Integrated PET/CT systems State of the art and Clinical Applications

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "Integrated PET/CT systems State of the art and Clinical Applications"

Transcription

1 Integrated PET/CT systems State of the art and Clinical Applications V. Bettinardi Nuclear Medicine Dep. Scientific Institute San Raffaele Hospital Milan Italy

2 The announcement of a new Diagnostic Imaging System (Integrated PET/CT or Hybrid PET/CT system) has been reported in the Time Magazine as the Medical Invention of the year (2000) to go with the title of most outstanding basic science paper the team members received from the Journal of Nuclear Medicine

3 Why integrated PET/CT systems? 18 F-FDG The major success of PET in oncology is it s ability to detect tumours as increased levels of [ 18 F]-fluoro-2-deoxyglucose (FDG) uptake compared to normal tissues

4 Why integrated PET/C systems? The poor spatial resolution of a PET system (4-5mm) makes difficult the interpretation of PET images due to the lack of identifiable anatomical structures. Localization of increased tracer uptake to a specific organ or structure is important when decisions affecting the diagnosis, staging and the treatment of the patient have to be taken. The need for an accurrate anatomical localization of the PET signal was the motivation for the PET/CT systems.

5 Integrated PET/CT systems A PET/CT system combines (in the same gantry) two of the most important (and complementary ) diagnostic imaging systems like CT and PET allowing to perform the PET/CT procedure, in a single study session, without moving the patient from the bed CT PET

6 Integrated PET/CT systems The anatomical study : CT

7 Integrated PET/CT systems The functional study : Multiple bed positions PET

8 Integrated PET/CT systems The functional study : PET

9 Integrated PET/CT systems The functional study : PET

10 Integrated PET/CT systems The functional study : PET

11 Integrated PET/CT Systems In a PET/CT system both techniques use the same spatial reference system

12 Integrated PET/CT systems Once reconstructed, the CT and PET images are spatially co-registered, allowing the physicians to fuse both the information and thus to localize the PET signals over the corresponding anatomy / anatomical structure. Lymph node metastasis Bone metastasis HSR Milano

13 Integrated PET/CT systems CT images are also used for the Attenuation Correction of PET EM data CT based Attenuation Correction has significant advantages over more traditional methods (Measured Transmission AC - MAC ) : 1) Much lower statistical noise compared to MAC 2) Shorter acquisition time ( CT: 20-40sec Vs MAC: 20-30min) 3) Unbiased post injection CT scan PET Without AC CT PET With AC by CT

14 State of art of PET/CT systems Siemens mct General Electric (GE) Discovery-600 Discovery-690 Philips Gemini-GXL Gemini-TF An important characteristic of the PET/CT systems is to combine, in the same gantry, the state of the art of both technologies

15 Integrated PET/CT Helical Multi Slices CT scanners Helical CT scnner First models of PET/CT systems were equipped with : cm 2cm 4cm State of the art PET/CT system are equipped with :

16 MS-CT Position-sensitive detector (rotating) X-ray fan beam (rotating) + + Fast & UltraFast Ceramic Scintillator + Photodiodes X-ray source (rotating)

17 State of the art and future of MS-CT Dual Sources Energy Discriminating Detectors kvp Switching 80keV 80keV 140keV 140keV Detector 1 Detector 2 Dual energy CT offers a more specific tissue characterization : m(e) w (E) CT [HU] = x 1000 w(e) 140 kvp image 80 kvp image Thorsten R.et al.n : Eur Radiol (2007) 17:

18 State of art of PET/CT systems Siemens mct GE Discovery-600 Discovery-690 Philips Gemini-GXL Gemini-TF PET Scanners

19 PET Scintillators BGO GSO LSO LYSO Density (g/cm 3 ) Effective Z keV (mm) Decay Time (ns) Relative Light Output % (to 100 for NaI(Tl) Energy Resolution % kev) 10(511) 8.5(511) 10(511) 11(511) Wavelength (nm) Index of Refraction IDEAL CHARACTERISTICS high stopping power, to maximize the probability to stop the radiation good energy resolution, to reject scatter events good time resolution, for counting rate linearity, low random rate (PET), TOF to be inexpensive for mass production

