scholarly journals The 2020 national diagnostic reference levels for nuclear medicine in Japan

2020 ◽  
Vol 34 (11) ◽  
pp. 799-806
Author(s):  
Koichiro Abe ◽  
Makoto Hosono ◽  
Takayuki Igarashi ◽  
Takashi Iimori ◽  
Masanobu Ishiguro ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Nuclear Medicine ◽  
Radiation Dose ◽  
Single Photon ◽  
Photon Emission ◽  
Emission Computed Tomography ◽  
Diagnostic Reference Levels ◽  
Reference Levels ◽  
Positron Emission ◽  
Pet Ct

Abstract The diagnostic reference levels (DRLs) are one of several effective tools for optimizing nuclear medicine examinations and reducing patient exposure. With the advances in imaging technology and alterations of examination protocols, the DRLs must be reviewed periodically. The first DRLs in Japan were established in 2015, and since 5 years have passed, it is time to review and revise the DRLs. We conducted a survey to investigate the administered activities of radiopharmaceuticals and the radiation doses of computed tomography (CT) in hybrid CT accompanied by single photon emission computed tomography (SPECT)/CT and positron emission tomography (PET)/CT. We distributed a Web-based survey to 915 nuclear medicine facilities throughout Japan and survey responses were provided by 256 nuclear medicine facilities (response rate 28%). We asked for the facility's median actual administered activity and median radiation dose of hybrid CT when SPECT/CT or PET/CT was performed for patients with standard habitus in the standard protocol of the facility for each nuclear medicine examination. We determined the new DRLs based on the 75th percentile referring to the 2015 DRLs, drug package inserts, and updated guidelines. The 2020 DRLs are almost the same as the 2015 DRLs, but for the relatively long-lived radionuclides, the DRLs are set low due to the changes in the Japanese delivery system. There are no items set higher than the previous values. Although the DRLs determined this time are roughly equivalent to the DRLs used in the US, overall they tend to be higher than the European DRLs. The DRLs of the radiation dose of CT in hybrid CT vary widely depending on each imaging site and the purpose of the examination.

scholarly journals PET – advanced nuclear imaging technology for medicine

2019 ◽  
Vol 65 (3) ◽  
Author(s):  
Hanna Piwowarska-Bilska ◽  
Aleksandra Supińska ◽  
Jacek Iwanowski ◽  
Adriana Tyczyńska ◽  
Bożena Birkenfeld
Keyword(s):  
Computed Tomography ◽  
Nuclear Medicine ◽  
Single Photon ◽  
Photon Emission ◽  
Nuclear Imaging ◽  
Emission Computed Tomography ◽  
Ct Scanner ◽  
Imaging Technology ◽  
Positron Emission ◽  
Pet Ct

Positron emission tomography (PET) is currently the most advanced diagnostic imaging technology along with well-known techniques like magnetic resonance imaging (MRI) and computed tomography (CT). Tremendous technical progress in engineering, imaging and radiopharmacy has provided the basis for impressive technological advances in the field of nuclear medicine over the past 50 years. Current nuclear medicine can be divided into 2 groups: the classic, which uses gamma-cameras for single photon emission computed tomography (SPECT) imaging, and the more modern PET technique. The clinical PET technique requires: (i) patient administration of the radiopharmaceutical labelled with a positron emitter, (ii) recording of the gamma radiation emitted from the patient’s body with a dedicated PET/ CT scanner, (iii) processing and analysis of recorded images. This article presents the basics of PET technology and research, and describes new technical trends introduced by the leading manufacturers of PET/CT scanners.

scholarly journals A Nordic survey of CT doses in hybrid PET/CT and SPECT/CT examinations

2019 ◽  
Vol 6 (1) ◽  
Author(s):  
Natalie A. Bebbington ◽  
Bryan T. Haddock ◽  
Henrik Bertilsson ◽  
Eero Hippeläinen ◽  
Ellen M. Husby ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Single Photon ◽  
Photon Emission ◽  
Emission Computed Tomography ◽  
Single Photon Emission ◽  
Positron Emission ◽  
Pet Ct ◽  
Clinical Purpose ◽  
Single Photon Emission Computed ◽  
Photon Emission Computed Tomography

