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Effectiveness of Data-Driven Gating FDG PET/CT for Abdominal Region. 数据驱动门控FDG PET/CT对腹部区域的有效性。
IF 1 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-03-05 DOI: 10.2967/jnmt.124.268350
Ryoma Ito, Kazuki Motegi, Kosuke Yamashita, Noriaki Miyaji, Mitsutomi Ishiyama, Naoki Shimada, Shohei Fukai, Takashi Terauchi

This study aimed to validate the effectiveness of MotionFree (MF) in the abdominal region using 2 different PET/CT scanners to determine how to use MF efficiently. Methods: All 198 patients underwent respiratory-gated 18F-FDG PET/CT with MF. Imaging was performed using Discovery MI (DMI) and Discovery IQ (DIQ) PET/CT scanners, and all data were divided into 2 groups in each category (abdominal: upper and lower abdomen, lesion size, <20 mm and ≥20 mm; scanner group: DMI and DIQ). A physician assessed whether the respiratory motion artifacts were reduced with MF. The SUV change rate (ΔSUV) of 80 measurable lesions with and without MF was calculated. The relationship between the ΔSUVs and these groups was compared. Results: Motion artifacts were reduced in 62 of 198 patients (31.3%) in the upper abdomen, in 1 of 198 patients (0.5%) in the lower abdomen, in 51 of 98 patients (52.0%) in the DMI, and in 12 of 100 patients (12.0%) in DIQ with MF. ΔSUVs were significantly higher in the upper abdomen than in the lower abdomen. ΔSUV was up to 58.3% in DMI and up to 47.6% in DIQ. ΔSUVs of lesions with a size of less than 20 mm were significantly higher than those with a lesion size of 20 mm or greater. Although DMI was more effective than DIQ in terms of motion artifacts, both DMI and DIQ have the potential to increase the SUV with MF. MF significantly reduced the respiratory motion artifacts and increased the SUV for lesions smaller than 20 mm in the upper abdomen. Conclusion: MF reduced the motion artifacts in higher-spatial-resolution PET/CT images. In both PET/CT scanners, SUVs in lesions smaller than 20 mm and lesions in the upper abdomen increased significantly with MF. To use MF without increasing the acquisition time, it may be useful to apply it to the upper abdomen.

本研究旨在通过2种不同的PET/CT扫描仪验证MotionFree (MF)在腹部区域的有效性,以确定如何有效地使用MF。方法:198例患者均行呼吸门控18F-FDG PET/CT扫描。使用Discovery MI (DMI)和Discovery IQ (DIQ) PET/CT扫描仪进行成像,所有数据按每个类别分为2组(腹部:上腹和下腹,病变大小)。结果:198例患者中有62例(31.3%)上腹部运动伪影减少,198例患者中有1例(0.5%)下腹部,98例患者中有51例(52.0%)DMI, 100例患者中有12例(12.0%)DIQ合并MF。ΔSUVs上腹部明显高于下腹部。ΔSUV在DMI中高达58.3%,在DIQ中高达47.6%。小于20mm的病变ΔSUVs明显高于大于20mm的病变。虽然DMI在运动伪影方面比DIQ更有效,但DMI和DIQ都有可能增加MF的SUV。对于上腹部小于20mm的病变,MF明显减少呼吸运动伪影,增加SUV。结论:MF降低了高空间分辨率PET/CT图像的运动伪影。在PET/CT扫描中,小于20mm病变和上腹部病变的suv随MF显著增加。为了在不增加采集时间的情况下使用MF,将其应用于上腹部可能是有用的。
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引用次数: 0
[18F]FDG PET/CT in Metastatic Extragonadal Choriocarcinoma. [18F]刘振华。FDG PET/CT在转移性绒毛膜癌中的应用。
IF 1 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-03-05 DOI: 10.2967/jnmt.124.268758
Ralph Emerson P, Sai Sradha Patro, Parneet Singh, Girish Kumar Parida, Kanhaiyalal Agrawal, Saurav Kumar Mishra

Extragonadal choriocarcinoma in men is an extremely rare and highly aggressive malignancy. Inconclusive biopsies due to a high necrotic component often delay diagnosis. Here is such a case, in which suggestive imaging findings on [18F]FDG PET/CT, a raised level of serum β-human chorionic gonadotropin, and gynecomastia clinched the diagnosis.

