M Allan Thomas, Sam Meiselman, J Daniel Giardina, John Karageorgiou, Naganathan Mani, Christopher D Malone
{"title":"截断的巨聚集白蛋白单光子发射断层扫描/未知肺肿块的计算机断层扫描对90Y放射栓塞的临床可成立的肺剂量估计。","authors":"M Allan Thomas, Sam Meiselman, J Daniel Giardina, John Karageorgiou, Naganathan Mani, Christopher D Malone","doi":"10.1097/MNM.0000000000002017","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Relative to planar imaging, macro-aggregated albumin-single photon emission tomography/computed tomography (MAA-SPECT/CT) offers more reliable lung shunt fraction (LSF) and lung mean dose (LMD) estimates in 90 Y radioembolization. But lung truncation in SPECT/CT can limit its utility, yielding uncertain LSF and LMD estimates. Here, the effects of lung mass on LSF and LMD corrections for lung truncation in SPECT/CT were analyzed.</p><p><strong>Methods: </strong>106 cases with planar LSF > 8% were analyzed. Lung truncation was simulated in 30 cases with full lung coverage, while 50 cases with clinical truncation were also assessed. Five LMD estimates were computed: (1) planar-imaging, 1-kg lung-mass (Planar 1-kg ), (2) planar-imaging, patient-specific lung-mass (Planar), (3) uncorrected-truncated SPECT and lung-mass (SPECT Trunc ), (4) truncation-corrected SPECT, 1-kg lung-mass (SPECT 1-kg ), (5) truncation-corrected SPECT, patient-specific lung-mass (SPECT Fit ). Bland-Altman analysis (mean difference ± 95% prediction interval; PI = 1.96σ) was used to compare the LMD estimates.</p><p><strong>Results: </strong>Planar 1-kg and Planar LMD were comparable on average, but variability was high (mean ± 95% PI: 0.1 ± 7.8 Gy). The mean ± 95% PI in LMD for Planar 1-kg relative to nontruncated-SPECT (SPECT True ) was 10.4 ± 11.4 Gy. LMD differences relative to SPECT True were 0.3 ± 1.0 Gy for SPECT Trunc , 0.1 ± 1.0 Gy for SPECT 1-kg , and 0.1 ± 1.1 Gy for SPECT Fit . In clinically truncated cases, differences between Planar 1-kg and SPECT Trunc were again high (11.2 ± 10.3 Gy), with differences between SPECT Trunc , SPECT 1-kg , and SPECT Fit much smaller (mean <0.2 Gy, 95% PI < 2.0 Gy).</p><p><strong>Conclusion: </strong>The most impactful difference in estimating LMD is using SPECT/CT data in place of planar imaging. Even when lung mass is unknown or a reference value (1-kg) is used, truncated MAA-SPECT/CT offers more robust LMD estimates than planar imaging.</p>","PeriodicalId":19708,"journal":{"name":"Nuclear Medicine Communications","volume":" ","pages":"913-922"},"PeriodicalIF":1.3000,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Clinically tenable lung dose estimates in 90 Y radioembolization from truncated macro-aggregated albumin-single photon emission tomography/computed tomography with unknown lung mass.\",\"authors\":\"M Allan Thomas, Sam Meiselman, J Daniel Giardina, John Karageorgiou, Naganathan Mani, Christopher D Malone\",\"doi\":\"10.1097/MNM.0000000000002017\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Relative to planar imaging, macro-aggregated albumin-single photon emission tomography/computed tomography (MAA-SPECT/CT) offers more reliable lung shunt fraction (LSF) and lung mean dose (LMD) estimates in 90 Y radioembolization. But lung truncation in SPECT/CT can limit its utility, yielding uncertain LSF and LMD estimates. Here, the effects of lung mass on LSF and LMD corrections for lung truncation in SPECT/CT were analyzed.</p><p><strong>Methods: </strong>106 cases with planar LSF > 8% were analyzed. Lung truncation was simulated in 30 cases with full lung coverage, while 50 cases with clinical truncation were also assessed. Five LMD estimates were computed: (1) planar-imaging, 1-kg lung-mass (Planar 1-kg ), (2) planar-imaging, patient-specific lung-mass (Planar), (3) uncorrected-truncated SPECT and lung-mass (SPECT Trunc ), (4) truncation-corrected SPECT, 1-kg lung-mass (SPECT 1-kg ), (5) truncation-corrected SPECT, patient-specific lung-mass (SPECT Fit ). Bland-Altman analysis (mean difference ± 95% prediction interval; PI = 1.96σ) was used to compare the LMD estimates.