ASSESSING BODY DOSE RATE CONSTANT AND EFFECTIVE BODY ABSORPTION FACTOR IN TAIWANESE REFERENCE PHANTOMS.

The self-attenuation of a patient's body is an important factor in nuclear medicine for designing radiation shielding. Taiwanese reference man (TRM) and Taiwanese reference woman (TRW) were constructed to simulate the body dose rate constant and the effective body absorption factor for 18F-FDG, 131I-NaI and 99mTc-MIBI using the Monte Carlo technique. For TRM, the maximum body dose rate constants for 18F-FDG, 131I-NaI and 99mTc-MIBI were 1.26 × 10-1, 4.89 × 10-2 and 1.76 × 10-2 mSv-m2/GBq-h, respectively, at heights of 110, 110 and 100 cm. For TRW, the results were 1.23 × 10-1, 4.75 × 10-2 and 1.68 × 10-2 mSv-m2/GBq-h at heights of 100, 100 and 90 cm. The effective body absorption factors were 32.6, 36.7 and 46.2% for TRM and 34.2, 38.5 and 48.6% for TRW. Regional reference phantoms along with the derived body dose rate constant and effective body absorption factor should be used for determining regulatory secondary standards in nuclear medicine.

Meta-analysis of the effectiveness of heparin in suppressing physiological myocardial FDG uptake in PET/CT.

BACKGROUND: The present meta-analysis aims to investigate the effectiveness of heparin administration in suppressing physiological myocardial 18F-fluorodeoxyglucose (FDG) uptake on positron emission tomography (PET)/computed tomography (CT), as its role in this regard has not been well investigated. METHODS: PRISMA guidelines were used to interrogate the PubMed, Embase, Cochrane library, Web of Knowledge, and www.clinicaltrail.gov databases from the earliest records to March 2023. The final analysis included five randomized controlled trials (RCTs). Meta-analysis was conducted to compare the effectiveness of unfractionated heparin (UFH) administration versus non-UFH administration, and subgroup analysis based on fixed and variable fasting durations was conducted. Effect sizes were pooled using a random-effects model, and the pooled odds ratios (ORs) were calculated. RESULTS: Five eligible RCTs with a total of 910 patients (550 with heparin, 360 without heparin) were included. The forest plot analysis initially indicated no significant difference in the suppression of myocardial FDG uptake between the UFH and non-UFH groups (OR 2.279, 95% CI 0.593 to 8.755, p = 0.23), with a high degree of statistical heterogeneity (I2 = 91.16%). Further subgroup analysis showed that the fixed fasting duration group with UFH administration had statistically significant suppression of myocardial FDG uptake (OR 4.452, 95% CI 1.221 to 16.233, p = 0.024), while the varying fasting duration group did not show a significant effect. CONCLUSIONS: According to the findings of our meta-analysis, we suggest that intravenous administration of UFH can be considered as a supplementary approach to suppress myocardial FDG uptake.

Diagnosis of Osteoporosis by Quantifying Volumetric Bone Mineral Density of Lumbar Vertebrae Using Abdominal CT Images and Two-Compartment Model.

With the aging population, osteoporosis has become an important public health issue. The purpose of this study was to establish a two-compartment model (TCM) to quantify the volumetric bone mineral density (vBMD) of the lumbar spine using abdominal computed tomography (CT) images. The TCM approach uses water as the bone marrow equivalent and K2HPO4 solution as the cortical bone equivalent. A phantom study was performed to evaluate the accuracy of vBMD estimation at 100 kVp and 120 kVp. The data of 180 patients who underwent abdominal CT imaging and dual-energy X-ray absorptiometry (DXA) within one month were retrospectively collected. vBMD of L1-L4 vertebrae were calculated, and the receiver-operating characteristic curve analysis was performed to establish the diagnostic thresholds for osteoporosis and osteopenia in terms of vBMD. The average difference between the measured vBMD following TCM and the theoretical vBMD of the self-made phantom was 0.2%, and the maximum difference was 0.5%. vBMD of lumbar vertebrae obtained from TCM and aBMD obtained by DXA had a significant positive correlation (r = 0.655 to 0.723). The average diagnostic threshold for osteoporosis was 0.116 g/cm3. The sensitivity, specificity, and accuracy were 95.7%, 75.6.5%, and 80.0%, respectively. The average diagnostic threshold for osteopenia was 0.126 g/cm3. The sensitivity, specificity, and accuracy were 81.3%, 82.5%, and 82.7%, respectively. The aforementioned threshold values were used to perform the diagnostics on a test cohort, and the performance was equivalent to that in the experimental cohort. From the perspective of preventive medicine, opportunistic screening of bone mineral density using abdominal CT images and the TCM approach can facilitate early detection of osteoporosis and osteopenia and, with in-time treatment, slow down their progression.

