Usefulness and limitations of various detector systems for estimation of131I thyroid activity following an RN event.

Following a radiological or nuclear (RN) event, rapid measurement of131I in members of the public is of utmost importance, and much equipment is needed for a high throughput. In this study, three gamma cameras (GCs), two thyroid uptake meters (TUMs) and one whole-body counter (WBC) were calibrated for activity measurements of131I in the thyroid. Minimum detectable activity was derived for the GCs, the TUMs and the WBC giving that a committed effective dose (CED) in the interval 2.0-85µSv, 13-700µSv and 0.52-6.4µSv, and thyroid absorbed doses in the interval 0.075-2.1 mGy, 0.48-17 mGy, and 0.020-0.15 mGy, respectively, can be assessed for children, adolescents, and adults. These numbers are based on 10 min measurement, performed at 1, 3 and 7 d after intake, and the CED includes intake by ingestion and inhalation of aerosols Type F, with an activity median aerodynamic diameter of 1µm. For a fractional signal loss of 63% due to dead time, a CED up to 2.0, 84 and 3.6 Sv and thyroid absorbed dose up to 47 Gy, 2000 Gy and 88 Gy for the three systems, respectively, can be assessed for children and intake by ingestion as a worst-case scenario in terms of CED, measured 7 d after intake. This study demonstrates the potential and limitations of using equipment readily available at larger hospitals for estimation of131I content in thyroid, which could increase the measurement capability following an RN event.

Effective methods for monitoring internal contamination among workers handling radioactive materials in various fields.

This study aimed to develop effective methods for monitoring internal contamination among workers handling radioactive materials in various fields. A total of 160 workers from nuclear power plants, medical institutions, military units, and educational/research institutions were included in the study. The monitoring methods included urinalysis and whole-body counting (WBC) using a mobile radio bioassay laboratory (MRL). Gamma-emitting radionuclides were monitored using the MRL WBC system, and a separate pretreatment procedure was used for tritium measurement in urine samples. Gross beta-screening was performed using a liquid scintillation counting system. The results were evaluated on the basis of the established screening criteria and compared with the dose limits. Additionally, tritium concentrations in the bodies of workers in the vicinity of a heavy-water reactor was analysed to assess the association between tritium concentration and occupation. The results showed a wide distribution of tritium concentrations. Workers involved in fuel and maintenance tasks demonstrated the maximum exposure. Workers in medical facilities showed low levels of internal contamination, which was primarily related to tasks involving radioactive isotopes. Military personnel involved in equipment repair showed significant tritium contamination due to damage during repairs. Workers in educational and research institutions in general had low levels of internal contamination.

Staff dose evaluation by application of radiation protection during endoscopic retrograde cholangiopancreatography (ERCP) procedures performed with a mobile C-arm.

BACKGROUND: The radiation dose to staff performing endoscopic retrograde cholangiopancreatography (ERCP) is not negligible. PURPOSE: To evaluate the shielding effect of a table-suspended lower-body radiation shield for the positions in the room occupied by the operator, assisting nurse, and anesthesiologist, used during ERCP procedures with a mobile C-arm. MATERIAL AND METHODS: Eye lens dose, whole body dose, and extremity dose were measured with and without a table-suspended lower-body radiation shield in a phantom model and in clinical routine work. The effect of the shield was evaluated for each scenario and compared, and a projection was made for when shielding should be required from a regulatory point of view. RESULTS: In the phantom measurements, the shield provided significant shielding effects on the body and lower extremities for the operator but no significant shielding of the eye lens. The shielding effect for the assisting nurse was limited to the lower extremity. The clinical measurements yielded the same general result as the phantom measurements, with the major difference that the shield provided no significant reduction in the whole-body dose to the operator. CONCLUSION: The table-suspended shield has a significant shielding effect for the lower extremities of the operator and assisting nurse. For annual dose-area product values >300,000 cGycm2, the protection of the operator should be reinforced with a ceiling-suspended shield to avoid doses to the eye lens and body in excess of regulatory dose restrictions.

