Quantitative performance of 124I PET/MR of neck lesions in thyroid cancer patients using 124I PET/CT as reference
Tóm tắt
In patients with differentiated thyroid cancer (DTC), serial 124I PET/CT imaging is, for instance, used to assess the absorbed (radiation) dose to lesions. Frequently, the lesions are located in the neck and they are close to or surrounded by different tissue types. In contrast to PET/CT, MR-based attenuation correction in PET/MR may be therefore challenging in the neck region. The aim of this retrospective study was to assess the quantitative performance of 124I PET/MRI of neck lesions by comparing the MR-based and CT-based 124I activity concentrations (ACs). Sixteen DTC patients underwent PET/CT scans at 24 and 120 h after administration of about 25 MBq 124I. Approximately 1 h before or after PET/CT examination, each patient additionally received a 24-h PET/MR scan and sometimes a 120-h PET/MR scan. PET images were reconstructed using the respective attenuation correction approach. Appropriate reconstruction parameters and corrections were used to harmonize the reconstructed PET images to provide, for instance, similar spatial resolution. For each lesion, two types of ACs were ascertained: the maximum AC (max-AC) and an average AC (avg-AC). The avg-AC is the average activity concentration obtained within a spherical volume of interest with a diameter of 7 mm, equaling the PET scanner resolution. For each type of AC, the percentage AC difference between MR-based and CT-based ACs was determined and Lin’s concordance correlation analysis was applied. Quantitative performance was considered acceptable if the standard deviation was ± 25% (precision), and the mean value was within ± 10% (accuracy). The avg-ACs (max-ACs within parentheses) of 74 lesions ranged from 0.20 (0.33) to 657 (733) kBq/mL. Excluding two lesions with ACs of approximately 1 kBq/mL, the mean (median) ± standard deviation (range) was − 4% (− 5%) ± 14% (− 28 to 29%) for the avg-AC and − 9% (− 11%) ± 14% (− 33 to 33%) for the max-AC. Lin’s concordance correlation coefficients were ≥ 0.97, indicating substantial AC agreement. Quantification of lesions in the neck region using 124I PET/MR showed acceptable quantitation performance to 124I PET/CT for AC above 1 kBq/mL. The PET/MRI-based 124I ACs in the neck region can be therefore reliably used in pre-therapy dosimetry planning.
Tài liệu tham khảo
Partovi S, Kohan A, Rubbert C, et al. Clinical oncologic applications of PET/MRI: a new horizon. Am J Nucl Med Mol Imaging. 2014;4:202–12.
Fraum TJ, Fowler KJ, McConathy J, et al. PET/MRI for the body imager: abdominal and pelvic oncologic applications. Abdom Imaging. 2015;40:1387–404.
Beyer T, Moser E. MR/PET or PET/MRI: does it matter? Magn Reson Mater Phy. 2013;26:1–4.
Heusch P, Buchbender C, Beiderwellen K, et al. Standardized uptake values for [18F] FDG in normal organ tissues: comparison of whole-body PET/CT and PET/MRI. Eur J Radiol. 2013;82:870–6.
Wiesmüller M, Quick HH, Navalpakkam B, et al. Comparison of lesion detection and quantitation of tracer uptake between PET from a simultaneously acquiring whole-body PET/MR hybrid scanner and PET from PET/CT. Eur J Nucl Med Mol Imaging. 2013;40:12–21.
Freudenberg LS, Jentzen W, Görges R, et al. 124I-PET dosimetry in advanced differentiated thyroid cancer: therapeutic impact. Nuklearmedizin. 2007;46:121–8.
Jentzen W, Hoppenbrouwers J, van Leeuwen P, et al. Assessment of lesion response in the initial radioiodine treatment of differentiated thyroid cancer using 124I PET imaging. J Nucl Med. 2014;55:1759–65.
Jentzen W, Verschure F, van Zon A, et al. 124I PET assessment of response of bone metastases to initial radioiodine treatment of differentiated thyroid cancer. J Nucl Med. 2016;57:1499–504.
Wierts R, Brans B, Havekes B, et al. Dose-response relationship in differentiated thyroid cancer patients undergoing radioiodine treatment assessed by means of 124I PET/CT. J Nucl Med. 2016;57:1027–32.
Jentzen W, Freudenberg L, Eising EG, et al. Optimized 124I PET dosimetry protocol for radioiodine therapy of differentiated thyroid cancer. J Nucl Med. 2008;49:1017–23.
Hayden C, Casey M, Watson C. Prompt gamma correction for non-standard isotopes in a PET scanner. US Patent. 2011;7:894. 652
Binse I, Poeppel TD, Ruhlmann M, et al. Imaging with (124)I in differentiated thyroid carcinoma: is PET/MRI superior to PET/CT? Eur J Nucl Med Mol Imaging. 2016;43:1011–7.
Jentzen W, Freudenberg L, Bockisch A. Quantitative imaging of 124I with PET/CT in pretherapy lesion dosimetry. Effects impairing image quantification and their corrections. Q J Nucl Med Mol Imaging. 2011;55:21–43.
Wierts R, Jentzen W, Quick HH, et al. Quantitative performance evaluation of 124I PET/MRI lesion dosimetry in differentiated thyroid cancer. Phys Med Biol. 2017 [in press]; https://doi.org/10.1088/1361-6560/aa990b.
McBride GB. A proposal for strength-of-agreement criteria for Lin’s concordance correlation coefficient. NIWA Client Report, 2005: HAM2005–062.
Bezrukov I, Mantlik F, Schmidt H, et al. MR-based PET attenuation correction for PET/MR imaging. Semin Nucl Med. 2013;43:45–59.
Bailey DL, Barthel H, Beuthin-Baumann B, et al. Combined PET/MR: where are we now? Summary report of the second international workshop on PET/MR imaging April 8-12, 2013, Tubingen, Germany. Mol Imaging Biol. 2014;16:295–310.
Matthies A, Hickeson M, Cuchiara A, et al. Dual time point 18F-FDG PET for the evaluation of pulmonary nodules. J Nucl Med. 2002;43:871–5.
