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Kesner AL, Carter LM, Ramos JCO, Lafontaine D, Olguin EA, Brown JL, President B, Jokisch DW, Fisher DR, Bolch WE. MIRD Pamphlet No. 28, Part 1: MIRDcalc-A Software Tool for Medical Internal Radiation Dosimetry. J Nucl Med 2023; 64:1117-1124. [PMID: 37268428 PMCID: PMC10315701 DOI: 10.2967/jnumed.122.264225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 03/21/2023] [Indexed: 06/04/2023] Open
Abstract
Medical internal radiation dosimetry constitutes a fundamental aspect of diagnosis, treatment, optimization, and safety in nuclear medicine. The MIRD committee of the Society of Nuclear Medicine and Medical Imaging developed a new computational tool to support organ-level and suborgan tissue dosimetry (MIRDcalc, version 1). Based on a standard Excel spreadsheet platform, MIRDcalc provides enhanced capabilities to facilitate radiopharmaceutical internal dosimetry. This new computational tool implements the well-established MIRD schema for internal dosimetry. The spreadsheet incorporates a significantly enhanced database comprising details for 333 radionuclides, 12 phantom reference models (International Commission on Radiological Protection), 81 source regions, and 48 target regions, along with the ability to interpolate between models for patient-specific dosimetry. The software also includes sphere models of various composition for tumor dosimetry. MIRDcalc offers several noteworthy features for organ-level dosimetry, including modeling of blood source regions and dynamic source regions defined by user input, integration of tumor tissues, error propagation, quality control checks, batch processing, and report-preparation capabilities. MIRDcalc implements an immediate, easy-to-use single-screen interface. The MIRDcalc software is available for free download (www.mirdsoft.org) and has been approved by the Society of Nuclear Medicine and Molecular Imaging.
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Affiliation(s)
- Adam L Kesner
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York;
| | - Lukas M Carter
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Juan C Ocampo Ramos
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Daniel Lafontaine
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Edmond A Olguin
- Beth Israel Deaconess Medical Center, Department of Radiology, Harvard Medical School, Boston, Massachusetts
| | - Justin L Brown
- J. Crayton Pruitt Department of Biomedical Engineering, University of Florida, Gainesville, Florida
| | - Bonnie President
- J. Crayton Pruitt Department of Biomedical Engineering, University of Florida, Gainesville, Florida
| | - Derek W Jokisch
- Department of Physics and Engineering, Francis Marion University, Florence, South Carolina
- Center for Radiation Protection Knowledge, Oak Ridge National Laboratory, Oak Ridge, Tennessee; and
| | - Darrell R Fisher
- University of Washington and Versant Medical Physics and Radiation Safety, Richland, Washington
| | - Wesley E Bolch
- J. Crayton Pruitt Department of Biomedical Engineering, University of Florida, Gainesville, Florida
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Analysis of absorbed dose in radioimmunotherapy with 177Lu-trastuzumab using two different imaging scenarios: a pilot study. Nucl Med Commun 2021; 42:1382-1395. [PMID: 34406146 DOI: 10.1097/mnm.0000000000001472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVES Internal organ dosimetry is an important procedure to demonstrate the reliable application of 177Lu-trastuzumab radioimmunotherapy for human epidermal growth factor receptor-positive metastatic breast cancers. We are reporting the first human dosimetry study for 177Lu-trastuzumab. Another objective of our study was to calculate and compare the absorbed doses for normal organs and tumor lesions in patients before radioimmunotherapy with 177Lu-trastuzumab using two different imaging scenarios. METHODS Eleven patients (48.27 ± 8.95 years) with a history of metastatic breast cancer were included in the study. Postadministration of 177Lu-trastuzumab (351.09 ± 23.89 MBq/2 mg), acquisition was performed using planar and hybrid imaging scenarios at 4, 24, 72 and 168 h. Single-photon emission computed tomography/computed tomography imaging was performed at 72 h postinjection. Acquired images were processed using Dosimetry Toolkit software for the estimation of normalized cumulated activity in organs and tumor lesions. OLINDA/EXM 2.0 software was used for absorbed dose calculation in both scenarios. RESULTS Significant difference in normalized cumulated activity and the absorbed dose is noted between two imaging scenarios for the organs and tumor lesions (P < 0.05). Mean absorbed dose (mGy/MBq) estimated from heart, lungs, liver, spleen, kidney, adrenal, pancreas and colon using planar and hybrid scenarios were 0.81 ± 0.19 and 0.63 ± 0.17; 0.75 ± 0.13 and 0.32 ± 0.06; 1.26 ± 0.25 and 1.01 ± 0.17; 0.68 ± 0.22 and 0.53 ± 0.16; 0.91 ± 0.3 and 0.69 ± 0.24; 0.18 ± 0.04 and 0.11 ± 0.02; 0.25 ± 0.22 and 0.09 ± 0.02 and 0.75 ± 0.61 and 0.44 ± 0.28, respectively. CONCLUSIONS On the basis of our dosimetric evaluation, we concluded that radioimmunotherapy with 177Lu-trastuzumab is well tolerated to be implemented in routine clinical practice against HER2 positive metastatic breast cancer. Liver is the main critical organ at risk. Hybrid scenario demonstrated significantly lower absorbed doses in organs and tumors compared to the multiplanar method.
