Transmission Imaging in Lymphoscintigraphy with a 153Gd Flood Source.
Identifieur interne : 000C69 ( PubMed/Corpus ); précédent : 000C68; suivant : 000C70Transmission Imaging in Lymphoscintigraphy with a 153Gd Flood Source.
Auteurs : Frank P. Difilippo ; Richard C. Brunken ; Donald R. NeumannSource :
- Journal of nuclear medicine technology [ 1535-5675 ] ; 2015.
English descriptors
- KwdEn :
- MESH :
- chemical : Gadolinium, Radioisotopes.
- diagnostic imaging : Breast, Lymphedema.
- methods : Lymphoscintigraphy.
- Artifacts, Humans, Image Processing, Computer-Assisted, Phantoms, Imaging, Signal-To-Noise Ratio.
Abstract
Lymphoscintigraphy uses intradermal or interstitial injections of (99m)Tc-labeled tracers to produce images of focal lymph nodes. Because there is little or no anatomic information in the (99m)Tc images, a (57)Co flood source is sometimes used to provide transmission data along with the emission data. The anatomic shadow from the transmission scan generally improves interpretation and surgical planning. However, the (57)Co transmission photons contribute to background on the (99m)Tc images, reducing contrast and signal-to-noise ratio (SNR). SNR is related to lesion detection, and some lymph nodes that would be detected in an emission-only scan might not be detected if acquired with a (57)Co flood source. An alternative to a (57)Co flood source is a (153)Gd flood source, which has primary photon emissions well below the (99m)Tc emission window, allowing the shadow to be acquired in a separate transmission window. Significantly smaller crosstalk from (153)Gd should improve SNR and therefore would be expected to improve lymph node detection. We hypothesized that the use of a (153)Gd flood source would reduce background and improve SNR for these studies.
DOI: 10.2967/jnmt.115.161935
PubMed: 26338486
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pubmed:26338486Le document en format XML
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<author><name sortKey="Difilippo, Frank P" sort="Difilippo, Frank P" uniqKey="Difilippo F" first="Frank P" last="Difilippo">Frank P. Difilippo</name>
<affiliation><nlm:affiliation>Department of Nuclear Medicine, Cleveland Clinic, Cleveland, Ohio difilif@ccf.org.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Brunken, Richard C" sort="Brunken, Richard C" uniqKey="Brunken R" first="Richard C" last="Brunken">Richard C. Brunken</name>
<affiliation><nlm:affiliation>Department of Nuclear Medicine, Cleveland Clinic, Cleveland, Ohio.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Neumann, Donald R" sort="Neumann, Donald R" uniqKey="Neumann D" first="Donald R" last="Neumann">Donald R. Neumann</name>
<affiliation><nlm:affiliation>Department of Nuclear Medicine, Cleveland Clinic, Cleveland, Ohio.</nlm:affiliation>
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<sourceDesc><biblStruct><analytic><title xml:lang="en">Transmission Imaging in Lymphoscintigraphy with a 153Gd Flood Source.</title>
<author><name sortKey="Difilippo, Frank P" sort="Difilippo, Frank P" uniqKey="Difilippo F" first="Frank P" last="Difilippo">Frank P. Difilippo</name>
<affiliation><nlm:affiliation>Department of Nuclear Medicine, Cleveland Clinic, Cleveland, Ohio difilif@ccf.org.</nlm:affiliation>
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<author><name sortKey="Brunken, Richard C" sort="Brunken, Richard C" uniqKey="Brunken R" first="Richard C" last="Brunken">Richard C. Brunken</name>
<affiliation><nlm:affiliation>Department of Nuclear Medicine, Cleveland Clinic, Cleveland, Ohio.</nlm:affiliation>
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<author><name sortKey="Neumann, Donald R" sort="Neumann, Donald R" uniqKey="Neumann D" first="Donald R" last="Neumann">Donald R. Neumann</name>
<affiliation><nlm:affiliation>Department of Nuclear Medicine, Cleveland Clinic, Cleveland, Ohio.</nlm:affiliation>
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<series><title level="j">Journal of nuclear medicine technology</title>
<idno type="eISSN">1535-5675</idno>
<imprint><date when="2015" type="published">2015</date>
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Artifacts</term>
<term>Breast (diagnostic imaging)</term>
<term>Gadolinium</term>
<term>Humans</term>
<term>Image Processing, Computer-Assisted</term>
<term>Lymphedema (diagnostic imaging)</term>
<term>Lymphoscintigraphy (methods)</term>
<term>Phantoms, Imaging</term>
<term>Radioisotopes</term>
<term>Signal-To-Noise Ratio</term>
</keywords>
<keywords scheme="MESH" type="chemical" xml:lang="en"><term>Gadolinium</term>
<term>Radioisotopes</term>
</keywords>
