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Comparative effectiveness of standard vs. AI-assisted PET/CT reading workflow for pre-treatment lymphoma staging: a multi-institutional reader study evaluation 治疗前淋巴瘤分期的标准 PET/CT 阅读工作流程与 AI 辅助阅读工作流程的效果比较:多机构阅读研究评估
Pub Date : 2024-01-11 DOI: 10.3389/fnume.2023.1327186
R. Frood, Julien M. Y. Willaime, Brad Miles, Greg Chambers, H’ssein Al-Chalabi, Tamir Ali, Natasha Hougham, Naomi Brooks, George Petrides, Matthew Naylor, Daniel Ward, Tom Sulkin, Richard Chaytor, Peter Strouhal, Chirag Patel, A. F. Scarsbrook
Fluorine-18 fluorodeoxyglucose (FDG)-positron emission tomography/computed tomography (PET/CT) is widely used for staging high-grade lymphoma, with the time to evaluate such studies varying depending on the complexity of the case. Integrating artificial intelligence (AI) within the reporting workflow has the potential to improve quality and efficiency. The aims of the present study were to evaluate the influence of an integrated research prototype segmentation tool implemented within diagnostic PET/CT reading software on the speed and quality of reporting with variable levels of experience, and to assess the effect of the AI-assisted workflow on reader confidence and whether this tool influenced reporting behaviour.Nine blinded reporters (three trainees, three junior consultants and three senior consultants) from three UK centres participated in a two-part reader study. A total of 15 lymphoma staging PET/CT scans were evaluated twice: first, using a standard PET/CT reporting workflow; then, after a 6-week gap, with AI assistance incorporating pre-segmentation of disease sites within the reading software. An even split of PET/CT segmentations with gold standard (GS), false-positive (FP) over-contour or false-negative (FN) under-contour were provided. The read duration was calculated using file logs, while the report quality was independently assessed by two radiologists with >15 years of experience. Confidence in AI assistance and identification of disease was assessed via online questionnaires for each case.There was a significant decrease in time between non-AI and AI-assisted reads (median 15.0 vs. 13.3 min, p < 0.001). Sub-analysis confirmed this was true for both junior (14.5 vs. 12.7 min, p = 0.03) and senior consultants (15.1 vs. 12.2 min, p = 0.03) but not for trainees (18.1 vs. 18.0 min, p = 0.2). There was no significant difference between report quality between reads. AI assistance provided a significant increase in confidence of disease identification (p < 0.001). This held true when splitting the data into FN, GS and FP. In 19/88 cases, participants did not identify either FP (31.8%) or FN (11.4%) segmentations. This was significantly greater for trainees (13/30, 43.3%) than for junior (3/28, 10.7%, p = 0.05) and senior consultants (3/30, 10.0%, p = 0.05).The study findings indicate that an AI-assisted workflow achieves comparable performance to humans, demonstrating a marginal enhancement in reporting speed. Less experienced readers were more influenced by segmentation errors. An AI-assisted PET/CT reading workflow has the potential to increase reporting efficiency without adversely affecting quality, which could reduce costs and report turnaround times. These preliminary findings need to be confirmed in larger studies.