Production of sealed rod sources made from epoxy resin for the Saint-Petersburg brick phantom for the calibration of whole-body counters.

Rod sources are a common tool for the calibration of whole-body counters in combination with the Saint-Petersburg brick phantom. Here, a method for the production of such sources in ordinary radiochemical laboratories is presented. The rod sources consist of a tubular capsule of rigid polyvinyl chloride with a radioactive filling of epoxy resin. The method allows the production of rod sources at material costs of about 1 € per rod source and of ten rod sources by one person per day. Quality-assurance measurements were performed regarding the spatial distribution of the activity within the rod sources and the distribution of the activity throughout a set of sources. The relative double standard deviation of the activities of five different segments of single rod sources was 7.1%. The relative double standard deviation within a set of 90 rod sources was 2.8% after those 11% of sources with the greatest deviation from the arithmetic mean were discarded. Tests according to ISO 2919 to certify the rod sources as sealed sources of Class 2 of this standard were successfully conducted. The bending test proved to be the most critical test for the rod sources; the sources were broken by a mass of 12-14 kg, which is only slightly more than the stipulated mass of 10.2 kg. The presented method allows for a cost- and labour-effective production of sealed radioactive rod sources and thus facilitates the application of the Saint-Petersburg brick phantom for calibrations and interlaboratory comparisons of whole-body counters.

Simple methodology for ensuring the precision of measuring radioactivity at low concentrations in very small tissues using quantitative whole-body autoradiography.

Quantitative whole-body autoradiography (QWBA) is largely used to evaluate tissue distribution of small molecule drugs. In QWBA, radioactivity is measured as the intensity obtained from the autoradiogram. It is known that lower intensity per a region of interest (ROI) or smaller size of ROI increases the variability of intensity. In fact, as some tissues are very small (e.g., the choroidea), ensuring reliability on the intensity for measuring radioactivity in these tissues is difficult in case of under- or over-estimation of radioactivity concentration owing to their variation of low radioactivity intensity of ROI. We thus analyzed the relationships between the size, intensity, and precision of ROI to determine the statistically significant lower limit of quantification (LLOQ) in very small tissues. To investigate the difference in correlation between the radiation source (commercial planar radiation standard [com-ST] and self-made radiation standard [self-ST] consisting of radioactive compounds and matrices), apparatus, or setting environment of the apparatus, correlation analysis was conducted under various conditions. Our results revealed that LLOQ can be calculated by simply using the correlation equation because a common relationship was observed between self-ST, which is used in QWBA, and com-ST. This methodology was thus considered valuable for ensuring LLOQ determination in QWBA.

Virtual Igor: an analytical phantom for the simulation of the Saint Petersburg brick phantom in arbitrary layouts in MCNP.

A computer code called Virtual Igor is presented. The code generates an analytical representation of the Saint Petersburg brick phantom family (Igor, Olga, Irina), which is frequently used for the calibration of whole-body counters, in arbitrary user-defined layouts for the use in the Monte-Carlo radiation transport code MCNP. The computer code reads a file in the ldraw format, which can easily be produced by simple freeware software with graphical user interfaces and which contains the types and coordinates of the bricks. Ldraw files with the canonical layouts of the brick phantom are provided with Virtual Igor. The code determines the positions of (2.75 cm)3 segments of the bricks, where 2.75 cm is the smallest length in the layout and, therefore, represents the spacing of the segment lattice. Each segment contains the exact geometry of the respective part of the brick, using cuboid and cylindrical surfaces. The user can define which rod source drill holes of which bricks contain the rod-type radionuclide sources. The method facilitates the comparison of different layouts of the Saint Petersburg brick phantom with each other and with anthropomorphic computational phantoms.

Deconvolution of bulk blood eQTL effects into immune cell subpopulations.

