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1.  Imaging Keratitis-Icthyosis-Deafness (KID) syndrome with FDG-PET (F18-fluorodeoxiglucose-Positron Emission Tomography) 
Keratitis-Icthyosis-Deafness (KID) syndrome is a rare dysplasia characterized by vascularizing keratitis, congenital sensorineural hearing-loss, and progressive erythrokeratoderma. To our knowledge, this is the first KID syndrome imaged with FDG-PET in the literature. This paper is intended to help familiarize with the FDG abnormalities related to this rare entity.
doi:10.3941/jrcr.v4i7.381
PMCID: PMC3303363  PMID: 22470741
Keratitis; Icthyosis; deafness; KID syndrome; FDG; PET
2.  Shaped magnetic field pulses by multi-coil repetitive transcranial magnetic stimulation (rTMS) differentially modulate anterior cingulate cortex responses and pain in volunteers and fibromyalgia patients 
Molecular Pain  2013;9:33.
Background
Repetitive transcranial magnetic stimulation (rTMS) has shown promise in the alleviation of acute and chronic pain by altering the activity of cortical areas involved in pain sensation. However, current single-coil rTMS technology only allows for effects in surface cortical structures. The ability to affect activity in certain deep brain structures may however, allow for a better efficacy, safety, and tolerability. This study used PET imaging to determine whether a novel multi-coil rTMS would allow for preferential targeting of the dorsal anterior cingulate cortex (dACC), an area always activated with pain, and to provide preliminary evidence as to whether this targeted approach would allow for efficacious, safe, and tolerable analgesia both in a volunteer/acute pain model as well as in fibromyalgia chronic pain patients.
Methods
Part 1: Different coil configurations were tested in a placebo-controlled crossover design in volunteers (N = 16). Tonic pain was induced using a capsaicin/thermal pain model and functional brain imaging was performed by means of H215O positron emission tomography – computed tomography (PET/CT) scans. Differences in NRS pain ratings between TMS and sham treatment (NRSTMS-NRSplacebo) which were recorded each minute during the 10 minute PET scans. Part 2: 16 fibromyalgia patients were subjected to 20 multi-coil rTMS treatments over 4 weeks and effects on standard pain scales (Brief Pain Inventory, item 5, i.e. average pain NRS over the last 24 hours) were recorded.
Results
A single 30 minute session using one of 3 tested rTMS coil configurations operated at 1 Hz consistently produced robust reduction (mean 70% on NRS scale) in evoked pain in volunteers. In fibromyalgia patients, the 20 rTMS sessions also produced a significant pain inhibition (43% reduction in NRS pain over last 24 hours), but only when operated at 10 Hz. This degree of pain control was maintained for at least 4 weeks after the final session.
Conclusion
Multi-coil rTMS may be a safe and effective treatment option for acute as well as for chronic pain, such as that accompanying fibromyalgia. Further studies are necessary to optimize configurations and settings as well as to elucidate the mechanisms that lead to the long-lasting pain control produced by these treatments.
doi:10.1186/1744-8069-9-33
PMCID: PMC3750766  PMID: 23819466
Pain; Transcranial magnetic simulation; Acute pain; Chronic pain; Fibromyalgia; Multi coil; Functional imaging; Psychophysics
3.  Combined SPECT and Multidetector CT for Prostate Cancer Evaluations 
111In-capromab pendetide is an imaging probe for noninvasive detection of prostate cancer dissemination, and can be difficult to interpret because of low photon statistics resulting in noisy images with limited anatomical precision. We examined if a 16-slice multidetector computed tomography (MDCT) combined with single photon emission computed tomography (SPECT) could increase the impact on the clinical management and improve confidence in SPECT image interpretations in comparison to a relatively low-mA (limited resolution) CT. 17 scans were reviewed from a SPECT combined with low-mA CT scanner; 21 scans were reviewed from a SPECT combined with 16-slice MDCT scanner. Reports of the clinical interpretations from the imaging studies, additional examinations performed by referring physicians as a follow-up to the imaging results, and long-term clinical and laboratory follow-ups were used to define confidence of the SPECT/CT readings and impact of the readings on the patient management. The impact was defined as: the occurrence of the 111In-capromab pendetide interpretation resulted in additional imaging studies or biopsies. MDCT improved the quality and confidence in the characterization of small lymph nodes with or without uptake of 111In-capromab pendetide. The increased confidence with MDCT in SPECT/CT readings was evident in all cases reviewed in this study, and the impact on the clinical management was higher (8 out of 21) using SPECT/MDCT than the impact using SPECT combined with low-mA CT (2 out of 17). The dual-modality SPECT/CT provides a quantifiable benefit when MDCT is used instead of low-mA CT, particularly for prostate cancer evaluations using 111In-capromab pendetide.
