (CNRs) for Ki images in tumor regions with notable background FDG concentration, such as the liver, where SUV performed relatively poorly. Overall, the proposed framework enables enhanced quantification of physiological parameters across the whole body. In addition, the total acquisition length can be reduced from 45 to ~35 min and still achieve improved or equivalent CNR compared to SUV, provided the true Ki contrast is sufficiently high. In the follow-up companion paper, a set of advanced linear regression schemes is presented to particularly address the presence of noise, and attempt to achieve a better trade-off between the mean-squared error and the CNR metrics, resulting in enhanced task-based imaging.
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Affiliation(s)
- Nicolas A. Karakatsanis
- Division of Nuclear Medicine, Department of Radiology, Johns Hopkins University, Baltimore, MD, 21287, USA
| | - Martin A. Lodge
- Division of Nuclear Medicine, Department of Radiology, Johns Hopkins University, Baltimore, MD, 21287, USA
| | - Abdel K. Tahari
- Division of Nuclear Medicine, Department of Radiology, Johns Hopkins University, Baltimore, MD, 21287, USA
| | - Y. Zhou
- Division of Nuclear Medicine, Department of Radiology, Johns Hopkins University, Baltimore, MD, 21287, USA
| | - Richard L. Wahl
- Division of Nuclear Medicine, Department of Radiology, Johns Hopkins University, Baltimore, MD, 21287, USA
| | - Arman Rahmim
- Division of Nuclear Medicine, Department of Radiology, Johns Hopkins University, Baltimore, MD, 21287, USA
- Department of Electrical & Computer Engineering, Johns Hopkins University, Baltimore, MD, 21287, USA
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Abstract
In the context of oncology, dynamic PET imaging coupled with standard graphical linear analysis has been previously employed to enable quantitative estimation of tracer kinetic parameters of physiological interest at the voxel level, thus, enabling quantitative PET parametric imaging. However, dynamic PET acquisition protocols have been confined to the limited axial field-of-view (~15-20 cm) of a single-bed position and have not been translated to the whole-body clinical imaging domain. On the contrary, standardized uptake value (SUV) PET imaging, considered as the routine approach in clinical oncology, commonly involves multi-bed acquisitions, but is performed statically, thus not allowing for dynamic tracking of the tracer distribution. Here, we pursue a transition to dynamic whole-body PET parametric imaging, by presenting, within a unified framework, clinically feasible multi-bed dynamic PET acquisition protocols and parametric imaging methods. In a companion study, we presented a novel clinically feasible dynamic (4D) multi-bed PET acquisition protocol as well as the concept of whole-body PET parametric imaging employing Patlak ordinary least squares (OLS) regression to estimate the quantitative parameters of tracer uptake rate Ki and total blood distribution volume V. In the present study, we propose an advanced hybrid linear regression framework, driven by Patlak kinetic voxel correlations, to achieve superior trade-off between contrast-to-noise ratio (CNR) and mean squared error (MSE) than provided by OLS for the final Ki parametric images, enabling task-based performance optimization. Overall, whether the observer's task is to detect a tumor or quantitatively assess treatment response, the proposed statistical estimation framework can be adapted to satisfy the specific task performance criteria, by adjusting the Patlak correlation-coefficient (WR) reference value. The multi-bed dynamic acquisition protocol, as optimized in the preceding companion study, was employed along with extensive Monte Carlo simulations and an initial clinical (18)F-deoxyglucose patient dataset to validate and demonstrate the potential of the proposed statistical estimation methods. Both simulated and clinical results suggest that hybrid regression in the context of whole-body Patlak Ki imaging considerably reduces MSE without compromising high CNR. Alternatively, for a given CNR, hybrid regression enables larger reductions than OLS in the number of dynamic frames per bed, allowing for even shorter acquisitions of ~30 min, thus further contributing to the clinical adoption of the proposed framework. Compared to the SUV approach, whole-body parametric imaging can provide better tumor quantification, and can act as a complement to SUV, for the task of tumor detection.
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Affiliation(s)
- Nicolas A. Karakatsanis
- Division of Nuclear Medicine, Department of Radiology, Johns Hopkins University, Baltimore, MD, 21287, USA
| | - Martin A. Lodge
- Division of Nuclear Medicine, Department of Radiology, Johns Hopkins University, Baltimore, MD, 21287, USA
| | - Y. Zhou
- Division of Nuclear Medicine, Department of Radiology, Johns Hopkins University, Baltimore, MD, 21287, USA
| | - Richard L. Wahl
- Division of Nuclear Medicine, Department of Radiology, Johns Hopkins University, Baltimore, MD, 21287, USA
| | - Arman Rahmim
- Division of Nuclear Medicine, Department of Radiology, Johns Hopkins University, Baltimore, MD, 21287, USA
- Department of Electrical & Computer Engineering, Johns Hopkins University, Baltimore, MD, 21287, USA
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Abstract
Standard 3D dynamic positron emission tomographic (PET) imaging consists of independent image reconstructions of individual frames followed by application of appropriate kinetic model to the time activity curves at the voxel or region-of-interest (ROI). The emerging field of 4D PET reconstruction, by contrast, seeks to move beyond this scheme and incorporate information from multiple frames within the image reconstruction task. Here we propose a novel reconstruction framework aiming to enhance quantitative accuracy of parametric images via introduction of priors based on voxel kinetics, as generated via clustering of preliminary reconstructed dynamic images to define clustered neighborhoods of voxels with similar kinetics. This is then followed by straightforward maximum a posteriori (MAP) 3D PET reconstruction as applied to individual frames; and as such the method is labeled '3.5D' image reconstruction. The use of cluster-based priors has the advantage of further enhancing quantitative performance in dynamic PET imaging, because: (a) there are typically more voxels in clusters than in conventional local neighborhoods, and (b) neighboring voxels with distinct kinetics are less likely to be clustered together. Using realistic simulated (11)C-raclopride dynamic PET data, the quantitative performance of the proposed method was investigated. Parametric distribution-volume (DV) and DV ratio (DVR) images were estimated from dynamic image reconstructions using (a) maximum-likelihood expectation maximization (MLEM), and MAP reconstructions using (b) the quadratic prior (QP-MAP), (c) the Green prior (GP-MAP) and (d, e) two proposed cluster-based priors (CP-U-MAP and CP-W-MAP), followed by graphical modeling, and were qualitatively and quantitatively compared for 11 ROIs. Overall, the proposed dynamic PET reconstruction methodology resulted in substantial visual as well as quantitative accuracy improvements (in terms of noise versus bias performance) for parametric DV and DVR images. The method was also tested on a 90 min (11)C-raclopride patient study performed on the high-resolution research tomography. The proposed method was shown to outperform the conventional method in visual as well as quantitative accuracy improvements (in terms of noise versus regional DVR value performance).
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Affiliation(s)
- Lijun Lu
- School of Biomedical Engineering, Southern Medical University, Guangzhou, Guangdong 510515, People’s Republic of China
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