ORIGINAL_ARTICLE
Economic Sanctions on Iran and Nuclear Medicine
"It is not a wise choice!", this was the reaction of my father when I applied for nuclear medicine residency program 26 years ago. The old retired officer continued that hi-tech nuclear medicine is dependent on multiple advanced sections that may not be easily available especially in the developing countries. Now he is not alive to see that political misconducts have added fuel to the fire. Global shortage of Technetium-99m in recent years revealed the vulnerability of nuclear medicine and dependency of our clinical departments on the policies of the governments to support production of radiotracers (1). Although the mission of International Atomic Energy Agency (IAEA) is to "accelerate and enlarge the contribution of atomic energy to peace, health, and prosperity throughout the world", its application is highly affected by local governmental policies (2) Recent unilateral withdrawal of USA from Iran nuclear deal (Joint Comprehensive Plan Of Action-JCPOA) followed by imposing economic, trade and financial sanctions against Iran, has deleterious effect on nuclear medicine either on supply of radiotracers or spare parts of nuclear medicine devices (3). Although medicine is apparently not included in the list of sanctions, secondary sanction, aviation and transport embargo as well as financial restrictions, made it extremely difficult for medical companies to be able to do any transaction. Payment for the drugs or instruments and shipment of the goods to and from Iran have turned to a lengthy, difficult and risky task. Nuclear medicine seems to be at particular risk due to its link with atomic energy agency.
https://aojnmb.mums.ac.ir/article_12039_ee7d7b5c6640c4ea53142e497ca4b37e.pdf
2019-01-01
1
3
10.22038/aojnmb.2018.36919.1248
Nuclear Medicine
Sanctions
Iran
Seyed Rasoul
Zakavi
zakavir@mums.ac.ir
1
Nuclear Medicine Research Center, Mashhad University of Medical Sciences
LEAD_AUTHOR
1.Perkins A, Hilson A, Hall J. Global shortage of medical isotopes threatens nuclear medicine services. BMJ. 2008;337:a1577.
1
2.Deatsch-Kratochvil AN, Pascual TN, Kesner A, Rosenblatt E, Chhem RK. The international atomic energy agency’s activities in radiation medicine and cancer: promoting global health through diplomacy. Can Assoc Radiol J. 2013;64(1):2-5.
2
3.Declaration on radiopharmaceutical sanctions. Iranian Society of Nuclear Medicine. Available at: URL: http://www.irsnm.ir; Accessed on 2018.
3
4.Kokabisaghi F. Assessment of the effects of economic sanctions on Iranians’ right to health by using human rights impact assessment tool: a systematic review. Int J Health Policy Manag. 2018;7(5):374-93.
4
5.Kheirandish M, Varahrami V, Kebriaeezade A, Cheraghali AM. Impact of economic sanctions on access to noncommunicable diseases medicines in the Islamic Republic of Iran. East Mediterr Health J. 2018;24(1):42-51.
5
6.Shahabi S. International sanctions: sanctions in Iran disrupt cancer care. Nature. 2015;520(7546):157.
6
7.Massoumi RL, Koduri S. Adverse effects of political sanctions on the health care system in Iran. J Global Health. 2015;5(2):020302.
7
8.Deilamizade A, Esmizade S. Economic sanctions against iran, and drug use in Tehran, Iran: a 2013 pilot study. Subst Use Misuse. 2015;50(7):859-68.
8
9.Baradaran-Seyed Z, Majdzadeh R. Economic sanctions strangle Iranians’ health, not just drug supply. Lancet. 2013;381(9878):1626.
9
10.Arya N. Economic sanctions: the kinder, gentler alternative? Med Conflict Survival. 2008;24(1):25-41.
10
11.Ghiasi G, Rashidian A, Kebriaeezadeh A, Salamzadeh J. The impact of the sanctions made against Iran on availability to asthma medicines in Tehran. Iran J Pharm Res. 2016;15(3):567-71.
11
12.Asadi-Pooya AA, Tavana B, Tavana B, Emami M. Drug adherence of patients with epilepsy in Iran: the effects of the international economic sanctions. Acta Neurol Belg. 2016;116(2):151-5.
12
13.Heidari R, Akbariqomi M, Tavoosidana G. Medical legacy of sanctions in Iran. Nature. 2017;552(7684):175.
13
14.Hassani M. Impact of sanctions on cancer care in Iran. Arch Bone Jt Surg. 2018;6(4):248-9.
14
15.Hosseini SA. Impact of sanctions on procurement of medicine and medical devices in Iran; a technical response. Arch Iran Med. 2013;16(12):736-8.
15
16.Shahabi S, Fazlalizadeh H, Stedman J, Chuang L, Shariftabrizi A, Ram R. The impact of international economic sanctions on Iranian cancer healthcare. Health Policy. 2015;119(10):1309-18.
16
17.Jalilian AR, Beiki D, Hassanzadeh-Rad A, Eftekhari A, Geramifar P, Eftekhari M. Production and clinical applications of radiopharmaceuticals and medical radioisotopes in Iran. Semin Nucl Med. 2016;46(4):340-58.
17
18.Radioisotope development & production for industrial & medical applications. ParsIsotpe Company. Available at: URL: http://www. parsisotope.com; Accessed on 12/15/2018. 19.
18
19.Sen K, Al-Faisal W, AlSaleh Y. Syria: effects of conflict and sanctions on public health. J Public Health. 2013;35(2):195-9.
19
20.Gibbons E, Garfield R. The impact of economic sanctions on health and human rights in Haiti, 1991- 1994. Am J Public Health. 1999;89(10):1499-504.
20
21.Duttagupta S, Yampolsky D, Chowdhury CA. Economic sanctions and market access for pharmaceuticals: case studies with Russia, cuba and Iran. Value Health. 2015;18(7):A569.
21
22.Marks SP. Economic sanctions as human rights violations: reconciling political and public health imperatives. Am J Public Health. 1999;89(10):1509-13.
22
ORIGINAL_ARTICLE
Clinical Impact of 18F-FDG PET/CT on the Management of Gynecologic Cancers: One Center Experience
Objective(s): We aim to investigate the clinical impact of 18F-FDG PET/CT in managing patients with gynecological malignancies and pelvic or extrapelvic lymph nodes that are of equivocal significance on conventional imaging.Methods: We retrospectively evaluated 18F-FDG PET/CT scans of patients with gynecologic tumors who were referred to King Hussein Cancer Center from January 2010 to August 2014. PET/CT results were compared with MRI and CT findings. We evaluated sensitivity and specificity of 18F-FDG PET/CT, its role in changing treatment planand its positive predictive value (PPV) and negative predictive value (NPV).Results: Ninety seven patients (mean age: 49 years) underwent 18F-FDG/PET in the study period (40 cervical, 37 endometrial and 20 ovarian cancers). PET/CT scan provided additional information in 23 patients; upstaging 4.1% (4 patients; 3 true positive) and down staging in 19.5% (19 patients; 15 true negative). As a result, treatment strategy was changed from curative to palliative in three patients, and modification of radiation field or additional curative therapy was implemented following exclusion of distant metastasis in 11 patients. Mean follow up time for the whole cohort was 35 months (range 6 - 60 months). NPV of 18F-FDG PET/CT in detecting extrapelvic lymphadenopathy was 83.3%.Conclusion: 18F-FDG PET/CT has high clinical impact in management of gynaecological cancers as it alters the treatment plan in a substantial number of patients who had equivocal findings on conventional imaging,as well as it offers excellent validity in lymph nodes staging.
https://aojnmb.mums.ac.ir/article_11208_a91645050d75bd62a150e448e806b0f9.pdf
2019-01-01
4
12
10.22038/aojnmb.2018.11208
Gynecological malignancies
Negative predictive value
PET/CT
Akram
Al-ibraheem
aibraheem@khcc.jo
1
King Hussein Cancer Center
LEAD_AUTHOR
Abedallatif
AlSharif
2
Department of Radiology & Nuclear Medicine, Jordan University hospital, Amman, Jordan
AUTHOR
Ramiz
Abu-Hijlih
rhijlih@khcc.jo
3
Department of Radiation Oncology, King Hussein Cancer Center, Amman, Jordan
AUTHOR
Imad
Jaradat
ijaradat@khcc.jo
4
Department of Radiation Oncology, King Hussein Cancer Center, Amman, Jordan
AUTHOR
Asem
Mansour
amansour@khcc.jo
5
Department of Radiology, King Hussein Cancer Center, Amman, Jordan
AUTHOR
1. Perroy A, Kotz H. Cervical cancer. The Bethesda handbook of clinical oncology. 3rd ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2010. P. 241-51.
1
2. Key statistics about ovarian cancer. American Cancer Society. Available at: URL: http://www. cancer.org/cancer/ovariancancer/detailedguide/ ovarian-cancer-key-statistics; 2016.
2
3. Nimiri O. Cancer incidence in Jordan. Jordan: NonCommunicable Diseases Directorate, Jordan Cancer Registry. Ministry of Health; 2012.
3
4. FIGO Committee on Gynecologic Oncology. FIGO staging for carcinoma of the vulva, cervix, and corpus uteri. Int J Gynaecol Obstet. 2014;125(2):97-8.
4
5. Prat J; FIGO Committee on Gynecologic Oncology. Staging classification for cancer of the ovary, fallopian tube, and peritoneum. Int J Gynaecol Obstet. 2014;124(1):1-5.
5
6. Pecorelli S, Zigliani L, Odicino F. Revised FIGO staging for carcinoma of the cervix. Int J Gynaecol Obstet. 2009;105(2):107-8.
6
7. Suppiah S, Kamal SH, Mohd Zabid AZ, Abu Hassan H. Characterization of adnexal masses using multidetector contrast-enhanced CT scan– recognising common pitfalls that masquerade as ovarian cancer. Pertanika J Sci Technol. 2017;25(1):337-52.
7
8. Hricak H, Gatsonis C, Chi DS, Amendola MA, Brandt K, Schwartz LH, et al. Role of imaging in pretreatment evaluation of early invasive cervical cancer: results of the intergroup study American College of Radiology Imaging Network 6651–Gynecologic Oncology Group 183. J Clin Oncol. 2005;23(36):9329-37.
8
9. Magné N, Chargari C, Vicenzi L, Gillion N, Messai T, Magné J, et al. New trends in the evaluation and treatment of cervix cancer: the role of FDG–PET. Cancer Treat Rev. 2008;34(8):671-81.
9
10. Musto A, Grassetto G, Marzola MC, Chondrogiannis S, Maffione AM, Rampin L, et al. Role of 18F-FDG PET/CT in the carcinoma of the uterus: a review of literature. Yonsei Med J. 2014;55(6):1467-72.
10
11. Rockall AG, Cross S, Flanagan S, Moore E, Avril N. The role of FDG-PET/CT in gynaecological cancers. Cancer Imaging. 2012;12:49-65.
11
12. Cihoric N, Tapia C, Krüger K, Aebersold DM, Klaeser B, Lössl K. IMRT with 18 FDG-PETCT based simultaneous integrated boost for treatment of nodal positive cervical cancer. Radiat Oncol. 2014;9:83.
12
13. Salem A, Salem AF, Al-Ibraheem A, Lataifeh I, Almousa A, Jaradat I. Evidence for the use PET for radiation therapy planning in patients with cervical cancer: a systematic review. Hematol Oncol Stem Cell Ther. 2011;4(4):173-81.
13
14. Sironi S, Buda A, Picchio M, Perego P, Moreni R, Pellegrino A, et al. Lymph node metastasis in patients with clinical early-stage cervical cancer: detection with integrated FDG PET/CT 1. Radiology. 2006;238(1):272-9.
14
15. Koh WJ, Greer BE, Abu-Rustum NR, Apte SM, Campos SM, Chan J, et al. Cervical cancer. J Natl Compr Canc Netw. 2013;11(3):320-43.
15
16. Koh WJ, Greer BE, Abu-Rustum NR, Apte SM, Campos SM, Chan J, et al. Uterine neoplasms, version 1.2014. J Natl Compr Canc Netw. 2014;12(2):248-80.