PMCID: PMC3260786  PMID: 22267999
prostate cancer; capromab pendetide; SPECT/CT; MDCT; prostate specific membrane antigen (PSMA)
4.  Two Cases of Thyroid Metastasis from Head and Neck Squamous Cell Carcinoma Detected by FDG-PET/CT 
We present two cases of head and neck squamous cell carcinoma (SCC) metastasizing to the thyroid gland. This is the first report that shows (18) F-fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) images of tonsillar and supraglottic SCCs invading the thyroid gland. Alcohol and tobacco use are the two most important risk factors for head and neck cancers, but recently human papilloma virus (HPV) infection has become a significant risk factor in the United States. FDG-PET/CT is very useful for SCC staging/restaging and follow-up.
doi:10.4103/2156-7514.145850
PMCID: PMC4278091  PMID: 25558429
(18) F-fluorodeoxyglucose-positron emission tomography/computed tomography; squamous cell carcinoma; supraglottic; thyroid; tonsillar
5.  Initial Experience of Utilizing Real-Time Intra-Procedural PET/CT Biopsy 
Objectives:
Nonreal-time Positron Emission Tomography/Computed Tomography (PET/CT) biopsies that use the image co-registration of a prior PET with an intra-procedural CT have been reported. The aim of this study was to report the initial experience of performing real-time intra-procedural PET/CT-guided biopsies.
Materials and Methods:
All patients (n = 4) had a prior PET/CT examination of the concerning lesion and no significant CT correlate. On the day of the biopsy, 5 mCi of 18F-fluorodeoxyglucose (FDG) or NaF18 was intravenously injected. After 60 min of biodistribution of the molecular probe, PET/CT images were obtained in a limited one bed position over the region of the concerning lesion to be biopsied.
Results:
One patient had a mesenteric mass and the other three had bone lesions, one located in the rib and two in the iliac bone. The pathology report revealed that two lesions (50%) were malignant and two lesions (50%) were benign. The results of the biopsy changed management in all cases. There was 0% complication rate.
Conclusions:
No additional software or hardware is required to perform real-time intra-procedural PET/CT-guided biopsies. It can optimize the yield, especially in cases where there are no anatomical abnormalities. Real-time intra-procedural PET/CT biopsy may have benefits over conventional biopsy techniques in terms of accuracy.
doi:10.4103/2156-7514.141941
PMCID: PMC4204304  PMID: 25337440
Biopsy; fluorodeoxyglucose; NaF-18; positron emission tomography/computed tomography
6.  Normal SUV Values Measured from NaF18- PET/CT Bone Scan Studies 
PLoS ONE  2014;9(9):e108429.
Objectives
Cancer and metabolic bone diseases can alter the SUV. SUV values have never been measured from healthy skeletons in NaF18-PET/CT bone scans. The primary aim of this study was to measure the SUV values from normal skeletons in NaF18-PET/CT bone scans.
Methods
A retrospective study was carried out involving NaF18- PET/CT bone scans that were done at our institution between January 2010 to May 2012. Our excluding criteria was patients with abnormal real function and patients with past history of cancer and metabolic bone diseases including but not limited to osteoporosis, osteopenia and Paget’s disease. Eleven studies met all the criteria.
