Annals of Nuclear Medicine　32-7

Original Article

 

1. Effects of rs591323 on serotonin transporter availability in healthy male subjects(pp 431-436)

Kyoungjune Pak, Hyun-Yeol Nam, Seunghyeon Shin, Keunyoung Kim, Myung Jun Lee,

Eun-Joo Kim, Jae Meen Lee, Seong-Jang Kim, In Joo Kim

 

Kyoungjune Pak (ilikechopin@me.com)

Department of Nuclear Medicine and Biomedical Research Institute Pusan National University Hospital, Busan, Republic of Korea

 

2. Optimal monochromatic color combinations for fusion imaging of FDG-PET and diffusion-weighted MR images (pp 437–445)

Ryotaro Kamei, Yuji Watanabe, Koji Sagiyama, Takuro Isoda, Osamu Togao, Hiroshi Honda

 

Yuji Watanabe (yuwata55@gmail.com)

Department of Molecular Imaging and Diagnosis Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan

 

3. Clinical application of ^99mTc-HYNIC-TOC SPECT/CT in diagnosing and monitoring of pancreatic neuroendocrine neoplasms (pp 446–452)

Junyan Xu, Yi Li, Xiaoping Xu, Jiangang Zhang, Yingjian Zhang, Xianjun Yu, Dan Huang

 

Yingjian Zhang (yjzhang111@aliyun.com)

Department of Nuclear Medicine Fudan University Shanghai Cancer Center, Shanghai, China

Center for Biomedical Imaging Fudan University, Shanghai, China

Shanghai Engineering Research Center of Molecular Imaging Probes Fudan University, Shanghai, China

Department of Oncology, Shanghai Medical College Fudan University, Shanghai, China

Key Laboratory of Nuclear Physics and Ion-beam Application (MOE)Fudan University, Shanghai, China

 

 

4. Assessment of tumor response to chemoradiotherapy and predicting prognosis in patients with head and neck squamous cell carcinoma by PERCIST (pp 453–462)

Takayuki Katsuura, Kazuhiro Kitajima, Masayuki Fujiwara, Tomonori Terada, Nobuhiro Uwa, Kazuma Noguchi, Hiroshi Doi, Yukihisa Tamaki, Rika Yoshida, Tatsuya Tsuchitani, Masahiro Fujita, Koichiro Yamakado

 

Kazuhiro Kitajima (kazu10041976@yahoo.co.jp)

Division of Nuclear Medicine and PET center, Department of Radiology Hyogo College of Medicine, Nishinomiya, Japan

 

5. Reliable radiosynthesis of 4-[¹⁰B]borono-2-[¹⁸F]fluoro-l-phenylalanine with quality assurance for boron neutron capture therapy-oriented diagnosis (pp 463–473)

Kiichi Ishiwata, Ryoichi Ebinuma, Chuichi Watanabe, Kunpei Hayashi, Jun Toyohara

 

Kiichi Ishiwata (kiichiishiwata@gmail.com)

Institute of Cyclotron and Drug Discovery Research Southern TOHOKU Research Institute for Neuroscience, Koriyama, Japan

Department of Bio functional Imaging Fukushima Medical University, Fukushima, Japan

Research Team for Neuroimaging Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan

 

6. Reconstruction/segmentation of attenuation map in TOF-PET based on mixture models

(pp 474–484)

Hamidreza Hemmati, Alireza Kamali-Asl, Pardis Ghafarian, Mohammad Reza Ay

 

Alireza Kamali-Asl (a_kamali@sbu.ac.ir)

Department of Medical Radiation Engineering Shahid Beheshti University, Tehran, Iran

 

7. Evaluation of the default-mode network by quantitative ¹⁵O-PET: comparative study between cerebral blood flow and oxygen consumption (pp 485–491)

Jo Aoe, Tadashi Watabe, Eku Shimosegawa, Hiroki Kato, Yasukazu Kanai, Sadahiro Naka,

Keiko Matsunaga, Kayako Isohashi, Mitsuaki Tatsumi, Jun Hatazawa

 

