1
|
Bouchareb Y, Tag N, Sulaiman H, Al-Riyami K, Jawa Z, Al-Dhuhli H. Optimization of BMI-Based Images for Overweight and Obese Patients - Implications on Image Quality, Quantification, and Radiation Dose in Whole Body 18F-FDG PET/CT Imaging. Nucl Med Mol Imaging 2023; 57:180-193. [PMID: 37483872 PMCID: PMC10359238 DOI: 10.1007/s13139-023-00795-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 01/16/2023] [Accepted: 03/01/2023] [Indexed: 03/28/2023] Open
Abstract
Purpose In PET/CT imaging, the activity of the 18F-FDG activity is injected either based on patient body weight (BW) or body mass index (BMI). The purpose of this study was to optimise BMI-based whole body 18F-FDG PET images obtained from overweight and obese patients and assess their image quality, quantitative value and radiation dose in comparison to BW-based images. Methods The NEMA-IEC-body phantom was scanned using the mCT 128-slice scanner. The spheres and background were filed with F-18 activity. Spheres-to-background ratio was 4:1. Data was reconstructed using the OSEM-TOF-PSF routine reconstruction. The optimization was performed by varying number of iterations and subsets, filter's size and type, and matrix size. The optimized reconstruction was applied to 17 patients' datasets. The optimized BMI-, routine BMI- and the BW-based images were compared visually and using contrast-to-noise ratio (CNR) and standardized uptake values (SUV) measurements. Results The visual assessment of the optimized phantom images showed better image quality and contrast-recovery-coefficients (CRCs) values compared to the routine reconstruction. Using patient data, the optimized BMI-based images provided better image quality compared to BW-based images in 87.5% of the overweight cases and 66.7% for obese cases. The optimized BMI-based images resulted in more than 50% reduction of radiation dose. No significant differences were found between the three series of images in SUV measurements. Conclusion The optimized BMI-based approach using 1 iteration, 21 subsets, and 3 mm Hamming filter improves image quality, reduces radiation dose, and provides, at least, similar quantification compared to the BW-based approach for overweight and obese patients.
Collapse
Affiliation(s)
- Yassine Bouchareb
- Sultan Qaboos University, College of Medicine and Health Sciences, Radiology and Molecular Imaging, Muscat, Oman
| | - Naima Tag
- Sultan Qaboos University Hospital, Radiology and Molecular Imaging, Muscat, Oman
| | - Hajir Sulaiman
- Sultan Qaboos Comprehensive Cancer Care and Research Centre, Muscat, Oman
| | - Khulood Al-Riyami
- Sultan Qaboos Comprehensive Cancer Care and Research Centre, Muscat, Oman
| | - Zabah Jawa
- Sultan Qaboos University Hospital, Radiology and Molecular Imaging, Muscat, Oman
| | - Humoud Al-Dhuhli
- Sultan Qaboos University Hospital, Radiology and Molecular Imaging, Muscat, Oman
| |
Collapse
|
2
|
Santoro M, Della Gala G, Paolani G, Zagni F, Civollani S, Strolin S, Strigari L. A novel figure of merit to investigate 68Ga PET/CT image quality based on patient weight and lesion size using Q.Clear reconstruction algorithm: A phantom study. Phys Med 2023; 106:102523. [PMID: 36641902 DOI: 10.1016/j.ejmp.2022.102523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 12/23/2022] [Accepted: 12/27/2022] [Indexed: 01/15/2023] Open
Abstract
INTRODUCTION Q.Clear is a Bayesian penalised-likelihood algorithm that uses a β-value for positron emission tomography(PET)/computed tomography(CT) image reconstruction(IR). Our study proposes a novel figure of merit, named CRBV, to compare the Q.Clear performances using 68Ga PET/CT image with the ordered-subset-expectation-maximization(OSEM) algorithm and to identify the optimal β-values for these images using two phantoms mimicking normal and overweight patients. METHODS NEMA IQ phantom with or without a ring of water-filled plastic bags (NEMAstd and NEMAow, respectively) was acquired and reconstructed with OSEM and Q.Clear at various β-values and minutes/bed position(min/bp). Contrast recovery(CR), background variability(BV) and CRBV were calculated. Highest CRBV values were used to identify optimal β-value ranges. RESULTS Q.Clear with 250 ≤ β ≤ 800 improved CRBV compared to OSEM for all the investigated spheres and acquisition setups. Outside of this range, Q.Clear still outperformed OSEM with few exceptions depending on spheres diameters and phantoms(e.g.,β-value = 1600 for diameters ≤ 17 mm using the NEMAow phantom). Regarding the CRBV performance for IR optimization, for the 4 min/bp NEMAstd IR, β-values = 300 ÷ 350 allowed to simultaneously optimize all diameters(except for the 10 mm); for the NEMAow IR, β-values = 350 ÷ 500 were needed for diameters > 20 mm, while β-values = 200 ÷ 250 were selected for the remaining diameters. For the 2 min/bp, β-value = 500 was suitable for diameters > 17 mm in both NEMAstd and NEMAow IR, while for smaller diameters β-value = 200 and β-values = 250 ÷ 350 were obtained for NEMAstd and NEMAow, respectively. CONCLUSION Almost all tested β-values of Q.Clear improved the CRBV compared to OSEM. In both phantoms, simulating normal and over-weight patients, optimal β-values were found according to lesion sizes and investigated acquisition times.