<keywords scheme="MESH" qualifier="diagnostic imaging" xml:lang="en"><term>Breast</term>
<term>Lymphedema</term>
</keywords>
<keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Lymphoscintigraphy</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Artifacts</term>
<term>Humans</term>
<term>Image Processing, Computer-Assisted</term>
<term>Phantoms, Imaging</term>
<term>Signal-To-Noise Ratio</term>
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<front><div type="abstract" xml:lang="en">Lymphoscintigraphy uses intradermal or interstitial injections of (99m)Tc-labeled tracers to produce images of focal lymph nodes. Because there is little or no anatomic information in the (99m)Tc images, a (57)Co flood source is sometimes used to provide transmission data along with the emission data. The anatomic shadow from the transmission scan generally improves interpretation and surgical planning. However, the (57)Co transmission photons contribute to background on the (99m)Tc images, reducing contrast and signal-to-noise ratio (SNR). SNR is related to lesion detection, and some lymph nodes that would be detected in an emission-only scan might not be detected if acquired with a (57)Co flood source. An alternative to a (57)Co flood source is a (153)Gd flood source, which has primary photon emissions well below the (99m)Tc emission window, allowing the shadow to be acquired in a separate transmission window. Significantly smaller crosstalk from (153)Gd should improve SNR and therefore would be expected to improve lymph node detection. We hypothesized that the use of a (153)Gd flood source would reduce background and improve SNR for these studies.</div>
</front>
</TEI>
<pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">26338486</PMID>
<DateCreated><Year>2015</Year>
<Month>12</Month>
<Day>04</Day>
</DateCreated>
<DateCompleted><Year>2016</Year>
<Month>09</Month>
<Day>12</Day>
</DateCompleted>
<DateRevised><Year>2016</Year>
<Month>11</Month>
<Day>26</Day>
</DateRevised>
<Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1535-5675</ISSN>
<JournalIssue CitedMedium="Internet"><Volume>43</Volume>
<Issue>4</Issue>
<PubDate><Year>2015</Year>
<Month>Dec</Month>
</PubDate>
</JournalIssue>
<Title>Journal of nuclear medicine technology</Title>
<ISOAbbreviation>J Nucl Med Technol</ISOAbbreviation>
</Journal>
<ArticleTitle>Transmission Imaging in Lymphoscintigraphy with a 153Gd Flood Source.</ArticleTitle>
<Pagination><MedlinePgn>253-60</MedlinePgn>
</Pagination>
<ELocationID EIdType="doi" ValidYN="Y">10.2967/jnmt.115.161935</ELocationID>
<Abstract><AbstractText Label="UNLABELLED">Lymphoscintigraphy uses intradermal or interstitial injections of (99m)Tc-labeled tracers to produce images of focal lymph nodes. Because there is little or no anatomic information in the (99m)Tc images, a (57)Co flood source is sometimes used to provide transmission data along with the emission data. The anatomic shadow from the transmission scan generally improves interpretation and surgical planning. However, the (57)Co transmission photons contribute to background on the (99m)Tc images, reducing contrast and signal-to-noise ratio (SNR). SNR is related to lesion detection, and some lymph nodes that would be detected in an emission-only scan might not be detected if acquired with a (57)Co flood source. An alternative to a (57)Co flood source is a (153)Gd flood source, which has primary photon emissions well below the (99m)Tc emission window, allowing the shadow to be acquired in a separate transmission window. Significantly smaller crosstalk from (153)Gd should improve SNR and therefore would be expected to improve lymph node detection. We hypothesized that the use of a (153)Gd flood source would reduce background and improve SNR for these studies.</AbstractText>
<AbstractText Label="METHODS" NlmCategory="METHODS">Phantom studies simulating lymphoscintigraphy were performed to compare performance with a (153)Gd flood source, a (57)Co flood source, and no flood source. SNR in the (99m)Tc emission images was measured using a water phantom to simulate patient body and point sources of various activities to simulate nodes and injection site. The encouraging phantom studies prompted use of the (153)Gd flood source in routine clinical breast lymphoscintigraphy, melanoma lymphoscintigraphy, and lymphedema studies. Because emission and transmission data were acquired in separate energy windows, fused planar images of emission and transmission data were available to the physician.</AbstractText>