氟-18脱氧葡萄糖(FDG)-正电子发射断层扫描/计算机断层扫描(PET/CT)被广泛用于高级别淋巴瘤的分期,评估此类研究的时间因病例的复杂程度而异。在报告工作流程中整合人工智能(AI)有可能提高质量和效率。本研究的目的是评估在 PET/CT 诊断阅片软件中实施的集成研究原型分割工具对不同经验水平的报告速度和质量的影响,并评估人工智能辅助工作流程对读者信心的影响以及该工具是否会影响报告行为。来自英国三个中心的九名盲法报告人员(三名实习生、三名初级顾问和三名高级顾问)参加了一项由两部分组成的读者研究。共对 15 份淋巴瘤分期 PET/CT 扫描进行了两次评估:首先,使用标准 PET/CT 报告工作流程;然后,在间隔 6 周后,在人工智能的辅助下,将疾病部位的预分割纳入阅片软件。提供的 PET/CT 分段平均分为金标准(GS)、假阳性(FP)过度轮廓或假阴性(FN)轮廓不足。读取时间是通过文件日志计算得出的,而报告质量则由两名具有 15 年以上经验的放射科医生独立评估。非人工智能和人工智能辅助读片的时间显著缩短(中位 15.0 分钟对 13.3 分钟,p < 0.001)。子分析表明,初级顾问(14.5 分钟 vs. 12.7 分钟,p = 0.03)和高级顾问(15.1 分钟 vs. 12.2 分钟,p = 0.03)都是如此,但实习生(18.1 分钟 vs. 18.0 分钟,p = 0.2)不是这样。不同读数的报告质量没有明显差异。人工智能辅助可显著提高疾病识别的可信度(p < 0.001)。将数据拆分为 FN、GS 和 FP 时,情况也是如此。在 19/88 个病例中,参与者既没有识别出 FP(31.8%),也没有识别出 FN(11.4%)分割。研究结果表明,人工智能辅助工作流程的性能与人类相当,在报告速度方面略有提高。经验不足的读者受分割错误的影响更大。人工智能辅助 PET/CT 阅读工作流程有可能在不影响质量的情况下提高报告效率,从而降低成本并缩短报告周转时间。这些初步研究结果还需要更大规模的研究来证实。
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引用次数: 0
Editorial: Molecular imaging of cardiovascular diseases: current and emerging approaches in nuclear medicine 社论:心血管疾病的分子成像:核医学中当前和新兴的方法
Pub Date : 2024-01-11 DOI: 10.3389/fnume.2023.1362018
Jonathan Vigne, Giorgio Treglia
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引用次数: 0
The application of radionuclide therapy for breast cancer 应用放射性核素治疗乳腺癌
Pub Date : 2024-01-10 DOI: 10.3389/fnume.2023.1323514
Anna Musket, Sandra Davern, Brianna M. Elam, Philip R. Musich, Jonathan P. Moorman, Yong Jiang
Radionuclide-mediated diagnosis and therapy have emerged as effective and low-risk approaches to treating breast cancer. Compared to traditional anatomic imaging techniques, diagnostic radionuclide-based molecular imaging systems exhibit much greater sensitivity and ability to precisely illustrate the biodistribution and metabolic processes from a functional perspective in breast cancer; this transitions diagnosis from an invasive visualization to a noninvasive visualization, potentially ensuring earlier diagnosis and on-time treatment. Radionuclide therapy is a newly developed modality for the treatment of breast cancer in which radionuclides are delivered to tumors and/or tumor-associated targets either directly or using delivery vehicles. Radionuclide therapy has been proven to be eminently effective and to exhibit low toxicity in eliminating both primary tumors and metastases, and even undetected tumors. In addition, the specific interaction between the surface modules of the delivery vehicles and the targets on the surface of tumor cells enables radionuclide targeting therapy, and this represents an exceptional potential for this treatment in breast cancer. This article reviews the development of radionuclide molecular imaging techniques that are currently employed for early breast cancer diagnosis and both the progress and challenges of radionuclide therapy employed in breast cancer treatment.
放射性核素介导的诊断和治疗已成为治疗乳腺癌的有效和低风险方法。与传统的解剖成像技术相比,基于放射性核素的分子成像诊断系统具有更高的灵敏度和能力,能从功能角度精确显示乳腺癌的生物分布和代谢过程;这就使诊断从有创可视化转变为无创可视化,从而可能确保更早的诊断和及时的治疗。放射性核素疗法是一种新开发的治疗乳腺癌的方法,通过直接或使用运载工具将放射性核素输送到肿瘤和/或肿瘤相关靶点。事实证明,放射性核素疗法在消除原发肿瘤和转移瘤,甚至是未发现的肿瘤方面非常有效,而且毒性低。此外,运载工具的表面模块与肿瘤细胞表面的靶点之间的特异性相互作用使放射性核素靶向治疗成为可能,这为乳腺癌的治疗带来了非凡的潜力。本文回顾了目前用于早期乳腺癌诊断的放射性核素分子成像技术的发展,以及放射性核素疗法在乳腺癌治疗中的进展和挑战。
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引用次数: 0
Automatic deep learning method for third lumbar selection and body composition evaluation on CT scans of cancer patients 针对癌症患者 CT 扫描的第三腰椎选择和身体成分评估的自动深度学习方法
Pub Date : 2024-01-10 DOI: 10.3389/fnume.2023.1292676
Lidia Delrieu, Damien Blanc, A. Bouhamama, Fabien Reyal, Frank Pilleul, Victor Racine, A. Hamy, Hugo Crochet, Timothée Marchal, Pierre Etienne Heudel
The importance of body composition and sarcopenia is well-recognized in cancer patient outcomes and treatment tolerance, yet routine evaluations are rare due to their time-intensive nature. While CT scans provide accurate measurements, they depend on manual processes. We developed and validated a deep learning algorithm to automatically select and segment abdominal muscles [SM], visceral fat [VAT], and subcutaneous fat [SAT] on CT scans.A total of 352 CT scans were collected from two cancer centers. The detection of the third lumbar vertebrae and three different body tissues (SM, VAT, and SAT) were annotated manually. The 5-fold cross-validation method was used to develop the algorithm and validate its performance on the training cohort. Results were validated on an external independent group of CT scans.The algorithm for automatic L3 slice selection had a mean absolute error of 4 mm for the internal validation dataset and 5.5 mm for the external validation dataset. The median DICE similarity coefficient for body composition was 0.94 for SM, 0.93 for VAT, and 0.86 for SAT in the internal validation dataset whereas it was 0.93 for SM, 0.93 for VAT, and 0.85 for SAT in the external validation dataset. There were high correlation scores with sarcopenia metrics in both internal and external validation datasets.Our deep learning algorithm facilitates routine research use and could be integrated into electronic patient records, enhancing care through better monitoring and the incorporation of targeted supportive measures like exercise and nutrition.