Tadashi Watabe (watabe@tracer.med.osaka-u.ac.jp)

Department of Nuclear Medicine and Tracer Kinetics Osaka University Graduate School of Medicine, Suita, Japan

 

8. Is ¹⁸F-FDG PET/CT useful for the differential diagnosis of solitary pulmonary nodules in patients with idiopathic pulmonary fibrosis? (pp 492–498)

Suk Hyun Lee, Changhwan Sung, Hyo Sang Lee, Hee-young Yoon, Soo-Jong Kim, Jungsu S. Oh, Jin Woo Song, Mi Young Kim, Jin-Sook Ryu

 

Jin-Sook Ryu (jsryu2@amc.seoul.kr)

Department of Nuclear Medicine, Asan Medical Center University of Ulsan College of Medicine, Seoul, South Korea

 

Short Communication

 

9. Radiation exposure after ¹⁷⁷Lu-DOTATATE and ¹⁷⁷Lu-PSMA-617 therapy (pp 499–502)

Christian Mair, Boris Warwitz, Katharina Fink, Lorenza Scarpa, Bernhard Nilica, Johanna Maffey-Steffan, Sabine Buxbaum, Irene J. Virgolini

 

Christian Mair (c.mair@tirol-kliniken.at)

Department of Nuclear Medicine Medical University of Innsbruck, Innsbruck, Austria

 

 

1. Effects of rs591323 on serotonin transporter availability in healthy male subjects

Kyoungjune Pak, Hyun-Yeol Nam, Seunghyeon Shin, Keunyoung Kim, Myung Jun Lee,

Eun-Joo Kim, Jae Meen Lee, Seong-Jang Kim, In Joo Kim

Abstract

Objectives

We aimed to investigate the association between genetic factors of SNPs dopamine transporter (DAT) and serotonin transporter (SERT) availabilities in healthy controls.

Methods

The study population consisted of healthy controls with screening ¹²³I-FP-CIT single-photon emission computed tomography. Specific binding of ¹²³I-FP-CIT regarding DAT and SERT was calculated using a region of interest analysis. VOI template was applied to measure specific binding ratios (SBRs) of caudate nucleus, putamen, striatum, midbrain, and pons.

Results

One hundred sixty healthy controls (male 106, female 54, 61.0 ± 11.5 years) were included in this study. Sex difference did not exist in DAT availabilities of caudate nucleus (p = 0.5344), putamen (p = 0.5006), and striatum (p = 0.5056). However, male subjects had higher SERT availabilities of both midbrain (p = 0.0436), and pons (p = 0.0061). Therefore, we analyzed the effect of SNP on DAT availabilities of subjects in all, and that on SERT availabilities of males and females separately. None of 19 SNPs included in this study showed the effect on DAT availabilities. However, rs591323 in Fibroblast Growth Factor 20 on chromosome 8 had a significant impact on SERT availability of both midbrain (p = 0.0056) and pons (p = 0.0007).

Conclusion

SNP rs591323 of risk loci for Parkinson’s disease is associated with SERT availability of healthy male subjects.

Keywords

SPECT, Serotonin transporter, Single nucleotide polymorphism

 

2. Optimal monochromatic color combinations for fusion imaging of FDG-PET and diffusion-weighted MR images

Ryotaro Kamei, Yuji Watanabe, Koji Sagiyama, Takuro Isoda, Osamu Togao, Hiroshi Honda

Abstract

Objective

To investigate the optimal monochromatic color combination for fusion imaging of FDG-PET and diffusion-weighted MR images (DW) regarding lesion conspicuity of each image.

Methods

Six linear monochromatic color-maps of red, blue, green, cyan, magenta, and yellow were assigned to each of the FDG-PET and DW images. Total perceptual color differences of the lesions were calculated based on the lightness and chromaticity measured with the photometer. Visual lesion conspicuity was also compared among the PET-only, DW-only and PET-DW-double positive portions with mean conspicuity scores. Statistical analysis was performed with a one-way analysis of variance and Spearman’s rank correlation coefficient.

