Department of Nuclear Medicine, Bern University Hospital, Inselspital, University of Bern, Freiburgstrasse 18, Bern, 3010, Switzerland.
Molecular Imaging, Siemens Healthineers, Knoxville, TN, USA.
Eur J Nucl Med Mol Imaging. 2024 Jun;51(7):2100-2113. doi: 10.1007/s00259-024-06650-9. Epub 2024 Feb 13.
Evaluation of Y liver radioembolization post-treatment clinical data using a whole-body Biograph Vision Quadra PET/CT to investigate the potential of protocol optimization in terms of scan time and dosimetry.
17 patients with hepatocellular carcinoma with median (IQR) injected activity 2393 (1348-3298) MBq were included. Pre-treatment dosimetry plan was based on Tc-MAA SPECT/CT with Simplicit90Y™ and post-treatment validation with Quadra using Simplicit90Y™ and HERMIA independently. Regarding the image analysis, mean and peak SNR, the coefficient of variation (COV) and lesion-to-background ratio (LBR) were evaluated. For the post-treatment dosimetry validation, the mean tumor, whole liver and lung absorbed dose evaluation was performed using Simplicit90Y and HERMES. Images were reconstructed with 20-, 15-, 10-, 5- and 1- min sinograms with 2, 4, 6 and 8 iterations. Wilcoxon signed rank test was used to show statistical significance (p < 0.05).
There was no difference of statistical significance between 20- and 5- min reconstructed times for the peak SNR, COV and LBR. In addition, there was no difference of statistical significance between 20- and 1- min reconstructed times for all dosimetry metrics. Lung dosimetry showed consistently lower values than the expected. Tumor absorbed dose based on Simplicit90Y™ was similar to the expected while HERMES consistently underestimated significantly the measured tumor absorbed dose. Finally, there was no difference of statistical significance between expected and measured tumor, whole liver and lung dose for all reconstruction times.
In this study we evaluated, in terms of image quality and dosimetry, whole-body PET clinical images of patients after having been treated with Y microspheres radioembolization for liver cancer. Compared to the 20-min standard scan, the simulated 5-min reconstructed images provided equal image peak SNR and noise behavior, while performing also similarly for post-treatment dosimetry of tumor, whole liver and lung absorbed doses.
使用全身 Biograph Vision Quadra PET/CT 评估 Y 肝放射性栓塞治疗后的临床数据，以研究在扫描时间和剂量学方面优化方案的潜力。
本研究纳入了 17 例中位数（IQR）为 2393（1348-3298）MBq 的肝细胞癌患者。基于 Tc-MAA SPECT/CT 使用 Simplicit90Y™ 进行治疗前剂量规划，并使用 Quadra 分别独立使用 Simplicit90Y™ 和 HERMIA 进行治疗后验证。在图像分析方面，评估了平均和峰值信噪比、变异系数（COV）和病变与背景比（LBR）。对于治疗后剂量学验证，使用 Simplicit90Y 和 HERMES 评估了平均肿瘤、全肝和肺吸收剂量。使用 2、4、6 和 8 次迭代、20、15、10、5 和 1 分钟的 sinogram 进行图像重建。使用 Wilcoxon 符号秩检验显示统计学意义（p<0.05）。
在峰值 SNR、COV 和 LBR 方面，20 分钟和 5 分钟重建时间之间没有统计学意义的差异。此外，在所有剂量学指标中，20 分钟和 1 分钟重建时间之间也没有统计学意义的差异。肺剂量始终低于预期值。基于 Simplicit90Y™ 的肿瘤吸收剂量与预期值相似，而 HERMES 则始终显著低估了测量的肿瘤吸收剂量。最后，在所有重建时间下，预计和测量的肿瘤、全肝和肺剂量之间均无统计学意义的差异。
在这项研究中，我们评估了 Y 微球放射性栓塞治疗肝癌后患者的全身 PET 临床图像的图像质量和剂量学。与 20 分钟的标准扫描相比，模拟的 5 分钟重建图像提供了相等的图像峰值 SNR 和噪声行为，同时在肿瘤、全肝和肺吸收剂量的治疗后剂量学方面也表现相当。