20 PET Scintillators Conti Physica Medica 25;1-11, 2009

21 PET Detector Design General Electric PET detector block D-600 (BGO) matrix 8X6 4.7x6.3x30 mm 3 D-690 (LYSO) 4.2x6.3x25mm3 Siemens PET detector block mct (LSO) matrix 13x13 4x4x 20 mm 3 PMT PHILIPS PIXELAR Detector panels optically coupled to continuous light guide G-GXL (GSO) 4 x 6 x 30 mm 3 G-TF (LYSO) 4 x 4 x 22 mm 3

22 Photo-Detectors PMT PS PMT APD and PS APD PMT APD SiPM Active area (mm2) cm mm mm 2 Gain Quantum efficiency 25% 60-80% <40% Temperature coefficient <1%/ C 2-3%/ C 3-5%/ C Magnetic suceptibility Very high No (up to 9.4T) No (up to 15T) Si PM

23 NON TOF Time-of-Flight LSO & LYSO Use time-of-flight to localize source along line of flight. Time of flight information reduces noise in images. Variance reduction given by: 2D / c t. TOF 500 ps timing resolution 7.5 cm localization 500 ps timing resolution 5 x reduction in variance! Reconstruction without TOF information assume that all the possible locations of the annihilation site along the LOR are equally likely. TOF information can be used in the Reconstruction of the PET data to constraint the possible locations of the annihilation site along the LOR SNR GAIN SENSITIVITY GAIN SNR TOF 2 D D = = SNR c t x t psec x cm D=20 cm D=35 cm D=20 cm D=35 cm

24 TOF LESION PHANTOM (Diameter = 27 cm - Activity ratio Lesion / Background = 6:1 ) Non-TOF similar contrast and scan time TOF lower noise 60s 60s similar contrast and noise TOF shorter scan 60s 180s Slide courtesy Joel Karp,University of Pennsylvania

25 Extended Axial Field-Of-View PET/CT (mct) Standard Extended axial FOV Axial 16.2 cm 21.6 cm Starting from the standard configuration which consists in a 16.2 cm axial FOV scanner the user can order, as an option, the addition of one more ring of detectors extending the axial FOV up to 21.6cm The extension of the FOV results in an increase of the overall System Sesitivity of 77% The design of an extended axial FOV open the way to a modular design of the PET systems and represents the first step toward a very wide axial PET scanner.

26 Clinical Advantages of the Extended Axial Field-Of-View bed # Standard FOV: 5 15 min Extended FOV: 4 8 min Higher sensitivity => shorter imaging per bed (same dose, same counts) Higher sensitivity => lower dose (same acq. time, same counts) Higher sensitivity => higher SNR ( same dose, same acq. time)

27 PET/CT Clinical Applications Oncology (90%) Cardiology ( 5%) Neurology ( 5%)

28 Oncological Applications of PET/CT 18F-FDG WB-PET The primary clinical applications of PET/CT is oncology for: - staging, - restaging, - follow -up - monitoring the response to therapies.

29 Oncology PET/CT for Radiotherapy Applications The state of the art in the technology of the RT systems is the intensity modulated radiation therapy (IMRT), in which many small pencil beams are used, under computer control, to conform the irradiated volume to complex and irregular shape. IMRT allows the beams to be modulated to the required intentisy for delivering highly conformal doses of radiation to the targets, while sparing the adjacent normal tissue structures. IMRT allows the design of tailored hot-spots (which Tomotherapy Helical treatment delivery receives much higher local dose) tumour mass (Dose painting). within the overall PET/CT allows to improve the Target Volume Definition by using the: Anatomical CT images for the definitionof the Gross Tumor Volume ( GTV) Functional PET images for the definition of the Biological Tumor Volume (BTV) By combining GTV and BTV a more accurate TVD can be obtained Lung Simulation: Courtesy MD Anderson Huston

30 Tumour CT-based TT Lynphonodes Greater than 1cm CT TOMOTHERAPY TREATMENT PLAN CT-based TT HSR Milano

31 Tumour PET/CT-based TT Lynphonodes Greater than 1cm Tumour Lynphonodes No significant uptake of FDG CT PET/CT TOMOTHERAPY TREATMENT PLAN CT-based TT PET/CT-based TT HSR Milano

32 Oncology PET/CT for Radiotherapy Applications Respiratory gating PET/CT (4D PET/CT) Specific Patient s motion Information can be used for a more accurate TVD and to personalize the treatment planning by reducing the overall PTV, increasing the dose to the tumour while sparing healthy tissues.