Effective suppression of myocardial glucose uptake using predesigned low-carbohydrate boxed meals.

BACKGROUND: Dietary preparation protocols are an effective means to suppress physiological myocardial 18F-fluorodeoxyglucose (FDG) uptake. This study aimed to investigate the efficacy of various carbohydrate-restricted diets using predesigned boxed meals. METHODS: The patients were divided into four groups to undergo different preparatory protocols as follows: a minimum 15-hour fast alone, two meals of high-fat, low-carbohydrate diet (HFLCD), two meals of high-animal-protein, low-carbohydrate diet (HAPLCD), and two meals of high-plant-based-protein, low-carbohydrate diet (HPPLCD). Boxed meals were prepared to meet the required carbohydrate restrictions. Myocardial SUVmax and SUVmean were measured and the suppression rate was analyzed. RESULTS: The average myocardial SUVmax of fast alone, HFLCD, HAPLCD, and HPPLCD were 8.26 ± 5.85, 2.21 ± 1.50, 2.34 ± 1.88, and 4.10 ± 3.61, respectively, and the suppression rates were 36.6%, 93.3%, 93.3%, and 70%, respectively. The effectiveness of HFLCD, HAPLCD, and HPPLCD was all statistically superior to that of a 15-hour fast alone. SUVmax of HFLCD and HAPLCD showed no significant differences (p = 1), whereas HFLCD and HPPLCD had significant differences (p = .046). CONCLUSIONS: Using the predesigned boxed meals based on carbohydrate restriction, HFLCD, HAPLCD, and HPPLCD can be administered to patients with different dietary needs while providing a substantial reduction in physiological myocardial FDG uptake.

Singlet Biradical Versus Triplet Biradical/Zwitterion Characteristics in Isomers of C6 -C5 -C6 -C7 -C6 -Fused Pentacyclic Aromatic Hydrocarbons Revealed through Reactivity Patterns.

Among various polycyclic aromatic hydrocarbons, C6 -C5 -C6 -C7 -C6 fused pentacyclic aromatic hydrocarbons have the unique potential to adopt quinonoid, zwitterion, singlet, or triplet biradical electronic configurations. Two such hybrid structures between pentacene and azulene were synthesized and their ground state electronic configurations were deduced from the reactivity patterns they exhibit respectively. Compound 6, where the radicaloid carbons are linked through a para-phenylene, forms a head-to-head dimer like a singlet biradical. In contrast, isomer 7, where the para-linkage was switched to meta, reacts readily with oxygen which resembles the reactivity of a triplet state. The oxidized intermediate(s) then undergoes rearrangement to furnish the C6 -C5 -C6 -C6 -C6 ring contraction product 13. Cation 14, the protonated form of 7, was synthesized, which implies 7 also reacts like a zwitterion. It was revealed the oxidative rearrangement takes place even with mesityl dibenzotropylium cation despite its perceived aromaticity. DFT calculations confirm the most stable forms of 6 and 7 are singlet and triplet diradical, which is consistent with the observed reactivity of respective molecules.

Cardiac catheterization real-time dynamic radiation dose measurement to estimate lifetime attributable risk of cancer.