Results
The average normal SUVmax values from 11 patients were: cervical vertebrae 6.84 (range 4.38–8.64), thoracic vertebrae 7.36 (range 6.99–7.66), lumbar vertebrae 7.27 (range 7.04–7.72), femoral head 2.22 (range 1.1–4.3), humeral head 1.82 (range 1.2–2.9), mid sternum 5.51 (range 2.6–8.1), parietal bone 1.71 (range 1.3–2.4).
Conclusion
According to our study, various skeletal sites have different normal SUV values. SUV values can be different between the normal bones and bones with tumor or metabolic bone disease. SUV can be used to quantify NaF-18 PET/CT studies. If the SUV values of the normal skeleton are known, they can be used in the characterization of bone lesions and in the assessment of treatment response to bone diseases.
doi:10.1371/journal.pone.0108429
PMCID: PMC4177910  PMID: 25254490
7.  Omental Nodular Deposits of Recurrent Chromophobe Renal Cell Carcinoma Seen on FDG-PET/CT 
We present the case of a 69-year-old male with chromophobe renal cell carcinoma (RCC). Chromophobe RCC accounts for only 4% of renal cancers and it is the least aggressive type. Omental nodular deposits due to RCC metastasis are very rare and it is reported only in more aggressive forms of RCC. This is the first report that shows FluoroDeoxyGlucose – Positron Emission Tomography/Computed Tomgraphy (FDG-PET/CT) images of omental nodular deposits from chromophobe RCC. FDG-PET/CT is becoming very useful in restaging RCC with distant metastases.
doi:10.4103/2156-7514.141560
PMCID: PMC4204302  PMID: 25337437
Chromophobe renal cell carcinoma; FDG-PET/CT; omental caking; peritoneal carcinomatosis
8.  Factors Affecting Uptake of NaF-18 by the Normal Skeleton 
Background
The primary aim of this study was to examine if factors such as renal function, height, weight and age could affect the uptake of sodium fluoride-18 (NaF-18) by the normal bone. This is the first study to examine the possible factors that can influence NaF-18 uptake in the normal bone.
Methods
A retrospective study was done on NaF-18 PET/CT bone scans from January 2010 to May 2012 at our institution. All NaF-18 PET/CT studies used the same clinical protocol. Our excluding criteria were patients with abnormal renal function and patients with past history of cancer and metabolic bone diseases. Spearman’s correlation was used to analyze the data.
Results
From our study (n = 11 patients), no correlation was found between SUVmax and serum creatinine and between SUVmax and age. However, significant correlations were found between SUVmax and height (cm) and between SUVmax and weight (kg) for thoracic 5, 7, 12 and lumbar 2 vertebral levels.
Conclusion
Based on our findings, SUVmax values in NaF-18 PET/CT bone scans can vary depending on the patient’s height, weight and bone region. This information can be helpful in diagnosing and monitoring bone pathologies and can help explain the clinical findings.
doi:10.14740/jocmr1901w
PMCID: PMC4169085  PMID: 25247017
SUV; Bone; NaF-18 PET/CT; Bone scan
9.  Use of NaF-18-Positron Emission Tomography/Computed Tomography in the Detection of Bone Metastasis from Papillary Renal Cell Carcinoma 
World Journal of Nuclear Medicine  2014;13(2):135-137.