身体成分和肌肉疏松症对于癌症患者的预后和治疗耐受性非常重要,这一点已得到广泛认可,但由于需要耗费大量时间,常规评估并不多见。虽然 CT 扫描能提供精确的测量结果,但它们依赖于人工操作。我们开发并验证了一种深度学习算法,可自动选择和分割 CT 扫描中的腹部肌肉(SM)、内脏脂肪(VAT)和皮下脂肪(SAT)。第三腰椎和三种不同身体组织(内脏脂肪、内脏脂肪层和皮下脂肪)的检测均由人工标注。采用 5 倍交叉验证法开发算法,并在训练组群中验证其性能。自动 L3 切片选择算法在内部验证数据集和外部验证数据集上的平均绝对误差分别为 4 毫米和 5.5 毫米。在内部验证数据集中,身体成分的 DICE 相似系数中位数分别为 SM 0.94、VAT 0.93 和 SAT 0.86,而在外部验证数据集中,身体成分的 DICE 相似系数中位数分别为 SM 0.93、VAT 0.93 和 SAT 0.85。在内部和外部验证数据集中,我们的深度学习算法与肌肉疏松症指标的相关性都很高。我们的深度学习算法便于常规研究使用,并可集成到电子病历中,通过更好的监测和纳入有针对性的支持措施(如运动和营养)来加强护理。
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引用次数: 0
Editorial: Insights in PET and SPECT: 2023 社论:PET 和 SPECT 透视:2023 年
Pub Date : 2023-12-21 DOI: 10.3389/fnume.2023.1342672
M. Petretta, C. Nappi, Alberto Cuocolo
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引用次数: 0
Quantitative imaging for 177Lu-PSMA treatment response monitoring and dosimetry 用于 177Lu-PSMA 治疗反应监测和剂量测定的定量成像技术
Pub Date : 2023-12-14 DOI: 10.3389/fnume.2023.1291253
Catherine Meyer, Laszlo Szidonya, Celeste Winters, Anna Mench, Nadine Mallak, Erik Mittra
PSMA-targeted radiopharmaceutical therapy is an established treatment option for metastatic castration-resistant prostate cancer (mCRPC). However, response rates and duration using 177Lu-PSMA-617 vary considerably between patients. Quantitative 177Lu SPECT imaging is one approach that may be leveraged to more closely monitor inter-cycle response, as well as patient-specific absorbed doses. In this work, we describe our experience implementing quantitative imaging throughout the course of 177Lu-PSMA treatment, including serial SPECT imaging to monitor response and for individualized dosimetry. We also describe our imaging protocols and dose calculation workflows for 3D voxelized patient-specific organ and tumor dosimetry, including a review of the current landscape and efforts towards harmonized dosimetry.