Cardiac catheterization procedure is the gold standard to diagnose and treat cardiovascular disease. However, radiation safety and cancer risk remain major concerns. This study aimed to real-time dynamic radiation dose measurement to estimate lifetime attributable risk (LAR) of cancer incidence and mortality in operators. Coronary angiography (CA) with percutaneous coronary intervention (PCI), CA, and others (radiofrequency ablation, pacemaker and defibrillator implantation) procedures with different beam directions, were undertaken on x-ray angiography system. A real-time electronic personal dosimeter (EPD) system was used to measure the radiation dose of staff during all procedures. We followed the Biological Effects of Ionizing Radiation (BEIR) VII report to estimate the LAR of all cancer incidence and mortality. Primary operators received radiation dose in CA with PCI, CA, and others procedures were 59.33 ± 95.03 µSv, 39.81 ± 103.85 µSv, and 21.92 ± 37.04 µSv, respectively. As to the assistant operators were 30.03 ± 55.67 µSv, 14.67 ± 14.88 µSv, and 4 µSv, respectively. LAR of all cancer incidences for staffs aged from 18 to 65 are varied from 0.40% for males to 1.50% for females. LAR of all cancer mortality for staffs aged from 18 to 65 are varied from 0.22% for males to 0.83% for females. Our study provided an easy, real-time and dynamic radiation dose measurement to estimate LAR of cancer for staff during the cardiac catheterization procedures. The LAR for all cancer incidence is about twice that for cancer mortality. Although the radiation doses of staff are lower during each procedure, the increased years of service leads to greater radiation risk to the staff.

Three-layer heterogeneous mammographic phantoms for Monte Carlo simulation of normalized glandular dose coefficients in mammography.

Normalized glandular dose (DgN) coefficients obtained using homogeneous breast phantoms are commonly used in breast dosimetry for mammography. However, glandular tissue is heterogeneously distributed in the breast. This study aimed to construct three-layer heterogeneous mammographic phantoms (THEPs) to examine the effect of glandular distribution on DgN coefficient. Each layer of THEPs was set to 25%, 50%, or 75% glandular fraction to emulate heterogeneous glandular distribution. Monte Carlo simulation was performed to attain mean glandular dose (MGD) and air kerma at 22-36 kVp and W/Al, W/Rh, and W/Ag target-filter combinations. The heterogeneous DgN coefficient was calculated as functions of the mean glandular fraction (MGF), breast thickness, tube voltage, and half-value layer. At 50% MGF, the heterogeneous DgN coefficients for W/Al, W/Rh, and W/Ag differed by 40.3%, 36.7%, and 31.2%. At 9-cm breast thickness, the DgN values of superior and inferior glandular distributions were 25.4% higher and 29.2% lower than those of uniform distribution. The proposed THEPs can be integrated with conventional breast dosimetry to consider the heterogeneous glandular distribution in clinical practice.

Model Image-Based Metal Artifact Reduction for Computed Tomography.

Metal implants often produce severe artifacts in the reconstructed computed tomography (CT) images, causing information and image detail loss and making the CT images diagnostically unusable. In order to eliminate the metal artifacts and enhance the diagnostic value of the reconstructed CT images, a post-processing metal artifact reduction algorithm, based on a tissue-class model segmented by thresholding and k-means clustering with spatial information, is proposed. The image inpainting technique is incorporated into the algorithm to improve the segmentation accuracy for CT images severely corrupted by metal artifacts. A study of a water phantom and of two sets of clinical CT images was performed to test the algorithm performance. The proposed method effectively eliminates typical metal artifacts, restores the average CT numbers of different tissues to the proper levels, and preserves the edge and contrast information, thus allowing the accurate reconstruction of the tissue attenuation map. The quality of the artifact-corrected CT images allows them to be subsequently used in other clinical applications, such as three-dimensional rendering, dose estimation for radiotherapy, attenuation correction for PET and SPECT, etc. The algorithm does not rely on the use of the raw sinogram and so is not limited by the proprietary format restrictions.

Sensitivity enhancement of methacrylic acid gel dosimeters by incorporating iodine for computed tomography scans.