We present a case of a 60-year-old white male with a history of papillary renal cell carcinoma (PRCC) status postpartial nepherectomy. He was followed-up annually with abdominal computed tomography (CT) scans to monitor for tumor recurrence. A solitary metastatic bony lesion was detected by CT 4 years after partial nephrectomy and it was confirmed by NaF-positron emission tomography (PET)/CT and magnetic resonance imaging. He underwent external beam radiation therapy (XRT) for solitary metastasis to L1 vertebra. The L1 lesion was treated with XRT, which exhibited no fluorodeoxyglucose activity after the treatment. This is the first case report to mention the use of NaF-18-PET/CT in the detection of bone metastasis from PRCC. Our case once again emphasizes the usefulness of NaF-18-PET/CT in RCC follow-up.
doi:10.4103/1450-1147.139146
PMCID: PMC4150157  PMID: 25191130
Bone metastasis; NaF-18-positron emission tomography/computed tomography; papillary renal cell carcinoma; partial nephrectomy
10.  Bilateral Diffuse Fluorodeoxyglucose Uptake in Thyroid Gland Diagnosed by Fluorodeoxyglucose-Positron Emission Tomography/Computed Tomography 
World Journal of Nuclear Medicine  2014;13(2):138-141.
Our patient is a female who was first diagnosed with breast cancer at the age of 23. A follow-up fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) at age 44 revealed diffuse high FDG uptake in an enlarged thyroid gland. Fine-needle aspiration (FNA) of the thyroid mass revealed estrogen receptor/progesterone receptor negative, human epidermal growth factor receptor 2+ breast cancer. To the best of our knowledge, this is the first case to report breast cancer metastasis to the thyroid in a diffuse pattern on FDG-PET/CT. Bilateral diffuse uptake of FDG in thyroid is the most commonly associated with benign conditions. However, FNA biopsies need to be done to rule out metastatic disease in thyroid lesions with diffuse high FDG uptake, especially for patients with history of cancer.
doi:10.4103/1450-1147.139147
PMCID: PMC4150158  PMID: 25191131
Breast cancer; diffuse; fluorodeoxyglucose-positron emission tomography/computed tomography; metastasis; thyroid
11.  Myocardial blood flow measurement with a conventional dual-head SPECT/CT with spatiotemporal iterative reconstructions - a clinical feasibility study 
Cardiac single photon emission computed tomography (SPECT) cameras typically rotate too slowly around a patient to capture changes in the blood pool activity distribution and provide accurate kinetic parameters. A spatiotemporal iterative reconstruction method to overcome these limitations was investigated. Dynamic rest/stress 99mTc-methoxyisobutylisonitrile (99mTc-MIBI) SPECT/CT was performed along with reference standard rest/stress dynamic positron emission tomography (PET/CT) 13N-NH3 in five patients. The SPECT data were reconstructed using conventional and spatiotemporal iterative reconstruction methods. The spatiotemporal reconstruction yielded improved image quality, defined here as a statistically significant (p<0.01) 50% contrast enhancement. We did not observe a statistically significant difference between the correlations of the conventional and spatiotemporal SPECT myocardial uptake K 1 values with PET K 1 values (r=0.25, 0.88, respectively) (p<0.17). These results indicate the clinical feasibility of quantitative, dynamic SPECT/CT using 99mTc-MIBI and warrant further investigation. Spatiotemporal reconstruction clearly provides an advantage over a conventional reconstruction in computing K 1.
PMCID: PMC3867729  PMID: 24380045
Dynamic SPECT; myocardial perfusion imaging; 99mTc-MIBI; SPECT/CT; spatiotemporal reconstruction; uptake rate constant
12.  Functional Imaging for Prostate Cancer: Therapeutic Implications 
Seminars in nuclear medicine  2012;42(5):328-342.
Functional radionuclide imaging modalities, now commonly combined with anatomical imaging modalities CT or MRI (SPECT/CT, PET/CT, and PET/MRI) are promising tools for the management of prostate cancer particularly for therapeutic implications. Sensitive detection capability of prostate cancer using these imaging modalities is one issue; however, the treatment of prostate cancer using the information that can be obtained from functional radionuclide imaging techniques is another challenging area. There are not many SPECT or PET radiotracers that can cover the full spectrum of the management of prostate cancer from initial detection, to staging, prognosis predictor, and all the way to treatment response assessment. However, when used appropriately, the information from functional radionuclide imaging improves, and sometimes significantly changes, the whole course of the cancer management. The limitations of using SPECT and PET radiotracers with regards to therapeutic implications are not so much different from their limitations solely for the task of detecting prostate cancer; however, the specific imaging target and how this target is reliably imaged by SPECT and PET can potentially make significant impact in the treatment of prostate cancer. Finally, while the localized prostate cancer is considered manageable, there is still significant need for improvement in noninvasive imaging of metastatic prostate cancer, in treatment guidance, and in response assessment from functional imaging including radionuclide-based techniques. In this review article, we present the rationale of using functional radionuclide imaging and the therapeutic implications for each of radionuclide imaging agent that have been studied in human subjects.