BACKGROUND: Expression quantitative trait loci (eQTL) studies are used to interpret the function of disease-associated genetic risk factors. To date, most eQTL analyses have been conducted in bulk tissues, such as whole blood and tissue biopsies, which are likely to mask the cell type-context of the eQTL regulatory effects. Although this context can be investigated by generating transcriptional profiles from purified cell subpopulations, current methods to do this are labor-intensive and expensive. We introduce a new method, Decon2, as a framework for estimating cell proportions using expression profiles from bulk blood samples (Decon-cell) followed by deconvolution of cell type eQTLs (Decon-eQTL). RESULTS: The estimated cell proportions from Decon-cell agree with experimental measurements across cohorts (R ≥ 0.77). Using Decon-cell, we could predict the proportions of 34 circulating cell types for 3194 samples from a population-based cohort. Next, we identified 16,362 whole-blood eQTLs and deconvoluted cell type interaction (CTi) eQTLs using the predicted cell proportions from Decon-cell. CTi eQTLs show excellent allelic directional concordance with eQTL (≥ 96-100%) and chromatin mark QTL (≥87-92%) studies that used either purified cell subpopulations or single-cell RNA-seq, outperforming the conventional interaction effect. CONCLUSIONS: Decon2 provides a method to detect cell type interaction effects from bulk blood eQTLs that is useful for pinpointing the most relevant cell type for a given complex disease. Decon2 is available as an R package and Java application (https://github.com/molgenis/systemsgenetics/tree/master/Decon2) and as a web tool (www.molgenis.org/deconvolution).

Usefulness of the whole-body counter for infants and small children (BABYSCAN) as a risk communication tool after the Fukushima Daiichi nuclear power plant incident.

Responding to the radiation-related concerns of parents/guardians with infants/small children is an important public health issue for regional recovery after radioactive contamination. This study summarizes the results of a systematic internal contamination screening of infants/small children, aged 0-6 years, using BABYSCAN and individual counselling sessions with physicians about radiation concerns from 2014 to 2018 in Minamisoma City. Of 3,114 participants, no one was found to have internal contamination with radioactive caesium with a detection limit of 50 Bq/body. The questionnaire survey showed a decreasing trend of concerns about food contamination and playing outside as possible causes of internal contamination over time. Because people's concerns were diverse in counselling sessions, individual responses are required. This study showed that examinations using BABYSCAN provide an opportunity for direct dialogue between the parents/guardians of infants/small children and experts. This can be considered a model case for risk communication conducted by the local government after a radioactive contamination incident.

Person-specific calibration of a partial body counter used for individualised Am241skull measurements.

Incorporation of bone seeking alpha-emitting radionuclides such as241Am are of special concern, due to the potential of alpha particles to damage the extremely radiation-sensitive bone marrow. In the case of an internal contamination with241Am, directin vivomeasurements using Gamma-detectors are typically used to quantify the incorporated activity. Such detectors need to be calibrated with an anatomical phantom, for example of the skull, of known241Am activity that reproduces the anatomy of the measured individual as closely as possible. Any difference in anatomy and material composition between phantom and individual will bias the estimation of the incorporated activity. Consequently, in this work the impact of the most important anatomical parameters on detection efficiency of one of the germanium detectors of the Helmholtz Center Munich (HMGU) partial body counter were systematically studied. For that a detailed model of the germanium detector was implemented in the Monte Carlo codes GEANT4 and MCNPX. To simulate the detector efficiency, various skull voxel phantoms were used. By changing the phantom dimensions and geometry the impact of parameters such as shape and size of the skull, thickness of tissue covering the skull bone, distribution of241Am across the scull and within the skull bone matrix, on the detector efficiency was studied. Approaches to correct for these parameters were specifically developed for three physical skull phantoms for which Voxel phantoms were available: Case 102 USTUR phantom, Max-06 phantom, BfS phantom. Based on the impact of each parameter, correction factors for an 'individual-specific' calibration were calculated and applied to a real241Am contamination case reported in 2014. It was found that the incorporated241Am activity measured with the HMGU partial body counter was about twice as large as that estimated when using the BfS skull phantom without applying any correction factor for person-specific parameters. It is concluded that the approach developed in the present study should in the future be applied routinely for skull phantom measurements, because it allows for a considerably improved reconstruction of incorporated241Am using partial body counters.