PURPOSE: Polymer gel dosimeters provide three-dimensional absorbed dose information and have gradually become a popular tool for quality assurance in radiotherapy. This study aims to incorporate iodine into the MAGAT-based gel as radiation sensitizer and investigate whether it can be used to measure the radiation dose and slice thickness for CT scans. METHODS: The nMAGAT(I) gel was doped with 0.03, 0.05, and 0.07-M iodine. The absorbed dose was delivered using a CT scanner (Alexion 16, Toshiba Medical Systems, Japan) with tube voltages of 80, 100, 120, and 135 kVp. The irradiated nMAGAT(I) gel was read using a cone beam optical CT scanner to produce dose-response curves. The nMAGAT(I) gel was used to obtain the slice sensitivity profile (SSP) and the CT dose index (CTDI) for quality assurance of CT scans. RESULTS: The 0.07-M iodine-doped nMAGAT(I) gel exhibited maximum sensitivity with the dose enhancement ratio of 2.12. The gel was chemically stable 24 h after its preparation, and the polymerization process was completed 24-48 h after the irradiation. For CT quality assurance, the full width at half maximum measured by the nMAGAT(I) gel matched the nominal slice thickness of CT. The CTDI at center, CTDI at peripheral, and weighted CTDI obtained by the nMAGAT(I) gel differed from those obtained by the ionization chamber by -4.2%, 3.1%, and 0.7%, respectively. CONCLUSIONS: The nMAGAT(I) gel can be used to assess radiation doses and slice thickness in CT scans, thus rendering it a potential quality assurance tool for CT and other radiological diagnostic applications.

Using an on-board cone-beam computed tomography scanner as an imaging modality for gel dosimetry: A feasibility study.

On-board cone-beam computed tomography (CBCT) was used to scan the N-isopropylacrylamide (NIPAM) gel dosimeter. A dose-response curve from 1 to 12 Gy was created. The dose profile and depth dose curve were measured, and the dose distribution acquired from CBCT was then compared with that obtained from a treatment planning system (TPS). The linearity of the dose-response curve obtained by CBCT scanning of the NIPAM gel was 0.985. The mean percent standard deviation of various doses was 12.8%. A 12- to 24-h post-irradiation time was required to achieve stable CBCT readouts. Both dose profile and depth dose were in agreement with the results of TPS. The dose difference at the isocenter between CBCT and TPS was 3.8%. The gamma evaluation under the conditions of 5% dose difference and 5 mm distance-to-agreement was performed with the pass rate of 92.6%. These results indicate that an on-board CBCT can be used for scanning gel dosimeters in clinical radiotherapy.

Using Cine-Averaged CT With the Shallow Breathing Pattern to Reduce Respiration-Induced Artifacts for Thoracic Cavity PET/CT Scans.

OBJECTIVE. PET/CT provides a fusion of both anatomic and functional information. However, because of the temporal difference of both modalities and respiratory motion of lungs, misregistration of lesions is frequently observed on thoracic PET/CT scans. The effect of cine-averaged CT (CACT) acquisition incorporated with the shallow breathing pattern of patients on the improvement of registration and quantification of lesions was investigated. MATERIALS AND METHODS. Thirty patients with cancer who underwent routine PET/CT followed by CACT of the thoracic region were enrolled. The misalignment between PET/helical CT (HCT) and PET/CACT was calculated. In addition, the PET data were attenuation-corrected by HCT and CACT images, and the maximum standardized uptake value (SUVmax) was evaluated. RESULTS. All lesions in the PET/HCT images showed misalignment larger than 5 mm, whereas only 33% of lesions in the PET/CACT images showed misalignment larger than 5 mm. The mean values of the maximum misalignment of the lesions in PET/HCT and PET/CACT images were 14.10 ± 6.26 mm and 5.92 ± 4.31 mm, respectively. Seven percent of the lesions had an increase in SUVmax of more than 20%, and 47% showed a slight increase in SUVmax of less than 5% after applying CACT. The mean percentage difference between the SUVmax of CACT and that of HCT was 12%. CONCLUSION. Using the CACT technique and the shallow breathing pattern effectively reduces misregistration of lesions and recovers the underestimated SUVmax. The CACT method can be applied in clinical practice of thoracic PET/CT for better cancer management.

