{"title":"Diuretic Renal Scintigraphy","authors":"M. Farrell, Kevin P. Banks, J. Peacock","doi":"10.2967/jnmt.122.264804","DOIUrl":"https://doi.org/10.2967/jnmt.122.264804","url":null,"abstract":"","PeriodicalId":22799,"journal":{"name":"The Journal of Nuclear Medicine Technology","volume":"11 1","pages":"319 - 321"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72799556","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}
Visual Abstract Labeling radiopharmaceuticals and testing the quality of the labeled product before injecting it into patients are standard operating procedures in the nuclear medicine department. There is a different shelf life for each labeled product, which determines how long a product can maintain in vitro stability before it needs to be discarded. 177Lu is a radioactive isotope that is increasingly being accepted into the treatment paradigm for palliation of advanced-stage tumors, including metastatic castration-resistant prostate cancer (mCRPC) and neuroendocrine tumors (NETs). In our institution, synthesis of 177Lu with prostate-specific membrane antigen imaging and therapy (PSMA I&T) for palliation of mCRPC is performed on an automated synthesis system. Methods: After each synthesis, the final product quality was evaluated by high-performance liquid chromatography (HPLC) and instant thin-layer chromatography (ITLC) at 3 different time points: 0, 24, and 48 h. Between February 2020 and October 2020, the quality of 35 batches of 177Lu-PSMA I&T was evaluated. Results: The average radiochemical purity of ITLC-silica gel was found to be greater than 99% (99.70% ± 0.05%), and HPLC was greater than 98% (98.60% ± 0.05%). Conclusion: Our findings demonstrate that synthesis of 177Lu-PSMA I&T with an automated synthesis system can remain stable for 48 h after labeling.
对放射性药物进行标记，并对标记后的产品进行质量检测，再将其注射到患者体内，是核医学部门的标准操作程序。每种有标签的产品都有不同的保质期，这决定了产品在需要丢弃之前可以保持体外稳定性的时间。177Lu是一种放射性同位素，越来越多地被接受用于晚期肿瘤的治疗模式，包括转移性去势抵抗性前列腺癌(mCRPC)和神经内分泌肿瘤(NETs)。在我们的机构中，用前列腺特异性膜抗原成像和治疗(PSMA I&T)合成177Lu用于缓解mCRPC是在自动化合成系统上进行的。方法:每次合成后，采用高效液相色谱法(HPLC)和即时薄层色谱法(ITLC)在0、24和48 h 3个不同时间点对最终产品质量进行评价。2020年2月至2020年10月，对35批177Lu-PSMA I&T进行质量评价。结果:itlc -硅胶平均放射化学纯度大于99%(99.70%±0.05%)，高效液相色谱纯度大于98%(98.60%±0.05%)。结论:我们的研究结果表明，在自动合成系统中合成的177Lu-PSMA I&T在标记后48小时内保持稳定。
{"title":"Stability Matters: Radiochemical Stability of Therapeutic Radiopharmaceutical 177Lu-PSMA I&T","authors":"M. Vyas, R. Lim, J. Fagan, Rudresh Chandrashekar","doi":"10.2967/jnmt.121.262423","DOIUrl":"https://doi.org/10.2967/jnmt.121.262423","url":null,"abstract":"Visual Abstract Labeling radiopharmaceuticals and testing the quality of the labeled product before injecting it into patients are standard operating procedures in the nuclear medicine department. There is a different shelf life for each labeled product, which determines how long a product can maintain in vitro stability before it needs to be discarded. 177Lu is a radioactive isotope that is increasingly being accepted into the treatment paradigm for palliation of advanced-stage tumors, including metastatic castration-resistant prostate cancer (mCRPC) and neuroendocrine tumors (NETs). In our institution, synthesis of 177Lu with prostate-specific membrane antigen imaging and therapy (PSMA I&T) for palliation of mCRPC is performed on an automated synthesis system. Methods: After each synthesis, the final product quality was evaluated by high-performance liquid chromatography (HPLC) and instant thin-layer chromatography (ITLC) at 3 different time points: 0, 24, and 48 h. Between February 2020 and October 2020, the quality of 35 batches of 177Lu-PSMA I&T was evaluated. Results: The average radiochemical purity of ITLC-silica gel was found to be greater than 99% (99.70% ± 0.05%), and HPLC was greater than 98% (98.60% ± 0.05%). Conclusion: Our findings demonstrate that synthesis of 177Lu-PSMA I&T with an automated synthesis system can remain stable for 48 h after labeling.","PeriodicalId":22799,"journal":{"name":"The Journal of Nuclear Medicine Technology","volume":"os-52 1","pages":"244 - 247"},"PeriodicalIF":0.0,"publicationDate":"2022-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87366138","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}