Large-scale individual monitoring of internal contamination by gamma-emitting radionuclides in nuclear accident scenarios.

The results obtained in a measurement campaign concerning internal contamination by the gamma-emitting radionuclides of a large number of individuals are presented in this work. The aim is to assess the effectiveness of the spectrometric method in an emergency response following a nuclear power plant accident or a spread of radionuclides in the atmosphere due to an act of terrorism. An HPGe portable spectrometer, deployed in a collective protection apparatus, was used for both whole-body and thyroid measurements. An adult bottle mannequin absorption (BOMAB) and thyroid phantoms were used to evaluate the detector performance. The BOMAB phantom was provided by the Italian Institute of Ionizing Radiation Metrology (INMRI) for the ENEA intercomparison exercise. Thyroid phantoms were provided by the Belgian Nuclear Research Centre for the 'Child and Adult Thyroid Monitoring After Reactor Accident' European intercomparison exercise. The instrument performance was further evaluated by collecting spectral data from healthy volunteers, using acquisition times of 180 s and 100 s, respectively, for the whole-body and thyroid measurements. The detector showed good accuracy in quantifying radionuclide activities in the adult BOMAB and in the thyroids of persons of all ages. The proposed method allows us to detect in vivo activity leading to a committed effective dose E(50) and committed thyroid equivalent doses H T greater than 2 mSv due to all gamma-emitting fission products, if the scan is performed within five days after intake. Assuming, for instance, an acute inhalation of 137Cs and 131I, the obtained detection limit values for adults lead to a E(50) value equal to 0.08 mSv and an H T value of 0.27 mSv. The E(50) and H T values show that the proposed method can be successfully used when the dose assessment must be rapidly performed for a large number of individuals in the eventuality of the scenarios previously mentioned.

In vivo measurement of pre-operational spallation source workers: baseline body burden levels and detection limits of relevant gamma emitters using high-resolution gamma spectrometry.

As a measure to prepare for long-term internal dose monitoring of workers at the European Spallation Source (ESS) in Lund, Sweden, operated by the European Research Infrastructure Consortium (ERIC), as well as to enhance emergency preparedness against accidental releases, a series of in vivo measurements were conducted using a high-resolution HPGe detector with a 123% relative efficiency (1.332 MeV). This study describes the whole-body counting set-up, calibration procedure, and subsequent validation measurements using conventional NaI(Tl)-scanning-bed geometry on a selection of workers from the ESS. Detection limits for the relevant gamma emitters 7Be, 172Hf, and 182Ta were determined to be 65 Bq, 130 Bq, and 22 Bq, respectively, using a 2400 s acquisition time. The baseline measurements suggest that care must be taken to ensure that the fluctuations in the presence of radon daughters 214Bi and 214Pb are minimised by, for example, ensuring a minimum air exchange between the measuring room and the ambient air, and by demanding that the measured subjects change clothes and shower before measurement. Furthermore, in a monitoring program for internal doses to spallation source workers, the presence of radionuclides originating from non-work-related sources (such as 226Ra from private water wells or 137Cs from intakes of Chernobyl contaminated foodstuffs), or radionuclides from previous work history (such as 60Co within the nuclear power industry), must be considered.

Accurate characterization of 99mTc-MDP uptake in extraosseous neoplasm mimicking bone metastasis on whole-body bone scan: contribution of SPECT/CT.