Results

Among all the 12 possible monochromatic color-map combinations, the 3 combinations of red/cyan, magenta/green, and red/green produced the highest conspicuity scores. Total color differences between PET-positive and double-positive portions correlated with conspicuity scores (ρ = 0.2933, p < 0.005). Lightness differences showed a significant negative correlation with conspicuity scores between the PET-only and DWI-only positive portions. Chromaticity differences showed a marginally significant correlation with conspicuity scores between DWI-positive and double-positive portions.

Conclusions

Monochromatic color combinations can facilitate the visual evaluation of FDG-uptake and diffusivity as well as registration accuracy on the FDG-PET/DW fusion images, when red- and green-colored elements are assigned to FDG-PET and DW images, respectively.

Keywords

FDG-PET, Diffusion-weighted MR Imaging, Fusion image, Color perception, Image processing

 

3. Clinical application of ^99mTc-HYNIC-TOC SPECT/CT in diagnosing and monitoring of pancreatic neuroendocrine neoplasms

Junyan Xu, Yi Li, Xiaoping Xu, Jiangang Zhang, Yingjian Zhang, Xianjun Yu, Dan Huang

Abstract

Objective

Our aim of this research was to determine the value of SPECT/CT with ^99mTc-HYNIC-TOC for evaluation of the pancreatic masses which were suspected as neuroendocrine neoplasms and follow-up of patients with pancreatic neuroendocrine neoplasms.

Methods

We retrospectively analyzed 184 patients who performed ^99mTc-HYNIC-TOC SPECT/CT. All the patients were divided into two groups: one for assessment of diagnostic efficiency for pancreatic suspected masses (n = 140) and another for monitoring recurrence after surgery (n = 44). The image findings acquired at 2 h postinjection were compared to final diagnoses from pathological results and clinical follow-up. Then, the correlation between ratios of tumor-to-background (TBR) and tumor grade was analyzed.

Results

In group 1, 95/140 (67.9%) patients were confirmed as neuroendocrine neoplasms including 85 neuroendocrine tumors and 10 neuroendocrine carcinomas. Patient-based analysis showed that the sensitivity, specificity and accuracy of diagnosing neuroendocrine neoplasms with SPECT/CT were 81.1, 84.4 and 82.1%. There was significant difference of TBRs among G1, G2 and G3 (F = 3.175, P = 0.048). In group 2, 22/44 (50.0%) patients occurred metastasis mainly in liver. The sensitivity, specificity and accuracy of monitoring recurrence were 87.0, 100 and 93.2%.

Conclusions

^99mTc-HYNIC-TOC SPECT/CT is a reliable method of diagnosing and monitoring of pancreatic neuroendocrine neoplasms, especially neuroendocrine tumors.

Keywords

^99mTc-HYNIC-TOC, Pancreatic neuroendocrine neoplasm, SPECT/CT, Ratios of tumor-to-background

 

4. Assessment of tumor response to chemoradiotherapy and predicting prognosis in patients with head and neck squamous cell carcinoma by PERCIST

Takayuki Katsuura, Kazuhiro Kitajima, Masayuki Fujiwara, Tomonori Terada, Nobuhiro Uwa, Kazuma Noguchi, Hiroshi Doi, Yukihisa Tamaki, Rika Yoshida, Tatsuya Tsuchitani, Masahiro Fujita, Koichiro Yamakado

Abstract

Purpose

To evaluate therapeutic response to chemoradiotherapy and prediction of recurrence and death in patients with head and neck squamous cell carcinoma (HNSCC) using Positron Emission Tomography Response Criteria in Solid Tumors (PERCIST).

Materials and methods

Forty-two patients (mean 63.4, range 20–79 years) with nasopharyngeal (n = 10), oropharyngeal (n = 13), hypopharyngeal (n = 11), or laryngeal (n = 8) cancer underwent fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) before and approximately 3 months (mean 95.0, range 70–119 days) after undergoing concurrent chemoradiotherapy. The effect of PERCIST regarding progression-free survival (PFS) and overall survival (OS) was examined using log-rank and Cox methods.

