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Tran-Gia J, Denis-Bacelar AM, Ferreira KM, Robinson AP, Bobin C, Bonney LM, Calvert N, Collins SM, Fenwick AJ, Finocchiaro D, Fioroni F, Giannopoulou K, Grassi E, Heetun W, Jewitt SJ, Kotzasarlidou M, Ljungberg M, Lourenço V, McGowan DR, Mewburn-Crook J, Sabot B, Scuffham J, Sjögreen Gleisner K, Solc J, Thiam C, Tipping J, Wevrett J, Lassmann M. On the use of solid 133Ba sources as surrogate for liquid 131I in SPECT/CT calibration: a European multi-centre evaluation. EJNMMI Phys 2023; 10:73. [PMID: 37993667 PMCID: PMC10665282 DOI: 10.1186/s40658-023-00582-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 09/25/2023] [Indexed: 11/24/2023] Open
Abstract
INTRODUCTION Commissioning, calibration, and quality control procedures for nuclear medicine imaging systems are typically performed using hollow containers filled with radionuclide solutions. This leads to multiple sources of uncertainty, many of which can be overcome by using traceable, sealed, long-lived surrogate sources containing a radionuclide of comparable energies and emission probabilities. This study presents the results of a quantitative SPECT/CT imaging comparison exercise performed within the MRTDosimetry consortium to assess the feasibility of using 133Ba as a surrogate for 131I imaging. MATERIALS AND METHODS Two sets of four traceable 133Ba sources were produced at two National Metrology Institutes and encapsulated in 3D-printed cylinders (volume range 1.68-107.4 mL). Corresponding hollow cylinders to be filled with liquid 131I and a mounting baseplate for repeatable positioning within a Jaszczak phantom were also produced. A quantitative SPECT/CT imaging comparison exercise was conducted between seven members of the consortium (eight SPECT/CT systems from two major vendors) based on a standardised protocol. Each site had to perform three measurements with the two sets of 133Ba sources and liquid 131I. RESULTS As anticipated, the 131I pseudo-image calibration factors (cps/MBq) were higher than those for 133Ba for all reconstructions and systems. A site-specific cross-calibration reduced the performance differences between both radionuclides with respect to a cross-calibration based on the ratio of emission probabilities from a median of 12-1.5%. The site-specific cross-calibration method also showed agreement between 133Ba and 131I for all cylinder volumes, which highlights the potential use of 133Ba sources to calculate recovery coefficients for partial volume correction. CONCLUSION This comparison exercise demonstrated that traceable solid 133Ba sources can be used as surrogate for liquid 131I imaging. The use of solid surrogate sources could solve the radiation protection problem inherent in the preparation of phantoms with 131I liquid activity solutions as well as reduce the measurement uncertainties in the activity. This is particularly relevant for stability measurements, which have to be carried out at regular intervals.
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Affiliation(s)
- Johannes Tran-Gia
- Department of Nuclear Medicine, University Hospital Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Germany.
| | | | | | | | - Christophe Bobin
- Université Paris-Saclay, CEA, List, Laboratoire National Henri Becquerel (LNE-LNHB), 91120, Palaiseau, France
| | - Lara M Bonney
- Department of Medical Physics and Clinical Engineering, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Nicholas Calvert
- Christie Medical Physics and Engineering (CMPE), The Christie NHS Foundation Trust, Manchester, UK
| | - Sean M Collins
- National Physical Laboratory, Hampton Road, Teddington, UK
- School of Mathematics and Physics, University of Surrey, Guildford, UK
| | | | - Domenico Finocchiaro
- Medical Physics Unit, Azienda Ospedaliero-Universitaria Policlinico di Modena, Modena, Italy
| | - Federica Fioroni
- Medical Physics Unit, Azienda USL-IRCCS Di Reggio Emilia, Reggio Emilia, Italy
| | | | - Elisa Grassi
- Medical Physics Unit, Azienda USL-IRCCS Di Reggio Emilia, Reggio Emilia, Italy
| | - Warda Heetun
- National Physical Laboratory, Hampton Road, Teddington, UK
| | - Stephanie J Jewitt
- Department of Medical Physics and Clinical Engineering, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Maria Kotzasarlidou
- Nuclear Medicine Department, "THEAGENIO" Anticancer Hospital, Thessaloniki, Greece
| | | | - Valérie Lourenço
- Université Paris-Saclay, CEA, List, Laboratoire National Henri Becquerel (LNE-LNHB), 91120, Palaiseau, France
| | - Daniel R McGowan
- Department of Medical Physics and Clinical Engineering, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- Department of Oncology, University of Oxford, Oxford, UK
| | | | - Benoit Sabot
- Université Paris-Saclay, CEA, List, Laboratoire National Henri Becquerel (LNE-LNHB), 91120, Palaiseau, France
| | - James Scuffham
- Royal Surrey County Hospital, Royal Surrey NHS Foundation Trust, Guildford, UK
| | | | - Jaroslav Solc
- Czech Metrology Institute, Okruzni 31, 638 00, Brno, Czech Republic
| | - Cheick Thiam
- Université Paris-Saclay, CEA, List, Laboratoire National Henri Becquerel (LNE-LNHB), 91120, Palaiseau, France
| | - Jill Tipping
- Department of Medical Physics and Clinical Engineering, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Jill Wevrett
- Royal Surrey County Hospital, Royal Surrey NHS Foundation Trust, Guildford, UK
| | - Michael Lassmann
- Department of Nuclear Medicine, University Hospital Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Germany
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2
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Pells S, Cullen DM, Deidda D, Denis-Bacelar AM, Fenwick A, Ferreira KM, Hamilton D, Heetun W, Julyan P, Needham G, Pietras B, Price E, Scuffham J, Tipping J, Robinson AP. Quantitative validation of Monte Carlo SPECT simulation: application to a Mediso AnyScan GATE simulation. EJNMMI Phys 2023; 10:60. [PMID: 37777689 PMCID: PMC10542438 DOI: 10.1186/s40658-023-00581-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 09/15/2023] [Indexed: 10/02/2023] Open
Abstract
BACKGROUND Monte Carlo (MC) simulations are used in nuclear medicine imaging as they provide unparalleled insight into processes that are not directly experimentally measurable, such as scatter and attenuation in an acquisition. Whilst MC is often used to provide a 'ground-truth', this is only the case if the simulation is fully validated against experimental data. This work presents a quantitative validation for a MC simulation of a single-photon emission computed tomography (SPECT) system. METHODS An MC simulation model of the Mediso AnyScan SCP SPECT system installed at the UK National Physical Laboratory was developed in the GATE (Geant4 Application for Tomographic Emission) toolkit. Components of the detector head and two collimator configurations were modelled according to technical specifications and physical measurements. Experimental detection efficiency measurements were collected for a range of energies, permitting an energy-dependent intrinsic camera efficiency correction function to be determined and applied to the simulation on an event-by-event basis. Experimental data were collected in a range of geometries with [Formula: see text]Tc for comparison to simulation. The procedure was then repeated with [Formula: see text]Lu to determine how the validation extended to another isotope and set of collimators. RESULTS The simulation's spatial resolution, sensitivity, energy spectra and the projection images were compared with experimental measurements. The simulation and experimental uncertainties were determined and propagated to all calculations, permitting the quantitative agreement between simulated and experimental SPECT acquisitions to be determined. Statistical agreement was seen in sinograms and projection images of both [Formula: see text]Tc and [Formula: see text]Lu data. Average simulated and experimental sensitivity ratios of ([Formula: see text]) were seen for emission and scatter windows of [Formula: see text]Tc, and ([Formula: see text]) and ([Formula: see text]) for the 113 and 208 keV emissions of [Formula: see text]Lu, respectively. CONCLUSIONS MC simulations will always be an approximation of a physical system and the level of agreement should be assessed. A validation method is presented to quantify the level of agreement between a simulation model and a physical SPECT system.
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Affiliation(s)
- Sophia Pells
- Department of Physics and Astronomy, The University of Manchester, Manchester, UK.
- National Physical Laboratory, Teddington, UK.
- Department of Radiology, UMass Chan Medical School, Worcester, MA, USA.