BACKGROUND: 99mTc-labelled methylene diphosphonate (99mTc-MDP) uptake can occasionally be identified in extraosseous neoplasms on whole-body scans (WBSs) and may be misinterpreted as bone metastasis. The purpose of our study was to investigate the frequency of 99mTc-MDP uptake in extraosseous neoplasms and to assess the additional value of SPECT/CT for the localization and characterization of this unusual uptake. METHODS: Data from 7308 patients (SPECT/CT was performed in 2147 patients) with known cancer who underwent WBSs for metastatic work-up between May 2015 and July 2018 were retrospectively reviewed. The locations, numbers, and intensities of extraosseous 99mTc-MDP uptake were evaluated by WBS, and the intratumoural calcification was evaluated by SPECT/CT. The diagnostic accuracy of SPECT/CT in locating 99mTc-MDP uptake in extraosseous neoplasms was compared to that of WBS. RESULTS: A total of 41 patients showed 99mTc-MDP uptake in extraosseous neoplasms. Of these patients, 23 patients had uncertain lesions by WBS, and further SPECT/CT was performed. The incidence of 99mTc-MDP uptake in extraosseous neoplasms was observed to be 0.6% by WBS and 1.1% (by) SPECT/CT. During imaging analysis, WBS had an accuracy of only 35% (14/40), whereas SPECT/CT correctly located and diagnosed all 40 lesion sites in the 23 patients. Twenty-three lesion sites (57.5%, 23/40) showed moderate or high intensity of extraosseous 99mTc-MDP uptake. Of the 23 patients, 17 patients (73.9%, 18/23) with 31 lesion sites (77.5%, 31/40) presented with intratumoural calcification. CONCLUSIONS: 99mTc-MDP uptake in extraosseous neoplasms can be observed as 0.6% on WBS and is usually localized to the breast, liver, and lung. Nuclear physicians should be familiar with such extraosseous uptake when interpreting WBSs. SPECT/CT offers better accuracy than WBS alone for locating the majority of lesions present with intratumoural calcification.

A comparison of pediatric and adult CT organ dose estimation methods.

BACKGROUND: Computed Tomography (CT) contributes up to 50% of the medical exposure to the United States population. Children are considered to be at higher risk of developing radiation-induced tumors due to the young age of exposure and increased tissue radiosensitivity. Organ dose estimation is essential for pediatric and adult patient cancer risk assessment. The objective of this study is to validate the VirtualDose software in comparison to currently available software and methods for pediatric and adult CT organ dose estimation. METHODS: Five age groups of pediatric patients and adult patients were simulated by three organ dose estimators. Head, chest, abdomen-pelvis, and chest-abdomen-pelvis CT scans were simulated, and doses to organs both inside and outside the scan range were compared. For adults, VirtualDose was compared against ImPACT and CT-Expo. For pediatric patients, VirtualDose was compared to CT-Expo and compared to size-based methods from literature. Pediatric to adult effective dose ratios were also calculated with VirtualDose, and were compared with the ranges of effective dose ratios provided in ImPACT. RESULTS: In-field organs see less than 60% difference in dose between dose estimators. For organs outside scan range or distributed organs, a five times' difference can occur. VirtualDose agrees with the size-based methods within 20% difference for the organs investigated. Between VirtualDose and ImPACT, the pediatric to adult ratios for effective dose are compared, and less than 21% difference is observed for chest scan while more than 40% difference is observed for head-neck scan and abdomen-pelvis scan. For pediatric patients, 2 cm scan range change can lead to a five times dose difference in partially scanned organs. CONCLUSIONS: VirtualDose is validated against CT-Expo and ImPACT with relatively small discrepancies in dose for organs inside scan range, while large discrepancies in dose are observed for organs outside scan range. Patient-specific organ dose estimation is possible using the size-based methods, and VirtualDose agrees with size-based method for the organs investigated. Careful range selection for CT protocols is necessary for organ dose optimization for pediatric and adult patients.

Development of computational pregnant female and fetus models and assessment of radiation dose from positron-emitting tracers.

