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Objective: To assess the efficacy of 177Lu‐PNT2002, a novel radiolabelled small molecule that binds with high affinity to prostate‐specific membrane antigen (PSMA), in combination with stereotactic body radiotherapy (SBRT) to all sites of metastasis, vs SBRT alone, in men with oligorecurrent metastatic hormone‐sensitive prostate cancer (mHSPC). Patients and Methods: The 177Lutetium‐PSMA Neoadjuvant to Ablative Radiotherapy for Oligorecurrent Prostate Cancer (LUNAR) trial is an open‐label, randomized, stratified, two‐arm, single‐centre, Phase 2 trial to compare the efficacy and safety of neoadjuvant 177Lu‐PNT2002 plus SBRT vs SBRT alone in men with oligorecurrent mHSPC. Key eligibility criteria include one to five lesions identified on a PSMA positron emission tomography (PET)/computed tomography (CT) scan centrally reviewed by a board‐certified nuclear medicine physician. Key exclusion criteria include castrate‐resistant disease, de novo oligometastatic disease and receipt of androgen deprivation therapy (ADT) within 6 months of trial enrolment. The trial aims to enrol 100 patients who will be centrally randomized to one of the two treatment arms, in a 1:1 ratio. Patients in the control arm receive SBRT to all sites of disease. Patients in the experimental arm receive two cycles of neoadjuvant 177Lu‐PNT2002 (6.8 GBq) 6–8 weeks apart, followed by an interval PSMA PET/CT in 4–6 weeks and dose‐adapted SBRT to all sites of disease 1–2 weeks later. The primary endpoint is progression‐free survival. Secondary endpoints are radiographic and prostate‐specific antigen‐based progression, acute and late physician‐scored toxicity, patient‐reported quality of life, ADT‐free survival, time to progression, overall survival, locoregional control, and duration of response. Enrolment in the study commenced in September 2022. Results and Conclusions: The addition of 177Lu‐PNT2002 to metastasis‐directed therapy alone may potentially further forestall disease progression. The results of this Phase 2 trial will determine, for the first time in a randomized fashion, the added benefit of 177Lu‐PNT2002 to SBRT in patients with oligorecurrent mHSPC. [ABSTRACT FROM AUTHOR]

Background: PSMA-TO-1 ("Tumor-Optimized-1") is a novel PSMA ligand with longer circulation time than PSMA-617. We compared the biodistribution in subcutaneous tumor-bearing mice of PSMA-TO-1, PSMA-617 and PSMA-11 when labeled with 68Ga and 177Lu, and the survival after treatment with 225Ac-PSMA-TO-1/-617 in a murine model of disseminated prostate cancer. We also report dosimetry data of 177Lu-PSMA-TO1/-617 in prostate cancer patients. Methods: First, PET images of 68Ga-PSMA-TO-1/-617/-11 were acquired on consecutive days in three mice bearing subcutaneous C4-2 xenografts. Second, 50 subcutaneous tumor-bearing mice received either 30 MBq of 177Lu-PSMA-617 or 177Lu-PSMA-TO-1 and were sacrificed at 1, 4, 24, 48 and 168 h for ex vivo gamma counting and biodistribution. Third, mice bearing disseminated lesions via intracardiac inoculation were treated with either 40 kBq of 225Ac-PSMA-617, 225Ac-PSMA-TO-1, or remained untreated and followed for survival. Additionally, 3 metastatic castration-resistant prostate cancer patients received 500 MBq of 177Lu-PSMA-TO-1 under compassionate use for dosimetry purposes. Planar images with an additional SPECT/CT acquisition were acquired for dosimetry calculations. Results: Tumor uptake measured by PET imaging of 68Ga-labeled agents in mice was highest using PSMA-617, followed by PSMA-TO-1 and PSMA-11. 177Lu-PSMA tumor uptake measured by ex vivo gamma counting at subsequent time points tended to be greater for PSMA-TO-1 up to 1 week following treatment (p > 0.13 at all time points). This was, however, accompanied by increased kidney uptake and a 26-fold higher kidney dose of PSMA-TO-1 compared with PSMA-617 in mice. Mice treated with a single-cycle 225Ac-PSMA-TO-1 survived longer than those treated with 225Ac-PSMA-617 and untreated mice, respectively (17.8, 14.5 and 7.7 weeks, respectively; p < 0.0001). Kidney, salivary gland, bone marrow and mean ± SD tumor dose coefficients (Gy/GBq) for 177Lu-PSMA-TO-1 in patients #01/#02/#03 were 2.5/2.4/3.0, 1.0/2.5/2.3, 0.14/0.11/0.10 and 0.42 ± 0.03/4.45 ± 0.07/1.8 ± 0.57, respectively. Conclusions: PSMA-TO-1 tumor uptake tended to be greater than that of PSMA-617 in both preclinical and clinical settings. Mice treated with 225Ac-PSMA-TO-1 conferred a significant survival benefit compared to 225Ac-PSMA-617 despite the accompanying increased kidney uptake. In humans, PSMA-TO-1 dosimetry estimates suggest increased tumor absorbed doses; however, the kidneys, salivary glands and bone marrow are also exposed to higher radiation doses. Thus, additional preclinical studies are needed before further clinical use. [ABSTRACT FROM AUTHOR]