Collapse
Affiliation(s)
- Miriam Santoro
- Department of Medical Physics, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; Medical Physics Specialization School, Alma Mater Studiorum, University of Bologna, 40138 Bologna, Italy
| | - Giuseppe Della Gala
- Department of Medical Physics, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Giulia Paolani
- Department of Medical Physics, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; Medical Physics Specialization School, Alma Mater Studiorum, University of Bologna, 40138 Bologna, Italy
| | - Federico Zagni
- Department of Medical Physics, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Simona Civollani
- Department of Medical Physics, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Silvia Strolin
- Department of Medical Physics, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Lidia Strigari
- Department of Medical Physics, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy.
| |
Collapse
|
3
|
He Y, Gu Y, Yu H, Wu B, Wang S, Tan H, Cao Y, Chen S, Sui X, Zhang Y, Shi H. Optimizing acquisition times for total-body positron emission tomography/computed tomography with half-dose 18F-fluorodeoxyglucose in oncology patients. EJNMMI Phys 2022; 9:45. [PMID: 35802280 PMCID: PMC9270529 DOI: 10.1186/s40658-022-00474-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 06/27/2022] [Indexed: 11/17/2022] Open
Abstract
Background The present study aimed to explore the boundary of acquisition time and propose an optimized acquisition time range for total-body positron emission tomography (PET)/computed tomography (CT) oncological imaging using half-dose (1.85 MBq/kg) 18F-fluorodeoxyglucose activity based on diagnostic needs. Methods In this retrospective study based on a total-body PET system (uEXPLORER), an exploration cohort (October 2019–December 2019) of 46 oncology patients was first studied. The acquisition time for all patients was 15 min, and the acquired images were reconstructed and further split into 15-, 8-, 5-, 3-, 2-, and 1-min duration groups (abbreviated as G15, G8, G5, G3, G2, and G1). The image quality and lesion detectability of reconstructed PET images with different acquisition times were evaluated subjectively (5-point scale, lesion detection rate) and objectively (standardized uptake values, tumor-to-background ratio). In the same way, the initial optimized acquisition times were further validated in a cohort of 147 oncology patients (December 2019–June 2021) by using the Gs images (the images obtained using the 15- and 10-min acquisition times) as controls. Results In the exploration cohort, the subjective scores for G1, G2, G3, G5, and G8 images were 2.0 ± 0.2, 2.9 ± 0.3, 3.0 ± 0.0, 3.9 ± 0.2, and 4.2 ± 0.4, respectively. Two cases in G1 were rated as 1 point. No significant difference in scores was observed between G5 and G8 (p > 0.99). In general, groups with a longer acquisition time showed lower background uptake and lesion conspicuity. Compared with G15, lesion detection rate significantly reduced to 85.3% in G1 (p < 0.05). In the validation cohort, the subjective score was 3.0 ± 0.2 for G2, 3.0 ± 0.1 for G3, 3.6 ± 0.5 for G5, 4.0 ± 0.3 for G8, and 4.4 ± 0.5 for Gs. Only the scores between G2 and G3 were not significantly different (p > 0.99). The detection rates (204 lesions) significantly reduced to 94.1–90.2% in G3 and G2 (all p < 0.05). Conclusion A 2-min acquisition time provided acceptable performance in certain groups and specific medical situations. And protocols with acquisition times ≥ 5 min could provide comparable lesion detectability as regular protocols, showing better compatibility and feasibility with clinical practice. Supplementary Information The online version contains supplementary material available at 10.1186/s40658-022-00474-y.
Collapse
Affiliation(s)
- Yibo He
- Shanghai Institute of Medical Imaging, Shanghai, 200032, China.,Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.,Nuclear Medicine Institute of Fudan University, Shanghai, 200032, China
| | - Yushen Gu
- Shanghai Institute of Medical Imaging, Shanghai, 200032, China.,Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.,Nuclear Medicine Institute of Fudan University, Shanghai, 200032, China
| | - Haojun Yu
- Shanghai Institute of Medical Imaging, Shanghai, 200032, China.,Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.,Nuclear Medicine Institute of Fudan University, Shanghai, 200032, China
| | - Bing Wu
- Shanghai Institute of Medical Imaging, Shanghai, 200032, China.,Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.,Nuclear Medicine Institute of Fudan University, Shanghai, 200032, China
| | - Siyang Wang
- Shanghai Institute of Medical Imaging, Shanghai, 200032, China.,Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.,Nuclear Medicine Institute of Fudan University, Shanghai, 200032, China
| | - Hui Tan
- Shanghai Institute of Medical Imaging, Shanghai, 200032, China.,Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.,Nuclear Medicine Institute of Fudan University, Shanghai, 200032, China
| | - Yanyan Cao
- Shanghai Institute of Medical Imaging, Shanghai, 200032, China.,Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.,Nuclear Medicine Institute of Fudan University, Shanghai, 200032, China
| | - Shuguang Chen
- Shanghai Institute of Medical Imaging, Shanghai, 200032, China.,Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.,Nuclear Medicine Institute of Fudan University, Shanghai, 200032, China
| | - Xiuli Sui
- Shanghai Institute of Medical Imaging, Shanghai, 200032, China.,Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.,Nuclear Medicine Institute of Fudan University, Shanghai, 200032, China
| | - Yiqiu Zhang
- Shanghai Institute of Medical Imaging, Shanghai, 200032, China. .,Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai, 200032, China. .,Nuclear Medicine Institute of Fudan University, Shanghai, 200032, China.
| | - Hongcheng Shi
- Shanghai Institute of Medical Imaging, Shanghai, 200032, China. .,Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai, 200032, China. .,Nuclear Medicine Institute of Fudan University, Shanghai, 200032, China.