PURPOSE: Molecular imaging using PET and hybrid (PET/CT and PET/MR) modalities nowadays plays a pivotal role in the clinical setting for diagnosis and staging, treatment response monitoring, and radiation therapy treatment planning of a wide range of oncologic malignancies. The developing embryo/fetus presents a high sensitivity to ionizing radiation. Therefore, estimation of the radiation dose delivered to the embryo/fetus and pregnant patients from PET examinations to assess potential radiation risks is highly praised. METHODS: We constructed eight embryo/fetus models at various gestation periods with 25 identified tissues according to reference data recommended by the ICRP publication 89 representing the anatomy of the developing embryo/fetus. The developed embryo/fetus models were integrated into realistic anthropomorphic computational phantoms of the pregnant female and used for estimating, using Monte Carlo calculations, S-values of common positron-emitting radionuclides, organ absorbed dose, and effective dose of a number of positron-emitting labeled radiotracers. RESULTS: The absorbed dose is nonuniformly distributed in the fetus. The absorbed dose of the kidney and liver of the 8-week-old fetus are about 47.45 % and 44.76 % higher than the average absorbed dose of the fetal total body for all investigated radiotracers. For 18F-FDG, the fetal effective doses are 2.90E-02, 3.09E-02, 1.79E-02, 1.59E-02, 1.47E-02, 1.40E-02, 1.37E-02, and 1.27E-02 mSv/MBq at the 8th, 10th, 15th, 20th, 25th, 30th, 35th, and 38th weeks of gestation, respectively. CONCLUSION: The developed pregnant female/fetus models matching the ICRP reference data can be exploited by dedicated software packages for internal and external dose calculations. The generated S-values will be useful to produce new standardized dose estimates to pregnant patients and embryo/fetus from a variety of positron-emitting labeled radiotracers.

Biodistribution and radiation dosimetry of (68)Ga-PSMA HBED CC-a PSMA specific probe for PET imaging of prostate cancer.

PURPOSE: Positron emission tomography (PET) agents targeting the prostate-specific membrane antigen (PSMA) are currently under broad clinical and scientific investigation. (68)Ga-PSMA HBED-CC constitutes the first (68)Ga-labelled PSMA-inhibitor and has evolved as a promising agent for imaging PSMA expression in vivo. The aim of this study was to evaluate the whole-body distribution and radiation dosimetry of this new probe. METHODS: Five patients with a history or high suspicion of prostate cancer were injected intravenously with a mean of 139.8 ± 13.7 MBq of (68)Ga-PSMA HBED-CC (range 120-158 MBq). Four static skull to mid-thigh scans using a whole-body fully integrated PET/MR-system were performed 10 min, 60 min, 130 min, and 175 min after the tracer injection. Time-dependent changes of the injected activity per organ were determined. Mean organ-absorbed doses and effective doses (ED) were calculated using OLINDA/EXM. RESULTS: Injection of a standard activity of 150 MBq (68)Ga-PSMA HBED-CC resulted in a median effective dose of 2.37 mSv (Range 1.08E-02 - 2.46E-02 mSv/MBq). The urinary bladder wall (median absorbed dose 1.64E-01 mGv/MBq; range 8.76E-02 - 2.91E-01 mGv/MBq) was the critical organ, followed by the kidneys (median absorbed dose 1.21E-01 mGv/MBq; range 7.16E-02 - 1.75E-01), spleen (median absorbed dose 4.13E-02 mGv/MBq; range 1.57E-02 - 7.32E-02 mGv/MBq) and liver (median absorbed dose 2.07E-02 mGv/MBq; range 1.80E-02 - 2.57E-02 mGv/MBq). No drug-related pharmacological effects occurred. CONCLUSION: The use of (68)Ga-PSMA HBED-CC results in a relatively low radiation exposure, delivering organ doses that are comparable to those of other (68)Ga-labelled PSMA-inhibitors used for PET-imaging. Total effective dose is lower than for other PET-agents used for prostate cancer imaging (e.g. (11)C- and (18)F-Choline).

Defining optimal tracer activities in pediatric oncologic whole-body 18F-FDG-PET/MRI.