{"title":"Small-Bowel and Colon Transit","authors":"M. Farrell","doi":"10.2967/jnmt.121.264294","DOIUrl":"https://doi.org/10.2967/jnmt.121.264294","url":null,"abstract":"","PeriodicalId":22799,"journal":{"name":"The Journal of Nuclear Medicine Technology","volume":"24 1","pages":"111 - 114"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81761402","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}
CE credit: For CE credit, you can access the test for this article, as well as additional JNMT CE tests, online at https://www.snmmilearningcenter.org. Complete the test online no later than June 2025. Your online test will be scored immediately. You may make 3 attempts to pass the test and must answer 75% of the questions correctly to receive Continuing Education Hour (CEH) credit. Credit amounts can be found in the SNMMI Learning Center Activity. SNMMI members will have their CEH credit added to their VOICE transcript automatically; nonmembers will be able to print out a CE certificate upon successfully completing the test. The online test is free to SNMMI members; nonmembers must pay $15.00 by credit card when logging onto the website to take the test. The goal of clinical research is to advance medical knowledge in hopes of improving patient care. At the core of clinical research is the need to perform research on human volunteers. This is absolutely required for the eventual approval of drugs and certain therapies. Unfortunately, history is replete with stories involving exploitation and abuse of individuals in research. Clinical research using radiopharmaceuticals introduces additional apprehension. Although the past few decades have witnessed significant improvements in safety and ethics, there remain indelible images seared into the psyche of the general population. Those new to clinical research may find themselves asking questions such as, What are the ethical guidelines and regulations for clinical research, How are they enforced and by whom, and How do we ensure the safety of participants? The answer, in large part, is the oversight and actions of the institutional review board. This article will focus on familiarizing the reader with the institutional review board and its role in protecting the rights and welfare of humans participating as subjects in Food and Drug Administration–regulated radiopharmaceutical research.
{"title":"SNMMI Clinical Trials Network Research Series for Technologists: Clinical Research Primer—Regulatory Process, Part II: The Role of the Institutional Review Board in Food and Drug Administration–Regulated Radiopharmaceutical Research","authors":"Charlotte D Jeffers, John M. Hoffman","doi":"10.2967/jnmt.122.264034","DOIUrl":"https://doi.org/10.2967/jnmt.122.264034","url":null,"abstract":"CE credit: For CE credit, you can access the test for this article, as well as additional JNMT CE tests, online at https://www.snmmilearningcenter.org. Complete the test online no later than June 2025. Your online test will be scored immediately. You may make 3 attempts to pass the test and must answer 75% of the questions correctly to receive Continuing Education Hour (CEH) credit. Credit amounts can be found in the SNMMI Learning Center Activity. SNMMI members will have their CEH credit added to their VOICE transcript automatically; nonmembers will be able to print out a CE certificate upon successfully completing the test. The online test is free to SNMMI members; nonmembers must pay $15.00 by credit card when logging onto the website to take the test. The goal of clinical research is to advance medical knowledge in hopes of improving patient care. At the core of clinical research is the need to perform research on human volunteers. This is absolutely required for the eventual approval of drugs and certain