睾丸外绒毛膜癌是一种极为罕见且高度侵袭性的恶性肿瘤。由于高坏死成分,不确定的活组织检查常常延误诊断。本例中,[18F]FDG PET/CT影像学提示,血清β-人绒毛膜促性腺激素水平升高,以及男性乳房发育确定了诊断。
{"title":"[<sup>18</sup>F]FDG PET/CT in Metastatic Extragonadal Choriocarcinoma.","authors":"Ralph Emerson P, Sai Sradha Patro, Parneet Singh, Girish Kumar Parida, Kanhaiyalal Agrawal, Saurav Kumar Mishra","doi":"10.2967/jnmt.124.268758","DOIUrl":"10.2967/jnmt.124.268758","url":null,"abstract":"<p><p>Extragonadal choriocarcinoma in men is an extremely rare and highly aggressive malignancy. Inconclusive biopsies due to a high necrotic component often delay diagnosis. Here is such a case, in which suggestive imaging findings on [<sup>18</sup>F]FDG PET/CT, a raised level of serum β-human chorionic gonadotropin, and gynecomastia clinched the diagnosis.</p>","PeriodicalId":16548,"journal":{"name":"Journal of nuclear medicine technology","volume":" ","pages":"87-88"},"PeriodicalIF":1.0,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Ventilation Lung Imaging: Technegas.
IF 1 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-03-05 DOI: 10.2967/jnmt.125.269536
Mary Beth Farrell, Kathy S Thomas, Eleanor S Mantel, Jessica Settle
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引用次数: 0
Logistics of Adopting 177Lu-Vipivotide Tetraxetan Therapy in a Community-Based Hospital Setting.
IF 1 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-03-05 DOI: 10.2967/jnmt.124.268039
Kathleen Marsh, Kayla Allickson, Amanda Jesz, Cheryl Hanson, Donna Newman, Erica Martin-Macintosh

Prostate cancer is a leading cause of cancer death in men. Advanced disease may progress to metastatic castration-resistant prostate cancer. In March 2022, 177Lu-vipivotide tetraxetan was U.S. Food and Drug Administration-approved for patients with prostate-specific membrane antigen-positive metastatic castration-resistant prostate cancer who have previously received other therapies, including androgen deprivation and taxane therapies. Methods: Although preliminary data for 177Lu-vipivotide tetraxetan has shown extension of overall survival of patients, there is little literature about realistically initiating 177Lu-vipivotide tetraxetan into non-academic-based clinical practices. Results: This article presents a multidisciplinary practice implementation workflow for 177Lu-vipivotide tetraxetan. It also highlights the challenges and considerations for initiating such a theranostics practice. Conclusion: The aim of this work is to help nontertiary medical centers improve patient accessibility for beneficial radiopharmaceutical therapies, specifically 177Lu-vipivotide tetraxetan.

{"title":"Logistics of Adopting <sup>177</sup>Lu-Vipivotide Tetraxetan Therapy in a Community-Based Hospital Setting.","authors":"Kathleen Marsh, Kayla Allickson, Amanda Jesz, Cheryl Hanson, Donna Newman, Erica Martin-Macintosh","doi":"10.2967/jnmt.124.268039","DOIUrl":"10.2967/jnmt.124.268039","url":null,"abstract":"<p><p>Prostate cancer is a leading cause of cancer death in men. Advanced disease may progress to metastatic castration-resistant prostate cancer. In March 2022, <sup>177</sup>Lu-vipivotide tetraxetan was U.S. Food and Drug Administration-approved for patients with prostate-specific membrane antigen-positive metastatic castration-resistant prostate cancer who have previously received other therapies, including androgen deprivation and taxane therapies. <b>Methods:</b> Although preliminary data for <sup>177</sup>Lu-vipivotide tetraxetan has shown extension of overall survival of patients, there is little literature about realistically initiating <sup>177</sup>Lu-vipivotide tetraxetan into non-academic-based clinical practices. <b>Results:</b> This article presents a multidisciplinary practice implementation workflow for <sup>177</sup>Lu-vipivotide tetraxetan. It also highlights the challenges and considerations for initiating such a theranostics practice. <b>Conclusion:</b> The aim of this work is to help nontertiary medical centers improve patient accessibility for beneficial radiopharmaceutical therapies, specifically <sup>177</sup>Lu-vipivotide tetraxetan.</p>","PeriodicalId":16548,"journal":{"name":"Journal of nuclear medicine technology","volume":" ","pages":"68-71"},"PeriodicalIF":1.0,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Technegas at Last! Implementing Technegas into Clinical Practice in the United States: Considerations, Challenges, and Recommendations.
IF 1 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-03-05 DOI: 10.2967/jnmt.124.269231
Delynn Silvestros, Tina M Buehner

