Safety injections of nuclear medicine radiotracers: towards a new modality for a real-time detection of extravasation events and 18F-FDG SUV data correction
Abstract Background 18F-FDG PET/CT imaging allows to study oncological patients and their relative diagnosis through the standardised uptake value (SUV) evaluation. During radiopharmaceutical injection, an extravasation event may occur, making the SUV value less accurate and possibly leading to seve...
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SpringerOpen
2023-05-01
|
| Series: | EJNMMI Physics |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40658-023-00556-5 |
| _version_ | 1797817785381814272 |
|---|---|
| author | Mauro Iori Elisa Grassi Lorenzo Piergallini Greta Meglioli Andrea Botti Giada Sceni Noemi Cucurachi Laura Verzellesi Domenico Finocchiaro Annibale Versari Beatrice Fraboni Federica Fioroni |
| author_facet | Mauro Iori Elisa Grassi Lorenzo Piergallini Greta Meglioli Andrea Botti Giada Sceni Noemi Cucurachi Laura Verzellesi Domenico Finocchiaro Annibale Versari Beatrice Fraboni Federica Fioroni |
| author_sort | Mauro Iori |
| collection | DOAJ |
| description | Abstract Background 18F-FDG PET/CT imaging allows to study oncological patients and their relative diagnosis through the standardised uptake value (SUV) evaluation. During radiopharmaceutical injection, an extravasation event may occur, making the SUV value less accurate and possibly leading to severe tissue damage. The study aimed to propose a new technique to monitor and manage these events, to provide an early evaluation and correction to the estimated SUV value through a SUV correction coefficient. Methods A cohort of 70 patients undergoing 18F- FDG PET/CT examinations was enrolled. Two portable detectors were secured on the patients' arms. The dose-rate (DR) time curves on the injected DRin and contralateral DRcon arm were acquired during the first 10 min of injection. Such data were processed to calculate the parameters Δpin NOR = (DRin max- DRin mean)/DRin max and ΔRt = (DRin(t) − DRcon(t)), where DRin max is the maximum DR value, DRin mean is the average DR value in the injected arm. OLINDA software allowed dosimetric estimation of the dose in the extravasation region. The estimated residual activity in the extravasation site allowed the evaluation of the SUV's correction value and to define an SUV correction coefficient. Results Four cases of extravasations were identified for which ΔRt [(390 ± 26) µSv/h], while ΔRt [(150 ± 22) µSv/h] for abnormal and ΔRt [(24 ± 11) µSv/h] for normal cases. The Δpin NOR showed an average value of (0.44 ± 0.05) for extravasation cases and an average value of (0.91 ± 0.06) and (0.77 ± 0.23) in normal and abnormal classes, respectively. The percentage of SUV reduction (SUV%CR) ranges between 0.3% and 6%. The calculated self-tissue dose values range from 0.027 to 0.573 Gy, according to the segmentation modality. A similar correlation between the inverse of Δpin NOR and the normalised ΔRt with the SUV correction coefficient was found. Conclusions The proposed metrics allowed to characterised the extravasation events in the first few minutes after the injection, providing an early SUV correction when necessary. We also assume that the characterisation of the DR-time curve of the injection arm is sufficient for the detection of extravasation events. Further validation of these hypotheses and key metrics is recommended in larger cohorts. |
| first_indexed | 2024-03-13T08:58:37Z |
| format | Article |
| id | doaj.art-8eb3f7bec00e4a2f8f0f30b5f3ebf9fa |
| institution | Directory Open Access Journal |
| issn | 2197-7364 |
| language | English |
| last_indexed | 2024-03-13T08:58:37Z |
| publishDate | 2023-05-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | EJNMMI Physics |
| spelling | doaj.art-8eb3f7bec00e4a2f8f0f30b5f3ebf9fa2023-05-28T11:28:02ZengSpringerOpenEJNMMI Physics2197-73642023-05-0110111610.1186/s40658-023-00556-5Safety injections of nuclear medicine radiotracers: towards a new modality for a real-time detection of extravasation events and 18F-FDG SUV data correctionMauro Iori0Elisa Grassi1Lorenzo Piergallini2Greta Meglioli3Andrea Botti4Giada Sceni5Noemi Cucurachi6Laura Verzellesi7Domenico Finocchiaro8Annibale Versari9Beatrice Fraboni10Federica Fioroni11Medical Physics Unit, Azienda USL-IRCCS di Reggio EmiliaMedical Physics Unit, Azienda USL-IRCCS di Reggio EmiliaMedical Physics Unit, Azienda USL-IRCCS di Reggio EmiliaMedical Physics Unit, Azienda USL-IRCCS di Reggio EmiliaMedical Physics Unit, Azienda USL-IRCCS di Reggio EmiliaMedical Physics Unit, Azienda USL-IRCCS di Reggio EmiliaMedical Physics Unit, Azienda USL-IRCCS di Reggio EmiliaMedical Physics Unit, Azienda USL-IRCCS di Reggio EmiliaMedical Physics Unit, Azienda USL-IRCCS di Reggio EmiliaNuclear Medicine Unit, Azienda USL-IRCCS di Reggio EmiliaDepartment of Physics, University of BolognaMedical Physics Unit, Azienda USL-IRCCS di Reggio EmiliaAbstract Background 18F-FDG PET/CT imaging allows to study oncological patients and their relative diagnosis through the standardised uptake value (SUV) evaluation. During radiopharmaceutical injection, an extravasation event may occur, making the SUV value less accurate and possibly leading to severe tissue damage. The study aimed to propose a new technique to monitor and manage these events, to provide an early evaluation and correction