Improving the prediction of the trabecular bone microarchitectural parameters using dental cone-beam computed tomography.

BACKGROUND: In this study, we explored how various preprocessing approaches can be employed to enhance the capability of dental CBCT to accurately estimate trabecular bone microarchitectural parameters. METHODS: In total, 30 bovine vertebrae cancellous bone specimens were used for in study. Voxel resolution 18-µm micro-computed tomography (micro-CT) and 100-µm dental CBCT were used to scan each specimen. Micro-CT images were used to calculate trabecular bone microarchitectural parameters; the results were set as the gold standard. Subsequently, before the dental CBCT images were converted into binary images to calculate trabecular bone microarchitectural parameters, three preprocessing approaches were used to process the dental CBCT images. For Group 1, no preprocessing approach was applied. For Group 2, images were sharpened and despeckable noises were removed. For Group 3, the function of local thresholding was added to Group 2 to form Group 3. For Group 4, the air pixels was removed from Group 3 to form Group 4. Subsequently, all images were imported into a software package to estimate trabecular bone microarchitectural parameters (bone volume fraction (BV/TV), trabecular thickness (TbTh), trabecular number (TbN), and trabecular separation (TbSp)). Finally, a paired t-test and a Pearson correlation test were performed to compare the capability of micro-CT with the capability of dental CBCT for estimating trabecular bone microarchitectural parameters. RESULTS: Regardless of whether dental CBCT images underwent image preprocessing (Groups 1 to 4), the four trabecular bone microarchitectural parameters measured using dental CBCT images were significantly different from those measured using micro-CT images. However, after three image preprocessing approaches were applied to the dental CBCT images (Group 4), the BV/TV obtained using dental CBCT was highly positively correlated with that obtained using micro-CT (r = 0.87, p < 0.001); the correlation coefficient was greater than that of Group 1 (r = -0.15, p = 0.412), Group 2 (r = 0.16, p = 0.386), and Group 3 (r = 0.47, p = 0.006). After dental CBCT images underwent image preprocessing, the efficacy of using dental CBCT for estimating TbN and TbSp was enhanced. CONCLUSIONS: Image preprocessing approaches can be used to enhance the efficacy of using dental CBCT for predicting trabecular bone microarchitectural parameters.

Using a Somatosensory Controller to Assess Body Size for Size-Specific Dose Estimates in Computed Tomography.

Computed tomography (CT) has been widely used in the healthcare environment. Presently, the radiation dose in CT is determined using the size-specific dose estimate (SSDE). Accurate assessment of individual's body size is essential for dose estimation. In this study, we integrated a somatosensory controller with a CT scanner to measure patient's anterior-posterior diameter (APD) and lateral diameter (LATD) and calculate the corresponding effective diameter (ED). A total of 108 individuals with an average age of 38.6 years were enrolled in this study. Microsoft Kinect was used to acquire the depth image of subjects. A grayscale-to-surface height conversion curve was created using acrylic sheets for APD estimation. The APD, LATD, and ED were measured and compared with the results obtained using F ruler and CT images. The mean absolute differences for APD, LATD, and ED between Kinect and F ruler measurements were 5.2%, 1.3%, and 2.5%, respectively, while those between Kinect and CT measurements were 8.8%, 2.6%, and 5.0%, respectively. Kinect can replace CT or F ruler for real-time body size measurements. The use of the somatosensory controller has the advantages of simple, low cost, no radiation, and automatic calculation. It can accurately estimate patient's APD, LATD, and ED for SSDE.

Quantification of Volumetric Bone Mineral Density of Proximal Femurs Using a Two-Compartment Model and Computed Tomography Images.