| |
Collapse
|
4
|
Zanoni L, Calabrò D, Fortunati E, Argalia G, Malizia C, Allegri V, Civollani S, Fanti S, Ambrosini V. Two birds with one stone: can [68Ga]Ga-DOTANOC PET/CT image quality be improved through BMI-adjusted injected activity without increasing acquisition times? Br J Radiol 2022; 95:20211152. [PMID: 35230151 PMCID: PMC10996427 DOI: 10.1259/bjr.20211152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 01/22/2022] [Accepted: 02/16/2022] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To assess how patients' dependent parameters may affect [68Ga]Ga-DOTANOC image quality and to propose a theoretical body mass index (BMI)-adjusted injected activity (IA) scheme, to improve imaging of high weight patients. METHODS Among patients prospectively enrolled (June-2019 and May-2020) in an Institutional Ethical Committee-approved electronic archive, we included those affected by primary gastro-entero-pancreatic (GEP) or lung neuroendocrine tumour and referred by our Institutional clinicians (excluding even minimal radiopharmaceutical extravasation, movement artefacts, renal insufficiency). All PET/CT images were acquired following EANM guidelines and rated for visual quality (1 = non-diagnostic, 2 = poor, 3 = moderate, 4 = good). Collected data included patient's body mass, height, BMI, age, IA (injected activity), IA/Kg (IAkg), IA/BMI (IABMI), liver SUVmean, liver SUVmax standard deviation, liver-signal-to-noise (LSNR), normalised_LSNR (LSNR_norm) and contrast-to-noise ratio (CNR) for positive scans and were compared to image rating (poor vs moderate/good). RESULTS Overall, 77 patients were included. Rating concordance was high (agreement = 81.8%, Fleiss k score = 0.806). All patients' dependent parameters resulted significantly different between poor-rated and moderate/good-rated scans (IA: p = 0.006, IAkg: p =< 0.001, body weight: p =< 0.001, BMI: p =< 0.001, IABMI: p =< 0.001). Factors significantly associated with moderate/good rating were BMI (p =< 0.001), body weight (p =< 0.001), IABMI (p =< 0.001), IAkg (p = 0.001), IA (p = 0.003), LSNR_norm (p = 0.01). The BMI-based model presented the best predictive efficiency (81.82%). IABMI performance to differentiate moderate/good from poor rating resulted statistically significant (IA-AUC = 0.78; 95% CI: 0.68-0.89; cut-off value of 4.17 MBq*m2/kg, sensitivity = 81.1%, specificity = 66.7%). If BMI-adjusted IA (=4.17*BMI) would have been applied in this population, the median IA would have slightly inferior (-4.8%), despite a different IA in each patient. ADVANCES IN KNOWLEDGE BMI resulted the best predictor of image quality. The proposed theoretical BMI-adjusted IA scheme (4.17*BMI) should yield images of better quality (especially in high-BMI patients) maintaining practical scanning times (3 min/bed).
Collapse
Affiliation(s)
- Lucia Zanoni
- Nuclear Medicine Unit, IRCCS Azienda Ospedaliero-Universitaria
di Bologna, Bologna,
Italy
| | - Diletta Calabrò
- Department of Experimental Diagnostic and Specialized Medicine
(DIMES), Alma Mater Studiorum University of Bologna,
Bologna, Italy
| | - Emilia Fortunati
- Department of Experimental Diagnostic and Specialized Medicine
(DIMES), Alma Mater Studiorum University of Bologna,
Bologna, Italy
| | - Giulia Argalia
- Department of Experimental Diagnostic and Specialized Medicine
(DIMES), Alma Mater Studiorum University of Bologna,
Bologna, Italy
| | - Claudio Malizia
- Nuclear Medicine Unit, IRCCS Azienda Ospedaliero-Universitaria
di Bologna, Bologna,
Italy
| | - Vincenzo Allegri
- Nuclear Medicine Unit, IRCCS Azienda Ospedaliero-Universitaria
di Bologna, Bologna,
Italy
| | - Simona Civollani
- Nuclear Medicine Unit, IRCCS Azienda Ospedaliero-Universitaria
di Bologna, Bologna,
Italy
| | - Stefano Fanti
- Nuclear Medicine Unit, IRCCS Azienda Ospedaliero-Universitaria
di Bologna, Bologna,
Italy
- Department of Experimental Diagnostic and Specialized Medicine
(DIMES), Alma Mater Studiorum University of Bologna,
Bologna, Italy
| | - Valentina Ambrosini
- Nuclear Medicine Unit, IRCCS Azienda Ospedaliero-Universitaria
di Bologna, Bologna,
Italy
- Department of Experimental Diagnostic and Specialized Medicine
(DIMES), Alma Mater Studiorum University of Bologna,
Bologna, Italy
| |
Collapse
|
5
|
Xing Y, Qiao W, Wang T, Wang Y, Li C, Lv Y, Xi C, Liao S, Qian Z, Zhao J. Deep learning-assisted PET imaging achieves fast scan/low-dose examination. EJNMMI Phys 2022; 9:7. [PMID: 35122172 PMCID: PMC8816983 DOI: 10.1186/s40658-022-00431-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 01/12/2022] [Indexed: 12/16/2022] Open
Abstract
PURPOSE This study aimed to investigate the impact of a deep learning (DL)-based denoising method on the image quality and lesion detectability of 18F-FDG positron emission tomography (PET) images. METHODS Fifty-two oncological patients undergoing an 18F-FDG PET/CT imaging with an acquisition of 180 s per bed position were retrospectively included. The list-mode data were rebinned into four datasets: 100% (reference), 75%, 50%, and 33.3% of the total counts, and then reconstructed by OSEM algorithm and post-processed with the DL and Gaussian filter (GS). The image quality was assessed using a 5-point Likert scale, and FDG-avid lesions were counted to measure lesion detectability. Standardized uptake values (SUVs) in livers and lesions, liver signal-to-noise ratio (SNR) and target-to-background ratio (TBR) values were compared between the methods. Subgroup analyses compared TBRs after categorizing lesions based on parameters like lesion diameter, uptake or patient habitus. RESULTS The DL method showed superior performance regarding image noise and inferior performance regarding lesion contrast in the qualitative assessment. More than 96.8% of the lesions were successfully identified in DL images. Excellent agreements on SUV in livers and lesions were found. The DL method significantly improved the liver SNR for count reduction down to 33.3% (p < 0.001). Lesion TBR was not significantly different between DL and reference images of the 75% dataset; furthermore, there was no significant difference either for lesions of > 10 mm or lesions in BMIs of > 25. For the 50% dataset, there was no significant difference between DL and reference images for TBR of lesion with > 15 mm or higher uptake than liver. CONCLUSIONS The developed DL method improved both liver SNR and lesion TBR indicating better image quality and lesion conspicuousness compared to GS method. Compared with the reference, it showed non-inferior image quality with reduced counts by 25-50% under various conditions.
