Impact on gadolinium anomaly in river waters in Tokyo related to the increased number of MRI devices in use.

The Gd-based contrast agents utilized in magnetic resonance imaging are difficult to remove by usual sewage treatment technology, and they enter rivers in the discharges from waste water treatment plants. Gd anomaly in rivers has been considered depends on used amount of Gd-based contrast agents. In this study, variation of Gd anomaly in rivers of Tokyo was determined by comparisons to previously reported values. The range of anthropogenic Gd was 0.1-138.8 ppt with an average value of 35.5 ppt (n = 40); in particular, the anthropogenic Gd was significantly changed depending on the location of the waste water treatment plants, and the measurement revealed significant increases in the Gd anomaly in the range of 5.0-6.6 times compared to data obtained 22 years ago. This study highlights the necessary of continuous research in setting new public policies for medical practices.

Changes of absorbed dose rate in air in metropolitan Tokyo relating to radiocesium released from the Fukushima Daiichi Nuclear Power Plant accident: Results of a five-year study.

Car-borne surveys were carried out in metropolitan Tokyo, Japan, in 2015, 2016, 2017 and 2018 to estimate the transition of absorbed dose rate in air from the Fukushima Daiichi Nuclear Power Plant accident. Additionally, the future transition of absorbed dose rates in air based on this five-year study and including previously reported measurements done in 2014 by the authors was analyzed because central Tokyo has large areas covered with asphalt and concrete. The average absorbed dose rate in air (range) in the whole area of Tokyo measured in 2018 was 59 ± 9 nGy h-1 (28-105 nGy h-1), and it was slightly decreased compared to the previously reported value measured in 2011 (61 nGy h-1; 30-200 nGy h-1). In the detailed dose rate distribution map, while areas of higher dose rates exceeding 70 nGy h-1 had been observed on the eastern and western ends of Tokyo after 2014, the dose rates in these areas have decreased yearly. Especially, the decreasing dose rate from radiocesium (Cs-134 + Cs-137) in the eastern end of Tokyo which is mainly covered by asphalt was higher than that measured in the western end which is mainly covered by forest. The percent reductions for the eastern end in the years 2014-2015, 2015-2016, 2016-2017 and 2017-2018 were 49%, 21%, 18% and 16%, and those percent reductions for western end were 26%, 18%, 6% and 3%, respectively. Additionally, the decrease for dose rate from radiocesium depended on the types of asphalt, and that on porous asphalt was larger than the decrease on standard asphalt.

[Administration Accuracy of Automated Infusion Device for PET Using Improved Disposable Kit].

PURPOSE: The AI-300 automated infusion device (Sumitomo Heavy Industries, Ltd., Tokyo, Japan) is subject to administration error as a function of smaller volumes of 18F-FDG dispensed via a three-way cock supplied with a disposable kit. The present study aimed to validate the administration accuracy of the AI-300 using an improved disposable kit for quantitative positron emission tomography (PET) assessment. METHODS: We determined administration accuracy between the improved and previous disposable kits by measuring variations in dispensed volumes and radioactive concentrations of 18F-FDG according to the criteria of the Japanese Society of Nuclear Medicine. A reference value was generated by measuring radioactivity using a standard dose calibrator. RESULTS: The values obtained using the previous kit deviated from the reference values by a maximum of -10.6%, and the deviation depended on dispensed volumes of 18F-FDG<0.25 mL. In contrast, the values were relatively stable when using the improved kit with dispensed 18F-FDG volumes < 0.25 mL. Variations in radioactive concentrations were relatively stable using the improved kit, whereas that of the previous kit was slightly unstable at high radioactive concentrations. CONCLUSION: The administration accuracy of the AI-300 using the previous kit varied considerably according to smaller dispensed volumes, but the improved kit might alleviate this problem. The present results indicated that the improved disposal kit should be immediately implemented to eliminate uncertainty surrounding quantitative PET findings.

Evaluation of bone metastatic burden by bone SPECT/CT in metastatic prostate cancer patients: defining threshold value for total bone uptake and assessment in radium-223 treated patients.