PSMA靶向放射性药物疗法是治疗转移性阉割耐药前列腺癌(mCRPC)的一种成熟疗法。然而,不同患者使用 177Lu-PSMA-617 的反应率和持续时间差异很大。定量 177Lu SPECT 成像是一种可用于更密切监测周期间反应以及患者特异性吸收剂量的方法。在这项工作中,我们介绍了在整个 177Lu-PSMA 治疗过程中实施定量成像的经验,包括用于监测反应和个体化剂量测定的序列 SPECT 成像。我们还介绍了用于三维体素化患者特异性器官和肿瘤剂量测定的成像方案和剂量计算工作流程,包括对当前形势和为统一剂量测定所做努力的回顾。
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引用次数: 0
Utilizing MRI, [18F]FDG-PET and [89Zr]Zr-DFO-28H1 FAP-PET tracer to assess inflammation and fibrogenesis in a reproducible lung injury rat model: a multimodal imaging study 利用核磁共振成像、[18F]FDG-PET 和[89Zr]Zr-DFO-28H1 FAP-PET 示踪剂评估可重复肺损伤大鼠模型中的炎症和纤维生成:一项多模态成像研究
Pub Date : 2023-12-12 DOI: 10.3389/fnume.2023.1306251
Milou Boswinkel, R. Raavé, A. Veltien, T. Scheenen, N. Fransén Petterson, René in ‘t Zandt, Lars E. Olsson, Karin von Wachenfeldt, Sandra Heskamp, Irma Mahmutovic Persson
Accurate imaging biomarkers that indicate disease progression at an early stage are highly important to enable timely mitigation of symptoms in progressive lung disease. In this context, reproducible experimental models and readouts are key. Here, we aim to show reproducibility of a lung injury rat model, by inducing disease and assessing disease progression by multi-modal non-invasive imaging techniques at two different research sites. Furthermore, we evaluated the potential of fibroblast activating protein (FAP) as an imaging biomarker in the early stage of lung fibrosis.An initial lung injury rat model was set up at one research site (Lund University, Lund, Sweden) and repeated at a second site (Radboudumc, Nijmegen, The Netherlands). To induce lung injury, Sprague-Dawley rats received intratracheal instillation of bleomycin as one single dose (1,000 iU in 200 µL) or saline as control. Thereafter, longitudinal images were acquired to track inflammation in the lungs, at 1 and 2 weeks after the bleomycin challenge by magnetic resonance imaging (MRI) and [18F]FDG-PET. After the final [18F]FDG-PET scan, rats received an intravenous tracer [89Zr]Zr-DFO-28H1 (anti-FAP antibody) and were imaged at day 15, to track fibrogenesis. Upon termination, bronchoalveolar lavage (BAL) was performed to assess cell and protein concentration. Subsequently, the biodistribution of [89Zr]Zr-DFO-28H1 was measured ex vivo and the spatial distribution in lung tissue was studied by autoradiography. Lung sections were stained, and fibrosis assessed using the modified Ashcroft score.Bleomycin-challenged rats showed body weight loss and increased numbers of immune cells and protein concentrations after BAL compared with control animals. The initiation and progression of the disease were reproduced at both research sites. Lung lesions in bleomycin-exposed rats were visualized by MRI and confirmed by histology. [18F]FDG uptake was higher in the lungs of bleomycin-challenged rats compared with the controls, similar to that observed in the Lund study. [89Zr]Zr-DFO-28H1 tracer uptake in the lung was increased in bleomycin-challenged rats compared with control rats (p = 0.03).Here, we demonstrate a reproducible lung injury model and monitored disease progression using conventional imaging biomarkers MRI and [18F]FDG-PET. Furthermore, we showed the first proof-of-concept of FAP imaging. This reproducible and robust animal model and imaging experimental set-up allows for future research on new therapeutics or biomarkers in lung disease.