OBJECTIVES: Dual-energy X-ray absorptiometry (DXA) is frequently used to measure the areal bone mineral density (aBMD) in clinical practice. However, DXA measurements are affected by the bone thickness and the body size and are unable to indicate nonosseous areas within the trabecular bone. This study aims to quantify the volumetric bone mineral density (vBMD) using computed tomography (CT) images and the two-compartment model (TCM) methods. METHODS: The TCM method was proposed and validated by dipotassium phosphate (K2HPO4) phantoms and a standard forearm phantom. 28 cases with DXA scans and pelvic CT scans acquired within six months were retrospectively collected. The vBMD calculated by TCM was compared with the aBMD obtained from DXA. RESULTS: For the K2HPO4 phantoms with vBMD ranging from 0.135 to 0.467 g/cm3, the average difference between the real and calculated vBMD was 0.009 g/cm3 and the maximum difference was 0.019 g/cm3. For the standard forearm phantom with vBMD of 0.194, 0.103, and 0.054 g/cm3, the average differences between the real and calculated vBMD were 0.017, 0.014, and 0.011 g/cm3. In the clinical CT image validation, a good linear relationship between vBMD and aBMD was observed with the Pearson correlation coefficient of 0.920 (p < 0.01). CONCLUSIONS: The proposed TCM method in combination with the homemade cortical bone equivalent phantom provides accurate quantification and spatial distribution of bone mineral content.

Dose and slice thickness evaluation with nMAG gel dosimeters in computed tomography.

Computed tomography (CT) has been widely used in clinical diagnosis. It is important to estimate radiation dose and perform image quality assurance procedures for CT scans. In this study, nMAG gel dosimeters were used to simultaneously measure the 300-mm weighted CT dose index (CTDI) and slice sensitivity profile (SSP) for multiple detector CT (MDCT). Magnetic resonance imaging (MRI) was performed on the irradiated gel to create R2‒dose response curves for the tube voltages of 120 and 140 kVp. The gel dosimeters were loaded in three home-made cylindrical phantoms to obtain CTDI100 and CTDI300. The full width at half maximum (FWHM) for 2, 5, 10, 14.4, and 38.4-mm slice thicknesses was measured and compared with the result obtained by radiochromic films. The difference in weighted CTDI100 obtained by the gel dosimeter and ionization chamber was less than 1%. The CTDI efficiency at 120 and 140 kVp was in the range of 80.1%-82.5%. The FWHM of SSP measured by the gel dosimeter matched very well with the nominal slice thickness. The use of nMAG gel dosimeters combined with the home-made cylindrical phantoms can provide 300-mm weighted CTDI and slice thickness information, showing potential for quality assurance and clinical applications in MDCT.

Intermittent parathyroid hormone improve bone microarchitecture of the mandible and femoral head in ovariectomized rats.

BACKGROUND: Intermittent parathyroid hormone (PTH) can be used to treat osteoporosis of the spine and hip. However, whether it can be used to treat osteoporosis of the mandible is unclear. The purpose of this study was to explore the influence of applying intermittent PTH to ovariectomized rats on the trabecular bone microarchitecture of the mandible and femoral head. METHODS: Eighteen female rats were divided into three groups: the healthy group, ovariectomized (OVX) group, and OVX + PTH group. The OVX group and OVX + PTH group had an OVX at 8 weeks of age. The OVX + PTH group received intermittent PTH therapy for 12 weeks. The mandibles and femurs of all rats were removed at 20 weeks and were then scanned using microcomputed tomography (micro-CT). RESULTS: From the micro-CT analysis, the trabecular bone microarchitecture of the mandible and femoral head are offered as follows: (1) The bone volume fraction and trabecular thickness in the OVX group were lower than those in the healthy group. (2) The bone volume fraction and trabecular thickness in the OVX + PTH group approximated those in the healthy group. CONCLUSION: The conclusions of this study regarding the trabecular bone microarchitecture of the mandible and femoral head are offered as follows: (1) The BV/TV and TbTh in the OVX group were lower than those in the healthy group. (2) The BV/TV and TbTh in the OVX + PTH group approximated those in the healthy group, therefore, intermittent PTH displayed high efficacy for treating femoral or mandibular deterioration of bone microstructure resulting from loss of ovarian function. Osteoporosis of the femur or mandible in the rats was ameliorated by intermittent PTH therapy.