</p><p><strong>Results: </strong>Planar 1-kg and Planar LMD were comparable on average, but variability was high (mean ± 95% PI: 0.1 ± 7.8 Gy). The mean ± 95% PI in LMD for Planar 1-kg relative to nontruncated-SPECT (SPECT True ) was 10.4 ± 11.4 Gy. LMD differences relative to SPECT True were 0.3 ± 1.0 Gy for SPECT Trunc , 0.1 ± 1.0 Gy for SPECT 1-kg , and 0.1 ± 1.1 Gy for SPECT Fit . In clinically truncated cases, differences between Planar 1-kg and SPECT Trunc were again high (11.2 ± 10.3 Gy), with differences between SPECT Trunc , SPECT 1-kg , and SPECT Fit much smaller (mean <0.2 Gy, 95% PI < 2.0 Gy).</p><p><strong>Conclusion: </strong>The most impactful difference in estimating LMD is using SPECT/CT data in place of planar imaging. Even when lung mass is unknown or a reference value (1-kg) is used, truncated MAA-SPECT/CT offers more robust LMD estimates than planar imaging.</p>\",\"PeriodicalId\":19708,\"journal\":{\"name\":\"Nuclear Medicine Communications\",\"volume\":\" \",\"pages\":\"913-922\"},\"PeriodicalIF\":1.3000,\"publicationDate\":\"2025-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Nuclear Medicine Communications\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/MNM.0000000000002017\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/6/24 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Nuclear Medicine Communications","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/MNM.0000000000002017","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/6/24 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
Clinically tenable lung dose estimates in 90 Y radioembolization from truncated macro-aggregated albumin-single photon emission tomography/computed tomography with unknown lung mass.
Objective: Relative to planar imaging, macro-aggregated albumin-single photon emission tomography/computed tomography (MAA-SPECT/CT) offers more reliable lung shunt fraction (LSF) and lung mean dose (LMD) estimates in 90 Y radioembolization. But lung truncation in SPECT/CT can limit its utility, yielding uncertain LSF and LMD estimates. Here, the effects of lung mass on LSF and LMD corrections for lung truncation in SPECT/CT were analyzed.
Methods: 106 cases with planar LSF > 8% were analyzed. Lung truncation was simulated in 30 cases with full lung coverage, while 50 cases with clinical truncation were also assessed. Five LMD estimates were computed: (1) planar-imaging, 1-kg lung-mass (Planar 1-kg ), (2) planar-imaging, patient-specific lung-mass (Planar), (3) uncorrected-truncated SPECT and lung-mass (SPECT Trunc ), (4) truncation-corrected SPECT, 1-kg lung-mass (SPECT 1-kg ), (5) truncation-corrected SPECT, patient-specific lung-mass (SPECT Fit ). Bland-Altman analysis (mean difference ± 95% prediction interval; PI = 1.96σ) was used to compare the LMD estimates.
Results: Planar 1-kg and Planar LMD were comparable on average, but variability was high (mean ± 95% PI: 0.1 ± 7.8 Gy). The mean ± 95% PI in LMD for Planar 1-kg relative to nontruncated-SPECT (SPECT True ) was 10.4 ± 11.4 Gy. LMD differences relative to SPECT True were 0.3 ± 1.0 Gy for SPECT Trunc , 0.1 ± 1.0 Gy for SPECT 1-kg , and 0.1 ± 1.1 Gy for SPECT Fit . In clinically truncated cases, differences between Planar 1-kg and SPECT Trunc were again high (11.2 ± 10.3 Gy), with differences between SPECT Trunc , SPECT 1-kg , and SPECT Fit much smaller (mean <0.2 Gy, 95% PI < 2.0 Gy).
Conclusion: The most impactful difference in estimating LMD is using SPECT/CT data in place of planar imaging. Even when lung mass is unknown or a reference value (1-kg) is used, truncated MAA-SPECT/CT offers more robust LMD estimates than planar imaging.
期刊介绍：
Nuclear Medicine Communications, the official journal of the British Nuclear Medicine Society, is a rapid communications journal covering nuclear medicine and molecular imaging with radionuclides, and the basic supporting sciences. As well as clinical research and commentary, manuscripts describing research on preclinical and basic sciences (radiochemistry, radiopharmacy, radiobiology, radiopharmacology, medical physics, computing and engineering, and technical and nursing professions involved in delivering nuclear medicine services) are welcomed, as the journal is intended to be of interest internationally to all members of the many medical and non-medical disciplines involved in nuclear medicine. In addition to papers reporting original studies, frankly written editorials and topical reviews are a regular feature of the journal.
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