| 1. |
- Hyafil, Fabien, et al.
(författare)
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EANM procedural guidelines for myocardial perfusion scintigraphy using cardiac-centered gamma cameras
- 2019
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Ingår i: European Journal of Hybrid Imaging. - : Springer Nature. - 2510-3636. ; 3:1
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Tidskriftsartikel (refereegranskat)abstract
- An increasing number of Nuclear Medicine sites in Europe are using cardiac-centered gamma cameras for myocardial perfusion scintigraphy (MPS). Three cardiac-centered gamma cameras are currently the most frequently used in Europe: the D-SPECT (Spectrum Dynamics), the Alcyone (Discovery NM 530c and Discovery NM/CT 570c; General Electric Medical Systems), and the IQ-SPECT (Siemens Healthcare). The increased myocardial count sensitivity of these three cardiac-centered systems has allowed for a decrease in the activities of radiopharmaceuticals injected to patients for myocardial perfusion imaging and, consequently, radiation exposure of patients. When setting up protocols for MPS, the overall objective should be to maintain high diagnostic accuracy of MPS, while injecting the lowest activities reasonably achievable to reduce the level of radiation exposure of patient and staff. These guidelines aim at providing recommendations for acquisition protocols and image interpretation using cardiac-centered cameras. As each imaging system has specific design and features for image acquisition and analysis, these guidelines have been separated into three sections for each gamma camera system. These recommendations have been written by the members of the Cardiovascular Committee of EANM and were based on their own experience with each of these systems and on the existing literature.
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| 2. |
- Sciagrà, Roberto, et al.
(författare)
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EANM procedural guidelines for PET/CT quantitative myocardial perfusion imaging
- 2021
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Ingår i: European Journal of Nuclear Medicine and Molecular Imaging. - : Springer. - 1619-7070 .- 1619-7089. ; 48:4, s. 1040-1069
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Tidskriftsartikel (refereegranskat)abstract
- The use of cardiac PET, and in particular of quantitative myocardial perfusion PET, has been growing during the last years, because scanners are becoming widely available and because several studies have convincingly demonstrated the advantages of this imaging approach. Therefore, there is a need of determining the procedural modalities for performing high-quality studies and obtaining from this demanding technique the most in terms of both measurement reliability and clinical data. Although the field is rapidly evolving, with progresses in hardware and software, and the near perspective of new tracers, the EANM Cardiovascular Committee found it reasonable and useful to expose in an updated text the state of the art of quantitative myocardial perfusion PET, in order to establish an effective use of this modality and to help implementing it on a wider basis. Together with the many steps necessary for the correct execution of quantitative measurements, the importance of a multiparametric approach and of a comprehensive and clinically useful report have been stressed.
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| 3. |
- Slart, Riemer H. J. A., et al.
(författare)
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Position paper of the EACVI and EANM on artificial intelligence applications in multimodality cardiovascular imaging using SPECT/CT, PET/CT, and cardiac CT
- 2021
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Ingår i: European Journal of Nuclear Medicine and Molecular Imaging. - : Springer. - 1619-7070 .- 1619-7089. ; 48:5, s. 1399-1413
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Tidskriftsartikel (refereegranskat)abstract
- In daily clinical practice, clinicians integrate available data to ascertain the diagnostic and prognostic probability of a disease or clinical outcome for their patients. For patients with suspected or known cardiovascular disease, several anatomical and functional imaging techniques are commonly performed to aid this endeavor, including coronary computed tomography angiography (CCTA) and nuclear cardiology imaging. Continuous improvement in positron emission tomography (PET), single-photon emission computed tomography (SPECT), and CT hardware and software has resulted in improved diagnostic performance and wide implementation of these imaging techniques in daily clinical practice. However, the human ability to interpret, quantify, and integrate these data sets is limited. The identification of novel markers and application of machine learning (ML) algorithms, including deep learning (DL) to cardiovascular imaging techniques will further improve diagnosis and prognostication for patients with cardiovascular diseases. The goal of this position paper of the European Association of Nuclear Medicine (EANM) and the European Association of Cardiovascular Imaging (EACVI) is to provide an overview of the general concepts behind modern machine learning-based artificial intelligence, highlights currently prefered methods, practices, and computational models, and proposes new strategies to support the clinical application of ML in the field of cardiovascular imaging using nuclear cardiology (hybrid) and CT techniques.
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| 4. |
- Slart, Riemer H. J. A., et al.