16
17. Michielsen K, Vergote I, Op de Beeck K, Amant F, Leunen K, Moerman P, et al. Whole-body MRI with diffusion-weighted sequence for staging of patients with suspected ovarian cancer: a clinical feasibility study in comparison to CT and FDG-PET/CT. Eur Radiol. 2014;24(4):889-901.
17
18. Signorelli M, Guerra L, Pirovano C, Crivellaro C, Fruscio R, Buda A, et al. Detection of nodal metastases by 18F-FDG PET/CT in apparent early stage ovarian cancer: a prospective study. Gynecol Oncol. 2013;131(2):395-9.
18
19. Landoni F, Maneo A, Colombo A, Placa F, Milani R, Perego P, et al. Randomised study of radical surgery versus radiotherapy for stage Ib-IIa cervical cancer. Lancet. 1997;350(9077):535-40.
19
20. Brockbank E, Kokka F, Bryant A, Pomel C, Reynolds K. Pretreatment surgical para-aortic lymph node assessment in locally advanced cervical cancer. Cochrane Database Syst Rev. 2013;3:CD008217.
20
21. Kim HS, Ju W, Jee BC, Kim YB, Park NH, Song YS, et al. Systemic lymphadnectomy for survival in epithelial ovarian cancer: a meta-analysis. Int J Gynecol Cancer. 2010;20(4):520-8.
21
22. Wright JD, Huang Y, Burke WM, Tegas AI, Hou JY, Hu JC, et al. Influence of lymphadenectomy on survival for early stage-endometrial cancer. Obstet Gynecol. 2016;127(1):109-18.
22
23. Kidd EA, Siegel BA, Dehdashti F, Rader JS, Mutic S, Mutch DG, et al. Clinical outcomes of definitive intensity-modulated radiation therapy with fluorodeoxyglucose–positron emission tomography simulation in patients with locally advanced cervical cancer. Int J Radiat Oncol Biol Phys. 2010;77(4):1085-91.
23
ORIGINAL_ARTICLE
Diagnostic Accuracy of Positron Emission Mammography with 18F-fluorodeoxyglucose in Breast Cancer Tumor of Less than 20 mm in Size
Objective(s): To investigate the diagnostic accuracy of positron emission mammography (PEM) and positron emission tomography/computed tomography (PET/CT) for small breast tumors of less than 20 mm in size.Methods: The study was conducted on a total of 100 subjects (i.e., 50 patients with pathologically proven breast cancer and 50 normal cases of medical screening). The total number of tumors was 54 (mean size: 11±5.1 mm, range:4-20 mm). The diagnostic accuracy of PEM alone, PET/CT alone, and combined PET/CT and PEM was evaluated by two nuclear medicine physicians based on visual inspection. The two groups (i.e., tumors of ≤ 10 mm and > 10-20 mm) werecompared in terms of the diagnostic capability of the three modalities (PEM alone, PET/CT alone, and PET/CT+PEM).Results: The sensitivities of PEM alone, PET/CT alone, and combined PET/CT and PEM were 72%, 60%, and 76%, respectively. The specificities of these tests were 98%, 100%, and 98%, respectively. Furthermore, the accuracies of these diagnostic modalities were 85%, 79%, and 87%, respectively. The combined PET/CT and PEM showed significantly higher sensitivity and accuracy than PET/CT alone (P=0.005 and P=0.02, respectively). In addition, PEM demonstrated asignificantly higher sensitivity than PET/CT in the ≤ 10 mm group (P=0.03); however, no difference was observed between the two modalities in the > 10 mm group in terms of sensitivity.Conclusion: 18F-fluorodeoxyglucose PET had limited capability for the detection of small breast cancers of < 10 mm. Combined PET/CT and PEM showed higher sensitivity and accuracy, compared to PET/CT alone.
https://aojnmb.mums.ac.ir/article_11443_b0573710169e978e5659b22170ffd9a7.pdf
2019-01-01
13
21
10.22038/aojnmb.2018.31101.1213
positron emission mammography
PEM
PET/CT
Breast Cancer
diagnostic accuracy
Fuzuki
Yano
yano@tracer.med.osaka-u.ac.jp
1
Department of Nuclear Medicine and Tracer Kinetics, Osaka University Graduate School of Medicine
AUTHOR
Masatoshi
Itoh
itomsts@gmail.com
2
Sendai Medical Imaging Clinic (Gazo Kenshin)
AUTHOR
Hisashi
Hirakawa
hirakawa@tohokukosai.com
3
Department of Breast Surgery, Tohoku Kosai Hospital
AUTHOR
Seiichi
Yamamoto
s-yama@met.nagoya-u.ac.jp
4
Department of Radiological and Medical Laboratory Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan
AUTHOR
Akira
Yoshikawa
yoshikawa@imr.tohoku.ac.jp
5
Institute for Materials Research, Tohoku University
AUTHOR
Jun
Hatazawa
hatazawa@tracer.med.osaka-u.ac.jp
6
Osaka University Graduate School of Medicine
LEAD_AUTHOR
1. Jadvar H, Alavi A, Gambhir SS. 18F-FDG uptake in lung, breast, and colon cancers: molecular biology correlates and disease characterization. J Nucl Med. 2009;50(11):1820-7.
1
2. Groheux D, Espié M, Giacchetti S, Hindié E. Performance of FDG PET/CT in the clinical management of breast cancer. Radiology. 2013;266(2):388-405.
2
3. Inoue T, Yutani K, Taguchi T, Tamaki Y, Shiba E, Noguchi S. Preoperative evaluation of prognosis in breast cancer patients by [(18)F]2Deoxy-2-fluoroD-glucose-positron emission tomography. J Cancer Res Clin Oncol. 2004;130(5):273-8.
3
4. Jo JE, Kim JY, Lee SH, Kim S, Kang T. Preoperative 18F-FDG PET/CT predicts disease-free survival in patients with primary invasive ductal breast cancer. Acta Radiol. 2015;56(12):1463-70.
4
5. Ohara M, Shigematsu H, Tsutani Y, Emi A, Masumoto N, Ozaki S, et al. Role of FDG-PET/CT in evaluating surgical outcomes of operable breast cancer: usefulness for malignant grade of triple-negative breast cancer. Breast. 2013;22(5):958-63.
5
6. Kalinyak JE, Berg WA, Schilling K, Madsen KS, Narayanan D, Tartar M. Breast cancer detection using high-resolution breast PET compared to whole-body PET or PET/CT. Eur J Nucl Med Mol Imaging. 2014;41(2):260-75.
6
7. Avril N, Rose CA, Schelling M, Dose J, Kuhn W, Bense S, et al. Breast imaging with positron emission tomography and fluorine-18 fluorodeoxyglucose: use and limitations. J Clin Oncol. 2000;18(20):3495- 502.
7
8. Berg WA, Weinberg IN, Narayanan D, Lobrano ME, Ross E, Amodei L, et al. High-resolution fluorodeoxyglucose positron emission tomography with compression (“positron emission mammography”) is highly accurate in depicting primary breast cancer. Breast J. 2006;12(4):309-23.
8
9. MacDonald L, Edwards J, Lewellen T, Haseley D, Rogers J, Kinahan P. Clinical imaging characteristics of the positron emission mammography camera: PEM Flex Solo II. J Nucl Med. 2009;50(10):1666-75.
9
10. Teixeira SC, Rebolleda JF, Koolen BB, Wesseling J, Jurado RS, Stokkel MP, et al. Evaluation of a hanging-breast PET system for primary tumor visualization in patients with stage I–III breast cancer: comparison with standard PET/CT. AJR Am J Roentgenol. 2016;206(6):1307-14.
10
11. Abreu MC, Almeida P, Balau F, Ferreira NC, Fetal S, Fraga F, et al. Clear-PEM: a dedicated PET camera for improved breast cancer detection. Radiat Prot Dosimetry. 2005;116(1-4 Pt 2):208-10.
11
12. Yamamoto Y, Ozawa Y, Kubouchi K, Nakamura S, Nakajima Y, Inoue T. Comparative analysis of imaging sensitivity of positron emission mammography and whole-body PET in relation to tumor size. Clin Nucl Med. 2015;40(1):21-5.
12
13. Eo JS, Chun IK, Paeng JC, Kang KW, Lee SM, Han W, et al. Imaging sensitivity of dedicated positron emission mammography in relation to tumor size. Breast. 2012;21(1):66-71.
13
14. Caldarella C, Treglia G, Giordano A. Diagnostic performance of dedicated positron emission mammography using fluoine-18-fluorodeoxyglucose in woman with suspicious breast lesions: a metaanalysis. Clin Breast Cancer. 2014;14(4):241-8.
14
15. Nishimatsu K, Nakamoto Y, Miyake KK, Ishimori T, Kanao S, Toi M, et al. Higher Breast cancer conspicuity on dbPET compared to WB-PET/CT. Eur J Radiol. 2017;90:138-45.
15
16. Sato H, Ito S, Usuki Y, Miyake M, Kumagai K, Baba M, et al. Evaluation and development for positron emission mammography based on Pr: LuAG scintillator crystals. Nuclear Science Symposium and Medical Imaging Conference Record Conference (NSS/MIC), 2012 IEEE; 2012 Oct 27.
16
17. Ito S, Sato H, Usuki Y, Miyake M, Kumagai K, Baba M, et al. Fundamental performance of a new planer PEM. Nuclear Science Symposium and Medical Imaging Conference (NSS/MIC), 2012 IEEE; 2012 Oct 27. P. 3519-20.
17
18. Yoshikawa A, Yanagida T, Kamada K, Yokota Y, Pejchal J, Yamaji A, et al. Positron emission mammography using Pr: LuAG scintillator-Fusion of optical material study and systems engineering. Optical Materials. 2010;32(10):1294-7.
18
19. Sasaki T, Sera K, Ishii K. Comparison of PET performance in clinical examination among PET facilities. Radioisotopes. 2011;60(11):473-86.
19
20. Narayanan D, Madsen KS, Kalinyak JE, Berg WA. Interpretation of positron emission mammography: feature analysis and rates of malignancy. AJR Am J Roentgenol. 2011;196(4):956-70.
20
21. Berg WA, Madsen KS, Schilling K, Tartar M, Pisano ED, Larsen LH, et al. Breast cancer: comparative effectiveness of positron emission mammography and MR imaging in presurgical planning for the ipsilateral breast. Radiology. 2011;258(1):59-72.
21
22. Boerner AR, Weckesser M, Herzog H, Schmitz T, Audretsch W, Nitz U, et al. Optimal scan time for fluorine-18 fluorodeoxyglucose positron emission tomography in breast cancer. Eur J Nucl Med. 1999;26(3):226-30.
22
23. Mavi A, Urhan M, Yu JQ, Zhuang H, Houseni M, Cermik TF, et al. Dual time point 18F-FDG WBPET imaging detects breast cancer with high sensitivity and correlates well with histologic subtypes. J Nucl Med. 2006;47(9):1440-6.