Results

Complete metabolic response (CMR), partial metabolic response (PMR), stable metabolic disease (SMD), and progressive metabolic disease shown by PERCIST were seen in 30 (71.4%), 9 (21.4%), 3 (7.1%), and 0 patients, respectively. Fourteen (33.3%) developed recurrent disease (median follow-up 27.2, range 8.7–123.1 months) and 9 (21.4%) died (median follow-up 43.6, range 9.6–132.6 months). Furthermore, 4 (13.3%) of 30 patients with CMR developed recurrence, while 7 (77.8%) of 9 with PMR and all 3 (100%) with SMD developed recurrence. Two (6.7%) of 30 patients with CMR, 4 (44.4%) of 9 with PMR, and all 3 (100%) with SMD died. Patients who achieved CMR showed significantly longer PFS and OS as compared to those who did not (PMR and SMD) (both, p < 0.0001).

Conclusion

PERCIST is useful for evaluating therapeutic response to chemoradiotherapy and predicting recurrence and death in HNSCC patients.

Keywords

Head and neck squamous cell carcinoma (HNSCC), FDG-PET/CT, PERCIST, Treatment response, Prognosis

 

5. Reliable radiosynthesis of 4-[¹⁰B]borono-2-[¹⁸F]fluoro-l-phenylalanine with quality assurance for boron neutron capture therapy-oriented diagnosis

Kiichi Ishiwata, Ryoichi Ebinuma, Chuichi Watanabe, Kunpei Hayashi, Jun Toyohara

Abstract

Objective

The aim of this study was to establish a reliable and routine method for the preparation of 4-[¹⁰B]borono-2-[¹⁸F]fluoro-l-phenylalanine (l-[¹⁸F]FBPA) for boron neutron capture therapy-oriented diagnosis using positron emission tomography.

Methods

To produce l-[¹⁸F]FBPA by electrophilic fluorination of 4-[¹⁰B]borono-l-phenylalanine (l-BPA) with [¹⁸F]acetylhypofluorite ([¹⁸F]AcOF) via [¹⁸F]F₂ derived from the ²⁰Ne(d,α)¹⁸F nuclear reaction, several preparation parameters and characteristics of l-[¹⁸F]FBPA were investigated, including: pre-irradiation for [¹⁸F]F₂ production, the carrier F₂ content in the Ne target, l-BPA-to-F₂ ratios, separation with high-performance liquid chromatography (HPLC) using 10 different eluents, enantiomeric purity, and residual trifluoroacetic acid used as the reaction solvent by gas chromatography-mass spectrometry.

Results

The activity yields and molar activities of l-[¹⁸F]FBPA (n = 38) were 1200 ± 160 MBq and 46–113 GBq/mmol, respectively, after deuteron-irradiation for 2 h. Two 5 min pre-irradiations prior to [¹⁸F]F₂ production for ¹⁸F-labeling were preferable. For l-[¹⁸F]FBPA synthesis, 0.15–0.2% of carrier F₂ in Ne and l-BPA-to-F₂ ratios > 2 were preferable. HPLC separations with five of the 10 eluents provided injectable l-[¹⁸F]FBPA without any further formulation processing, which resulted in a synthesis time of 32 min. Among the five eluents, 1 mM phosphate-buffered saline was the eluent of choice. The l-[¹⁸F]FBPA injection was sterile and pyrogen-free, and contained very small amounts of D-enantiomer (< 0.1% of l-[¹⁸F]FBPA), l-BPA (< 1% of l-FBPA), and trifluoroacetic acid (< 0.5 ppm).

Conclusions

l-[¹⁸F]FBPA injection was reliably prepared by the electrophilic fluorination of l-BPA with [¹⁸F]AcOF followed by HPLC separation with 1 mM phosphate-buffered saline.