therapies. Unfortunately, history is replete with stories involving exploitation and abuse of individuals in research. Clinical research using radiopharmaceuticals introduces additional apprehension. Although the past few decades have witnessed significant improvements in safety and ethics, there remain indelible images seared into the psyche of the general population. Those new to clinical research may find themselves asking questions such as, What are the ethical guidelines and regulations for clinical research, How are they enforced and by whom, and How do we ensure the safety of participants? The answer, in large part, is the oversight and actions of the institutional review board. This article will focus on familiarizing the reader with the institutional review board and its role in protecting the rights and welfare of humans participating as subjects in Food and Drug Administration–regulated radiopharmaceutical research.","PeriodicalId":22799,"journal":{"name":"The Journal of Nuclear Medicine Technology","volume":"18 7","pages":"97 - 102"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91434661","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}
C. Hruska, Christinne L S Corion, L. de Geus-Oei, B. Adrada, A. Fowler, Katie N Hunt, S. Kappadath, P. Pilkington, L. Arias-Bouda, G. Rauch
Department of Radiology, Mayo Clinic, Rochester, Minnesota; Department of Surgery, Haaglanden Medical Center, The Hague, Netherlands; Department of Radiology, Leiden University Medical Center, Leiden, Netherlands; Biomedical Photonic Imaging Group, University of Twente, Enschede, Netherlands; Department of Breast Imaging, The University of Texas MD Anderson Cancer Center, Houston, Texas; Department of Radiology, University of Wisconsin, Madison, Wisconsin; Department of Medical Physics, University of Wisconsin, Madison, Wisconsin; University of Wisconsin Carbone Cancer Center, Madison, Wisconsin; Department of Medical Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas; Department of Nuclear Medicine, University Hospital 12 de Octubre, Madrid, Spain; Department of Nuclear Medicine, Alrijne Hospital, Leiderdorp, Netherlands; and Department of Abdominal Imaging, The University of Texas MD Anderson Cancer Center, Houston, Texas
{"title":"SNMMI Procedure Standard/EANM Practice Guideline for Molecular Breast Imaging with Dedicated γ-Cameras","authors":"C. Hruska, Christinne L S Corion, L. de Geus-Oei, B. Adrada, A. Fowler, Katie N Hunt, S. Kappadath, P. Pilkington, L. Arias-Bouda, G. Rauch","doi":"10.2967/jnmt.121.264204","DOIUrl":"https://doi.org/10.2967/jnmt.121.264204","url":null,"abstract":"Department of Radiology, Mayo Clinic, Rochester, Minnesota; Department of Surgery, Haaglanden Medical Center, The Hague, Netherlands; Department of Radiology, Leiden University Medical Center, Leiden, Netherlands; Biomedical Photonic Imaging Group, University of Twente, Enschede, Netherlands; Department of Breast Imaging, The University of Texas MD Anderson Cancer Center, Houston, Texas; Department of Radiology, University of Wisconsin, Madison, Wisconsin; Department of Medical Physics, University of Wisconsin, Madison, Wisconsin; University of Wisconsin Carbone Cancer Center, Madison, Wisconsin; Department of Medical Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas; Department of Nuclear Medicine, University Hospital 12 de Octubre, Madrid, Spain; Department of Nuclear Medicine, Alrijne Hospital, Leiderdorp, Netherlands; and Department of Abdominal Imaging, The University of Texas MD Anderson Cancer Center, Houston, Texas","PeriodicalId":22799,"journal":{"name":"The Journal of Nuclear Medicine Technology","volume":"1 1","pages":"103 - 110"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88918189","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}
Ankit Watts, Baljinder Singh, Harmandeep Singh, H. Kaur, A. Bal, Mehak Vohra, S. Arora, D. Behera
