Impact of contamination with long-lived radionuclides on PET kinetics modelling in multitracer studies.

Introduction: An important issue in multitracer studies is the separation of signals from the different radiotracers. This is especially the case when an early tracer has a long physical half-life and kinetic modelling has to be performed, because the early tracer can confer a long-lived contaminating background not only to images but also to a measured input function derived from blood samples. In this study, we examined data from a sequential multitracer infection study involving In (t1/2=2.8 days), investigating the influence on gamma counting of blood samples and on the kinetic modelling of subsequent PET tracers. Blood sample counts were corrected by recounting the samples a few days later. A more optimal choice of energy window was also explored. The effect of correction versus noncorrection was investigated using a two-tissue kinetic model with irreversible uptake (K1, k2, k3).
Results: K1 was least affected and k3 was most affected by the contamination, corresponding to the effect being relatively larger on the late part of the blood input function. A narrower energy window reduced the problem, but this will not be possible for all types of contaminating background.
Conclusion: Gamma counting of blood samples can lead to a contaminating background not observed in PET imaging and this background can affect kinetic modelling. If the contaminating tracer has a much longer half-life than the foreground tracer, then the problem can be solved by late recounting of the samples.