Development of a new quantification method using partial volume effect correction for individual energy peaks in 111In-pentetreotide SPECT/CT

Document Type : Technical note

Authors

1 Department of Nuclear Medicine, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan

2 Graduate School of Health Sciences, Kumamoto University, Kumamoto, Japan

3 Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan

Abstract

Objective(s): Somatostatin receptor scintigraphy (SRS) using 111In-pentetreotide has no established quantification method. The purpose of this study was to develop a new quantitative method to correct the partial volume effect (PVE) for individual energy peaks in 111In-pentetreotide single-photon emission computed tomography (SPECT).
Methods: Phantom experiments were performed to construct a new quantitative method. In the phantom experiments, a NEMA IEC body phantom was used. Acquisition was performed using two energy peaks (171 keV and 245 keV) on the SPECT/CT system. The volume of interest was set at each hot sphere and lung insert in the SPECT images of each energy peak, and the recovery coefficient (RC) was calculated to understand the PVE. A new quantitative index, the indium uptake index (IUI), was calculated using the RC to correct the PVE. The quantitative accuracy of the IUI in the hot sphere was confirmed. Case studies were performed to clarify the quantitative accuracy. In a case study, the relationship between the IUI and the Krenning score, which is used as a visual assessment, was evaluated for each lesion.
Results: The obtained RCs showed that the energy peak at 171 keV was faster in recovering the effect of PVE than that at 245 keV. The IUI in the 17-mm-diameter hot sphere was overestimated by 4.8% and 8.3% at 171 keV and 245 keV, respectively, compared to the actual IUIs. The relationship between IUI and Krenning score was rs=0.773 (p<0.005) at sum, rs=0.739 (p<0.005) at 171 keV, and rs=0.773 (p<0.005) at 245 keV.
Conclusion: We have developed a new quantification method for 111In-pentetreotide SPECT/CT using RC-based PVE correction for an individual energy peak of 171 keV. The quantitative accuracy of this method was high even for accumulations of less than 20 mm, and it showed a good relationship with the Krenning score; therefore, the clinical usefulness of IUI was demonstrated.

