Hiroki Miyatake

Evaluation of a respiratory navigator-gating technique in Gd-EOB-DTPA-enhanced magnetic resonance imaging for the assessment of liver tumors

OBJECTIVES We investigated the clinical usefulness of respiratory navigator-gating technique for the assessment of liver tumors in Gd-EOB-DTPA-enhanced magnetic resonance (MR) imaging. METHODS Eighty patients who underwent Gd-EOB-DTPA-enhanced MR imaging to evaluate known or suspected liver tumors were enrolled. Three-dimensional spoiled gradient-recalled echo images of the liver were acquired in the hepatobiliary phase by the following three methods: breath-hold imaging, navigator-gated low-resolution imaging, and navigator-gated high-resolution imaging. Navigator-gated imaging was performed during free breathing. Spatial resolution was identical between breath-hold imaging and gated low-resolution imaging. Signal intensities in the liver, muscle, and spleen were measured in 20 patients. Image quality was visually evaluated in all 80 patients. The detection rate and lesion conspicuity were assessed for 71 malignant liver lesions identified in 29 patients. RESULTS The liver-to-muscle and liver-to-spleen signal ratios were significantly lower for gated images compared to breath-hold images. Images of acceptable quality were obtained in most patients by all three methods, and the overall image quality of axial images did not differ significantly among the imaging methods, although superior reformatted coronal images were obtained by gated high-resolution imaging. The detection rates of malignant liver lesions were similar among the three imaging methods, although lesion conspicuity was significantly better for breath-hold imaging compared to gated imaging. CONCLUSIONS Navigator-gated imaging provided image qualities and detection rates of malignant liver lesions comparable to breath-hold imaging in Gd-EOB-DTPA-enhanced MR imaging; however, no additional benefits of high-resolution imaging were proven for lesion evaluation.

Methods of CT dose estimation in whole-body 18F-FDG PET/CT

We evaluated the effective dose (ED) of the CT component of whole-body PET/CT using software dedicated to CT dose estimation and from dose–length product (DLP) values to establish practical methods of ED estimation. Methods: Eighty adult patients who underwent 18F-FDG whole-body PET/CT were divided into groups A and B, each consisting of 20 men and 20 women. In group A, ED of the CT component was calculated using CT-Expo for 6 anatomic regions separately, and whole-body ED was obtained by summing the regional EDs (CT-Expo method). DLP was calculated for each of the 6 regions and multiplied by a corresponding conversion factor described in International Commission on Radiological Protection publication 102 to obtain the ED for each region (regional DLP method). Whole-body ED was also calculated as the product of a whole-body DLP value provided by the scanner automatically and a conversion factor (simple DLP method). Moreover, the ED/DLP values were calculated using whole-body ED estimated by the CT-Expo method and the scanner-derived DLP, to optimize the conversion factor. In group B, the optimized conversion factor was applied for the estimation of ED by the simple DLP method. Results: In group A, the regional DLP method allowed an accurate estimation of mean whole-body ED as a result of counterbalance of mild overestimation in men and mild underestimation in women, regarding the CT-Expo method as a standard. The simple DLP method using a conversion factor for the trunk (0.015 mSv/mGy/cm) caused overestimation. On the basis of the ED/DLP values in group A, a modified conversion factor of 0.013 mSv/mGy/cm and sex-specific conversion factors of 0.012 and 0.014 mSv/mGy/cm for men and women, respectively, were determined. In group B, the use of the modified conversion factor improved accuracy, and the use of sex-specific conversion factors eliminated sex-dependent residual errors. Conclusion: ED of the CT component of whole-body PET/CT can be assessed by multiplying the scanner-derived DLP by a conversion factor optimized for whole-body PET/CT.

Reliability of 3D arterial spin labeling MR perfusion measurements: The effects of imaging parameters, scanner model, and field strength

The aim of this study was to investigate the reliability of cerebral blood flow (CBF) measurements obtained by 3D pseudo-continuous arterial spin labeling (pCASL) imaging according to imaging parameters, scanner model, and field strength. We acquired 3D pCASL images in 12 healthy volunteers using four different scanners: two 3.0 T scanners and two 1.5 T scanners. Reliability was evaluated using intraclass correlation coefficient. Our results indicate that the influence of the post-labeling delay and scanner model on CBF measurements should be taken into consideration. If two scanners of the same model are used, scannerdependent differences may be small.

Measurement of Renal Depth in Dynamic Renal Scintigraphy Using Ultralow-Dose CT.

Purpose Renal depths predicted using predefined formulas are commonly used for camera-based evaluation of renal function. We investigated the feasibility and utility of renal depth measurement using ultralow-dose CT images acquired in conjunction with dynamic renal scintigraphy. Methods Dynamic renal scintigraphy with 99mTc-MAG3 was performed in 117 patients (225 kidneys) using a SPECT/CT scanner, and ultralow-dose CT (estimated effective dose of 0.17 mSv) was performed during free breathing immediately before tracer injection. The clarity of the renal contour on the CT images was evaluated visually. The renal depths were measured by 2 methods and compared with depths predicted by 2 previously reported methods. The accuracy of camera-based clearance using predicted and measured depths was evaluated using a single-sample method as a standard. Results The clarity of the renal contour was poor in 18 of 225 kidneys, and 12 of 117 patients were considered ineligible for depth measurement. The measurement for eligible patients showed excellent intraobserver and interobserver repeatabilities. Although mean depths were similar among the 2 CT measurement methods and 2 prediction methods, absolute differences of more than 1 cm were observed in approximately 20% of kidneys between CT measurement and prediction. CT measurement of renal depth failed to improve the accuracy of camera-based clearance evaluation. Conclusion Ultralow-dose CT allowed measurement of renal depth in most patients. Substantial differences in renal depth between prediction and CT measurement indicated potential usefulness of CT measurement, although no actual improvement in the accuracy of clearance estimation was demonstrated in this study.

Application of novel calibration scheme based on traceable point-like 22 Na sources to various types of PET scanners

Purpose: We have been developing a practical and reliable calibration scheme based on the use of traceable pointlike sources. In using 22Na sources, special care should be taken to avoid the effects of 1.275-MeV γ rays accompanying β+ decays. The purpose of this study is to validate this calibration method with traceable point-like 22Na sources on various types of PET scanners. Method: The traceable point-like 22Na sources with a spherical absorber design used in this study were of the same type as those used in a previous study. The tested PET scanners included one clinical whole-body PET scanner, four types of clinical PET/CT scanners from different manufacturers, and one small-animal PET scanner. The ROI (region of interest) diameter dependence of ROI values were represented with a fitting function, which was assumed to consist of a recovery part due to spatial resolution and a quadratic background part originating from the scattered γ rays. Results: The calibration factors determined using the point-like source were consistent with those by the standard cross-calibration method within ±4%, which was comparable to the uncertainty of the standard cross-calibration method. Conclusion: The novel calibration scheme based on the use of traceable 22Na point-like sources was validated for six types of commercial PET scanners.