FAPI-04 Uptake in Healthy Tissues of Cancer Patients in 68Ga-FAPI-04 PET/CT Imaging

Objective. The aim of this study is to investigate the uptake of 68Ga-FAPI-04 in normal tissues and calculate standardized uptake values (SUVs) for various organs in the body. Methods. A total of 49 patients who underwent 68Ga-FAPI-04 PET/CT were included in our study. The following organs were identified on CT images: brain, parotid, and submandibular glands, palatine tonsils, thyroid, lymph nodes (if present), breasts, lungs, thymus, left ventricle walls, mediastinal blood pool, vertebral bone marrow, liver, spleen, pancreas, stomach, small and large intestines, adrenal glands, kidneys, uterus, testes, and prostate. Median, minimum, and maximum values (max) and average (avg) values of standard uptake value (SUV) of tissues and organs were calculated. Results. The accumulation of 68Ga-FAPI in normal organs showed variations. The cerebral/cerebellar cortex exhibited no 68Ga-FAPI uptake, while the scalp showed low uptake. Low uptake was also observed in the lung parenchyma, esophagus, left ventricle walls, nipple, and glandular breast tissue. In the abdominopelvic area, the pancreas exhibited low uptake, which was higher in the tail region. Low uptake was observed in the renal cortex. Intense 68Ga-FAPI uptake was observed throughout the uterus, which was higher in the corpus. There was no uptake of 68Ga-FAPI in the bone cortex and medulla. Conclusion. We determined the physiological uptake and SUVmax of FAPI-04 in different tissues and organs and created a guide for researchers.

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Radiation exposure of patients during 68Ga-DOTATOC PET/CT examinations

Nuklearmedizin ◽

10.3413/nukmed-0214 ◽

2009 ◽

Vol 48 (05) ◽

pp. 201-207 ◽

Cited By ~ 30

Author(s):

K. Zöphel ◽

R. Freudenberg ◽

L. Oehme ◽

M. Andreeff ◽

G. Wunderlich ◽

...

Keyword(s):

Pituitary Gland ◽

Radiation Exposure ◽

Somatostatin Receptor ◽

Blood Pool ◽

Biological Data ◽

Whole Body ◽

Physiological Uptake ◽

Standardized Uptake Values ◽

Pet Ct ◽

Routine Clinical Setting

Summary Aim: Investigation of the biodistribution and calculation of dosimetry of Ga-68-DOTATOCfor patients imaged in the routine clinical setting for diagnosis or exclusion of neuroendocrine tumours. Patients, methods: Dynamic PET/CT-imaging (Biograph 16) was performed over 20 min in 14 patients (8 men, 6 women) after injection of (112 ± 22) MBq 68Ga-DOTATOC followed by whole body 3D-acquisition (8 bed positions, 3 or 4 min each) 30 min p.i. and 120 min p.i. Urinary tracer elimination was measured and blood activity was derived non-invasively from the blood pool of the heart. The relevant organs for dosimetry were spleen, kidneys, liver, adrenals, urinary bladder and pituitary gland. Dosimetry was performed using OLINDA/ EXM 1.0 software and specific organ uptake was expressed as standardized uptake values (SUVs). Results: Rapid physiological uptake of the radiotracer could be demonstrated in liver, spleen and kidneys, adrenals and pituitary gland (mean SUVs were 6, 20, 16, 10, and 4, respectively). Radiotracer elimination was exclusively via urine (16% of injected dose within 2h); no redistribution could be observed. The spleen and the kidneys received the highest radiation exposure (0.24 mSv/MBq, 0.22 mSv/MBq resp.), mean effective dose yielded 0.023 mSv/MBq. Conclusion: 68Ga-DOTATOC is used extensively for diagnosis of somatostatin receptor positive tumours because it has several advantages over the 111In-labelled ligand. The derived dosimetric values are lower than first approximations from the biological data of OctreoScan. The use of CT for transmission correction of the PET data delivers radiation exposure up to 1 mSv (low dose).

