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The influence of Q.Clear reconstruction on the contrast recovery coefficient and semi-quantitative parameters of NEMA phantom imaging

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Skórkiewicz K. , Łątka K. , Sowa-Staszczak A. , Hubalewska-Dydejczyk A.

Bio-Algorithms and Med-Systems

2023

tom Vol. 19, no. 1

17--22

Background: The aim of the study is to optimise the value of B parameter (β), which is used in the Q.Clear reconstruction in the imaging of neuroendocrine tumours. The study is divided into two parts: analysis of phantom data aiming at selection of the appropriate β for small changes, and then assessment of its impact on the quality of patients' images. The literature data on the optimal β value are inconclusive. Furthermore, the suggested values are not the result of the semi-quantitative assessment of Standard Uptake Volume (SUV) or the proper verification based on, for example, phantom studies using the known activity. Results: The obtained results show that β increase raises the image uniformity in the Q.Clear reconstruction algorithm. Also, referring to the scientific reports, one can see that the signal to noise ratio in the image increases. The effect of the β change on the SUV mean and Contrast Recovery Coefficient (CRC) value is greatest for the smallest objects. The decrease of this parameter is also much higher with lower values of activity (a lower counts statistic in the PET system). Conclusions: An increase of β has an adverse effect on the quality of a semi-quantitative assessment of SUV -as the parameter increases, the SUV and CRC values decrease. In the visual assessment, a satisfactory image quality is present with β = 450. Based on the analysis of SUV and CRC, an appropriate range of β values was selected as 350-450. At the selected range, a retrospective analysis of the clinical images of neuroendocrine tumours will be performed in the future and the impact of the change on the semi-quantitative analysis of pathological changes will be verified.

Peptide receptor radionuclide therapy as a tool for the treatment of severe hypoglycemia in patients with primary inoperable insulinoma

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Opalińska M. , Sowa-Staszczak A. , Al Maraih I. , Gilis-Januszewska A. , Hubalewska-Dydejczyk A.

Bio-Algorithms and Med-Systems

2021

tom Vol. 17, no. 4

221--226

Objectives: Severe hypoglycemia in a course of inoperable insulinoma may be life-threating and often it is not well controlled, even by high doses of diazoxide requiring second line treatment. Among available methods PRRT is characterized by relatively low toxicity and is connected with favorable antitumor effect. The aim of the study was an evaluation of the PRRT effectiveness in control of hypoglycemia in patients with primary inoperable insulinoma. Methods: Three patients (female with metastatic insulinoma,male with primaryinoperable pancreatic tumor, female with MEN1 syndrome and hepatic metastases) were treated with PRRT due to severe hypoglycemia poorly controlled by diazoxide in course of primary inoperable insulinoma. Results: Patient 1 baseline fasting glucose concentration increased from 2.4 mmol/L [3.30-5.60] to 5.9 mmol/L after PRRT. In patient 2 fasting glucose level 2.30 mmol/L increased after PRRT to 7.0 mmol/L, while baseline insulin level initially 31.15 uU/mL [2.6–24.9] decreased to 15.4 uU/mL. In patients 3, baseline fasting glucose level 2.5 mmol/L increased after PRRT to 7.9 mmol/L, and insulin decreased from 57.9 uU/mL to 6.3 uU/mL. In imaging there was partial response (PR) in patient 1 and 2 and stabilization of the tumor size in patient 3. In patient 2 reduction of tumor infiltration let for curative surgery performed 4 months after PPRT. Conclusions: PRRT may be effective as a first or second line treatment in management of hypoglycemia for patients with hormonally active inoperable insulinoma.