(författare)
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Procedural recommendations of cardiac PET/CT imaging : standardization in inflammatory-, infective-, infiltrative-, and innervation (4Is)-related cardiovascular diseases: a joint collaboration of the EACVI and the EANM
- 2021
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Ingår i: European Journal of Nuclear Medicine and Molecular Imaging. - : Springer. - 1619-7070 .- 1619-7089. ; 48:4, s. 1016-1039
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Tidskriftsartikel (refereegranskat)abstract
- With this document, we provide a standard for PET/(diagnostic) CT imaging procedures in cardiovascular diseases that are inflammatory, infective, infiltrative, or associated with dysfunctional innervation (4Is). This standard should be applied in clinical practice and integrated in clinical (multicenter) trials for optimal procedural standardization. A major focus is put on procedures using [18F]FDG, but 4Is PET radiopharmaceuticals beyond [18F]FDG are also described in this document. Whilst these novel tracers are currently mainly applied in early clinical trials, some multicenter trials are underway and we foresee in the near future their use in clinical care and inclusion in the clinical guidelines. Finally, PET/MR applications in 4Is cardiovascular diseases are also briefly described. Diagnosis and management of 4Is-related cardiovascular diseases are generally complex and often require a multidisciplinary approach by a team of experts. The new standards described herein should be applied when using PET/CT and PET/MR, within a multimodality imaging framework both in clinical practice and in clinical trials for 4Is cardiovascular indications.
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| 5. |
- Slart, Riemer H J A, et al.
(författare)
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Procedural recommendations of cardiac PET/CT imaging : standardization in inflammatory-, infective-, infiltrative-, and innervation- (4Is) related cardiovascular diseases
- 2020
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Ingår i: European Heart Journal Cardiovascular Imaging. - : Oxford University Press (OUP). - 2047-2404 .- 2047-2412. ; 21:12, s. 1320-1330
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Tidskriftsartikel (refereegranskat)abstract
- With this summarized document we share the standard for positron emission tomography (PET)/(diagnostic)computed tomography (CT) imaging procedures in cardiovascular diseases that are inflammatory, infective, infiltrative, or associated with dysfunctional innervation (4Is) as recently published in the European Journal of Nuclear Medicine and Molecular Imaging. This standard should be applied in clinical practice and integrated in clinical (multicentre) trials for optimal standardization of the procedurals and interpretations. A major focus is put on procedures using [18F]-2-fluoro-2-deoxyglucose ([18F]FDG), but 4Is PET radiopharmaceuticals beyond [18F]FDG are also described in this summarized document. Whilst these novel tracers are currently mainly applied in early clinical trials, some multicentre trials are underway and we foresee in the near future their use in clinical care and inclusion in the clinical guidelines. Diagnosis and management of 4Is related cardiovascular diseases are generally complex and often require a multidisciplinary approach by a team of experts. The new standards described herein should be applied when using PET/CT and PET/magnetic resonance, within a multimodality imaging framework both in clinical practice and in clinical trials for 4Is cardiovascular indications.
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| 6. |
- Totzeck, Matthias, et al.
(författare)
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Nuclear medicine in the assessment and prevention of cancer therapy-related cardiotoxicity : prospects and proposal of use by the European Association of Nuclear Medicine (EANM)
- 2023
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Ingår i: European Journal of Nuclear Medicine and Molecular Imaging. - : Springer Nature. - 1619-7070 .- 1619-7089. ; 50:3, s. 792-812
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Tidskriftsartikel (refereegranskat)abstract
- Cardiotoxicity may present as (pulmonary) hypertension, acute and chronic coronary syndromes, venous thromboembolism, cardiomyopathies/heart failure, arrhythmia, valvular heart disease, peripheral arterial disease, and myocarditis. Many of these disease entities can be diagnosed by established cardiovascular diagnostic pathways. Nuclear medicine, however, has proven promising in the diagnosis of cardiomyopathies/heart failure, and peri- and myocarditis as well as arterial inflammation. This article first outlines the spectrum of cardiotoxic cancer therapies and the potential side effects. This will be complemented by the definition of cardiotoxicity using non-nuclear cardiovascular imaging (echocardiography, CMR) and biomarkers. Available nuclear imaging techniques are then presented and specific suggestions are made for their application and potential role in the diagnosis of cardiotoxicity.
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| 7. |
- Weber, Manuel, et al.
