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Brun, Eva, et al.
(författare)
FDG PET studies during treatment: Prediction of therapy outcome in head and neck squamous cell carcinoma.
2002
Ingår i: Head and Neck. - : Wiley. - 1043-3074. ; 24:2, s. 127-135
Tidskriftsartikel (refereegranskat) abstract
BACKGROUND: Positron emission tomography (PET) provides metabolic information of tissues in vivo. The purpose of this study was to assess the value of PET with 2-[(18) F] fluoro-2-deoxy-D-glucose (FDG) in prediction of therapy outcome (tumor response, survival, and locoregional control) in locally advanced HNSCC. METHODS: Between 1993 and 1999 47 patients underwent PET before (PET(1)) and after (PET(2)) 1 to 3 weeks of radical treatment with evaluation of metabolic rate (MR) and standardized uptake value (SUV) of FDG. All patients received radiotherapy, and 10 also received neoadjuvant chemotherapy. Median follow-up time was 3.3 years. RESULTS: Low and high MR FDG at PET(2), with median value as cutoff, was associated with complete remission in 96% and 62% (p =.007), with 5-year overall survival in 72% and 35% (p =.0042) and with local control in 96% and 55% (p =.002), respectively. CONCLUSIONS: FDG PET in the early phase of treatment of HNSCC is associated with tumor response, survival, and local control. Copyright 2002 John Wiley & Sons, Inc.
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Jönsson, Lena M, et al.
(författare)
A dosimetry model for the small intestine incorporating intestinal wall activity and cross-doses.
2002
Ingår i: Journal of Nuclear Medicine. - 0161-5505. ; 43:12, s. 1657-1664
Tidskriftsartikel (refereegranskat) abstract
Current internal radiation dosimetry models for the small intestine, and for most walled organs, lack the ability to account for the activity uptake in the intestinal wall. In existing models the cross-dose from nearby loops of the small intestine is not taken into consideration. The aim of this investigation was to develop a general model for calculating the absorbed dose to the radiation-sensitive cells in the small intestinal mucosa from radionuclides located in the small intestinal wall or contents. Methods: A model was developed for calculation of the self-dose and cross-dose from activity in the intestinal wall or contents. The small intestine was modeled as a cylinder with 2 different wall thicknesses and with an infinite length. Calculations were performed for various mucus thicknesses. S values were calculated using the EGS4 Monte Carlo simulation package with the PRESTA algorithm and the simulation results were integrated over the depth of the radiosensitive cells. The cross-organ dose was calculated by summing the dose contributions from other intestinal segments. Calculations of S values for self-dose and cross-dose were made for monoenergetic electrons, 0.050–10 MeV, and for the radionuclides 99mTc, 111In, 131I, 67Ga, 90Y, and 211At. Results: The self-dose S value from activity located in the small intestinal wall is considerably greater than the S values for self-dose from the contents and the cross-dose from wall and contents except for high electron energies. For all radionuclides investigated and for electrons 0.10–0.20 MeV and 8–10 MeV in energy, the cross-dose from activity in the contents is higher than the self-dose from the contents. The mucus thickness affects the S value when the activity is located in the contents. Conclusion: A dosimetric model for the small intestine was developed that takes into consideration the localization of the radiopharmaceutical in the intestinal wall or in the contents. It also calculates the contribution from self-dose and cross-dose. With this model, more accurate calculations of absorbed dose to radiation-sensitive cells in the intestine are possible.
5.
Larsson, Jörgen, et al.
(författare)
Distribution of iodine 125-labeled alpha1-microglobulin in rats after intravenous injection
2001
Ingår i: Journal of Laboratory and Clinical Medicine. - : Elsevier BV. - 0022-2143 .- 1532-6543. ; 137:3, s. 165-175
Tidskriftsartikel (refereegranskat) abstract
The 28-kd plasma protein alpha(1)-microglobulin is found in the blood of mammals and fish in a free, monomeric form and as high-molecular-weight complexes with molecular masses above 200 kd. In this study, iodine 125-labeled free and high-molecular weight rat alpha(1)-microglobulin (a mixture of alpha(1)-microglobulin/alpha(1)-inhibitor-3 and alpha(1)-microglobulin/fibronectin complexes) were injected intravenously into rats. The distribution of the proteins was measured by using scintillation camera imaging. Both forms of (125)I-labeled alpha(1)-microglobulin were rapidly cleared from the blood, with a half-life of 2 and 16 minutes for the initial and late phase, respectively, for free alpha(1)-microglobulin; and a half-life of 3 and 130 minutes for the initial and late phase, respectively, for the complexes. After 45 minutes, 6%, 16%, 27%, 13%, and 34% of the free (125)I-labeled alpha(1)-microglobulin and 18%, 21%, 6%, 10%, and 42% of the (125)I-labeled alpha(1)-microglobulin complexes were found in the blood, gastrointestinal tract, kidneys, liver, and the remainder of the body, respectively. The local distribution of injected (125)I-labeled alpha(1)-microglobulin in intestines and kidneys was investigated by microscopy and autoradiography. In the intestine, both forms were distributed in the basal layers, villi, and luminal contents. The results also suggested intracellular labeling of epithelial cells. Well-defined local regions containing higher concentrations of injected protein could be seen in the intestine. In the kidneys, both forms were found mostly in the cortex. Free (125)I-labeled alpha(1)-microglobulin was found predominantly in epithelial cells of a subset of the tubules, whereas the (125)I-labeled complexes were more evenly distributed. Intracellular labeling was indicated for both alpha(1)-microglobulin forms. The results thus indicate a rapid transport of (125)I-labeled alpha(1)-microglobulin from the blood to most tissues.
