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Background: This study evaluated, as a snapshot, the variability in quantification and image quality (IQ) of the clinically utilized PET [18F]FDG whole-body protocols in Finland using a NEMA/IEC IQ phantom permanently filled with 68Ge. Methods: The phantom was imaged on 14 PET-CT scanners, including a variety of models from two major vendors. The variability of the recovery coefficients (RCmax, RCmean and RCpeak) of the hot spheres as well as percent background variability (PBV), coefficient of variation of the background (COVBG) and accuracy of corrections (AOC) were studied using images from clinical and standardized protocols with 20 repeated measurements. The ranges of the RCs were also compared to the limits of the EARL 18F standards 2 accreditation (EARL2). The impact of image noise on these parameters was studied using averaged images (AVIs). Results: The largest variability in RC values of the routine protocols was found for the RCmax with a range of 68% and with 10% intra-scanner variability, decreasing to 36% when excluding protocols with suspected cross-calibration failure or without point-spread-function (PSF) correction. The RC ranges of individual hot spheres in routine or standardized protocols or AVIs fulfilled the EARL2 ranges with two minor exceptions, but fulfilling the exact EARL2 limits for all hot spheres was variable. RCpeak was less dependent on averaging and reconstruction parameters than RCmax and RCmean. The PBV, COVBG and AOC varied between 2.3–11.8%, 9.6–17.8% and 4.8–32.0%, respectively, for the routine protocols. The RC ranges, PBV and COVBG were decreased when using AVIs. With AOC, when excluding routine protocols without PSF correction, the maximum value dropped to 15.5%. Conclusion: The maximum variability of the RC values for the [18F]FDG whole-body protocols was about 60%. The RC ranges of properly cross-calibrated scanners with PSF correction fitted to the EARL2 RC ranges for individual sphere sizes, but fulfilling the exact RC limits would have needed further optimization. RCpeak was the most robust RC measure. Besides COVBG, also RCs and PVB were sensitive to image noise. [ABSTRACT FROM AUTHOR]

Background: This study evaluated, as a snapshot, the variability in quantification and image quality (IQ) of the clinically utilized PET [ 18 F]FDG whole-body protocols in Finland using a NEMA/IEC IQ phantom permanently filled with 68 Ge., Methods: The phantom was imaged on 14 PET-CT scanners, including a variety of models from two major vendors. The variability of the recovery coefficients (RC max , RC mean and RC peak ) of the hot spheres as well as percent background variability (PBV), coefficient of variation of the background (COV BG ) and accuracy of corrections (AOC) were studied using images from clinical and standardized protocols with 20 repeated measurements. The ranges of the RCs were also compared to the limits of the EARL 18 F standards 2 accreditation (EARL2). The impact of image noise on these parameters was studied using averaged images (AVIs)., Results: The largest variability in RC values of the routine protocols was found for the RC max with a range of 68% and with 10% intra-scanner variability, decreasing to 36% when excluding protocols with suspected cross-calibration failure or without point-spread-function (PSF) correction. The RC ranges of individual hot spheres in routine or standardized protocols or AVIs fulfilled the EARL2 ranges with two minor exceptions, but fulfilling the exact EARL2 limits for all hot spheres was variable. RC peak was less dependent on averaging and reconstruction parameters than RC max and RC mean . The PBV, COV BG and AOC varied between 2.3-11.8%, 9.6-17.8% and 4.8-32.0%, respectively, for the routine protocols. The RC ranges, PBV and COV BG were decreased when using AVIs. With AOC, when excluding routine protocols without PSF correction, the maximum value dropped to 15.5%., Conclusion: The maximum variability of the RC values for the [ 18 F]FDG whole-body protocols was about 60%. The RC ranges of properly cross-calibrated scanners with PSF correction fitted to the EARL2 RC ranges for individual sphere sizes, but fulfilling the exact RC limits would have needed further optimization. RC peak was the most robust RC measure. Besides COV BG , also RCs and PVB were sensitive to image noise., (© 2023. The Author(s).)

