Abstract
Purpose
The purpose of this study was to evaluate the clinical feasibility of next generation solid-state digital photon counting PET/CT (dPET/CT) technology and imaging findings in patients following 90Y microsphere radioembolization in comparison with standard of care (SOC) bremsstrahlung SPECT/CT (bSPECT/CT).
Methods
Five patients underwent SOC 90Y bremsstrahlung imaging immediately following routine radioembolization with 3.5 ± 1.7 GBq of 90Y-labeled glass microspheres. All patients also underwent dPET/CT imaging at 29 ± 11 h following radioembolization. Matched pairs comparison was used to compare image quality, image contrast and 90Y biodistribution between dPET/CT and bSPECT/CT images. Volumetric assessments of 90Y activity using different isocontour thresholds on dPET/CT and bSPECT/CT images were also compared.
Results
Digital PET/CT consistently provided better visual image quality and 90Y-to-background image contrast while depicting 90Y biodistribution than bSPECT/CT. Isocontour volumetric assessment using a 1% threshold precisely outlined 90Y activity and the treatment volume on dPET/CT images, whereas a more restrictive 20% threshold on bSPECT/CT images was needed to obtain comparable treatment volumes. The use of a less restrictive 10% threshold isocontour on bSPECT/CT images grossly overestimated the treatment volume when compared with the 1% threshold on dPET/CT images.
Conclusions
Digital PET/CT is clinically feasible for the assessment of 90Y microsphere biodistribution following radioembolization, and provides better visual image quality and image contrast than routine bSPECT/CT with comparable acquisition times. With further optimization and clinical validation, dPET technology may allow faster and more accurate imaging-based assessment of 90Y microsphere biodistribution.
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Acknowledgments
C.L.W. is supported by (1) grant no. IRG-67-003-50 from the American Cancer Society, (2) grant no. RSD1339 from the Radiological Society of North America Research & Education Foundation, and (3) a National Institutes of Health (NIH)/National Cancer Institute (NCI) Clinical Loan Repayment Program. C.L.W., K.B., J.Z. and M.V.K. are supported by the Wright Center of Innovation in Biomedical Imaging and State of Ohio, Third Frontier grants TECH 09-028, TECH 10-012, and TECH 13-060. Philips Healthcare is a partner in these OTF grants and provided access to the pre commercial release Vereos system.
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All applicable international, national, and/or institutional guidelines for the care and use of animals were followed.
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Informed consent was obtained from all individual participants included in the study.
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Wright, C.L., Binzel, K., Zhang, J. et al. Clinical feasibility of 90Y digital PET/CT for imaging microsphere biodistribution following radioembolization. Eur J Nucl Med Mol Imaging 44, 1194–1197 (2017). https://doi.org/10.1007/s00259-017-3694-4
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DOI: https://doi.org/10.1007/s00259-017-3694-4