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Resection of a large primary left ventricle tumour by cardiac autotransplantation in a 2-month-old infant: a case report

European Heart Journal - Case Reports ◽

10.1093/ehjcr/ytz205 ◽

2019 ◽

Author(s):

Yuhang Liu ◽

Ning Wang ◽

Ping Wen ◽

Gengxu Zhou

Keyword(s):

Left Ventricle ◽

Left Atrium ◽

The Body ◽

Chordae Tendineae ◽

Anatomical Structures ◽

Normal Tissues ◽

Cardiac Tumours ◽

Primary Cardiac Tumour ◽

Successful Case ◽

Large Primary

Abstract Background Surgery is the fundamental method for the treatment of primary cardiac tumours. However, due to the inaccessibility of anatomy and the proximity of important structures, it is very difficult to completely resect tumours of the left atrium or left ventricle without damaging the normal tissues. Cardiac autotransplantation for the resection of cardiac tumours is carried out by taking out the heart from the body, resecting cardiac tumours, and then transplanting the heart back into the body. Case summary This article presents a successful case of cardiac autotransplantation for the complete resection of primary cardiac tumour in a 2-month-old infant and shares the noteworthy experience. Discussion Tumours located in the left atrium and left ventricle are difficult to be exposed because of their deep posterior location and proximity to important anatomical structures such as mitral valve and chordae tendineae. How to resect the tumours completely without damaging the normal tissues is a great challenge. This case proves that cardiac autotransplantation is a good solution for tumours that are difficult to be resected completely by orthotopic cardiac transplantation.

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Day-to-day variability of [68Ga]Ga-PSMA-11 accumulation in primary prostate cancer: effects on tracer uptake and visual interpretation

EJNMMI Research ◽

10.1186/s13550-020-00708-z ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Judith olde Heuvel ◽

Berlinda J. de Wit-van der Veen ◽

Maarten L. Donswijk ◽

Cornelis H. Slump ◽

Marcel P. M. Stokkel

Keyword(s):

Prostate Cancer ◽

Blood Pool ◽

Prostate Tumor ◽

Ct Scans ◽

Response Monitoring ◽

Clinical Indication ◽

Repeatability Coefficient ◽

Normal Tissues ◽

Psma Pet ◽

Pet Ct

Abstract Purpose Prostate-specific membrane antigen (PSMA) agents, such as [68Ga]Ga-PSMA-11, have an unprecedented accuracy in staging prostate cancer (PCa) and detecting disease recurrence. PSMA PET/CT may also be used for response monitoring by displaying molecular changes, instead of morphological changes alone. However, there are still limited data available on the variability in biodistribution and intra-prostatic uptake of PSMA targeting radiotracers. Therefore, the aim of this study was to assess the repeatability of [68Ga]Ga-PSMA-11 uptake in primary PCa patients in a 4-week interval. Methods Twenty-four primary PCa patients were prospectively included, who already were scheduled for [68Ga]Ga-PSMA-11 PET/CT scan on clinical indication (≥ cT3, Gleason score ≥ 7 or PSA ≥ 20 ng/mL). These patients received two [68Ga]Ga-PSMA-11 PET/CT scans with a 4-week interval. No treatment was started in between the scans. Semiquantitative measurements (SULmax, SULmean, and SULpeak) were determined in the prostate tumor, normal tissues, and blood pool. The repeatability coefficient of every region was determined. All scans were visually analyzed by two nuclear medicine physicians. Results Within-subject coefficient of variation of [68Ga]Ga-PSMA-11 uptake between the two scans was on average 10% in the prostate tumor, normal tissues (liver, kidney, parotid), and blood pool. The repeatability coefficient of the prostate tumor was 18% for SULpeak and 22% for SULmax. Lesion uptake was visually different in 5 patients, though not clinically relevant. Conclusion Results of test-retest [68Ga]Ga-PSMA-11 PET/CT scans in a 4-week interval show that [68Ga]Ga-PSMA-11 uptake is repeatable, with a clinical irrelevant variation in tumor and physiological distribution. Based on the presented repeatable uptake, [68Ga]Ga-PSMA-11 PET/CT scans can potentially be used for disease surveillance and therapy response monitoring. Changes in uptake larger than the RC are therefore likely to reflect actual biological changes in PSMA expression. Trial registration NL8263 at Trialregister.nl retrospectively registered on 03-01-2020. https://www.trialregister.nl/trial/8263

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Head-to-Head Comparison of [68Ga]Ga-P16-093 and [68Ga]Ga-PSMA-617 in Dynamic PET/CT Evaluation of the Same Group of Recurrent Prostate Cancer Patients

10.21203/rs.3.rs-739096/v1 ◽

2021 ◽

Author(s):

Guochang Wang ◽

Haiyan Hong ◽

Jie Zang ◽

Qingxing Liu ◽

Yuanyuan Jiang ◽

...