23
ORIGINAL_ARTICLE
Dopamine Transporter imaging with Tc-99m TRODAT-1 SPECT in Parkinson’s disease and its correlation with clinical disease severity
Objective(s): To evaluate the role of Tc-99m TRODAT-1 Single Photon Emission Computed Tomography (SPECT) in Parkinson’s Disease (PD) by assessing the correlation of clinical disease severity, disease duration and age at onset of disease with specific uptake ratio of Tc-99m TRODAT-1 in striatum.Methods: The study included 63 patients in age range of 40-72 years with clinical diagnosis of PD and nine controls. Clinical history of patients was obtained regarding age at onset of disease and disease duration. Disease severity in each patient was assessed using H and Y stage and UPDRS. Tc-99m TRODAT-1 SPECT was performed and specific uptake ratios were calculated for six regions in bilateral striata, caudate nuclei and putamina. Difference in specific uptake ratios between different stages of disease was analyzed for statistical significance. Specific uptake ratios were correlated with UPDRS, motor score of UPDRS, duration of disease and age at onset of disease using Pearson’s correlation co-efficient.Results: Median specific uptake ratio was found to be least in contralateral putamen for all H and Y stages. There was a statistically significant difference between specific uptake ratios of controls vs stage 1, stage 1 vs 2, 1 vs 3, 1 vs 4, and 2 vs 4 for all 6 regions. The difference in uptake ratio between 3 and 4 H and Y stages was significant only for contralateralregions. There was no significant difference in uptake ratio between 2 and 3 H and Y stages. The uptake ratios showed a strong negative correlation with UPDRS and motor score, a weak negative correlation with duration of disease and no significant correlation with age at onset of disease.Conclusion: We conclude that Tc-99m TRODAT-1 SPECT can be used to assess the disease severity in PD patients.
https://aojnmb.mums.ac.ir/article_11477_6288cb7611d4b972e7055011e19d31ac.pdf
2019-01-01
22
28
10.22038/aojnmb.2018.30356.1208
Tc-99m TRODAT-1 SPECT
Parkinson’s disease
Severity
H and Y scale
UPDRS
Asra
Patel
asra_patel@yahoo.co.in
1
Department of Nuclear Medicine and PET-CT, Apollo Hospitals, Chennai, Tamilnadu, India
LEAD_AUTHOR
Shelley
Simon
shelleysimon@rediffmail.com
2
Department of Nuclear Medicine and PET-CT, Apollo Hospitals, Chennai, Tamilnadu India
AUTHOR
Indirani
Elangoven
drindinm@gmail.com
3
Department of Nuclear Medicine and PET-CT Apollo Hospitals, Chennai, Tamilnadu, India
AUTHOR
Jaykanth
Amalchandran
jaykanthamal@gmail.com
4
Department of Nuclear Medicine and PET-CT Apollo Hospitals, Chennai, Tamilnadu India
AUTHOR
Avani
Jain
dr.avani21@yahoo.in
5
Department of Nuclear Medicine and PET-CT Apollo Hospitals, Chennai, Tamilnadu India
AUTHOR
Thangalakshmi
S
tlashmiraj2012@gmail.com
6
Department of Nuclear Medicine and PET-CT Apollo Hospitals, Chennai, Tamilnadu India
AUTHOR
1. World Health Organization. Neurological disorders: public health challenges. Switzerland: World Health Organization; 2016.
1
2. Geng Y, Shi GH, Jiang Y, Xu LX, Hu XY, Shao YQ. Investigating the role of 99mTc-TRODAT-1 SPECT imaging in idiopathic Parkinson’s disease. J Zhejiang Univ Sci B. 2005;6(1):22-7.
2
3. Wang L, Zhang Q, Li H, Zhang H. SPECT molecular imaging in Parkinson’s disease. J Biomed Biotechno. 2012;2012:1-16.
3
4. Kagi G, Bhatia KP, Tolosa E. The role of DAT-SPECT in movement disorders. J Neurol Neurosurg Psychiatry. 2010;81(1):5-12.
4
5. Park E. A new era of clinical dopamine transporter imaging using 123I-FP-CIT. J Nucl Med Technol. 2010;40(4):222-8.
5
6. Van Laere K, Casteels C, De Ceuninck L, Vanbilloen B, Maes A, Mortelmans L et al. Dual-tracer dopamine transporter and perfusion SPECT in differential diagnosis of parkinsonism using template-based discriminant analysis. J Nucl Med. 2006;47(3):384-92.
6
7. Chou KL, Hurtig HI, Stern MB, Colcher A, Ravina B, Newberg A, et al. Diagnostic accuracy of [99mTc] TRODAT-1 SPECT imaging in early Parkinson’s disease. Parkinsonism Relat Disord. 2004;10(6):375-9.
7
8. Weng YH, Yen TC, Chen MC, Kao PF, Tzen KY, Chen RS, et al. Sensitivity and specificity of 99mTcTRODAT-1 SPECT imaging in differentiating patients with idiopathic Parkinson’s disease from healthy subjects. J Nucl Med. 2004;45(3):393-401.
8
9. Spiegel J, Mollers MO, Jost WH, Fuss G, Samnick S, Dillmann U, et al. FP-CIT and MIBG scintigraphy in early Parkinson’s disease. Mov Disord. 2005;20(5):552-61.
9
10. Tissingh G, Booij J, Bergmans P, Winogrodzka A, Janssen AG, van Royen EA, et al. Iodine-123-N- {omega}-fluoropropyl-2{beta}-carbomethoxy- 3{beta}-(4-Iodophenyl) Tropane SPECT in healthy controls and early-stage, drug-naive Parkinson’s disease. J Nucl Med. 1998;39(7):1143-8.
10
11. Benamer HT, Patterson J, Wyper DJ, Hadley DM, Macphee GJ, Grosset DG. Correlation of Parkinson’s disease severity and duration with 123I-FP-CIT SPECT striatal uptake. Mov Disord. 2000;15(4):692-8.
11
12. Tatsch K, Poepperl G. Nigrostriatal dopamine terminal imaging with dopamine transporter SPECT: an update. J Nucl Med. 2013;54(8):1331-8.
12
13. Bor-Seng-Shu E, Felicio AC, Braga-Neto P, Batista IR, Paiva WS, de Andrade DC, et al. Dopamine transporter imaging using 99mTc-TRODAT-1 SPECT in Parkinson’s disease. Med Sci Monit. 2014;20:1413-8.
13
14. Wu H, Lou C, Huang Z, Shi G. SPECT imaging of dopamine transporters with (99m)Tc-TRODAT-1 in major depression and Parkinson’s disease. J Neuropsychiatry Clin Neurosci. 2011;23(1):63-7.
14
15. Yin TK, Lee BF, Yang YK, Chiu NT. Differences of various region-of-interest methods for measuring dopamine transporter availability using 99mTcTRODAT-1 SPECT. Sci World J. 2014;2014:837439.
15
16. Huang WS, Lin SZ, Lin JC, Wey SP, Ting G, Liu RS. Evaluation of early-stage Parkinson’s disease with 99mTc-TRODAT-1 imaging. J Nucl Med. 2001;42(9):1303-8.
16
17. Eskandar EN. Hoehn and Yahr staging of Parkinson’s disease, Unified Parkinson disease Rating Scale (UPDRS), and Schwab and England activities of daily living. Available at: URL: http://neurosurgery.mgh. harvard.edu /functional/ pdstages.htm; Accessed 3 April 2016.
17
18. Booij J, Tissingh G, Boer GJ, Speelman JD, Stoof JC, Janssen AG, et al. 123I FP-CIT SPECT shows a pronounced decline of striatal dopamine transporter labelling in early and advanced Parkinson’s disease. J Neurol Neurosurg Psychiatry. 1997;62(2):133-40.
18
19. Van Laere K, De Ceuninck L, Dom R, Van den Eynden J, Vanbilloen H, Cleynhens J, et al. Dopamine transporter SPECT using fast kinetic ligands: 123I-FP-β-CIT versus 99mTc-TRODAT-1. Eur J Nucl Med Mol Imaging. 2004;31(5):1119-27.
19
20. Lu CS, Weng YH, Chen MC, Chen RS, Tzen KY, Wey SP, et al. 99mTc-TRODAT-1 imaging of multiple system atrophy. J Nucl Med. 2004;45(1):49-55.
20
21. Hwang WJ, Yao WJ, Wey SP, Ting G. Reproducibility of 99mTc-TRODAT-1 SPECT measurement of dopamine transporters in Parkinson’s disease. J Nucl Med. 2004;45(2):207-13.
21
ORIGINAL_ARTICLE
Automated classification of pulmonary nodules through a retrospective analysis of conventional CT and two-phase PET images in patients undergoing biopsy
Objective(s): Positron emission tomography/computed tomography (PET/CT) examination is commonly used for the evaluation of pulmonary nodules since it provides both anatomical and functional information. However, given the dependence of this evaluation on physician’s subjective judgment, the results could be variable. The purpose of this study was to develop an automated scheme for the classification of pulmonary nodules using early and delayed phase PET/ CT and conventional CT images.Methods: We analysed 36 early and delayed phase PET/CT images in patients who underwent both PET/CT scan and lung biopsy, following bronchoscopy. In addition, conventional CT images at maximal inspiration were analysed. The images consisted of 18 malignant and 18 benign nodules. For the classification scheme, 25 types of shape and functional features were first calculated from the images. The random forest algorithm, which is a machine learning technique, was used for classification.Results: The evaluation of the characteristic features and classification accuracy was accomplished using collected images. There was a significant difference between the characteristic features of benign and malignant nodules with regard to standardised uptake value and texture. In terms of classification performance, 94.4% of the malignant nodules were identified correctly assuming that 72.2% of the benign nodules were diagnosed accurately. The accuracy rate of benign nodule detection by means of CT plus two-phase PET images was 44.4% and 11.1% higher than those obtained by CT images alone and CT plus early phase PET images, respectively.Conclusion: Based on the findings, the proposed method may be useful to improve the accuracy of malignancy analysis.
https://aojnmb.mums.ac.ir/article_12014_2737ff2538b8f01510e4148e0fa775b5.pdf
2019-01-01
29
37
10.22038/aojnmb.2018.12014
classification
computer-aided diagnosis
Lung cancer
pulmonary nodule
PET/CT
Atsushi
Teramoto
teramoto@fujita-hu.ac.jp
1
Fujita Health University
LEAD_AUTHOR
Masakazu
Tsujimoto
mckz-t@fujita-hu.ac.jp
2
Fujita Health University Hospital
AUTHOR
Takahiro
Inoue
teralab.journal01@gmail.com
3
School of Medicine, Fujita Health Hniversity
AUTHOR
Tetsuya
Tsukamoto
ttsukamt@gmail.com
4
School of Medicine, Fujita Health University
AUTHOR
Kazuyoshi
Imaizumi
jeanluc@fujita-hu.ac.jp
5
School of Medicine, Fujita Health University
AUTHOR
Hiroshi
Toyama
htoyama@fujita-hu.ac.jp
6
Department of Radiology, Fujita Health University
AUTHOR
Kuniaki
Saito
teralab.journal02@gmail.com
7
School of Health Sciences, Fujita Health University
AUTHOR
Hiroshi
Fujita
fujita@fjt.info.gifu-u.ac.jp
8
Dep. Electrical, Electronic & Computer Engineering, Fac. Engineering Gifu University
AUTHOR
1. American cancer society, cancer facts and figures 2015. Available at: URL: https://www.cancer. org/content/dam/cancer-org/research/cancerfacts-and-statistics/annual-cancer-facts-andfigures/2015/cancer-facts-and-figures-2015.pdf; Accessed September 14, 2018.
1
2. Sone S, Takashima S, Li F, Yang Z, Honda T, Maruyama Y, et al. Mass screening for lung cancer with mobile spiral computed tomography scanner. Lancet. 1998;351(9111):1242-5.
2
3. National Lung Screening Trial Research Team, Aberle DR, Adams AM, Berg CD, Black WC, Clapp JD, et al. Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med. 2011;365(5):395-409.
3
4. Gould MK, Maclean CC, Kuschner WG, Rydzak CE, Owens DK. Accuracy of positron emission tomography for diagnosis of pulmonary nodules and mass lesions: a meta-analysis. JAMA. 2001; 285(7):914-24.
4
5. Armato SG 3rd, Altman MB, Wilkie J, Sone S, Li F, Doi K, et al. Automated lung nodule classification following automated nodule detection on CT: a serial approach. Med Phys. 2003;30(6):1188-97.
5
6. Way TW, Hadjiiski LM, Sahiner B, Chan HP, Cascade PN, Kazerooni EA, et al. Computer-aided diagnosis of pulmonary nodules on CT scans: segmentation and classification using 3D active contours. Med Phys. 2006;33(7):2323-37.
6
7. Zhang F, Song, Y, Cai W, Lee MZ, Zhou Y, Huang H, et al. Lung nodule classification with multilevel patchbased context analysis. IEEE Trans Biomed Eng. 2014;61(4):1155-66.
