Ye Li1,2, Shannon O'Reilly3, Donika Plyku2, S Ted Treves4,5, Frederic Fahey5,6, Yong Du2, Xinhua Cao5,6, Briana Sexton-Stallone6, Justin Brown7, George Sgouros2,8, Wesley E Bolch7, Eric C Frey1,2,8. 1. Department of Electrical and Computer Engineering, Whiting School of Engineering, Johns Hopkins University, Baltimore, MD, 21218, USA. 2. The Russell H Morgan Department of Radiology and Radiological Science, School of Medicine, Johns Hopkins University, Baltimore, MD, 21287, USA. 3. Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA, 19104, USA. 4. Department of Radiology, Brigham and Women's Hospital, Boston, MA, 02115, USA. 5. Department of Radiology, Harvard Medical School, Boston, MA, 02115, USA. 6. Department of Radiology, Boston Children's Hospital, Boston, MA, 02115, USA. 7. J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL, 32611, USA. 8. School of Medicine, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD, 21287, USA.
Abstract
PURPOSE: In the current clinical practice, administered activity (AA) for pediatric molecular imaging is often based on the North American expert consensus guidelines or the European Association of Nuclear Medicine dosage card, both of which were developed based on the best clinical practice. These guidelines were not formulated using a rigorous evaluation of diagnostic image quality (IQ) relative to AA. In the guidelines, AA is determined by a weight-based scaling of the adult AA, along with minimum and maximum AA constraints. In this study, we use task-based IQ assessment methods to rigorously evaluate the efficacy of weight-based scaling in equalizing IQ using a population of pediatric patients of different ages and body weights. METHODS: A previously developed projection image database was used. We measured task-based IQ, with respect to the detection of a renal functional defect at six different AA levels (AA relative to the AA obtained from the guidelines). IQ was assessed using an anthropomorphic model observer. Receiver-operating characteristics (ROC) analysis was applied; the area under the ROC curve (AUC) served as a figure-of-merit for task performance. In addition, we investigated patient girth (circumference) as a potential improved predictor of the IQ. RESULTS: The data demonstrate a monotonic and modestly saturating increase in AUC with increasing AA, indicating that defect detectability was limited by quantum noise and the effects of object variability were modest over the range of AA levels studied. The AA for a given value of the AUC increased with increasing age. The AUC vs AA plots for all the patient ages indicate that, for the current guidelines, the newborn and 10- and 15-yr phantoms had similar IQ for the same AA suggested by the North American expert consensus guidelines, but the 5- and 1-yr phantoms had lower IQ. The results also showed that girth has a stronger correlation with the needed AA to provide a constant AUC for 99m Tc-DMSA renal SPECT. CONCLUSIONS: The results suggest that (a) weight-based scaling is not sufficient to equalize task-based IQ for patients of different weights in pediatric 99m Tc-DMSA renal SPECT; and (b) patient girth should be considered instead of weight in developing new administration guidelines for pediatric patients.
PURPOSE: In the current clinical practice, administered activity (AA) for pediatric molecular imaging is often based on the North American expert consensus guidelines or the European Association of Nuclear Medicine dosage card, both of which were developed based on the best clinical practice. These guidelines were not formulated using a rigorous evaluation of diagnostic image quality (IQ) relative to AA. In the guidelines, AA is determined by a weight-based scaling of the adult AA, along with minimum and maximum AA constraints. In this study, we use task-based IQ assessment methods to rigorously evaluate the efficacy of weight-based scaling in equalizing IQ using a population of pediatric patients of different ages and body weights. METHODS: A previously developed projection image database was used. We measured task-based IQ, with respect to the detection of a renal functional defect at six different AA levels (AA relative to the AA obtained from the guidelines). IQ was assessed using an anthropomorphic model observer. Receiver-operating characteristics (ROC) analysis was applied; the area under the ROC curve (AUC) served as a figure-of-merit for task performance. In addition, we investigated patient girth (circumference) as a potential improved predictor of the IQ. RESULTS: The data demonstrate a monotonic and modestly saturating increase in AUC with increasing AA, indicating that defect detectability was limited by quantum noise and the effects of object variability were modest over the range of AA levels studied. The AA for a given value of the AUC increased with increasing age. The AUC vs AA plots for all the patient ages indicate that, for the current guidelines, the newborn and 10- and 15-yr phantoms had similar IQ for the same AA suggested by the North American expert consensus guidelines, but the 5- and 1-yr phantoms had lower IQ. The results also showed that girth has a stronger correlation with the needed AA to provide a constant AUC for 99m Tc-DMSA renal SPECT. CONCLUSIONS: The results suggest that (a) weight-based scaling is not sufficient to equalize task-based IQ for patients of different weights in pediatric 99m Tc-DMSA renal SPECT; and (b) patient girth should be considered instead of weight in developing new administration guidelines for pediatric patients.
Authors: Xin Li; Abhinav K Jha; Michael Ghaly; Fatma E A Elshahaby; Jonathan M Links; Eric C Frey Journal: IEEE Trans Med Imaging Date: 2016-12-22 Impact factor: 10.048
Authors: Ye Li; Shannon O'Reilly; Donika Plyku; S Ted Treves; Yong Du; Frederic Fahey; Xinhua Cao; Abhinav K Jha; George Sgouros; Wesley E Bolch; Eric C Frey Journal: Phys Med Biol Date: 2018-07-09 Impact factor: 3.609
Authors: Ye Li; Junyu Chen; Justin L Brown; S Ted Treves; Xinhua Cao; Frederic H Fahey; George Sgouros; Wesley E Bolch; Eric C Frey Journal: J Med Imaging (Bellingham) Date: 2021-01-28
Authors: Donika Plyku; Michael Ghaly; Ye Li; Justin L Brown; Shannon O'Reilly; Kitiwat Khamwan; Alison B Goodkind; Briana Sexton-Stallone; Xinhua Cao; David Zurakowski; Frederic H Fahey; S Ted Treves; Wesley E Bolch; Eric C Frey; George Sgouros Journal: EJNMMI Phys Date: 2021-07-20