Collapse
Affiliation(s)
- Yan Xing
- Department of Nuclear Medicine, Shanghai General Hospital, Shanghai Jiaotong University, No. 100 Haining Road, Shanghai, 200080, People's Republic of China
| | - Wenli Qiao
- Department of Nuclear Medicine, Shanghai General Hospital, Shanghai Jiaotong University, No. 100 Haining Road, Shanghai, 200080, People's Republic of China
| | - Taisong Wang
- Department of Nuclear Medicine, Shanghai General Hospital, Shanghai Jiaotong University, No. 100 Haining Road, Shanghai, 200080, People's Republic of China
| | - Ying Wang
- United Imaging Healthcare, Shanghai, People's Republic of China
| | - Chenwei Li
- United Imaging Healthcare, Shanghai, People's Republic of China
| | - Yang Lv
- United Imaging Healthcare, Shanghai, People's Republic of China
| | - Chen Xi
- United Imaging Healthcare, Shanghai, People's Republic of China
| | - Shu Liao
- Shanghai United Imaging Intelligence Co. Ltd, Shanghai, People's Republic of China
| | - Zheng Qian
- United Imaging Healthcare, Shanghai, People's Republic of China
| | - Jinhua Zhao
- Department of Nuclear Medicine, Shanghai General Hospital, Shanghai Jiaotong University, No. 100 Haining Road, Shanghai, 200080, People's Republic of China.
| |
Collapse
|
6
|
Can Q.Clear reconstruction be used to improve [68 Ga]Ga-DOTANOC PET/CT image quality in overweight NEN patients? Eur J Nucl Med Mol Imaging 2021; 49:1607-1612. [PMID: 34693467 DOI: 10.1007/s00259-021-05592-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 10/11/2021] [Indexed: 12/17/2022]
Abstract
AIM/INTRODUCTION Digital PET/CT allows Q.Clear image reconstruction with different Beta (β) levels. However, no definitive standard β level for [68 Ga]Ga-DOTANOC PET/CT has been established yet. As patient's body mass index (BMI) can affect image quality, the aim of the study was to visually and semi-quantitatively assess different β levels compared to standard OSEM in overweight patients. MATERIALS AND METHODS Inclusion criteria: (1) patients with NEN included in a prospective CE-approved electronic archive; (2) [68 Ga]Ga-DOTANOC PET/CT performed on a digital tomograph between September2019/March2021; (3) BMI ≥ 25. Images were acquired following EANM guidelines and reconstructed with OSEM and Q.Clear with three β levels (800, 1000, 1600). Scans were independently reviewed by three expert readers, unaware of clinical data, who independently chose the preferred β level reconstruction for visual overall image quality. Semi-quantitative analysis was performed on each scan: SUVmax of the highest uptake lesion (SUVmax-T), liver background SUVmean (SUVmean-L), SUVmax-T/SUVmean-L, Signal-to-noise ratio for both liver (LSNR) and the highest uptake lesion (SNR-T), Contrast-to-noise ratio (CNR). RESULTS Overall, 75 patients (median age: 63 years old [23-87]) were included: pre-obesity sub-group (25 ≤ BMI < 30, n = 50) and obesity sub-group (BMI ≥ 30, n = 25). PET/CT was positive for disease in 45/75 (60.0%) cases (14 obese and 31 pre-obese patients). Agreement among readers' visual rating was high (Fleiss κ = 0.88) and the β1600 was preferred in most cases (in 96% of obese patients and in 53.3% of pre-obese cases). OSEM was considered visually equal to β1600 in 44.7% of pre-obese cases and in 4% of obese patients. In a minority of pre-obese cases, OSEM was preferred (2%). In the whole population, CNR, SNR-T and LSNR were significantly different (p < 0.001) between OSEM and β1600, conversely to SUVmean-L (not significant). These results were also confirmed when calculated separately for the pre-obesity and obesity sub-groups β800 and β1000 were always rated inferior. CONCLUSIONS Q.Clear is a new technology for PET/CT image reconstruction that can be used to increase CNR and SNR-T, to subsequently optimise overall image quality as compared to standard OSEM. Our preliminary data on [68 Ga]Ga-DOTANOC PET/CT demonstrate that in overweight NEN patients, β1600 is preferable over β800 and β1000. Further studies are warranted to validate these results in lesions of different anatomical region and size; moreover, currently employed interpretative PET positivity criteria should be adjusted to the new reconstruction method.
