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Ra-223 SPECT for semi-quantitative analysis in comparison with Tc-99m HMDP SPECT: phantom study and initial clinical experience

BACKGROUND: Image-based measurement of absorbed dose of Ra-223 dichloride may be useful in predicting therapeutic outcome in patients with castration-resistant prostate cancer (CRPC). In general, SPECT has been found to be more accurate than planar imaging in terms of lesion-based analysis. The aims...

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Autores principales: Owaki, Yoshiki, Nakahara, Tadaki, Kosaka, Takeo, Fukada, Junichi, Kumabe, Atsuhiro, Ichimura, Akira, Murakami, Mikoto, Nakajima, Kiyotaka, Fukushi, Masahiro, Inoue, Kazumasa, Oya, Mototsugu, Jinzaki, Masahiro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5626671/
https://www.ncbi.nlm.nih.gov/pubmed/28975570
http://dx.doi.org/10.1186/s13550-017-0330-z
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author Owaki, Yoshiki
Nakahara, Tadaki
Kosaka, Takeo
Fukada, Junichi
Kumabe, Atsuhiro
Ichimura, Akira
Murakami, Mikoto
Nakajima, Kiyotaka
Fukushi, Masahiro
Inoue, Kazumasa
Oya, Mototsugu
Jinzaki, Masahiro
author_facet Owaki, Yoshiki
Nakahara, Tadaki
Kosaka, Takeo
Fukada, Junichi
Kumabe, Atsuhiro
Ichimura, Akira
Murakami, Mikoto
Nakajima, Kiyotaka
Fukushi, Masahiro
Inoue, Kazumasa
Oya, Mototsugu
Jinzaki, Masahiro
author_sort Owaki, Yoshiki
collection PubMed
description BACKGROUND: Image-based measurement of absorbed dose of Ra-223 dichloride may be useful in predicting therapeutic outcome in patients with castration-resistant prostate cancer (CRPC). In general, SPECT has been found to be more accurate than planar imaging in terms of lesion-based analysis. The aims of this study were to assess the feasibility and clinical usefulness of Ra-223 SPECT. The energy spectrum of Ra-223 and SPECT images of a cylindrical phantom with a hot rod were obtained to determine the collimator candidates and energy window settings suitable for clinical Ra-223 SPECT (basic study A). Another phantom with a tube-shaped chamber and two spheres simulating bowel activity and metastatic lesions in the lumbar spine was scanned with medium-energy general-purpose (MEGP) and high-energy general-purpose (HEGP) collimators (basic study B). Ten patients with CRPC underwent SPECT imaging 2 h after Ra-223 injection successively with MEGP and HEGP collimators in random order for 30 min each. Lesion detectability and semi-quantitative analyses of bone metastasis (i.e. lesion-to-background ratio (LBR)) were performed compared to Tc-99m HMDP SPECT. RESULTS: Basic study A revealed that an 84-keV photopeak ± 20% using the HEGP collimator offers better SPECT image quality than the other imaging conditions. Basic study B showed that uptake in one of the spheres was overestimated by overlapped activity of the tube-shaped chamber in planar imaging whereas the spheres had similar counts and significantly higher sphere-to-background ratio in SPECT. On both planar and SPECT images, HEGP gave higher image contrast than MEGP (p < 0.01). In the clinical study, Ra-223 SPECT at 84 keV ± 20% depicted more lesions with the HEGP than with the MEGP collimator (51 vs 36, p = 0.013). There was a positive correlation between LBR in Tc-99m SPECT and in Ra-223 SPECT (r = 0.67 with the MEGP and 0.69 with the HEGP collimator, p < 0.01). LBRs were significantly higher with the HEGP than with the MEGP collimator (p < 0.01). CONCLUSIONS: We recommended the use of the HEGP collimator at 84 keV ± 20% for Ra-223 SPECT imaging. Lesion-based semi-quantitative analysis in the human study revealed a good correlation between Ra-223 and Tc-99m HMDP SPECT in the early phase (2–3 h post injection). ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s13550-017-0330-z) contains supplementary material, which is available to authorized users.
