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A validation protocol for 177Lu-SPECT image quantification as a basis for multi-centre kidney dosimetry

Jessen, Lovisa LU ; Curkic Kapidzic, Selma LU ; Gustafsson, Johan LU orcid ; Larsson, Erik ; Ljungberg, Michael LU orcid ; Sandström, Mattias ; Dalmo, Johanna ; Hagmarker, Linn ; Hindorf, Cecilia LU and Taprogge, Jan , et al. (2025) In Physics in Medicine and Biology 70(11).
Abstract

Objective. Multicentre studies in molecular radiotherapy face challenges in ensuring the comparability of dosimetry results. The aim of this study was to develop a validation protocol to achieve equivalent 177Lu-SPECT quantification across centres, consisting of a test exercise in combination with an action level. Approach. 177Lu-SPECT/CT imaging of 3D-printed kidney phantoms with non-uniform activity distributions was conducted at five hospitals in Sweden and the UK. In total, 12 quantification systems (QSs) were included, where a QS was defined as the combination of a given camera system, reconstruction method and image-analysis method. The accuracy of image-based estimates of the activity concentration was... (More)

Objective. Multicentre studies in molecular radiotherapy face challenges in ensuring the comparability of dosimetry results. The aim of this study was to develop a validation protocol to achieve equivalent 177Lu-SPECT quantification across centres, consisting of a test exercise in combination with an action level. Approach. 177Lu-SPECT/CT imaging of 3D-printed kidney phantoms with non-uniform activity distributions was conducted at five hospitals in Sweden and the UK. In total, 12 quantification systems (QSs) were included, where a QS was defined as the combination of a given camera system, reconstruction method and image-analysis method. The accuracy of image-based estimates of the activity concentration was investigated for three approaches to multicentre dosimetry: one site-specific, and two variants of centralised approaches. For the site-specific approach, the reference value was blinded to the evaluating operators. Prior to the evaluation, the participants agreed on an action level, specified as an obtained deviation larger than ±10% from the reference value. Sites responsible for a QS that yielded larger deviations, and therefore did not comply, were required to present an action plan, i.e., a plan for further method optimisation. Main results. For the site-specific approach, deviations larger than 10% were obtained for six out of 12 QS (range −11% to +27%). Action plans were presented for these QS and was implemented by one site (two QS). For the two variants of centralised approaches, where nine QS were included in total, deviations of within 10% were obtained for nine and seven QS, respectively. Significance. A quantification test combined with an action level can serve as an initial validation to enable further development and to achieve equivalent 177Lu-SPECT quantification across sites.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
comparability, equivalent dosimetry, multicentre clinical trials, quantitative Lu-SPECT
in
Physics in Medicine and Biology
volume
70
issue
11
article number
115001
publisher
IOP Publishing
external identifiers
  • pmid:40345222
  • scopus:105005657258
ISSN
0031-9155
DOI
10.1088/1361-6560/add708
language
English
LU publication?
yes
id
aefff12b-b932-4a52-a310-9fc28ee72f31
date added to LUP
2025-07-28 10:24:26
date last changed
2025-07-29 02:23:12
@article{aefff12b-b932-4a52-a310-9fc28ee72f31,
  abstract     = {{<p>Objective. Multicentre studies in molecular radiotherapy face challenges in ensuring the comparability of dosimetry results. The aim of this study was to develop a validation protocol to achieve equivalent <sup>177</sup>Lu-SPECT quantification across centres, consisting of a test exercise in combination with an action level. Approach. <sup>177</sup>Lu-SPECT/CT imaging of 3D-printed kidney phantoms with non-uniform activity distributions was conducted at five hospitals in Sweden and the UK. In total, 12 quantification systems (QSs) were included, where a QS was defined as the combination of a given camera system, reconstruction method and image-analysis method. The accuracy of image-based estimates of the activity concentration was investigated for three approaches to multicentre dosimetry: one site-specific, and two variants of centralised approaches. For the site-specific approach, the reference value was blinded to the evaluating operators. Prior to the evaluation, the participants agreed on an action level, specified as an obtained deviation larger than ±10% from the reference value. Sites responsible for a QS that yielded larger deviations, and therefore did not comply, were required to present an action plan, i.e., a plan for further method optimisation. Main results. For the site-specific approach, deviations larger than 10% were obtained for six out of 12 QS (range −11% to +27%). Action plans were presented for these QS and was implemented by one site (two QS). For the two variants of centralised approaches, where nine QS were included in total, deviations of within 10% were obtained for nine and seven QS, respectively. Significance. A quantification test combined with an action level can serve as an initial validation to enable further development and to achieve equivalent <sup>177</sup>Lu-SPECT quantification across sites.</p>}},
  author       = {{Jessen, Lovisa and Curkic Kapidzic, Selma and Gustafsson, Johan and Larsson, Erik and Ljungberg, Michael and Sandström, Mattias and Dalmo, Johanna and Hagmarker, Linn and Hindorf, Cecilia and Taprogge, Jan and Gear, Jonathan and Flux, Glenn and Sjögreen Gleisner, Katarina}},
  issn         = {{0031-9155}},
  keywords     = {{comparability; equivalent dosimetry; multicentre clinical trials; quantitative Lu-SPECT}},
  language     = {{eng}},
  number       = {{11}},
  publisher    = {{IOP Publishing}},
  series       = {{Physics in Medicine and Biology}},
  title        = {{A validation protocol for <sup>177</sup>Lu-SPECT image quantification as a basis for multi-centre kidney dosimetry}},
  url          = {{http://dx.doi.org/10.1088/1361-6560/add708}},
  doi          = {{10.1088/1361-6560/add708}},
  volume       = {{70}},
  year         = {{2025}},
}