The aim of this work was to develop a novel phantom that supports the construction of highly reproducible phantoms with arbitrary activity distributions for PET imaging. It could offer a methodology for answering questions related to texture measurements in PET imaging. The basic idea is to move a point source on a 3-D trajectory in the field of view, while continuously acquiring data. The reconstruction results in a 3-D activity concentration map according to the pathway of the point source. A 22Na calibration point source was attached to a high precision robotic arm system, where the 3-D movement was software controlled. 3-D activity distributions of a homogeneous cube, a sphere, a spherical shell and a heart shape were simulated. These distributions were used to measure uniformity and to characterize reproducibility. Two potential applications using the lesion simulation method are presented: evaluation in changes of textural properties related to the position in the PET field of view; scanner comparison based on visual and quantitative evaluation of texture features. A lesion with volume of 50x50x50 mm3 can be simulated during approximately 1 hour. The reproducibility of the movement was found to be >99%. The coefficients of variation of the voxels within a simulated homogeneous cube was 2.34%. Based on 5 consecutive and independent measurements of a 36 mm diameter hot sphere, the coefficient of variation of the mean activity concentration was 0.68%. We obtained up to 18% differences within the values of investigated textural indexes, when measuring a lesion in different radial positions of the PET field of view. In comparison of two different human PET scanners the percentage differences between heterogeneity parameters were in the range of 5–55%. After harmonizing the voxel sizes this range reduced to 2–16%. The general activity distributions provided by the two different vendor show high similarity visually. For the demonstration of the flexibility of this method, the same pattern was also simulated on a small animal PET scanner giving similar results, both quantitatively and visually. 3-D motion of a point source in the PET field of view is capable to create an irregular shaped activity distribution with high reproducibility. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to examine the value of fluorodeoxyglucose (FDG) positron emission tomography (PET) in predicting subsequent rates of functional and cognitive decline among subjects considered cognitively normal (CN) or clinically diagnosed with mild cognitive impairment (MCI). Methods: Analyses of 276 subjects, 92 CN subjects and 184 with MCI, who were enrolled in the Alzheimer's Disease Neuroimaging Initiative, were conducted. Functional decline was assessed using scores on the Functional Activities Questionnaire (FAQ) obtained over a period of 36 months, while cognitive decline was determined using the Alzheimer's disease Assessment Scale-Cognitive subscale (ADAS-Cog) and Mini-Mental State Examination (MMSE) scores. PET images were analyzed using clinically routine brain quantification software. A dementia prognosis index (DPI), derived from a ratio of uptake values in regions of interest known to be hypometabolic in Alzheimer's disease to regions known to be stable, was generated for each baseline FDG-PET scan. The DPI was correlated with change in scores on the neuropsychological examinations to examine the predictive value of baseline FDG-PET. Results: DPI powerfully predicted rate of functional decline among MCI patients (t = 5.75, p < 1.0E-8) and pooled N + MCI patient groups (t = 7.02, p < 1.0E-11). Rate of cognitive decline on MMSE was also predicted by the DPI among MCI (t = 6.96, p < 1.0E-10) and pooled N + MCI (t = 8.78, p < 5.0E-16). Rate of cognitive decline on ADAS-cog was powerfully predicted by the DPI alone among N ( p < 0.001), MCI (t = 6.46, p < 1.0E-9) and for pooled N + MCI (t = 8.85, p = 1.1E-16). Conclusions: These findings suggest that an index, derivable from automated regional analysis of brain PET scans, can be used to help predict rates of functional and cognitive deterioration in the years following baseline PET. [ABSTRACT FROM AUTHOR]