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Qian Y, Liu Q, Li P, Han Y, Zhang J, Xu J, Sun J, Wu A, Song S, Lu W. Highly Tumor-Specific and Long-Acting Iodine-131 Microbeads for Enhanced Treatment of Hepatocellular Carcinoma with Low-Dose Radio-Chemoembolization. ACS NANO 2021; 15:2933-2946. [PMID: 33529007 DOI: 10.1021/acsnano.0c09122] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Transarterial radioembolization (TARE) is considered the standard treatment for intermediate-stage hepatocellular carcinoma (HCC). Iodine-131 (131I)-labeled lipiodol TARE is an effective treatment for HCC but has been withdrawn due to its poor retention in tumor lesions and significant distribution in normal tissues with severe side effects. In this work, a highly tumor-specific 131I-TARE agent with long-time retention is developed by simply introducing tyrosine to poly(vinyl alcohol) (PVA) drug-eluting microbeads (Tyr-PVA-DEBs). The labeling efficiency of 131I-labeled microbeads remains above 85% in 50% serum for 31 days. Micro-single-photon emission computed tomography/computed tomography (μSPECT/CT) evidences that the 131I-labeled microbeads accumulate in the orthotopic N1S1 hepatoma of rats for 31 days following intra-arterial injection. The cumulative radiation dose per cubic centimeter of the tumor is at least 13 678-fold higher than that of normal tissues. The highly tumor-selective radiation of the 131I-labeled microbeads allows localized delivery of 345.04 ± 139.16 Gy to the tumor following a single injection dose as low as 0.2 mCi of 131I. Moreover, the 131I-labeled microbeads are loaded with doxorubicin hydrochloride (DOX) through the carboxy groups on tyrosine of the polymer. The 131I-DOX-loaded microbeads present a synergetic antitumor effect without recurrence in comparison with the microbeads labeled with 131I or loading DOX alone, attributed to the sensitization of DOX to 131I-induced ionizing radiation damage to DNA under the embolization-induced hypoxia. Our results demonstrate a high tumor retention of 131I-labeled embolic agent for low-dose transarterial radio-chemoembolization (TARCE) with a synergetic therapeutic effect on treating HCC, showing potential for clinical application.