to the estimated SUV value through a SUV correction coefficient. Methods A cohort of 70 patients undergoing 18F- FDG PET/CT examinations was enrolled. Two portable detectors were secured on the patients' arms. The dose-rate (DR) time curves on the injected DRin and contralateral DRcon arm were acquired during the first 10 min of injection. Such data were processed to calculate the parameters Δpin NOR = (DRin max- DRin mean)/DRin max and ΔRt = (DRin(t) − DRcon(t)), where DRin max is the maximum DR value, DRin mean is the average DR value in the injected arm. OLINDA software allowed dosimetric estimation of the dose in the extravasation region. The estimated residual activity in the extravasation site allowed the evaluation of the SUV's correction value and to define an SUV correction coefficient. Results Four cases of extravasations were identified for which ΔRt [(390 ± 26) µSv/h], while ΔRt [(150 ± 22) µSv/h] for abnormal and ΔRt [(24 ± 11) µSv/h] for normal cases. The Δpin NOR showed an average value of (0.44 ± 0.05) for extravasation cases and an average value of (0.91 ± 0.06) and (0.77 ± 0.23) in normal and abnormal classes, respectively. The percentage of SUV reduction (SUV%CR) ranges between 0.3% and 6%. The calculated self-tissue dose values range from 0.027 to 0.573 Gy, according to the segmentation modality. A similar correlation between the inverse of Δpin NOR and the normalised ΔRt with the SUV correction coefficient was found. Conclusions The proposed metrics allowed to characterised the extravasation events in the first few minutes after the injection, providing an early SUV correction when necessary. We also assume that the characterisation of the DR-time curve of the injection arm is sufficient for the detection of extravasation events. Further validation of these hypotheses and key metrics is recommended in larger cohorts.https://doi.org/10.1186/s40658-023-00556-518F-FDGPETSUVExtravasationRadiopharmaceuticalDosimetry |
| spellingShingle | Mauro Iori Elisa Grassi Lorenzo Piergallini Greta Meglioli Andrea Botti Giada Sceni Noemi Cucurachi Laura Verzellesi Domenico Finocchiaro Annibale Versari Beatrice Fraboni Federica Fioroni Safety injections of nuclear medicine radiotracers: towards a new modality for a real-time detection of extravasation events and 18F-FDG SUV data correction EJNMMI Physics 18F-FDG PET SUV Extravasation Radiopharmaceutical Dosimetry |
| title | Safety injections of nuclear medicine radiotracers: towards a new modality for a real-time detection of extravasation events and 18F-FDG SUV data correction |
| title_full | Safety injections of nuclear medicine radiotracers: towards a new modality for a real-time detection of extravasation events and 18F-FDG SUV data correction |
| title_fullStr | Safety injections of nuclear medicine radiotracers: towards a new modality for a real-time detection of extravasation events and 18F-FDG SUV data correction |
| title_full_unstemmed | Safety injections of nuclear medicine radiotracers: towards a new modality for a real-time detection of extravasation events and 18F-FDG SUV data correction |
| title_short | Safety injections of nuclear medicine radiotracers: towards a new modality for a real-time detection of extravasation events and 18F-FDG SUV data correction |
| title_sort | safety injections of nuclear medicine radiotracers towards a new modality for a real time detection of extravasation events and 18f fdg suv data correction |
| topic | 18F-FDG PET SUV Extravasation Radiopharmaceutical Dosimetry |
| url | https://doi.org/10.1186/s40658-023-00556-5 |
| work_keys_str_mv | AT mauroiori safetyinjectionsofnuclearmedicineradiotracerstowardsanewmodalityforarealtimedetectionofextravasationeventsand18ffdgsuvdatacorrection AT elisagrassi safetyinjectionsofnuclearmedicineradiotracerstowardsanewmodalityforarealtimedetectionofextravasationeventsand18ffdgsuvdatacorrection AT lorenzopiergallini safetyinjectionsofnuclearmedicineradiotracerstowardsanewmodalityforarealtimedetectionofextravasationeventsand18ffdgsuvdatacorrection AT gretameglioli safetyinjectionsofnuclearmedicineradiotracerstowardsanewmodalityforarealtimedetectionofextravasationeventsand18ffdgsuvdatacorrection AT andreabotti safetyinjectionsofnuclearmedicineradiotracerstowardsanewmodalityforarealtimedetectionofextravasationeventsand18ffdgsuvdatacorrection AT giadasceni safetyinjectionsofnuclearmedicineradiotracerstowardsanewmodalityforarealtimedetectionofextravasationeventsand18ffdgsuvdatacorrection AT noemicucurachi safetyinjectionsofnuclearmedicineradiotracerstowardsanewmodalityforarealtimedetectionofextravasationeventsand18ffdgsuvdatacorrection AT lauraverzellesi safetyinjectionsofnuclearmedicineradiotracerstowardsanewmodalityforarealtimedetectionofextravasationeventsand18ffdgsuvdatacorrection AT domenicofinocchiaro safetyinjectionsofnuclearmedicineradiotracerstowardsanewmodalityforarealtimedetectionofextravasationeventsand18ffdgsuvdatacorrection AT annibaleversari safetyinjectionsofnuclearmedicineradiotracerstowardsanewmodalityforarealtimedetectionofextravasationeventsand18ffdgsuvdatacorrection AT beatricefraboni safetyinjectionsofnuclearmedicineradiotracerstowardsanewmodalityforarealtimedetectionofextravasationeventsand18ffdgsuvdatacorrection AT federicafioroni safetyinjectionsofnuclearmedicineradiotracerstowardsanewmodalityforarealtimedetectionofextravasationeventsand18ffdgsuvdatacorrection |