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Mini EXPLORER II: a prototype high-sensitivity PET/CT scanner for companion animal whole body and human brain scanning
摘要： As part of the EXPLORER total-body positron emission tomography (PET) project, we have designed and built a high-resolution, high-sensitivity PET/CT scanner which is expected to have excellent performance for companion animal whole body and human brain imaging. The PET component has a ring diameter of 52 cm and an axial field of view of 48.3 cm. The detector modules are composed of arrays of lutetium (yttrium) oxyorthosilicate (LYSO) crystals of dimensions 2.76x2.76x18.1 mm coupled to silicon photomultipliers (SiPMs) for read-out. The CT component is a 24 detector row CT scanner with a 50 kW X-ray tube. PET system time-of-flight resolution was measured to be 409±39 ps and average system energy resolution was 11.7%±1.5% at 511 keV. The NEMA NU2-2012 system sensitivity was found to be 52-54 kcps/MBq. Spatial resolution was 2.6 mm at 10mm from the center of the FOV and 2.0 mm rods were clearly resolved on a mini-Derenzo phantom. Peak noise-equivalent count (NEC) rate, using the NEMA NU 2-2012 phantom, was measured to be 314 kcps at 9.2 kBq/cc. The CT scanner passed the technical components of the American College of Radiology (ACR) accreditation tests. We have also performed scans of a Hoffman brain phantom and we show images from the first canine patient imaged on this device.
关键词： NEMA,PET/CT,EXPLORER,total-body PET,companion animal,brain
更新于2025-09-23 15:23:52
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Comparison of image quality and lesion detection between digital and analog PET/CT
摘要： Objective The purpose of this study was to compare image quality and lesion detection capability between a digital and an analog PET/CT system in oncological patients. Materials and methods One hundred oncological patients (62 men, 38 women; mean age of 65 ± 12 years) were prospectively included from January–June 2018. All patients, who accepted to be scanned by two systems, consecutively underwent a single day, dual imaging protocol (digital and analog PET/CT). Three nuclear medicine physicians evaluated image quality using a 4-point scale (?1, poor; 0, fair; 1, good; 2, excellent) and detection capability by counting the number of lesions with increased radiotracer uptake. Differences were considered significant for a p value <0.05. Results Improved image quality in the digital over the analog system was observed in 54% of the patients (p = 0.05, 95% CI, 44.2–63.5). The percentage of interrater concordance in lesion detection capability between the digital and analog systems was 97%, with an interrater measure agreement of κ = 0.901 (p < 0.0001). Although there was no significant difference in the total number of lesions detected by the two systems (digital: 5.03 ± 10.6 vs. analog: 4.53 ± 10.29; p = 0.7), the digital system detected more lesions in 22 of 83 of PET+ patients (26.5%) (p = 0.05, 95% CI, 17.9–36.7). In these 22 patients, all lesions detected by the digital PET/CT (and not by the analog PET/CT) were < 10 mm. Conclusion Digital PET/CT offers improved image quality and lesion detection capability over the analog PET/CT in oncological patients, and even better for sub-centimeter lesions.
关键词： Analog PET/CT,Digital PET/CT,Image quality,Lesion detection capability
更新于2025-09-23 15:23:52
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PET/CT with Fluorodeoxyglucose During Neoadjuvant
摘要： Objective: The aim of the present study is to evaluate the accuracy of Positron Emission Tomography/Computed Tomography (PET/CT) with Fluorodeoxyglucose ([18F]FDG) to predict treatment response in patients with locally advanced rectal cancer (LARC) during neoadjuvant chemoradiotherapy. Patients and methods: Forty-one LARC patients performed [18F]FDG-PET/CT at baseline (PET0). All patients received continuous capecitabine concomitant to radiotherapy on the pelvis, followed by intermittent capecitabine until two weeks before curative surgery. [18F]FDG-PET/CT was also carried out at 40 Gy-time (PET1) and at the end of neoadjuvant therapy (PET2). PET imaging was analysed semi-quantitatively through the measurement of maximal standardised uptake value (SUVmax) and the tumour volume (TV). Histology was expressed through pTNM and Dworak tumor regression grading. Patients were categorised into responder (downstaging or downsizing) and non-responder (stable or progressive disease by comparison pretreatment parameters with clinical/pathological characteristics posttreatment/after surgery). Logistic regression was used to evaluate SUVmax and TV absolute and percent reduction as predictors of response rate using gender, age, and CEA as covariates. Progression-free survival (PFS) and overall survival (OS) were estimated by the Kaplan-Meier method. Survivals were compared by the Log-Rank test. Results: Twenty-three responders (9 ypCR, 14 with downstaged disease) and 18 non-responders showed differences in terms of both early and posttreatment SUVmax percent reduction (median comparison: responder = 63.2%, non-responder = 44.2%, p = 0.04 and responder = 76.9%, non-responder = 61.6%, p = 0.06 respectively). The best predictive cut-offs of treatment response for early and post-treatment SUVmax percent reduction were ≥57% and ≥66% from baseline (p = 0.02 and p = 0.01 respectively). Conclusions: [18F]FDG-PET/CT is a reliable technique for evaluating therapy response during neoadjuvant treatment in LARC, through a categorical classification of the SUV max reduction during treatment.