Textural analysis might give new insights into the quantitative characterization of metabolically active tumors. More than thirty textural parameters have been investigated in former F18-FDG studies already. The purpose of the paper is to declare basic requirements as a selection strategy to identify the most appropriate heterogeneity parameters to measure textural features. Our predefined requirements were: a reliable heterogeneity parameter has to be volume independent, reproducible, and suitable for expressing quantitatively the degree of heterogeneity. Based on this criteria, we compared various suggested measures of homogeneity. A homogeneous cylindrical phantom was measured on three different PET/CT scanners using the commonly used protocol. In addition, a custom-made inhomogeneous tumor insert placed into the NEMA image quality phantom was imaged with a set of acquisition times and several different reconstruction protocols. PET data of 65 patients with proven lung lesions were retrospectively analyzed as well. Four heterogeneity parameters out of 27 were found as the most attractive ones to characterize the textural properties of metabolically active tumors in FDG PET images. These four parameters included Entropy, Contrast, Correlation, and Coefficient of Variation. These parameters were independent of delineated tumor volume (bigger than 25–30 ml), provided reproducible values (relative standard deviation< 10%), and showed high sensitivity to changes in heterogeneity. Phantom measurements are a viable way to test the reliability of heterogeneity parameters that would be of interest to nuclear imaging clinicians. [ABSTRACT FROM AUTHOR]

Head movement during a dynamic brain PET/CT imaging results in mismatch between CT and dynamic PET images. It can cause artifacts in CT-based attenuation corrected PET images, thus affecting both the qualitative and quantitative aspects of the dynamic PET images and the derived parametric images. In this study, we developed an automated retrospective image-based movement correction (MC) procedure. The MC method first registered the CT image to each dynamic PET frames, then re-reconstructed the PET frames with CT-based attenuation correction, and finally re-aligned all the PET frames to the same position. We evaluated the MC method's performance on the Hoffman phantom and dynamic FDDNP and FDG PET/CT images of patients with neurodegenerative disease or with poor compliance. Dynamic FDDNP PET/CT images (65 min) were obtained from 12 patients and dynamic FDG PET/CT images (60 min) were obtained from 6 patients. Logan analysis with cerebellum as the reference region was used to generate regional distribution volume ratio (DVR) for FDDNP scan before and after MC. For FDG studies, the image derived input function was used to generate parametric image of FDG uptake constant (Ki) before and after MC. Phantom study showed high accuracy of registration between PET and CT and improved PET images after MC. In patient study, head movement was observed in all subjects, especially in late PET frames with an average displacement of 6.92 mm. The z-direction translation (average maximum = 5.32 mm) and x-axis rotation (average maximum = 5.19 degrees) occurred most frequently. Image artifacts were significantly diminished after MC. There were significant differences (P<0.05) in the FDDNP DVR and FDG Ki values in the parietal and temporal regions after MC. In conclusion, MC applied to dynamic brain FDDNP and FDG PET/CT scans could improve the qualitative and quantitative aspects of images of both tracers. [ABSTRACT FROM AUTHOR]

Purpose: In this study, kinetic parameters of the cellular proliferation tracer F-3′-deoxy-3′-fluoro- l-thymidine (FLT) and the amino acid probe 3,4-dihydroxy-6-F-fluoro- l-phenylalanine (FDOPA) were measured before and early after the start of therapy, and were used to predict the overall survival (OS) of patients with recurrent malignant glioma using multiple linear regression (MLR) analysis. Methods: High-grade recurrent brain tumors in 21 patients (11 men and 10 women, age range 26 - 76 years) were investigated. Each patient had three dynamic PET studies with each probe: at baseline and after 2 and 6 weeks from the start of treatment. Treatment consisted of biweekly cycles of bevacizumab (an angiogenesis inhibitor) and irinotecan (a chemotherapeutic agent). For each study, about 3.5 mCi of FLT (or FDOPA) was administered intravenously and dynamic PET images were acquired for 1 h (or 35 min for FDOPA). A total of 126 PET scans were analyzed. A three-compartment, two-tissue model was applied to estimate tumor FLT and FDOPA kinetic rate constants using a metabolite- and partial volume-corrected input function. MLR analysis was used to model OS as a function of FLT and FDOPA kinetic parameters for each of the three studies as well as their relative changes between studies. An exhaustive search of MLR models using three or fewer predictor variables was performed to find the best models. Results: Kinetic parameters from FLT were more predictive of OS than those from FDOPA. The three-predictor MLR model derived using information from both probes (adjusted R = 0.83) fitted the OS data better than that derived using information from FDOPA alone (adjusted R = 0.41), but was only marginally different from that derived using information from FLT alone (adjusted R = 0.82). Standardized uptake values (either from FLT alone, FDOPA alone, or both together) gave inferior predictive results (best adjusted R = 0.25). Conclusion: For recurrent malignant glioma treated with bevacizumab and irinotecan, FLT kinetic parameters obtained early after the start of treatment (absolute values and their associated changes) can provide sufficient information to predict OS with reasonable confidence using MLR. The slight increase in accuracy for predicting OS with a combination of FLT and FDOPA PET information may not warrant the additional acquisition of FDOPA PET for therapy monitoring in patients with recurrent glioma. [ABSTRACT FROM AUTHOR]