| | - David M Cullen
- Department of Physics and Astronomy, The University of Manchester, Manchester, UK
| | | | | | | | | | | | | | - Peter Julyan
- The Christie NHS Foundation Trust, Manchester, UK
| | - George Needham
- Department of Physics and Astronomy, The University of Manchester, Manchester, UK
- The Christie NHS Foundation Trust, Manchester, UK
| | - Ben Pietras
- Department of Physics and Astronomy, The University of Manchester, Manchester, UK
| | - Emlyn Price
- Department of Physics and Astronomy, The University of Manchester, Manchester, UK
| | - James Scuffham
- National Physical Laboratory, Teddington, UK
- Royal Surrey County Hospital, Guildford, UK
| | - Jill Tipping
- The Christie NHS Foundation Trust, Manchester, UK
| | - Andrew P Robinson
- Department of Physics and Astronomy, The University of Manchester, Manchester, UK
- National Physical Laboratory, Teddington, UK
- The Christie NHS Foundation Trust, Manchester, UK
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3
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Deidda D, Denis-Bacelar AM, Fenwick AJ, Ferreira KM, Heetun W, Hutton BF, McGowan DR, Robinson AP, Scuffham J, Thielemans K, Twyman R. Triple modality image reconstruction of PET data using SPECT, PET, CT information increases lesion uptake in images of patients treated with radioembolization with [Formula: see text] micro-spheres. EJNMMI Phys 2023; 10:30. [PMID: 37133766 PMCID: PMC10156904 DOI: 10.1186/s40658-023-00549-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 04/13/2023] [Indexed: 05/04/2023] Open
Abstract
PURPOSE Nuclear medicine imaging modalities like computed tomography (CT), single photon emission CT (SPECT) and positron emission tomography (PET) are employed in the field of theranostics to estimate and plan the dose delivered to tumors and the surrounding tissues and to monitor the effect of the therapy. However, therapeutic radionuclides often provide poor images, which translate to inaccurate treatment planning and inadequate monitoring images. Multimodality information can be exploited in the reconstruction to enhance image quality. Triple modality PET/SPECT/CT scanners are particularly useful in this context due to the easier registration process between images. In this study, we propose to include PET, SPECT and CT information in the reconstruction of PET data. The method is applied to Yttrium-90 ([Formula: see text]Y) data. METHODS Data from a NEMA phantom filled with [Formula: see text]Y were used for validation. PET, SPECT and CT data from 10 patients treated with Selective Internal Radiation Therapy (SIRT) were used. Different combinations of prior images using the Hybrid kernelized expectation maximization were investigated in terms of VOI activity and noise suppression. RESULTS Our results show that triple modality PET reconstruction provides significantly higher uptake when compared to the method used as standard in the hospital and OSEM. In particular, using CT-guided SPECT images, as guiding information in the PET reconstruction significantly increases uptake quantification on tumoral lesions. CONCLUSION This work proposes the first triple modality reconstruction method and demonstrates up to 69% lesion uptake increase over standard methods with SIRT [Formula: see text]Y patient data. Promising results are expected for other radionuclide combination used in theranostic applications using PET and SPECT.
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Affiliation(s)
- Daniel Deidda
- National Physical Laboratory, Teddington, UK
- Nuclear Medicine Institute, University College London, London, UK
| | | | | | | | | | - Brian F. Hutton
- Nuclear Medicine Institute, University College London, London, UK
| | - Daniel R. McGowan
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- University of Oxford, Oxford, UK
| | | | | | - Kris Thielemans
- Nuclear Medicine Institute, University College London, London, UK
- Centre for Medical Image Computing, University College London, London, UK
| | - Robert Twyman
- Nuclear Medicine Institute, University College London, London, UK
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4
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Robinson AP, Calvert N, Tipping J, Denis-Bacelar AM, Ferreira KM, Lassmann M, Tran-Gia J. Development of a validation imaging dataset for Molecular Radiotherapy dosimetry multicenter intercomparison exercises based on anthropomorphic phantoms. Phys Med 2023; 109:102583. [PMID: 37062101 PMCID: PMC10165308 DOI: 10.1016/j.ejmp.2023.102583] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 03/23/2023] [Accepted: 04/06/2023] [Indexed: 04/18/2023] Open
Abstract
Validation of a Molecular Radiotherapy (MRT) dosimetry system requires imaging data for which an accompanying "ground truth" pharmacokinetic model and absorbed dose calculation are known. METHODS We present a methodology for production of a validation dataset for image based 177Lu dotatate dosimetry calculations. A pharmacokinetic model is presented with activity concentrations corresponding to common imaging timepoints. Anthropomorphic 3D printed phantoms, corresponding to the organs at risk, have been developed to provide SPECT/CT and Whole Body imaging with known organ activities corresponding to common clinical timepoints. RESULTS Results for the accuracy of phantom filling reproduce the activity concentrations from the pharmacokinetic model for all timepoints and organs within measurement uncertainties, with a mean deviation of 0.6(8)%. The imaging dataset, ancillary data and phantoms designs are provided as a source of well characterized input data for the validation of clinical MRT dosimetry systems. CONCLUSIONS The combination of pharmacokinetic modelling with the use of anthropomorphic 3D printed phantoms are a promising procedure to provide data for the validation of Molecular Radiotherapy Dosimetry systems, allowing multicentre comparisons.
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Affiliation(s)
- Andrew P Robinson
- National Physical Laboratory, Teddington, TW11 0LW, United Kingdom; Christie Medical Physics and Engineering (CMPE), The Christie NHS Foundation Trust, Wilmslow Road, Manchester M20 4BX, United Kingdom; Schuster Laboratory, School of Physics and Astronomy, The University of Manchester, Manchester M13 9PL, United Kingdom.
| | - Nick Calvert
- Christie Medical Physics and Engineering (CMPE), The Christie NHS Foundation Trust, Wilmslow Road, Manchester M20 4BX, United Kingdom
| | - Jill Tipping
- Christie Medical Physics and Engineering (CMPE), The Christie NHS Foundation Trust, Wilmslow Road, Manchester M20 4BX, United Kingdom
| | | | | | - Michael Lassmann
- Department of Nuclear Medicine, University Hospital Würzburg, Oberdürrbacher Str. 6, 97080 Würzburg, Germany
| | - Johannes Tran-Gia
- Department of Nuclear Medicine, University Hospital Würzburg, Oberdürrbacher Str. 6, 97080 Würzburg, Germany
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Dickson JC, Armstrong IS, Gabiña PM, Denis-Bacelar AM, Krizsan AK, Gear JM, Van den Wyngaert T, de Geus-Oei LF, Herrmann K. EANM practice guideline for quantitative SPECT-CT. Eur J Nucl Med Mol Imaging 2023; 50:980-995. [PMID: 36469107 PMCID: PMC9931838 DOI: 10.1007/s00259-022-06028-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 10/30/2022] [Indexed: 12/12/2022]
Abstract
PURPOSE Quantitative SPECT-CT is a modality of growing importance with initial developments in post radionuclide therapy dosimetry, and more recent expansion into bone, cardiac and brain imaging together with the concept of theranostics more generally. The aim of this document is to provide guidelines for nuclear medicine departments setting up and developing their quantitative SPECT-CT service with guidance on protocols, harmonisation and clinical use cases. METHODS These practice guidelines were written by members of the European Association of Nuclear Medicine Physics, Dosimetry, Oncology and Bone committees representing the current major stakeholders in Quantitative SPECT-CT. The guidelines have also been reviewed and approved by all EANM committees and have been endorsed by the European Association of Nuclear Medicine. CONCLUSION The present practice guidelines will help practitioners, scientists and researchers perform high-quality quantitative SPECT-CT and will provide a framework for the continuing development of quantitative SPECT-CT as an established modality.
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Affiliation(s)
- John C Dickson
- Institute of Nuclear Medicine, University College London Hospitals Foundation Trust, London, UK
| | - Ian S Armstrong
- Nuclear Medicine, Manchester University NHS Foundation Trust, Manchester, UK
| | - Pablo Minguez Gabiña
- Department of Medical Physics and Radiation Protection, Gurutzeta-Cruces University Hospital/Biocruces Health Research Institute, Barakaldo, Spain
- Department of Applied Physics, Faculty of Engineering, UPV/EHU, Bilbao, Spain
| | | | | | - Jonathan M Gear
- Joint Department of Physics Institute of Cancer Research and Royal Marsden, NHS Foundation Trust, Sutton, Surrey, UK
| | - Tim Van den Wyngaert
- Department of Nuclear Medicine, Antwerp University Hospital, Edegem, Belgium
- Faculty of Medicine and Health Sciences (MICA - IPPON), , University of Antwerp, Wilrijk, Belgium
| | - Lioe-Fee de Geus-Oei
- Department of Radiology, Section of Nuclear Medicine, Leiden University Medical Center, Leiden, The Netherlands
- Biomedical Photonic Imaging Group, University of Twente, Enschede, The Netherlands
| | - Ken Herrmann
- Department of Nuclear Medicine, University of Duisburg-Essen, and German Cancer Consortium (DKTK)-University Hospital Essen, Essen, Germany.
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Herrmann K, Giovanella L, Santos A, Gear J, Ozgen Kiratli P, Kurth J, Denis-Bacelar AM, Hustinx R, Patt M, Wahl RL, Paez D, Giammarile F, Jadvar H, Pandit-Taskar N, Ghesani M, Kunikowska J. Joint EANM, SNMMI, and IAEA Enabling Guide: How to Set up a Theranostics Center. J Nucl Med 2022; 63:1836-1843. [PMID: 35450957 DOI: 10.2967/jnumed.122.264321] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 04/20/2022] [Indexed: 01/14/2023] Open
Abstract
The theranostics concept using the same target for both imaging and therapy dates back to the middle of the last century, when radioactive iodine was first used to treat thyroid diseases. Since then, radioiodine has become broadly established clinically for diagnostic imaging and therapy of benign and malignant thyroid disease, worldwide. However, only since the approval of SSTR2-targeting theranostics following the NETTER-1 trial in neuroendocrine tumors, and the positive outcome of the VISION trial has theranostics gained substantial attention beyond nuclear medicine. The roll-out of radioligand therapy for treating a high-incidence tumor such as prostate cancer requires the expansion of existing and the establishment of new theranostics centers. Despite wide global variation in the regulatory, financial and medical landscapes, this guide attempts to provide valuable information to enable interested stakeholders to safely initiate and operate theranostic centers. This enabling guide does not intend to answer all possible questions, but rather to serve as an overarching framework for multiple, more detailed future initiatives. It recognizes that there are regional differences in the specifics of regulation of radiation safety, but common elements of best practice valid globally.