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spelling pubmed-56266712017-10-11 Ra-223 SPECT for semi-quantitative analysis in comparison with Tc-99m HMDP SPECT: phantom study and initial clinical experience Owaki, Yoshiki Nakahara, Tadaki Kosaka, Takeo Fukada, Junichi Kumabe, Atsuhiro Ichimura, Akira Murakami, Mikoto Nakajima, Kiyotaka Fukushi, Masahiro Inoue, Kazumasa Oya, Mototsugu Jinzaki, Masahiro EJNMMI Res Original Research BACKGROUND: Image-based measurement of absorbed dose of Ra-223 dichloride may be useful in predicting therapeutic outcome in patients with castration-resistant prostate cancer (CRPC). In general, SPECT has been found to be more accurate than planar imaging in terms of lesion-based analysis. The aims of this study were to assess the feasibility and clinical usefulness of Ra-223 SPECT. The energy spectrum of Ra-223 and SPECT images of a cylindrical phantom with a hot rod were obtained to determine the collimator candidates and energy window settings suitable for clinical Ra-223 SPECT (basic study A). Another phantom with a tube-shaped chamber and two spheres simulating bowel activity and metastatic lesions in the lumbar spine was scanned with medium-energy general-purpose (MEGP) and high-energy general-purpose (HEGP) collimators (basic study B). Ten patients with CRPC underwent SPECT imaging 2 h after Ra-223 injection successively with MEGP and HEGP collimators in random order for 30 min each. Lesion detectability and semi-quantitative analyses of bone metastasis (i.e. lesion-to-background ratio (LBR)) were performed compared to Tc-99m HMDP SPECT. RESULTS: Basic study A revealed that an 84-keV photopeak ± 20% using the HEGP collimator offers better SPECT image quality than the other imaging conditions. Basic study B showed that uptake in one of the spheres was overestimated by overlapped activity of the tube-shaped chamber in planar imaging whereas the spheres had similar counts and significantly higher sphere-to-background ratio in SPECT. On both planar and SPECT images, HEGP gave higher image contrast than MEGP (p < 0.01). In the clinical study, Ra-223 SPECT at 84 keV ± 20% depicted more lesions with the HEGP than with the MEGP collimator (51 vs 36, p = 0.013). There was a positive correlation between LBR in Tc-99m SPECT and in Ra-223 SPECT (r = 0.67 with the MEGP and 0.69 with the HEGP collimator, p < 0.01). LBRs were significantly higher with the HEGP than with the MEGP collimator (p < 0.01). CONCLUSIONS: We recommended the use of the HEGP collimator at 84 keV ± 20% for Ra-223 SPECT imaging. Lesion-based semi-quantitative analysis in the human study revealed a good correlation between Ra-223 and Tc-99m HMDP SPECT in the early phase (2–3 h post injection). ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s13550-017-0330-z) contains supplementary material, which is available to authorized users. Springer Berlin Heidelberg 2017-10-03 /pmc/articles/PMC5626671/ /pubmed/28975570 http://dx.doi.org/10.1186/s13550-017-0330-z Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Original Research
Owaki, Yoshiki
Nakahara, Tadaki
Kosaka, Takeo
Fukada, Junichi
Kumabe, Atsuhiro
Ichimura, Akira
Murakami, Mikoto
Nakajima, Kiyotaka
Fukushi, Masahiro
Inoue, Kazumasa
Oya, Mototsugu
Jinzaki, Masahiro
Ra-223 SPECT for semi-quantitative analysis in comparison with Tc-99m HMDP SPECT: phantom study and initial clinical experience
title Ra-223 SPECT for semi-quantitative analysis in comparison with Tc-99m HMDP SPECT: phantom study and initial clinical experience
title_full Ra-223 SPECT for semi-quantitative analysis in comparison with Tc-99m HMDP SPECT: phantom study and initial clinical experience
title_fullStr Ra-223 SPECT for semi-quantitative analysis in comparison with Tc-99m HMDP SPECT: phantom study and initial clinical experience
title_full_unstemmed Ra-223 SPECT for semi-quantitative analysis in comparison with Tc-99m HMDP SPECT: phantom study and initial clinical experience
title_short Ra-223 SPECT for semi-quantitative analysis in comparison with Tc-99m HMDP SPECT: phantom study and initial clinical experience
title_sort ra-223 spect for semi-quantitative analysis in comparison with tc-99m hmdp spect: phantom study and initial clinical experience
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5626671/
https://www.ncbi.nlm.nih.gov/pubmed/28975570
http://dx.doi.org/10.1186/s13550-017-0330-z
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