Visual Abstract 68Ga-pentixafor PET/CT imaging allows noninvasive assessment of C-X-C chemokine receptor type 4 (CXCR4) expression in various malignancies, but its use in rare lung cancer variants has not been reported. Methods: 68Ga-pentixafor PET/CT imaging was performed on 6 patients (3 men, 3 women; mean age, 57.0 ± 16.8 y) with suspected lung masses. Whole-body PET/CT images were acquired 1 h after intravenous injection of 148.0–185.0 MBq of the tracer. PET/CT images were reconstructed and analyzed. The image findings were correlated with histopathologic and quantitative (CXCR4) fluorescence-activated cell sorting analysis. Results: Histopathologic diagnosis of hemangioendothelioma, sarcomatoid carcinoma, and hemangiopericytoma was confirmed in 1 patient each. Lung metastasis was diagnosed in the remaining 3 of 6 patients with primary sarcoma (n = 1), renal cell carcinoma (n = 1), and unknown primary (n = 1). Increased uptake in the primary lung mass, with an SUVmax of 3.0, 6.34, and 13.0, was noted in the hemangiopericytoma, sarcomatoid carcinoma and hemangioendothelioma cases, respectively. The mean SUVmax, mean fluorescence intensity, and percentage of stained cells were highest in hemangioendothelioma. Among 3 patients with lung metastases, the highest SUVmax, 9.5, was in the primary sarcoma patient. Conclusion: 68Ga-pentixafor selectively targets the in vivo whole-body disease burden of CXCR4 receptors. This approach thus holds promise for developing suitable radiotheranostics for lung cancers expressing these targets.
{"title":"68Ga-Pentixafor PET/CT Demonstrating In Vivo CXCR4 Receptor Overexpression in Rare Lung Malignancies: Correlation with Histologic and Histochemical Findings","authors":"Ankit Watts, Baljinder Singh, Harmandeep Singh, H. Kaur, A. Bal, Mehak Vohra, S. Arora, D. Behera","doi":"10.2967/jnmt.122.264141","DOIUrl":"https://doi.org/10.2967/jnmt.122.264141","url":null,"abstract":"Visual Abstract 68Ga-pentixafor PET/CT imaging allows noninvasive assessment of C-X-C chemokine receptor type 4 (CXCR4) expression in various malignancies, but its use in rare lung cancer variants has not been reported. Methods: 68Ga-pentixafor PET/CT imaging was performed on 6 patients (3 men, 3 women; mean age, 57.0 ± 16.8 y) with suspected lung masses. Whole-body PET/CT images were acquired 1 h after intravenous injection of 148.0–185.0 MBq of the tracer. PET/CT images were reconstructed and analyzed. The image findings were correlated with histopathologic and quantitative (CXCR4) fluorescence-activated cell sorting analysis. Results: Histopathologic diagnosis of hemangioendothelioma, sarcomatoid carcinoma, and hemangiopericytoma was confirmed in 1 patient each. Lung metastasis was diagnosed in the remaining 3 of 6 patients with primary sarcoma (n = 1), renal cell carcinoma (n = 1), and unknown primary (n = 1). Increased uptake in the primary lung mass, with an SUVmax of 3.0, 6.34, and 13.0, was noted in the hemangiopericytoma, sarcomatoid carcinoma and hemangioendothelioma cases, respectively. The mean SUVmax, mean fluorescence intensity, and percentage of stained cells were highest in hemangioendothelioma. Among 3 patients with lung metastases, the highest SUVmax, 9.5, was in the primary sarcoma patient. Conclusion: 68Ga-pentixafor selectively targets the in vivo whole-body disease burden of CXCR4 receptors. This approach thus holds promise for developing suitable radiotheranostics for lung cancers expressing these targets.","PeriodicalId":22799,"journal":{"name":"The Journal of Nuclear Medicine Technology","volume":"69 1","pages":"278 - 281"},"PeriodicalIF":0.0,"publicationDate":"2022-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81362898","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}
S. Dannoon, Saud A. Alenezi, Naheel Al-Nafisi, Samar Almutairi, Fatma Dashti, M. Osman, Abdelhamaid Elgazzar