Technegas, 99mTc-labeled aerosolized carbon nanoparticles, has been used internationally since 1986 for pulmonary ventilation imaging. Unlike traditional gases, Technegas exhibits only a gaslike behavior, allowing deep and uniform deposition in the lungs' subsegmental regions. This hydrophobic property minimizes central airway clumping, as is particularly advantageous for patients with chronic obstructive pulmonary disease. Approved by the U.S. Food and Drug Administration in September 2023, Technegas is now available in the United States for diagnosing pulmonary embolism and broader ventilation and airway evaluations. The Technegas Plus system, which produces the radioaerosol onsite by heating [99mTc]sodium pertechnetate in a carbon crucible at ultrahigh temperatures, requires a specific infrastructure, including a 220-volt power supply and an argon gas source. Its rapid administration-often requiring only 1-3 breaths-streamlines workflows while ensuring patient comfort, especially for those with respiratory limitations. Additionally, Technegas supports SPECT and SPECT/CT imaging, enabling sensitivity and specificity superior to those of traditional planar methods. Despite the global adoption of ventilation-perfusion SPECT as the standard for pulmonary embolism diagnosis, its use in the United States remains limited. Now that Technegas is available in the United States, U.S. nuclear medicine departments can transition to advanced ventilation imaging, aligning with international best practices. This paper outlines essential considerations for Technegas implementation: infrastructure requirements, staff training, protocol development, and imaging optimization, including clinical experiences and perspectives from the staff at Barnes Jewish Hospital in St. Louis, Missouri. By integrating Technegas, departments can enhance diagnostic accuracy, improve workflow efficiency, and expand clinical applications, particularly for patients with complex pulmonary conditions.

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引用次数: 0
Assessment of Residual [99mTc]Tc-Tetrofosmin Activity in Routine Nuclear Medicine Practice at Hospital Kuala Lumpur.
IF 1 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-03-05 DOI: 10.2967/jnmt.124.268886
Ren Yi Fong, Nurul Maisara Jaffar, Rachel Jen Lyn Chung, Hui Ling Tong, Syifaa' Aminudin, Kee Wei Lau

Myocardial perfusion imaging using the radiopharmaceutical [99mTc]Tc-tetrofosmin plays a crucial role in diagnosing cardiac conditions. However, variations in the residual activity of [99mTc]Tc-tetrofosmin in plastic syringes after administration may impact imaging quality and patient safety. This study aimed to evaluate the residual activity of [99mTc]Tc-tetrofosmin in plastic syringes after administration during routine nuclear medicine procedures at Hospital Kuala Lumpur, assessing compliance with department protocols and variability among different syringe brands. Methods: A single-center prospective observational study was conducted using stratified quota sampling, encompassing 396 samples across 3 syringe brands (SJ, BD, and Ciringe). Residual activity was measured immediately after administration, and statistical analysis was performed to compare brands and assess compliance with the department dosage protocol range of 333-555 MBq. Results: All injected activities aligned with the department protocol dose, with a mean effective activity of 451.23 ± 30.73 MBq and a mean residual activity of 12.63% ± 4.73%. However, variability in residual activity was observed among syringe brands. BD exhibited the highest mean residual activity (16.45%), significantly differing from SJ (9.95%) and Ciringe (11.50%) (P < 0.001). Conclusion: Rigorous syringe selection is crucial in myocardial perfusion imaging procedures to minimize residual activity and ensure compliance with dosimetry standards, emphasizing the importance of integrating pharmacy practices into nuclear medicine protocols. Standardized protocols and quality assurance measures are essential to optimize imaging outcomes and prioritize patient safety. These findings highlight the importance of ongoing monitoring and interdisciplinary collaboration to navigate residual activity management effectively in routine nuclear medicine practice.