doi:10.1053/j.semnuclmed.2012.04.004
PMCID: PMC3408625  PMID: 22840598
13.  A Patient with Psoriatic Arthritis Imaged with FDG-PET/CT Demonstrated an Unusual Imaging Pattern with Muscle and Fascia Involvement: A Case Report 
We describe the case of a patient with known history of psoriasis that presented with 1 year of unexplained fever, muscle weakness and marked weight loss, suspicious for B symptoms of a malignant origin. [18F]-Fluorodeoxyglucose positron emission tomography-computed tomography (FDG-PET/CT) scans demonstrated an unusual serpiginous pattern of uptake in the fascia and muscles as well as lymph node activity. Multiple histological samples, including a final PET-probe guided lymph node surgical resection, excluded malignancy and confirmed the diagnosis of reactive inflammatory changes, with a plausible diagnosis of autoimmune lymphoproliferative syndrome with associated lymphadenitis, fasciitis and myositis, possibly mediated by tumor necrosis factor (TNF) inhibitor. To our knowledge, there is no evidence of a previously reported FDG uptake pattern of fascia and muscle involvement in psoriatic arthritis.
doi:10.1007/s13139-012-0137-9
PMCID: PMC4042994  PMID: 24900049
FDG-PET/CT; Autoimmune lymphoproliferative syndrome; Autoimmune; Psoriasis
14.  Lymphatic drainage mapping of prostate using filtered 99mTc-sulfur nanocolloid and SPECT/CT 
We have developed a practice procedure of prostate lymphoscintigraphy using SPECT/CT and filtered 99mTc-sulfur nanocolloid.
Methods
A total of 10 patients were enrolled for this study, and all administred with the radiotracer prepared using a 100-nm membrane filter at a commercial radiopharmacy. Whole-body scans and SPECT/CT studies were performed within 1.5–3 hours after the radiotracer administration directly into six locations of the prostate gland under a transrectal ultrasound guide. Radiation dose was estimated from the first 3 patients. The lymphatic drainage mapping and identification of lymph nodes were performed.
Results
Radiation dose estimates of filtered 99mTc-sulfur nanocollid from the first three patients were in the range of 3.9–5.2 mSv/MBq. Our results showed the locations of lymph nodes drainged from the prostate gland are similar to those found using 99mTc-Nanocoll.
Conclusion
Without the proprietary radiolabeled nanocolloid indicated for lymphoscintigraphy, prostate lymph node mapping and identification were feasible using filtered 99mTc-sulfur nanocolloid.
doi:10.2967/jnumed.110.085944
PMCID: PMC3129454  PMID: 21680690
prostate cancer; sulfur colloid; SPECT/CT; lymphatic mapping; sentinel node
15.  Investigation of dynamic SPECT measurements of the arterial input function in human subjects using simulation, phantom and human studies 
Physics in Medicine and Biology  2011;57(2):375-393.