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Affiliation(s)
- Yuyi Qian
- Minhang Hospital & School of Pharmacy, Key Laboratory of Smart Drug Delivery, Ministry of Education, & State Key Laboratory of Molecular Engineering of Polymers, Fudan University, Shanghai 201199, China
| | - Qiufang Liu
- Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Fudan University, Shanghai 200032, China
| | - Panli Li
- Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Fudan University, Shanghai 200032, China
| | - Yaobao Han
- Center for Molecular Imaging and Nuclear Medicine, State Key Laboratory of Radiation Medicine and Protection, School for Radiological and Interdisciplinary Sciences (RAD-X), Soochow University, Collaborative Innovation Center of Radiation Medicine of Jiangsu Higher Education Institutions, Suzhou 215123, China
| | - Jianping Zhang
- Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Fudan University, Shanghai 200032, China
| | - Jiaojiao Xu
- Minhang Hospital & School of Pharmacy, Key Laboratory of Smart Drug Delivery, Ministry of Education, & State Key Laboratory of Molecular Engineering of Polymers, Fudan University, Shanghai 201199, China
| | - Jingwen Sun
- Minhang Hospital & School of Pharmacy, Key Laboratory of Smart Drug Delivery, Ministry of Education, & State Key Laboratory of Molecular Engineering of Polymers, Fudan University, Shanghai 201199, China
| | - Aihua Wu
- Minhang Hospital & School of Pharmacy, Key Laboratory of Smart Drug Delivery, Ministry of Education, & State Key Laboratory of Molecular Engineering of Polymers, Fudan University, Shanghai 201199, China
| | - Shaoli Song
- Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Fudan University, Shanghai 200032, China
| | - Wei Lu
- Minhang Hospital & School of Pharmacy, Key Laboratory of Smart Drug Delivery, Ministry of Education, & State Key Laboratory of Molecular Engineering of Polymers, Fudan University, Shanghai 201199, China
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Jirsa L, Varga F, Quinn A. Identification of thyroid gland activity in radioiodine therapy. INFORMATICS IN MEDICINE UNLOCKED 2017. [DOI: 10.1016/j.imu.2017.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Pre-therapeutic dosimetry of normal organs and tissues of (177)Lu-PSMA-617 prostate-specific membrane antigen (PSMA) inhibitor in patients with castration-resistant prostate cancer. Eur J Nucl Med Mol Imaging 2015; 42:1976-83. [PMID: 26227531 DOI: 10.1007/s00259-015-3125-3] [Citation(s) in RCA: 137] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Accepted: 06/29/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE (177)Lu-617-prostate-specific membrane antigen (PSMA) ligand seems to be a promising tracer for radionuclide therapy of progressive prostate cancer. However, there are no published data regarding the radiation dose given to the normal tissues. The aim of the present study was to estimate the pretreatment radiation doses in patients who will undergo radiometabolic therapy using a tracer amount of (177)Lu-labeled PSMA ligand. METHODS The study included seven patients with progressive prostate cancer with a mean age of 63.9 ± 3.9 years. All patients had prior PSMA positron emission tomography (PET) imaging and had intense tracer uptake at the lesions. The injected (177)Lu-PSMA-617 activity ranged from 185 to 210 MBq with a mean of 192.6 ± 11.0 MBq. To evaluate bone marrow absorbed dose 2-cc blood samples were withdrawn in short variable times (3, 15, 30, 60, and 180 min and 24, 48, and 120 h) after injection. Whole-body images were obtained at 4, 24, 48, and 120 h post-injection (p.i.). The geometric mean of anterior and posterior counts was determined through region of interest (ROI) analysis. Attenuation correction was applied using PSMA PET/CT images. The OLINDA/EXM dosimetry program was used for curve fitting, residence time calculation, and absorbed dose calculations. RESULTS The calculated radiation-absorbed doses for each organ showed substantial variation. The highest radiation estimated doses were calculated for parotid glands and kidneys. Calculated radiation-absorbed doses per megabecquerel were 1.17 ± 0.31 mGy for parotid glands and 0.88 ± 0.40 mGy for kidneys. The radiation dose given to the bone marrow was significantly lower than those of kidney and parotid glands (p < 0.05). The calculated radiation dose to bone marrow was 0.03 ± 0.01 mGy/MBq. CONCLUSION Our first results suggested that (177)Lu-PSMA-617 therapy seems to be a safe method. The dose-limiting organ seems to be the parotid glands rather than kidneys and bone marrow. The lesion radiation doses are within acceptable ranges; however, there is a substantial individual variance so patient dosimetry seems to be mandatory.