33 PET/CT for Cardiological Applications The value of PET/CT in cardiac imaging has extended beyond the assessment of myocardial viability and perfusion. The combination of PET and CT allows a comprehensive anatomical and functional mapping / assessment of the Heart and has demonstrated its use in diagnosing and managing coronary artery disease. HSR-Milan

34 Cardiological Application of PET/CT With the state of the art of MSCT scanner it is possible to image coronary arteries (non-invasively), to obtain important clinical information on the presence, severity, and characteristics of Coronary arthery disease (CAD) including the visualization of luminal obstruction and atherosclerosis plaques. The negative predictive value of CT is very high. LAD D1 LCX Case SM This suggest that CTA combined with the complementary information by PET (e.g. perfusion imaging) is likely to offer added value for the CAD evaluation. RCA CTA Image courtesy : Turku PET Centre Turku PET Centre, Finland

35 Cardiological Application of PET/CT Case SM O 15 -water parametric PET/CT hybrid images MBF 3 ml/g/min MBF 4 ml/g/min MBF 2 ml/g/min CTA+ Adenosine stress perfusion Courtesy:Turku PET Centre, Finland

36 Neurological Application of PET/CT Dementias (e.g. Alzheimer s) Epilepsy Movement Disorded (e.g. Parkinson, Huntingtons) Oncology Cerebravascular disease Tumour Tumour 18F-FDG Normal Brain 18F-FDG Oncology 11C-Choline Oncology 18F-FESP D2 dopamine receptors Movement disorders Parkinson

37 Prospective and future of the Hybrid PET/CT systems Nowadays Hybrid PET/CT is certainly on the most important cancer imaging modality. CT scanner Dual Energy CT Multispectral imaging Fastest Temporal Resolution (assessment of time-dependent parameters) Increased Axial FOV ( to capture whole organs in a single rotation ) Dose Reduction Techiques PET scanner New crystal scintillator / detector material Smaller crystal / detectors to improve spatial resolution Fastest crystal scintillator / detectors for TOF New Detector Desgin from PMT to APD to SiPMT APD could be used also for DOI correction Extended Axial FOV Improve System Sensitivity Dose Reduction

Typical PET Image. Elevated uptake of FDG (related to metabolism) Lung cancer example: But where exactly is it located?

Typical PET Image. Elevated uptake of FDG (related to metabolism) Lung cancer example: But where exactly is it located? Typical PET Image Elevated uptake of FDG (related to metabolism) Lung cancer example: But where exactly is it located? PET/CT Oncology Imaging Anatometabolic fusion images are useful in the management

More information

PET-CT for radiotherapy planning in lung cancer: current recommendations and future directions

PET-CT for radiotherapy planning in lung cancer: current recommendations and future directions PET-CT for radiotherapy planning in lung cancer: current recommendations and future directions Gerry Hanna Centre for Cancer Research and Cell Biology Queen s University of Belfast @gerryhanna Talk Outline

More information

An Overview of Clinical PET/CT

An Overview of Clinical PET/CT 1 INVITED ARTICLE An Overview of Clinical PET/CT Arman Rahmim 1* PhD and Richard L. Wahl 2 MD Department of Radiology, School of Medicine Johns Hopkins University, Baltimore MD, USA (Received 10 November

More information

Pitfalls and Remedies in PET/CT imaging for RT planning

Pitfalls and Remedies in PET/CT imaging for RT planning Pitfalls and Remedies in PET/CT imaging for RT planning Tinsu Pan, Ph.D. M.D. Anderson Cancer Center The University of Texas Outlines Background Average CT (< 1 msv) to reduce mis-alignment of PET and

More information

CT Perfusion. U. Joseph Schoepf, MD, FAHA, FSCBT MR, FSCCT Professor of Radiology, Medicine, and Pediatrics Director of Cardiovascular Imaging

CT Perfusion. U. Joseph Schoepf, MD, FAHA, FSCBT MR, FSCCT Professor of Radiology, Medicine, and Pediatrics Director of Cardiovascular Imaging CT Perfusion U. Joseph Schoepf, MD, FAHA, FSCBT MR, FSCCT Professor of Radiology, Medicine, and Pediatrics Director of Cardiovascular Imaging Disclosures Consultant for / research support from Bayer Bracco