Visual Abstract This study measured the typical emitted radiation rate from the urinary bladder of PET patients after their scan and investigated simple methods for reducing the emitted radiation before discharge. Methods: The study included 83 patients (63 18F-FDG and 20 18F-NaF patients). Emitted radiation from the patients’ urinary bladder was measured with an ionization survey meter at a 1-m distance, presuming the urinary bladder to be the primary source of radiation. The measurements were taken at different time points after PET image acquisition: immediate (prevoid 1), voided (postvoid 1), after waiting 30 min in the uptake room while drinking 500 mL of water (prevoid 2), and voided again (postvoid 2). Results: For 18F-FDG patients, the reduction of emitted radiation due to drinking water and voiding alone from prevoid 1 to decay-corrected postvoid 2 was an average of 22.49% ± 7.48% (13.65 ± 3.42 μSv/h to 10.48 ± 2.37 μSv/h, P < 0.001). For 18F-NaF patients, the reduction was an average of 25.80% ± 10.03% (9.83 ± 2.01 μSv/h to 7.23 ± 1.49 μSv/h, P < 0.001). Conclusion: In addition to the physical decay of the radiotracers, using the biologic clearance properties resulted in a significant decrease of the emitted radiation in this study. Implementing additional water consumption to facilitate voiding with 30 min of wait time before discharging certain 18F-FDG and 18F-NaF patients who need to be in close contact with others, such as elderly, caregivers, and inpatients, might facilitate lowering their emitted radiation by an average of 22%–25% due to voiding, not counting in the physical decay that should add an additional 17% reduction.
{"title":"Reducing Radiation Exposure from PET Patients","authors":"S. Dannoon, Saud A. Alenezi, Naheel Al-Nafisi, Samar Almutairi, Fatma Dashti, M. Osman, Abdelhamaid Elgazzar","doi":"10.2967/jnmt.121.263223","DOIUrl":"https://doi.org/10.2967/jnmt.121.263223","url":null,"abstract":"Visual Abstract This study measured the typical emitted radiation rate from the urinary bladder of PET patients after their scan and investigated simple methods for reducing the emitted radiation before discharge. Methods: The study included 83 patients (63 18F-FDG and 20 18F-NaF patients). Emitted radiation from the patients’ urinary bladder was measured with an ionization survey meter at a 1-m distance, presuming the urinary bladder to be the primary source of radiation. The measurements were taken at different time points after PET image acquisition: immediate (prevoid 1), voided (postvoid 1), after waiting 30 min in the uptake room while drinking 500 mL of water (prevoid 2), and voided again (postvoid 2). Results: For 18F-FDG patients, the reduction of emitted radiation due to drinking water and voiding alone from prevoid 1 to decay-corrected postvoid 2 was an average of 22.49% ± 7.48% (13.65 ± 3.42 μSv/h to 10.48 ± 2.37 μSv/h, P < 0.001). For 18F-NaF patients, the reduction was an average of 25.80% ± 10.03% (9.83 ± 2.01 μSv/h to 7.23 ± 1.49 μSv/h, P < 0.001). Conclusion: In addition to the physical decay of the radiotracers, using the biologic clearance properties resulted in a significant decrease of the emitted radiation in this study. Implementing additional water consumption to facilitate voiding with 30 min of wait time before discharging certain 18F-FDG and 18F-NaF patients who need to be in close contact with others, such as elderly, caregivers, and inpatients, might facilitate lowering their emitted radiation by an average of 22%–25% due to voiding, not counting in the physical decay that should add an additional 17% reduction.","PeriodicalId":22799,"journal":{"name":"The Journal of Nuclear Medicine Technology","volume":"1 1","pages":"263 - 268"},"PeriodicalIF":0.0,"publicationDate":"2022-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75469480","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}
E. Etchebehere, Rebeca Andrade, Mariana R. Camacho, M. Lima, A. Brink, J. Cerci, H. Nadel, C. Bal, V. Rangarajan, T. Pfluger, O. Kagna, O. Alonso, F. Begum, Kahkashan Bashir Mir, V. P. Magboo, L. Menezes, D. Paez, T. Pascual