7
8. Madero Orozco H, Vergara Villegas OO, Cruz Sánchez VG, Ochoa Domínguez Hde J, Nandayapa Alfaro Mde J. Automated system for lung nodules classification based on wavelet feature descriptor and support vector machine. Biomed Eng Online. 2015;14:9.
8
9. Shen W, Zhou M, Yang F, Yu D, Dong D, Yang C, et al. Multi-crop convolutional neural networks for lung nodule malignancy suspiciousness classification. Pattern Recognition. 2017;61:663-73.
9
10. Nie Y, Li Q, Li F, Pu Y, Appelbaum D, Doi K. Integrating PET and CT Information to improve diagnostic accuracy for lung nodules: a semiautomatic computer-aided method. J Nucl Med. 2006;47(7):1075-80.
10
11. MacMahon H, Naidich DP, Goo JM, Lee KS, Leung ANC, Mayo JR, et al. Guidelines for management of incidental pulmonary nodules detected on CT images: from the Fleischner Society 2017. Radiology. 2017;284(1):228-43.
11
12. Sim YT, Poon FW. Imaging of solitary pulmonary nodule-a clinical review. Quant Imaging Med Surg. 2013;3(6):316-26.
12
13. Keyes JW Jr. SUV: standard uptake or silly useless value? J Nucl Med. 1995;36(10):1836-9.
13
14. Li Q, Sone S, Doi K. Selective enhancement filters for nodules, vessels, and airway walls in twoand three-dimensional CT scans. Med Phys. 2003;30(8):2040-51.
14
15. Rangayyan RM, Ayres FJ. Gabor filter and phase portraits for the detection of architectural distortion in mammograms. Med Biol Eng Comput. 2006;44(10):883-94.
15
16. Yoshikawa R, Teramoto A, Matsubara T, Fujita H. Automated detection of architectural distortion using improved adaptive Gabor filter. International Workshop on Digital Mammography, Springer, Cham; 2014 Jun 29. P. 606-11.
16
17. Haralick RM, Shanmugam K, Dinstein I. Textural features for image classification. IEEE Trans Syst Man Cybernetics. 1973;3(6):610-21.
17
18. Breiman L. Random forests. Machine Learn. 2001;45(1):5-32.
18
19. Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed. Hillsdale: Lawrence Erlbaum Associates; 1988.
19
20. Krizhevsky A, Sutskever I, Hinton GE. Imagenet classification with deep convolutional neural networks. Adv Neural Informat Proc Syst. 2012;25(2):1106-14.
20
21. LeCun Y, Bengio Y, Hinton G. Deep learning. Nature. 2015;521(7553):436-44.
21
22. Teramoto A, Fujita H, Yamamuro O, Tamaki T. Automated detection of pulmonary nodules in PET/ CT images: ensemble false-positive reduction using a convolutional neural network technique. Med Phys. 2016;43(6):2821-7.
22
23. Teramoto A, Tsukamoto T, Kiriyama Y, Fujita H. Automated classification of lung cancer types from cytological images using deep convolutional neural networks. Biomed Res Int. 2017;2017:4067832.
23
ORIGINAL_ARTICLE
Simplified Dynamic Phantom for Pediatric Renography: A Description of Instrument and Its Performance
Objective(s): Renography is used for the diagnostic evaluation of pediatric patients with a suspected obstruction of urinary tract or impaired renal function. The recommended dose for children have been released by the European Association of Nuclear Medicine, Society of Nuclear Medicine and Molecular Imaging, and Japanese Society of Nuclear Medicine. Since acquisition counts in dynamic scintigraphy are affected by the administered doses and sensitivity of the scintillation camera, the scan procedure should be determined independently. In this study, we constructed simplified dynamic phantom imitating pediatric renography and tested its performance.Methods: Simplified dynamic phantom consisted of three components (i.e.,infusion, imitated kidney, and drainage sections). The infusion rates (mL/min) were determined by comparing the time activity curves obtained from patientswith normal renal function. The time-points of the maximum counts (Tmax), as well as the two-thirds and one-half of the maximum counts (T2/3 and T1/2) were measured in different doses using the phantom with the best-match infusion rateand duration, and low-energy general-purpose (LEGP) or low-energy highresolution (LEHR) collimators and applying different attenuations.Results: The best-match infusion rates of the phantom to imitate the time activity curve of the normal renal function were 42.0, 1.0, 0.6, and 0.3 mL/min in the arterial, secretory, early-excretory, and late-excretory phases, respectively. When 30 MBq, LEHR collimator and non-water-equivalent phantom were applied, Tmax, T2/3, and T1/2 were 242±15.3, 220±10.0 and 317±25.2 seconds, respectively. Using LEGP collimator and (3 MBq of activity) 5-cm water-equivalent phantom, Tmax, T2/3, and T1/2 values were estimated as 242±5.8, 213±11.5, and 310±17.3 sec, respectively.Conclusion: Our simplified dynamic phantom for pediatric renography could imitate the time activity curves obtained from patients with normal renal function. Tmax, T2/3, and T1/2 could be measured under various settings of dose,collimator, and tissue attenuation.
https://aojnmb.mums.ac.ir/article_11803_e08ba729631ad5b3008a6db7029ed8b0.pdf
2019-01-01
38
48
10.22038/aojnmb.2018.11803
pediatric dose guidelines
pediatric renography
simplified dynamic phantom
99mTc-MAG3
Takashi
Kamiya
ka38@hp-rad.med.osaka-u.ac.jp
1
Osaka University Hospital
AUTHOR
Tadashi
Watabe
watabe@tracer.med.osaka-u.ac.jp
2
Department of Nuclear Medicine and Tracer Kinetics, Osaka University Graduate School of Medicine
AUTHOR
Koichi
Fujino
fujino@hp-rad.med.osaka-u.ac.jp
3
Osaka University Hospital
AUTHOR
Romanov
Victor
rommanov@tracer.med.osaka-u.ac.jp
4
Osaka University Graduate School of Medicine
AUTHOR
Yoshiki
Kawamura
y_kawamura@hp-rad.med.osaka-u.ac.jp
5
Osaka University Hospital
AUTHOR
Kayako
Isohashi
isohashi-k@tracer.med.osaka-u.ac.jp
6
Department of Nuclear Medicine and Tracer Kinetics, Osaka University Graduate School of Medicine
AUTHOR
Keiko
Matsunaga
matsunaga@tracer.med.osaka-u.ac.jp
7
Department of Nuclear Medicine and Tracer Kinetics, Osaka University Graduate School of Medicine Osaka University Graduate School of Medicine Immunology Frontier Research Center
AUTHOR
Mitsuaki
Tatsumi
m-tatsumi@radiol.med.osaka-u.ac.jp
8
Department of Radiology, Osaka University Graduate School of Medicine
AUTHOR
Hiroki
Kato
kato@tracer.med.osaka-u.ac.jp
9
Department of Nuclear Medicine and Tracer Kinetics, Osaka University Graduate School of Medicine
AUTHOR
Eku
Shimosegawa
eku@tracer.med.osaka-u.ac.jp
10
Department of Molcular Imaging in Medicine,Osaka University Graduate School of Medicine
AUTHOR
Jun
Hatazawa
hatazawa@tracer.med.osaka-u.ac.jp
11
Osaka University Graduate School of Medicine
LEAD_AUTHOR
1. O’Reilly P, Aurell M, Britton K, Kletter K, Rosenthal L, Testa T. Consensus on diuresis renography for investigating the dilated upper urinary tract. Radionuclides in Nephrourology Group. Consensus Committee on Diuresis Renography. J Nucl Med. 1996;37(11):1872-6.
1
2. Taylor A, Nally J, Aurell M, Blaufox M, Dondi M, Dubovsky E, et al. Consensus report on ACE inhibitor renography for detecting renovascular hypertension. Radionuclides in Nephrourology Group. Consensus Group on ACEI Renography. J Nucl Med. 1996;37(11):1876-82.
2
3. Boubaker A, Prior JO, Meuwly JY, Bischof-Delaloye A. Radionuclide investigations of urinary tract in the era of multimodality imaging. J Nucl Med. 2006;47(11):1819-36.
3
4. Asaidi M, Eftekhari M, Hozhabrosadati M, Saghari M, Ebrahimi A, Nabipour I, et al. Comparison of methods for determination of glomerular filtration rate: raw and high-dose Tc-99m-DTPA renography, predicted creatinine clearance method, and plasma sample method. Int Urol Nephrol. 2008;40(4):1059-65.
4
5. Ilhan H, Wang H, Gildehaus F, Wangler C, Herrler T, Todica A, et al. Nephroprotective effects of enalapril after [177Lu]-DOTATATE therapy using serial renal scintigraphies in a murine model of radiationinduced nephropathy. EJNMMI Res. 2016;6:64
5
6. Blum ES, Porras AR, Biggs E, Tabrizi PR, Sussman RD, Sprague BM, et al. Early detection of ureteropelvic junction obstruction using signal analysis and machine learning: a dynamic Solution to a dynamic Problem. J Urol. 2017;199(3):847-52.
6
7. Fahey FH, Bom HH, Chiti A, Choi YY, Hunag G, Lassman M, et al. Standardization of administered activities in pediatric nuclear medicine: a report of the first nuclear medicine global initiative project, part 1-statement of the issue and a review of available resource. J Nucl Med. 2015;56(4):646-51.
7
8. Fahey FH, Bom HH, Chiti A, Choi YY, Hunag G, Lassman M, et al. Standardization of administered activities in pediatric nuclear medicine: a report of the first nuclear medicine global initiative project, part 2-current standards and the path toward global standardization. J Nucl Med. 2016;57(7):1148-57.
8
9. Gordon I, Piepsz A, Sixt R; Auspices of Paediatric Committee of European Association of Nuclear Medicine. Guidelines for standard and diuretic renogram in children. Eur J Nucl Med. 2001;28(6):1175-88.
9
10. Lassmann M, Biassoni L, Monsieurs M, Franzius C, Jacobs F. The new EANM paediatric dosage card. Eur J Nucl Med Mol Imaging. 2008;35(9):1748.
10
11. Gelfand MJ, Parisi MT, Treves ST; Pediatric Nuclear Medicine Dose Reduction Workgroup. Pediatric radiopharmaceutical administered doses: 2010 North American consensus guidelines. J Nucl Med. 2011;52(2):318-22.
11
12. Koizumi K, Masaki H, Matsuda H, Uchiyama M, Okuno M, Oguma E, et al. Japanese consensus guidelines for pediatric nuclear medicine. Part 1: pediatric radiopharmaceutical administered doses (JSNM pediatric dosage card). Part 2: Technical considerations for pediatric nuclear medicine imaging procedures. Ann Nucl Med. 2014;28(5):498-503.
12
13. Heikkinen JO. New automated physical phantom for renography. J Nucl Med. 2004;45(3):495-9.
13
14. Sabbir Ahmed AS, Demir M, Kabasakal L, Uslu I. A dynamic renal phantom for nuclear medicine studies. Med Phys. 2005;32(2):530-8.
14
15. Karagoz I, Erogul O. A new dynamic renal phantom and its application to scintigraphic studies for pixel basis functional radionuclide imaging. Med Eng Phys. 1998;20(6):473-9.
15
16. Nykanen AO, Rautio PJ, Aarnio JV, Heikkinen JO. Multicenter evaluation of renography with automated physical phantom. Nucl Med Commun. 2014;35(9):977-84.
16
17. Esteves PF, Taylor A, Manatunga A, Folks RD, Krishnan M, Garcia EV. 99mTc-MAG3 renography: normal values for MAG3 clearance and curve parameters, excretory parameters, and residual urine volume. AJR Am J Raentgenol. 2006;187(6):610-7.
17
18. Ikekubo K, Hino M, Ito H, Yamamoto K, Torizuka K. The phase I study of 99mTc-MAG3 injection, a dynamic renal imaging agent-evaluation of its safety and biodistribution in normal volunteers. Kaku Igaku. 1993;30(5):507-16.