OBJECTIVES: To establish a new three-dimensional quantitative evaluation method for bone metastasis, we applied bone single photon emission tomography with computed tomography (SPECT/CT). The total bone uptake (TBU), which measures active bone metastatic burden, was calculated as the sum of [mean uptake obtained as standardized uptake value (SUV) above a cut-off level] × (the volume of the lesion) in the trunk using bone SPECT/CT. We studied the threshold value and utility of TBU in prostate cancer patients treated with radium-223 (Ra-223) therapy. METHODS: To establish the threshold value of TBU, we compared bone metastatic and non-metastatic regions in 61 prostate cancer patients with bone metastasis and 69 without. Five fixed sites in each patient were selected as evaluation points and divided into bone metastatic and non-metastatic sites. Sensitivity and specificity analysis was applied to establish the threshold level. Using the obtained threshold value, we then calculated the TBU in nine prostate cancer patients who received Ra-223 therapy, and compared the results with the bone scan index (BSI) by BONENAVI® and visual evaluation of bone scintigraphy. RESULTS: Uptake was significantly lower in non-metastatic sites in patients with bone metastasis than in patients without metastasis. Sensitivity and specificity analysis revealed SUV = 7.0 as the threshold level. There was a discrepancy between TBU and BSI change in two of the nine patients, in whom TBU change correlated with visual judgement, but BSI change did not. In two patients, BSI was nearly 0 throughout the course, but the TBU was positive and changed, although the change was not large. These results suggest that TBU may be more accurate and sensitive than BSI for quantitative evaluation of active bone metastatic burden. CONCLUSION: We established a threshold value (SUV > 7.0) for three-dimensional TBU for evaluating active bone metastatic burden in prostate cancer patients using bone SPECT/CT. Despite the small number of patients, we expect the change in TBU could be more accurate and sensitive than the change in BSI among patients who received Ra-223.

[A Comparison of Planar Sensitivity and Spatial Resolution among Different Collimators and Energy Windows on 223Ra Imaging].

OBJECTIVE: The present study aimed to reveal the influence of combination of different collimators and energy windows on the planar sensitivity and the spatial resolution during experimental 223Ra imaging, and to determine optimal imaging parameters. METHODS: A vial type source containing 223Ra solution (4.55 MBq / 5.6 ml) was placed in the air at 100 mm away from the collimator surface. Planar images were acquired with LEHR, LMEGP, ELEGP and MEGP collimators on two dual-head gamma cameras (Symbia intevo (Siemens) and Infinia 3 (GE)). We compared three energy window combinations: 1) single window at 82 keV, 2) double window at 82+154 keV, 3) triple window at 82+154+270 keV. The energy spectrum, the sensitivity and the spatial resolution, such as full-width at half-maximum (FWHM) and full-width at tenth-maximum (FWTM), of each collimator were assessed. RESULTS: Five energy spectra (at around 82, 154, 270, 351 and 405 keV) were essentially observed among four collimators. The sensitivity was high for LEHR collimator, then ELEGP and LMEGP collimator was 3-4 fold, which is greater than MEGP collimator. The 82 keV energy window of four collimators has best spatial resolution. Moreover, the spatial resolution of the 82 keV energy window with LMEGP and ELEGP collimator was almost equal to that of the triple window with MEGP collimator. CONCLUSIONS: Optimal imaging parameters were single energy window using LMEGP or ELEGP, and then triple energy window using MEGP collimator.

Calculation Accuracy of Gross Tumor Volume at the Diaphragm Boundary Evaluated Using Respiratory-gated PET/CT.

OBJECTIVE: The present study aimed to clarify gross tumor volume (GTV) contouring accuracy at the diaphragm boundary using respiratory-gated PET/CT. METHODS: The lung/diaphragm boundary was simulated using a phantom containing 18F solution (10.6 kBq/mL). Tumors were simulated using spheres (diameter, 11-38 mm) containing 18F and located at the positions of the lungs and liver. The tumor background ratios (TBR) were 2, 4, and 8. The phantom was moved from the superior to inferior direction with a 20-mm motion displacement at 3.6 s intervals. The recovery coefficient (RC), volume RC (VRC), and standardized uptake value (SUV) threshold were calculated using stationary, non-gated (3D), and gated (4D) PET/CT. RESULTS: In lung cancer simulation, RC and VRC in 3D PET images were, respectively, underestimated and overestimated in smaller tumors, whereas both improved in 4D PET images regardless of tumor size and TBR. The optimal SUV threshold was about 30% in 4D PET images. In liver cancer simulation, RC and VRC were, respectively, underestimated and overestimated in smaller tumors, and when the TBR was lower, but both improved in 4D PET images when tumors were >17 mm and the TBR was >4. The optimal SUV threshold tended to depend on the TBR. CONCLUSIONS: The contouring accuracy of GTV was improved by considering TBR and using an optimal SUV threshold acquired from 4D PET images.