More information

Optimized. clinical pathway. propels high utilization of PET/MR at Pitié-Salpêtrière Hospital

Optimized. clinical pathway. propels high utilization of PET/MR at Pitié-Salpêtrière Hospital Optimized propels high utilization of PET/MR at Pitié-Salpêtrière Hospital clinical pathway As one of Europe s largest teaching hospitals, Pitié-Salpêtrière Hospital is renowned for its innovative research

More information

Cardiac CT - Coronary Calcium Basics Workshop II (Basic)

Cardiac CT - Coronary Calcium Basics Workshop II (Basic) Cardiac CT - Coronary Calcium Basics Workshop II (Basic) J. Jeffrey Carr, MD, MSCE Dept. of Radiology & Public Health Sciences Wake Forest University School of Medicine Winston-Salem, NC USA No significant

More information

Dual Energy CT of the Heart: Perfusion and Beyond

Dual Energy CT of the Heart: Perfusion and Beyond Dual Energy CT of the Heart: Perfusion and Beyond U. Joseph Schoepf, MD, FAHA, FSCBT MR, FSCCT Professor of Radiology, Medicine, and Pediatrics Director of Cardiovascular Imaging Disclosures Consultant

More information

MRI-PET: Oncologic Applications

MRI-PET: Oncologic Applications MRI-PET: Oncologic Applications Pablo R. Ros, MD University Hospitals Case Medical Center Case Western Reserve University SCBT-MR Boston, MA October, 2012 Pablo.Ros@UHhospitals.org Acknowledgement Osman

More information

X-Ray & CT Physics / Clinical CT

X-Ray & CT Physics / Clinical CT Computed Tomography-Basic Principles and Good Practice X-Ray & CT Physics / Clinical CT INSTRUCTORS: Dane Franklin, MBA, RT (R) (CT) Office hours will be Tuesdays from 5pm to 6pm CLASSROOM: TIME: REQUIRED

More information

CT or PET/CT for coronary artery disease

CT or PET/CT for coronary artery disease CT or PET/CT for coronary artery disease Rotterdam 2012 Juhani Knuuti, MD, PhD, FESC Turku PET Centre University of Turku Turku, Finland Juhani.knuuti@utu.fi Turku PET Centre University of Turku Åbo Akademi

More information

Introduction. Cardiac Imaging Modalities MRI. Overview. MRI (Continued) MRI (Continued) Arnaud Bistoquet 12/19/03

Introduction. Cardiac Imaging Modalities MRI. Overview. MRI (Continued) MRI (Continued) Arnaud Bistoquet 12/19/03 Introduction Cardiac Imaging Modalities Arnaud Bistoquet 12/19/03 Coronary heart disease: the vessels that supply oxygen-carrying blood to the heart, become narrowed and unable to carry a normal amount

More information

Title: TC simulation versus TC/PET simulation for radiotherapy in lung cancer: volumes comparison in two cases.

Title: TC simulation versus TC/PET simulation for radiotherapy in lung cancer: volumes comparison in two cases. Title: TC simulation versus TC/PET simulation for radiotherapy in lung cancer: volumes comparison in two cases. Authors: Franzone, P.; 1* Muni, A; 2 Cazzulo, E.; 3 Berretta, L.; 1 Pozzi, G. 1 ; Todisco,

More information

Quantitative Molecular Imaging Using PET/CT to Assess Response to Therapy

Quantitative Molecular Imaging Using PET/CT to Assess Response to Therapy Quantitative Molecular Imaging Using PET/CT to Assess Response to Therapy Paul Kinahan, PhD Director of PET/CT Physics Imaging Research Laboratory, Department of Radiology University of Washington, Seattle,

More information

I. Equipments for external beam radiotherapy

I. Equipments for external beam radiotherapy I. Equipments for external beam radiotherapy 5 linear accelerators (LINACs): Varian TrueBeam 6, 10 & 18 MV photons, 6-18 MeV electrons, image-guided (IGRT) and intensity modulated radiotherapy (IMRT),

More information

14/09/2013 FDG PET PET-CT = FDG PET-CT. = Metabolism. Anatometabolic Imaging. = Anatomy. Nuclear Medicine in the Era of Hybrid Imaging