Collapse
|
7
|
R Di Ciaccio P, Emmett L, Hamad N. Qualitative study of nuclear medicine physicians' perceptions of positron emission tomography/computed tomography in pregnant patients with cancer. Intern Med J 2021; 51:1722-1726. [PMID: 34664361 DOI: 10.1111/imj.15515] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 05/18/2021] [Accepted: 08/09/2021] [Indexed: 01/02/2023]
Abstract
Staging using positron emission tomography/computed tomography (PET/CT) is standard of care in many cancers that occur most frequently in pregnancy, particularly lymphoma. While expert guidelines generally recommend against PET/CT in pregnant women, there is emerging evidence that likely absorbed foetal doses in pregnancy are relatively low, and as such in certain circumstances PET/CT may be acceptable when balancing benefit and risk. We conducted a qualitative survey of nuclear medicine physicians in Australia and New Zealand to assess practice and attitudes with respect to PET/CT in pregnancy women, finding that most respondents considered PET/CT in pregnancy may be an appropriate modality in carefully selected clinical contexts with appropriate modifications. It is important to continue to define the role of PET/CT in pregnancy into the future, particularly as this imaging modality has emerged as the standard of care in staging and response assessment for many cancers.
Collapse
Affiliation(s)
- Pietro R Di Ciaccio
- Department of Haematology, St Vincent's Hospital, Sydney, New South Wales, Australia.,Faculty of Medicine, The University of New South Wales, Sydney, New South Wales, Australia
| | - Louise Emmett
- Faculty of Medicine, The University of New South Wales, Sydney, New South Wales, Australia.,Department of Theranostics and Nuclear Medicine, St Vincent's Hospital, Sydney, New South Wales, Australia
| | - Nada Hamad
- Department of Haematology, St Vincent's Hospital, Sydney, New South Wales, Australia.,Faculty of Medicine, The University of New South Wales, Sydney, New South Wales, Australia
| |
Collapse
|
8
|
Nautiyal A, Mondal T, Manii M, Kaushik A, Goel A, Dey SK, Mitra D. Significant reduction of radiation dose and DNA damage in 18F- FDG whole-body PET/CT study without compromising diagnostic image quality. JOURNAL OF RADIATION RESEARCH AND APPLIED SCIENCES 2021. [DOI: 10.1080/16878507.2021.1969197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Amit Nautiyal
- Institute of Nuclear Medicine & Molecular Imaging, Amri Hospitals, Dhakuria, Kolkata
- Amity Institute of Nuclear Science & Technology, Amity University Uttar Pradesh, Noida
| | - Tanmoy Mondal
- Department of Biotechnology, Maulana Abul Kalam Azad University of Technology, Salt Lake, Kolkata
| | - Manu Manii
- Department of Nuclear Medicine, Quadra Medical Services Private Limited, Kolkata
| | - Aruna Kaushik
- Institute of Nuclear Medicine & Allied Sciences, Timarpur, Delhi
| | - Alpana Goel
- Amity Institute of Nuclear Science & Technology, Amity University Uttar Pradesh, Noida
| | - Subrata Kumar Dey
- Department of Biotechnology, Maulana Abul Kalam Azad University of Technology, Salt Lake, Kolkata
| | - Deepanjan Mitra
- Institute of Nuclear Medicine & Molecular Imaging, Amri Hospitals, Dhakuria, Kolkata
| |
Collapse
|
9
|
Optimization of injection dose in 18F-FDG PET/CT based on the 2020 national diagnostic reference levels for nuclear medicine in Japan. Ann Nucl Med 2021; 35:1177-1186. [PMID: 34287782 PMCID: PMC8494693 DOI: 10.1007/s12149-021-01656-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 07/12/2021] [Indexed: 11/23/2022]
Abstract
Objective Recently, the national diagnostic reference levels (DRLs) in Japan were revised as the DRLs 2020, wherein the body weight-based injection dose optimization in positron emission tomography/computed tomography using 18F-fluoro-2-deoxy-D-glucose (18F-FDG PET/CT) was first proposed. We retrospectively investigated the usefulness of this optimization method in improving image quality and reducing radiation dose. Methods A total of 1,231 patients were enrolled in this study. A fixed injection dose of 240 MBq was administered to 624 patients, and a dose adjusted to 3.7 MBq/kg body weight was given to 607 patients. The patients with body weight-based injection doses were further divided according to body weight: group 1 (≤ 49 kg), group 2 (50–59 kg), group 3 (60–69 kg), and group 4 (≥ 70 kg). The effective radiation dose of FDG PET was calculated using the conversion factor of 0.019 mSv/MBq, per the International Commission on Radiological Protection publication 106. Image quality was assessed using noise equivalent count density (NECdensity), which was calculated by excluding the counts of the brain and bladder. The usefulness of the injection dose optimization in terms of radiation dose and image quality was analyzed. Results The body weight-based injection dose optimization significantly decreased the effective dose by 11%, from 4.54 ± 0.1 mSv to 4.05 ± 0.8 mSv (p < 0.001). Image quality evaluated by NECdensity was also significantly improved by 10%, from 0.39 ± 0.1 to 0.43 ± 0.2 (p < 0.001). In no case did NECdensity deteriorate when the effective dose was decreased. In group 1, the dose decreased by 32%, while there was no significant deterioration in NECdensity (p = 0.054). In group 2, the dose decreased by 17%, and the NECdensity increased significantly (p < 0.01). In group 3, the dose decreased by 3%, and the NECdensity increased significantly (p < 0.01). In group 4, the dose increased by 14%, but there was no significant change in the NECdensity (p = 0.766). Conclusion Body weight-based FDG injection dose optimization contributed to not only the reduction of effective dose but also the improvement of image quality in patients weighing between 50 and 69 kg.