(författare)
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Changes in Tumor-to-Blood Ratio as a prognostic marker for progression-free survival and overall survival in neuroendocrine tumor patients undergoing PRRT
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Background:Historically, patient selection for peptide receptor radionuclide therapy (PRRT) has been performed by virtue of somatostatin-receptor scintigraphy (SRS). In recent years, somatostatin-receptor positron emission tomography (SSTR-PET) has gradually replaced SRS because of its improved diagnostic capacity, creating an unmet need for SSTR-PET-based selection criteria for PRRT. Tumor-to-Blood-ratio (TBR) measurements have shown high correlation with the net influx rate Ki, reflecting the tumor somatostatin-receptor expression, to a higher degree than standardized uptake value (SUV) measurements. TBR may therefore predict treatment response to PRRT. In addition, changes in semiquantitative SSTR-PET parameters have been shown to predate morphological changes, making them a suitable metric for response assessment. Methods:The institutional database of the Department of Nuclear Medicine (University Hospital Essen) was searched for NET patients undergoing ≥2 PRRT cycles with available baseline and follow-up SSTR-PET. Two blinded independent readers reported the occurrence of new lesions quantified tumor uptake of up to 9 lesions per-patient using SUV, TBR, and tumor-spleen ratio (TSR). The association between baseline TBR and changes in uptake / occurrence of new lesions with progression-free survival (PFS) and overall survival (OS) was tested by use of a Cox regression model and log-rank test. Results: Patients with baseline TBR in the 1st quartile had a shorter PFS (14.4 months) than those in the 3rd (23.7 months; p=0.03) and 4th (24.1 months; p=0.02) quartile. Similarly, these patients had significantly shorter OS (32.5 months) than those with baseline TBR in the 2nd (41.8 months; p=0.03), 3rd (69.2 months; p<0.01), and 4th (42.7 months; p=0.03) quartile. Baseline to follow-up increases in TBR were independently associated with shorter PFS when accounting for prognostic markers, e.g. RECIST response (Hazard Ratio=3.29[95%CI= 1.62-6.68]; p<0.01). This was confirmed with regards to OS (Hazard Ratio=1.94[95%CI= 1.14-3.32]; p=0.02). Changes in TSR and SUVmean were not associated with PFS or OS. Conclusions: Baseline TBR as well as changes in TBR were significantly associated with PFS and OS and may improve patient selection and morphological response assessment. Future trials need to assess the role of TBR for therapy monitoring also during PRRT, and prospectively explore TBR as a predictive marker for patient selection.
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| 8. |
- Weber, Manuel, et al.
(författare)
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Changes in tumor-to-blood ratio as a prognostic marker for progression-free survival and overall survival in neuroendocrine tumor patients undergoing PRRT.
- 2024
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Ingår i: European Journal of Nuclear Medicine and Molecular Imaging. - 1619-7070 .- 1619-7089. ; 51:3, s. 841-851
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Historically, patient selection for peptide receptor radionuclide therapy (PRRT) has been performed by virtue of somatostatin receptor scintigraphy (SRS). In recent years, somatostatin receptor positron emission tomography (SSTR-PET) has gradually replaced SRS because of its improved diagnostic capacity, creating an unmet need for SSTR-PET-based selection criteria for PRRT. Tumor-to-blood ratio (TBR) measurements have shown high correlation with the net influx rate Ki, reflecting the tumor somatostatin receptor expression, to a higher degree than standardized uptake value (SUV) measurements. TBR may therefore predict treatment response to PRRT. In addition, changes in semiquantitative SSTR-PET parameters have been shown to predate morphological changes, making them a suitable metric for response assessment.METHODS: The institutional database of the Department of Nuclear Medicine (University Hospital Essen) was searched for NET patients undergoing ≥ 2 PRRT cycles with available baseline and follow-up SSTR-PET. Two blinded independent readers reported the occurrence of new lesions quantified tumor uptake of up to nine lesions per patient using SUV and TBR. The association between baseline TBR and changes in uptake/occurrence of new lesions with progression-free survival (PFS) and overall survival (OS) was tested by use of a Cox regression model and log-rank test.RESULTS: Patients with baseline TBR in the 1st quartile had a shorter PFS (14.4 months) than those in the 3rd (23.7 months; p = 0.03) and 4th (24.1 months; p = 0.02) quartile. Similarly, these patients had significantly shorter OS (32.5 months) than those with baseline TBR in the 2nd (41.8 months; p = 0.03), 3rd (69.2 months; p < 0.01), and 4th (42.7 months; p = 0.03) quartile. Baseline to follow-up increases in TBR were independently associated with shorter PFS when accounting for prognostic markers, e.g., RECIST response (hazard ratio = 2.91 [95%CI = 1.54-5.50]; p = 0.01). This was confirmed with regard to OS (hazard ratio = 1.64 [95%CI = 1.03-2.62]; p = 0.04). Changes in SUVmean were not associated with PFS or OS.CONCLUSIONS: Baseline TBR as well as changes in TBR were significantly associated with PFS and OS and may improve patient selection and morphological response assessment. Future trials need to assess the role of TBR for therapy monitoring also during PRRT and prospectively explore TBR as a predictive marker for patient selection.
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