Optimization of Pediatric PET/CT

Parisi, Marguerite T.; Bermo, Mohammed; Alessio, Adam M.; Sharp, Susan E.; Gelfand, Michael J.; Shulkin, Barry L.

doi:10.1053/j.semnuclmed.2017.01.002

Cited by 52 publications

(63 citation statements)

References 95 publications

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“…Multiple medical imaging sessions increase the cost to the health care system and inconvenience the patients. Furthermore, multiple medical imaging may have substantial detrimental side effect, such as increased risk for cancer, in particular to children [14–18]. Taken as a whole, the disadvantages of repeat head imaging may surpass the advantages.…”

Section: Introductionmentioning

confidence: 99%

Radar based technology for non-contact monitoring of accumulation of blood in the head: A numerical study

2017

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BackgroundThis theoretical study examines the use of radar to continuously monitor “accumulation of blood in the head” (ACBH) non-invasively and from a distance, after the location of a hematoma or hemorrhage in the brain was initially identified with conventional medical imaging. Current clinical practice is to monitor ABCH with multiple, subsequent, conventional medical imaging. The radar technology introduced in this study could provide a lower cost and safe alternative to multiple conventional medical imaging monitoring for ACBH.Materials and methodsThe goal of this study is to evaluate the feasibility of using radar to monitor changes in blood volume in the brain through a numerical simulation of ACBH monitoring from remote, with a directional spiral slot antennae, in 3-D models of the brain. The focus of this study is on evaluating the effect of frequencies on the antennae reading. To that end we performed the calculations for frequencies of 100 MHz, 500 MHz and 1 GHz.Results and discussionThe analysis shows that the ACBH can be monitored with radar and the monitoring resolution improves with an increase in frequency, in the range studied. However, it also appears that when typical clinical dimensions of hematoma and hemorrhage are used, the variable ratio of blood volume radius and radar wavelength can bring the measurements into the Mie and Rayleigh regions of the radar cross section. In these regions there is an oscillatory change in signal with blood volume size. For some frequencies there is an increase in signal with an increase in volume while in others there is a decrease.ConclusionsWhile radar can be used to monitor ACBH non-invasively and from a distance, the observed Mie region dependent oscillatory relation between blood volume size and wavelength requires further investigation. Classifiers, multifrequency algorithms or ultra-wide band radar are possible solutions that should be explored in the future.

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Section: Introductionmentioning

confidence: 99%

Radar based technology for non-contact monitoring of accumulation of blood in the head: A numerical study

2017

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“…The survey results reported here indicated that there is considerable variation in the acquisition of the CT component even among dedicated pediatric institutions, which further shows the potential need for standardization. Over the past decade, several groups have reported on the optimization of pediatric PET/CT (25,(41)(42)(43)(44). We have presented the Boston Children's approach as an option that uses AEC to manage radiation dose without setting specific levels for different-sized patients.…”

Section: Discussionmentioning

confidence: 99%

Operational and Dosimetric Aspects of Pediatric PET/CT

et al. 2017

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Learning Objectives: On successful completion of this activity, participants should be able to (1) list 3 factors that affect CT radiation dose; (2) discuss 3 ways that CT is used in the context of PET/CT; and (3) describe various approaches to integrating PET/CT and diagnostic CT in children.Financial Disclosure: Dr. Fahey is a board member of the American Association of Physicists in Medicine and an employee of Boston Children's Hospital. The authors of this article have indicated no other relevant relationships that could be perceived as a real or apparent conflict of interest. CME Credit: SNMMI is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to sponsor continuing education for physicians. SNMMI designates each JNM continuing education article for a maximum of 2.0 AMA PRA Category 1 Credits. Physicians should claim only credit commensurate with the extent of their participation in the activity. For CE credit, SAM, and other credit types, participants can access this activity through the SNMMI website (http://www.snmmilearningcenter.org) through September 2020.No consistent guidelines exist for the acquisition of a CT scan as part of pediatric PET/CT. Given that children may be more vulnerable to the effects of ionizing radiation, it is necessary to develop methods that provide diagnostic-quality imaging when needed, in the shortest time and with the lowest patient radiation exposure. This article describes the basics of CT dosimetry and PET/CT acquisition in children. We describe the variability in pediatric PET/CT techniques, based on a survey of 19 PET/CT pediatric institutions in North America. The results of the survey demonstrated that, although most institutions used automatic tube current modulation, there remained a large variation of practice, on the order of a factor of 2-3, across sites, pointing to the need for guidelines. We introduce the approach developed at our institution for using a multiseries PET/CT acquisition technique that combines diagnostic-quality CT in the essential portion of the field of view and a low-dose technique to image the remainder of the body. This approach leads to a reduction in radiation dose to the patient while combining the PET and the diagnostic CT into a single acquisition. The standardization of pediatric PET/CT provides an opportunity for a reduction in the radiation dose to these patients while maintaining an appropriate level of diagnostic image quality.

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“…SPECT/CT and PET/CT result in an increased patient radiation dose compared with SPECT or PET imaging alone. 6,8,9 Consequently, for musculoskeletal imaging with SPECT/CT, it is important to remember that the CT component may not always be necessary. SPECT alone may be sufficient.…”

Section: Radiation Dosimetry Of Spect/ct and Pet/ctmentioning

confidence: 99%

“…Diagnostic CT incurs the highest patient radiation dose; SPECT or PET performed with limited low-dose localization CT imparts the lowest dose. 6,8,9 Each case should be evaluated individually, using best practices to adjust CT parameters to a lower radiation dose. It is also important to "Go with the Guidelines" campaign, and use pediatric-appropriate radiopharmaceutical-administered activities when performing nuclear medicine imaging in children.…”

Section: Radiation Dosimetry Of Spect/ct and Pet/ctmentioning

confidence: 99%

Nuclear Medicine Applications in Pediatric Musculoskeletal Diseases: The Added Value of Hybrid Imaging

Parisi

Iyer

Stanescu

2018

Semin Musculoskelet Radiol

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The introduction of diphosphonates in the 1970s revolutionized not only nuclear medicine but musculoskeletal imaging as well, providing functional assessment of entities such as osteomyelitis, trauma, and osseous metastatic disease. Although rarely the first-line imaging modality used today, nuclear medicine procedures continue to play a pivotal role in the evaluation of musculoskeletal diseases in children, providing whole-body assessment of disease involvement. More recently, the introduction of technologies such as single-photon emission computed tomography/computed tomography (SPECT/CT), as well as newer positron-emitting tracers such as fluorine-fluorodeoxyglucose and sodiumF-fluorine, particularly when combined with CT (positron emission tomography/CT), have injected new life into the older established techniques and expanded the application of nuclear medicine imaging into new arenas. This article discusses the utility of standard nuclear medicine procedures as they apply to children with musculoskeletal disorders, focusing on the added value of and indications for SPECT/CT. Subsequently, we discuss the expanding role of positron-emitting agents in infection, trauma, and for the diagnosis, staging, and therapeutic response monitoring of children with malignant bone and soft tissue tumors. Differences between disease processes encountered in children as compared with adults are discussed; developmental variants that can, but should not, be confused with disease are illustrated. The need for pediatric-specific protocols is addressed.

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Optimization of Pediatric PET/CT

Cited by 52 publications

References 95 publications

Radar based technology for non-contact monitoring of accumulation of blood in the head: A numerical study

Radar based technology for non-contact monitoring of accumulation of blood in the head: A numerical study

Operational and Dosimetric Aspects of Pediatric PET/CT

Nuclear Medicine Applications in Pediatric Musculoskeletal Diseases: The Added Value of Hybrid Imaging

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