能在早期阶段显示疾病进展的精确成像生物标志物对于及时缓解进展性肺病的症状非常重要。在这种情况下,可重复的实验模型和读数是关键。在这里,我们旨在展示肺损伤大鼠模型的可重复性,在两个不同的研究地点诱发疾病,并通过多模态无创成像技术评估疾病进展。此外,我们还评估了成纤维细胞活化蛋白(FAP)作为肺纤维化早期阶段成像生物标志物的潜力。在一个研究机构(瑞典隆德市隆德大学)建立了初始肺损伤大鼠模型,并在另一个研究机构(荷兰奈梅亨市拉德布鲁德姆克)重复建立了该模型。为了诱导肺损伤,Sprague-Dawley大鼠接受了博莱霉素单剂量(1,000 iU,200 µL)气管内灌注或生理盐水作为对照。之后,在博莱霉素作用1周和2周后,通过磁共振成像(MRI)和[18F]FDG-PET获取纵向图像,以追踪肺部炎症情况。最后一次[18F]FDG-PET扫描后,大鼠接受静脉注射示踪剂[89Zr]Zr-DFO-28H1(抗FAP抗体),并在第15天进行成像,以跟踪纤维生成情况。扫描结束后,进行支气管肺泡灌洗(BAL)以评估细胞和蛋白质浓度。随后,在体内测量[89Zr]Zr-DFO-28H1的生物分布,并通过自显影研究其在肺组织中的空间分布。与对照组相比,博莱霉素挑战大鼠体重下降,BAL后免疫细胞数量和蛋白质浓度增加。博莱霉素感染大鼠的体重减轻,与对照组相比,BAL后免疫细胞数量和蛋白质浓度增加。疾病的发生和发展过程在两个研究地点均有重现。暴露于博莱霉素的大鼠的肺部病变可通过核磁共振成像观察到,并通过组织学证实。与对照组相比,博莱霉素致病大鼠肺部的[18F]FDG摄取量更高,这与隆德研究中观察到的情况相似。[在这里,我们展示了一种可重复的肺损伤模型,并利用传统的成像生物标志物核磁共振成像和[18F]FDG-PET监测了疾病的进展。此外,我们还首次展示了 FAP 成像的概念验证。这种可重复性强的动物模型和成像实验装置为未来研究肺部疾病的新疗法或生物标记物提供了可能。
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引用次数: 0
Editorial: Quantitative [18F]NaF PET in metastatic and metabolic bone diseases 社论:转移性和代谢性骨病中的定量[18F]NaF PET
Pub Date : 2023-12-11 DOI: 10.3389/fnume.2023.1343913
T. Puri, Amelia E. B. Moore, Abhishek Mahajan, Alan McWilliam, M. Vrist, G. M. Blake
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引用次数: 0
Editorial: Prof. Frank Rösch's legacy in the radiopharmaceutical chemistry field 社论:弗兰克-罗施教授在放射性药物化学领域的遗产
Pub Date : 2023-11-27 DOI: 10.3389/fnume.2023.1336481
C. Poulie, Markus Piel, Bernd Neumaier, Tobias Ross, Matthias Herth
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引用次数: 0
Effects of dynamic [18F]NaF PET scan duration on kinetic uptake parameters in the knee 动态[18F]NaF PET 扫描持续时间对膝关节动力学摄取参数的影响
Pub Date : 2023-11-24 DOI: 10.3389/fnume.2023.1194961
L. Watkins, Bryan Haddock, Ananya Goyal, Feliks Kogan
Accurately estimating bone perfusion and metabolism using [18F]NaF kinetics from shorter scan times could help address concerns related to patient comfort, motion, and throughput for PET scans. We examined the impact of changing the PET scan duration on the accuracy of [18F]NaF kinetic parameters in the knee.Both knees of twenty participants with and without osteoarthritis were scanned using a hybrid PET-MRI system (53 ± 13 years, BMI 25.9 ± 4.2 kg/m2, 13 female). Seventeen participants were scanned for 54 ± 2 min, and an additional three participants were scanned for 75 min. Patlak Ki and Hawkins kinetic parameters (Ki, K1, extraction fraction) were assessed using 50- or 75-minutes of scan data as well as for scan durations that were retrospectively shortened. The error of the kinetic uptake parameters was calculated in bone regions throughout the knee.The mean error of Patlak Ki, Hawkins Ki, K1, and extraction fraction was less than 10% for scan durations exceeding 30 min and decreased with increasing scan duration.The length of dynamic data acquisition can be reduced to as short as 30 min while retaining accuracy within the limits of reproducibility of Hawkins kinetic uptake parameters.
使用较短扫描时间的[18F]NaF动力学参数准确估计骨灌注和新陈代谢有助于解决与患者舒适度、运动和PET扫描吞吐量有关的问题。我们研究了改变 PET 扫描持续时间对膝关节[18F]NaF 动力学参数准确性的影响。我们使用 PET-MRI 混合系统扫描了 20 名患有和未患有骨关节炎的参与者的双膝(53 ± 13 岁,BMI 25.9 ± 4.2 kg/m2,13 名女性)。17 名参与者的扫描时间为 54 ± 2 分钟,另有 3 名参与者的扫描时间为 75 分钟。帕特拉克 Ki 和霍金斯动力学参数(Ki、K1、萃取分数)使用 50 或 75 分钟的扫描数据以及回顾性缩短的扫描时间进行评估。在扫描时间超过 30 分钟时,Patlak Ki、Hawkins Ki、K1 和萃取分数的平均误差小于 10%,随着扫描时间的延长,误差逐渐减小。
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引用次数: 0
期刊
Frontiers in Nuclear Medicine
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