PURPOSE: To explore the feasibility of reducing administered tracer activities and to assess optimal activities for combined 18F-FDG-PET/MRI in pediatric oncology. METHODS: 30 18F-FDG-PET/MRI examinations were performed on 24 patients with known or suspected solid tumors (10 girls, 14 boys, age 12 ± 5.6 [1-18] years; PET scan duration: 4 min per bed position). Low-activity PET images were retrospectively simulated from the originally acquired data sets using randomized undersampling of list mode data. PET data of different simulated administered activities (0.25-2.5 MBq/kg body weight) were reconstructed with or without point spread function (PSF) modeling. Mean and maximum standardized uptake values (SUVmean and SUVmax) as well as SUV variation (SUVvar) were measured in physiologic organs and focal FDG-avid lesions. Detectability of organ structures and of focal 18F-FDG-avid lesions as well as the occurrence of false-positive PET lesions were assessed at different simulated tracer activities. RESULTS: Subjective image quality steadily declined with decreasing tracer activities. Compared to the originally acquired data sets, mean relative deviations of SUVmean and SUVmax were below 5 % at 18F-FDG activities of 1.5 MBq/kg or higher. Over 95 % of anatomic structures and all pathologic focal lesions were detectable at 1.5 MBq/kg 18F-FDG. Detectability of anatomic structures and focal lesions was significantly improved using PSF. No false-positive focal lesions were observed at tracer activities of 1 MBq/kg 18F-FDG or higher. Administration of 18F-FDG activities of 1.5 MBq/kg is, thus, feasible without obvious diagnostic shortcomings, which is equivalent to a dose reduction of more than 50 % compared to current recommendations. CONCLUSION: Significant reduction in administered 18F-FDG tracer activities is feasible in pediatric oncologic PET/MRI. Appropriate activities of 18F-FDG or other tracers for specific clinical questions have to be further established in selected patient populations.

Synthesis and preclinical evaluation of an Al18F radiofluorinated GLU-UREA-LYS(AHX)-HBED-CC PSMA ligand.

PURPOSE: The aim of this study was to synthesize and preclinically evaluate an 18F-PSMA positron emission tomography (PET) tracer. Prostate-specific membrane antigen (PSMA) specificity, biodistribution, and dosimetry in healthy and tumor-bearing mice were determined. METHODS: Several conditions for the labeling of 18F-PSMA-11 via 18F-AlF-complexation were screened to study the influence of reaction temperature, peptide amount, ethanol volume, and reaction time. After synthesis optimization, biodistribution and dosimetry studies were performed in C57BL6 mice. For proof of PSMA-specificity, mice were implanted with PSMA-negative (PC3) and PSMA-positive (LNCaP) tumors in contralateral flanks. Static and dynamic microPET/computed tomography (CT) imaging was performed. RESULTS: Quantitative labeling yields could be achieved with >97 % radiochemical purity. The 18F-PSMA-11 uptake was more than 24-fold higher in PSMA-high LNCaP than in PSMA-low PC3 tumors (18.4 ± 3.3 %ID/g and 0.795 ± 0.260 %ID/g, respectively; p < 4.2e-5). Results were confirmed by ex vivo gamma counter analysis of tissues after the last imaging time point. The highest absorbed dose was reported for the kidneys. The maximum effective dose for an administered activity of 200 MBq was 1.72 mSv. CONCLUSION: 18F-PSMA-11 using direct labeling of chelate-attached peptide with aluminum-fluoride detected PSMA-expressing tumors with high tumor-to-liver ratios. The kidneys were the dose-limiting organs. Even by applying the most stringent dosimetric calculations, injected activities of up to 0.56 GBq are feasible.

[(68)Ga]NODAGA-RGD - Metabolic stability, biodistribution, and dosimetry data from patients with hepatocellular carcinoma and liver cirrhosis.