18
19. Ishii K, Ishibashi A, Torizuka K. Phase I clinical study of 99mTc-MAG3. Kaku Igaku. 1993;30(2):181-8.
19
20. Taylor A, Eshima D, Fritzberg AR, Christian PE, Kasina S. Comparison of iodine-131 OIH and technetium-99m MAG3 renal imaging in volunteers. J Nucl Med. 1986;27(6):795-803.
20
21. Gibson P, Shammas A, Cada M, Licht C, Gupta AA. The role of Tc-99m DTPA nuclear medicine GFR studies in pediatric solid tumor patients. J Pediatr Hematol Oncol. 2013;35(2):108-11.
21
22. Hubertus J, Plieninger S, Martinovic V, Heinrich M, Schuster T, Burst M, et al. Children and adolescents with ureteropelvic junction obstruction: is an additional voiding cystourethorogram necessary? Results of multi center study. World J Urol. 2013;31(3):683-7.
22
23. Hsiao EM, Cao X, Zurakowski D, Zukotynski KA, Drubach LA, Grant FD, et al. Reduction in radiation dose in mercaptoacetyltriglycerine renography with enhanced planar processing. Radiology. 2011;261(3):907-15.
23
24. Smith T, Zanelli D, Veall N. Radiation absorbed dose from technetium-99m DTPA. J Nucl Med. 1987;28(2):240-3.
24
25. Hazar V, Gungor O, Guven AG, Aydin F, Akbas H, Gungor F, et al. Renal function after hematopoietic stem cell transplantation in children. Pediatr Blood Cancer. 2009;53(2):197-202.
25
26. Filler G, Sharma AP. How to monitor renal functions in pediatric solid organ transplant recipients. Pediatr Transplant. 2008;12(4):393-401.
26
27. Boubaker A, Prior JO, Meyrat B, Bischof Delaloye A, McAleer IM, Frey P. Unilateral ureteropelvic junction obstruction in children: long-term followup after unilateral phyeloplasty. J Urol. 2003;170(2):575-9.
27
ORIGINAL_ARTICLE
Impact of Novel Incorporation of CT-based Segment Mapping into a Conjugated Gradient Algorithm on Bone SPECT Imaging: Fundamental Characteristics of a Context-specific Reconstruction Method
Objective(s): The latest single-photon emission computed tomography (SPECT)/computed tomography (CT) reconstruction system, referred to as xSPECT Bone™, is a context-specific reconstruction system utilizing tissue segmentation information from CT data, which is called a zone map. The aim of this study was to evaluate theeffects of zone-map enhancement incorporated into the ordered-subset conjugated gradient minimization (OSCGM) reconstruction method on SPECT images.Methods: Image quality with zone-map enhanced OSCGM (OSCGMz) and nonenhanced OSCGM methods was compared using various reconstruction parameters. The compartment phantom had 3 radioactive sections with CT values of about 1000, 250, and 0 HU. SPECT data were acquired using a lowenergy high-resolution (LEHR) collimator, with a 256×256 matrix and 2.4-mm pixel size. The performances of the 2 reconstruction methods (OSCGM vs.OSCGMz) were evaluated on the basis of %error, coefficient of variation (%CV), and normalized mean squared error (NMSE), and adequate iterative update numbers were determined. The relative CV representing the ratio of smoothed images to non-smoothed images was calculated to evaluate the effects of the Gaussian filter on each section set with different CT values.Results: On comparing the OSCGM and OSCGMz methods, it was found that the %error of the OSCGMz method tended to show convergence with fewer updates, especially in the high CT value section mimicking bone absorption. In the watersection, the %CV of the OSCGMz method was lower than that of the OSCGM method. The NMSE minimum values for the OSCGM and OSCGMz methods were obtained at 30 and 20 updates, respectively. The relative CV for the OSCGMzmethod in the water section decreased remarkably according to the size of the full width at half maximum (FWHM) of the Gaussian filter.Conclusion: The zone-map enhancement contributed to SPECT reconstruction for the reproduction of radioactive concentrations in bone tissues, using a low number of OSCGM updates. Our findings indicated that the incorporation of zone maps into SPECT reconstruction might improve image quality.
https://aojnmb.mums.ac.ir/article_11396_8cff09428b15cff90f7ee96e21a16ae3.pdf
2019-01-01
49
57
10.22038/aojnmb.2018.31711.1219
SPECT/CT
OSCGM
zone-map
99mTc-MDP
Kyohei
Okuda
kokuda-jsnmt@umin.ac.jp
1
Department of Clinical Radiology, Tottori University Hospital, Tottori, Japan
LEAD_AUTHOR
Susumu
Fujii
rqhnk290@ybb.ne.jp
2
Department of Clinical Radiology, Tottori University Hospital, Tottori, Japan
AUTHOR
Shota
Sakimoto
yukinotiratuki@yahoo.co.jp
3
Department of Clinical Radiology, Tottori University Hospital, Tottori, Japan
AUTHOR
1. Ritt P, Sanders J, Kuwert T. SPECT/CT technology. Clin Transl Imaging. 2014;2(6):445-57.
1
2. Mariani G, Bruselli L, Kuwert, T, Kim EE, Flotats A, Israel O, et al. A review on the clinical use of SPECT/CT. Eur J Nucl Med Mol Imaging. 2010; 37(10):1959-85.
2
3. Palmedo H, Marx C, Ebert A, Kreft B, Ko Y, Türler A. Whole-body SPECT/CT for bone scintigraphy: diagnostic value and effect on patient management in oncological patients. Eur J Nucl Med Mol Imaging. 2014;41(1):59-67.
3
4. Utsunomiya D, Shiraishi S, Imuta M, Tomiguchi S, Kawanaka K, Morishita S, et al. Added value of SPECT/CT fusion in assessing suspected bone metastasis: comparison with scintigraphy alone and nonfused scintigraphy and CT. Radiology. 2006;238(1):264-71.
4
5. Hoogendam JP, Veldhuis WB, Hobbelink MG, Verheijen RH, van den Bosch MA, Zweemer RP. 99mTc SPECT/CT versus planar lymphoscintigraphy for preoperative sentinel lymph node detection in cervical cancer: a systematic review and metaanalysis. J Nucl Med. 2015;56(5):675-80.
5
6. Chowdhury FU, Scarsbrook AF. The role of hybrid SPECT-CT in oncology: current and emerging clinical applications. Clin Radiol. 2008;63(3):241-51.
6
7. Bailey D, Willowson K. An evidence-based review of quantitative SPECT imaging and potential clinical applications. J Nucl Med. 2013;54(1):83-9.
7
8. Dewaraja YK, Frey EC, Sgouros G, Brill AB, Roberson P, Zanzonico PB, et al. MIRD pamphlet no. 23: quantitative SPECT for patient-specific 3-dimensional dosimetry in internal radionuclide therapy. J Nucl Med. 2012;53(8):1310-25.
8
9. Zeintl J, Vija AH, Yahil A, Hornegger J, Kuwert T. Quantitative accuracy of clinical 99mTc SPECT/CTusing ordered-subset expectation maximization with 3-dimensional resolution recovery, attenuation, and scatter correction. J Nucl Med. 2010;51(6):921-8.
9
10. Seret A, Nguyen D, Bernard C. Quantitative capabilities of four state-of-the-art SPECT-CT cameras. EJNMMI Res. 2012;2(1):45.
10
11. Ritt P, Vija H, Hornegger J, Kuwert T. Absolute quantification in SPECT. Eur J Nucl Med Mol Imaging. 2011;38(Suppl 1):S69-77.
11
12. Ma J, Vija AH. Evaluation of quantitation accuracy for xSPECT. Nuclear Science Symposium and Medical Imaging Conference (NSS/MIC); 31 Oct.-7 Nov. 2015. P. 1-4.
12
13. Vija AH. Introduction to xSPECT technology: evolving multi-modal SPECT to become contextbased and quantitative. White Paper. 2013;7:1-29.
13
14. Kuji I, Yamane T, Seto A, Yasumizu Y, Shirotake S, Oyama M. Skeletal standardized uptake values obtained by quantitative SPECT/CT as an osteoblastic biomarker for the discrimination of active bone metastasis in prostate cancer. Eur J Hybrid Imaging. 2017;1(1):2.
14
15. Armstrong IS, Hoffmann SA. Activity concentration measurements using a conjugate gradient (Siemens xSPECT) reconstruction algorithm in SPECT/CT. Nucl Med Commun. 2016;37(11):1212-7.
15
16. Okuda K, Nakajima K, Yamada M, Wakabayashi H, Ichikawa H, Arai H, et al. Optimization of iterative reconstruction parameters with attenuation correction, scatter correction and resolution recovery in myocardial perfusion SPECT/CT. Ann Nucl Med. 2014;28(1):60-8.
16
17. Matsutomo N, Nagaki A, Yamao F, Sasaki M. Optimization of iterative reconstruction parameters with 3-dimensional resolution recovery, scatter and attenuation correction in 123I-FP-CIT SPECT. Ann Nucl Med. 2015;29(7):636-42.
17
18. Cachovan M, Vija AH, Hornegger J, Kuwert T. Quantification of 99m Tc-DPD concentration in the lumbar spine with SPECT/CT. EJNMMI Res. 2013;3(1):45.
18
19. Knoll P, Kotalova D, Köchle G, Kuzelka I, Minear G, Mirzaei S, et al. Comparison of advanced iterative reconstruction methods for SPECT/CT. Z Med Phys. 2012;22(1):58-69.
19
20. Adams MC, Turkington TG, Wilson JM, Wong TZ. A systematic review of the factors affecting accuracy of SUV measurements. AJR Am J Roentgenol. 2010;195(2):310-20.
20
21. Beck M, Sanders JC, Ritt P, Reinfelder J, Kuwert T. Longitudinal analysis of bone metabolism using SPECT/CT and 99mTcdiphosphonopropanedicarboxylic acid: comparison of visual and quantitative analysis. EJNMMI Res. 2016;6(1):60.
21
22. Hippeläinen E, Tenhunen M, Mäenpää H, Sohlberg A. Quantitative accuracy of 177Lu SPECT reconstruction using different compensation methods: phantom and patient studies. EJNMMI Res. 2016;6(1):16.
22
23. Lee H, Kim JH, Kang YK, Moon JH, So Y, Lee WW. Quantitative single-photon emission computed tomography/computed tomography for technetium pertechnetate thyroid uptake measurement. Medicine. 2016;95(27):e4170.