Visual Abstract 18F-FDG PET/CT quantification of whole-body tumor burden in lymphoma is not routinely performed because of the lack of fast methods. Although the semiautomatic method is fast, it is not fast enough to quantify tumor burden in daily clinical practice. Our purpose was to evaluate the performance of convolutional neural network (CNN) software in localizing neoplastic lesions in whole-body 18F-FDG PET/CT images of pediatric lymphoma patients. Methods: The retrospective image dataset, derived from the data pool of the International Atomic Energy Agency (coordinated research project E12017), included 102 baseline staging 18F-FDG PET/CT studies of pediatric lymphoma patients (mean age, 11 y). The images were quantified to determine the whole-body tumor burden (whole-body metabolic tumor volume [wbMTV] and whole-body total lesion glycolysis [wbTLG]) using semiautomatic software and CNN-based software. Both were displayed as semiautomatic wbMTV and wbTLG and as CNN wbMTV and wbTLG. The intraclass correlation coefficient (ICC) was applied to evaluate concordance between the CNN-based software and the semiautomatic software. Results: Twenty-six patients were excluded from the analysis because the software was unable to perform calculations for them. In the remaining 76 patients, CNN and semiautomatic wbMTV tumor burden metrics correlated strongly (ICC, 0.993; 95% CI, 0.989 − 0.996; P < 0.0001), as did CNN and semiautomatic wbTLG (ICC, 0.999; 95% CI, 0.998–0.999; P < 0.0001). However, the time spent calculating these metrics was significantly (<0.0001) less by CNN (mean, 19 s; range, 11–50 s) than by the semiautomatic method (mean, 21.6 min; range, 3.2–62.1 min), especially in patients with advanced disease. Conclusion: Determining whole-body tumor burden in pediatric lymphoma patients using CNN is fast and feasible in clinical practice.
{"title":"Validation of Convolutional Neural Networks for Fast Determination of Whole-Body Metabolic Tumor Burden in Pediatric Lymphoma","authors":"E. Etchebehere, Rebeca Andrade, Mariana R. Camacho, M. Lima, A. Brink, J. Cerci, H. Nadel, C. Bal, V. Rangarajan, T. Pfluger, O. Kagna, O. Alonso, F. Begum, Kahkashan Bashir Mir, V. P. Magboo, L. Menezes, D. Paez, T. Pascual","doi":"10.2967/jnmt.121.262900","DOIUrl":"https://doi.org/10.2967/jnmt.121.262900","url":null,"abstract":"Visual Abstract 18F-FDG PET/CT quantification of whole-body tumor burden in lymphoma is not routinely performed because of the lack of fast methods. Although the semiautomatic method is fast, it is not fast enough to quantify tumor burden in daily clinical practice. Our purpose was to evaluate the performance of convolutional neural network (CNN) software in localizing neoplastic lesions in whole-body 18F-FDG PET/CT images of pediatric lymphoma patients. Methods: The retrospective image dataset, derived from the data pool of the International Atomic Energy Agency (coordinated research project E12017), included 102 baseline staging 18F-FDG PET/CT studies of pediatric lymphoma patients (mean age, 11 y). The images were quantified to determine the whole-body tumor burden (whole-body metabolic tumor volume [wbMTV] and whole-body total lesion glycolysis [wbTLG]) using semiautomatic software and CNN-based software. Both were displayed as semiautomatic wbMTV and wbTLG and as CNN wbMTV and wbTLG. The intraclass correlation coefficient (ICC) was applied to evaluate concordance between the CNN-based software and the semiautomatic software. Results: Twenty-six patients were excluded from the analysis because the software was unable to perform calculations for them. In the remaining 76 patients, CNN and semiautomatic wbMTV tumor burden metrics correlated strongly (ICC, 0.993; 95% CI, 0.989 − 0.996; P < 0.0001), as did CNN and semiautomatic wbTLG (ICC, 0.999; 95% CI, 0.998–0.999; P < 0.0001). However, the time spent calculating these metrics was significantly (<0.0001) less by CNN (mean, 19 s; range, 11–50 s) than by the semiautomatic method (mean, 21.6 min; range, 3.2–62.1 min), especially in patients with advanced disease. Conclusion: Determining whole-body tumor burden in pediatric lymphoma patients using CNN is fast and feasible in clinical practice.","PeriodicalId":22799,"journal":{"name":"The Journal of Nuclear Medicine Technology","volume":"1 1","pages":"256 - 262"},"PeriodicalIF":0.0,"publicationDate":"2022-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76186355","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}
