Personalized Dosimetry for 188Re Radionuclide Therapies Based on Post-Treatment SPECT/CT Scans

Over the last three decades, Rhenium-188 (188Re) applications in Nuclear Medicine therapies have gathered a lot of interest thanks to the favorable physical and chemical characteristics of this isotope. In order to optimize 188Re therapies, the accurate knowledge of the activity distribution within the patient body is required. To this end, the nuclear medicine images must yield accurate quantitative measurements. However, the decay of 188Re results in a large variety of emissions such as β-particles, γ-particles and Bremsstrahlung, making quantitative measurements of 188Re activity a very difficult task. In this paper, we discuss the imaging protocols, data acquisitions, techniques used in image reconstruction and processing, and dose estimation methods required for accurate, image-based, personalized dosimetry for molecular therapies with 188Re

33S as a cooperative capturer for BNCT

33S is a stable isotope of sulfur for which the emission of an α-particle is the dominant exit channel for neutron-induced reactions. In this work the enhancement of both the absorbed and the equivalent biologically weighted dose in a BNCT treatment with 13.5keV neutrons, due to the presence of 33S, has been tested by means of Monte Carlo simulations. The kerma-fluence factors for the ICRU-4 tissue have been calculated using standard weighting factors. The simulations depend crucially on the scarce 33S(n,α)30Si cross-section data. The presence of a high resonance at 13.5keV was established by previous authors providing discrepant resonance parameters. No experimental data below 10keV are available. All of this has motivated a proposal of experiment at the n_TOF facility at CERN. A setup was designed and tested in 2011. Some results of the successful test will be shown. The experiment is scheduled for the period November to December 2012. © 2014 Elsevier Ltd

Deadtime effects in quantification of 177Lu activity for radionuclide therapy

Background: The aim of this study was to investigate the deadtime (DT) effects that are present in 177Lu images acquired after radionuclide therapy injection, assess differences in DT based on the full spectrum and the photopeak-only measurements, and design a method to correct for the deadtime losses. A Siemens SymbiaT SPECT/CT camera with a medium energy collimator was used. A 295-mL bottle was placed off-center inside a large cylinder filled with water, and 177Lu activity was sequentially added up to a maximum of 9.12 GBq. The true count rates vs. observed count rates were plotted and fitted to the DT paralyzable model. This analysis was performed using counts recorded in the full spectrum and in other energy windows. The DT correction factors were calculated using the percentage difference between the true and the observed count rates. Results: The DT values of 5.99 ± 0.02 μs, 4.60 ± 0.052 μs, and 0.19 ± 0.18 μs were obtained for the primary photons (PP) recorded in the 113- and 208-keV photopeaks and for the full spectrum, respectively. For the investigated range of count rates, the DT correction factors of up to 23% were observed for PP corresponding to the 113-keV photopeak, while for the 208-keV photopeak values of up to 20% were obtained. These values were almost three times higher than the deadtime correction factors derived from the full spectrum. Conclusions: The paralyzable model showed to be appropriate for the investigated range of counts, which were five to six times higher than those observed in the patient post-therapy imaging. Our results suggest that the deadtime corrections should be based on count losses in the scatter-corrected photopeak window and not on the deadtime determined from the full spectrum. Finally, a general procedure that can be followed to correct patient images for deadtime is presented.Medicine, Faculty ofOther UBCNon UBCRadiology, Department ofReviewedFacult

Accuracy of 177Lu activity quantification in SPECT imaging: a phantom study

Background: The aim of the study is to assess accuracy of activity quantification of 177Lu studies performed according to recommendations provided by the committee on Medical Internal Radiation Dose (MIRD) pamphlets 23 and 26. The performances of two scatter correction and three segmentation methods were compared. Additionally, the accuracy of tomographic and planar methods for determination of the camera normalization factor (CNF) was evaluated. Eight phantoms containing inserts of different sizes and shapes placed in air, water, and radioactive background were scanned using a Siemens SymbiaT SPECT/CT camera. Planar and tomographic scans with 177Lu sources were used to measure CNF. Images were reconstructed with our SPEQToR software using resolution recovery, attenuation, and two scatter correction methods (analytical photon distribution interpolated (APDI) and triple energy window (TEW)). Segmentation was performed using a fixed threshold method for both air and cold water scans. For hot water experiments three segmentation methods were compared as folows: a 40% fixed threshold, segmentation based on CT images, and our iterative adaptive dual thresholding (IADT). Quantification error, defined as the percent difference between experimental and true activities, was evaluated. Results: Quantification error for scans in air was better for TEW scatter correction (100 ml) were obtained when APDI and IADT were used for scatter correction and segmentation, respectively. Additionally, we showed that planar acquisitions with scatter correction and tomographic scans provide similar CNF values. This is an important finding because planar acquisitions are easier to perform than tomographic scans. TEW and APDI resulted in similar quantification errors with APDI showing a small advantage for objects placed in medium with non-uniform density. Conclusions: Following the MIRD recommendations for data acquisition and reconstruction resulted in accurate activity quantification (errors <5% for large objects). However, techniques for better organ/tumor segmentation must still be developed.Medicine, Faculty ofScience, Faculty ofOther UBCNon UBCPhysics and Astronomy, Department ofRadiology, Department ofReviewedFacult

Determination of gamma camera calibration factors for quantitation of therapeutic radioisotopes

Background: Camera calibration, which translates reconstructed count map into absolute activity map, is a prerequisite procedure for quantitative SPECT imaging. Both planar and tomographic scans using different phantom geometries have been proposed for the determination of the camera calibration factor (CF). However, there is no consensus on which approach is the best. The aim of this study is to evaluate all these calibration methods, compare their performance, and propose a practical and accurate calibration method for SPECT quantitation of therapeutic radioisotopes. Twenty-one phantom experiments (Siemens Symbia SPECT/CT) and 12 Monte Carlo simulations (GATE v6.1) using three therapy isotopes (131I, 177Lu, and 188Re) have been performed. The following phantom geometries were used: (1) planar scans of point source in air (PS), (2) tomographic scans of insert(s) filled with activity placed in non-radioactive water (HS + CB), (3) tomographic scans of hot insert(s) in radioactive water (HS + WB), and (4) tomographic scans of cylinders uniformly filled with activity (HC). Tomographic data were reconstructed using OSEM with CT-based attenuation correction and triple energy window (TEW) scatter correction, and CF was determined using total counts in the reconstructed image, while for planar scans, the photopeak counts, corrected for scatter and background with TEW, were used. Additionally, for simulated data, CF obtained from primary photons only was analyzed. Results: For phantom experiments, CF obtained from PS and HS + WB agreed to within 6% (below 3% if experiments performed on the same day are considered). However, CF from HS + CB exceeded those from PS by 4–12%. Similar trend was found in simulation studies. Analysis of CFs from primary photons helped us to understand this discrepancy. It was due to underestimation of scatter by the TEW method, further enhanced by attenuation correction. This effect becomes less important when the source is distributed over the entire phantom volume (HS + WB and HC). Conclusions: Camera CF could be determined using planar scans of a point source, provided that the scatter and background contributions are removed, for example using the clinically available TEW method. This approach is simple and yet provides CF with sufficient accuracy (~ 5%) to be used in clinics for radiotracer quantification.Medicine, Faculty ofScience, Faculty ofOther UBCNon UBCPhysics and Astronomy, Department ofRadiology, Department ofReviewedFacult