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Performance of coincidence imaging with long-lived positron emitters as an alternative to dedicated PET and SPECT
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Oncology, Radiology and Clinical Immunology. (Onkologi)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Oncology, Radiology and Clinical Immunology. (Biomedicinsk strålningsvetenskap)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Oncology, Radiology and Clinical Immunology. (Onkologi)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Oncology, Radiology and Clinical Immunology. (Biomedicinsk strålningsvetenskap)
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2004 (English)In: Physics in Medicine and Biology, ISSN 0031-9155, E-ISSN 1361-6560, Vol. 49, no 24, 5419-32 p.Article in journal (Refereed) Published
Abstract [en]

An important application of quantitative imaging in nuclear medicine is the estimation of absorbed doses in radionuclide therapy. Depending on the radionuclide used for therapy, quantitative imaging of the kinetics of the therapeutic radiopharmaceutical could be done using planar imaging, SPECT or PET. Since many nuclear medicine departments have a gamma camera system that is also suitable for coincidence imaging, the performance of these systems with respect to quantitative imaging of PET isotopes that could be of use in radionuclide dosimetry is of interest. We investigated the performance of a gamma camera with coincidence imaging capabilities with 99mTc, 111In, 18F and 76Br and a dedicated PET system with 18F and 76Br, using a single standard set of phantom measurements. Here, 76Br was taken as a typical example of prompt gamma-emitting PET isotopes that are applicable in radionuclide therapy dosimetry such as 86Y and 124I. Image quality measurements show comparable image contrasts for 76Br coincidence imaging and 111In SPECT. Although the spatial resolution of coincidence imaging is better than single photon imaging, the contrast obtained with 76Br is not better than that with 99mTc or 111In because of the prompt gamma involved. Additional improvements are necessary to allow for quantitative coincidence imaging of long-lived, prompt gamma producing positron emitters.

Place, publisher, year, edition, pages
2004. Vol. 49, no 24, 5419-32 p.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-72947DOI: 10.1088/0031-9155/49/24/002PubMedID: 15724533OAI: oai:DiVA.org:uu-72947DiVA: diva2:100858
Available from: 2005-09-26 Created: 2005-09-26 Last updated: 2017-12-14Bibliographically approved
In thesis
1. Dosimetry of Radionuclide Therapy with 177Lu-octreotate
Open this publication in new window or tab >>Dosimetry of Radionuclide Therapy with 177Lu-octreotate
2011 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

In radionuclide therapy it is still common to administer standard activities or to scale administered activity with blunt parameters such as body weight or surface area. This is not ideal because, due to considerable variation in kinetics, large safety margins have to be applied to avoid radiation damage to healthy organs, which causes under-treatment of many patients. To base the administered activity on individual dosimetry, as in other therapy modalities using ionizing radiation, will essentially solve this problem. However, dosimetry in radionuclide therapy is resource-demanding and debilitating for the patient because it involves a number of measurements to determine the kinetics of the therapy radionuclide and needs to be optimized for clinical feasibility.

First, the ability to measure radioactivity distributions of radionuclides for therapy was investigated. SPECT measurements of 177Lu, which was later used clinically, showed good spatial resolution and a reasonable quantitative accuracy.

A new method to calculate absorbed dose to solid risk organs and tumours was developed and applied in the clinic. Kinetic data were obtained by repeated SPECT measurements. Radiation concentration determined in small volumes of interest could then be multiplied by a constant to obtain absorbed dose because it was shown that cross-fire was negligible in organs with high activity concentration. The new dosimetry method, compared to other methods, was found to give better results with less effort. In addition, a method to calculate absorbed dose to bone marrow was developed and clinically implemented.

In 200 patients, individual kinetics and absorbed dose were studied and variations were found to be large. Kidney was the dose-limiting organ in almost all patients (98.5%). Keeping the kidney dose < 23Gy, about half of the patients could receive 5, or up to 10 treatments instead of the stipulated 4.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2011. 58 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 707
Keyword
177Lu-octreotate, Absorbed dose, Neuroendocrine tumour
National Category
Cancer and Oncology
Research subject
Medical Radiophysics
Identifiers
urn:nbn:se:uu:diva-158973 (URN)978-91-554-8171-1 (ISBN)
Public defence
2011-11-15, Grönwallsalen, Akademiska sjukhuset Ing. 70, Uppsala, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2011-10-24 Created: 2011-09-19 Last updated: 2011-11-04Bibliographically approved

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Sandström, MattiasTolmachev, VladimirLundqvist, Hans

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