Y. Kao, Calvin Gan, Alicia Corlett, Alexander Rhodes, D. Sivaratnam, B. Lim
Visual Abstract Postradioembolization lung absorbed dose verification was historically problematic and impractical in clinical practice. We devised an indirect method using 90Y PET/CT. Methods: Conceptually, true lung activity is simply the difference between the total prepared activity minus all activity below the diaphragm and residual activity within delivery apparatus. Patient-specific lung mass is measured by CT densitovolumetry. True lung mean absorbed dose is calculated by MIRD macrodosimetry. Results: Proof of concept is shown in a hepatocellular carcinoma patient with a high lung shunt fraction of 26%, where evidence of technically successful hepatic vein balloon occlusion for radioembolization lung protection was required. Indirect lung activity quantification showed the postradioembolization lung shunt fraction to be reduced to approximately 1% with a true lung mean absorbed dose of approximately 1 Gy, suggesting complete lung protection by hepatic vein balloon occlusion. Conclusion: We discuss possible clinical applications such as lung absorbed dose verification, refining the limits of lung tolerance, and the concept of massive activity radioembolization.
{"title":"Indirect Lung Absorbed Dose Verification by 90Y PET/CT and Complete Lung Protection by Hepatic Vein Balloon Occlusion: Proof of Concept","authors":"Y. Kao, Calvin Gan, Alicia Corlett, Alexander Rhodes, D. Sivaratnam, B. Lim","doi":"10.2967/jnmt.121.263422","DOIUrl":"https://doi.org/10.2967/jnmt.121.263422","url":null,"abstract":"Visual Abstract Postradioembolization lung absorbed dose verification was historically problematic and impractical in clinical practice. We devised an indirect method using 90Y PET/CT. Methods: Conceptually, true lung activity is simply the difference between the total prepared activity minus all activity below the diaphragm and residual activity within delivery apparatus. Patient-specific lung mass is measured by CT densitovolumetry. True lung mean absorbed dose is calculated by MIRD macrodosimetry. Results: Proof of concept is shown in a hepatocellular carcinoma patient with a high lung shunt fraction of 26%, where evidence of technically successful hepatic vein balloon occlusion for radioembolization lung protection was required. Indirect lung activity quantification showed the postradioembolization lung shunt fraction to be reduced to approximately 1% with a true lung mean absorbed dose of approximately 1 Gy, suggesting complete lung protection by hepatic vein balloon occlusion. Conclusion: We discuss possible clinical applications such as lung absorbed dose verification, refining the limits of lung tolerance, and the concept of massive activity radioembolization.","PeriodicalId":22799,"journal":{"name":"The Journal of Nuclear Medicine Technology","volume":"38 1","pages":"240 - 243"},"PeriodicalIF":0.0,"publicationDate":"2022-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82862540","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}
{"title":"Pharmacology Primer for Medications in Nuclear Medicine and Medical Imaging","authors":"Cybil J. Nielsen","doi":"10.2967/JNMT.121.262380","DOIUrl":"https://doi.org/10.2967/JNMT.121.262380","url":null,"abstract":"","PeriodicalId":22799,"journal":{"name":"The Journal of Nuclear Medicine Technology","volume":"38 1","pages":"293 - 293"},"PeriodicalIF":0.0,"publicationDate":"2021-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78070439","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}
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