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Title: Correction for FDG PET dose extravasations: Monte Carlo validation and quantitative evaluation of patient studies

Abstract

Purpose: Current procedure guidelines for whole body [18F]fluoro-2-deoxy-D-glucose (FDG)-positron emission tomography (PET) state that studies with visible dose extravasations should be rejected for quantification protocols. Our work is focused on the development and validation of methods for estimating extravasated doses in order to correct standard uptake value (SUV) values for this effect in clinical routine. Methods: One thousand three hundred sixty-seven consecutive whole body FDG-PET studies were visually inspected looking for extravasation cases. Two methods for estimating the extravasated dose were proposed and validated in different scenarios using Monte Carlo simulations. All visible extravasations were retrospectively evaluated using a manual ROI based method. In addition, the 50 patients with higher extravasated doses were also evaluated using a threshold-based method. Results: Simulation studies showed that the proposed methods for estimating extravasated doses allow us to compensate the impact of extravasations on SUV values with an error below 5%. The quantitative evaluation of patient studies revealed that paravenous injection is a relatively frequent effect (18%) with a small fraction of patients presenting considerable extravasations ranging from 1% to a maximum of 22% of the injected dose. A criterion based on the extravasated volume and maximum concentration was established in order to identifymore » this fraction of patients that might be corrected for paravenous injection effect. Conclusions: The authors propose the use of a manual ROI based method for estimating the effectively administered FDG dose and then correct SUV quantification in those patients fulfilling the proposed criterion.« less

Authors:
;  [1]; ; ;  [2]; ;  [3];  [4];  [5]
  1. Fundación Ramón Domínguez, Santiago de Compostela, Galicia (Spain)
  2. Servicio de Radiofísica y Protección Radiológica, Complexo Hospitalario Universidade de Santiago de Compostela (USC), 15782, Galicia (Spain)
  3. Servicio de Medicina Nuclear, Complexo Hospitalario Universitario de Santiago de Compostela, 15706, Galicia, Spain and Grupo de Imaxe Molecular, Instituto de Investigación Sanitarias (IDIS), Santiago de Compostela, 15706, Galicia (Spain)
  4. Servicio de Radiofísica y Protección Radiológica, Complexo Hospitalario Universitario de Santiago de Compostela, 15706, Galicia (Spain)
  5. Servicio de Medicina Nuclear, Complexo Hospitalario Universidade de Santiago de Compostela (USC), 15782, Galicia (Spain)
Publication Date:
OSTI Identifier:
22250711
Resource Type:
Journal Article
Journal Name:
Medical Physics
Additional Journal Information:
Journal Volume: 41; Journal Issue: 5; Other Information: (c) 2014 American Association of Physicists in Medicine; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0094-2405
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; COMPUTERIZED SIMULATION; EVALUATION; FLUORINE 18; GLUCOSE; INJECTION; MONTE CARLO METHOD; PATIENTS; POSITRON COMPUTED TOMOGRAPHY; RADIATION DOSES; RECOMMENDATIONS; VALIDATION

Citation Formats

Silva-Rodríguez, Jesús, Aguiar, Pablo, Servicio de Medicina Nuclear, Complexo Hospitalario Universidade de Santiago de Compostela, Grupo de Imaxe Molecular, Instituto de Investigación Sanitarias, Sánchez, Manuel, Mosquera, Javier, Luna-Vega, Víctor, Cortés, Julia, Garrido, Miguel, Pombar, Miguel, Ruibal, Álvaro, Grupo de Imaxe Molecular, Instituto de Investigación Sanitarias, and Fundación Tejerina, 28003, Madrid. Correction for FDG PET dose extravasations: Monte Carlo validation and quantitative evaluation of patient studies. United States: N. p., 2014. Web. doi:10.1118/1.4870979.
Silva-Rodríguez, Jesús, Aguiar, Pablo, Servicio de Medicina Nuclear, Complexo Hospitalario Universidade de Santiago de Compostela, Grupo de Imaxe Molecular, Instituto de Investigación Sanitarias, Sánchez, Manuel, Mosquera, Javier, Luna-Vega, Víctor, Cortés, Julia, Garrido, Miguel, Pombar, Miguel, Ruibal, Álvaro, Grupo de Imaxe Molecular, Instituto de Investigación Sanitarias, & Fundación Tejerina, 28003, Madrid. Correction for FDG PET dose extravasations: Monte Carlo validation and quantitative evaluation of patient studies. United States. doi:10.1118/1.4870979.
Silva-Rodríguez, Jesús, Aguiar, Pablo, Servicio de Medicina Nuclear, Complexo Hospitalario Universidade de Santiago de Compostela, Grupo de Imaxe Molecular, Instituto de Investigación Sanitarias, Sánchez, Manuel, Mosquera, Javier, Luna-Vega, Víctor, Cortés, Julia, Garrido, Miguel, Pombar, Miguel, Ruibal, Álvaro, Grupo de Imaxe Molecular, Instituto de Investigación Sanitarias, and Fundación Tejerina, 28003, Madrid. Thu . "Correction for FDG PET dose extravasations: Monte Carlo validation and quantitative evaluation of patient studies". United States. doi:10.1118/1.4870979.
@article{osti_22250711,
title = {Correction for FDG PET dose extravasations: Monte Carlo validation and quantitative evaluation of patient studies},
author = {Silva-Rodríguez, Jesús and Aguiar, Pablo and Servicio de Medicina Nuclear, Complexo Hospitalario Universidade de Santiago de Compostela and Grupo de Imaxe Molecular, Instituto de Investigación Sanitarias and Sánchez, Manuel and Mosquera, Javier and Luna-Vega, Víctor and Cortés, Julia and Garrido, Miguel and Pombar, Miguel and Ruibal, Álvaro and Grupo de Imaxe Molecular, Instituto de Investigación Sanitarias and Fundación Tejerina, 28003, Madrid},
abstractNote = {Purpose: Current procedure guidelines for whole body [18F]fluoro-2-deoxy-D-glucose (FDG)-positron emission tomography (PET) state that studies with visible dose extravasations should be rejected for quantification protocols. Our work is focused on the development and validation of methods for estimating extravasated doses in order to correct standard uptake value (SUV) values for this effect in clinical routine. Methods: One thousand three hundred sixty-seven consecutive whole body FDG-PET studies were visually inspected looking for extravasation cases. Two methods for estimating the extravasated dose were proposed and validated in different scenarios using Monte Carlo simulations. All visible extravasations were retrospectively evaluated using a manual ROI based method. In addition, the 50 patients with higher extravasated doses were also evaluated using a threshold-based method. Results: Simulation studies showed that the proposed methods for estimating extravasated doses allow us to compensate the impact of extravasations on SUV values with an error below 5%. The quantitative evaluation of patient studies revealed that paravenous injection is a relatively frequent effect (18%) with a small fraction of patients presenting considerable extravasations ranging from 1% to a maximum of 22% of the injected dose. A criterion based on the extravasated volume and maximum concentration was established in order to identify this fraction of patients that might be corrected for paravenous injection effect. Conclusions: The authors propose the use of a manual ROI based method for estimating the effectively administered FDG dose and then correct SUV quantification in those patients fulfilling the proposed criterion.},
doi = {10.1118/1.4870979},
journal = {Medical Physics},
issn = {0094-2405},
number = 5,
volume = 41,
place = {United States},
year = {2014},
month = {5}
}