Computer simulations, a phantom study and a human study were performed to determine whether a slowly rotating single-photon computed emission tomography (SPECT) system could provide accurate arterial input functions for quantification of myocardial perfusion imaging using kinetic models. The errors induced by data inconsistency associated with imaging with slow camera rotation during tracer injection were evaluated with an approach called SPECT/P (dynamic SPECT from positron emission tomography (PET)) and SPECT/D (dynamic SPECT from database of SPECT phantom projections). SPECT/P simulated SPECT-like dynamic projections using reprojections of reconstructed dynamic 94Tc-methoxyisobutylisonitrile (94Tc-MIBI) PET images acquired in three human subjects (1 min infusion). This approach was used to evaluate the accuracy of estimating myocardial wash-in rate parameters K1 for rotation speeds providing 180° of projection data every 27 or 54 s. Blood input and myocardium tissue time-activity curves (TACs) were estimated using spatiotemporal splines. These were fit to a one-compartment perfusion model to obtain wash-in rate parameters K1. For the second method (SPECT/D), an anthropomorphic cardiac torso phantom was used to create real SPECT dynamic projection data of a tracer distribution derived from 94Tc-MIBI PET scans in the blood pool, myocardium, liver and background. This method introduced attenuation, collimation and scatter into the modeling of dynamic SPECT projections. Both approaches were used to evaluate the accuracy of estimating myocardial wash-in parameters for rotation speeds providing 180° of projection data every 27 and 54 s. Dynamic cardiac SPECT was also performed in a human subject at rest using a hybrid SPECT/CT scanner. Dynamic measurements of 99mTc-tetrofosmin in the myocardium were obtained using an infusion time of 2 min. Blood input, myocardium tissue and liver TACs were estimated using the same spatiotemporal splines. The spatiotemporal maximum-likelihood expectation-maximization (4D ML-EM) reconstructions gave more accurate reconstructions than did standard frame-by-frame static 3D ML-EM reconstructions. The SPECT/P results showed that 4D ML-EM reconstruction gave higher and more accurate estimates of K1 than did 3D ML-EM, yielding anywhere from a 44% underestimation to 24% overestimation for the three patients. The SPECT/D results showed that 4D ML-EM reconstruction gave an overestimation of 28% and 3D ML-EM gave an underestimation of 1% for K1. For the patient study the 4D ML-EM reconstruction provided continuous images as a function of time of the concentration in both ventricular cavities and myocardium during the 2 min infusion. It is demonstrated that a 2 min infusion with a two-headed SPECT system rotating 180° every 54 s can produce measurements of blood pool and myocardial TACs, though the SPECT simulation studies showed that one must sample at least every 30 s to capture a 1 min infusion input function.
doi:10.1088/0031-9155/57/2/375
PMCID: PMC3325151  PMID: 22170801
16.  Combined SPECT and multidetector CT for prostate cancer evaluations 
111In-capromab pendetide is an imaging probe for noninvasive detection of prostate cancer dissemination, and can be difficult to interpret because of low photon statistics resulting in noisy images with limited anatomical precision. We examined if a 16-slice multidetector computed tomography (MDCT) combined with single photon emission computed tomography (SPECT) could increase the impact on the clinical management and improve confidence in SPECT image interpretations in comparison to a relatively low-mA (limited resolution) CT. 17 scans were reviewed from a SPECT combined with low-mA CT scanner; 21 scans were reviewed from a SPECT combined with 16-slice MDCT scanner. Reports of the clinical interpretations from the imaging studies, additional examinations performed by referring physicians as a follow-up to the imaging results, and long-term clinical and laboratory follow-ups were used to define confidence of the SPECT/CT readings and impact of the readings on the patient management. The impact was defined as: the occurrence of the 111In-capromab pendetide interpretation resulted in additional imaging studies or biopsies. MDCT improved the quality and confidence in the characterization of small lymph nodes with or without uptake of 111In-capromab pendetide. The increased confidence with MDCT in SPECT/CT readings was evident in all cases reviewed in this study, and the impact on the clinical management was higher (8 out of 21) using SPECT/MDCT than the impact using SPECT combined with low-mA CT (2 out of 17). The dual-modality SPECT/CT provides a quantifiable benefit when MDCT is used instead of low-mA CT, particularly for prostate cancer evaluations using 111In-capromab pendetide.