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Hanaoka K, Hosono M, Tatsumi Y, Ishii K, Im SW, Tsuchiya N, Sakaguchi K, Matsumura I. Heterogeneity of intratumoral (111)In-ibritumomab tiuxetan and (18)F-FDG distribution in association with therapeutic response in radioimmunotherapy for B-cell non-Hodgkin's lymphoma. EJNMMI Res 2015; 5:10. [PMID: 25853016 PMCID: PMC4385239 DOI: 10.1186/s13550-015-0093-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Accepted: 02/25/2015] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND The purpose of this study was to quantitatively evaluate the tumor accumulation and heterogeneity of (111)In-ibritumomab tiuxetan (Zevalin®) and tumor accumulation of (18)F-fluoro-deoxyglucose (FDG) and compare them to the tumor response in B-cell non-Hodgkin's lymphoma patients receiving (90)Y-ibritumomab tiuxetan (Zevalin®) therapy. METHODS Sixteen patients with histologically confirmed non-Hodgkin's B-cell lymphoma who underwent (90)Y-ibritumomab tiuxetan therapy along with (111)In-ibritumomab tiuxetan single-photon emission computerized tomography (SPECT)/CT and FDG positron emission tomography (PET)/CT were enrolled in this retrospective study. On pretherapeutic FDG PET/CT images, the maximum standardized uptake value (SUVmax) was measured. On SPECT/CT images, a percentage of the injected dose per gram (%ID/g) and SUVmax of (111)In-ibritumomab tiuxetan were measured at 48 h after its administration. The skewness and kurtosis of the voxel distribution were calculated to evaluate the intratumoral heterogeneity of tumor accumulation. As another intratumoral heterogeneity index, cumulative SUV-volume histograms describing the percentage of the total tumor volume above the percentage thresholds of pretherapeutic FDG and (111)In-ibritumomab tiuxetan SUVmax (area under the curve of the cumulative SUV histograms (AUC-CSH)) were calculated. All lesions (n = 42) were classified into responders and non-responders lesion-by-lesion on pre- and post-therapeutic CT images. RESULTS A positive correlation was observed between the FDG SUVmax and accumulation of (111)In-ibritumomab tiuxetan in lesions. A significant difference in pretherapeutic FDG SUVmax was observed between responders and non-responders, while no significant difference in (111)In-ibritumomab tiuxetan SUVmax was observed between the two groups. In contrast, voxel distribution of FDG demonstrated no significant differences in the three heterogeneity indices between responders and non-responders, while (111)In-ibritumomab tiuxetan demonstrated skewness of 0.58 ± 0.16 and 0.73 ± 0.24 (p < 0.05), kurtosis of 2.39 ± 0.32 and 2.78 ± 0.53 (p < 0.02), and AUC-CSH of 0.37 ± 0.04 and 0.34 ± 0.05 (p < 0.05) for responders and non-responders. CONCLUSIONS Pretherapeutic FDG accumulation was predictive of the tumor response in (90)Y-ibritumomab tiuxetan therapy. The heterogeneity of the intratumoral distribution rather than the absolute level of (111)In-ibritumomab tiuxetan was correlated with the tumor response.
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Affiliation(s)
- Kohei Hanaoka
- Department of Radiology, Faculty of Medicine, Kinki University, 377-2 Ohno-Higashi, Osaka-Sayama, 589-8511 Japan
| | - Makoto Hosono
- Division of Positron Emission Tomography, Institute of Advanced Clinical Medicine, Faculty of Medicine, Kinki University, 377-2 Ohno-Higashi, Osaka-Sayama, 589-8511 Japan
| | - Yoichi Tatsumi
- Department of Hematology, Faculty of Medicine, Kinki University, 377-2 Ohno-Higashi, Osaka-Sayama, 589-8511 Japan
| | - Kazunari Ishii
- Neurocognitive Disorders Center, Faculty of Medicine, Kinki University, 377-2 Ohno-Higashi, Osaka-Sayama, 589-8511 Japan
| | - Sung-Woon Im
- Department of Radiology, Faculty of Medicine, Kinki University, 377-2 Ohno-Higashi, Osaka-Sayama, 589-8511 Japan
| | - Norio Tsuchiya
- Division of Positron Emission Tomography, Institute of Advanced Clinical Medicine, Faculty of Medicine, Kinki University, 377-2 Ohno-Higashi, Osaka-Sayama, 589-8511 Japan
| | - Kenta Sakaguchi
- Division of Positron Emission Tomography, Institute of Advanced Clinical Medicine, Faculty of Medicine, Kinki University, 377-2 Ohno-Higashi, Osaka-Sayama, 589-8511 Japan
| | - Itaru Matsumura
- Department of Hematology, Faculty of Medicine, Kinki University, 377-2 Ohno-Higashi, Osaka-Sayama, 589-8511 Japan