Time-of-flight (TOF) information improves the signal-to-noise ratio in positron emission tomography (PET). The computation cost in processing TOF-PET sinograms is substantially higher than for nonTOF data because the data in each line of response is divided among multiple TOF bins. This additional cost has motivated research into methods for rebinning TOF data into lower dimensional representations that exploit redundancies inherent in TOF data. We have previously developed approximate Fourier methods that rebin TOF data into either three-dimensional (3D) nonTOF or 2D nonTOF formats. We refer to these methods respectively as FORET-3D and FORET-2D. Here we describe maximum a posteriori (MAP) estimators for use with FORET rebinned data. We first derive approximate expressions for the variance of the rebinned data. We then use these results to rescale the data so that the variance and mean are approximately equal allowing us to use the Poisson likelihood model for MAP reconstruction. MAP reconstruction from these rebinned data uses a system matrix in which the detector response model accounts for the effects of rebinning. Using these methods we compare the performance of FORET-2D and 3D with TOF and nonTOF reconstructions using phantom and clinical data. Our phantom results show a small loss in contrast recovery at matched noise levels using FORET compared to reconstruction from the original TOF data. Clinical examples show FORET images that are qualitatively similar to those obtained from the original TOF-PET data but with a small increase in variance at matched resolution. Reconstruction time is reduced by a factor of 5 and 30 using FORET3D+MAP and FORET2D+MAP respectively compared to 3D TOF MAP, which makes these methods attractive for clinical applications. [ABSTRACT FROM AUTHOR]

Whole Body PET scans are typically performed as a series of image sets acquired at discrete axial positions to cover most or all of the body. The acquisition time at each axial position is typically kept fixed for all positions although the total imaging time is typically adjusted according to the patient’s weight. Because of the varying amount of attenuation for different sections of the body, it is expected that the image Signal-to-Noise (S/N) will vary accordingly. The aim of this work is to investigate the possibility of varying the acquisition time at different sections of the body such that the image S/N is kept relatively constant for all slices. To estimate the acquisition times for the different sections of the body we propose to use the attenuation correction (AC) sinogram generated from the CT scan that is acquired prior to the PET scan. Both simulations and phantom measurements of different diameter cylinders with activity distributions were performed. The image noise was estimated in every pixel from multiple replicate image sets. The image noise was compared to the average AC factors through the center of each body slice. A simple polynomial function was found for both the simulations and the phantom measurement images to accurately describe the image noise as a function of AC factors. These results indicate that the noise properties of whole body images can be made more uniform axially by adjusting the acquisition time according to the amount of attenuation. Instead of using a fixed scan time per bed position, the acquisition time can be reduced in areas of lower attenuation and increased in more absorbing sections of the body. Since there is a strong correlation of the image noise and the AC factors, the relative acquisition times can be quickly calculated using a simple functional relationship. [ABSTRACT FROM PUBLISHER]

Purpose: The aim of the study was to determine whether glucose uptake in viable myocardium of ischemic cardiomyopathy patients depends on rest myocardial blood flow (MBF) and the residual myocardial flow reserve (MFR). Methods: Thirty-six patients with ischemic cardiomyopathy (left ventricular ejection fraction 25 ± 10 %) were studied with N-ammonia and F-fluorodeoxyglucose (FDG) positron emission tomography (PET). Twenty age-matched normals served as controls. Regional MBF was determined at rest and during dipyridamole hyperemia and regional FDG extraction was estimated from regional FDG to N-ammonia activity ratios. Results: Rest MBF was reduced in viable (0.42 ± 0.18 ml/min per g) and nonviable regions (0.32 ± 0.09 ml/min per g) relative to remote regions (0.68 ± 0.23 ml/min per g, p < 0.001) and to normals (0.63 ± 0.13 ml/min per g). Dipyridamole raised MBFs in controls, remote, viable, and nonviable regions. MBFs at rest ( p < 0.05) and stress ( p < 0.05) in viable regions were significantly higher than that in nonviable regions, while MFRs did not differ significantly ( p > 0.05). Compared to MFR in remote myocardium, MFRs in viable regions were similar (1.39 ± 0.56 vs 1.70 ± 0.45, p > 0.05) but were significantly lower in nonviable regions (1.23 ± 0.43, p < 0.001). Moreover, the FDG and thus glucose extraction was higher in viable than in remote (1.40 ± 0.14 vs 0.90 ± 0.20, p < 0.001) and in nonviable regions (1.13 ± 0.21, p < 0.001). The extraction of FDG in viable regions was independent of rest MBF but correlated inversely with MFRs ( r =−0.424, p < 0.05). No correlation between the FDG extraction and MFR was observed in nonviable regions. Conclusion: As in the animal model, decreasing MFRs in viable myocardium are associated with increasing glucose extraction that likely reflects a metabolic adaptation of remodeling hibernating myocytes. [ABSTRACT FROM AUTHOR]