Keywords

Main Subjects


  1. Modlin IM, Lye KD, Kidd M. A 5-decade analysis of 13,715 carcinoid tumors. Cancer. 2003; 97(4):934–59.
  2. Yao JC, Hassan M, Phan A, Dagohoy C, Leary C, Mares JE, et al. One hundred years after “carcinoid”: Epidemiology of and prognostic factors for neuroendocrine tumors in 35,825 cases in the United States. J Clin Oncol. 2008; 26(18):3063–72.
  3. Zuetenhorst JM, Taal BG. Metastatic Carcinoid Tumors: A Clinical Review. Oncologist. 2005; 10(2):123–31.
  4. Kubota K. PET and SPECT for neuro endocrine tumor. Off. J. Japan Assoc. Endocr. Surg. Japanese Soc. Thyroid Surg. 2015; 32(2):112-5.
  5. Kwekkeboom DJ, Krenning EP, Scheidhauer K, Lewington V, Lebtahi R, Grossman A, et al. ENETS Consensus Guidelines for the Standards of Care in Neuroendocrine Tumors: Somatostatin Receptor Imaging with 111In-Pentetreotide. Neuroendocrino- logy. 2009; 90(2):184–9.
  6. Strosberg J, Wolin E, Chasen B, Kulke M, Bushnell D, Caplin M, et al. Health-related quality of life in patients with progressive midgut neuroendocrine tumors treated with 177lu-dotatate in the phase III netter-1 trial. J Clin Oncol. 2018; 36(25):2578–84.
  7. Deppen SA, Liu E, Blume JD, Clanton J, Shi C, Jones-Jackson LB, et al. Safety and Efficacy of 68Ga-DOTATATE PET/CT for Diagnosis, Staging, and Treatment Management of Neuroendocrine Tumors. J Nucl Med. 2016; 57(5):708-14.
  8. Öberg K. Molecular imaging radiotherapy: Theranostics for personalized patient management of neuroendocrine tumors (NETs). Theranostics. 2012; 2(5):448-58.
  9. Krenning EP, De Jong M, Kooij PPM, Breeman WAP, Bakker WH, De Herder WW, et al. Radiolabelled somatostatin analogue(s) for peptide receptor scintigraphy and radionuclide therapy. Ann Oncol. 1999; 10: S23-9.
  10. De Jong M, Breeman WA, Bernard BF, Bakker WH, Schaar M, van Gameren A, et al. [177Lu-DOTA(0),Tyr3] octreotate for somato- statin receptor-targeted radionuclide Int J Cancer. 2001; 92(5):628-33.
  11. Strosberg J, El-Haddad G, Wolin E, Hendifar A, Yao J, Chasen B, et al. Phase 3 Trial of 177Lu-Dotatate for Midgut Neuroendocrine Tumors. N Engl J Med. 2017; 376(2):125–35.
  12. Wetz C, Apostolova I, Steffen IG, Hofheinz F, Furth C, Kupitz D, et al. Predictive Value of Asphericity in Pretherapeutic [111In] DTPA-Octreotide SPECT/CT for Response to Peptide Receptor Radionuclide Therapy with [177 Lu] DOTATATE. Mol Imaging Biol. 2017; 19(3):437–45.
  13. Ito T, Sasano H, Tanaka M, Osamura RY,Sasaki I, Kimura W, et al. Epidemiological study of gastroentero pancreatic neuro endocrine tumors in Japan. J Gastroenterol. 2010; 45(2): 234–43.
  14. Hope TA, Calais J, Zhang L, Dieckmann W, Millo C. 111In-pentetreotide scintigraphy versus 68Ga-DOTATATE PET: Impact on krenning scores and effect of tumor burden. J Nucl Med. 2019; 60(9):1266–9.
  15. Soret M, Bacharach SL, Buvat I. Partial-volume effect in PET tumor imaging. J Nucl Med. 2007; 48(6):932-45.
  16. Tran-Gia J, Lassmann M. Optimizing image quantification for 177Lu SPECT/CT based on a 3D printed 2-Compartment kidney phantom. J Nucl Med.2018; 59(4):616–24.
  17. Finocchiaro D, Berenato S, Grassi E, Bertolini V, Castellani G, Lanconelli N, et al. Partial volume effect of SPECT images in PRRT with 177Lu labelled somatostatin analogues: A practical solution. Phys Med. 2019; 57:153-9.
  18. Ritt P, Vija H, Hornegger J, Kuwert T. Absolute quantification in SPECT. Eur. J. Nucl. Med. Mol. Imaging. 2011; 38 Suppl 1:69-77.
  19. Dziel T, Listkowska A, Tymiński Z. Standardisation and half-life measurements of (111) In. Appl Radiat Isot. 2016; 109:345-8.
  20. Endo A, Yamaguchi Y, Eckerman KF. Nuclear decay data for dosimetry calculation Revised data of ICRP Publication 38. JAERI 1347. 2005.
  21. Koral KF, Clinthorne NH, Leslie Rogers W. Improving emission-computed-tomography quantification by Compton-scatter rejection through offset windows. Nucl Inst Methods Phys Res A. North-Holland. 1986; 242:610–4.
  22. Bombardieri E, Ambrosini V, Aktolun C, Baum RP, Bishof-Delaloye A, Del Vecchio S, et al. 111In-pentetreotide scintigraphy: Procedure guidelines for tumour imaging. Eur J Nucl Med Mol Imaging. 2010; 37(7): 1441-8.