{"title":"Assessment of Residual [<sup>99m</sup>Tc]Tc-Tetrofosmin Activity in Routine Nuclear Medicine Practice at Hospital Kuala Lumpur.","authors":"Ren Yi Fong, Nurul Maisara Jaffar, Rachel Jen Lyn Chung, Hui Ling Tong, Syifaa' Aminudin, Kee Wei Lau","doi":"10.2967/jnmt.124.268886","DOIUrl":"10.2967/jnmt.124.268886","url":null,"abstract":"<p><p>Myocardial perfusion imaging using the radiopharmaceutical [<sup>99m</sup>Tc]Tc-tetrofosmin plays a crucial role in diagnosing cardiac conditions. However, variations in the residual activity of [<sup>99m</sup>Tc]Tc-tetrofosmin in plastic syringes after administration may impact imaging quality and patient safety. This study aimed to evaluate the residual activity of [<sup>99m</sup>Tc]Tc-tetrofosmin in plastic syringes after administration during routine nuclear medicine procedures at Hospital Kuala Lumpur, assessing compliance with department protocols and variability among different syringe brands. <b>Methods:</b> A single-center prospective observational study was conducted using stratified quota sampling, encompassing 396 samples across 3 syringe brands (SJ, BD, and Ciringe). Residual activity was measured immediately after administration, and statistical analysis was performed to compare brands and assess compliance with the department dosage protocol range of 333-555 MBq. <b>Results:</b> All injected activities aligned with the department protocol dose, with a mean effective activity of 451.23 ± 30.73 MBq and a mean residual activity of 12.63% ± 4.73%. However, variability in residual activity was observed among syringe brands. BD exhibited the highest mean residual activity (16.45%), significantly differing from SJ (9.95%) and Ciringe (11.50%) (<i>P</i> < 0.001). <b>Conclusion:</b> Rigorous syringe selection is crucial in myocardial perfusion imaging procedures to minimize residual activity and ensure compliance with dosimetry standards, emphasizing the importance of integrating pharmacy practices into nuclear medicine protocols. Standardized protocols and quality assurance measures are essential to optimize imaging outcomes and prioritize patient safety. These findings highlight the importance of ongoing monitoring and interdisciplinary collaboration to navigate residual activity management effectively in routine nuclear medicine practice.</p>","PeriodicalId":16548,"journal":{"name":"Journal of nuclear medicine technology","volume":" ","pages":"57-62"},"PeriodicalIF":1.0,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Does Arthrography Improve Accuracy of SPECT/CT for Diagnosis of Aseptic Loosening in Patients with Painful Knee Arthroplasty: A Systematic Review and Metaanalysis.
IF 1 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-03-05 DOI: 10.2967/jnmt.123.266050
Charlie Timon, Aoife Feeley, John Mahon, Iain Feeley, John Quinlan, Eoin Sheehan

SPECT/CT combines scintigraphy with a CT scan forming a 3-dimensional reconstruction of bone-tracer uptake patterns. It has become a fundamental component of the work-up of a painful total knee arthroplasty (TKA). The addition of an arthrogram is purported to improve its diagnostic yield. The aim of this study was to assess whether the addition of a concurrent arthrogram to a SPECT/CT enhances its sensitivity and specificity for diagnosing aseptic loosening in a painful total knee replacement. Methods: PubMed, Embase, and Scopus were searched in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Included studies compared the results of SPECT/CT with or without an arthrogram against an appropriate reference standard for diagnosing TKA aseptic loosening. The quality of included studies was independently assessed using the QUADAS-2 tool. Results: In total, 160 abstracts were identified by our search strategy. Of these, 6 studies comprising 472 patients met our inclusion criteria. All included studies used operative findings or a period of clinical and radiologic observation as reference standards. The SPECT/CT arthrogram was more sensitive in identifying aseptic loosening of knee prostheses, and it also provided greater specificity for excluding its diagnosis. Conclusion: The amalgamated results of included studies of the use of SPECT/CT demonstrate it is the best test in helping determine aseptic loosening in patients with painful TKAs (specificity, 97% vs. 85%). It is also a more sensitive test (sensitivity, 78% vs. 75%). Considering the potential morbidity of injection of contrast into the prosthetic joint, addition of an arthrogram to SPECT/CT is not beneficial and is potentially harmful.