Keyword(s):

Prostate Cancer ◽

Ct Scan ◽

Cancer Patients ◽

Blood Pool ◽

Organ Distribution ◽

Dynamic Pet ◽

Recurrent Prostate Cancer ◽

Detection Ability ◽

Standardized Uptake Values ◽

Pet Ct

Abstract Purpose: This study was prospectively designed to evaluate the early dynamic organ distribution and tumor detection ability of [68Ga]Ga-P16-093, which was compared with [68Ga]Ga-PSMA-617 in the same group of recurrent prostate cancer patients.Methods: Twenty patients with recurrent prostate cancer were enrolled. In two consecutive days, each patient underwent a 60-min dynamic PET/CT scan after intravenous administration of 148–185 MBq (4–5 mCi) [68Ga]Ga-P16-093 and [68Ga]Ga-PSMA-617, respectively. Following a low-dose CT scan, serial dynamic PET scans were performed from head to proximate thigh at 9 time points (30 sec/bed at 4, 7, 10, 13 and 16 min, 1 min/bed at 20, 30 and 45 min, and 2 min/bed at 60 min). Standardized uptake values were measured for semi-quantitative comparison.Results: [68Ga]Ga-P16-093 PET/CT revealed a significantly higher tumor uptake at 4 min (SUVmax 7.88 ± 5.26 vs. 6.01 ± 3.88, P < 0.001), less blood pool retention at 4 min (SUVmean 5.12 ± 1.16 vs. 6.14 ± 0.98, P < 0.001) and lower bladder accumulation at 60 min (SUVmean 31.33 ± 27.47 vs. 48.74 ± 34.01, P = 0.042) than [68Ga]Ga-PSMA-617 scan. Significantly higher [68Ga]Ga-P16-093 uptakes were also observed in the parotid gland, liver, spleen and kidney. Besides, [68Ga]Ga-P16-093 exhibited a better detection ability than [68Ga]Ga-PSMA-617 (366 vs. 321, P = 0.009).Conclusions: [68Ga]Ga-P16-093 showed advantages over [68Ga]Ga-PSMA-617 with higher tumor uptakes, tumor-to-blood pool ratio and detection ability, less blood pool and bladder accumulation in recurrent prostate cancer patients.Trial registration [68Ga]Ga-P16-093 and [68Ga]Ga-PSMA-617 PET/CT Imaging in the Same Group of Prostate Cancer Patients (NCT04796467, Registered 12 March 2021, retrospectively registered)URL of registry https://clinicaltrials.gov/ct2/show/NCT04796467

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Influence of scan time point and volume of intravenous contrast administration on blood-pool and liver SUVmax and SUVmean in [18F] FDG PET/CT

Nuklearmedizin ◽

10.3413/nukmed-0919-17-08 ◽

2018 ◽

Vol 57 (02) ◽

pp. 50-55

Author(s):

Timm Braun ◽

Panagiota Manava ◽

Sigrid Ludwigs ◽

Michael Lell ◽

Matthias Schoen

Keyword(s):

Fdg Pet ◽

Contrast Material ◽

Blood Pool ◽

Intravenous Contrast ◽

Scan Time ◽

Standardized Uptake Values ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct ◽