Abstract Background Computed tomography (CT) scans are routinely performed in positron emission tomography (PET) and single photon emission computed tomography (SPECT) examinations globally, yet few surveys have been conducted to gather national diagnostic reference level (NDRL) data for CT radiation doses in positron emission tomography/computed tomography (PET/CT) and single photon emission computed tomography/computed tomography (SPECT/CT). In this first Nordic-wide study of CT doses in hybrid imaging, Nordic NDRL CT doses are suggested for PET/CT and SPECT/CT examinations specific to the clinical purpose of CT, and the scope for optimisation is evaluated. Data on hybrid imaging CT exposures and clinical purpose of CT were gathered for 5 PET/CT and 8 SPECT/CT examinations via designed booklet. For each included dataset for a given facility and scanner type, the computed tomography dose index by volume (CTDIvol) and dose length product (DLP) was interpolated for a 75-kg person (referred to as CTDIvol,75kg and DLP75kg). Suggested NDRL (75th percentile) and achievable doses (50th percentile) were determined for CTDIvol,75kg and DLP75kg according to clinical purpose of CT. Differences in maximum and minimum doses (derived for a 75-kg patient) between facilities were also calculated for each examination and clinical purpose. Results Data were processed from 83 scanners from 43 facilities. Data were sufficient to suggest Nordic NDRL CT doses for the following: PET/CT oncology (localisation/characterisation, 15 systems); infection/inflammation (localisation/characterisation, 13 systems); brain (attenuation correction (AC) only, 11 systems); cardiac PET/CT and SPECT/CT (AC only, 30 systems); SPECT/CT lung (localisation/characterisation, 12 systems); bone (localisation/characterisation, 30 systems); and parathyroid (localisation/characterisation, 13 systems). Great variations in dose were seen for all aforementioned examinations. Greatest differences in DLP75kg for each examination, specific to clinical purpose, were as follows: SPECT/CT lung AC only (27.4); PET/CT and SPECT/CT cardiac AC only (19.6); infection/inflammation AC only (18.1); PET/CT brain localisation/characterisation (16.8); SPECT/CT bone localisation/characterisation (10.0); PET/CT oncology AC only (9.0); and SPECT/CT parathyroid localisation/characterisation (7.8). Conclusions Suggested Nordic NDRL CT doses are presented according to clinical purpose of CT for PET/CT oncology, infection/inflammation, brain, PET/CT and SPECT/CT cardiac, and SPECT/CT lung, bone, and parathyroid. The large variation in doses suggests great scope for optimisation in all 8 examinations.

Is there a role for PET-CT and SPECT-CT in pediatric oncology?

2013 ◽  
Vol 54 (9) ◽  
pp. 1037-1045 ◽  
Author(s):  
Martin Biermann ◽  
Thomas Schwarzlmüller ◽  
Kristine Eldevik Fasmer ◽  
Bernt C Reitan ◽  
Boel Johnsen ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Radiation Dose ◽  
Pediatric Oncology ◽  
Hybrid Imaging ◽  
Single Photon ◽  
Photon Emission ◽  
Soft Tissue Sarcomas ◽  
Somatostatin Analogues ◽  
Emission Computed Tomography ◽  
Pet Ct