14/09/2013 FDG PET PET-CT = FDG PET-CT. = Metabolism. Anatometabolic Imaging. = Anatomy. Nuclear Medicine in the Era of Hybrid Imaging Nuclear Medicine in the Era of Hybrid Imaging Focus on a New SPECT-CT Device : HWK-4 Tarik Belhocine, MD, Ph.D Nuclear Medicine = SPECT = Functional Imaging Function Radiology = Morphological Imaging Anatomy

More information

Physics of MBI (~10 slides)

Physics of MBI (~10 slides) Physics of MBI (~10 slides) Molecular Breast Imaging (MBI) physics and performance testing JW Hugg, BR Simrak, PD Smith, BE Patt Gamma Medica, Inc., Northridge, CA Molecular Breast Imaging (MBI) is an

More information

Radiation treatment planning in lung cancer

Radiation treatment planning in lung cancer Radiation treatment planning in lung cancer Georg Dietmar 1,2 1 Div. Medical Rad. Phys., Dept. of Radiation Oncology / Medical Univ. Vienna & AKH Wien 2 Christian Doppler Laboratory for Medical Radiation

More information

Medical Imaging. Alex Elliott Western Infirmary Glasgow

Medical Imaging. Alex Elliott Western Infirmary Glasgow Medical Imaging Alex Elliott Western Infirmary Glasgow History of medical imaging X-rays - Roentgen, 1895 Nuclear medicine - Cassen, 1951 Ultrasound Donald, 1962 SPECT - Kuhl, Edwards, 1963 PET Ter-Pogossian,

More information

I. Cancer staging problem

I. Cancer staging problem Instrumentation Lab (Craig Levin) Angela Craig Peter Jin Frezghi Guillem Billie Garry Research interests (by imaging modality) I. High resolution radionuclide imaging : positron emission tomography (PET)

More information

Maximizing the Utility of Integrated PET/MRI in Clinical Applications

Maximizing the Utility of Integrated PET/MRI in Clinical Applications Maximizing the Utility of Integrated PET/MRI in Clinical Applications Spencer Behr, MD Department of Nuclear Medicine & Abdominal Imaging University of California, San Francisco PET/MR at UCSF Device:

More information

SPECT-CT: Τι πρέπει να γνωρίζει ο Καρδιολόγος

SPECT-CT: Τι πρέπει να γνωρίζει ο Καρδιολόγος SPECT-CT: Τι πρέπει να γνωρίζει ο Καρδιολόγος Δρ Αναστασία Κίτσιου Διευθύντρια, Καρδιολογική Κλινική, Σισμανόγλειο ΓΝΑ Chair, Education Committee, Section on Nuclear Cardiology & Cardiac CT, EACVI, ESC

More information

Multi-Modality Imaging: Technologies and Applications

Multi-Modality Imaging: Technologies and Applications Multi-Modality Imaging Multi-Modality Imaging: Technologies and Applications JH Siewerdsen Ontario Cancer Institute, Princess Margaret Hospital Department of Medical Biophysics, University of Toronto Department

More information

PET/MRI: a new era in multimodality molecular imaging

PET/MRI: a new era in multimodality molecular imaging Clin Transl Imaging (2013) 1:5 10 DOI 10.1007/s40336-013-0003-5 REVIEW ARTICLE PET/MRI: a new era in multimodality molecular imaging Osman Ratib Received: 22 October 2012 / Accepted: 10 January 2013 /

More information

PET-MRI in Cardiac Imaging: Initial Experience

PET-MRI in Cardiac Imaging: Initial Experience PET-MRI in Cardiac Imaging: Initial Experience Mallinckrodt Institute of Radiology Washington University School of Medicine Pamela K. Woodard, M.D. Professor of Radiology and Biomedical Engineering Head,

More information

POSITRON EMISSION TOMOGRAPHY (PET)

POSITRON EMISSION TOMOGRAPHY (PET) Status Active Medical and Behavioral Health Policy Section: Radiology Policy Number: V-27 Effective Date: 08/27/2014 Blue Cross and Blue Shield of Minnesota medical policies do not imply that members should

More information

The radiation dose in retrospective

The radiation dose in retrospective The radiation dose in retrospective gated tdcoronary computed td tomography (CCT) Saeed AL Ahmari, Ghormallah AL Zahrani, Sumiah AL Helali, Samir AL Dulikan, Abdullah Bafagih, HibaKhashojji Prince Sultan