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Bernard D, Desruet MD, Wolf M, Roux J, Boin C, Mazet R, Gallazzini C, Calizzano A, Vuillez JP, Allenet B, Fagret D. Radioiodine therapy in benign thyroid disorders. Evaluation of French nuclear medicine practices. ANNALES D'ENDOCRINOLOGIE 2014; 75:241-6. [DOI: 10.1016/j.ando.2014.07.863] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2014] [Revised: 07/11/2014] [Accepted: 07/16/2014] [Indexed: 10/24/2022]
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Grimes J, Uribe C, Celler A. JADA: a graphical user interface for comprehensive internal dose assessment in nuclear medicine. Med Phys 2014; 40:072501. [PMID: 23822450 DOI: 10.1118/1.4810963] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE The main objective of this work was to design a comprehensive dosimetry package that would keep all aspects of internal dose calculation within the framework of a single software environment and that would be applicable for a variety of dose calculation approaches. METHODS Our MATLAB-based graphical user interface (GUI) can be used for processing data obtained using pure planar, pure SPECT, or hybrid planar/SPECT imaging. Time-activity data for source regions are obtained using a set of tools that allow the user to reconstruct SPECT images, load images, coregister a series of planar images, and to perform two-dimensional and three-dimensional image segmentation. Curve fits are applied to the acquired time-activity data to construct time-activity curves, which are then integrated to obtain time-integrated activity coefficients. Subsequently, dose estimates are made using one of three methods. RESULTS The organ level dose calculation subGUI calculates mean organ doses that are equivalent to dose assessment performed by OLINDA/EXM. Voxelized dose calculation options, which include the voxel S value approach and Monte Carlo simulation using the EGSnrc user code DOSXYZnrc, are available within the process 3D image data subGUI. CONCLUSIONS The developed internal dosimetry software package provides an assortment of tools for every step in the dose calculation process, eliminating the need for manual data transfer between programs. This saves times and minimizes user errors, while offering a versatility that can be used to efficiently perform patient-specific internal dose calculations in a variety of clinical situations.
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Affiliation(s)
- Joshua Grimes
- Department of Physics and Astronomy, University of British Columbia, Vancouver V5Z 1M9, Canada.
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Wierts R, de Pont CD, Brans B, Mottaghy FM, Kemerink GJ. Dosimetry in molecular nuclear therapy. Methods 2011; 55:196-202. [DOI: 10.1016/j.ymeth.2011.09.016] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2011] [Revised: 09/11/2011] [Accepted: 09/13/2011] [Indexed: 01/06/2023] Open
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A radionuclide dosimetry toolkit based on material-specific Monte Carlo dose kernels. Nucl Med Commun 2009; 30:504-12. [DOI: 10.1097/mnm.0b013e3283299a11] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Filesi M, Travascio L, Montesano T, Di Nicola AD, Colandrea M, Ugolini F, Bruno R, Gross MD, Vestri A, Rubello D, Ronga G. The relationship between 24 h/4 h radioiodine-131 uptake ratio and outcome after radioiodine therapy in 1402 patients with solitary autonomously functioning thyroid nodules. Ann Nucl Med 2009; 23:229-34. [DOI: 10.1007/s12149-009-0232-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2008] [Accepted: 10/22/2008] [Indexed: 10/21/2022]
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Abstract
Basic calculational methods and models used in dose assessment for internal emitters in nuclear medicine are discussed in this overview. Methods for quantification of activity in clinical and preclinical studies also are discussed, and we show how to implement them in currently available dose calculational models. Current practice of the use of internal emitters in therapy also is briefly presented here. Some of the future challenges for dose assessment in nuclear medicine are discussed, including application of patient-specific dose calculational methods and the need for significant advances in radiation biology.
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Affiliation(s)
- Michael G Stabin
- Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN 37232-2675, USA.
