Abstract
Background: Infiltrations of 18F-fluorodeoxyglucose (FDG) injections affect positron emission tomography/computed tomography (PET/CT) image quality and quantification. A device using scintillation sensors (Lucerno Dynamics, Cary, NC) provides dynamic measurements acquired during FDG uptake to identify and characterize radioactivity near the injection site prior to patient imaging. Our aim was to compare sensor measurements against dynamic PET image acquisition, our proposed reference in assessing injection quality during the uptake period.Methods: Subjects undergoing routine FDG PET/CT imaging were eligible for this Institutional Review Board approved prospective study. After providing informed consent, subjects had sensors topically placed on their arms. FDG was injected into subjects' veins directly on the PET imaging table. Dynamic images of the injection site were acquired during 45 min of the uptake period. These dynamic image acquisitions and subjects' routine standard static images were evaluated by nuclear medicine physicians for abnormal FDG accumulation near the injection site. Sensor measurements were interpreted independently by Lucerno staff. Dynamic image acquisition interpretation results were compared to the sensor measurement interpretations and to static image interpretations.Results: Twenty-four subjects were consented and enrolled. Data from 21 subjects were gathered. During dynamic image acquisition review, physicians interpreted 4 subjects with no FDG accumulation at the injection site, whereas 17 showed evidence of accumulation. In 10 of the 17 cases that showed FDG accumulation, the FDG presence at the injection site resolved completely during uptake corresponding to venous stasis, the temporary sequestration of blood from circulation. Static image interpretation agreed with dynamic images interpretation in 11/21 (52%) subjects. Sensor measurement interpretations agreed with the dynamic images interpretations in 18/21 (86%) subjects.Conclusions: Sensor measurements can be an effective way to identify and characterize infiltrations and venous stasis. Comparable to an infiltration, venous stasis may produce spurious and clinically meaningful measurement bias and possibly even scan misinterpretation. Since the quality and quantification of PET/CT studies are of clinical importance, sensor measurements acquired during the FDG uptake may prove to be a useful quality control measure to reduce infiltration rates and potentially improve patient care.Registration: Clinicaltrials.gov, Identifier: NCT03041090
Highlights
In 2017, 90% of the ∼3.1 million positron emission tomography/computed tomography (PET/CT) studies performed in the United States were used to help oncologists diagnose, stage, plan treatments, assess tumor response, or longitudinally monitor cancer patients [1]
Subjects referred to a PET/CT center for a standard-ofcare FDG PET/CT examination were eligible to participate in this prospective, non-significant risk device study
After evaluating potential venous access sites, subjects were positioned on the Philips Gemini TF 64-slice PET/CT imaging table so that the injection site would be at the caudal edge of the PET imaging bed
Summary
In 2017, 90% of the ∼3.1 million PET/CT studies performed in the United States were used to help oncologists diagnose, stage, plan treatments, assess tumor response, or longitudinally monitor cancer patients [1]. Oncologic PET/CT studies require a prescribed dose of 18Ffluorodeoxyglucose (FDG) be injected as a bolus within 1 min, followed by a pre-defined uptake period [2]. PET/CT scanner and procedural quality control (QC) help ensure the accuracy of the administered dose. For procedural QC, clocks are synchronized to ensure proper decay corrections, injection-to-image times are recorded to ensure longitudinal studies are comparable, and FDG delivery syringe residuals are measured (or estimated by some centers) and recorded to calculate actual administered dose [3,4,5,6,7,8,9]. Our aim was to compare sensor measurements against dynamic PET image acquisition, our proposed reference in assessing injection quality during the uptake period
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
