Faculty of Science, Charles Sturt University, Port Macquarie, Australia.
Faculty of Science, Charles Sturt University, Wagga Wagga, Australia.
J Med Imaging Radiat Sci. 2020 Jun;51(2):247-255. doi: 10.1016/j.jmir.2020.01.003. Epub 2020 Feb 20.
Calculation of the standard uptake value (SUV) and image quality in positron emission tomography (PET) hinges on accurate dose delivery. Extravasation or partial extravasation of the radiopharmaceutical dose can undermine SUV and image quality, and contribute to unnecessary imaging (time and CT dose). Topical sensor characterisation of injections has been reported, with extravasation rates ranging from 9% to 23% for 18F-FDG after manual injection.
A single site, single PET/CT scanner was used to characterise injections using an autoinjector with standardised apparatus, flush volume and infusion rate using 18F-FDG, 68Ga-PSMA and 68Ga-DOTATATE; more reflective of Australian PET facilities. 296 patients with topical application of LARA sensors were retrospectively analysed.
Only 1.1% of studies showed evidence of partial dose extravasation. In total, 9.1% were identified to have an injection anomaly (including venous retention). No statistically significant differences were noted across the radiopharmaceuticals for demographic data. Although not demonstrating a statistically significant correlation, there was more extravasated doses associated with female patients (P = .334), right side (P = .372), and hand injections (P = .539). Extravasation was independent of dose administered (P = .495), the radiopharmaceutical (P = .887), who injected the dose (P = .343), height (P = .438), weight (P = .607) or age (P = .716). Extravasation was associated with higher glucose levels (P < .001), higher t-half (P = .019) and higher aUCR10, tc50, aUCR1 and c1 (all P < .001).
Topical monitoring and characterisation of PET dose administration is possible and practical with the LARA device. Extravasation and partial extravasation of PET doses are not only readily detected but they are also preventable. The LARA device can provide the insights into variables that could eliminate extravasation as a cause of image quality or SUV accuracy issues.
正电子发射断层扫描（PET）中的标准摄取值（SUV）和图像质量的计算依赖于准确的剂量输送。放射性药物剂量的外渗或部分外渗会破坏 SUV 和图像质量，并导致不必要的成像（时间和 CT 剂量）。已经报道了注射部位传感器的特征，对于手动注射后 18F-FDG，外渗率范围为 9%至 23%。
使用自动注射器和标准化设备、冲洗量和输注率，使用 18F-FDG、68Ga-PSMA 和 68Ga-DOTATATE，在单个地点、单个 PET/CT 扫描仪上对注射进行特征描述，更能反映澳大利亚 PET 设施的情况。回顾性分析了 296 例使用 LARA 传感器进行局部应用的患者。
只有 1.1%的研究显示出部分剂量外渗的证据。总共，9.1%的研究被确定为注射异常（包括静脉滞留）。在人口统计学数据方面，不同放射性药物之间没有显著差异。尽管没有显示出统计学上的显著相关性，但女性患者（P =.334）、右侧（P =.372）和手部注射（P =.539）与更多的外渗剂量相关。外渗与给药剂量无关（P =.495）、放射性药物（P =.887）、给药者（P =.343）、身高（P =.438）、体重（P =.607）或年龄（P =.716）无关。外渗与更高的血糖水平相关（P <.001）、更高的 t1/2（P =.019）和更高的 aUCR10、tc50、aUCR1 和 c1（均 P <.001）。
使用 LARA 设备可以对 PET 剂量给药进行局部监测和特征描述。PET 剂量的外渗和部分外渗不仅很容易被发现，而且还可以预防。LARA 设备可以提供有关变量的见解，这些变量可以消除外渗作为图像质量或 SUV 准确性问题的原因。