PMCID: PMC3260786  PMID: 22267999
Prostate cancer; capromab pendetide; SPECT/CT; MDCT; prostate specific membrane antigen (PSMA)
17.  Technological Development and Advances in SPECT/CT 
Seminars in nuclear medicine  2008;38(3):177-198.
SPECT/CT has emerged over the past decade as a means of correlating anatomical information from CT with functional information from SPECT. The integration of SPECT and CT in a single imaging device facilitates anatomical localization of the radiopharmaceutical to differentiate physiological uptake from that associated with disease and patient-specific attenuation correction to improve the visual quality and quantitative accuracy of the SPECT image. The first clinically available SPECT/CT systems performed emission-transmission imaging using a dual-headed SPECT camera and a low-power x-ray CT sub-system. Newer SPECT/CT systems are available with high-power CT sub-systems suitable for detailed anatomical diagnosis, including CT coronary angiography and coronary calcification that can be correlated with myocardial perfusion measurements. The high-performance CT capabilities also offer the potential to improve compensation of partial volume errors for more accurate quantitation of radionuclide measurement of myocardial blood flow and other physiological processes and for radiation dosimetry for radionuclide therapy. In addition, new SPECT technologies are being developed that significantly improve the detection efficiency and spatial resolution for radionuclide imaging of small organs including the heart, brain, and breast, and therefore may provide new capabilities for SPECT/CT imaging in these important clinical applications.
doi:10.1053/j.semnuclmed.2008.01.001
PMCID: PMC3049175  PMID: 18396178
18.  In vivo Tumor Grading of Prostate Cancer using Quantitative 111In-Capromab Pendetide SPECT/CT 
We have developed an in vivo antibody uptake quantification method using 111In-capromab pendetide single photon emission computed tomography combined with computed tomography (SPECT/CT) technology. Our goal is to evaluate this noninvasive antibody quantification method for potential prostate tumor grading.
Methods
Our phantom experiments focused on the robustness of an advanced iterative reconstruction algorithm that involves corrections for photon attenuation, scatter, and geometric blurring caused by radionuclide collimators. The conversion factors between image values and tracer concentrations (in Bq/ml) were calculated from uniform phantom filled with aqueous solution of 111InCl3 using the same acquisition protocol and reconstruction parameters as for patient studies. In addition, the spatial resolution of the reconstructed images was measured from a point source phantom. The measured spatial resolution was modeled into a point spread function (PSF), and the PSF was implemented in a deconvolution-based partial volume error (PVE) correction algorithm. The recovery capability to correctly estimate true tracer concentration values was tested using prostate-like and bladder-like lesion phantoms fitted in the modified NEMA/IEC body phantom. Patients with biopsy-proven prostate cancer (n=10) who underwent prostatectomy were prospectively enrolled in the preoperative SPECT/CT studies at the San Francisco VA Medical Center. The CT portion of SPECT/CT was used for CT-based attenuation map generation as well as an anatomical localization tool for clinical interpretation. Pathologic Gleason grades were compared with in vivo “antibody uptake value” (AUV) normalized by injected dose, effective half-life, and injection-scan time difference. AUVs were calculated in each lobe of prostate gland with cylindrical volumes of interest (VOIs) having dimensions of 1.5 cm both in diameter and height.
Results
Reconstructed SPECT images further corrected by the deconvolution-based PVE correction could recover true tracer concentrations in volumes as small as 7.77 ml up to 90% in phantom measurements. From patient studies, there was a statistically significant correlation (ρ = 0.71, P = 0.033) between higher AUVs (from either left or right lobe) and higher components of pathologic Gleason scores.
Conclusion
Our results strongly indicate noninvasive prostate tumor grading potential using quantitative 111In-capromab pendetide SPECT/CT for prostate cancer evaluation.
doi:10.2967/jnumed.109.067108
PMCID: PMC2821016  PMID: 20008977
prostate cancer; capromab pendetide; SPECT; SPECT/CT; quantification; tracer quantification; quantitative SPECT; prostate specific membrane antigen (PSMA)

Results 1-18 (18)