Beyond current guidelines: reduction in minimum administered radiopharmaceutical activity with preserved diagnostic image quality in pediatric hepatobiliary scintigraphy

详细信息    查看全文

• 作者：Frederic Fahey (1) (2)
  Katherine Zukotynski (2) (3)
  David Zurakowski (4)
  Robert Markelewicz (1) (2)
  Anthony Falone (1)
  Marie Vitello (1)
  Xinhua Cao (1)
  Frederick Grant (1) (2)
  Laura Drubach (1) (2)
  A. Hans Vija (5)
  Manojeet Bhattacharya (5)
  Xinhong Ding (5)
  Zvi Bar-Sever (6) (7)
  Michael Gelfand (8)
  S. Ted Treves (1) (2)
  
• 关键词：Hepatobiliary ; Dose optimization ; Pediatric ; Nuclear medicine
• 刊名：European Journal of Nuclear Medicine and Molecular Imaging
• 出版年：2014
• 出版时间：December 2014
• 年：2014
• 卷：41
• 期：12
• 页码：2346-2353
• 全文大小：318 KB
• 参考文献：1. Treves ST. Pediatric nuclear medicine and molecular imaging. 4th ed. New York: Springer; 2014. CrossRef
  2. Tulchinski M, Ciak B, Delbeke D, Hilson A, Holes-Lewis K, Stabin M, et al. SNM practice guideline for hepatobiliary scintigraphy 4.0. J Nucl Med Tech. 2010;38(4):210-. CrossRef
  3. Howman-Giles R, Uren R, Bernard E, Dorney S. Hepatobiliary scintigraphy in infancy. J Nucl Med. 1998;39:311-.
  4. Treves ST, Davis RT, Fahey FH. Administered radiopharmaceutical doses in children: a survey of 13 pediatric hospitals in North America. J Nucl Med. 2008;49(6):1024-. CrossRef
  5. Fahey FH, Treves ST, Adelstein SJ. Minimizing and communicating radiation risk in pediatric nuclear medicine. J Nucl Med. 2011;52:1240-1.
  6. Pina RK, Puetter RC. Bayesian image reconstruction -the pixon and optimal image modeling. Publ Astron Soc Pac. 1993;105:630-. CrossRef
  7. Wesolowski CA, Yahil A, Puetter RC, Babyn PS, Gilday DL, Khan MZ. Improved lesion detection from spatially adaptive, minimally complex, pixon reconstruction of planar scintigraphic images. Comput Med Imaging Graph. 2005;29(1):65-1. CrossRef
  8. Gelfand MJ, Parisi MT, Treves ST. Pediatric radiopharmaceutical administered doses: 2010 North American consensus guidelines. J Nucl Med. 2011;52(2):318-2. CrossRef
  9. Treves ST, Parisi MT, Galfand MJ. Pediatric radiopharmaceutical doses: new guidelines. Radiology. 2011;261(2):347-. CrossRef
  10. Lassmann M. The new EANM paediatric dosage card. Eur J Nucl Med Mol Imaging. 2008;35(9):1748. CrossRef
  11. Wiuf C, Stumpf M. Binomial subsampling. Proc Roy Soc A. 2006;462(2068):1181-5. CrossRef
  12. Vija AH, Gosnell TR, Yahil A, Hawman EG, Engdhal JC. Statistically based, spatially adaptive noise reduction of planar nuclear studies. Proc SPIE. 2005;5747:634-5. CrossRef
  13. Fahrmmeir L, Tutz G. Multivariate statistical modeling based on generalized linear models. New York: Springer; 2001. p. 69-37.
  14. Vittinghoff E, Glidden DV, Shiboski SC, McCulloch CE. Regression methods in biostatistics: Linear, logistic, survival, and repeated measures models. New York: Springer; 2005. p. 253-9.
  15. Fleiss JL, Levin B, Paik MC. Statistical methods for rates and proportions. 3rd ed. New York: John Wiley & Sons; 2003. p. 598-26. CrossRef
  
• 作者单位：Frederic Fahey (1) (2)
  Katherine Zukotynski (2) (3)
  David Zurakowski (4)
  Robert Markelewicz (1) (2)
  Anthony Falone (1)
  Marie Vitello (1)
  Xinhua Cao (1)
  Frederick Grant (1) (2)
  Laura Drubach (1) (2)
  A. Hans Vija (5)
  Manojeet Bhattacharya (5)
  Xinhong Ding (5)
  Zvi Bar-Sever (6) (7)
  Michael Gelfand (8)
  S. Ted Treves (1) (2)
  
  1. Division of Nuclear Medicine and Molecular Imaging, Boston Children’s Hospital, Harvard Medical School, 300 Longwood Ave, Boston, MA, 02115, USA
  2. Joint Program in Nuclear Medicine, Harvard Medical School, Boston, USA
  3. Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada
  4. Departments of Anesthesia and Surgery, Boston Children’s Hospital, Boston, USA
  5. Siemens Medical Solutions USA, Inc., Molecular Imaging, Malvern, PA, USA
  6. Schneider Children’s Medical Center, Petach Tikvah, Israel
  7. Tel-Aviv University, Tel-Aviv, Israel
  8. Cincinnati Children’s Hospital, Cincinnati, OH, USA
  
• ISSN：1619-7089

文摘

Purpose To determine if the minimum administered radiopharmaceutical activity for hepatobiliary scintigraphy can be reduced while preserving diagnostic image quality using enhanced planar processing (EPP). Methods A total of 40 infants between 10 and 270?days old (body mass 2.2 -6.5?kg) had hepatobiliary scintigraphy during the period 2004?–?010 following the intravenous administration of either 99mTc-mebrofenin (18 patients) or 99mTc-disofenin (22 patients). Due to the small size of these patients, they all received the minimum administered activity of 18.5?MBq consistent with the North American Consensus Guidelines. Six nuclear medicine physicians subjectively graded the acceptability of the image quality for clinical interpretation using a four-point scale (not acceptable, fair, good, excellent). Each physician independently graded seven image sets including the original study (full activity) and simulated reduced activity studies using binomial subsampling (50?% of full activity, 25?% of full activity and activity reduced by weight), with and without EPP. Results For full-activity studies, 98?% were deemed acceptable by the six physicians for clinical interpretation. The percentages of acceptable 50?% reduced activity studies with and without EPP were not significantly different from the percentage of acceptable full-activity studies (P--.193 and P--.998, respectively). The percentage of acceptable 25?% reduced activity studies without EPP was significantly different from the percentage of acceptable full-activity studies (P--.001); however, this difference vanished when EPP was applied (P--.482). The activity reduced by weight ranged from 1.85 to 4.81?MBq (10?% to 26?% of full dose) and the percentages of acceptable studies with and without EPP were significantly different from the percentage of acceptable full-activity studies (P--.001 and P--.02, respectively). Conclusion Clinically interpretable hepatobiliary scintigraphy images can be obtained in infants when the minimum administered activity is substantially reduced. Without EPP, clinically acceptable images may be produced with a reduction of 50?%, and with EPP, a reduction of 75?% or more may be possible.