关键词： neoadjuvant therapy,PET/CT,rectal cancer,fluorodeoxyglucose
更新于2025-09-23 15:23:52
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Evaluation of patient effective dose in a PET/CT test
摘要： The positron emission tomography (PET)/computed tomography (CT) technique generates high doses in patients because two radiodiagnostic modalities are used in a single examination. In this study, the absorbed and effective doses generated by CT scans and by the incorporation of radiopharmaceutical solution were evaluated in 19 organs. It was found that 78.2% of the effective dose in PET/CT examinations comes from the CT scan. With an activity of 3.33 MBq/kg, 18F-FDG contributes 21.8% of the final effective dose.
关键词： Patient dosimetry,PET/CT,Computed tomography
更新于2025-09-23 15:23:52
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Performance of whole-body 18F-FDG PET/CT as a posttreatment surveillance tool for sinonasal malignancies
摘要： Purpose To determine the diagnostic utility of posttreatment surveillance whole-body 18F-FDG PET/CT in detecting local tumor recurrence (R), regional lymph-node metastasis (LM), and distant metastasis (DM) in asymptomatic sinonasal cancer patients. Methods Eighty consecutive patients (53 men, 27 women; mean age, 60 years; range, 28–92 years) who had undergone 197 posttreatment whole-body 18F-FDG PET/CT examinations for sinonasal malignancies between January 2009 and August 2017 were retrospectively reviewed. 18F-FDG PET/CT findings were categorized as positive or negative for R, LM, and DM, separately. Outcomes of 18F-FDG PET/CT scans were compared with the final diagnosis confirmed by histological analysis or follow-up period for a minimum 12 months. The diagnostic accuracy of scans was calculated for each site using contingency tables. Impact on the management of 18F-FDG PET/CT examinations was additionally evaluated. Results 18F-FDG PET/CT scans identified 37/44 of local recurrences, 21/23 of LMs, and 30/37 of DMs. For local recurrence, sensitivity, specificity, positive predictive value, and negative predictive value were 84% (68–97%), 95% (80–100%), 84% (68–97%), and 95% (80–100%), respectively. For LM, the respective values were 91% (75–100%), 99% (83–100%), 91% (75–100%), and 99% (83–100%). For DM, the values were 81% (64–97%), 99% (85–100%), 97% (81–100%), and 96% (81–100%), respectively. 18F-FDG PET/CT accounted for a change in management of 85% patients with recurrences. Conclusions Whole-body 18F-FDG PET/CT is a suitable surveillance tool for sinonasal malignancies in detecting locoregional and distant recurrences in asymptomatic patients without any evidence of recurrence on regular follow-up and endoscopy during the posttreatment period.
关键词： Posttreatment,Recurrence,Surveillance,Sinonasal malignancies,18F-FDG PET/CT
更新于2025-09-23 15:23:52
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Uso de análisis semicuantitativo en la recidiva local del carcinoma colorrectal mediante PET/TC con 18F-FDG: ?mito o realidad?
摘要： Objective: Recurrence of colorectal cancer is mostly seen within the first 2 years after surgery. The most frequent site of recurrence is the postsurgical areas and its surroundings. The purpose of this study was to evaluate the usefulness of semiquantitative analysis of 18Fluorine fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in determining recurrence of colorectal carcinoma in the operation site. Material and methods: Files of 35 patients with colorectal carcinoma (25 men, 10 women, mean age: 59.25 ± 2.82 years, range: 27-80 years) who were treated with surgery and underwent FDG PET/CT scanning for restaging of colorectal carcinoma and showing increased FDG uptake in the postsurgical area, were retrospectively analysed. Besides calculating SUVmax of the areas showing FDG uptake, SUVmax of physiological colonic activity was also obtained and SUVmax of lesion/SUVmax of colonic wall (RSUVmax), was calculated. Characteristics of FDG uptake were classified according to histological analysis or clinical and imaging follow-up. Results: In 17 of 35 patients (49%) the standard of reference for the final diagnosis was histologic analysis and in 18 (51%), final diagnosis was based on imaging and clinical follow-up. In 15 of 35 patients (43%) the etiology of increased FDG uptake was recurrence and in 20 (57%), FDG accumulation was observed due to benign etiology. The difference between the mean of the results of SUVmax in patients with recurrent disease and with no evidence of recurrence was statistically significant (P = .030). For SUVmax, a cut-off value for recurrence was calculated as 9.51 with a sensitivity of 80% and a specificity of 70%. In terms of RSUVmax results, a statistically significant difference was also observed between mean values in patients with recurrent disease and in those without (P = .002). ROC analysis demonstrated that the best predictive value of RSUVmax for recurrence was 1.75 with a sensitivity of 67% and specificity of 95%. Conclusions: Semiquantitative analysis of FDG PET/CT may be used in detecting recurrent disease of patients with colorectal carcinoma. Eliminating interfering physiological colonic activity in analysis may have an incremental effect on the success of this technique, by means of increasing the specificity.