Collapse
|
10
|
Hu P, Zhang Y, Yu H, Chen S, Tan H, Qi C, Dong Y, Wang Y, Deng Z, Shi H. Total-body 18F-FDG PET/CT scan in oncology patients: how fast could it be? Eur J Nucl Med Mol Imaging 2021; 48:2384-2394. [PMID: 33866409 DOI: 10.1007/s00259-021-05357-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 04/04/2021] [Indexed: 02/01/2023]
Abstract
PURPOSE The aim of the study was to determine a faster PET acquisition protocol for a total-body PET/CT scanner by assessing the image quality that is equivalent to a conventional digital PET/CT scanner from both a phantom and a clinical perspective. METHODS A phantom study using a NEMA/IEC NU-2 body phantom was first performed in both a total-body PET/CT (uEXPLORER) and a routine digital PET/CT (uMI 780), with a hot sphere to background activity concentration ratio of 4:1. The contrast recovery coefficient (CRC), background variability (BV), and recovery coefficient (RC: RCmax and RCmean) were assessed in the uEXPLORER with different scanning durations and reconstruction protocols, which were compared to those acquired from the uMI 780 with clinical acquisition settings. The coefficient of variation (COV) of the uMI 780 with clinical settings was calculated and used as a threshold reference to determine the optimized scanning duration and reconstruction protocol for the uEXPLORER. The obtained protocol from the phantom study was subsequently tested and validated in 30 oncology patients. Images acquired from the uMI 780 with 2-3 min per bed position were referred as G780 and served as the reference for comparison. All PET raw data from the uEXPLORER were reconstructed using the data-cutting technique to simulate a 30-s, 45-s, or 60-s acquisition duration, respectively. The iterations were 2 and 3 for the uEXPLORER, referred as G30s_3i, G45s_2i, G45s_3i, G60s_2i, and G60s_3i, respectively. A 5-point Likert scale was used in the qualitative analysis to assess the image quality. The image quality was also evaluated by the liver COV, the lesion target-to-background ratio (TBR), and the lesion signal-to-noise ratio (SNR). RESULTS In the phantom study, CRC, BV, RCmax, and RCmean in the uEXPLORER with different scanning durations and reconstruction iterations were compared with those in the uMI 780 with clinical settings. A minor fluctuation was found among different scanning durations. COV of the uMI 780 with clinical settings was 11.6%, and a protocol with a 30-45-s scanning duration and 2 or 3 iterations for the uEXPLORER was found to provide an equivalent image quality as the uMI 780. An almost perfect agreement was shown with a kappa value of 0.875. The qualitative score of the G30s_3i in the uEXPLORER was inferior to the G780 reference (p = 0.001); however, the scores of other groups in the uEXPLORER with a 45-s and above acquisition time were higher than the G780 in the uMI 780. In quantitative analysis, the delay time between the two scans in the two orders was not significantly different. There was no significant difference of the liver COV between the G780 and G30s_3i (p = 0.162). A total of 33 lesions were analyzed in the clinical patient study. There was no significant difference in lesion TBR between the reference G780 and the G45s_2i obtained from the uEXPLORER (p = 0.072), while the latter showed a higher lesion SNR value compared to that in uMI 780 with clinical settings (p < 0.001). CONCLUSIONS This study showed that a fast PET protocol with a 30-45-s acquisition time in the total-body uEXPLORER PET/CT can provide an equivalent image quality as the conventional digital uMI 780 PET/CT with longer clinical acquisition settings.
Collapse
Affiliation(s)
- Pengcheng Hu
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China
- Nuclear Medicine Institute of Fudan University, Shanghai, 200032, China
- Shanghai Institute of Medical Imaging, Shanghai, 200032, China
| | - Yiqiu Zhang
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China
- Nuclear Medicine Institute of Fudan University, Shanghai, 200032, China
- Shanghai Institute of Medical Imaging, Shanghai, 200032, China
| | - Haojun Yu
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China
- Nuclear Medicine Institute of Fudan University, Shanghai, 200032, China
- Shanghai Institute of Medical Imaging, Shanghai, 200032, China
| | - Shuguang Chen
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China
- Nuclear Medicine Institute of Fudan University, Shanghai, 200032, China
- Shanghai Institute of Medical Imaging, Shanghai, 200032, China
| | - Hui Tan
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China
- Nuclear Medicine Institute of Fudan University, Shanghai, 200032, China
- Shanghai Institute of Medical Imaging, Shanghai, 200032, China
| | - Chi Qi
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China
- Nuclear Medicine Institute of Fudan University, Shanghai, 200032, China
- Shanghai Institute of Medical Imaging, Shanghai, 200032, China
| | - Yun Dong
- United Imaging Healthcare Co., Ltd., Shanghai, China
| | - Ying Wang
- United Imaging Healthcare Co., Ltd., Shanghai, China
| | - Zilin Deng
- United Imaging Healthcare Co., Ltd., Shanghai, China
| | - Hongcheng Shi
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.
- Nuclear Medicine Institute of Fudan University, Shanghai, 200032, China.