More information

PET-MRI in malignant bone tumours. Lars Stegger Department of Nuclear Medicine University Hospital Münster, Germany

PET-MRI in malignant bone tumours. Lars Stegger Department of Nuclear Medicine University Hospital Münster, Germany PET-MRI in malignant bone tumours Lars Stegger Department of Nuclear Medicine University Hospital Münster, Germany Content From PET to PET/MRI General considerations Bone metastases Primary bone tumours

More information

PET/MR. Are You Ready?? Derek Lee, BS, CNMT, PET

PET/MR. Are You Ready?? Derek Lee, BS, CNMT, PET PET/MR Are You Ready?? Derek Lee, BS, CNMT, PET Allow Myself to Introduce Myself I ve been around a while: 23+ years in Nuclear Medicine and counting PET & PET/CT for 13 years and counting Currently working

More information

Preview of Presentation

Preview of Presentation Preview of Presentation Discuss Healthcare Environment Clinical Implementation of Technical Innovations SNMMI/ASNC Joint Statement on Rb-82 Cardiac PET Imaging Protocol Principles of Rb-82 Cardiac Imaging

More information

Chapter 7 General conclusions and suggestions for future work

Chapter 7 General conclusions and suggestions for future work Chapter 7 General conclusions and suggestions for future work Radiation therapy (RT) is one of the principle treatment modalities for the management of cancer. In recent decades, advances in the radiation

More information

Advantages of PET Myocardial Imaging

Advantages of PET Myocardial Imaging Advantages of PET Myocardial Imaging Legal Disclaimers These materials were prepared in good faith by MITA as a service to the profession and are believed to be reliable based on current scientific literature.

More information

Effects of Motion and Tissue Weighting on PET Myocardial Blood Flow Estimates

Effects of Motion and Tissue Weighting on PET Myocardial Blood Flow Estimates Effects of Motion and Tissue Weighting on PET Myocardial Blood Flow Estimates Benjamin C. Lee 1, Jonathan B. Moody 1, Venkatesh L. Murthy 2, James R. Corbett 2, Edward P. Ficaro 2 1 INVIA Medical Imaging

More information

In-Room Radiographic Imaging for Localization

In-Room Radiographic Imaging for Localization In-Room Radiographic Imaging for Localization Fang-Fang Yin, Zhiheng Wang, Sua Yoo, Devon Godfrey, Q.-R. Jackie Wu Department of Radiation Oncology Duke University Medical Center Durham, North Carolina

More information

Noncoronary Cardiac MDCT

Noncoronary Cardiac MDCT Noncoronary Cardiac MDCT David A. Bluemke, M.D., Ph.D. Professor, of Radiology and Medicine Johns Hopkins University School of Medicine Baltimore, Maryland Toshiba Disclosures Grant support Noncoronary

More information

Computed tomography Acceptance testing and dose measurements

Computed tomography Acceptance testing and dose measurements Computed tomography Acceptance testing and dose measurements Jonas Andersson Medical Physicist, Ph.D. Department of Radiation Sciences University Hospital of Norrland, Umeå Sweden Contents The Computed

More information

CT angiography techniques. Boot camp

CT angiography techniques. Boot camp CT angiography techniques Boot camp Overview Basic concepts Contrast administration arterial opacification Time scan acquisition during the arterial phase Protocol examples Helical non-gated CTA Pulmonary

More information

Positron Emission Tomography Computed Tomography (PET/CT)

Positron Emission Tomography Computed Tomography (PET/CT) Positron Emission Tomography Computed Tomography (PET/CT) What is Positron Emission Tomography Computed Tomography (PET/CT) Scanning? What are some common uses of the procedure? How should I prepare for

More information

Many vendors are beginning to allow couch motion during radiation delivery.

