Abstract

The purpose of this study is to investigate the optimal reference geometry for gamma camera calibration. Yet another question of interest was to assess the influence of the number of 3D Ordered Subsets Expectation Maximization (3D-OSEM) updates on activity quantification for SPECT imaging with 177Lu. The accuracy of 177Lu activity quantification was assessed both in small and in large objects. Two different reference geometries, namely a cylindrical homogeneous phantom and a Jaszczak 16 ml sphere surrounded by cold water, were used to determine the gamma camera calibration factor of a commercial SPECT/CT system. Moreover, the noise level and the concentration recovery coefficient were evaluated as a function of the number of 3D-OSEM updates by using the SPECT/CT images of the reference geometry phantoms and those of a cold Jaszczak phantom with three hot spheres (16ml, 8ml and 4ml), respectively. The optimal choice of the number of 3D-OSEM updates was based on a compromise between the noise level achievable in the reconstructed SPECT images and the concentration recovery coefficients. The quantitative accuracy achievable was finally validated on a test phantom, where a spherical insert composed of two concentric spheres was used to simulate a lesion in a warm background. Our data confirm and extend previous observations. Using the calibration factor obtained with the cylindrical homogeneous phantom and the Jaszczak 16 ml sphere, the recovered activity in the test phantom was underestimated by -16.4% and -24.8%, respectively. Our work has led us to conclude that gamma camera calibration performed with large homogeneous phantom outperforms calibration executed with the Jaszczak 16ml sphere. Furthermore, the results obtained support the assumption that approximately 50 OSEM updates represent a good trade-off to reach convergence in small volumes, meanwhile minimizing the noise level.

Highlights

  • In recent years, molecular radiotherapy (MRT) based on peptide receptor radionuclide therapy has gained popularity for treatment of neuroendocrine tumors [1,2,3,4]

  • As in the clinical case the tumor volume is smaller than the kidney one, the present study focuses on small volume lesions and investigates the coefficient of variation (COV) and concentration recovery coefficient (cRC) behaviors for Js and Rp phantoms (16 ml, 8 ml and 4 ml), respectively

  • The use of a cylindrical homogeneous reference geometry, together with the gamma camera acquisition parameters used for SPECT image acquisition, and optimization of 3D Ordered Subsets Expectation Maximization (3D-OSEM) updates has been proved suitable for 177Lu SPECT activity quantification related to small volumes

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Summary

Introduction

Molecular radiotherapy (MRT) based on peptide receptor radionuclide therapy has gained popularity for treatment of neuroendocrine tumors [1,2,3,4]. Peptides labeled with Lutetium-177 (177Lu) have gained today an established use in the treatment of this disease [5,6,7,8,9,10]. Encouraging results have been obtained with theranostic radiopharmaceuticals in metastatic prostate cancer patients, indicating that the use and importance of 177Lu is expected to increase in the coming years in the management of these patients [11,12,13,14]. Even if promising results are obtained in terms of treatment outcomes from patients treated with 177Lu using fixed activities, it is expected that personalized dose assessment could further improve the clinical outcomes in terms of the tumor control and reduction of the normal tissue effects. SPECT/CT systems have the potential of enabling the conversion from counts in each voxel into activity values

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