23
ORIGINAL_ARTICLE
Comparison of Count Normalization Methods for Statistical Parametric Mapping Analysis Using a Digital Brain Phantom Obtained from Fluorodeoxyglucose-positron Emission Tomography
Objective(s): Alternative normalization methods were proposed to solve the biased information of SPM in the study of neurodegenerative disease. The objective of this study was to determine the most suitable count normalization method for SPM analysis of a neurodegenerative disease based on the results of different count normalization methods applied on a prepared digital phantom similar to one obtained using fluorodeoxyglucose-positron emission tomography (FDG-PET) data of a brain with a known neurodegenerative condition.Methods: Digital brain phantoms, mimicking mild and intermediate neurodegenerative disease conditions, were prepared from the FDG-PET data of 11 healthy subjects. SPM analysis was performed on these simulations using different count normalization methods. Results: In the slight-decrease phantom simulation, the Yakushev method correctly visualized wider areas of slightly decreased metabolism with the smallest artifacts of increased metabolism. Other count normalization methods were unable to identify this slightly decreases and produced more artifacts. The intermediate-decreased areas were well visualized by all methods. The areas surrounding the grey matter with the slight decreases were not visualized withthe GM and VOI count normalization methods but with the Andersson. The Yakushev method well visualized these areas. Artifacts were present in all methods. When the number of reference area extraction was increased, the Andersson method better-captured the areas with decreased metabolism and reduced the artifacts of increased metabolism. In the Yakushev method, increasing the threshold for the reference area extraction reduced such artifacts.Conclusion: The Yakushev method is the most suitable count normalization method for the SPM analysis of neurodegenerative disease.
https://aojnmb.mums.ac.ir/article_11745_67b54d265bd3ff26303ea8a7dd4759a6.pdf
2019-01-01
58
70
10.22038/aojnmb.2018.11745
Count normalization
FDG- PET
Neurodegenerative disease
SPM analysis
Yakushev method
Win
Thet Pe
thetpewin@gmail.com
1
Department of Radiological Sciences, International University of Health and Welfare, School of Health Sciences
AUTHOR
Yoshiyuki
Hosokai
hosokai@iuhw.ac.jp
2
Department of Radiological Sciences, International Univercity of Health and Welfare
LEAD_AUTHOR
Takashi
Minagawa
minagawa_221@yahoo.co.jp
3
Department of Diagnostic Image Analysis, Course of Radiological Technology, Tohoku University Graduate School of Medicine
AUTHOR
Kenzo
Muroi
kmuroi@iuhw.ac.jp
4
Department of Radiological Sciences, International University of Health and Welfare, School of Health Sciences
AUTHOR
Kenta
Miwa
miwa@iuhw.ac.jp
5
Department of Radiological Sciences, International University of Health and Welfare, School of Health Sciences
AUTHOR
Ayaka
Maruyama
1415106@g.iuhw.ac.jp
6
Department of Radiological Sciences, International University of Health and Welfare, School of Health Sciences
AUTHOR
Toshiya
Yamaguchi
1415119@g.iuhw.ac.jp
7
Department of Radiological Sciences, International University of Health and Welfare, School of Health Sciences
AUTHOR
Kazuto
Okano
okanok@iuhw.ac.jp
8
Department of Radiological Sciences, International University of Health and Welfare, School of Health Sciences
AUTHOR
Htwe
Khin Moh Moh
peachmomo75@gmail.com
9
Department of Radiological Sciences, International University of Health and Welfare, School of Health Sciences
AUTHOR
Haruo
Saito
hsaito@med.tohoku.ac.jp
10
Department of Diagnostic Image Analysis, Tohoku University Graduate School of Medicine
AUTHOR
1. Eckert T, Barnes A, Dhawan V, Frucht S, Gordon MF, Feigin AS, et al. FDG PET in the differential diagnosis of parkinsonian disorders. Neuroimage. 2005;26(3):912-21.
1
2. Eidelberg D, Moeller JR, Dhawan V, Spetsieris P, Takikawa S, Ishikawa T, et al. The metabolic topography of parkinsonism. J Cereb Blood Flow and Metab. 1994;14(5):783-801.
2
3. Hosey LA, Thompson JL, Metman LV, van den Munckhof P, Braun AR. Temporal dynamics of cortical and subcortical responses to apomorphine in Parkinson disease: an H2(15)O PET study. Clin Neuropharmacol. 2005;28(1):18-27.
3
4. Huang C, Tang C, Feigin A, Lesser M, Ma Y, Pourfar M, et al. Changes in network activity with the progression of Parkinson’s disease. Brain. 2007;130(Pt 7):1834-46.
4
5. Kawachi T, Ishii K, Sakamoto S, Sasaki M, Mori T, Yamashita F, et al. Comparison of the diagnostic performance of FDG-PET and VBM-MRI in very mild Alzheimer’s disease. Eur J Nucl Med Mol Imaging. 2006;33(7):801-9.
5
6. Hosokai Y, Nishio Y, Hirayama K, Takeda A, Ishioka T, Sawada Y, et al. Distinct patterns of regional cerebral glucose metabolism in Parkinson’s disease with and without mild cognitive impairment. Mov Disord. 2009;24(6):854-62.
6
7. Soonawala D, Amin T, Ebmeier KP, Steele JD, Dougall NJ, Best J, et al. Statistical parametric mapping of 99mTc HMPAO-SPECT images for the diagnosis of Alzheimer’s disease: normalizing to cerebellar tracer uptake. Neuroimage. 2002;17(3):1193-202.
7
8. Borghammer P, Østergaard K, Cumming P, Gjedde A, Rodell A, Hall N, et al. A deformation-based morphometry study of patients with early-stage Parkinson’s disease. Eur J Neurol. 2010;17(2):314-20.
8
9. Borghammer P. Perfusion and metabolism imaging studies in Parkinson’s disease. Eur J Neurol. 2012;17(2):314-20.
9
10. Adachi N, Watanabe T, Matsuda H, Onuma T. Hyperperfusion in the lateral temporal cortex the striatum and the thalamus during complex visual hallucination: single photon emission computed tomography findings in patients with Charles Bonnet syndrome. Psychiatry Clin Neurosci. 2000;54(2):157-62.
10
11. Borghammer P, Chakravarty M, Jonsdottir KY, Sato N, Matsuda H, Ito K, et al. Cortical hypometabolism and hypoperfusion in Parkinson’s disease is extensiveprobably even at early disease stages. Brain Struct Funct. 2010;214(4):303-17.
11
12. Scarmeas N, Habecka CG, Zarahna E, Anderson KE, Park A, Hilton J, et al. Covariance PET patterns in early Alzheimer’s disease and subjects with cognitive impairment but no dementia: utility in group discrimination and correlations with functional performance. Neuroimage. 2004;23(1):35-45.
12
13. Yakushev I, Hammers A, Fellgiebel A, Schmidtmann I, Scheurich A, Buchholz HG, et al. SPM-based count normalization provides excellent discrimination of mild Alzheimer’s disease and amnestic mild cognitive impairment from healthy aging. Neuroimage. 2009;44(1):43-50.
13
14. Borghammer P, Jonsdottir KY, Cumming P, Ostergaard K, Vang K, Ashkanian M, et al. Normalization in PET group comparison studies--the importance of a valid reference region. Neuroimage. 2008;40(2):529-40.
14
15. Andersson JL. How to estimate global activity independent of changes in local Activity. Neuroimage. 1997;6(4):237-44.
15
16. Buchsbaum MS, Buchsbaum BR, Hazlett EA, Haznedar MM, Newmark R, Tang CY, et al. Relative glucose metabolic rate higher in white matter in patients with schizophrenia. Am J Psychiatry. 2007;164(7):1072-81.
16
17. Videbech P, Ravnkilde B, Pedersen TH, Hartvig H, Egander A, Clemmensen K, et al. The Danish PET/ depression project: clinical symptoms and cerebral blood flow: a regions-of-interest analysis. Acta Psychiatr Scand. 2002;106(1):35-44.
17
18. Habeck C, Foster NL, Perneczky R, Kurz A, Alexopoulos P, Koeppe RA, et al. Multivariate and univariate neuroimaging biomarkers of Alzheimer’sdisease. Neuroimage. 2008;40(4):1503-15.
18
19. Borghammer P, Cumming P, Aanerud J, Gjedde A. Artefactual subcortical hyperperfusion in PET studies normalized to global mean: lessons from Parkinson’s disease. Neuroimage. 2009;45(2):249-57.
19
20. Borghammer P, Aanerud J, Gjedde A. Data-driven intensity normalization of PET group comparison studies is superior to global mean normalization. Neuroimage. 2009;46(4):981-8.
20
21. Maeda H, Yamaki N, Azuma M. Development of the software package of the nuclear medicine data processor for education and research. Nihon Hoshasen Gijutsu Gakkai Zasshi. 2012;68(3):299-306.
21
22. Worsley KJ, Liao CH, Aston J, Petre V, Duncan GH, Morales F, et al. A general statistical analysis for fMRI data. Neuroimage. 2002;15(1):1-15.
22
23. Worsley KJ, Marrett S, Neelin P, Vandal AC, Friston KJ, Evans AC. A unified statistical approach for determining significant signals in mages of cerebral activation. Hum Brain Map. 1996;4(1):58-73.
23
ORIGINAL_ARTICLE
Effect of Beta Particles Spectrum on Absorbed Fraction in Internal Radiotherapy
Objective(s): The purpose of this research is to study the effect of beta spectrum on absorbed fraction ( ) and to find suitable analytical functions for beta spectrum absorbed fractions in spherical and ellipsoidal volumes with a uniform distribution for several radionuclides that are commonly used in nuclear medicine.Methods: In order to obtain the beta particle absorbed fraction, Monte Carlo simulations were performed by using the MCNPX code. The validation of the simulations was performed by calculating the absorbed fractions in spheres and comparing the results with the data published by other investigators. The absorbed fractions were calculated and compared by using an actual beta energy spectrum with those obtained through the mean beta energy of 14C, 199Au, 177Lu, 131I, 90Sr, 153Sm, 186Re, 32P, 90Y, 38Cl and 88Rb radionuclides.Results: The maximum difference between the absorbed fractions for beta particles accounting for the whole beta spectrum of all the considered nuclides was 29.62% with respect to the mean beta energy case. Suitable analytical relationships were found between the absorbed fraction and the generalized radius, and the dependence of the fitting parameters from beta spectrum energy was discussed and fitted by appropriate parametric functions.Conclusion: The results allowed the calculation of the absorbed fractions from the above stated beta sources uniformly distributed in spherical and ellipsoidal volumes of any ellipticity and volume, in a wide range of practical volumes that are not only used for internal dosimetry in nuclear medicine applications, but also in radiological protection estimates ofdoses from internal contamination.
https://aojnmb.mums.ac.ir/article_11610_46b41c23f67de9809a871a6eb6a900c0.pdf
2019-01-01
71
83
10.22038/aojnmb.2018.11610
Beta emitters
absorbed fraction
analytical function
Monte Carlo Simulation
internal radiotherapy
Mahdi
Ghorbani
mhdghorbani@gmail.com
1
Biomedical Engineering and Medical Physics Department, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
LEAD_AUTHOR
Marjan
Hashempour
hashempoor.ma@gmail.com
2
Physics Group, Faculty of Basic Sciences, Hakim Sabzevari University, Sabzevar, Iran,
AUTHOR
Ernesto
Amato
eamato@unime.it
3
Department of Biomedical and Dental Sciences and of Morpho functional Imaging, University of Messina, Messina
AUTHOR
Courtney
Knaup
courtney.knaup@usoncology.com
4
Comprehensive Cancer Centers of Nevada, Las Vegas, Nevada, USA, Courtney
AUTHOR
1. Siegel JA, Stabin MG. Absorbed fractions for electrons and beta particles in spheres of various sizes. J Nucl Med. 1994;35(1):152-6.
1
2. Salek N, Shamsaei M, Ghannadi Maragheh M, Shirvani Arani S, Bahrami Samani A. Production and quality control 177Lu (NCA)-DOTMP as a potential agent for bone pain palliation. J Appl Clin Med Phys. 2016;17(6):128-39.
2
3. Jalili AR, Biki D, Hassanzadeh-Rad A, Eftekhari A, Geramifar P, Eftekhari M. Production and clinical applications of radiopharmaceuticals and medical radioisotopes in Iran. Semin Nucl Med. 2016;46(4):340-58.
3
4. Cohen VM, Papastefanou VP, Liu S, Stoker I, Hungerford JL. The use of strontium-90 Beta radiotherapy as adjuvant treatment for conjunctival melanoma. J Oncol. 2013;2013:349162.
4
5. Andreou M, Lagopati N, Lyra M. Re-186 and Sm- 153 dosimetry based on scintigraphic imaging data in skeletal metastasis palliative treatment and Monte Carlo simulation. J Phys Conf Ser. 2011;317(1):012013.
5
6. Tu SM, Lin SH, Podoloff DA, Loqothetis CJ. Multimodality therapy: bone-targeted radioisotope therapy of prostate cancer. Clin Adv Hematol Oncol.2010;8(5):341-51.
6
7. Stank J, Melichar F, Filyanin AT, Tomes M, Beran M. Preparation of 90YCl3 radiopharmaceutical precursor for nuclear medicine using technology of centrifugal extractors. Appl Radiat Isot. 2010;68(12):2163-8.
7
8. Naseri Z, Hakimi A, Jalilian AR, Nemati Kharat A, Bahrami-Samani A, Ghannadi-Maragheh M. Preparation and quality control of the [153sm]- samarium maltolate complex as a lanthanide mobilization product in rats. Sci Pharm. 2011;79(2):265-75.
