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D'Antonio A, Assante R, Zampella E, Mannarino T, Buongiorno P, Cuocolo A, Acampa W. Myocardial blood flow evaluation with dynamic cadmium-zinc-telluride single-photon emission computed tomography: Bright and dark sides. Diagn Interv Imaging 2023; 104:323-329. [PMID: 36797156 DOI: 10.1016/j.diii.2023.02.001] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 02/01/2023] [Accepted: 02/01/2023] [Indexed: 02/16/2023]
Abstract
Myocardial blood flow (MBF) and myocardial perfusion reserve (MPR) assessment with non-invasive techniques represent an important tool to evaluate both coronary artery disease severity and extent. Currently, cardiac positron emission tomography-computed tomography (PET-CT) is the "gold standard" for the assessment of coronary function and provides accurate estimations of baseline and hyperemic MBF and MFR. Nevertheless, due to the high cost and complexity, PET-CT is not widely used in clinical practice. The introduction of cardiac-dedicated cadmium-zinc-telluride (CZT) cameras has renewed researchers' interest on MBF quantitation by single-photon emission computed tomography (SPECT). Indeed, many studies evaluated MPR and MBF measurements by dynamic CZT-SPECT in different cohorts of patients with suspected or overt coronary artery disease. As well, many others have compared the values obtained by CZT-SPECT to the ones by PET-CT, showing good correlations in detecting significant stenosis, although with different and non-standardized cut-off values. Nevertheless, the lack of standardized protocol for acquisition, reconstruction and elaboration makes more difficult to compare different studies and to further assess the real advantages of MBF quantitation by dynamic CZT-SPECT in clinical routine. Many are the issues involved in the bright and dark sides of dynamic CZT-SPECT. They include different type of CZT cameras, different execution protocols, different tracers with different myocardial extraction fraction and distribution, different software packages with different tools and algorithms, often requiring manual post-processing elaboration. This review article provides a clear summary of the state of the art on MBF and MPR evaluation by dynamic CZT-SPECT and outlines the major issues to solve to optimize this technique.
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Affiliation(s)
- Adriana D'Antonio
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy
| | - Roberta Assante
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy
| | - Emilia Zampella
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy
| | - Teresa Mannarino
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy
| | - Pietro Buongiorno
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy
| | - Alberto Cuocolo
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy
| | - Wanda Acampa
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy
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Hyafil F. Quantification of myocardial blood flow with cadmium-zinc-telluride SPECT: Is it worth the effort? Diagn Interv Imaging 2023; 104:309-310. [PMID: 37085422 DOI: 10.1016/j.diii.2023.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 04/03/2023] [Indexed: 04/23/2023]
Affiliation(s)
- Fabien Hyafil
- Department of Nuclear Medicine, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, 75015, Paris, France; Université Paris Cité, Faculté de Médecine, INSERM U970, 75006 Paris, France.
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Liu G, Qi C, Shi H. Neuroendocrine Neoplasms: Total-body PET/Computed Tomography. PET Clin 2023; 18:251-257. [PMID: 36858747 DOI: 10.1016/j.cpet.2022.11.010] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
Total-body PET/computed tomography (CT) (uExplorer) static and dynamic scan using low-dose (48.1 to 73.6 MBq) gallium-68 (68Ga) DOTATATE combined with low-dose (1.55 MBq/kg) or ultra-low-dose (0.37 MBq/kg) 18F-fluorodeoxyglucose (18F-FDG) were used as a routine in patients with neuroendocrine neoplasms (NENs). 68Ga DOTATATE and 18F-FDG PET/CT static imaging play complementary roles in diagnosis, staging, and therapy-response evaluation in a patient with NENs. Kinetic parameters and time activity curve derived from the dynamic scan is helpful for understanding tumors biological characteristics and differential diagnosis of NENs.
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Affiliation(s)
- Guobing Liu
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, China; Institute of Nuclear Medicine, Fudan University, Shanghai, China; Shanghai Institute of Medical Imaging, Shanghai, China; Cancer Prevention and Treatment Center, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Chi Qi
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, China; Institute of Nuclear Medicine, Fudan University, Shanghai, China; Shanghai Institute of Medical Imaging, Shanghai, China; Cancer Prevention and Treatment Center, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Hongcheng Shi
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, China; Institute of Nuclear Medicine, Fudan University, Shanghai, China; Shanghai Institute of Medical Imaging, Shanghai, China; Cancer Prevention and Treatment Center, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
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Sui X, Liu G, Hu P, Chen S, Yu H, Wang Y, Shi H. Total-Body PET/Computed Tomography Highlights in Clinical Practice: Experiences from Zhongshan Hospital, Fudan University. PET Clin 2021; 16:9-14. [PMID: 33218606 DOI: 10.1016/j.cpet.2020.09.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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: 11/16/2022]
Abstract
"The initial experience of using total-body PET/computed tomography (CT) (uExplorer) in Zhongshan Hospital, Fudan University, is described. Compared with conventional PET/CT, total-body PET/CT imaging provides more comprehensive information for evaluation of disease. Using fludeoxyglucose F 18, regular-dose (3.7 MBq/kg), low-dose (1.85 MBq/kg), or extra low-dose (0.37 MBq/kg) scanning, as well as high-quality imaging, protocols were used in clinical practice according to the situation. Dynamic studies were also used to assess tumor biological characteristics or for radiotracer angiography."