Many vendors are beginning to allow couch motion during radiation delivery. Dynamic Couch Motion Many vendors are beginning to allow couch motion during radiation delivery. Varian developer mode allows institutions to perform research using these types of treatments. Tomotherapy

More information

ClearPEM-Sonic: a multimodal PET-ultrasound mammography system

ClearPEM-Sonic: a multimodal PET-ultrasound mammography system ClearPEM-Sonic: a multimodal PET-ultrasound mammography system Giacomo Cucciati, University of Milano Bicocca on behalf of the ClearPEM-Sonic Collaboration Outline Introduction ClearPEM Aixplorer Multimodality

More information

An Epidemic of Heart Disease The Silent Killer. Professor Mike Kirby FRCP University of Hertfordshire Institute of Diabetes for Older People

An Epidemic of Heart Disease The Silent Killer. Professor Mike Kirby FRCP University of Hertfordshire Institute of Diabetes for Older People An Epidemic of Heart Disease The Silent Killer Professor Mike Kirby FRCP University of Hertfordshire Institute of Diabetes for Older People Initial clinical presentation of CAD Angina MI Atypical CP Death

More information

Low Dose Era in Cardiac CT

Low Dose Era in Cardiac CT Low Dose Era in Cardiac CT DIANA E. LITMANOVICH, MD Department of Radiology Beth Israel Deaconess Medical Center Harvard Medical School Disclosures Neither I nor my immediate family members have a financial

More information

The objective of this lecture is to integrate our knowledge of the differences between 2D and 3D planning and apply the same to various clinical

The objective of this lecture is to integrate our knowledge of the differences between 2D and 3D planning and apply the same to various clinical The objective of this lecture is to integrate our knowledge of the differences between 2D and 3D planning and apply the same to various clinical sites. The final aim will be to be able to make out these

More information

Varian Edge Experience. Jinkoo Kim, Ph.D Henry Ford Health System

Varian Edge Experience. Jinkoo Kim, Ph.D Henry Ford Health System Varian Edge Experience Jinkoo Kim, Ph.D Henry Ford Health System Disclosures I participate in research funded by Varian Medical Systems. Outline of Presentation Review advanced imaging in Varian Edge Linear

More information

Nuclear Cardiology Cardiac Myocardial Perfusion with 82 Rb. Dominique Delbeke, MD, PhD Vanderbilt University Medical Center Nashville, TN

Nuclear Cardiology Cardiac Myocardial Perfusion with 82 Rb. Dominique Delbeke, MD, PhD Vanderbilt University Medical Center Nashville, TN Nuclear Cardiology Cardiac Myocardial Perfusion with 82 Rb Dominique Delbeke, MD, PhD Vanderbilt University Medical Center Nashville, TN VUMC PET/CT conference 2009 82 Rb Cardiac Perfusion PET 82 Rb is

More information

8/3/2016. The EPID Strikes Back! - EPID In-Vivo Dosimetry. EPID Research Number of Publications. Why EPID in-vivo? Detectable errors: patient

8/3/2016. The EPID Strikes Back! - EPID In-Vivo Dosimetry. EPID Research Number of Publications. Why EPID in-vivo? Detectable errors: patient Number of Publications Number of publications 8/3/2016 The Strikes Back! - In-Vivo Dosimetry AAPM, Washington D.C, USA, 2016 Peter Greer 1,2 (1) University of Newcastle, Australia, (2) Calvary Mater Newcastle,

More information

Nuclear Medicine in Oncology

Nuclear Medicine in Oncology Radiopharmaceuticals Nuclear Medicine in Oncology Practice Pharmaceutical Radionuc lide Function Tumor type Diphosphonates Tc-99m Osteoblast Bone tumor & metast. Ga-citrate Ga-67 Fe-analogue Bronchogenous

More information

Stereotaxy. Outlines. Establishing SBRT Program: Physics & Dosimetry. SBRT - Simulation. Body Localizer. Sim. Sim. Sim. Stereotaxy?

Stereotaxy. Outlines. Establishing SBRT Program: Physics & Dosimetry. SBRT - Simulation. Body Localizer. Sim. Sim. Sim. Stereotaxy? Establishing SBRT Program: Physics & Dosimetry Lu Wang, Ph.D. Radiation Oncology Department Fox Chase Cancer Center Outlines Illustrate the difference between SBRT vs. CRT Introduce the major procedures