8
9. Amato E, Lizio D, Baldari S. Absorbed fractions for electrons in ellipsoidal volumes. Phys Med Biol. 2011;56(2):357-65.
9
10. Mowlavi AA, Fornasier MR, Mizaei M, Breqant P, de Denaro M. Analytical functions for beta and gamma absorbed fractions of iodine-131 in spherical and ellipsoidal volumes. Ann Nucl Med. 2014;28(8):824-8.
10
11. Akabani G, Poston JW Sr, Bolch WE. Estimates of beta absorbed fractions in small tissue volumes for selected radionuclides. J Nucl Med. 1991;32(5):835-9.
11
12. Wen W, Meng-Yun C, Peng-Cheng L, Li-Qin H. Specific absorbed fractions of electrons and photons for Rad-HUMAN phantom using Monte Carlo method. Chinese Phys C. 2014;39(7):1-9.
12
13. Amato E, Lizio D, Baldari S. Absorbed fractions in ellipsoidal volumes for β- radionuclides employed in internal radiotherapy. Phys Med Biol. 2009;54(13):4171-80.
13
14. Eckerman KF, Westfall RJ, Ryman JC, Cristy M. Availability of nuclear decay data in electronic form, including beta spectra not previously published. Health Phys. 1994;67(4):338-45.
14
15. Bouchet LG, Bolch WE, Blanco HP, Wessels BW, Siegel JA, Rajon DA, et al. MIRD Pamphlet No 19: absorbed fractions and radionuclide S values for six age-dependent multiregion models of the kidney. J Nucl Med. 2003;44(7):1113-47.
15
16. Amato E, Italiano A, Baldari S. An analytical model to calculate absorbed fraction for internal dosimetry with alpha, beta and gamma emitters. Pericol Classe Sci Fis Mat Nat. 2014;92(1):A1.
16
17. Sgouros G. Dosimetry of internal emitters. J Nucl Med. 2005;46(1):18S-27S.
17
18. Stabin MG, Sparks RB, Crowe E. OLINDA/EXM: the second-generation personal computer software for internal dose assessment in nuclear medicine. J Nucl Med. 2005;46(6):1023-7.
18
19. Bacher K, D’Asseler Y. Evaluation of patient-specific dosimetric methodologies for radionuclide therapy. [Master Thesis]. Ghent, Belgium: Ghent University; 2014.
19
20. RADAR changes the dosimetry world. The Radiation Dose Assessment Resource. Available at: URL: www. doseinfo-radar.com; Accessed on: 23/1/2017.
20
21. Asl RG, Parach AA, Nasseri S, Momennezhad M, Zakavi SR, Sadoughi HR. Specific absorbed fractions of internal photon and electron emitters in a human voxel-based phantom: a Monte Carlo study. World J Nucl Med. 2017;16(2):114-21.
21
22. Interaction of radiation with matter–environmental health. University of Toronto. Available at: URL: https://ehs.utoronto.ca/our-services/radiationsafety/radiation-protection; Accessed on: 8/1/2018.
22
23. International Commission on Radiation Units and Measurements. Determination of absorbed dose in a patient irradiated by beams of X or gamma rays in radiotherapy procedures. Washington: International Commission on Radiation Units and Measurements (ICRU); 1976.
23
ORIGINAL_ARTICLE
False Negativity of Tc-99m Labeled Sodium Phytate Bone Marrow Imaging Under the Effect of G-CSF Prescription in Aplastic Anemia: A Case Report
Granulocyte colony-stimulating factor (G-CSF) is a hematopoietic cytokine which controls the differentiation and growth of hematopoietic cells in the bone marrow. We report a severe aplastic anemia (SAA) patient with false-negative 99mTc sodium phytate bone marrow imaging findings under concurrent G-CSF therapy. The first bone marrow imaging showed a normal bone marrow activity. However, the bone marrow biopsy pathology report revealed a lack of hematopoietic cells. Furthermore, the complete blood count indicated severe pancytopenia resulting in the diagnosis of aplastic anemia (AA). A second marrow scan implemented after the stoppage of G-CSF showed an abnormal bone marrow activity, which matched the pathology reports. Accordingly, the concurrent administration of G-CSF was considered as the cause of false-negative bone marrow imaging findings obtained in the first scan. Consequently, it should be kept in mind that a 99mTc sodium phytate bone marrow scintigraphy during the concurrent administration of G-CSF may lead to the achievement of false negative results because it induces changes in bone marrow mimicking a normal marrow scan in patients with AA.
https://aojnmb.mums.ac.ir/article_11804_71b6405284f56225b597ec54c2d04e3f.pdf
2019-01-01
84
88
10.22038/aojnmb.2018.11804
Aplastic anemia
Bone marrow imaging
SPECT
G-CSF
Akanganyira
Kasenene
kasenenejr@outlook.com
1
Department of Radiology and Nuclear Medicine, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan 430071, PR China
LEAD_AUTHOR
Aju
Baidya
a_baidya@hotmail.com
2
Department of Radiology and Nuclear Medicine, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan 430071, PR China
AUTHOR
Changyin
Wang
changyinwang@whu.edu.cn
3
Department of Radiology and Nuclear Medicine, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan 430071, PR China
AUTHOR
Hai-Bo
Xu
xuhaibo1120@hotmail.com
4
Department of Radiology and Nuclear Medicine, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan 430071, PR China
AUTHOR
1. Mehta HM, Malandra M, Corey SJ. G-CSF and GM-CSF in neutropenia. J Immunol. 2015;195(4):1341-9.
1
2. Hanna SL, Fletcher BD, Fairclough DL, Jenkins JH 3rd, Le AH. Magnetic resonance imaging of disseminated bone marrow disease in patients treated for malignancy. Skeletal Radiol. 1991;20(2):79-84.
2
3. Ricci C, Cova M, Kang YS, Yang A, Rahmouni A, Scott WW Jr, et al. Normal age-related patterns of cellular and fatty bone marrow distribution in the axial skeleton: MR imaging study. Radiology. 1990;177(1):83-8.
3
4. Kojima S. Use of granulocyte colony-stimulating factor for treatment of aplastic anemia. Nagoya J Med Sci. 1999;62(3-4):77-82.
4
5. Hanrahan CJ, Christensen CR, Crim JR. Current concepts in the evaluation of multiple myeloma with MR imaging and FDG PET/CT. Radiographic. 2010;30(1):127-42.
5
6. Mabuchi S, Morimoto A, Fujita M, Isohashi K, Kimura T. G-CSF induces focal intense bone marrow FDG uptake mimicking multiple bone metastases from uterine cervical cancer: a case report and review of the literature. Eur J Gynaecol Oncol. 2012;33(3):316-7.
6
7. Zampa V, Cosottini M, Michelassi C, Ortori S, Bruschini L, Bartolozzi C. Value of opposed-phase gradient-echo technique in distinguishing between benign and malignant vertebral lesions. Eur Radiol. 2002;12(7):1811-8.
7
8. Cakir FB, Baysal B, Dogan O. False positivity of magnetic resonance imaging under the effect of granulocyte-colony stimulating factor in a child with leukemia. Contemp Oncol. 2013;17(3):334-6.
8
9. Liang C. Hematic and lymphatic system. In: Zhang Y, Kuang A, Huang G, editors. Nuclear Medicine. 1st ed. Beijing, China: People’s Health Publishing House; 2005. P. 305-15
9
ORIGINAL_ARTICLE
A Rare Presentation of Colorectal Cancer with Unusual Progressive Intramuscular and Subcutaneous Metastatic Spread
Colorectal carcinoma is one of the most common causes of cancer-related death, worldwide. Recently, due to the introduction of novel imaging and therapeutic techniques, five-year survival of patients has increased. However, distant metastasis is still expected in half of the patients. Colorectal cancer tends to target the abdominal cavity, liver, lungs, and bones as the common sites of metastasis. Nevertheless, rare cases of muscle metastasis have been reported. This report presents a 23-year-old male, who despite chemotherapy, demonstrated gradual progressive disease and metastases to the submandibular region, lungs, adrenal gland as well as muscles and subcutaneous tissues. He had developed multiple asymptomatic muscular metastases metachronously over two-year time period discovered on an 18FDGPET/CT, namely in the deltoid, external oblique abdominis, rectus abdominis, and quadriceps muscles, as well as one of the extrinsic muscles of the tongue. The presence of distant, especially extrahepatic metastasis, adversely affects the prognosis of colon carcinoma. Since limited cases of muscle metastasis have been reported in carcinoma of colon, the underlying pathophysiology, optimum treatment, and prognostic issues are yet to be substantiated.
https://aojnmb.mums.ac.ir/article_11934_34ecaaf216261e92101d53282254e56a.pdf
2019-01-01
89
94
10.22038/aojnmb.2018.11934
Colorectal carcinoma
Muscle metastasis
Rare metastasis
18F-fluorodeoxyglucose PET/CT
Reyhaneh
Manafi-Farid
rmfarid@razi.tums.ac.ir
1
Research institute for Nuclear Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
AUTHOR
Narjess
Ayati
ayatin@mums.ac.ir
2
Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
AUTHOR
Mohammad
Eftekhari
meftekhari@yahoo.com
3
Research institute for Nuclear Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
LEAD_AUTHOR
Babak
Fallahi
bfallahi@sina.tums.ac.ir
4
Research institute for Nuclear Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
AUTHOR
Fardad
Masoumi
masoumi.fardad@gmail.com
5
Tabriz University of Medical Sciences, Tabriz, Iran
AUTHOR
1. Torre LA, Bray F, Siegel RL, Ferlay J, Lortet‐Tieulent J, Jemal A. Global cancer statistics, 2012. CA Cancer J Clin. 2015;65(2):87-108.
1
2. Van Cutsem E, Cervantes A, Adam R, Sobrero A, Van Krieken J, Aderka D, et al. ESMO consensus guidelines for the management of patients with metastatic colorectal cancer. Ann Oncol. 2016;27(8):1386-422.
2
3. Van Cutsem E, Cervantes A, Nordlinger B, Arnold D. Metastatic colorectal cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2016;25(suppl 3):iii1-9.
3
4. Maffione AM, Lopci E, Bluemel C, Giammarile F, Herrmann K, Rubello D. Diagnostic accuracy and impact on management of 18 F-FDG PET and PET/ CT in colorectal liver metastasis: a meta-analysisand systematic review. Eur J Nucl Med Mol Imaging. 2015;42(1):152-63.
4
5. Ismaili N. Treatment of colorectal liver metastases. World J Surg Oncol. 2011;9(1):154.
5
6. Engledow AH, Skipworth JR, Blackman G, Groves A, Bomanji J, Warren SJ, et al. The role of 18fluoro‐ deoxy glucose combined position emission and computed tomography in the clinical management of anal squamous cell carcinoma. Colorectal Dis. 2011;13(5):532-7.
6
7. Coelho MI, Albano MN, Costa Almeida CE, Reis LS, Moreira N, Almeida CM. Colon cancer metastasis to the thyroid gland: a case report. Int J Surg Case Rep. 2017;37:221-4.
7
8. Hasegawa S, Sakurai Y, Imazu H, Matsubara T, Ochiai M, Funabiki T, et al. Metastasis to the forearm skeletal muscle from an adenocarcinoma of the colon: report of a case. Surg Today. 2000;30(12):1118-23.
8
9. Hlavatá Z, Pazderová N, Povinec P, Paulí�ny P, Majidi A, Fiala P, et al. The value of 18-FDG PET/CT imaging in a patient with atypical metastatic colorectal cancer–case report: 18-FDG PET/CT in colorectal cancer. Klin Onkol. 2009;22(6):284-7.
9
10. Blank A, Roberts DE 2nd, Dawson H, Zlobec I, Lugli A. Tumor heterogeneity in primary colorectal cancer and corresponding metastases. does the apple fall far from the tree? Front Med. 2018;5:234.
10
11. Gambardella V, Tarazona N, Cervantes A. New molecular challenges in metastatic colorectal cancer. Medicographia. 2018;40(3):101-8.