Dose Conversion Coefficients Based on Taiwanese Reference Phantoms and Monte Carlo Simulations for Use in External Radiation Protection.

Reference phantoms are widely applied to evaluate the radiation dose for external exposure. However, the frequently used reference phantoms are based on Caucasians. Dose estimation for Asians using a Caucasian phantom can result in significant errors. This study recruited 40 volunteers whose body sizes are close to the average Taiwanese population. Magnetic resonance imaging was performed to obtain the organ volume for construction of the Taiwanese reference man (TRM) and Taiwanese reference woman (TRW). The dose conversion coefficients (DCC) resulting from photo beams in anterior-posterior, posterior-anterior, right-lateral, left-lateral, and isotropic irradiation geometries were estimated. In the anterior-posterior geometry, the mean DCC differences among organs between the TRM and ORNL phantom at 0.1, 1, and 10 MeV were 7.3%, 5.8%, and 5.2%, respectively. For the TRW, the mean differences from the ORNL phantom at the three energies were 10.6%, 7.4%, and 8.3%. The DCCs of the Taiwanese reference phantoms and the ORNL phantom presented similar trends in other geometries. The torso size of the phantom and the mass and geometric location of the organ have a significant influence on the DCC. The Taiwanese reference phantoms can be used to establish dose guidelines and regulations for radiation protection from external exposure.

Four patients with gastrointestinal bleeding identified by a modified in vivo technique with labeled red blood cells sedimentation.

OBJECTIVE: Gastrointestinal bleeding scintigraphy (GIBS) offers the advantage of continuous monitoring of patients to localize the site of gastrointestinal bleeding. In this study, a modified in vivo labeling method with sedimentation of the labeled red blood cells (RBC) was applied to remove free technetium-99m (99mTc) and increase labeling efficiency. PATIENTS AND METHODS: Four patients were studied. A modified in vivo RBC labeling method was used. After 10 minutes of RBC sedimentation, patients' blood plasma in the upper part of the syringe was removed, and the erythrocytes labeled with 99mTc were re-administered to the patient. Serial dynamic scintiphotos were taken during the first 60 minutes. Delayed static images were acquired up to 22 hours after injection. RESULTS: The labeling efficiency of 99mTc-RBC increased up to 93%. GIBS can be performed after 20 hours post-injection and provide accurate diagnosis of gastrointestinal bleeding. No false positive findings due to free 99mTc accumulation were observed for the four patients. CONCLUSION: The modified in vivo method with sedimentation is a simple and effective way to increase the labeling efficiency and thus the diagnosis for the detection of gastrointestinal bleeding.

Converting computed tomography images into photon interaction coefficients by using stoichiometric calibration and parametric fit models.

PURPOSE: X ray and γ-ray are widely applied in radiology, radiotherapy, and nuclear medicine. Linear attenuation coefficients and linear energy absorption coefficients are essential for dose calculation and image correction. In this study, a method that entails combining the stoichiometric calibration and parametric physical models was developed to convert computed tomography (CT) images into the linear attenuation coefficients and linear energy absorption coefficients. METHODS: A calibration scan was performed using standard tissue-equivalent materials to obtain the characteristics of the x-ray energy spectrum. Subsequently, relationships between CT numbers and tissue parameters were established using standard soft tissue and bone tissue data adopted from the literature. The linear attenuation coefficient and linear energy absorption coefficient were calculated using the parametric fit model. RESULTS: The results showed a linear relationship between CT numbers and tissue parameters. The tissue-equivalent materials differed from real human tissues, leading to considerable errors in estimation of mass attenuation coefficients when the photon energy was lower than 50 keV. Mass attenuation coefficients and mass energy transfer coefficients of five tissues were calculated and validated using clinical CT images. The error was less than ± 5% and ± 8%, compared with the values of the International Commission on Radiation Units (ICRU) 46 report. CONCLUSIONS: The probability of photon interaction with tissues and physical characteristics of tissues can be accurately evaluated by using the proposed method and applied in various clinical applications.