Chiesa C, Negri A, Albertini C, Azzeroni R, Setti E, Mainardi L, Aliberti G, Seregni E, Bombardieri E
Unit of Nuclear Medicine, National Cancer Institute IRCCS Milan, Italy.
Q J Nucl Med Mol Imaging. 2009 Dec;53(6):658-70. Epub 2009 Oct 7.
Gamma camera saturation is the first quantification problem in dosimetric studies following therapeutic administrations of 131I labeled radiopharmaceuticals. A new approach for dead time correction (DTC) is here proposed. It employs planar whole-body (WB) images without the need of standard radionuclide sources or of preliminary phantom calibrations.
Step and shoot WB acquisitions of the patient are required. A program was developed to compensate for the image discontinuities ("Continuity DTC method") between two adjacent static fields of view (FOVs) caused by different dead time count losses. For its validation, authors used two 99mTc 6 GBq phantom scans after administration of six patients with 131I labeled agents with different statistics and ten clinical scans taken between 16 h and 48 h after administration of 131I labeled agents, whose activity ranged from 4 to 10 GBq. The deviation from true decay corrected counts on phantoms and the constancy of monitor point-source counts in different patients' FOVs (root mean square error and maximum deviation) served as figures of merit. The accuracy of absorbed dose calculation was also estimated by comparison with the standard source correction method, computing the area under the time activity curve (AUC) of six lesions.
With respect to the true phantom counts, corrected images gave excellent results, giving a 6% maximum deviation. For what concerns the other figures of merit, continuity DTC reduced the average root mean square error from 36% to 2% and the mean maximum deviation from 50% to 2%, on phantom, while from 51% to 32/28% (absence/presence of triple energy window scatter correction) and from 72% to 21/14% on patients. Mean compensation of AUC gave a correction of +56% with our method, while +78% with standard source method.
The "Continuity DTC method" is a useful tool in dosimetry during nuclear medicine treatment, showing good accuracy. Moreover, since it does not require the use of any source, it provides with several advantages in terms of practicability and applicability, with respect to the standard source method and to methods based on the count rate characteristic curve.
γ相机饱和是131I标记放射性药物治疗给药后剂量学研究中的首要定量问题。本文提出一种新的死时间校正(DTC)方法。该方法采用全身平面(WB)图像,无需标准放射性核素源或预先进行体模校准。
需要对患者进行步进式全身采集。开发了一个程序来补偿由不同死时间计数损失导致的两个相邻静态视野(FOV)之间的图像不连续性(“连续性DTC方法”)。为验证该方法,作者在6例接受不同统计量的131I标记药物治疗的患者给药后,对两个99mTc 6 GBq体模进行扫描,并在131I标记药物给药后16小时至48小时之间进行10次临床扫描,其活度范围为4至10 GBq。体模上与真实衰变校正计数的偏差以及不同患者视野中监测点源计数的稳定性(均方根误差和最大偏差)作为性能指标。还通过与标准源校正方法比较,计算六个病灶的时间活度曲线(AUC)下的面积,来估计吸收剂量计算的准确性。
相对于真实的体模计数,校正后的图像给出了优异的结果,最大偏差为6%。对于其他性能指标,连续性DTC在体模上使平均均方根误差从36%降至2%,平均最大偏差从50%降至2%,而在患者身上从51%降至32/28%(无/有三重能量窗散射校正),从72%降至21/14%。AUC的平均补偿在我们的方法中为+56%,而在标准源方法中为+78%。
“连续性DTC方法”是核医学治疗剂量学中的一种有用工具,具有良好的准确性。此外,由于它不需要使用任何源,相对于标准源方法和基于计数率特征曲线的方法,在实用性和适用性方面具有多个优势。