The axial field of view (AFOV) of the current generation of clinical wholebody PET scanners range from 15-22 cm, which limits sensitivity and renders applications such as whole-body dynamic imaging or imaging of very low activities inwhole-body cellular tracking studies, almost impossible. Generally, extending the AFOV significantly increases the sensitivity and count-rate performance. However, extending the AFOV while maintaining detector thickness has significant cost implications. In addition, random coincidences, detector dead time, and object attenuation may reduce scanner performance as the AFOV increases. In this paper, we use Monte Carlo simulations to find the optimal scanner geometry (i.e. AFOV, detector thickness and acceptance angle) based on count-rate performance for a range of scintillator volumes ranging from 10 to 93 lwith detector thickness varying from 5 to 20 mm. We compare the results to the performance of a scanner based on the current Siemens Biograph mCT geometry and electronics. Our simulation models were developed based on individual components of the Siemens Biograph mCT and were validated against experimental data using the NEMA NU-2 2007 count-rate protocol. In the study, noise-equivalent count rate (NECR) was computed as a function of maximum ring difference (i.e. acceptance angle) and activity concentration using a 27 cm diameter, 200 cm uniformly filled cylindrical phantom for each scanner configuration. To reduce the effect of random coincidences, we implemented a variable coincidence time window based on the length of the lines of response, which increased NECR performance up to 10% compared to using a static coincidence time window for scanners with a large maximum ring difference values. For a given scintillator volume, the optimal configuration results in modest count-rate performance gains of up to 16% compared to the shortest AFOV scanner with the thickest detectors. However, the longest AFOV of approximately 2 m with 20 mm thick detectors resulted in performance gains of 25-31 times higher NECR relative to the current Siemens Biograph mCT scanner configuration. [ABSTRACT FROM AUTHOR]

Deviations in reward sensitivity and behavioral flexibility, particularly in the ability to change or stop behaviors in response to changing environmental contingencies, are important phenotypic dimensions of several neuropsychiatric disorders. Neuroimaging evidence suggests that variation in dopamine signaling through dopamine D2-like receptors may influence these phenotypes, as well as associated psychiatric conditions, but the specific neurocognitive mechanisms through which this influence is exerted are unknown. To address this question, we examined the relationship between behavioral sensitivity to reinforcement during discrimination learning and D2-like receptor availability in vervet monkeys. Monkeys were assessed for their ability to acquire, retain, and reverse three-choice, visual discrimination problems, and once behavioral performance had stabilized, they received positron emission tomography (PET) scans. D2-like receptor availability in dorsal aspects of the striatum was not related to individual differences in the ability to acquire or retain visual discriminations but did relate to the number of trials required to reach criterion in the reversal phase of the task. D2-like receptor availability was also strongly correlated with behavioral sensitivity to positive, but not negative, feedback during learning. These results go beyond electrophysiological findings by demonstrating the involvement of a striatal dopaminergic marker in individual differences in feedback sensitivity and behavioral flexibility, providing insight into the neural mechanisms that are affected in neuropsychiatric disorders that feature these deficits. [ABSTRACT FROM AUTHOR]