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Bybel B, Brunken RC, DiFilippo FP, Neumann DR, Wu G, Cerqueira MD. SPECT/CT imaging: clinical utility of an emerging technology. Radiographics 2008; 28:1097-113. [PMID: 18635631 DOI: 10.1148/rg.284075203] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Single-photon emission computed tomography (SPECT) has been a mainstay of nuclear medicine practice for several decades. More recently, combining the functional imaging available with SPECT and the anatomic imaging of computed tomography (CT) has gained more acceptance and proved useful in many clinical situations. Most vendors now offer integrated SPECT/CT systems that can perform both functions on one gantry and provide fused functional and anatomic data in a single imaging session. In addition to allowing anatomic localization of nuclear imaging findings, SPECT/CT also enables accurate and rapid attenuation correction of SPECT studies. These attributes have proved useful in many cardiac, general nuclear medicine, oncologic, and neurologic applications in which the SPECT results alone were inconclusive. Optimal clinical use of this rapidly emerging imaging modality requires an understanding of the fundamental principles of SPECT/CT, including quality control issues as well as potential pitfalls and limitations. The long-term clinical and economic effects of this technology have yet to be established.
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Affiliation(s)
- Bohdan Bybel
- Department of Nuclear Medicine, Health Sciences Centre Winnipeg, 820 Sherbrook St, GC321, Winnipeg, MB, Canada R3A 1R9.
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Shcherbinin S, Celler A, Belhocine T, Vanderwerf R, Driedger A. Accuracy of quantitative reconstructions in SPECT/CT imaging. Phys Med Biol 2008; 53:4595-604. [PMID: 18678930 DOI: 10.1088/0031-9155/53/17/009] [Citation(s) in RCA: 90] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The goal of this study was to determine the quantitative accuracy of our OSEM-APDI reconstruction method based on SPECT/CT imaging for Tc-99m, In-111, I-123, and I-131 isotopes. Phantom studies were performed on a SPECT/low-dose multislice CT system (Infinia-Hawkeye-4 slice, GE Healthcare) using clinical acquisition protocols. Two radioactive sources were centrally and peripherally placed inside an anthropometric Thorax phantom filled with non-radioactive water. Corrections for attenuation, scatter, collimator blurring and collimator septal penetration were applied and their contribution to the overall accuracy of the reconstruction was evaluated. Reconstruction with the most comprehensive set of corrections resulted in activity estimation with error levels of 3-5% for all the isotopes.
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Affiliation(s)
- S Shcherbinin
- Department of Radiology, University of British Columbia, 366-828 West 10th Avenue, Vancouver BC, V5Z 1L8, Canada.
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Buck AK, Nekolla S, Ziegler S, Beer A, Krause BJ, Herrmann K, Scheidhauer K, Wester HJ, Rummeny EJ, Schwaiger M, Drzezga A. SPECT/CT. J Nucl Med 2008; 49:1305-19. [PMID: 18632825 DOI: 10.2967/jnumed.107.050195] [Citation(s) in RCA: 228] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
In view of the commercial success of integrated PET/CT scanners, there is an increasing interest in comparable SPECT/CT systems. SPECT in combination with CT enables a direct correlation of anatomic information and functional information, resulting in better localization and definition of scintigraphic findings. Besides anatomic referencing, the added value of CT coregistration is based on the attenuation correction capabilities of CT. The number of clinical studies is limited, but pilot studies have indicated a higher specificity and a significant reduction in indeterminate findings. The superiority of SPECT/CT over planar imaging or SPECT has been demonstrated in bone scintigraphy, somatostatin receptor scintigraphy, parathyroid scintigraphy, and adrenal gland scintigraphy. Also, rates of detection of sentinel nodes by biopsy can be increased with SPECT/CT. This review highlights recent technical developments in integrated SPECT/CT systems and summarizes the current literature on potential clinical uses and future directions for SPECT/CT in cardiac, neurologic, and oncologic applications.
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Affiliation(s)
- Andreas K Buck
- Department of Nuclear Medicine, Technische Universität München, München, Germany.