<AbstractText Label="RESULTS" NlmCategory="RESULTS">SNR was highest with no flood source and was lowest with the (57)Co flood source by a significant margin. SNR with the (153)Gd flood source was similar to that with no flood source on the anterior (transmission) view. SNR was reduced somewhat in the posterior (nontransmission) view because of attenuation of signal by the flood source itself. Minor crosstalk in the (99m)Tc window was observed with the (153)Gd flood source, attributed to simultaneous detection of x-ray photons and gamma-photons. This crosstalk was reduced by introducing thin metal filters to absorb most x-ray photons, at the expense of more attenuation in the posterior view. Unlike with the (57)Co flood source, a usable posterior view (with anatomic shadow derived from the anterior view) was generated with the (153)Gd flood source. Clinical lymphoscintigraphy images with the (153)Gd flood source were of high quality. Interpretation was aided by the ability to control image mixing and brightness and contrast of separate color scales.</AbstractText>
<AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">By producing fused images with reduced crosstalk and improved image quality, a (153)Gd flood source offers advantages over a conventional (57)Co flood source for anatomic shadowing in lymphoscintigraphy. Lymph nodes in emission images have higher SNR, indicating a likely improvement in clinical lesion detection. Separate emission and transmission images provide additional flexibility in image display during interpretation.</AbstractText>
<CopyrightInformation>© 2015 by the Society of Nuclear Medicine and Molecular Imaging, Inc.</CopyrightInformation>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>DiFilippo</LastName>
<ForeName>Frank P</ForeName>
<Initials>FP</Initials>
<AffiliationInfo><Affiliation>Department of Nuclear Medicine, Cleveland Clinic, Cleveland, Ohio difilif@ccf.org.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Brunken</LastName>
<ForeName>Richard C</ForeName>
<Initials>RC</Initials>
<AffiliationInfo><Affiliation>Department of Nuclear Medicine, Cleveland Clinic, Cleveland, Ohio.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Neumann</LastName>
<ForeName>Donald R</ForeName>
<Initials>DR</Initials>
<AffiliationInfo><Affiliation>Department of Nuclear Medicine, Cleveland Clinic, Cleveland, Ohio.</Affiliation>
</AffiliationInfo>
</Author>
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<Language>eng</Language>
<PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType>
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<ArticleDate DateType="Electronic"><Year>2015</Year>
<Month>09</Month>
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<MedlineJournalInfo><Country>United States</Country>
<MedlineTA>J Nucl Med Technol</MedlineTA>
<NlmUniqueID>0430303</NlmUniqueID>
<ISSNLinking>0091-4916</ISSNLinking>
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<ChemicalList><Chemical><RegistryNumber>0</RegistryNumber>
<NameOfSubstance UI="D011868">Radioisotopes</NameOfSubstance>
</Chemical>
<Chemical><RegistryNumber>AU0V1LM3JT</RegistryNumber>
<NameOfSubstance UI="D005682">Gadolinium</NameOfSubstance>
</Chemical>
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<CitationSubset>IM</CitationSubset>
<MeshHeadingList><MeshHeading><DescriptorName UI="D016477" MajorTopicYN="N">Artifacts</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D001940" MajorTopicYN="N">Breast</DescriptorName>
<QualifierName UI="Q000000981" MajorTopicYN="N">diagnostic imaging</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D005682" MajorTopicYN="Y">Gadolinium</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D007091" MajorTopicYN="N">Image Processing, Computer-Assisted</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D008209" MajorTopicYN="N">Lymphedema</DescriptorName>
<QualifierName UI="Q000000981" MajorTopicYN="N">diagnostic imaging</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D061305" MajorTopicYN="N">Lymphoscintigraphy</DescriptorName>
<QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D019047" MajorTopicYN="N">Phantoms, Imaging</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D011868" MajorTopicYN="Y">Radioisotopes</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D059629" MajorTopicYN="N">Signal-To-Noise Ratio</DescriptorName>
</MeshHeading>
</MeshHeadingList>
<KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">153Gd</Keyword>
<Keyword MajorTopicYN="N">flood source</Keyword>
<Keyword MajorTopicYN="N">lymph node detection</Keyword>
<Keyword MajorTopicYN="N">lymphoscintigraphy</Keyword>
</KeywordList>
</MedlineCitation>
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