Background: Radiation synovectomy is an effective technique for the treatment of chronic synovitis in patients with rheumatoid arthritis (RA), and is an alternative for surgical synovectomy. Holmium ferric hydroxide macroaggregates (166Ho-FHMA) is suitable for radiation synovectomy, especially because it emits high-energy beta particles and a smaller proportion of low-energy photons that are suitable for gamma-camera imaging., Objective: The aim of this study was to develop a method to fuse 166Ho-FHMA single photon emission computed tomography (SPECT) and magnetic resonance (MRI) images, to show the distribution of 166Ho-FHMA inside the joint with images that localize synovitis., Methods: The knees of 6 patients with RA were treated with 166Ho-FHMA. (99m)Tc-human immunoglobulin ((99m)Tc-HIG) SPECT images and MRI images were taken before 166Ho-FHMA injections. 166Ho-FHMA SPECT images were taken 4, 28, and 40 hours after injections. SPECT and MRI images were merged using a specific image fusion method, called mutual information algorithm, to study associations between anatomical and metabolic information from these images., Results: Fusion of SPECT and MRI images indicated that intensity of radioactivity was associated with the amount of synovitis. Activity distribution of 166Ho-FHMA could be registered using anatometabolic images., Conclusions: A new method to fuse the distribution of radiation in the synovectomy of the knee was developed using SPECT/MRI image registration. Image registration of SPECT and MRI can be used to determine the activity distribution of radioisotopes in relation to synovitis.

This study was designed to find out if the lymph flow, indicated as albumin clearance, from active skeletal muscle is maintained constant during a prolonged steady-state exercise. 99mTc-labelled albumin was injected bilaterally into the vastus lateralis muscles of eight endurance-trained men. The radioactivity at the injection site was monitored by a gamma-camera before, frequently during, and after a 2 h run at a controlled steady intensity of 69 +/- 4% of the maximal heart rate. The fractional clearance rate of albumin was calculated for each monitoring interval, and was expressed as percentage clearance per minute (% min(-1)). During the first 15 min of exercise the clearance rate was five times higher than at rest before the exercise (0.29 +/- 0.12 vs. 0.06 +/- 0.05% min(-1), P = 0.001). During the next 25 min of running the clearance rate fell to 0.19 +/- 0.08% min(-1) (P = 0.02), from which level it was further attenuated, being 0.12 +/- 0.04% min(-1) at the end of the exercise. After the exercise the clearance rate fell rapidly to the level of 0.04 +/- 0.03% min(-1). The results showed that the albumin clearance from working muscles is not constant during steady-state exercise, suggesting that lymph flow from exercising skeletal muscle may not be constant despite lymphatic pumping being assumed to be unchanged during the course of exercise (i.e. constant exercise intensity and running speed).

1. The effects of dynamic and isometric muscle contractions on the lymph flow dynamics in human skeletal muscle were studied with a scintographic method. 2. Radioactively labelled human serum albumin (99mTc-HSA) was injected bilaterally into the vastus lateralis muscles of eight men (n = 16), four of whom had had an endurance training background. The subjects performed 100 submaximal contractions in 10 min as (i) dynamic knee extensions (CONS), (ii) isometric contractions with the knees at full extension (IMExt), or (iii) isometric contractions with knees fixed at 90 deg angle flexion (IMFlex). The exercises were separated by 65 min periods in supine rest. The level of radioactivity at the injection site was monitored by a gamma-camera, and the clearance rate of radioactivity (CR) was calculated as the fractional decrease during the periods of interest (CR unit = % min-1). 3. The clearance rate was low during the rest periods (0.04 +/- 0.05% min-1), though higher in the trained than in the sedentary subjects (0.06 +/- 0.05 vs. 0.03 +/- 0.03% min-1; P = 0.008). Exercise increased the clearance rate three- to sixfold, to 0.16 +/- 0.16% min-1 during CONS, 0.20 +/- 0.15% min-1 during IMExt and 0.09 +/- 0.11% min-1 during IMFlex. There were no differences between the subject subgroups. 4. The higher clearance rate during IMExt than during IMFlex (P = 0.02) demonstrates the importance of muscle deformations on lymph propulsion and experimentally confirms the current concepts of lymph formation and propulsion in voluntarily active skeletal muscle. It is suggested that lymph propulsion by working muscle is most efficient when the muscle is able to shorten close to its minimum length.