Subcortical white matter is known to be relatively unaffected by amyloid deposition in Alzheimer’s disease (AD). We investigated the use of subcortical white matter as a reference region to quantify [18F]FDDNP binding in the human brain. Dynamic [18F]FDDNP PET studies were performed on 7 control subjects and 12 AD patients. Population efflux rate constants ( $$ {k\prime_2} $$) from subcortical white matter (centrum semiovale) and cerebellar cortex were derived by a simplified reference tissue modeling approach incorporating physiological constraints. Regional distribution volume ratio (DVR) estimates were derived using Logan and simplified reference tissue approaches, with either subcortical white matter or cerebellum as reference input. Discriminant analysis with cross-validation was performed to classify control subjects and AD patients. The population estimates of $$ {k\prime_2} $$ in subcortical white matter did not differ significantly between control subjects and AD patients but the variability of individual estimates of $$ {k\prime_2} $$ determined in white matter was lower than that in cerebellum. Logan DVR showed dependence on the efflux rate constant in white matter. The DVR estimates in the frontal, parietal, posterior cingulate, and temporal cortices were significantly higher in the AD group ( p<0.01). Incorporating all these regional DVR estimates as predictor variables in discriminant analysis yielded accurate classification of control subjects and AD patients with high sensitivity and specificity, and the results agreed well with those using the cerebellum as the reference region. Subcortical white matter can be used as a reference region for quantitative analysis of [18F]FDDNP with the Logan method which allows more accurate and less biased binding estimates, but a population efflux rate constant has to be determined a priori. [ABSTRACT FROM AUTHOR]

Respiratory motion in PET degrades image quality and limits detectability of small or low-contrast lesions. Although image quality can be improved using respiratory-gating, this adds to the complexity and expense of acquiring PET data. We aimed to develop a data-driven method, based on individual voxel signal fluctuations, for accomplishing electronic respiratory gating of clinical, PET data, requiring no additional hardware or end-user input. We tested our methods using both simulated PET scans and actual human PET acquisitions. For the simulations, our methods correctly identified the start frame of each respiratory cycle defined for the phantom. Resultant gated images demonstrated improved effective resolution and increased measured uptake for lesions located in the thorax. For human PET data, we were able to recover respiratory phase information with a high signal-to-noise ratio. We report here a method to achieve fully automated voxel-based respiratory gating of PET images, without the need for gating hardware or additional user input, capable of improving effective resolution and increasing lesion detectability. [ABSTRACT FROM AUTHOR]

The article presents a study which examines radiation dose to surgical staff from positron-emitter-based localization and radiosurgery of tumors. Positron emission tomography (PET) imaging with 18F-labeled fluorodeoxyglucose (FDG) is becoming the preferred approach for staging and re-staging of several solid tumors, for the localization of distant metastases and in evaluating response to treatment. The metabolism of 18FDG results to the buildup of isotope in the bladder. Key findings suggest that occupational risk from 18FDG-guided localization of tumors seems to be quite low.

18F-labeled deoxy-fluorothymidine (FLT), a marker of cellular proliferation, has been used in PET tumor imaging. Here, the FLT kinetics of malignant brain tumors were investigated. Seven patients with high-grade tumors and two patients with metastases had 12 studies. After 1.5 MBq/kg 18F-FLT had been administered intravenously, dynamic PET studies were acquired for 75 min. Images were reconstructed with iterative algorithms, and corrections applied for attenuation and scatter. Parametric images were generated with factor analysis, and vascular input and tumor output functions were derived. Compartmental models were used to estimate the rate constants. The standard three-compartment model appeared appropriate to describe 18F-FLT uptake. Corrections for blood volume, metabolites, and partial volume were necessary. Kinetic parameters were correlated with tumor pathology and clinical follow-up data. Two groups could be distinguished: lesions that were tumor predominant (TumP) and lesions that were treatment change predominant (TrcP). Both groups had a widely varying k 1 (transport across the damaged BBB, range 0.02–0.2). Group TrcP had a relatively low k 3 (phosphorylation rate, range 0.017–0.027), whereas k 3 varied sevenfold in group TumP (range 0.015–0.11); the k 3 differences were significant ( p < 0.01). The fraction of transported FLT that is phosphorylated [ k 3/( k 2+ k 3)] was able to separate the two groups ( p < 0.001). A three-compartment model with blood volume, metabolite, and partial volume corrections could adequately describe 18F-FLT kinetics in malignant brain tumors. Patients could be distinguished as having: (1) tumor-predominant or (2) treatment change-predominant lesions, with significantly different phosphorylation rates. [ABSTRACT FROM AUTHOR]