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Affiliation(s)
- Ken Herrmann
- Department of Nuclear Medicine, University of Duisburg-Essen, Duisburg, Germany; .,German Cancer Consortium (DKTK)-University Hospital Essen, Essen, Germany
| | - Luca Giovanella
- Clinic for Nuclear Medicine and Molecular Imaging, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
| | - Andrea Santos
- Department of Nuclear Medicine, Hospital Cuf Descobertas, Lisbon, Portugal
| | - Jonathan Gear
- Joint Department of Physics, Royal Marsden NHS Foundation Trust, Sutton, Sutton, United Kingdom
| | | | - Jens Kurth
- Department of Nuclear Medicine, Rostock University Medical Center, Rostock, Germany
| | | | - Roland Hustinx
- Division of Nuclear Medicine and Oncological Imaging, University Hospital of Liège, Liège, Belgium.,GIGA-CRC in vivo imaging, University of Liège, Liège, Belgium
| | - Marianne Patt
- Department for Nuclear Medicine, University Hospital Leipzig, Leipzig, Germany
| | - Richard L Wahl
- Department of Radiology, Washington University School of Medicine, St. Louis, Missouri
| | - Diana Paez
- Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, Department of Nuclear Sciences and Application, International Atomic Energy Agency, Vienna, Austria
| | - Francesco Giammarile
- Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, Department of Nuclear Sciences and Application, International Atomic Energy Agency, Vienna, Austria
| | - Hossein Jadvar
- Division of Nuclear Medicine, Department of Radiology, University of Southern California, Los Angeles, California
| | - Neeta Pandit-Taskar
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Munir Ghesani
- Diagnostic, Molecular & Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, New York; and
| | - Jolanta Kunikowska
- Nuclear Medicine Department, Medical University of Warsaw, Warsaw, Poland
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7
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Gillen R, Erlandsson K, Denis-Bacelar AM, Thielemans K, Hutton BF, McQuaid SJ. Towards accurate partial volume correction in 99mTc oncology SPECT: perturbation for case-specific resolution estimation. EJNMMI Phys 2022; 9:59. [PMID: 36064882 PMCID: PMC9445108 DOI: 10.1186/s40658-022-00489-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 08/22/2022] [Indexed: 11/30/2022] Open
Abstract
Background Currently, there is no consensus on the optimal partial volume correction (PVC) algorithm for oncology imaging. Several existing PVC methods require knowledge of the reconstructed resolution, usually as the point spread function (PSF)—often assumed to be spatially invariant. However, this is not the case for SPECT imaging. This work aimed to assess the accuracy of SPECT quantification when PVC is applied using a case-specific PSF. Methods Simulations of SPECT \documentclass[12pt]{minimal}
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\begin{document}$$^{99{\mathrm{m}}}$$\end{document}99mTc imaging were performed for a range of activity distributions, including those replicating typical clinical oncology studies. Gaussian PSFs in reconstructed images were estimated using perturbation with a small point source. Estimates of the PSF were made in situations which could be encountered in a patient study, including; different positions in the field of view, different lesion shapes, sizes and contrasts, noise-free and noisy data. Ground truth images were convolved with the perturbation-estimated PSF, and with a PSF reflecting the resolution at the centre of the field of view. Both were compared with reconstructed images and the root-mean-square error calculated to assess the accuracy of the estimated PSF. PVC was applied using Single Target Correction, incorporating the perturbation-estimated PSF. Corrected regional mean values were assessed for quantitative accuracy. Results Perturbation-estimated PSF values demonstrated dependence on the position in the Field of View and the number of OSEM iterations. A lower root mean squared error was observed when convolution of the ground truth image was performed with the perturbation-estimated PSF, compared with convolution using a different PSF. Regional mean values following PVC using the perturbation-estimated PSF were more accurate than uncorrected data, or data corrected with PVC using an unsuitable PSF. This was the case for both simple and anthropomorphic phantoms. For the simple phantom, regional mean values were within 0.7% of the ground truth values. Accuracy improved after 5 or more OSEM iterations (10 subsets). For the anthropomorphic phantoms, post-correction regional mean values were within 1.6% of the ground truth values for noise-free uniform lesions. Conclusion Perturbation using a simulated point source could potentially improve quantitative SPECT accuracy via the application of PVC, provided that sufficient reconstruction iterations are used.
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Affiliation(s)
- Rebecca Gillen
- Institute of Nuclear Medicine, University College London, London, UK. .,National Physical Laboratory, Teddington, UK. .,Department of Clinical Physics and Bioengineering, Nuclear Medicine, North East Sector, NHS Greater Glasgow and Clyde, Glasgow, UK.
| | - Kjell Erlandsson
- Institute of Nuclear Medicine, University College London, London, UK
| | | | - Kris Thielemans
- Institute of Nuclear Medicine, University College London, London, UK.,Centre for Medical Image Computing, University College London, London, UK
| | - Brian F Hutton
- Institute of Nuclear Medicine, University College London, London, UK
| | - Sarah J McQuaid
- Institute of Nuclear Medicine, University College London, London, UK
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8
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Deidda D, Denis-Bacelar AM, Fenwick AJ, Ferreira KM, Heetun W, Hutton BF, Robinson AP, Scuffham J, Thielemans K. Hybrid kernelised expectation maximisation for Bremsstrahlung SPECT reconstruction in SIRT with 90Y micro-spheres. EJNMMI Phys 2022; 9:25. [PMID: 35377085 PMCID: PMC8980141 DOI: 10.1186/s40658-022-00452-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 03/16/2022] [Indexed: 11/16/2022] Open
Abstract
Background Selective internal radiation therapy with Yttrium-90 microspheres is an effective therapy for liver cancer and liver metastases. Yttrium-90 is mainly a high-energy beta particle emitter. These beta particles emit Bremsstrahlung radiation during their interaction with tissue making post-therapy imaging of the radioactivity distribution feasible. Nevertheless, image quality and quantification is difficult due to the continuous energy spectrum which makes resolution modelling, attenuation and scatter estimation challenging and therefore the dosimetry quantification is inaccurate. As a consequence a reconstruction algorithm able to improve resolution could be beneficial. Methods In this study, the hybrid kernelised expectation maximisation (HKEM) is used to improve resolution and contrast and reduce noise, in addition a modified HKEM called frozen HKEM (FHKEM) is investigated to further reduce noise. The iterative part of the FHKEM kernel was frozen at the 72nd sub-iteration. When using ordered subsets algorithms the data is divided in smaller subsets and the smallest algorithm iterative step is called sub-iteration. A NEMA phantom with spherical inserts was used for the optimisation and validation of the algorithm, and data from 5 patients treated with Selective internal radiation therapy were used as proof of clinical relevance of the method. Results The results suggest a maximum improvement of 56% for region of interest mean recovery coefficient at fixed coefficient of variation and better identification of the hot volumes in the NEMA phantom. Similar improvements were achieved with patient data, showing 47% mean value improvement over the gold standard used in hospitals. Conclusions Such quantitative improvements could facilitate improved dosimetry calculations with SPECT when treating patients with Selective internal radiation therapy, as well as provide a more visible position of the cancerous lesions in the liver.
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Affiliation(s)
- Daniel Deidda
- National Physical Laboratory, Teddington, UK. .,Institute of Nuclear Medicine, University College London, London, UK.
| | | | | | | | | | - Brian F Hutton
- Institute of Nuclear Medicine, University College London, London, UK
| | - Andrew P Robinson
- National Physical Laboratory, Teddington, UK.,Christie Medical Physics and Engineering (CMPE), The Christie NHS Foundation Trust, Manchester, UK.,The University of Manchester, Manchester, UK
| | - James Scuffham
- National Physical Laboratory, Teddington, UK.,Department of Medical Physics, Royal Surrey NHS Foundation Trust, Guildford, UK
| | - Kris Thielemans
- Institute of Nuclear Medicine, University College London, London, UK
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9
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Craig AJ, Murray I, Denis-Bacelar AM, Rojas B, Gear JI, Hossen L, Maenhout A, Khan N, Flux GD. Comparison of 90Y SIRT predicted and delivered absorbed doses using a PSF conversion method. Phys Med 2021; 89:1-10. [PMID: 34339928 PMCID: PMC8501309 DOI: 10.1016/j.ejmp.2021.07.026] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 06/23/2021] [Accepted: 07/19/2021] [Indexed: 12/24/2022] Open
Abstract
PURPOSE The aims of this study were to develop and apply a method to correct for the differences in partial volume effects of pre-therapy Technetium-99 m (99mTc)-MAA SPECT and post-therapy Yttrium-90 (90Y) bremsstrahlung SPECT imaging in selective internal radiation therapy, and to use this method to improve quantitative comparison of predicted and delivered 90Y absorbed doses. METHODS The spatial resolution of 99mTc SPECT data was converted to that of 90Y SPECT data using a function calculated from 99mTc and 90Y point spread functions. This resolution conversion method (RCM) was first applied to 99mTc and 90Y SPECT phantom data to validate the method, and then to clinical data to assess the power of 99mTc SPECT imaging to predict the therapeutic absorbed dose. RESULTS The maximum difference between absorbed doses to phantom spheres was 178%. This was reduced to 27% after the RCM was applied. The clinical data demonstrated differences within 38% for mean absorbed doses delivered to the normal liver, which were reduced to 20% after application of the RCM. Analysis of clinical data showed that therapeutic absorbed doses delivered to tumours greater than 100 cm3 were predicted to within 52%, although there were differences of up to 210% for smaller tumours, even after the RCM was applied. CONCLUSIONS The RCM was successfully verified using phantom data. Analysis of the clinical data established that the 99mTc pre-therapy imaging was predictive of the 90Y absorbed dose to the normal liver to within 20%, but had poor predictability for tumours smaller than 100 cm3.