Time Point

Summary Aim: To investigate the influence of scan time point and volume of intravenous contrast material in 18F-FDG PET/CT on maximum and mean standardized uptake values (SUVmax/mean) in bloodpool and liver. Methods: In 120 patients scheduled for routine whole-body 18F-FDG PET/CT the maximum and mean standardized uptake values (SUVmax/SUVmean) in the liver and blood pool were measured after varying scan time-point (delay 0 s-140 s post injectionem) and volume of contrast material (CM; 0 ml, 80 ml, 100 ml of 300 mg/ml of Iodine). Six groups of 20 patients were investigated: (1) without intravenous CM, (2-5) injection of 100 ml CM with a delay of 80 s (2), 100 s (3), 120 s (4), 140 s (5), and 80 ml CM and a delay of 100 s (6). SUVmax, SUVmean, maximum Hounsfield units (HUmax) and average Hounsfield units (HUav) were calculated with the use of manually drawn regions of interests (ROIs) over the aortic arch and healthy liver tissue. Results: SUVmax in bloodpool was significantly higher in group 3, 4 and 6 compared to group 1. Groups 2 and 5 also showed higher mean values of SUVmax, but the difference was not significant. SUVmean in bloodpool was also higher in groups 2, 3, 4, 5 and 6 compared to group 1, but the differences were only statistically significant in group 3. Both SUVmax and SUVmean in healthy liver tissue did not show significant differences when compared to the non contrast-enhanced control group. Conclusion: SUVmax and to a lesser extent SUVmean measured in CM enhanced FDG PET/CT in blood pool could be significantly altered in high contrast CT examinations. This should be kept in mind in PET/CT protocols and evaluation relying on SUVmax and SUVmean, for example when used in the assessment of therapy response, especially in highly vascularized tumor lesions.

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Standardised uptake values of 2-deoxy-2-[18F]fluoro-d-glucose using PET/CT in normal cats

Veterinární Medicína ◽

10.17221/6701-vetmed ◽

2013 ◽

Vol 58 (No. 2) ◽

pp. 96-104 ◽

Cited By ~ 1

Author(s):

YK Cho ◽

KC Lee

Keyword(s):

Blood Pool ◽

Left Ventricular ◽

Field Of View ◽

Ct Scanner ◽

Left Ventricular Free Wall ◽

Hepatic Parenchyma ◽

Standardized Uptake Values ◽

Pet Ct ◽

Normal Humans ◽

Left And Right

In this study we assessed the normal physiological and dynamic thoracoabdominal distribution of 18F fluorodeoxyglucose (18F-FDG) uptake and the standardized uptake values (SUVs) of the major parenchymal organs in five normal young adult domestic short haired cats. Dynamic PET data were acquired with a transaxial field-of-view (FOV) PET/CT scanner, Regions of interests (ROIs) were manually drawn over the left ventricular free wall, left ventricular blood pool, liver, spleen, and left and right renal cortices. The SUVs of these organs were calculated for 5-min frames over the 90 min acquisition. The uptake of 18F-FDG within the major organs, showed a tendency to gradually decline, except for the left ventricle and blood pool. The decrease in SUV was rapid after injection with a plateau occurring after 30 minutes. The uptake of 18F -FDG within the hepatic parenchyma was low compared to that in the kidney at the beginning of study. A steady decline in the hepatic parenchyma SUV was quite similar to that observed for the kidneys .The SUV of 18F-FDG within the spleen was low. Uptake of 18F-FDG within the myocardium was minimal. These SUV data from the parenchymal organs of normal cats compares favourably with those of normal humans and dogs and can be used in feline studies using PET/CT for the evaluation of various diseases. Furthermore, PET/CT can provide higher quality images over shorter examination times than conventional PET.

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[18F]-florbetaben PET/CT Imaging in the Alzheimer’s Disease Mouse Model APPswe/PS1dE9

Current Alzheimer Research ◽

10.2174/1567205015666181022095904 ◽

2018 ◽

Vol 16 (1) ◽

pp. 49-55 ◽

Cited By ~ 1

Author(s):