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Ljungberg, Michael, et al.
(författare)
A 3-dimensional absorbed dose calculation method based on quantitative SPECT for radionuclide therapy: evaluation for (131)I using monte carlo simulation.
2002
Ingår i: Journal of Nuclear Medicine. - 0161-5505. ; 43:8, s. 1101-1109
Tidskriftsartikel (refereegranskat) abstract
A general method is presented for patient-specific 3-dimensional absorbed dose calculations based on quantitative SPECT activity measurements. METHODS: The computational scheme includes a method for registration of the CT image to the SPECT image and position-dependent compensation for attenuation, scatter, and collimator detector response performed as part of an iterative reconstruction method. A method for conversion of the measured activity distribution to a 3-dimensional absorbed dose distribution, based on the EGS4 (electron-gamma shower, version 4) Monte Carlo code, is also included. The accuracy of the activity quantification and the absorbed dose calculation is evaluated on the basis of realistic Monte Carlo-simulated SPECT data, using the SIMIND (simulation of imaging nuclear detectors) program and a voxel-based computer phantom. CT images are obtained from the computer phantom, and realistic patient movements are added relative to the SPECT image. The SPECT-based activity concentration and absorbed dose distributions are compared with the true ones. RESULTS: Correction could be made for object scatter, photon attenuation, and scatter penetration in the collimator. However, inaccuracies were imposed by the limited spatial resolution of the SPECT system, for which the collimator response correction did not fully compensate. CONCLUSION: The presented method includes compensation for most parameters degrading the quantitative image information. The compensation methods are based on physical models and therefore are generally applicable to other radionuclides. The proposed evaluation methodology may be used as a basis for future intercomparison of different methods.
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Sjögreen Gleisner, Katarina, et al.
(författare)
An activity quantification method based on registration of CT and whole-body scintillation camera images, with application to 131I.
2002
Ingår i: Journal of Nuclear Medicine. - 0161-5505. ; 43:7, s. 972-982
Tidskriftsartikel (refereegranskat) abstract
This article presents a new method for conjugate view activity quantification for 131I-labeled monoclonal antibody distribution. METHODS: The method is based on the combined use of images from 3 modalities: whole-body (WB) scintillation camera scanning, WB transmission scanning using 57Co, and CT. All images are coaligned using a recently developed program for the registration of WB images. Corrections for attenuation, scatter, and septal penetration are performed in image space. Compensation for scatter and septal penetration is performed by deconvolution, using point-response functions determined from Monte Carlo simulations. Attenuation correction is performed by applying a patient-specific 364-keV narrow-beam attenuation map obtained by combining information from the CT and the transmission scan. A relationship is presented for the conversion of the CT numbers to mass density. The attenuation- and scatter-compensated image is converted from counts to activity using a sensitivity value that was determined for 364-keV photons in air. This activity projection image is then analyzed for the activity of volumes of interest (VOI) using 2-dimensional regions of interest (ROIs) that are determined from the CT study. The CT is first resliced into coronal slices, and a maximum-extension ROI is outlined that encloses the VOI. Compensation for background activity and overlapping organs is performed on the basis of total patient thickness in the projection line, and on precalculated organ- background thickness fractions. RESULTS: Method evaluation was performed using data from both experimental measurements and Monte Carlo simulations. The use of an attenuation map derived directly from the CT study was also evaluated. For organ activity quantification, an accuracy of > or =10% was obtained. For small-diameter tumors, deviations were larger because of lack of correction for the background-dependent partial-volume effect. CONCLUSION: Registration of CT and WB scintillation camera images was successfully applied to improve activity quantification by the conjugate view method.
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Sjögreen Gleisner, Katarina, et al.
(författare)
Registration of emission and transmission whole-body scintillation-camera images
2001
Ingår i: Journal of Nuclear Medicine. - 0161-5505. ; 42:10, s. 1563-1570
Tidskriftsartikel (refereegranskat) abstract
In this work, a method for registration of whole-body (WB) scintillation-camera images is presented. The primary motive for the development is to perform activity quantification using the conjugate view method on an image basis. Accurate image registration is required for sequential anterior and posterior scans, for serial emission images for analysis of the biokinetics, and for transmission and emission images for a pixel-based attenuation correction. METHODS: Registration is performed by maximization of the mutual information. The spatial transformation has been tailored for the registration of WB images and is composed of global and local transformations, including rigid, projective, and curved transformations. A coarse registration is first performed using cross-correlation and direct pixel scaling. Optimization is then performed in a sequence, beginning with the 2 legs independently, followed by the upper body and head. Evaluation is performed for clinical images of an (131)I-labeled monoclonal antibody and for Monte Carlo-simulated images. An anthropomorphic WB computer phantom, which has been especially modified to match the patient position during WB scanning, is used for the simulations. RESULTS: For simulated images, registration errors are within 1 pixel (<3.6 mm) for a sufficient image count level. Separate evaluation of the influence of noise shows that the errors increase below a total image count of approximately 10(5) (signal-to-noise ratio, approximately 4). For clinical evaluations, the deviations between point markers are 9 +/- 5 mm. CONCLUSION: An automatic registration method for WB images has been developed, which is applicable to emission-emission and transmission-emission registration. This method has been applied in more than 50 clinical studies and has shown to be robust and reliable.