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Affiliation(s)
- Allison J. Craig
- Joint Department of Physics, Royal Marsden NHSFT, Sutton, United Kingdom,The Institute of Cancer Research, London, United Kingdom,Corresponding author.
| | - Iain Murray
- Joint Department of Physics, Royal Marsden NHSFT, Sutton, United Kingdom,The Institute of Cancer Research, London, United Kingdom
| | | | - Bruno Rojas
- Joint Department of Physics, Royal Marsden NHSFT, Sutton, United Kingdom,The Institute of Cancer Research, London, United Kingdom
| | - Jonathan I. Gear
- Joint Department of Physics, Royal Marsden NHSFT, Sutton, United Kingdom,The Institute of Cancer Research, London, United Kingdom
| | - Lucy Hossen
- Royal Brompton & Harefield NHSFT, London, United Kingdom
| | | | - Nasir Khan
- Chelsea & Westminster NHSFT, London, United Kingdom
| | - Glenn D. Flux
- Joint Department of Physics, Royal Marsden NHSFT, Sutton, United Kingdom,The Institute of Cancer Research, London, United Kingdom
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10
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Tran-Gia J, Denis-Bacelar AM, Ferreira KM, Robinson AP, Calvert N, Fenwick AJ, Finocchiaro D, Fioroni F, Grassi E, Heetun W, Jewitt SJ, Kotzassarlidou M, Ljungberg M, McGowan DR, Scott N, Scuffham J, Gleisner KS, Tipping J, Wevrett J, Lassmann M. A multicentre and multi-national evaluation of the accuracy of quantitative Lu-177 SPECT/CT imaging performed within the MRTDosimetry project. EJNMMI Phys 2021; 8:55. [PMID: 34297218 PMCID: PMC8302709 DOI: 10.1186/s40658-021-00397-0] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 06/21/2021] [Indexed: 11/10/2022] Open
Abstract
PURPOSE Patient-specific dosimetry is required to ensure the safety of molecular radiotherapy and to predict response. Dosimetry involves several steps, the first of which is the determination of the activity of the radiopharmaceutical taken up by an organ/lesion over time. As uncertainties propagate along each of the subsequent steps (integration of the time-activity curve, absorbed dose calculation), establishing a reliable activity quantification is essential. The MRTDosimetry project was a European initiative to bring together expertise in metrology and nuclear medicine research, with one main goal of standardizing quantitative 177Lu SPECT/CT imaging based on a calibration protocol developed and tested in a multicentre inter-comparison. This study presents the setup and results of this comparison exercise. METHODS The inter-comparison included nine SPECT/CT systems. Each site performed a set of three measurements with the same setup (system, acquisition and reconstruction): (1) Determination of an image calibration for conversion from counts to activity concentration (large cylinder phantom), (2) determination of recovery coefficients for partial volume correction (IEC NEMA PET body phantom with sphere inserts), (3) validation of the established quantitative imaging setup using a 3D printed two-organ phantom (ICRP110-based kidney and spleen). In contrast to previous efforts, traceability of the activity measurement was required for each participant, and all participants were asked to calculate uncertainties for their SPECT-based activities. RESULTS Similar combinations of imaging system and reconstruction lead to similar image calibration factors. The activity ratio results of the anthropomorphic phantom validation demonstrate significant harmonization of quantitative imaging performance between the sites with all sites falling within one standard deviation of the mean values for all inserts. Activity recovery was underestimated for total kidney, spleen, and kidney cortex, while it was overestimated for the medulla. CONCLUSION This international comparison exercise demonstrates that harmonization of quantitative SPECT/CT is feasible when following very specific instructions of a dedicated calibration protocol, as developed within the MRTDosimetry project. While quantitative imaging performance demonstrates significant harmonization, an over- and underestimation of the activity recovery highlights the limitations of any partial volume correction in the presence of spill-in and spill-out between two adjacent volumes of interests.
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Affiliation(s)
- Johannes Tran-Gia
- Department of Nuclear Medicine, University of Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Germany.
| | | | | | - Andrew P Robinson
- National Physical Laboratory, Teddington, UK
- Christie Medical Physics and Engineering (CMPE), The Christie NHS Foundation Trust, Manchester, UK
- The University of Manchester, Manchester, UK
| | - Nicholas Calvert
- Christie Medical Physics and Engineering (CMPE), The Christie NHS Foundation Trust, Manchester, UK
| | - Andrew J Fenwick
- National Physical Laboratory, Teddington, UK
- Cardiff University, Cardiff, UK
| | - Domenico Finocchiaro
- Medical Physics Unit, Azienda Unità Sanitaria Locale di Reggio Emilia-IRCCS, Reggio Emilia, Italy
- Department of Physics and Astronomy, University of Bologna, Bologna, Italy
| | - Federica Fioroni
- Medical Physics Unit, Azienda Unità Sanitaria Locale di Reggio Emilia-IRCCS, Reggio Emilia, Italy
| | - Elisa Grassi
- Medical Physics Unit, Azienda Unità Sanitaria Locale di Reggio Emilia-IRCCS, Reggio Emilia, Italy
| | | | - Stephanie J Jewitt
- Radiation Physics and Protection, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Maria Kotzassarlidou
- Nuclear Medicine Department, "THEAGENIO" Anticancer Hospital, Thessaloniki, Greece
| | | | - Daniel R McGowan
- Radiation Physics and Protection, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- Department of Oncology, University of Oxford, Oxford, UK
| | - Nathaniel Scott
- Radiation Physics and Protection, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - James Scuffham
- National Physical Laboratory, Teddington, UK
- Royal Surrey County Hospital, Guildford, UK
- Department of Physics, University of Surrey, Guildford, UK
| | | | - Jill Tipping
- Christie Medical Physics and Engineering (CMPE), The Christie NHS Foundation Trust, Manchester, UK
| | - Jill Wevrett
- National Physical Laboratory, Teddington, UK
- Royal Surrey County Hospital, Guildford, UK
- Department of Physics, University of Surrey, Guildford, UK
| | - Michael Lassmann
- Department of Nuclear Medicine, University of Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Germany
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11
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Abbott EM, Falzone N, Lee BQ, Kartsonaki C, Winter H, Greenhalgh TA, McGowan DR, Syed N, Denis-Bacelar AM, Boardman P, Sharma RA, Vallis KA. The Impact of Radiobiologically Informed Dose Prescription on the Clinical Benefit of 90Y SIRT in Colorectal Cancer Patients. J Nucl Med 2020; 61:1658-1664. [PMID: 32358093 DOI: 10.2967/jnumed.119.233650] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 03/16/2020] [Indexed: 12/31/2022] Open
Abstract
The purpose of this study was to establish the dose-response relationship of selective internal radiation therapy (SIRT) in patients with metastatic colorectal cancer (mCRC), when informed by radiobiological sensitivity parameters derived from mCRC cell lines exposed to 90Y. Methods: Twenty-three mCRC patients with liver metastases refractory to chemotherapy were included. 90Y bremsstrahlung SPECT images were transformed into dose maps assuming the local dose deposition method. Baseline and follow-up CT scans were segmented to derive liver and tumor volumes. Mean, median, and D70 (minimum dose to 70% of tumor volume) values determined from dose maps were correlated with change in tumor volume and volumetric RECIST response using linear and logistic regression, respectively. Radiosensitivity parameters determined by clonogenic assays of mCRC cell lines HT-29 and DLD-1 after exposure to 90Y or external beam radiotherapy (EBRT; 6 MV photons) were used in biologically effective dose (BED) calculations. Results: Mean administered radioactivity was 1,469 ± 428 MBq (range, 847-2,185 MBq), achieving a mean absorbed radiation dose to tumor of 35.5 ± 9.4 Gy and mean normal liver dose of 26.4 ± 6.8 Gy. A 1.0 Gy increase in mean, median, and D70 absorbed dose was associated with a reduction in tumor volume of 1.8%, 1.8%, and 1.5%, respectively, and an increased probability of a volumetric RECIST response (odds ratio, 1.09, 1.09, and 1.10, respectively). Threshold mean, median and D70 doses for response were 48.3, 48.8, and 41.8 Gy, respectively. EBRT-equivalent BEDs for 90Y are up to 50% smaller than those calculated by applying protraction-corrected radiobiological parameters derived from EBRT alone. Conclusion: Dosimetric studies have assumed equivalence between 90Y SIRT and EBRT, leading to inflation of BED for SIRT and possible undertreatment. Radiobiological parameters for 90Y were applied to a BED model, providing a calculation method that has the potential to improve assessment of tumor control.