J. Stenzel ◽

C. Rühlmann ◽

T. Lindner ◽

S. Polei ◽

S. Teipel ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Mouse Model ◽

New Drugs ◽

Imaging Data ◽

Wild Type ◽

Preclinical Research ◽

Standardized Uptake Values ◽

Pet Ct

Background: Positron-emission-tomography (PET) using 18F labeled florbetaben allows noninvasive in vivo-assessment of amyloid-beta (Aβ), a pathological hallmark of Alzheimer’s disease (AD). In preclinical research, [18F]-florbetaben-PET has already been used to test the amyloid-lowering potential of new drugs, both in humans and in transgenic models of cerebral amyloidosis. The aim of this study was to characterize the spatial pattern of cerebral uptake of [18F]-florbetaben in the APPswe/ PS1dE9 mouse model of AD in comparison to histologically determined number and size of cerebral Aβ plaques. Methods: Both, APPswe/PS1dE9 and wild type mice at an age of 12 months were investigated by smallanimal PET/CT after intravenous injection of [18F]-florbetaben. High-resolution magnetic resonance imaging data were used for quantification of the PET data by volume of interest analysis. The standardized uptake values (SUVs) of [18F]-florbetaben in vivo as well as post mortem cerebral Aβ plaque load in cortex, hippocampus and cerebellum were analyzed. Results: Visual inspection and SUVs revealed an increased cerebral uptake of [18F]-florbetaben in APPswe/ PS1dE9 mice compared with wild type mice especially in the cortex, the hippocampus and the cerebellum. However, SUV ratios (SUVRs) relative to cerebellum revealed only significant differences in the hippocampus between the APPswe/PS1dE9 and wild type mice but not in cortex; this differential effect may reflect the lower plaque area in the cortex than in the hippocampus as found in the histological analysis. Conclusion: The findings suggest that histopathological characteristics of Aβ plaque size and spatial distribution can be depicted in vivo using [18F]-florbetaben in the APPswe/PS1dE9 mouse model.

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Head-to-head intra-individual comparison of biodistribution and tumor uptake of 68Ga-FAPI and 18F-FDG PET/CT in cancer patients

European Journal of Nuclear Medicine and Molecular Imaging ◽

10.1007/s00259-021-05307-1 ◽

2021 ◽

Author(s):

Frederik L. Giesel ◽

Clemens Kratochwil ◽

Joel Schlittenhardt ◽

Katharina Dendl ◽

Matthias Eiber ◽

...

Keyword(s):

Fdg Pet ◽

Standard Of Care ◽

Blood Pool ◽

Tracer Uptake ◽

Time Interval ◽

Tumor Uptake ◽

Primary Tumors ◽

Individual Comparison ◽

Pet Ct ◽

Fdg Pet Ct

Abstract Purpose FAPI ligands (fibroblast activation protein inhibitor), a novel class of radiotracers for PET/CT imaging, demonstrated in previous studies rapid and high tumor uptake. The purpose of this study is the head-to-head intra-individual comparison of 68Ga-FAPI versus standard-of-care 18F-FDG in PET/CT in organ biodistribution and tumor uptake in patients with various cancers. Material and Methods This international retrospective multicenter analysis included PET/CT data from 71 patients from 6 centers who underwent both 68Ga-FAPI and 18F-FDG PET/CT within a median time interval of 10 days (range 1–89 days). Volumes of interest (VOIs) were manually drawn in normal organs and tumor lesions to quantify tracer uptake by SUVmax and SUVmean. Furthermore, tumor-to-background ratios (TBR) were generated (SUVmax tumor/ SUVmax organ). Results A total of 71 patients were studied of, which 28 were female and 43 male (median age 60). In 41 of 71 patients, the primary tumor was present. Forty-three of 71 patients exhibited 162 metastatic lesions. 68Ga-FAPI uptake in primary tumors and metastases was comparable to 18F-FDG in most cases. The SUVmax was significantly lower for 68Ga-FAPI than 18F-FDG in background tissues such as the brain, oral mucosa, myocardium, blood pool, liver, pancreas, and colon. Thus, 68Ga-FAPI TBRs were significantly higher than 18F-FDG TBRs in some sites, including liver and bone metastases. Conclusion Quantitative tumor uptake is comparable between 68Ga-FAPI and 18F-FDG, but lower background uptake in most normal organs results in equal or higher TBRs for 68Ga-FAPI. Thus, 68Ga-FAPI PET/CT may yield improved diagnostic information in various cancers and especially in tumor locations with high physiological 18F-FDG uptake.