关键词： Colorectal carcinoma,Physiological activity,Recurrence,Semiquantitative,FDG PET/CT
更新于2025-09-23 15:23:52
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Image-based Absorbed Dosimetry of Radioisotope
摘要： An absorbed dose calculation method using a digital phantom is implemented in normal organs. This method cannot be employed for calculating the absorbed dose of tumor. In this study, we measure the S-value for calculating the absorbed dose of each organ and tumor. We inject a radioisotope into a torso phantom and perform Monte Carlo simulation based on the CT data. The torso phantom has lung, liver, spinal, cylinder, and tumor simulated using a spherical phantom. The radioactivity of the actual absorbed dose is measured using the injected dose of the radioisotope, which is Cu-64 73.85 MBq, and detected using a glass dosimeter in the torso phantom. To perform the Monte Carlo simulation, the information on each organ and tumor acquired using the PET/CT and CT data provides anatomical information. The anatomical information is offered above mean value and manually segmented for each organ and tumor. The residence time of the radioisotope in each organ and tumor is calculated using the time activity curve of Cu-64 radioactivity. The S-values of each organ and tumor are calculated based on the Monte Carlo simulation data using the spatial coordinate, voxel size, and density information. The absorbed dose is evaluated using that obtained through the Monte Carlo simulation and the S-value and the residence time in each organ and tumor. The absorbed dose in liver, tumor1, and tumor2 is 4.52E-02, 4.61E-02, and 5.98E-02 mGy/MBq, respectively. The difference in the absorbed dose measured using the glass dosimeter and that obtained through the Monte Carlo simulation data is within 12.3%. The result of this study is that the absorbed dose obtained using an image can evaluate each difference region and size of a region of interest.
关键词： Absorbed dosimetry,Torso phantom,Cu-64,PET/CT,Glass dosimeter
更新于2025-09-23 15:23:52
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Clinical Value of Positron Emission Tomography-Computed Tomography Combined with Ultrasound in Detection of Primary Tumors in Patients with Malignant Ascites
摘要： Objective: To investigate and discuss the clinical value of positron emission tomography-computed tomography (PET-CT) combined with ultrasound in detection of primary tumors in patients with malignant ascites (MA). Materials and Methods: A total of 122 malignant tumor patients with ascites as the initial symptom and 48 patients with benign ascites were enrolled in this study. All patients underwent PET-CT and abdominal B-ultrasound examinations. The corresponding specificity, sensitivity, accuracy rate, positive predictive value, and negative predictive value of PET-CT, abdominal B-ultrasound, and combined detection group were recorded, respectively, with pathological findings as the gold standards. Statistical Product and Service Solutions 17.0 software was used for statistical analysis. p < 0.05 suggested that the difference was statistically significant. Results: The detection rate of primary foci through PET-CT was 79.5%, of which the detection rate of primary foci of MA derived from gastric cancer was the highest. The detection rate of primary foci through B-ultrasound was 62.5%, which is the highest for MA derived from ovarian cancer. B-ultrasound had the highest specificity in diagnosing the primary foci of MA (73.2%), PET-CT had the highest sensitivity in diagnosing the primary foci of MA (91.7%), and PET-CT combined with abdominal B-ultrasound had the highest sensitivity and accuracy in diagnosing the primary foci of MA (98.1% and 89.1%, respectively). The diagnostic accuracy rate of B-ultrasound was the highest in detecting tumors >5 cm (77.0%), whereas that of PET-CT was the highest in detecting tumors of 3–5 cm (84.2%). Conclusion: The PET-CT combined with ultrasound is conducive to improving the diagnostic efficiency for primary tumors in patients with MA.