The aim of this study was to quantify image noise and signal recovery in respiratory gated PET. A Jaszczak phantom filled with 18F was placed on a custom built motion platform. Different source to background activity ratios were used. An Anzai belt, a surface tension monitoring device, was strapped around the phantom to track the motion and to trigger the gated PET cycle. Data were acquired into 12 bins throughout one gating cycle. The binned data were also summed to produce image sets representing acquisitions with different numbers of gates, including a non-gated image set. The image noise was estimated using the bootstrap method. Images were generated from 100 sinogram replicates and reconstructed using ordered subsets-expectation maximization (OSEM), 4 iterations and 8 subsets. From the reconstructed image replicates, mean and standard deviation images were created, from which the average image signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of each sphere were calculated. The SNR and CNR were evaluated as a function of the number of gates. The SNR and CNR result in the expected Poisson limited correlation with the number of gates for the larger lesions. Because of the motion, the CNR calculated from the images produced with no or few gates is nearly a factor of 2 less than the expected value for the 3 smallest spheres. As the number of gates increases, the CNR correlates with the expected values. Beyond 6 gates, image noise dominates over any signal improvement, which is reflected in the low CNR values of the smallest spheres. The results of this study show that gating can provide improvement in signal recovery with minimal loss of CNR for small, moving lesions. [ABSTRACT FROM AUTHOR]

The aim of this paper was to investigate the correlation between noise equivalent count (NEC) Rates and the signal-to-noise ratio (S/N) in the reconstructed images. NEC rates were determined using uniform 20- and 60-cm-tall 20-cm-diameter cylinders filled with 18F. The phantoms were scanned in both two-dimensional (2-D) and 3-D mode. The reconstructed image noise, for each frame, was estimated using the bootstrap method. For each acquired frame, 250 sinogram replicates were generated (prompts and randoms, separately), which were reconstructed using FBP and OSEM (2i8s and 4i8s). The images were filtered to a final image resolution of 6 mm. From the reconstructed image sets, mean and standard deviation images were generated, from which the average image S/N (=mean/standard deviation) was calculated within a 5-cm central ROI. The effect of applying variance reduction processing on the random events, prior to subtraction from the prompt events, on the image noise was also investigated. The NEC was found to have a linear relationship to the square of the image S/N, where the only difference found was in the slope between different reconstruction methods, implying a difference in noise properties specific to each reconstruction algorithm. The linear relationship was also found in both 2-D and 3-D acquisition modes, as well as for the different activity distributions. The randoms processing showed an improvement in image S/N, consistent with a near noiseless estimate of the random rate. These results indicate that the NEC is not only a measure for comparing the count rate performance of imaging systems, but this measure also translates into a measure for comparing image noise. [ABSTRACT FROM AUTHOR]

Evaluates the bootstrap method applied to positron emission tomography (PET) data as a technique to determine regional image noise in PET. Noise distribution in three dimensional whole body scans; Use of subset expectation maximization; Axial cross sections through the Jaszczak phantom.

Provides information on the application of factor analysis to dynamic studies using positron emission topography to create factor images and factor curves from which input and output functions could be derived for kinetic modeling. Dynamic behavior of the tracer in the structure of interest; Derivation of the body contour from the transmission images; Use of different algorithms.

Presents a study which discussed the implementation of a true continuous axial bed motion on a high-resolution positron emission tomography (PET) scanner for use in both two-dimensional and three-dimensional acquisition modes. Materials and methods; Results; Discussion of the results.

Presents information on a study which investigated a scheme for defining coincidence planes in positron emission tomography. Methodology; Results and discussion; Conclusions.

Presents a study which investigated the feasibility of simultaneously acquiring whole body emission and transmission scans using short or partially extended transmission rods. Materials and methods used; Results and discussion; Conclusions.

The contrast recovery coefficients (CRC) were evaluated for five different small animal PET scanners: GE Explore Vista, Genisys4, MiniPET-2, nanoScan PC and Siemens Inveon. The NEMA NU-4 2008 performance test with the suggested image quality phantom (NU4IQ) does not allow the determination of the CRC values for the hot regions in the phantom. This drawback of NU4IQ phantom motivated us to develop a new method for this purpose. The method includes special acquisition and reconstruction protocols using the original phantom, and results in an artificially merged image enabling the evaluation of CRC values. An advantageous feature of this method is that it stops the cold wall effect from distorting the CRC calculation. Our suggested protocol results in a set of CRC values contributing to the characterization of small animal PET scanners. GATE simulations were also performed to validate the new method and verify the evaluated CRC values. We also demonstrated that the numerical values of this parameter depend on the actual object contrast of the hot region(s) and this mainly comes from the spillover effect. This effect was also studied while analysing the background activity level around the hot rods. We revealed that the calculated background mean values depended on the target contrast in a scanner specific manner. Performing the artificially merged imaging procedure and additional simulations using the micro hollow sphere (MHS) phantom geometry, we also proved that the inactive wall around the hot spheres can have a remarkable impact on the calculated CRC. In conclusion, we have shown that the proposed artificial merging procedure and the commonly used NU4IQ phantom prescribed by the NEMA NU-4 can easily deliver reliable CRC data otherwise unavailable for the NU4IQ phantom in the conventional protocol or the MHS phantom. [ABSTRACT FROM AUTHOR]

A correction to the article "Optimal whole-body PET scanner configurations for different volumes of LSO scintillator: a simulation study" that was published in the November 20, 2012 issue is presented.