Keywords

l-[¹⁸F]FBPA, [¹⁸F]F2 production, Quality control, PET, BNCT

 

6. Reconstruction/segmentation of attenuation map in TOF-PET based on mixture models

Hamidreza Hemmati, Alireza Kamali-Asl, Pardis Ghafarian, Mohammad Reza Ay

Abstract

Attenuation correction is known as a necessary step in positron emission tomography (PET) system to have accurate and quantitative activity images. Emission-based method is known as a promising approach for attenuation map estimation on TOF-PET scanners. The proposed method in this study imposes additional histogram-based information as a mixture model prior on the emission-based approach using maximum a posteriori (MAP) framework to improve its performance and make such a nearly segmented attenuation map. To eliminate misclassification of histogram modeling, a Median root prior is incorporated on the proposed approach to reduce the noise between neighbor voxels and encourage spatial smoothness in the reconstructed attenuation map. The joint-MAP optimization is carried out as an iterative approach wherein an alteration of the activity and attenuation updates is followed by a mixture decomposition of the attenuation map histogram. Also, the proposed method can segment attenuation map during the reconstruction. The evaluation of the proposed method on the numerical, simulation and real contexts indicate that the presented method has the potential to be used as a stand-alone method or even combined with other methods for attenuation correction on PET/MR systems.

Keywords

TOF emission data, Reconstruction, Attenuation map, Mixture models, PET/MR 

 

7. Evaluation of the default-mode network by quantitative ¹⁵O-PET: comparative study between cerebral blood flow and oxygen consumption

Jo Aoe, Tadashi Watabe, Eku Shimosegawa, Hiroki Kato, Yasukazu Kanai, Sadahiro Naka,

Keiko Matsunaga, Kayako Isohashi, Mitsuaki Tatsumi, Jun Hatazawa

Abstract

Objective

Resting-state functional MRI (rs-fMRI) has revealed the existence of a default-mode network (DMN) based on spontaneous oscillations of the blood oxygenation level-dependent (BOLD) signal. The BOLD signal reflects the deoxyhemoglobin concentration, which depends on the relationship between the regional cerebral blood flow (CBF) and the cerebral metabolic rate of oxygen (CMRO₂). However, these two factors cannot be separated in BOLD rs-fMRI. In this study, we attempted to estimate the functional correlations in the DMN by means of quantitative ¹⁵O-labeled gases and water PET, and to compare the contribution of the CBF and CMRO₂ to the DMN.

Methods

Nine healthy volunteers (5 men and 4 women; mean age, 47.0 ± 1.2 years) were studied by means of ¹⁵O-O₂, ¹⁵O-CO gases and ¹⁵O-water PET. Quantitative CBF and CMRO₂ images were generated by an autoradiographic method and transformed into MNI standardized brain template. Regions of interest were placed on normalized PET images according to the previous rs-fMRI study. For the functional correlation analysis, the intersubject Pearson’s correlation coefficients (r) were calculated for all pairs in the brain regions and correlation matrices were obtained for CBF and CMRO₂, respectively. We defined r > 0.7 as a significant positive correlation and compared the correlation matrices of CBF and CMRO₂.

Results

Significant positive correlations (r > 0.7) were observed in 24 pairs of brain regions for the CBF and 22 pairs of brain regions for the CMRO₂. Among them, 12 overlapping networks were observed between CBF and CMRO₂. Correlation analysis of CBF led to the detection of more brain networks as compared to that of CMRO₂, indicating that the CBF can capture the state of the spontaneous activity with a higher sensitivity.

Conclusions

We estimated the functional correlations in the DMN by means of quantitative PET using ¹⁵O-labeled gases and water. The correlation matrix derived from the CBF revealed a larger number of brain networks as compared to that derived from the CMRO₂, indicating that contribution to the functional correlation in the DMN is higher in the blood flow more than the oxygen consumption.

Keywords

Default-mode network, Functional correlation, ¹⁵O PET, Cerebral blood flow, Cerebral metabolic rate of oxygen

 

8. Is ¹⁸F-FDG PET/CT useful for the differential diagnosis of solitary pulmonary nodules in patients with idiopathic pulmonary fibrosis?