  23. Holstensson M, Hindorf C, Ljungberg M, Partridge M, Flux GD. Optimization of Energy-Window Settings for Scatter Correction in Quantitative 111In Imaging: Comparison of Measurements and Monte Carlo Simulations. Cancer Biother Radiopharm. 2007; 22(1):136-42.
  24. Sher A, Lacoeuille F, Fosse P, Vervueren L, Cahouet-Vannier A, Dabli D, et al. For avid glucose tumors, the SUV peak is the most reliable parameter for [(18) F] FDG-PET/CT quantification, regardless of acquisition time. EJNMMI Res. 2016; 6(1):21.
  25. Akamatsu G, Nishida H, Fujino A, Ohnishi A, Ikari Y, Nishio T, et al. Harmonization of Standardized Uptake Value among Different Generation PET/ CT Cameras Based on a Phantom Experiment -Utility of SUV(peak). Nihon Hoshasen Gijutsu Gakkai Zasshi. 2015; 71(9):735-45.
  26. Jönsson L, Stenvall A, Mattsson E, Larsson E, Sundlöv A, Ohlsson T, et al. Quantitative analysis of phantom studies of 111In and 68Ga imaging of neuroendocrine tumours. EJNMMI Phys. 2018; 20; 5(1):5.
  27. Huang SC. Anatomy of SUV. Nucl Med Biol. 2000; 27(7):643–6.
  28. Kanda Y. Investigation of the freely available easy-to-use software “EZR” for medical statistics. Bone Marrow Transplant. 2013; 48(3):452–8.
  29. Yoneyama H, Tsushima H, Kobayashi M, Onoguchi M, Nakajima K, Kinuya S. Improved detection of sentinel lymph nodes in SPECT/CT images acquired using a low- to medium-energy general-purpose collimator. Clin Nucl Med. 2014; 39(1):1-6.
  30. Noori-Asl M. Assessment of four scatter correction methods in In-111 SPECT imaging: A simulation study. J Med Phys. 2020; 45(2):107–15.
  31. Du Y, Tsui BMW, Frey EC. Model-based compensation for quantitative 123I brain SPECT imaging. Phys Med Biol. 2006; 51(5): 1269–82.
  32. Mähler E, Sundström T, Axelsson J, Larsson A. Detecting small liver tumors with 111In-pentetreotide SPECT-a collimator study based on Monte Carlo simulations. IEEE Trans Nucl Sci. 2012; 59(1):47–53.
  33. Dickson J, Ross J, Vöö S. Quantitative SPECT: the time is now. EJNMMI Phys. 2019; 6:4.
  34. Nakahara T, Daisaki H, Yamamoto Y, Iimori T, Miyagawa K, Okamoto T, et al. Use of a digital phantom developed by QIBA for harmonizing SUVs obtained from the state-of-the-art SPECT/CT systems: a multicenter study. EJNMMI Res. 2017; 7(1):53.
  35. 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.
  36. Sánchez Catasús CA, Rodríguez Castillo M, Rodríguez Rojas R, Rodríguez Mesa N. A way to reduce the radius of rotation in brain SPET with a single-head system. Nuclear Medicine Communications. 1999; 20(1): 99-103.
  37. Tokorodani R, Ueta K, Kume T, Ohno Y, Miyagawa K, Nishigawa T. Evaluation of normal bone standardized uptake values using quantitative SPECT with improved spatial resolution. Jpn J Nucl Med Tech 2017; 37:201–210.
  38. Miyaji N, Miwa K, Motegi K, Yamashita K, Terauchi T, Onoguchi M. Patient arm position during quantitative bone single-photon emission computed tomography/ computed tomography acquisition can affect image quality and quantitative accuracy: a phantom study. Nucl Med Commun. 2021; 42(3): 267-275.
  39. Caplin ME, Pavel M, Ćwikła JB, Phan AT, Raderer M, Sedláčkova E, et al. Anti-tumour effects of lanreotide for pancreatic and intestinal neuroendocrine tumours: The CLARINET open-label extension study. Endocr Relat Cancer. 2016; 23(3):191–9.
  40. Kwekkeboom DJ, Teunissen JJ, Bakker WH, Kooij PP, De Herder WW, Feelders RA, et al. Radiolabeled somatostatin analog [177Lu-DOTA0, Tyr3]octreotate in patients with endocrine gastro enteropancreatic tumors. J Clin Oncol. 2005; 23(12):2754–62.
  41. Bettinardi V, Castiglioni I, De Bernardi E, Gilardi MC. PET quantification: strategies for partial volume correction. Clin Transl Imaging. 2014; 2:199–218.
  42. Sakaguchi Y, Mizoguchi N, Mitsumoto T, Mitsumoto K, Himuro K, Ohya N et al. A simple table lookup method for PET/CT partial volume correction using a point-spread function in diagnosing lymph node metastasis. Ann Nucl Med. 2010; 24(8): 585-91.