关键词： ultrasound,malignant ascites,PET-CT,clinical value
更新于2025-09-23 15:23:52
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Design and performance evaluation of high resolution small animal PET scanner based on monolithic crystal: a simulation study
摘要： Dedicated small-animal PET scanners functionality can be optimized by improving the sensitivity and spatial resolution of the scanner. Approximately most of the developed and commercially available small-animal PET scanners are equipped with pixelated scintillators; therefore, their spatial resolution is limited to the crystal pixel size. Complex fabrication, low-sensitivity, and disability in depth of interaction calculation (DOI) are the major disadvantages of pixelated crystals. However, monolithic scintillator crystals are known as one of the most commonly used substitutions, as they have higher sensitivity, DOI recognition, and lower cost. We already designed and implemented a dedicated small-animal PET scanner based on pixelated scintillator crystals and silicon photomultiplier (SiPM). In this study, we plan to present a new optimized design based on the monolithic crystal, with similar performance by the previous scanner. Then we would optimize the thickness of the monolithic crystals for animal PET scanners as a function of sensitivity and spatial resolution. All simulations were performed based on GEANT4, a validated Monte Carlo toolkit. We simulated a recently fabricated scanner with pixelated crystals and compared it with a simulated scanner based on an optimized monolithic crystal. The experimental setup used for comparison and validation is a small Animal PET consisting of ten pixelated modules. This study anticipates that by replacing a pixelated crystal (consist of 24 × 24 LYSO elements, and 2 × 2 × 10 mm3 crystal size) with a monolithic crystal (with 8 mm thickness and 50.2 × 50.2 entrance area), the average spatial resolution stays the same and sensitivity grows ～ 17% in the center of AFOV and also the fabrication cost dives remarkably. Simulation reveals that although the depth of interaction DOI was not taken into consideration, the crystals with 6 mm thickness have acceptable spatial resolution (～ 1.3 mm FWHM at the centre of the AFOV) and relatively good absolute sensitivity (～ 1.6%).
关键词： SPECT,coronary CT angiography (CTA),PET PET/CT,Gamma camera,Models and simulations
更新于2025-09-23 15:22:29
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Randomized prospective phase III trial of 68Ga-PSMA-11 PET/CT molecular imaging for prostate cancer salvage radiotherapy planning [PSMA-SRT]
摘要： Background: Salvage radiotherapy (SRT) for prostate cancer (PCa) recurrence after prostatectomy offers long-term biochemical control in about 50–60% of patients. SRT is commonly initiated in patients with serum PSA levels < 1 ng/mL, a threshold at which standard-of-care imaging is insensitive for detecting recurrence. As such, SRT target volumes are usually drawn in the absence of radiographically visible disease. 68Ga-PSMA-11 (PSMA) PET/CT molecular imaging is highly sensitive and may offer anatomic localization of PCa biochemical recurrence. However, it is unclear if incorporation of PSMA PET/CT imaging into the planning of SRT could improve its likelihood of success. The purpose of this trial is to evaluate the success rate of SRT for recurrence of PCa after prostatectomy with and without planning based on PSMA PET/CT. Methods: We will randomize 193 patients to proceed with standard SRT (control arm 1, n = 90) or undergo a PSMA PET/CT scan (free of charge for patients) prior to SRT planning (investigational arm 2, n = 103). The primary endpoint is the success rate of SRT measured as biochemical progression-free survival (BPFS) after initiation of SRT. Biochemical progression is defined by PSA ≥ 0.2 ng/mL and rising. The randomization ratio of 1:1.13 is based on the assumption that approximately 13% of subjects randomized to Arm 2 will not be treated with SRT because of PSMA-positive extra-pelvic metastases. These patients will not be included in the primary endpoint analysis but will still be followed. The choice of treating the prostate bed alone vs prostate bed and pelvic lymph nodes, with or without androgen deprivation therapy (ADT), is selected by the treating radiation oncologist. The radiation oncologist may change the radiation plan depending on the findings of the PSMA PET/CT scan. Any other imaging is allowed for SRT planning in both arms if done per routine care. Patients will be followed until either one of the following conditions occur: 5 years after the date of initiation of randomization, biochemical progression, diagnosis of metastatic disease, initiation of any additional salvage therapy, death. Discussion: This is the first randomized phase 3 prospective trial designed to determine whether PSMA PET/CT molecular imaging can improve outcomes in patients with PCa early BCR following radical prostatectomy. Acronym: PSMA-SRT Phase 3 trial.
关键词： Randomized phase 3 trial,PET/CT,Prostate cancer,PSMA,Salvage radiation therapy
更新于2025-09-23 15:22:29