- Shanghai Institute of Medical Imaging, Shanghai, 200032, China.
| |
Collapse
|
11
|
Nautiyal A, Mondal T, Mukherjee A, Mitra D, Kaushik A, Goel HC, Goel A, Dey SK. Quantification of DNA damage in patients undergoing non-contrast and contrast enhanced whole body PET/CT investigations using comet assay and micronucleus assay. Int J Radiat Biol 2019; 95:710-719. [PMID: 30707050 DOI: 10.1080/09553002.2019.1577569] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Objective: To quantify DNA damage in patients undergoing non-contrast and contrast-enhanced 18F-FDG PET/CT whole body positron emission tomography/computed tomography (WB PET/CT) investigations using comet assay technique and micronucleus assay, and to study the effect of other baseline parameters of patients on DNA damage. Methodology: Eighty-four patients referred for 18F-FDG PET/CT investigation were included in the study of which 44 patients underwent contrast-enhanced WB PET/CT and 40 patients underwent non-contrast WB PET/CT investigations. The investigations were performed on Discovery 690 PET/CT. For contrast-enhanced investigation, Omnipaque300 was injected intravenously based on the patient body weight. Absorbed dose resulting from the intravenous administration of 18F-FDG was estimated using the ICRP 106 dose coefficients. Radiation dose from the acquisition of CT scans was estimated using CT dose index and dose-length product. Blood samples were collected from the patients for DNA damage analysis. Comet assay and MN assay was used to assess the DNA damage. The Differences in the comet TM (Tail Moment) and MNBC % in both groups were calculated. Result: The radiation dose received by the study population during 18F-FDG WB PET/CT examination was 27.03 ± 2.33 mSv. Comet TM and percentage frequency of MNBC % was 65.22 ± 35.42 and 18.55 ± 10.14, respectively in the patients injected with contrast and 42.49 ± 28.52 and 13.76 ± 7.52 for non-contrast group. Significant increase in DNA damage was observed in the contrast group as compared to non-contrast group. Significant association was observed between patient weight, contrast volume and TM and MNBC%. Baseline parameters of the patients did not show significant correlation with TM and MNBC%. Conclusion: The patients undergoing contrast-enhanced WB PET/CT investigations have demonstrated higher DNA damage. The DNA damage was also observed to be more in heavier patients. The other baseline parameters of patients like age, sex, CBG, serum creatinine did not show any correlation with DNA damage.
Collapse
Affiliation(s)
- Amit Nautiyal
- a Institute of Nuclear Medicine & Molecular Imaging , AMRI Hospitals , Kolkata , India
| | - Tanmoy Mondal
- b Department of Biotechnology , Maulana Abul Kalam Azad University of Technology , Kolkata , India
| | - Anirban Mukherjee
- a Institute of Nuclear Medicine & Molecular Imaging , AMRI Hospitals , Kolkata , India
| | - Deepanjan Mitra
- a Institute of Nuclear Medicine & Molecular Imaging , AMRI Hospitals , Kolkata , India
| | - Aruna Kaushik
- c Institute of Nuclear Medicine & Allied Sciences , Delhi , India
| | | | - Alpana Goel
- e Amity Institute of Nuclear Science & Technology, Amity University , Noida , India
| | - Subrata Kumar Dey
- b Department of Biotechnology , Maulana Abul Kalam Azad University of Technology , Kolkata , India
| |
Collapse
|
12
|
Thompson JD, Wareing A, Szczepura KR, Vinjamuri S, Hogg P. A JAFROC study of nodule detection performance in CT images of a thorax acquired during PET/CT. Radiography (Lond) 2017; 23:191-196. [PMID: 28687285 DOI: 10.1016/j.radi.2017.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Revised: 03/01/2017] [Accepted: 03/03/2017] [Indexed: 11/27/2022]
Abstract
PURPOSE Two types of CT images (modalities) are acquired in PET/CT: for attenuation correction (AC) and diagnosis. The purpose of the study was to compare nodule detection and localization performance between these two modalities. METHODS CT images, using both modalities, of an anthropomorphic chest phantom containing zero or more simulated spherical nodules of 5, 8, 10 and 12 mm diameters and contrasts -800, -630 and 100 HU were acquired. An observer performance study using nine observers interpreting 45 normal (zero nodules) images and 47 abnormal images (1-3 nodules; average 1.26) was conducted using the free-response receiver operating characteristic (FROC) paradigm. Data were analysed using an R software package implemented jackknife alternative FROC (JAFROC) analysis. Both empirical areas under the equally weighted AFROC curve (wAFROC) and under the highest rating inferred ROC (HR-ROC) curve were used as figures of merit (FOM). To control the probability of Type I error test alpha was set at 0.05. RESULTS Nodule detection as measured by either FOM was significantly better on the diagnostic quality images (2nd modality), irrespective of the method of analysis, [reader averaged inter-modality wAFROC FOM difference = -0.07 (-0.11,-0.04); reader averaged inter-modality HR-ROC FOM difference = -0.05 (-0.09, -0.01)]. CONCLUSION Nodule detection was statistically worse on images acquired for AC; suggesting that images acquired for AC should not be used to evaluate pulmonary pathology.