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Stabin MG. Update: The Case for Patient-Specific Dosimetry in Radionuclide Therapy. Cancer Biother Radiopharm 2008; 23:273-84. [DOI: 10.1089/cbr.2007.0445] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Michael G. Stabin
- RADAR, Inc., and Vanderbilt University, Department of Radiology and Radiological Sciences, Nashville, TN
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Bernal P, Raoul JL, Stare J, Sereegotov E, Sundram FX, Kumar A, Jeong JM, Pusuwan P, Divgi C, Zanzonico P, Vidmar G, Buscombe J, Chau TTM, Saw MM, Chen S, Ogbac R, Dondi M, Padhy AK. International Atomic Energy Agency-Sponsored Multination Study of Intra-Arterial Rhenium-188-Labeled Lipiodol in the Treatment of Inoperable Hepatocellular Carcinoma: Results With Special Emphasis on Prognostic Value of Dosimetric Study. Semin Nucl Med 2008; 38:S40-5. [DOI: 10.1053/j.semnuclmed.2007.10.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Internal dosimetry as a tool for radiation protection of the patient in nuclear medicine. Biomed Imaging Interv J 2007. [DOI: 10.2349/biij.3.2.e28] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Abstract
Samarium-153 lexidronam (153Sm-EDTMP) is FDA approved for painful osteoblastic bone metastases that image on bone scan. 153Sm-EDTMP decay has a therapeutic beta-emission and a gamma-photon for bone scan imaging. Monitoring of osteosarcoma radiation treatment effectiveness was performed with bone, CT, MRI and PET/CT fusion imaging. Bone scan and PET/CT improved in 5 out of 9 and 16 out of 18 osteosarcoma sites, respectively. 153Sm-EDTMP targets multiple sites of disease, with a single administration. Side effects of 153Sm-EDTMP (0.5-2.5 mCi/kg) have been minimal and include transient thrombocytopenia and neutropenia. 153Sm-EDTMP can be combined with radiation therapy, bisphosphonates and/or chemotherapy to synergistically improve palliation. This article reviews the rationale, indications and monitoring of standard-dose samarium and investigational high-dose 153Sm-EDTMP treatment of cancer involving bone.
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Affiliation(s)
- Pete Anderson
- Department of Pediatrics, University of Texas, MD Anderson Cancer Center, 1515 Holcombe Blvd., Unit 87, Houston, TX 77030-4009, USA.
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In vivo molecular targeted radiotherapy. Biomed Imaging Interv J 2005; 1:e9. [PMID: 21625282 PMCID: PMC3097596 DOI: 10.2349/biij.1.2.e9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2005] [Revised: 09/26/2005] [Accepted: 09/29/2005] [Indexed: 11/17/2022] Open
Abstract
Unsealed radionuclides have been in clinical therapeutic use for well over half a century. Following the early inappropriate clinical administrations of radium salts in the early 20th century, the first real clinical benefits became evident with the use of 131I-sodium iodide for the treatment of hypothyroidism and differentiated thyroid carcinoma and 32P-sodium phosphate for the treatment of polycythaemia vera. In recent years the use of bone seeking agents 89Sr, 153Sm and 186Re for the palliation of bone pain have become widespread and considerable progress has been evident with the use of 131I-MIBG and 90Y-somatostatin receptor binding agents. Although the use of monoclonal antibody based therapeutic products has been slow to evolve, the start of the 21st century has witnessed the first licensed therapeutic antibody conjugates based on 90Y and 131I for the treatment of non-Hodgkin's lymphoma. The future clinical utility of this form of therapy will depend upon the development of radiopharmaceutical conjugates capable of selective binding to molecular targets. The availability of some therapeutic radionuclides such as 188Re produced from the tungsten generator system which can produce activity as required over many months, may make this type of therapy more widely available in some remote and developing countries. Future products will involve cytotoxic radionuclides with appropriate potency, but with physical characteristics that will enable the administration of therapeutic doses with the minimal need for patient isolation. Further developments are likely to involve molecular constructs such as aptamers arising from new developments in biotechnology. Patient trials are still underway and are now examining new methods of administration, dose fractionation and the clinical introduction of alpha emitting radiopharmaceutical conjugates. This review outlines the history, development and future potential of these forms of therapy.
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