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A multicentre and multi-national evaluation of the accuracy of quantitative Lu-177 SPECT/CT imaging performed within the MRTDosimetry project

Tran-Gia, Johannes ; Denis-Bacelar, Ana M. ; Ferreira, Kelley M. ; Robinson, Andrew P. ; Calvert, Nicholas ; Fenwick, Andrew J. ; Finocchiaro, Domenico ; Fioroni, Federica ; Grassi, Elisa LU and Heetun, Warda , et al. (2021) In EJNMMI Physics 8(1).
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... (More)

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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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Lu SPECT/CT imaging, 3D printing, Harmonization of SPECT/CT imaging, International multicenter comparison exercise, Molecular radiotherapy (MRT), Phantom, Quantitative SPECT/CT, Standardization of SPECT/CT imaging, Traceability of SPECT/CT imaging
in
EJNMMI Physics
volume
8
issue
1
article number
55
publisher
Springer
external identifiers
  • pmid:34297218
  • scopus:85111708621
ISSN
2197-7364
DOI
10.1186/s40658-021-00397-0
language
English
LU publication?
yes
id
55a85ccb-d9c5-49c6-a4d6-656163960b54
date added to LUP
2021-08-26 13:50:36
date last changed
2024-04-06 07:37:47
@article{55a85ccb-d9c5-49c6-a4d6-656163960b54,
  abstract     = {{<p>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 <sup>177</sup>Lu 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.</p>}},
  author       = {{Tran-Gia, Johannes and Denis-Bacelar, Ana M. and Ferreira, Kelley M. and Robinson, Andrew P. and Calvert, Nicholas and Fenwick, Andrew J. and Finocchiaro, Domenico and Fioroni, Federica and Grassi, Elisa and Heetun, Warda and Jewitt, Stephanie J. and Kotzassarlidou, Maria and Ljungberg, Michael and McGowan, Daniel R. and Scott, Nathaniel and Scuffham, James and Gleisner, Katarina Sjögreen and Tipping, Jill and Wevrett, Jill and Lassmann, Michael}},
  issn         = {{2197-7364}},
  keywords     = {{Lu SPECT/CT imaging; 3D printing; Harmonization of SPECT/CT imaging; International multicenter comparison exercise; Molecular radiotherapy (MRT); Phantom; Quantitative SPECT/CT; Standardization of SPECT/CT imaging; Traceability of SPECT/CT imaging}},
  language     = {{eng}},
  number       = {{1}},
  publisher    = {{Springer}},
  series       = {{EJNMMI Physics}},
  title        = {{A multicentre and multi-national evaluation of the accuracy of quantitative Lu-177 SPECT/CT imaging performed within the MRTDosimetry project}},
  url          = {{http://dx.doi.org/10.1186/s40658-021-00397-0}},
  doi          = {{10.1186/s40658-021-00397-0}},
  volume       = {{8}},
  year         = {{2021}},
}