Suk Hyun Lee, Changhwan Sung, Hyo Sang Lee, Hee-young Yoon, Soo-Jong Kim, Jungsu S. Oh, Jin Woo Song, Mi Young Kim, Jin-Sook Ryu

Abstract

Objective

Idiopathic pulmonary fibrosis (IPF) is associated with an increased incidence of lung cancer, but patients with IPF often have poor pulmonary function and are vulnerable to pneumothorax and so using an invasive procedure to diagnose a single nodule detected on chest CT risks a critical adverse outcome. ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography/computed tomography (PET/CT) is recognized to be useful for differentiating between benign and malignant solitary pulmonary nodules (SPN) in patients without IPF, but its diagnostic accuracy has not been investigated in patients with IPF. In this study, therefore, we investigated whether ¹⁸F-FDG PET/CT is useful for the differential diagnosis of SPNs in patients with IPF.

Methods

From the IPF patient cohort of our institution, we retrospectively reviewed 55 patients (54 men, 1 woman; age 67.8 ± 7.6 years) with an SPN sized 8–30 mm (mean 18.5 ± 5.7 mm) who underwent chest CT followed by ¹⁸F-FDG PET/CT between April 2004 and March 2016. The ¹⁸F-FDG uptake of the SPN was analyzed visually and semiquantitatively, and these determinations were compared with the final diagnosis obtained by pathology (n = 52) or imaging follow-up (n = 3).

Results

The final diagnoses showed that 41 (75%) of the SPNs were malignant (21 squamous cell carcinomas, 9 adenocarcinomas, 5 small-cell carcinomas, 4 mixed-type carcinomas, 1 large-cell neuroendocrine carcinoma, and 1 sarcoid carcinoma) and 14 (25%) were benign. The determination of malignant SPNs by visual analysis of the PET/CT images had a sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 98, 86, 95, and 92%, respectively. The semiquantitative analysis using a maximum standardized uptake value of 2.0 as the cut-off had a sensitivity, specificity, PPV, and NPV of 95, 93, 98, and 87%, respectively.

Conclusions

¹⁸F-FDG PET/CT is useful for differentiating benign and malignant SPNs in patients with IPF, as it is for patients without IPF.

Keywords

¹⁸F-fluorodeoxyglucose, Positron emission tomography, Lung cancer, Solitary pulmonary nodule, Idiopathic pulmonary fibrosis

 

9. Radiation exposure after ¹⁷⁷Lu-DOTATATE and ¹⁷⁷Lu-PSMA-617 therapy

Christian Mair, Boris Warwitz, Katharina Fink, Lorenza Scarpa, Bernhard Nilica, Johanna Maffey-Steffan, Sabine Buxbaum, Irene J. Virgolini

Abstract

Purpose

As radionuclide therapy is gaining importance in palliative treatment of patients suffering from neuroendocrine tumour (NET) as well as castration resistant prostate cancer (CRPC), the radiation protection of patients, staff, family members and the general public is of increasing interest. Here, we determine patient discharge dates according to European guidelines.

Methods

In 40 patients with NET and 25 patients with CRPC organ and tumour doses based on the MIRD concept were calculated from data obtained during the first therapy cycle. Planar whole body images were recorded at 0.5, 4, 20, 68 und 92 h postinjection. Residence times were calculated from the respective time-activity-curves based on the conjugated view method. Residence times for critical organs were fitted into the commercially available OLINDA software to calculate the organ doses. The doses of tumours and salivary glands were calculated via their self-irradiation by approximation with spheres of equivalent volume. Kidney volumes were gained by organ segmentation, volumes of all other organs were estimated by means of OLINDA and hence were lean body mass corrected. Out of the whole body curves reference points for patient discharge were estimated.

Results

In patients with NET discharge dates could be properly estimated from dosimetric data, which is not only crucial for radiation protection, but also makes therapy planning easier. For ¹⁷⁷Lu-PSMA-617 ligand therapy it is difficult to seriously estimate a generalized discharge date due to large interpatient variation resulting from different tumor loads and heavy pre-treatment.

Conclusion

Patient release is predictable for ¹⁷⁷Lu-DOTATATE therapy but not for ¹⁷⁷Lu-PSMA ligand therapy.

Keywords

Patient discharge, Radiation protection, Dosimetry, ¹⁷⁷Lu-DOTATATE, ¹⁷⁷Lu-PSMA