Collapse
Affiliation(s)
- J D Thompson
- Directorate of Radiography, University of Salford, Greater Manchester, M6 6PU, UK; Radiology, Furness General Hospital, University Hospitals of Morecambe Bay NHS Foundation Trust, Dalton Lane, Barrow-in-Furness, Cumbria, LA14 4LF, UK.
| | - A Wareing
- School of Health Sciences, Faculty of Health and Social Care, Robert Gordon University, Garthdee Road, Aberdeen, AB10 7QG, UK
| | - K R Szczepura
- Radiology, Furness General Hospital, University Hospitals of Morecambe Bay NHS Foundation Trust, Dalton Lane, Barrow-in-Furness, Cumbria, LA14 4LF, UK
| | - S Vinjamuri
- Department of Nuclear Medicine, Royal Liverpool and Broadgreen University Hospitals NHS Trust, Prescot Street, Liverpool, L7 8XP, UK
| | - P Hogg
- Radiology, Furness General Hospital, University Hospitals of Morecambe Bay NHS Foundation Trust, Dalton Lane, Barrow-in-Furness, Cumbria, LA14 4LF, UK; Karolinska Institute, Stockholm, SE-171 77, Sweden
| |
Collapse
|
13
|
Whole-body diffusion-weighted magnetic resonance imaging (WB-DW-MRI) vs choline-positron emission tomography-computed tomography (choline-PET/CT) for selecting treatments in recurrent prostate cancer. Clin Transl Oncol 2016; 19:553-561. [PMID: 27796820 DOI: 10.1007/s12094-016-1563-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Accepted: 10/11/2016] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To determine the effectiveness of whole-body diffusion-weighted magnetic resonance imaging (WB-DW-MRI) in detecting metastases by comparing the results with those from choline-positron emission tomography-computed tomography (choline-PET/CT) in patients with biochemical relapse after primary treatment, and no metastases in bone scintigraphy, CT and/or pelvic MRI, or metastatic/oligometastatic prostate cancer (PCa). Patients with this disease profile who could benefit from treatment with stereotactic body radiation therapy (SBRT) were selected and their responses to these techniques were rated. MATERIALS AND METHODS This was a prospective, controlled, unicentric study, involving 46 consecutive patients from our centre who presented biochemical relapse after adjuvant, salvage or radical treatment with external beam radiotherapy, or brachytherapy. After initial tests (bone scintigraphy, CT, pelvic MRI), 35 patients with oligometastases or without them were selected. 11 patients with multiple metastases were excluded from the study. WB-DW-MRI and choline-PET/CT was then performed on each patient within 1 week. The results were interpreted by specialists in nuclear medicine and MRI. If they were candidates for treatment with ablative SBRT (SABR), they were then evaluated every three months with both tests. RESULTS Choline-PET/CT detected lesions in 16 patients that were not observable using WB-DW-MRI. The results were consistent in seven patients and in three cases, a lesion was observed using WB-DW-MRI that was not detected with choline-PET/CT. The Kappa value obtained was 0.133 (p = 0.089); the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of WB-DW-MRI were estimated at 44.93, 64.29, 86.11, and 19.15%, respectively. For choline-PET/CT patients, the sensitivity, specificity, PPV, and NPV were 97.10, 58.33, 93.06, and 77.78%, respectively. CONCLUSIONS Choline-PET/CT has a high global sensitivity while WB-DW-MRI has a high specificity, and so they are complementary techniques. Future studies with more enrolled patients and a longer follow-up period will be required to confirm these data. The initial data show that the best technique for evaluating response after SBRT is choline-PET/CT. Trial registration number NCT02858128.
Collapse
|
14
|
Effects of Height and Blood Volume on Venous Enhancement After Gadolinium-Based Contrast Administration in MR Venography: A Paradigm Challenge and Implications for Clinical Imaging. AJR Am J Roentgenol 2016; 207:621-7. [PMID: 27304717 DOI: 10.2214/ajr.16.16049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The purpose of this study was to analyze quantitative and qualitative effects of estimated blood volume on venous enhancement in patients undergoing cerebral MR venography (MRV) with standard weight-based dosing of a gadolinium-based contrast agent. MATERIALS AND METHODS Fifty-two patients with normal 1.5-T cerebral MRV findings and contemporaneous height and weight measurements were included. Estimated blood volume was calculated with the Nadler formula for blood volume. Standard weight-based cerebral MRV was performed after administration of gadobenate dimeglumine (0.1 mmol/kg up to 20 mL). Venous enhancement within the superior sagittal sinus, right jugular bulb, and left jugular bulb was measured. Patients were dichotomized on the basis of administration of less than versus a maximum weight-based gadolinium-based contrast dose of 20 mL. Venographic quality was assigned by two neuroradiologists. Correlational and multiple linear regression analyses were performed. RESULTS Among patients receiving less than the maximum 20 mL of gadolinium, no significant correlations were observed between weight and vascular enhancement (p > 0.05). Significant correlations between height and enhancement were observed in the superior sagittal sinus and left jugular bulb. This finding suggests that differences in estimated blood volume driven by height remain unaccounted for (p < 0.05). With the 20-mL maximal dose, a significant inverse relation was noted between estimated blood volume and contrast enhancement of all vascular segments (p < 0.05). Within all vascular segments, significant correlations were observed between enhancement and user-defined quality scores (p < 0.05). This finding suggests that optimized dosing may affect reader confidence. CONCLUSION Standard weight-based dosing for cerebral MRV insufficiently accounts for differences in circulating blood volume. An expanded biometric dosing paradigm leveraging readily attainable subject data may mitigate unintended variations in enhancement affecting venography and other clinical imaging modalities.
Collapse
|
15
|
Andersson M, Mattsson S. Dose management in conventional nuclear medicine imaging and PET. Clin Transl Imaging 2015. [DOI: 10.1007/s40336-015-0150-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|