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Affiliation(s)
- Elliot M Abbott
- Oxford Institute for Radiation Oncology, Department of Oncology, Oxford University, Oxford, United Kingdom
| | - Nadia Falzone
- Oxford Institute for Radiation Oncology, Department of Oncology, Oxford University, Oxford, United Kingdom
| | - Boon Q Lee
- Oxford Institute for Radiation Oncology, Department of Oncology, Oxford University, Oxford, United Kingdom
| | | | - Helen Winter
- Department of Oncology, Oxford University, Oxford, United Kingdom
| | | | - Daniel R McGowan
- Department of Radiology, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - Nigar Syed
- Department of Radiology, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | | | - Philip Boardman
- Department of Radiology, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - Ricky A Sharma
- Radiation Oncology, University College London, London, United Kingdom
| | - Katherine A Vallis
- Oxford Institute for Radiation Oncology, Department of Oncology, Oxford University, Oxford, United Kingdom
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12
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Chen DL, Ballout S, Chen L, Cheriyan J, Choudhury G, Denis-Bacelar AM, Emond E, Erlandsson K, Fisk M, Fraioli F, Groves AM, Gunn RN, Hatazawa J, Holman BF, Hutton BF, Iida H, Lee S, MacNee W, Matsunaga K, Mohan D, Parr D, Rashidnasab A, Rizzo G, Subramanian D, Tal-Singer R, Thielemans K, Tregay N, van Beek EJR, Vass L, Vidal Melo MF, Wellen JW, Wilkinson I, Wilson FJ, Winkler T. Consensus Recommendations on the Use of 18F-FDG PET/CT in Lung Disease. J Nucl Med 2020; 61:1701-1707. [PMID: 32948678 DOI: 10.2967/jnumed.120.244780] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 09/09/2020] [Indexed: 01/04/2023] Open
Abstract
PET with 18F-FDG has been increasingly applied, predominantly in the research setting, to study drug effects and pulmonary biology and to monitor disease progression and treatment outcomes in lung diseases that interfere with gas exchange through alterations of the pulmonary parenchyma, airways, or vasculature. To date, however, there are no widely accepted standard acquisition protocols or imaging data analysis methods for pulmonary 18F-FDG PET/CT in these diseases, resulting in disparate approaches. Hence, comparison of data across the literature is challenging. To help harmonize the acquisition and analysis and promote reproducibility, we collated details of acquisition protocols and analysis methods from 7 PET centers. From this information and our discussions, we reached the consensus recommendations given here on patient preparation, choice of dynamic versus static imaging, image reconstruction, and image analysis reporting.
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Affiliation(s)
- Delphine L Chen
- Department of Radiology, University of Washington, Seattle Cancer Care Alliance, Seattle, Washington
| | - Safia Ballout
- School of Physics and Astronomy, University of Leeds, Leeds, United Kingdom
| | - Laigao Chen
- Worldwide Research, Development, and Medical, Pfizer Inc., Cambridge, Massachusetts
| | - Joseph Cheriyan
- Cambridge University Hospitals, NHS Foundation Trust, Cambridge, United Kingdom.,Department of Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Gourab Choudhury
- Edinburgh Imaging, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
| | | | - Elise Emond
- Institute of Nuclear Medicine, University College London, London, United Kingdom
| | - Kjell Erlandsson
- Institute of Nuclear Medicine, University College London, London, United Kingdom
| | - Marie Fisk
- Department of Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Francesco Fraioli
- Institute of Nuclear Medicine, University College London, London, United Kingdom
| | - Ashley M Groves
- Institute of Nuclear Medicine, University College London, London, United Kingdom
| | - Roger N Gunn
- inviCRO, London, United Kingdom.,Department of Medicine, Imperial College London, London, United Kingdom
| | - Jun Hatazawa
- Department of Nuclear Medicine and Tracer Kinetics, Osaka University, Osaka, Japan
| | - Beverley F Holman
- Nuclear Medicine Department, Royal Free Hospital, London, United Kingdom
| | - Brian F Hutton
- Institute of Nuclear Medicine, University College London, London, United Kingdom
| | - Hidehiro Iida
- Faculty of Biomedicine and Turku PET Center, University of Turku, Turku, Finland
| | - Sarah Lee
- Amallis Consulting Ltd., London, United Kingdom
| | - William MacNee
- Edinburgh Imaging, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Keiko Matsunaga
- Department of Nuclear Medicine and Tracer Kinetics, Osaka University, Osaka, Japan
| | - Divya Mohan
- Medical Innovation, Value Evidence, and Outcomes, GlaxoSmithKline R&D, Collegeville, Pennsylvania
| | - David Parr
- University Hospitals Coventry and Warwickshire, Coventry, United Kingdom
| | - Alaleh Rashidnasab
- Institute of Nuclear Medicine, University College London, London, United Kingdom
| | - Gaia Rizzo
- inviCRO, London, United Kingdom.,Department of Medicine, Imperial College London, London, United Kingdom
| | | | - Ruth Tal-Singer
- Medical Innovation, Value Evidence, and Outcomes, GlaxoSmithKline R&D, Collegeville, Pennsylvania
| | - Kris Thielemans
- Institute of Nuclear Medicine, University College London, London, United Kingdom
| | - Nicola Tregay
- Department of Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Edwin J R van Beek
- Edinburgh Imaging, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Laurence Vass
- Department of Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Marcos F Vidal Melo
- Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Jeremy W Wellen
- Research and Early Development, Celgene, Cambridge, Massachusetts; and
| | - Ian Wilkinson
- Cambridge University Hospitals, NHS Foundation Trust, Cambridge, United Kingdom.,Department of Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Frederick J Wilson
- Clinical Imaging, Clinical Pharmacology, and Experimental Medicine, GlaxoSmithKline, Stevenage, United Kingdom
| | - Tilo Winkler
- Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
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13
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Chauvin M, Borys D, Botta F, Bzowski P, Dabin J, Denis-Bacelar AM, Desbrée A, Falzone N, Lee BQ, Mairani A, Malaroda A, Mathieu G, McKay E, Mora-Ramirez E, Robinson AP, Sarrut D, Struelens L, Gil AV, Bardiès M. OpenDose: Open-Access Resource for Nuclear Medicine Dosimetry. J Nucl Med 2020; 61:1514-1519. [PMID: 32169912 DOI: 10.2967/jnumed.119.240366] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 02/26/2020] [Indexed: 11/16/2022] Open
Abstract
Radiopharmaceutical dosimetry depends on the localization in space and time of radioactive sources and requires the estimation of the amount of energy emitted by the sources deposited within targets. In particular, when computing resources are not accessible, this task can be performed using precomputed tables of specific absorbed fractions (SAFs) or S values based on dosimetric models. The aim of the OpenDose collaboration is to generate and make freely available a range of dosimetric data and tools. Methods: OpenDose brings together resources and expertise from 18 international teams to produce and compare traceable dosimetric data using 6 of the most popular Monte Carlo codes in radiation transport (EGSnrc/EGS++, FLUKA, GATE, Geant4, MCNP/MCNPX, and PENELOPE). SAFs are uploaded, together with their associated statistical uncertainties, in a relational database. S values are then calculated from monoenergetic SAFs on the basis of the radioisotope decay data presented in International Commission on Radiological Protection Publication 107. Results: The OpenDose collaboration produced SAFs for all source region and target combinations of the 2 International Commission on Radiological Protection Publication 110 adult reference models. SAFs computed from the different Monte Carlo codes were in good agreement at all energies, with SDs below individual statistical uncertainties. Calculated S values were in good agreement with OLINDA/EXM 2.0 (commercial) and IDAC-Dose 2.1 (free) software. A dedicated website (www.opendose.org) has been developed to provide easy and open access to all data. Conclusion: The OpenDose website allows the display and downloading of SAFs and the corresponding S values for 1,252 radionuclides. The OpenDose collaboration, open to new research teams, will extend data production to other dosimetric models and implement new free features, such as online dosimetric tools and patient-specific absorbed dose calculation software, together with educational resources.
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Affiliation(s)
- Maxime Chauvin
- CRCT, UMR 1037, Inserm, Université Toulouse III Paul Sabatier, Toulouse, France
| | - Damian Borys
- Department of Systems Biology and Engineering, Silesian University of Technology, Gliwice, Poland
| | - Francesca Botta
- Medical Physics Unit, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Pawel Bzowski
- Department of Systems Biology and Engineering, Silesian University of Technology, Gliwice, Poland
| | - Jérémie Dabin
- SCK-CEN, Belgian Nuclear Research Centre, Mol, Belgium
| | | | - Aurélie Desbrée
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), Fontenay-aux-Roses, France
| | - Nadia Falzone
- MRC Oxford Institute for Radiation Oncology, University of Oxford, Oxford, United, Kingdom.,GenesisCare, Sydney, New South Wales, Australia
| | - Boon Quan Lee
- MRC Oxford Institute for Radiation Oncology, University of Oxford, Oxford, United, Kingdom.,GenesisCare, Sydney, New South Wales, Australia
| | - Andrea Mairani
- Heidelberg Ion-Beam Therapy Center (HIT), Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany.,Medical Physics, National Centre of Oncological Hadrontherapy (CNAO), Pavia, Italy
| | - Alessandra Malaroda
- School of Physics and CMRP, University of Wollongong, Wollongong, New South Wales, Australia.,Theranostic and Nuclear Medicine Department, St. Vincent's Public Hospital, Sydney, New South Wales, Australia
| | - Gilles Mathieu
- Département du Système d'Information, Inserm, Paris, France
| | - Erin McKay
- St. George Hospital, Sydney, New South Wales, Australia
| | - Erick Mora-Ramirez
- CRCT, UMR 1037, Inserm, Université Toulouse III Paul Sabatier, Toulouse, France.,CICANUM, Escuela de Física, Universidad de Costa Rica, San Jose, Costa Rica
| | - Andrew P Robinson
- National Physical Laboratory, Teddington, United Kingdom.,Schuster Laboratory, School of Physics and Astronomy, University of Manchester, Manchester, United Kingdom; and.,The Christie NHS Foundation Trust, Manchester, United Kingdom
| | | | | | - Alex Vergara Gil
- CRCT, UMR 1037, Inserm, Université Toulouse III Paul Sabatier, Toulouse, France
| | - Manuel Bardiès
- CRCT, UMR 1037, Inserm, Université Toulouse III Paul Sabatier, Toulouse, France
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14
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Denis-Bacelar AM, Chittenden SJ, McCready VR, Divoli A, Dearnaley DP, O’Sullivan JM, Johnson B, Flux GD. Bone lesion absorbed dose profiles in patients with metastatic prostate cancer treated with molecular radiotherapy. Br J Radiol 2018; 91:20170795. [PMID: 29293372 PMCID: PMC5966004 DOI: 10.1259/bjr.20170795] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 12/06/2017] [Accepted: 12/21/2017] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE The aim of this study was to calculate the range of absorbed doses that could potentially be delivered by a variety of radiopharmaceuticals and typical fixed administered activities used for bone pain palliation in a cohort of patients with metastatic castration-resistant prostate cancer (mCRPC). The methodology for the extrapolation of the biodistribution, pharmacokinetics and absorbed doses from a given to an alternative radiopharmaceutical is presented. METHODS Sequential single photon emission CT images from 22 patients treated with 5 GBq of 186Re-HEDP were used to extrapolate the time-activity curves for various radiopharmaceuticals. Cumulated activity distributions for the delivered and extrapolated treatment plans were converted into absorbed dose distributions using the convolution dosimetry method. The lesion absorbed doses obtained for the different treatments were compared using the patient population distributions and cumulative dose-volume histograms. RESULTS The median lesion absorbed doses across the patient cohort ranged from 2.7 Gy (range: 0.6-11.8 Gy) for 1100 MBq of 166Ho-DOTMP to 21.8 Gy (range: 4.5-117.6 Gy) for 150 MBq of 89Sr-dichloride. 32P-Na3PO4, 153Sm-EDTMP, 166Ho-DOTMP, 177Lu-EDTMP and 188Re-HEDP would have delivered 41, 32, 85, 20 and 64% lower absorbed doses, for the typical administered activities as compared to 186Re-HEDP, respectively, whilst 89Sr-dichloride would have delivered 25% higher absorbed doses. CONCLUSION For the patient cohort studied, a wide range of absorbed doses would have been delivered for typical administration protocols in mCRPC. The methodology presented has potential use for emerging theragnostic agents. Advances in knowledge: The same patient cohort can receive a range of lesion absorbed doses from typical molecular radiotherapy treatments for patients with metastatic prostate cancer, highlighting the need to establish absorbed dose response relationships and to treat patients according to absorbed dose instead of using fixed administered activities.