Purpose: To quantitatively compare the accuracy of tumor volume segmentation in amplitude-based and phase-based respiratory gating algorithms in respiratory-correlated positron emission tomography (PET). Methods and Materials: List-mode fluorodeoxyglucose-PET data was acquired for 10 patients with a total of 12 fluorodeoxyglucose-avid tumors and 9 lymph nodes. Additionally, a phantom experiment was performed in which 4 plastic butyrate spheres with inner diameters ranging from 1 to 4 cm were imaged as they underwent 1-dimensional motion based on 2 measured patient breathing trajectories. PET list-mode data were gated into 8 bins using 2 amplitude-based (equal amplitude bins [A1] and equal counts per bin [A2]) and 2 temporal phase-based gating algorithms. Gated images were segmented using a commercially available gradient-based technique and a fixed 40% threshold of maximum uptake. Internal target volumes (ITVs) were generated by taking the union of all 8 contours per gated image. Segmented phantom ITVs were compared with their respective ground-truth ITVs, defined as the volume subtended by the tumor model positions covering 99% of breathing amplitude. Superior-inferior distances between sphere centroids in the end-inhale and end-exhale phases were also calculated. Results: Tumor ITVs from amplitude-based methods were significantly larger than those from temporal-based techniques (P=.002). For lymph nodes, A2 resulted in ITVs that were significantly larger than either of the temporal-based techniques (P<.0323). A1 produced the largest and most accurate ITVs for spheres with diameters of ≥2 cm (P=.002). No significant difference was shown between algorithms in the 1-cm sphere data set. For phantom spheres, amplitude-based methods recovered an average of 9.5% more motion displacement than temporal-based methods under regular breathing conditions and an average of 45.7% more in the presence of baseline drift (P<.001). Conclusions: Target volumes in images generated from amplitude-based gating are larger and more accurate, at levels that are potentially clinically significant, compared with those from temporal phase-based gating. [Copyright &y& Elsevier]

Abstract: Logan graphical analysis with cerebellum as reference region has been widely used for the estimation of the distribution volume ratio (DVR) of [18F]FDDNP as a measure of amyloid burden and tau deposition in human brain because of its simplicity and computational ease. However, spurious parametric DVR images may be produced with shorter scanning times and when the noise level is high. In this work, we have characterized a relative-equilibrium-based (RE) graphical method against the Logan analysis for parametric imaging and region-of-interest (ROI) analysis. Methods: Dynamic [18F]FDDNP PET scans were performed on 9 control subjects and 12 patients diagnosed with Alzheimer''s disease. Using the cerebellum as reference input, regional DVR estimates were derived using both the Logan analysis and the RE plot approach. Effects on DVR estimates obtained at voxel and ROI levels by both graphical approaches using data in different time windows were investigated and compared with the standard values derived using the Logan analysis on a voxel-by-voxel basis for the time window of 35–125min used in previous studies. Results: Larger bias and variability were observed for DVR estimates obtained by the Logan graphical analysis at the voxel level when short time windows (85–125 and 45–65min) were used, because of high noise levels in voxel-wise parametric imaging. However, when the Logan graphical analysis was applied at the ROI level over those short time windows, the DVR estimates did not differ significantly from the standard values derived using the Logan analysis on the voxel level for the time window of 35–125min, and their bias and variability were remarkably lower. Conversely, the RE plot approach was more robust in providing DVR estimates with less bias and variability even when short time windows were used. The DVR estimates obtained at voxel and ROI levels were consistent. No significant differences were observed in DVR estimates obtained by the RE plot approach for all paired comparisons with the standard values. Conclusions: The RE plot approach provides less noisy parametric images and gives consistent and reliable regional DVR estimates at both voxel and ROI levels, indicating that it is preferred over the Logan graphical analysis for analyzing [18F]FDDNP PET data. [Copyright &y& Elsevier]