{"title":"Does Arthrography Improve Accuracy of SPECT/CT for Diagnosis of Aseptic Loosening in Patients with Painful Knee Arthroplasty: A Systematic Review and Metaanalysis.","authors":"Charlie Timon, Aoife Feeley, John Mahon, Iain Feeley, John Quinlan, Eoin Sheehan","doi":"10.2967/jnmt.123.266050","DOIUrl":"10.2967/jnmt.123.266050","url":null,"abstract":"<p><p>SPECT/CT combines scintigraphy with a CT scan forming a 3-dimensional reconstruction of bone-tracer uptake patterns. It has become a fundamental component of the work-up of a painful total knee arthroplasty (TKA). The addition of an arthrogram is purported to improve its diagnostic yield. The aim of this study was to assess whether the addition of a concurrent arthrogram to a SPECT/CT enhances its sensitivity and specificity for diagnosing aseptic loosening in a painful total knee replacement. <b>Methods:</b> PubMed, Embase, and Scopus were searched in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Included studies compared the results of SPECT/CT with or without an arthrogram against an appropriate reference standard for diagnosing TKA aseptic loosening. The quality of included studies was independently assessed using the QUADAS-2 tool. <b>Results:</b> In total, 160 abstracts were identified by our search strategy. Of these, 6 studies comprising 472 patients met our inclusion criteria. All included studies used operative findings or a period of clinical and radiologic observation as reference standards. The SPECT/CT arthrogram was more sensitive in identifying aseptic loosening of knee prostheses, and it also provided greater specificity for excluding its diagnosis. <b>Conclusion:</b> The amalgamated results of included studies of the use of SPECT/CT demonstrate it is the best test in helping determine aseptic loosening in patients with painful TKAs (specificity, 97% vs. 85%). It is also a more sensitive test (sensitivity, 78% vs. 75%). Considering the potential morbidity of injection of contrast into the prosthetic joint, addition of an arthrogram to SPECT/CT is not beneficial and is potentially harmful.</p>","PeriodicalId":16548,"journal":{"name":"Journal of nuclear medicine technology","volume":" ","pages":"44-49"},"PeriodicalIF":1.0,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Generative Artificial Intelligence in Nuclear Medicine Education.
IF 1 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-03-05 DOI: 10.2967/jnmt.124.268323
Geoffrey M Currie

Generative artificial intelligence (genAI) has become assimilated into the education, research, and clinical domains of nuclear medicine and health care. Understanding the principles, limitations, and applications of genAI is important for capitalizing on its transformative potential in student education and impact on sustainability within both the education and the clinical sectors. In this article, the fundamental principles and applications of artificial intelligence are explored from the context of nuclear medicine. GenAI technologies are defined and capabilities outlined. A detailed investigation of the potential and limitations of both text-to-text and text-to-image genAI based in empiric and anecdotal research is provided. Specific examples of applications of text-to-text and text-to-image genAI are provided. GenAI has the potential to reinvigorate nuclear medicine education by supporting and enriching student learning and to be transformative in nuclear medicine education, but at the time of writing, both text-to-text and text-to-image genAI are far from revolutionary. Nonetheless, the horizon promises transformative education applications of genAI. GenAI can enhance nuclear medicine education and student learning and provide economies to improve sustainability in the education and clinical sectors. Although there are some limitations to current capabilities, this rapidly evolving space will soon offer potential benefits to education.

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引用次数: 0
Turning the Calendar Page to 2025.
IF 1 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-03-05
Kathy S Thomas
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引用次数: 0
Can an Abnormal Gastric Emptying Study Be Normal?
IF 1 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-03-04 DOI: 10.2967/jnmt.124.269182
Ben Freiberg

The American Neurogastroenterology and Motility Society and the Society of Nuclear Medicine and Molecular Imaging collaboratively wrote consensus statements to standardize gastric emptying scintigraphy. Despite this, centers are using nonstandard protocols. This study examined how these protocols contrast with standards. Methods: Consecutive charts were analyzed for meal, radionuclide dose, half-emptying time (T½) and its normal range, and documented retention and emptying. Impressions were compared with how emptying mapped on a graph based on standard 4-h values. Results: Thirty-four studies were identified. Ten of 14 abnormal studies were normal when plotted on the standard 4-h graph. Eight of 10 abnormal studies had normal 2- or 4-h retention. Normal T½ ranges varied significantly. Most altered the meal, and over 25% received a radionucleotide dose outside the recommended range. Conclusion: The upper bound of normal T½ falls within standard 4-h bounds, with many individuals given an erroneous impression. Though further optimization may be needed, adhering to standards is critical.

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引用次数: 0
期刊
Journal of nuclear medicine technology
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