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Affiliation(s)
| | - Sarah J Chittenden
- Joint Department of Physics, The Institute of Cancer Research and The Royal Marsden Hospital NHS Foundation Trust, London, UK
| | - V Ralph McCready
- Department of Nuclear Medicine, Royal Sussex County Hospital, Brighton, UK
| | - Antigoni Divoli
- Joint Department of Physics, The Institute of Cancer Research and The Royal Marsden Hospital NHS Foundation Trust, London, UK
| | - David P Dearnaley
- Division of Radiotherapy and Imaging, The Institute of Cancer Research and The Royal Marsden Hospital NHS Foundation Trust, London, UK
| | - Joe M O’Sullivan
- Centre for Cancer Research and Cell Biology, Queen’s University Belfast, Belfast, UK
| | - Bernadette Johnson
- Division of Radiotherapy and Imaging, The Institute of Cancer Research and The Royal Marsden Hospital NHS Foundation Trust, London, UK
| | - Glenn D Flux
- Joint Department of Physics, The Institute of Cancer Research and The Royal Marsden Hospital NHS Foundation Trust, London, UK
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15
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Denis-Bacelar AM, Chittenden SJ, Dearnaley DP, Divoli A, O'Sullivan JM, McCready VR, Johnson B, Du Y, Flux GD. Reply to 'Single high dose versus repeated bone-targeted radionuclide therapy'. Eur J Nucl Med Mol Imaging 2018; 45:515-517. [PMID: 29247283 DOI: 10.1007/s00259-017-3902-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Ana M Denis-Bacelar
- Chemical, Medical and Environmental Science Department, National Physical Laboratory, Hampton Road, Teddington, TW11 0LW, UK.
- Joint Department of Physics, The Institute of Cancer Research and The Royal Marsden Hospital NHS Foundation Trust, London, SM2 5NG, UK.
| | - Sarah J Chittenden
- Joint Department of Physics, The Institute of Cancer Research and The Royal Marsden Hospital NHS Foundation Trust, London, SM2 5NG, UK
| | - David P Dearnaley
- Division of Radiotherapy and Imaging, The Institute of Cancer Research and The Royal Marsden Hospital NHS Foundation Trust, London, SM2 5NG, UK
| | - Antigoni Divoli
- Joint Department of Physics, The Institute of Cancer Research and The Royal Marsden Hospital NHS Foundation Trust, London, SM2 5NG, UK
| | - Joe M O'Sullivan
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, Belfast, BT7 1NN, UK
| | - V Ralph McCready
- Department of Nuclear Medicine, Brighton and Sussex University Hospitals NHS Trust, Brighton, BN2 5BE, UK
| | - Bernadette Johnson
- Division of Radiotherapy and Imaging, The Institute of Cancer Research and The Royal Marsden Hospital NHS Foundation Trust, London, SM2 5NG, UK
| | - Yong Du
- Department of Nuclear Medicine and PET/CT, The Royal Marsden NHS Foundation Trust, London, SM2 5PT, UK
| | - Glenn D Flux
- Joint Department of Physics, The Institute of Cancer Research and The Royal Marsden Hospital NHS Foundation Trust, London, SM2 5NG, UK
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16
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Fenwick AJ, Wevrett JL, Ferreira KM, Denis-Bacelar AM, Robinson AP. Quantitative imaging, dosimetry and metrology; Where do National Metrology Institutes fit in? Appl Radiat Isot 2017; 134:74-78. [PMID: 29158037 DOI: 10.1016/j.apradiso.2017.11.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 11/09/2017] [Accepted: 11/10/2017] [Indexed: 12/17/2022]
Abstract
In External Beam Radiotherapy, National Metrology Institutes (NMIs) play a critical role in the delivery of accurate absorbed doses to patients undergoing treatment. In contrast for nuclear medicine the role of the NMI is less clear and although significant work has been done in order to establish links for activity measurement, the calculation of administered absorbed doses is not traceable in the same manner as EBRT. Over recent decades the use of novel radiolabelled pharmaceuticals has increased dramatically. The limitation of secondary complications due to radiation damage to non-target tissue has historically been achieved by the use of activity escalation studies during clinical trials and this in turn has led to a chronic under dosing of the majority of patients. This paper looks to address the difficulties in combining clinical everyday practice with the grand challenges laid out by national metrology institutes to improve measurement capability in all walks of life. In the life sciences it can often be difficult to find the correct balance between pure research and practical solutions to measurement problems, and this paper is a discussion regarding these difficulties and how some NMIs have chosen to tackle these issues. The necessity of establishing strong links to underlying standards in the field of quantitative nuclear medicine imaging is highlighted. The difficulties and successes of current methods for providing traceability in nuclear medicine are discussed.
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Affiliation(s)
- A J Fenwick
- National Physical Laboratory, Hampton Road, Teddington, UK; Cardiff University, Cardiff, UK.
| | - J L Wevrett
- National Physical Laboratory, Hampton Road, Teddington, UK; University of Surrey, Guildford, UK; Royal Surrey County Hospital, Guildford, UK
| | - K M Ferreira
- National Physical Laboratory, Hampton Road, Teddington, UK
| | | | - A P Robinson
- National Physical Laboratory, Hampton Road, Teddington, UK; The University of Manchester, Manchester, UK; The Christie NHS Foundation Trust, Manchester, UK
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Murray I, Chittenden SJ, Denis-Bacelar AM, Hindorf C, Parker CC, Chua S, Flux GD. The potential of 223Ra and 18F-fluoride imaging to predict bone lesion response to treatment with 223Ra-dichloride in castration-resistant prostate cancer. Eur J Nucl Med Mol Imaging 2017; 44:1832-1844. [PMID: 28612079 PMCID: PMC6175045 DOI: 10.1007/s00259-017-3744-y] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 05/25/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE The aims of this study were to calculate bone lesion absorbed doses resulting from a weight-based administration of 223Ra-dichloride, to assess the relationship between those doses and corresponding 18F-fluoride uptake and to assess the potential of quantitative 18F-fluoride imaging to predict response to treatment. METHODS Five patients received two intravenous injections of 223Ra-dichloride, 6 weeks apart, at 110 kBq/kg whole-body weight. The biodistribution of 223Ra in metastatic lesions as a function of time after administration as well as associated lesion dosimetry were determined from serial 223Ra scans. PET/CT imaging using 18F-fluoride was performed prior to the first treatment (baseline), and at week 6 immediately before the second treatment and at week 12 after baseline. RESULTS Absorbed doses to metastatic bone lesions ranged from 0.6 Gy to 44.1 Gy. For individual patients, there was an average factor difference of 5.3 (range 2.5-11.0) between the maximum and minimum lesion dose. A relationship between lesion-absorbed doses and serial changes in 18F-fluoride uptake was demonstrated (r2 = 0.52). A log-linear relationship was demonstrated (r2 = 0.77) between baseline measurements of 18F-fluoride uptake prior to 223Ra-dichloride therapy and changes in uptake 12 weeks after the first cycle of therapy. Correlations were also observed between both 223Ra and 18F-fluoride uptake in lesions (r = 0.75) as well as between 223Ra absorbed dose and 18F-fluoride uptake (r = 0.96). CONCLUSIONS There is both inter-patient and intra-patient heterogeneity of absorbed dose estimates to metastatic lesions. A relationship between 223Ra lesion absorbed dose and subsequent lesion response was observed. Analysis of this small group of patients suggests that baseline uptake of 18F-fluoride in bone metastases is significantly correlated with corresponding uptake of 223Ra, the associated 223Ra absorbed dose and subsequent lesion response to treatment.
