Johannes Tran-Gia1, Ana M Denis-Bacelar2, Kelley M Ferreira2, Andrew P Robinson2,3,4, Nicholas Calvert3, Andrew J Fenwick2,5, Domenico Finocchiaro6,7, Federica Fioroni6, Elisa Grassi6, Warda Heetun2, Stephanie J Jewitt8, Maria Kotzassarlidou9, Michael Ljungberg10, Daniel R McGowan8,11, Nathaniel Scott8, James Scuffham2,12,13, Katarina Sjögreen Gleisner10, Jill Tipping3, Jill Wevrett2,12,13, Michael Lassmann14. 1. Department of Nuclear Medicine, University of Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Germany. Tran_J@ukw.de. 2. National Physical Laboratory, Teddington, UK. 3. Christie Medical Physics and Engineering (CMPE), The Christie NHS Foundation Trust, Manchester, UK. 4. The University of Manchester, Manchester, UK. 5. Cardiff University, Cardiff, UK. 6. Medical Physics Unit, Azienda Unità Sanitaria Locale di Reggio Emilia-IRCCS, Reggio Emilia, Italy. 7. Department of Physics and Astronomy, University of Bologna, Bologna, Italy. 8. Radiation Physics and Protection, Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK. 9. Nuclear Medicine Department, "THEAGENIO" Anticancer Hospital, Thessaloniki, Greece. 10. Medical Radiation Physics, Lund, Lund University, Lund, Sweden. 11. Department of Oncology, University of Oxford, Oxford, UK. 12. Royal Surrey County Hospital, Guildford, UK. 13. Department of Physics, University of Surrey, Guildford, UK. 14. Department of Nuclear Medicine, University of Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Germany.
Abstract
PURPOSE: Patient-specific dosimetry is required to ensure the safety of molecular radiotherapy and to predict response. Dosimetry involves several steps, the first of which is the determination of the activity of the radiopharmaceutical taken up by an organ/lesion over time. As uncertainties propagate along each of the subsequent steps (integration of the time-activity curve, absorbed dose calculation), establishing a reliable activity quantification is essential. The MRTDosimetry project was a European initiative to bring together expertise in metrology and nuclear medicine research, with one main goal of standardizing quantitative 177Lu SPECT/CT imaging based on a calibration protocol developed and tested in a multicentre inter-comparison. This study presents the setup and results of this comparison exercise. METHODS: The inter-comparison included nine SPECT/CT systems. Each site performed a set of three measurements with the same setup (system, acquisition and reconstruction): (1) Determination of an image calibration for conversion from counts to activity concentration (large cylinder phantom), (2) determination of recovery coefficients for partial volume correction (IEC NEMA PET body phantom with sphere inserts), (3) validation of the established quantitative imaging setup using a 3D printed two-organ phantom (ICRP110-based kidney and spleen). In contrast to previous efforts, traceability of the activity measurement was required for each participant, and all participants were asked to calculate uncertainties for their SPECT-based activities. RESULTS: Similar combinations of imaging system and reconstruction lead to similar image calibration factors. The activity ratio results of the anthropomorphic phantom validation demonstrate significant harmonization of quantitative imaging performance between the sites with all sites falling within one standard deviation of the mean values for all inserts. Activity recovery was underestimated for total kidney, spleen, and kidney cortex, while it was overestimated for the medulla. CONCLUSION: This international comparison exercise demonstrates that harmonization of quantitative SPECT/CT is feasible when following very specific instructions of a dedicated calibration protocol, as developed within the MRTDosimetry project. While quantitative imaging performance demonstrates significant harmonization, an over- and underestimation of the activity recovery highlights the limitations of any partial volume correction in the presence of spill-in and spill-out between two adjacent volumes of interests.
PURPOSE:Patient-specific dosimetry is required to ensure the safety of molecular radiotherapy and to predict response. Dosimetry involves several steps, the first of which is the determination of the activity of the radiopharmaceutical taken up by an organ/lesion over time. As uncertainties propagate along each of the subsequent steps (integration of the time-activity curve, absorbed dose calculation), establishing a reliable activity quantification is essential. The MRTDosimetry project was a European initiative to bring together expertise in metrology and nuclear medicine research, with one main goal of standardizing quantitative 177Lu SPECT/CT imaging based on a calibration protocol developed and tested in a multicentre inter-comparison. This study presents the setup and results of this comparison exercise. METHODS: The inter-comparison included nine SPECT/CT systems. Each site performed a set of three measurements with the same setup (system, acquisition and reconstruction): (1) Determination of an image calibration for conversion from counts to activity concentration (large cylinder phantom), (2) determination of recovery coefficients for partial volume correction (IEC NEMA PET body phantom with sphere inserts), (3) validation of the established quantitative imaging setup using a 3D printed two-organ phantom (ICRP110-based kidney and spleen). In contrast to previous efforts, traceability of the activity measurement was required for each participant, and all participants were asked to calculate uncertainties for their SPECT-based activities. RESULTS: Similar combinations of imaging system and reconstruction lead to similar image calibration factors. The activity ratio results of the anthropomorphic phantom validation demonstrate significant harmonization of quantitative imaging performance between the sites with all sites falling within one standard deviation of the mean values for all inserts. Activity recovery was underestimated for total kidney, spleen, and kidney cortex, while it was overestimated for the medulla. CONCLUSION: This international comparison exercise demonstrates that harmonization of quantitative SPECT/CT is feasible when following very specific instructions of a dedicated calibration protocol, as developed within the MRTDosimetry project. While quantitative imaging performance demonstrates significant harmonization, an over- and underestimation of the activity recovery highlights the limitations of any partial volume correction in the presence of spill-in and spill-out between two adjacent volumes of interests.
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Authors: Ken Herrmann; Luca Giovanella; Andrea Santos; Jonathan Gear; Pinar Ozgen Kiratli; Jens Kurth; Ana M Denis-Bacelar; Roland Hustinx; Marianne Patt; Richard L Wahl; Diana Paez; Francesco Giammarile; Hossein Jadvar; Neeta Pandit-Taskar; Munir Ghesani; Jolanta Kunikowska Journal: Eur J Nucl Med Mol Imaging Date: 2022-04-11 Impact factor: 10.057