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Implications of Standardized Uptake Values of Oral Squamous Cell Carcinoma in PET-CT on Prognosis, Tumor Characteristics and Mitochondrial DNA Heteroplasmy

Cancers ◽

10.3390/cancers13092273 ◽

2021 ◽

Vol 13 (9) ◽

pp. 2273

Author(s):

Lukas Latzko ◽

Bernd Schöpf ◽

Hansi Weissensteiner ◽

Federica Fazzini ◽

Liane Fendt ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Mitochondrial Dna ◽

Oral Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Survival Rates ◽

Tumor Characteristics ◽

Dna Mutations ◽

Standardized Uptake Values ◽

Pet Ct

Under aerobic conditions, some cancers switch to glycolysis to cover their energy requirements. Taking advantage of this process, functional imaging techniques such as PET-CT can be used to detect and assess tumorous tissues. The aim of this study was to investigate standardized uptake values and mitochondrial DNA mutations in oral squamous cell carcinoma. A cohort of 57 patients underwent 18[F]FDG-PET-CT and standardized uptake values were collected. In 15 patients, data on mitochondrial DNA mutations of the tumor were available. Kaplan–Meier curves were calculated, and correlation analyses as well as univariate Cox proportional hazard models were performed. Using ROC analysis to determine a statistical threshold for SUVmax in PET investigations, a cut-off value was determined at 9.765 MB/mL. Survival analysis for SUVmax in these groups showed a Hazard Ratio of 4 (95% CI 1.7–9) in the high SUVmax group with 5-year survival rates of 23.5% (p = 0.00042). For SUVmax and clinicopathological tumor features, significant correlations were found. A tendency towards higher mtDNA heteroplasmy levels in high SUVmax groups could be observed. We were able to confirm the prognostic value of SUVmax in OSCC, showing higher survival rates at lower SUVmax levels. Correlations between SUVmax and distinct tumor characteristics were highly significant, providing evidence that SUVmax may act as a reliable diagnostic parameter. Correlation analysis of mtDNA mutations suggests an influence on metabolic activity in OSCC.

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Comparison between silicon photomultiplier-based and conventional PET/CT in patients with suspected lung cancer—a pilot study

EJNMMI Research ◽

10.1186/s13550-019-0504-y ◽

2019 ◽

Vol 9 (1) ◽

Cited By ~ 1

Author(s):

Johan Economou Lundeberg ◽

Jenny Oddstig ◽

Ulrika Bitzén ◽

Elin Trägårdh

Keyword(s):

Lung Cancer ◽

Expectation Maximization ◽

Image Interpretation ◽

Imaging Study ◽

Reconstruction Algorithm ◽

Tnm Staging ◽

Reconstruction Algorithms ◽

Silicon Photomultiplier ◽

Standardized Uptake Values ◽

Pet Ct

Abstract Background Lung cancer is one of the most common cancers in the world. Early detection and correct staging are fundamental for treatment and prognosis. Positron emission tomography with computed tomography (PET/CT) is recommended clinically. Silicon (Si) photomultiplier (PM)-based PET technology and new reconstruction algorithms are hoped to increase the detection of small lesions and enable earlier detection of pathologies including metastatic spread. The aim of this study was to compare the diagnostic performance of a SiPM-based PET/CT (including a new block-sequential regularization expectation maximization (BSREM) reconstruction algorithm) with a conventional PM-based PET/CT including a conventional ordered subset expectation maximization (OSEM) reconstruction algorithm. The focus was patients admitted for 18F-fluorodeoxyglucose (FDG) PET/CT for initial diagnosis and staging of suspected lung cancer. Patients were scanned on both a SiPM-based PET/CT (Discovery MI; GE Healthcare, Milwaukee, MI, USA) and a PM-based PET/CT (Discovery 690; GE Healthcare, Milwaukee, MI, USA). Standardized uptake values (SUV) and image interpretation were compared between the two systems. Image interpretations were further compared with histopathology when available. Results Seventeen patients referred for suspected lung cancer were included in our single injection, dual imaging study. No statically significant differences in SUVmax of suspected malignant primary tumours were found between the two PET/CT systems. SUVmax in suspected malignant intrathoracic lymph nodes was 10% higher on the SiPM-based system (p = 0.026). Good consistency (14/17 cases) between the PET/CT systems were found when comparing simplified TNM staging. The available histology results did not find any obvious differences between the systems. Conclusion In a clinical setting, the new SiPM-based PET/CT system with a new BSREM reconstruction algorithm provided a higher SUVmax for suspected lymph node metastases compared to the PM-based system. However, no improvement in lung cancer detection was seen.

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