Ng Aik H, Blackshaw Patricia E, Alqahtani Mohammed S, Jambi Layal K, Bugby Sarah L, Lees John E, Perkins Alan C
aRadiological Sciences, Division of Clinical Neuroscience bSchool of Medicine, Sir Peter Mansfield Imaging Centre, University of Nottingham cMedical Physics and Clinical Engineering, Nottingham University Hospitals NHS Trust, Nottingham dDepartment of Physics and Astronomy, Space Research Centre, Michael Atiyah Building, University of Leicester, Leicester, UK eMinistry of Health, Federal Government Administration Centre, Putrajaya, Malaysia fDepartment of Radiological Sciences, College of Applied Medical Sciences, King Khalid University, Abha gDepartment of Radiological Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Kingdom of Saudi Arabia.
Nucl Med Commun. 2017 Sep;38(9):729-736. doi: 10.1097/MNM.0000000000000715.
Hybrid imaging has proven to be a major innovation in nuclear medicine, allowing the fusion of functional information with anatomical detail. In the past, the use of hybrid imaging such as PET-CT, PET-MRI and SPECT-CT has been of great clinical benefit; however, these scanners are relatively large and bulky. We have developed and investigated the clinical application of a compact small field of view hybrid gamma camera (HGC) that is suitable for small-organ imaging at the patient bedside.
The HGC - consisting of a CsI(Tl) scintillation crystal coupled to an electron-multiplying charge-coupled device and an optical camera - was used in this study. Eligible patients attending the nuclear medicine clinic at Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK, were invited to take part in this study. Following the standard injection of either a Tc-labelled or I-labelled radiopharmaceutical, images of the patient were acquired using the HGC and presented in a fused optical-gamma display.
There were 24 patients enrolled in the study (age range between 30 and 83 years, mean: 58.6 years), images of 18 of whom were successfully acquired. These included patients who were undergoing bone, thyroid, lacrimal drainage, DaTscan and lymphatic imaging. In general, the small field of view system was well suited to small-organ imaging. The uptake could be clearly seen in relation to the patient surface anatomy and showed particular promise for lymphatic, thyroid and lacrimal drainage studies.
This pilot study has demonstrated the first clinical results of hybrid optical-gamma imaging in patients. The use of this system has raised new possibilities for small-organ imaging, in which the localization of radiopharmaceutical uptake can be presented in an anatomical context using optical imaging. The compact nature of the hybrid system offers the potential for bedside investigations and intraoperative use.
混合成像已被证明是核医学领域的一项重大创新，它能够将功能信息与解剖细节相融合。过去，正电子发射断层扫描-计算机断层扫描（PET-CT）、正电子发射断层扫描-磁共振成像（PET-MRI）和单光子发射计算机断层扫描-计算机断层扫描（SPECT-CT）等混合成像技术的应用带来了巨大的临床益处；然而，这些扫描仪相对体积较大且笨重。我们已研发并研究了一种紧凑型小视野混合伽马相机（HGC）的临床应用，该相机适用于在患者床边进行小器官成像。
本研究使用了由碘化铯（铊）闪烁晶体与电子倍增电荷耦合器件及光学相机组成的HGC。邀请了英国诺丁汉大学医院国民保健服务信托基金旗下女王医疗中心核医学门诊符合条件的患者参与本研究。在标准注射锝标记或碘标记的放射性药物后，使用HGC获取患者图像，并在融合的光学-伽马显示器上呈现。
本研究共纳入24例患者（年龄范围为30至83岁，平均年龄：58.6岁），其中18例患者的图像成功获取。这些患者包括正在接受骨骼、甲状腺、泪道引流、多巴胺转运体显像（DaTscan）及淋巴成像的患者。总体而言，小视野系统非常适合小器官成像。放射性药物摄取情况与患者体表解剖结构的关系清晰可见，在淋巴、甲状腺及泪道引流研究中显示出特别的前景。
这项初步研究展示了混合光学-伽马成像在患者中的首批临床结果。该系统的使用为小器官成像带来了新的可能性，即放射性药物摄取的定位可以通过光学成像在解剖背景下呈现。混合系统的紧凑特性为床边检查和术中使用提供了潜力。