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Affiliation(s)
- Iain Murray
- Joint Department of Physics, Royal Marsden NHS Foundation Trust, Downs Rd., Sutton, Surrey, SM2 5PT, UK.
- The Institute of Cancer Research, London, UK.
| | - Sarah J Chittenden
- Joint Department of Physics, Royal Marsden NHS Foundation Trust, Downs Rd., Sutton, Surrey, SM2 5PT, UK
- The Institute of Cancer Research, London, UK
| | - Ana M Denis-Bacelar
- Joint Department of Physics, Royal Marsden NHS Foundation Trust, Downs Rd., Sutton, Surrey, SM2 5PT, UK
- The Institute of Cancer Research, London, UK
| | - Cecilia Hindorf
- Joint Department of Physics, Royal Marsden NHS Foundation Trust, Downs Rd., Sutton, Surrey, SM2 5PT, UK
- The Institute of Cancer Research, London, UK
- Department of Radiation Physics, Skåne University Hospital, Lund, Sweden
| | | | - Sue Chua
- Department of Nuclear Medicine, Royal Marsden NHS Foundation Trust, Sutton, UK
| | - Glenn D Flux
- Joint Department of Physics, Royal Marsden NHS Foundation Trust, Downs Rd., Sutton, Surrey, SM2 5PT, UK
- The Institute of Cancer Research, London, UK
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Chauvin M, Borys D, Botta F, Bzowski P, Coca Pérez MA, Cremonesi M, Dabin J, Denis-Bacelar AM, Desbrée A, Bitar ZE, Falzone N, Ferrer L, Franck D, Lanconelli N, Mairani A, Malaroda A, Matusik K, McKay E, Pacilio M, Pieter J, Robinson AP, Rodríguez JL, Struelens L, Torres Aroches LA, Gil AV, Bardiès M. Abstract ID: 155 OpenDose: A collaborative effort to produce reference dosimetric data with Monte Carlo simulation software. Phys Med 2017. [DOI: 10.1016/j.ejmp.2017.09.081] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Denis-Bacelar AM, Chittenden SJ, Murray I, Divoli A, Ralph McCready V, Dearnaley DP, O’Sullivan JM, Johnson B, Flux GD. A radiobiological model of metastatic burden reduction for molecular radiotherapy: application to patients with bone metastases. Phys Med Biol 2017; 62:2859-2870. [PMID: 28291739 PMCID: PMC5953197 DOI: 10.1088/1361-6560/aa5e6f] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Revised: 01/05/2017] [Accepted: 02/06/2017] [Indexed: 12/26/2022]
Abstract
Skeletal tumour burden is a biomarker of prognosis and survival in cancer patients. This study proposes a novel method based on the linear quadratic model to predict the reduction in metastatic tumour burden as a function of the absorbed doses delivered from molecular radiotherapy treatments. The range of absorbed doses necessary to eradicate all the bone lesions and to reduce the metastatic burden was investigated in a cohort of 22 patients with bone metastases from castration-resistant prostate cancer. A metastatic burden reduction curve was generated for each patient, which predicts the reduction in metastatic burden as a function of the patient mean absorbed dose, defined as the mean of all the lesion absorbed doses in any given patient. In the patient cohort studied, the median of the patient mean absorbed dose predicted to reduce the metastatic burden by 50% was 89 Gy (interquartile range: 83-105 Gy), whilst a median of 183 Gy (interquartile range: 107-247 Gy) was found necessary to eradicate all metastases in a given patient. The absorbed dose required to eradicate all the lesions was strongly correlated with the variability of the absorbed doses delivered to multiple lesions in a given patient (r = 0.98, P < 0.0001). The metastatic burden reduction curves showed a potential large reduction in metastatic burden for a small increase in absorbed dose in 91% of patients. The results indicate the range of absorbed doses required to potentially obtain a significant survival benefit. The metastatic burden reduction method provides a simple tool that could be used in routine clinical practice for patient selection and to indicate the required administered activity to achieve a predicted patient mean absorbed dose and reduction in metastatic tumour burden.
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Affiliation(s)
- Ana M Denis-Bacelar
- Joint Department of Physics, The Institute of Cancer Research and The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom
| | - Sarah J Chittenden
- Joint Department of Physics, The Institute of Cancer Research and The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom
| | - Iain Murray
- Joint Department of Physics, The Institute of Cancer Research and The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom
| | - Antigoni Divoli
- Joint Department of Physics, The Institute of Cancer Research and The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom
| | - V Ralph McCready
- Department of Nuclear Medicine, Brighton and Sussex University Hospitals NHS Trust, Brighton, United Kingdom
| | - David P Dearnaley
- Division of Radiotherapy and Imaging, The Institute of Cancer Research and The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom
| | - Joe M O’Sullivan
- Centre for Cancer Research and Cell Biology, Queen’s University Belfast, Belfast, United Kingdom
| | - Bernadette Johnson
- Division of Radiotherapy and Imaging, The Institute of Cancer Research and The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom
| | - Glenn D Flux
- Joint Department of Physics, The Institute of Cancer Research and The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom
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20
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Denis-Bacelar AM, Chittenden SJ, Dearnaley DP, Divoli A, O'Sullivan JM, McCready VR, Johnson B, Du Y, Flux GD. Phase I/II trials of 186Re-HEDP in metastatic castration-resistant prostate cancer: post-hoc analysis of the impact of administered activity and dosimetry on survival. Eur J Nucl Med Mol Imaging 2017; 44:620-629. [PMID: 27770145 PMCID: PMC5323472 DOI: 10.1007/s00259-016-3543-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Accepted: 09/30/2016] [Indexed: 12/13/2022]
Abstract
PURPOSE To investigate the role of patient-specific dosimetry as a predictive marker of survival and as a potential tool for individualised molecular radiotherapy treatment planning of bone metastases from castration-resistant prostate cancer, and to assess whether higher administered levels of activity are associated with a survival benefit. METHODS Clinical data from 57 patients who received 2.5-5.1 GBq of 186Re-HEDP as part of NIH-funded phase I/II clinical trials were analysed. Whole-body and SPECT-based absorbed doses to the whole body and bone lesions were calculated for 22 patients receiving 5 GBq. The patient mean absorbed dose was defined as the mean of all bone lesion-absorbed doses in any given patient. Kaplan-Meier curves, log-rank tests, Cox's proportional hazards model and Pearson's correlation coefficients were used for overall survival (OS) and correlation analyses. RESULTS A statistically significantly longer OS was associated with administered activities above 3.5 GBq in the 57 patients (20.1 vs 7.1 months, hazard ratio: 0.39, 95 % CI: 0.10-0.58, P = 0.002). A total of 379 bone lesions were identified in 22 patients. The mean of the patient mean absorbed dose was 19 (±6) Gy and the mean of the whole-body absorbed dose was 0.33 (±0.11) Gy for the 22 patients. The patient mean absorbed dose (r = 0.65, P = 0.001) and the whole-body absorbed dose (r = 0.63, P = 0.002) showed a positive correlation with disease volume. Significant differences in OS were observed for the univariate group analyses according to disease volume as measured from SPECT imaging of 186Re-HEDP (P = 0.03) and patient mean absorbed dose (P = 0.01), whilst only the disease volume remained significant in a multivariable analysis (P = 0.004). CONCLUSION This study demonstrated that higher administered activities led to prolonged survival and that for a fixed administered activity, the whole-body and patient mean absorbed doses correlated with the extent of disease, which, in turn, correlated with survival. This study shows the importance of patient stratification to establish absorbed dose-response correlations and indicates the potential to individualise treatment of bone metastases with radiopharmaceuticals according to patient-specific imaging and dosimetry.
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Affiliation(s)
- Ana M Denis-Bacelar
- Joint Department of Physics, The Institute of Cancer Research and The Royal Marsden Hospital NHS Foundation Trust, London, UK.