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Affiliation(s)
- Xiuli Sui
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai, China; Institute of Nuclear Medicine, Fudan University, Shanghai, China; Shanghai Institute of Medical Imaging, Shanghai, China
| | - Guobing Liu
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai, China; Institute of Nuclear Medicine, Fudan University, Shanghai, China; Shanghai Institute of Medical Imaging, Shanghai, China
| | - Pengcheng Hu
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai, China; Institute of Nuclear Medicine, Fudan University, Shanghai, China; Shanghai Institute of Medical Imaging, Shanghai, China
| | - Shuguang Chen
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai, China; Institute of Nuclear Medicine, Fudan University, Shanghai, China; Shanghai Institute of Medical Imaging, Shanghai, China
| | - Haojun Yu
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai, China; Institute of Nuclear Medicine, Fudan University, Shanghai, China; Shanghai Institute of Medical Imaging, Shanghai, China
| | - Ying Wang
- United Imaging Healthcare, Shanghai, China
| | - Hongcheng Shi
- Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai, China; Institute of Nuclear Medicine, Fudan University, Shanghai, China; Shanghai Institute of Medical Imaging, Shanghai, China.
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Kotani T, Nishimura M, Tamaki N, Matsushima S, Akiyama S, Kanayama T, Bamba C, Tanada Y, Nii T, Yamada K. Comparison between dynamic whole-body FDG-PET and early-delayed imaging for the assessment of motion in focal uptake in colorectal area. Ann Nucl Med 2021; 35:1305-11. [PMID: 34426890 DOI: 10.1007/s12149-021-01671-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 08/15/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Serial changes of focal uptake in whole-body dynamic positron emission tomography (PET) imaging were assessed and compared with those in early-delayed imaging to differentiate pathological uptake from physiological uptake in the colorectal area, based on the change in uptake shape. METHODS In 60 patients with at least 1 pathologically diagnosed colorectal cancer or adenoma, a serial 3 min dynamic whole-body PET/computed tomography imaging was performed four times around 60 min after the administration of 18F-fluorodeoxyglucose (FDG) to create a conventional (early) image by summation. Delayed imaging was performed separately at 110 min after FDG administration. High focal uptake lesions in the colorectal area were visually assessed as "changed" or "unchanged" on serial dynamic imaging and early-delayed imaging, based on the alteration in uptake shape over time. These criteria on the images were used to differentiate pathological uptake from physiological uptake. RESULTS In this study, 334 lesions with high focal FDG uptake were observed. Among 73 histologically proven pathological FDG uptakes, no change was observed in 69 on serial dynamic imaging and 72 on early-delayed imaging (sensitivity of 95 vs. 99%, respectively; ns). In contrast, out of 261 physiological FDG uptakes, a change in uptake shape was seen in 159 on dynamic PET imaging and 66 on early-delayed imaging (specificity of 61 vs. 25%, respectively; p < 0.01). High and similar negative predictive values for identifying pathological uptake were obtained by both methods (98 vs 99%, respectively). Thus, the overall accuracy for differentiating pathological from physiological FDG uptake based on change in uptake shape tended to be higher on serial dynamic imaging (68%) than on early-delayed imaging (41%; p < 0.01). CONCLUSIONS Dynamic whole-body FDG imaging enables differentiation of pathological uptake from physiological uptake based on the serial changes in uptake shape in the colorectal area. It may provide greater diagnostic value than early-delayed PET imaging. Thus, this technique holds a promise for minimizing the need for delayed imaging.
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Nishimura M, Tamaki N, Matsushima S, Kiba M, Kotani T, Bamba C, Nakamura Y, Yamada K. Dynamic whole-body 18F-FDG PET for differentiating abnormal lesions from physiological uptake. Eur J Nucl Med Mol Imaging 2020; 47:2293-2300. [PMID: 32189027 DOI: 10.1007/s00259-020-04726-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 02/14/2020] [Indexed: 01/23/2023]
Abstract
PURPOSE Serial assessment of visual change in 18F-FDG uptake on whole-body 18F-FDG PET imaging was performed to differentiate pathological uptake from physiological uptake in the urinary and gastrointestinal tracts. METHODS In 88 suspected cancer patients, serial 3-min dynamic whole-body PET imaging was performed four times, from 60 min after 18F-FDG administration. In dynamic image evaluation, high 18F-FDG uptake was evaluated by two nuclear medicine physicians and classified as "changed" or "unchanged" based on change in uptake shape over time. Detectability of pathological uptake based on these criteria was assessed and compared with conventional image evaluation. RESULTS Dynamic whole-body PET imaging provided images of adequate quality for visual assessment. Dynamic image evaluation was "changed" in 118/154 regions of high physiological 18F-FDG uptake (77%): in 9/19 areas in the stomach (47%), in 32/39 in the small intestine (82%), in 17/33 in the colon (52%), and in 60/63 in the urinary tract (95%). In the 86 benign or malignant lesions, 84 lesions (98%) were "unchanged." A high 18F-FDG uptake area that shows no change over time using these criteria is highly likely to represent pathological uptake, with sensitivity of 97%, specificity of 76%, PPV of 70%, NPV of 98%, and accuracy of 84%. CONCLUSION Dynamic whole-body 18F-FDG PET imaging enabled differentiation of pathological uptake from physiological uptake in the urinary and gastrointestinal tracts, based on visual change of uptake shape.
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Affiliation(s)
- Motoki Nishimura
- Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Nagara Tamaki
- Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
| | - Shigenori Matsushima
- Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Maki Kiba
- Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Tomoya Kotani
- Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Chisa Bamba
- Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yasunori Nakamura
- Department of Radiological Technology, University Hospital, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Kei Yamada
- Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
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