PURPOSE: This study was designed to determine safety, tolerability, and radiation burden of a [(68)Ga]NODAGA-RGD-PET for imaging integrin αvß3 expression in patients with hepatocellular carcinoma (HCC) and liver cirrhosis. Moreover, metabolic stability and biokinetic data were compiled. METHODS: After injection of 154-184 MBq [(68)Ga]NODAGA-RGD three consecutive PET/CT scans were acquired starting 8.3 ± 2.1, 36.9 ± 2.8, and 75.1 ± 3.4 min after tracer injection. For metabolite analysis, blood and urine samples were analyzed by HPLC. For dosimetry studies, residence time VOIs were placed in the corresponding organs. The OLINDA/EXM program was used to estimate the absorbed radiation dose. RESULTS: The radiopharmaceutical was well tolerated and no drug-related adverse effects were observed. No metabolites could be detected in blood (30 and 60 min p.i.) and urine (60 min p.i.). [(68)Ga]NODAGA-RGD showed rapid and predominantly renal elimination. Background radioactivity in blood, intestine, lung, and muscle tissue was low (%ID/l 60 min p.i. was 0.56 ± 0.43, 0.54 ± 0.39, 0.22 ± 0.05, and 0.16 ± 0.8, respectively). The calculated effective dose was 21.5 ± 5.4 µSv/MBq, and the highest absorbed radiation dose was found for the urinary bladder wall (0.26 ± 0.09 mSv/MBq). No increased uptake of the tracer was found in HCC compared with the background liver tissue. CONCLUSIONS: [(68)Ga]NODAGA-RGD uptake in the HCCs lesions was not sufficient to use this tracer for imaging these tumors. [(68)Ga]NODAGA-RGD was well tolerated and metabolically stable. Due to rapid renal excretion, background radioactivity was low in most of the body, resulting in low radiation burden and indicating the potential of [(68)Ga]NODAGA-RGD PET for non-invasive determination of integrin αvß3 expression.

How Low Can We Go in Radiation Dose for the Data-Completion Scan on a Research Whole-Body Photon-Counting Computed Tomography System.

PURPOSE: A research photon-counting computed tomography (CT) system that consists of an energy-integrating detector (EID) and a photon-counting detector (PCD) was installed in our laboratory. The scanning fields of view of the EID and PCD at the isocenter are 500 and 275 mm, respectively. When objects are larger than the PCD scanning field of view, a data-completion scan (DCS) using the EID subsystem is needed to avoid truncation artifacts in PCD images. The goals of this work were to (1) find the impact of a DCS on noise of PCD images and (2) determine the lowest possible dose for a DCS such that truncation artifacts are negligible in PCD images. METHODS: First, 2 semianthropomorphic abdomen phantoms were scanned on the PCD subsystem. For each PCD scan, we acquired 1 DCS with the maximum effective mAs and 5 with lower effective mAs values. The PCD image reconstructed using the maximum effective mAs was considered as the reference image, and those using the lower effective mAs as the test images. The PCD image reconstructed without a DCS was considered the baseline image. Each PCD image was assessed in terms of noise and CT number uniformity; the results were compared among the baseline, test, and reference images. Finally, the impact of a DCS on PCD image quality was qualitatively assessed for other body regions using an anthropomorphic torso phantom. RESULTS: The DCS had a negligible impact on the noise magnitude in the PCD images. The PCD images with the minimum available dose (CTDIvol < 2 mGy) showed greatly enhanced CT number uniformity compared with the baseline images without noticeable truncation artifacts. Further increasing the effective mAs of a DCS did not yield noticeable improvement in CT number uniformity. CONCLUSIONS: A DCS using the minimum available dose had negligible effect on image noise and was sufficient to maintain satisfactory CT number uniformity for the PCD scans.

A puzzling case of contamination with 241Am.

Two people were exposed to and contaminated with 241Am. In vivo determinations of the incorporated 241Am were performed using a whole-body counter and two partial-body counters for the skull and lung, respectively. Additionally, urine samples were analysed to estimate the systemic activity removed from the body. To improve the geometry of the skull measurements, an optimised detector configuration was used, a calibration with three physical phantoms of the human head was conducted, and the morphological variability between the individuals was also considered. The results of the measurements indicate that activity is not deposited in the deep tissues, rather in the skin tissues close to the body surface. Unfortunately, the many open questions relating to the actual circumstances during and after the incident make the interpretation of this case difficult if at all possible.