| | - Sarah J Chittenden
- Joint Department of Physics, The Institute of Cancer Research and The Royal Marsden Hospital NHS Foundation Trust, London, UK
| | - David P Dearnaley
- Division of Radiotherapy and Imaging, The Institute of Cancer Research and The Royal Marsden Hospital NHS Foundation Trust, London, UK
| | - Antigoni Divoli
- Joint Department of Physics, The Institute of Cancer Research and The Royal Marsden Hospital NHS Foundation Trust, London, UK
| | - Joe M O'Sullivan
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, Belfast, UK
| | - V Ralph McCready
- Department of Nuclear Medicine, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
| | - Bernadette Johnson
- Division of Radiotherapy and Imaging, The Institute of Cancer Research and The Royal Marsden Hospital NHS Foundation Trust, London, UK
| | - Yong Du
- Department of Nuclear Medicine and PET/CT, The Royal Marsden Hospital NHS Foundation Trust, London, UK
| | - Glenn D Flux
- Joint Department of Physics, The Institute of Cancer Research and The Royal Marsden Hospital NHS Foundation Trust, London, UK
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Denis-Bacelar AM, Cronin SE, Da Pieve C, Paul RL, Eccles SA, Spinks TJ, Box C, Hall A, Sosabowski JK, Kramer-Marek G, Flux GD. Pre-clinical quantitative imaging and mouse-specific dosimetry for 111In-labelled radiotracers. EJNMMI Res 2016; 6:85. [PMID: 27885618 PMCID: PMC5122527 DOI: 10.1186/s13550-016-0238-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Accepted: 11/14/2016] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Accurate quantification in molecular imaging is essential to improve the assessment of novel drugs and compare the radiobiological effects of therapeutic agents prior to in-human studies. The aim of this study was to investigate the challenges and feasibility of pre-clinical quantitative imaging and mouse-specific dosimetry of 111In-labelled radiotracers. Attenuation, scatter and partial volume effects were studied using phantom experiments, and an activity calibration curve was obtained for varying sphere sizes. Six SK-OV-3-tumour bearing mice were injected with 111In-labelled HER2-targeting monoclonal antibodies (mAbs) (range 5.58-8.52 MBq). Sequential SPECT imaging up to 197 h post-injection was performed using the Albira SPECT/PET/CT pre-clinical scanner. Mice were culled for quantitative analysis of biodistribution studies. The tumour activity, mass and percentage of injected activity per gram of tissue (%IA/g) were calculated at the final scan time point and compared to the values determined from the biodistribution data. Delivered 111In-labelled mAbs tumour absorbed doses were calculated using mouse-specific convolution dosimetry, and absorbed doses for 90Y-labelled mAbs were extrapolated under the assumptions of equivalent injected activities, biological half-lives and uptake distributions as for 111In. RESULTS For the sphere sizes investigated (volume 0.03-1.17 ml), the calibration factor varied by a factor of 3.7, whilst for the range of tumour masses in the mice (41-232 mg), the calibration factor changed by a factor of 2.5. Comparisons between the mice imaging and the biodistribution results showed a statistically significant correlation for the tumour activity (r = 0.999, P < 0.0001) and the tumour mass calculations (r = 0.977, P = 0.0008), whilst no correlation was found for the %IA/g (r = 0.521, P = 0.29). Median tumour-absorbed doses per injected activity of 52 cGy/MBq (range 36-69 cGy/MBq) and 649 cGy/MBq (range 441-950 cGy/MBq) were delivered by 111In-labelled mAbs and extrapolated for 90Y-labelled mAbs, respectively. CONCLUSIONS This study demonstrates the need for multidisciplinary efforts to standardise imaging and dosimetry protocols in pre-clinical imaging. Accurate image quantification can improve the calculation of the activity, %IA/g and absorbed dose. Diagnostic imaging could be used to estimate the injected activities required for therapeutic studies, potentially reducing the number of animals used.
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Affiliation(s)
- Ana M Denis-Bacelar
- Joint Department of Physics, The Institute of Cancer Research and The Royal Marsden Hospital NHS Foundation Trust, London, SM2 5NG, United Kingdom.
| | - Sarah E Cronin
- Joint Department of Physics, The Institute of Cancer Research and The Royal Marsden Hospital NHS Foundation Trust, London, SM2 5NG, United Kingdom
| | - Chiara Da Pieve
- Joint Department of Physics, The Institute of Cancer Research and The Royal Marsden Hospital NHS Foundation Trust, London, SM2 5NG, United Kingdom
| | - Rowena L Paul
- Joint Department of Physics, The Institute of Cancer Research and The Royal Marsden Hospital NHS Foundation Trust, London, SM2 5NG, United Kingdom
| | - Sue A Eccles
- Division of Cancer Therapeutics, The Institute of Cancer Research, London, SM2 5NG, United Kingdom
| | - Terence J Spinks
- Joint Department of Physics, The Institute of Cancer Research and The Royal Marsden Hospital NHS Foundation Trust, London, SM2 5NG, United Kingdom
| | - Carol Box
- Division of Cancer Therapeutics, The Institute of Cancer Research, London, SM2 5NG, United Kingdom
| | - Adrian Hall
- Radiopharmacy Department, The Royal Marsden Hospital NHS Foundation Trust, London, SM2 5PT, United Kingdom
| | - Jane K Sosabowski
- Centre for Molecular Oncology, Barts Cancer Institute, Queen Mary University of London, London, EC1M 6BQ, United Kingdom
| | - Gabriela Kramer-Marek
- Division of Cancer Therapeutics, The Institute of Cancer Research, London, SM2 5NG, United Kingdom
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, SM2 5NG, United Kingdom
| | - Glenn D Flux
- Joint Department of Physics, The Institute of Cancer Research and The Royal Marsden Hospital NHS Foundation Trust, London, SM2 5NG, United Kingdom
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George SL, Falzone N, Chittenden S, Kirk SJ, Lancaster D, Vaidya SJ, Mandeville H, Saran F, Pearson AD, Du Y, Meller ST, Denis-Bacelar AM, Flux GD. Individualized 131I-mIBG therapy in the management of refractory and relapsed neuroblastoma. Nucl Med Commun 2016; 37:466-72. [PMID: 26813989 PMCID: PMC4819901 DOI: 10.1097/mnm.0000000000000470] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Revised: 11/18/2015] [Accepted: 12/07/2015] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Iodine-131-labelled meta-iodobenzylguanidine (I-mIBG) therapy is an established treatment modality for relapsed/refractory neuroblastoma, most frequently administered according to fixed or weight-based criteria. We evaluate response and toxicity following a dosimetry-based, individualized approach. MATERIALS AND METHODS A review of 44 treatments in 25 patients treated with I-mIBG therapy was performed. Patients received I-mIBG therapy following relapse (n=9), in refractory disease (n=12), or with surgically unresectable disease despite conventional treatment (n=4). Treatment schedule (including mIBG dose and number of administrations) was individualized according to the clinical status of the patient and dosimetry data from either a tracer study or previous administrations. Three-dimensional tumour dosimetry was also performed for eight patients. RESULTS The mean administered activity was 11089±7222 MBq and the mean whole-body dose for a single administration was 1.79±0.57 Gy. Tumour-absorbed doses varied considerably (3.70±3.37 mGy/MBq). CTCAE grade 3/4 neutropenia was documented following 82% treatments and grade 3/4 thrombocytopenia following 71% treatments. Further acute toxicity was found in 49% of patients. All acute toxicities resolved with appropriate therapy. The overall response rate was 58% (complete or partial response), with a further 29% of patients having stable disease. CONCLUSION A highly personalized approach combining patient-specific dosimetry and clinical judgement enables delivery of high activities that can be tolerated by patients, particularly with stem cell support. We report excellent response rates and acceptable toxicity following individualized I-mIBG therapy.
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Affiliation(s)
| | - Nadia Falzone
- Joint Department of Physics, Institute of Cancer Research, Royal Marsden NHS Foundation Trust
| | - Sarah Chittenden
- Joint Department of Physics, Institute of Cancer Research, Royal Marsden NHS Foundation Trust
| | | | | | | | | | - Frank Saran
- Joint Department of Physics, Institute of Cancer Research, Royal Marsden NHS Foundation Trust
| | | | - Yong Du
- Department of Nuclear Medicine, The Royal Marsden Hospital, Surrey, UK
| | | | - Ana M. Denis-Bacelar
- Joint Department of Physics, Institute of Cancer Research, Royal Marsden NHS Foundation Trust
| | - Glenn D. Flux
- Joint Department of Physics, Institute of Cancer Research, Royal Marsden NHS Foundation Trust
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Denis-Bacelar AM, Romanchikova M, Chittenden S, Saran FH, Mandeville H, Du Y, Flux GD. Patient-specific dosimetry for intracavitary 32P-chromic phosphate colloid therapy of cystic brain tumours. Eur J Nucl Med Mol Imaging 2013; 40:1532-41. [PMID: 23740370 DOI: 10.1007/s00259-013-2451-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2013] [Accepted: 04/30/2013] [Indexed: 10/26/2022]
Abstract
PURPOSE (32)P-chromic phosphate colloid treatments of astrocytoma and craniopharyngioma cystic brain tumours in paediatric patients are conventionally based on a sphere model under the assumption of uniform uptake. The aims of this study were to determine the distribution of the absorbed dose delivered by (32)P on a patient-specific basis and to evaluate the accuracy with which this can be predicted from a pretherapy administration of (99m)Tc-Sn colloid. METHODS Three patients were treated with (32)P-chromic phosphate colloid following (99m)Tc-Sn colloid administrations. Convolution dosimetry was performed using pretherapy and posttherapy sequential SPECT imaging, and verified with EGSnrc Monte Carlo radiation transport simulations. Mean absorbed doses to the cyst wall and dose-volume histograms were also calculated and compared with those obtained by the sphere model approach. RESULTS Highly nonuniform uptake distributions of both the (99m)Tc and (32)P colloids were observed and characterized by dose-volume histograms to the cyst wall. Mean absorbed doses delivered to the cyst wall, obtained with the convolution method, were on average 21 % (SD 18 %) and 50 % (SD 30 %) lower than those predicted by the (99m)Tc distribution and the uniform assumption of the sphere model, respectively. CONCLUSION Absorbed doses delivered to the cyst wall by (32)P are more accurately predicted from image-based patient-specific convolution dosimetry than from simple sphere models. These results indicate the necessity to perform personalized treatment planning and verification for intracavitary irradiation of cystic brain tumours treated with radiocolloids. Patient-specific dosimetry can be used to guide the frequency and levels of repeated administrations and would facilitate data collection and comparison to support the multicentre trials necessary to progress this therapy.
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Affiliation(s)
- Ana M Denis-Bacelar
- Joint Department of Physics, Institute of Cancer Research, Sutton, London, SM2 5NG, UK,
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