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PET Lung Ventilation/Perfusion Imaging Using 68Ga Aerosol (Galligas) and 68Ga-Labeled Macroaggregated Albumin

  • S. J. Ament
  • S. Maus
  • H. Reber
  • H. G. Buchholz
  • N. Bausbacher
  • C. Brochhausen
  • F. Graf
  • M. Miederer
  • M. Schreckenberger
Conference paper
Part of the Recent Results in Cancer Research book series (RECENTCANCER, volume 194)

Abstract

Pulmonary imaging using ventilation/perfusion (V/P) single-photon emission tomography (V/P scan) with Tc-99m-labeled radiotracers is a well-established diagnostic tool for clinically suspected pulmonary embolism (PE). Ga-68 aerosol (Galligas) and Ga-68-labeled macroaggregated albumin (MAA) are potential tracers for positron emission tomography (PET) lung V/P imaging and could display an advantage over conventional V/P scans in terms of sensitivity and specificity. After radiochemical and animal studies, the clinical applicability of Ga-68 aerosol (Galligas) and Ga-68-labeled MAA was investigated in an exploratory study in patients with clinical suspicion of PE. PET scans were acquired using a 16-slice Gemini TF positron emission tomography/computed tomography (PET/CT) scanner. The acquisition protocol included low-dose computed tomography (CT) for attenuation correction (AC). Dosimetry calculations and continuative phantom measurements were performed. Structural analyses showed no modification of the particles due to the labeling process. In addition, in vitro experiments showed stability of Ga-68 MAA in various media. As expected, Ga-68-labeled human serum albumin microspheres (HSAM) were completely retained in the lung of the animals. In clinical use, PET lung ventilation and perfusion imaging using Ga-68 aerosol (Galligas) and Ga-68-labeled MAA was successful in all cases. In one case a clinically suspected PE could be detected and verified. The administered activity of Ga-68 aerosol (Galligas) and Ga-68-labeled MAA may be reduced by more than 50%, resulting in comparable radiation exposure to conventional V/P scans. In conclusion, Ga-68 aerosol (Galligas) and Ga-68-labeled MAA are efficient substitutes for clinical use and could be an interesting alternative with high accuracy for lung V/P imaging with Tc-99m-labeled radiotracers, especially in times of Mo-99 shortages and increasing use and spread of PET/CT scanners and Ga-68 generators, respectively.

Keywords

Positron Emission Tomography Pulmonary Embolism Human Serum Albumin Perfusion Imaging Lung Ventilation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Abbreviations

AC

Attenuation correction

CT

Computed tomography

CTA

Computed tomography angiography

cGMP

Current good manufacturing practice

DLP

Dose–length product

DOTA

1,4,7,10-Tetraazacyclododecane-1,4,7,10-tetraacetic acid (chelate)

DVT

Deep vein thrombosis

EANM

European Association of Nuclear Medicine

HSA

Human serum albumin

HSAM

Human serum albumin microspheres

HU

Hounsfield unit

ICRP

International Commission on Radiological Protection

ITLC

Instant thin-layer chromatography

MAA

Macroaggregated albumin

NEC

Noise-equivalent count

OSEM

Ordered-subsets expectation maximization (reconstruction)

PE

Pulmonary embolism

PET

Positron emission tomography

PET/CT

Positron emission tomography/computed tomography

RNP

Radionuclide purity

ROI

Region of interest

rpm

Revolutions per minute

SEM

Scanning electron microscopy

SPECT

Single-photon emission computed tomography

SUV

Standardized uptake value

VOI

Volumes of interest

V/P

Ventilation/perfusion

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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • S. J. Ament
    • 1
  • S. Maus
    • 1
  • H. Reber
    • 1
  • H. G. Buchholz
    • 1
  • N. Bausbacher
    • 1
  • C. Brochhausen
    • 2
  • F. Graf
    • 1
  • M. Miederer
    • 1
  • M. Schreckenberger
    • 1
  1. 1.Department of Nuclear MedicineUniversity Medical Centre, Johannes Gutenberg-UniversityMainzGermany
  2. 2.Institute of PathologyUniversity Medical Centre, Johannes Gutenberg-UniversityMainzGermany

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