11
12. Mekenkamp LJ, Heesterbeek KJ, Koopman M, Tol J, Teerenstra S, Venderbosch S, et al. Mucinous adenocarcinomas: poor prognosis in metastatic colorectal cancer. Eur J Cancer. 2012;48(4):501-9.
12
13. Liu YY, Chen ZH, Zhai ET, Yang J, Xu JB, Cai SR, et al. Case of metachronous bilateral isolated adrenal metastasis from colorectal adenocarcinoma and review of the literature. World J Gastroenterol. 2016;22(14):3879-84.
13
ORIGINAL_ARTICLE
False-positive FDG PET CT Scan in Vertebral Hemangioma
FDG PET CT scan is considered to be a sensitive tool to detect skeletal metastasis in known malignancies. However, it’s high sensitivity and low specificity may account for false positive diagnosis in cases of trauma, infection, inflammation and other benign conditions. Skeletal hemangioma is one of the common benign conditions which are typically ametabolic on FDG PET CT with no uptake on bone scan. However, rarely they may have atypical imaging features and appear hypermetabolic. Other imaging modalities such as MRI and CT scan have typical imaging findings for hemangioma and can be used for evaluation of focal hypermetabolic skeletal lesions. There are atypical imaging characteristics in each of these modalities. Hence when used judiciously they can complement each other and avoid a false positive test result. This case report highlights the importance of bone scan and CT scan in excluding pathological involvement of skeleton with false positive FDG PET scan results.
https://aojnmb.mums.ac.ir/article_12010_ad983755aed6000e1f43a28b302114ed.pdf
2019-01-01
95
98
10.22038/aojnmb.2018.12010
Bone scan
CT
FDG PET CT
Tumor induced osteomalacia
Vertebral hemangioma
Shrikant
Solav
drsolav@gmail.com
1
Consultant Incharge, Dr Solav's SPECT Lab, India
AUTHOR
Shailendra
Salve
drshailu_81@yahoo.co.in
2
Consultant Radiologist, Dr Solav's SPECT Lab
AUTHOR
Abhijit
Patil
abhi_patil6688@yahoo.com
3
Consultant Radiologist, Dr Solav's SPECT Lab, Consultant Radiologist
LEAD_AUTHOR
1. Pessaaud T. The polka-dot sign. Radiology. 2008; 246(3):980-1.
1
2. Pastushyn AI, Slinko EI, Mirzoveva GM. Vertebral hemangiomas: diagnosis, management, natural history and clinicoathological correlates in 86 patients. Surg Neurol. 1999;50(6):535-47.
2
3. Han BK, Ryu JS, Moon DH, Shin MJ, Kim YT, Lee HK. Bone SPECT imaging of vertebral hemangioma correlation with MR imaging and symptoms. Clin Nucl Med. 1995;20(10):916-21.
3
4. Gerard PS, Wilck E. Spinal hemangioma. An unusual photopenic presentation on bone scan. Spine. 1976;17(5):607-10.
4
5. Halkar RK, Motawi MM, Hebbar HG, Jahan MS. Vertebral body hemangioma showing increased uptake of Tc-99m MDP and decreased Tc-99m labeled red blood cells. Clin Nucl Med. 1994;19(9):827-8.
5
6. Raphael J, Hephzibah J, Mani S, Shanthly N, Oommen R. Abnormal appearance of spinal hemangioma mimicking metastasis in bone scintigraphy and SPECT CT: a case report. J Nucl Med Radiat Ther. 2013;S6:16-8.
6
7. Bybel B, Raja S. Vertebral hemangioma on FDG PET scan. Clin Nucl Med. 2003;28(6):522-3.
7
8. Nakayama M, Okizaki A, Ishitoya S, Aburano T. “Hot” vertebra on FDG PET scan; a case of vertebral hemangioma. Clin Nucl Med. 2012;37(12):1990-3.
8
9. Feldman F, van Heertum R, Manus C. 18FDG PET scanning of benign and malignant musculoskeletal lesions. Skeletal Radiol. 2003;32(4):201-8.
9
10. Kwee TC, de Klerk JMH, Nix M, Heggelman BGF, Dubois SV, Adams HJA. Benign bone conditions that may be FDG -avid and mimmic malignancy. Semin Nucl Med. 2017;47(4):322-51.
10
11. Itabashi T, Emori M, Terashima Y, Hasegawa T, Shimizu J, Nagoya S, et al. Hemangioma of the rib showing relatively high 18F-FDG uptake: a case report with a literature review. Acta Radiol Open. 2017;6(9):1-5.
11
12. Cha JG, Yoo JH, Kim HK, Park JM, Paik SH, Park SJ. PET/CT and MRI of intra-osseous hemangioma of the tibia. Br J Radiol. 2012;85(1012):e094-8.
12
13. Ko SW, Park JG. Cavernous hemangioma of the ilium mimmiking aggressive malignant bone tumor with increased activity on 18F-FDG/CT. Korean J Radiol. 2013;14(2):294-8.
13
14. Dupond JL, Mahammedi H, Prie D, Collin F, Gil H, Blagosklonov O, et al. Oncogenic osteomalacia: diagnostic importance of fibroblast growth factor 23 and F-18 FDG PET CT for the diagnosis and follow up in one case. Bone. 2005;36(3):375-8.
14
15. Weidner N, Santa Cruz D. Phosphaturic mesenchymal tumors. A polymorphous group causing osteomalacia or rickets. Cancer. 1987;59(8):1442-54.
15
16. Malhotra G, Agrawal A, Jambhekar NA, Sarathi V, Jagtap V, Agarwal MG, et al. Interesting image. The search for primary tumor in a patient with oncogenic osteomalacia: F-18 FDG PET resolves the conundrum. Clin Nucl Med. 2010;35(11):896-8.
16
17. Breer S, Brunkhorst T, Beil FT, Peldschus K, Heiland M, Klutmann S, et al. 68Ga DOTA-TATE PET/CT allows tumor localization in patients with tumorinduced osteomalacia but negative 111In-octreotide SPECT/CT. Bone. 2014;64:222-7.
17
18. Taira AV, Herfkens RJ, Gambhir SS, Quan A. Detection of bone metastases: assessment of integrated FDG PET/CT imaging. Radiology. 2007;243(1):204-11.
18
ORIGINAL_ARTICLE
Extra-striatal Uptake of 99mTc-TRODAT SPECT in a Cerebral Meningioma: A Case Report
We reported a 71 years old woman, with history of rest and postural tremor, bradykinesia and memory problems. In her dynamic MRI, a contrastenhanced tumor in the cerebellopontine (CP) angle was found which was compatible with a meningioma. 99mTc-TRODAT SPECT showed decreased activity in the left putamen, indicating idiopathic Parkinson disease. There was also a focus of increased activity on the right side of the skull base, which was compatible with meningioma in MRI.
https://aojnmb.mums.ac.ir/article_11933_a2e5161b48017e38739054bb52fdcf17.pdf
2019-01-01
99
102
10.22038/aojnmb.2018.11933
Meningioma
Nuclear Medicine
TRODAT
Parkinsonism
Ramin
Sadeghi
sadeghir@mums.ac.ir
1
Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
LEAD_AUTHOR
Mahsa
Sabour
sabourdm931@mums.ac.ir
2
Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
AUTHOR
Ali
Shoeibi
shoeibia@mums.ac.ir
3
Department of Neurology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
AUTHOR
somaye
ghahremani
ghahremanis931@mums.ac.ir
4
Nuclear Medicine Research Center, Ghaem Hospital,Mashhad,Iran
AUTHOR
1. Sasannezhad P, Juibary AG, Sadri K, Sadeghi R, Sabour M, Kakhki VRD, et al. (99m)Tc-TRODAT-1 SPECT imaging in early and late onset Parkinson’s disease. Asia Ocean J Nucl Med Biol. 2017;5(2):114-9.
1
2. Fallahi B, Esmaeili A, Beiki D, Oveisgharan S, Noorollahi-Moghaddam H, Erfani M, et al. Evaluation of (99m)Tc-TRODAT-1 SPECT in the diagnosis of Parkinson’s disease versus other progressive movement disorders. Ann Nucl Med. 2016;30(2):153-62.
2
3. Benincasa D, Romano A, Mastronardi L, Pellicano C, Bozzao A, Pontieri FE. Hemiparkinsonism due to frontal meningioma. Acta Neurol Belg. 2008;108(1):29-32.
3
4. Bor-Seng-Shu E, Pedroso JL, Felicio AC, de Andrade DC, Teixeira MJ, Braga-Neto P, et al. Substantia nigra echogenicity and imaging of striatal dopamine transporters in Parkinson’s disease: a cross-sectional study. Parkinsonism Relat Disord. 2014;20(5):477-81.
4
5. Adhiyaman V, Meara J. Meningioma presenting as bilateral parkinsonism. Age Ageing. 2003;32(4):456-8.
5
6. Watts J, Box G, Galvin A, Brotchie P, Trost N, Sutherland T. Magnetic resonance imaging of meningiomas: a pictorial review. Insights Imaging. 2014;5(1):113-22.
6
7. Saloner D, Uzelac A, Hetts S, Martin A, Dillon W. Modern meningioma imaging techniques. J Neurooncol. 2010;99(3):333-40.
7
8. Bor-Seng-Shu E, Felicio AC, Braga-Neto P, Batista IR, Paiva WS, de Andrade DC, et al. Dopamine transporter imaging using 99mTc-TRODAT-1 SPECT in Parkinson’s disease. Med Sci Monit. 2014;20:1413-8.
8
9. Chandra P, Nath S. Extra-striatal uptake of (99m)TcTRODAT-1 in meningioma detected on SPECT/CT: diagnostic clue or mere coincidence? Indian J Nucl Med. 2017;32(3):243-4.
9
10. Hwang WJ, Yao WJ, Wey SP, Ting G. Reproducibility of 99mTc-TRODAT-1 SPECT measurement of dopamine transporters in Parkinson’s disease. J Nucl Med. 2004;45(2):207-13.
10
11. Chiu YL, Hu C, Li JY, Weng MJ, Lin WC, Peng NJ. An incidental finding of cerebral meningioma on 99mTc-TRODAT-1 dopamine transporter SPECT/CT. Clin Nucl Med. 2012;37(9):899-900.
11
12. Vitor T, Carvalho GC, Nogueira SA, Wagner J, Felicio AC. Incidental detection of probable meningioma in brain scintigraphy using 99mTc-TRODAT-1. Arq Neuropsiquiatr. 2017;75(4):258-9.
12
ORIGINAL_ARTICLE
Sectional Anatomy Quiz III
This series comprises of a quiz pertaining to the identification of salient and important anatomical structures and landmarks expected to be seen at a given level on the computed tomography (CT) image. The representativeimage is followed by a series of images showing examples of different commonly encountered pathological entities that can be seen at this level in a routine clinical practice. Readers are encouraged to identify highlighted anatomical structures and landmarks in all the images and appreciate how a given abnormality can alter the appearance of normal structures. It is expected that this series will help nuclear physicians in interpretation of the CT component of the single photon emission computed tomography (SPECT) and positron emission tomography (PET) studies.
https://aojnmb.mums.ac.ir/article_11441_50c7420b3d212bf8d4cb7152ce238737.pdf
2019-01-01
103
107
10.22038/aojnmb.2018.33101.1228
Anatomy
Computed Tomography
Thorax
Rashid
Hashmi
rashidhashmi@yahoo.com
1
University of New South Wales (UNSW)
LEAD_AUTHOR
1. Ryan S, McNicholas M, Eustace SJ. Anatomy for diagnostic imaging e-book. 3rd ed. New York: Elsevier Health Sciences; 2010.
1
2. Olivetti L. Atlas of imaging anatomy. Berlin: Springer; 2015.
2
3. Currie S, Kennish S, Flood K. Essential radiological anatomy for the MRCS. Cambridge: Cambridge University Press; 2009.
3
4. Moeller TB, Reif E. Pocket atlas of sectional anatomy. CT and MRI. Thieme Stuttgart: Thorax, Abdomen, and Pelvis; 2001.
4