During the last decade, hybrid imaging has revolutionized nuclear medicine. Multimodal camera systems, integrating positron emission tomography (PET) or single photon emission computed tomography (SPECT) with computed tomography (CT) now combine the contrast provided by tumor-avid radioactive drugs with the anatomic precision of CT. While PET-CT to a great extent has replaced single-modality PET in adult oncology, the use of PET-CT in children has been controversial, since even the lowest dose CT protocols adds approximately 2 mSv to the radiation dose of about 4 mSv from the PET-study with F-18-fluorodeoxyglucose (F-18-FDG). The article describes the current techniques used, discusses radiation doses and gives an overview of current indications for PET-CT and SPECT-CT in children. Hybrid imaging with a tumor-avid radioactive drug provides extremely high contrast between tumor and background tissues, while the CT component helps to locate the lesion anatomically. Currently both PET-CT and SPECT-CT play a role in pediatric oncology; PET-CT using F-18-FDG particularly for staging and follow-up of lymphoma and brain cancer, bone and soft tissue sarcomas; SPECT-CT with I-123-metaiodobenzylguanidine (MIBG) for tumors of the sympathetic nervous system such as neuroblastoma and pheochromocytoma while the remaining neuroendocrine tumors are imaged with radioactively labeled somatostatin analogues. To reduce radiation dose, a low-dose CT in combination with ultrasound and/or magnetic resonance imaging for the assessment of anatomy is often preferred.

Computerized Tomography (CT) Updates and Challenges in Diagnosis of Bone Metastases During Prostate Cancer

2020 ◽  
Vol 16 (5) ◽  
pp. 565-571
Author(s):  
Jinguo Zhang ◽  
Guanzhong Zhai ◽  
Bin Yang ◽  
Zhenhe Liu
Keyword(s):  
Prostate Cancer ◽  
Computed Tomography ◽  
Bone Metastases ◽  
Computerized Tomography ◽  
Single Photon ◽  
Photon Emission ◽  
Major Complication ◽  
Tracer Uptake ◽  
Emission Computed Tomography ◽  
Pet Ct

Prostate cancer is one of the most common cancers in men. This cancer is often associated with indolent tumors with little or no lethal potential. Some of the patients with aggressive prostate cancer have increased morbidity and early deaths. A major complication in advanced prostate cancer is bone metastasis that mainly results in pain, pathological fractures, and compression of spinal nerves. These complications in turn cause severe pain radiating to the extremities and possibly sensory as well as motor disturbances. Further, in patients with a high risk of metastases, treatment is limited to palliative therapies. Therefore, accurate methods for the detection of bone metastases are essential. Technical advances such as single-photon emission computed tomography/ computed tomography (SPECT/CT) have emerged after the introduction of bone scans. These advanced methods allow tomographic image acquisition and help in attenuation correction with anatomical co-localization. The use of positron emission tomography/CT (PET/CT) scanners is also on the rise. These PET scanners are mainly utilized with 18F-sodium-fluoride (NaF), in order to visualize the skeleton and possible changes. Moreover, NaF PET/CT is associated with higher tracer uptake, increased target-to-background ratio and has a higher spatial resolution. However, these newer technologies have not been adopted in clinical guidelines due to lack of definite evidence in support of their use in bone metastases cases. The present review article is focused on current perspectives and challenges of computerized tomography (CT) applications in cases of bone metastases during prostate cancer.

Neuroimaging and the Origin of Psychiatric Symptoms in Dementia

1997 ◽  
Vol 8 (S3) ◽  
pp. 239-243 ◽  
Author(s):  
David L. Sultzer
Keyword(s):  
Computed Tomography ◽  
Density Functional ◽  
Psychiatric Symptoms ◽  
Functional Neuroimaging ◽  
Single Photon ◽  
Photon Emission ◽  
Emission Computed Tomography ◽  
Positron Emission ◽  
Single Photon Emission Computed ◽  
Photon Emission Computed Tomography

Neuroimaging studies have contributed greatly to our understanding of Alzheimer's disease and other dementias. Computed tomography and magnetic resonance imaging reveal brain structure and aid in the diagnostic evaluation of patients with cognitive impairment. Functional neuroimaging studies use positron emission tomography, single-photon emission computed tomography, and other methods to measure regional cerebral activity, including metabolic rate, blood flow, and neuroreceptor density. Functional neuroimaging results can be useful clinically and have also been used in a variety of research applications to examine physiologic variables in neuropsychiatric illnesses.

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