More information

Η Πυρηνική Καρδιολογία Το 2017 ΟΜΑΔΑ ΕΡΓΑΣΙΑΣ ΑΠΕΙΚΟΝΙΣΤΙΚΩΝ ΤΕΧΝΙΚΩΝ

Η Πυρηνική Καρδιολογία Το 2017 ΟΜΑΔΑ ΕΡΓΑΣΙΑΣ ΑΠΕΙΚΟΝΙΣΤΙΚΩΝ ΤΕΧΝΙΚΩΝ Η Πυρηνική Καρδιολογία Το 2017 ΟΜΑΔΑ ΕΡΓΑΣΙΑΣ ΑΠΕΙΚΟΝΙΣΤΙΚΩΝ ΤΕΧΝΙΚΩΝ huma human n Setting diagnosis of the early stages of chronic diseases (i.e cancer, neuropsychiatric, cardiovascular disorders), in

More information

Precision of pre-sirt predictive dosimetry

Precision of pre-sirt predictive dosimetry International Course on THERANOSTICS AND MOLECULAR RADIOTHERAPY Precision of pre-sirt predictive dosimetry Hugo Levillain Department of Nuclear Medicine Medical Physics Jules Bordet Institute, Université

More information

PET is currently the accepted gold standard in noninvasive

PET is currently the accepted gold standard in noninvasive CT Attenuation Correction for Myocardial Perfusion Quantification Using a PET/CT Hybrid Scanner Pascal Koepfli, MD 1 ; Thomas F. Hany, MD 2 ; Christophe A. Wyss, MD 1 ; Mehdi Namdar, MD 1 ; Cyrill Burger,

More information

Gender differences in CT calcium scoring: A phantom study

Gender differences in CT calcium scoring: A phantom study Gender differences in CT calcium scoring: A phantom study Nicholas Petrick, Qin Li, Benjamin Berman, Marios A Gavrielides, Rongping Zeng, Berkman Sahiner CDRH/OSEL/DIDSR U.S. Food and Drug Administration

More information

Patient preparation and coronary CTA techniques. Gregory Kicska, M.D. Ph.D. University of Washington, Thoracic Imaging

Patient preparation and coronary CTA techniques. Gregory Kicska, M.D. Ph.D. University of Washington, Thoracic Imaging Patient preparation and coronary CTA techniques Gregory Kicska, M.D. Ph.D. University of Washington, Thoracic Imaging Overview 1. Patient preparation 2. Scanning techniques Patient preparation Preparation

More information

8/18/2011. Acknowledgements. Managing Pediatric CT Patient Doses INTRODUCTION

8/18/2011. Acknowledgements. Managing Pediatric CT Patient Doses INTRODUCTION Managing Pediatric CT Patient Doses Keith J. Strauss, MSc, FAAPM, FACR President X-Ray Computations, Inc. Boston, Massachusetts Acknowledgements Marilyn Goske, MD John Boone, PhD Cynthia McCollough, PhD

More information

MRI Applications in Radiation Oncology:

MRI Applications in Radiation Oncology: MRI Applications in Radiation Oncology: Physician s Perspective Jeff Olsen, MD Department of Radiation Oncology Washington University, St. Louis, MO Disclosures Washington University has research and service

More information

Disclosures. GETTING TO THE HEART OF THE MATTER WITH MULTIMODALITY CARDIAC IMAGING Organ Review Meeting 25 September. Overview

Disclosures. GETTING TO THE HEART OF THE MATTER WITH MULTIMODALITY CARDIAC IMAGING Organ Review Meeting 25 September. Overview GETTING TO THE HEART OF THE MATTER WITH MULTIMODALITY CARDIAC IMAGING Organ Review Meeting 25 September Disclosures None relevant to this presentation Mini Pakkal Assistant Professor of Radiology University

More information

OUTLINE. Radiation 2/21/2017. PRINCIPLES and PRACTICE of RADIATION ONCOLOGY. Matthew B. Podgorsak, PhD, FAAPM Department of Radiation Oncology

OUTLINE. Radiation 2/21/2017. PRINCIPLES and PRACTICE of RADIATION ONCOLOGY. Matthew B. Podgorsak, PhD, FAAPM Department of Radiation Oncology PRINCIPLES and PRACTICE of RADIATION ONCOLOGY Matthew B. Podgorsak, PhD, FAAPM Department of Radiation Oncology OUTLINE Physical basis Biological basis History of radiation therapy Treatment planning Technology

More information

Bone Densitometry Radiation dose: what you need to know

Bone Densitometry Radiation dose: what you need to know Bone Densitometry Radiation dose: what you need to know John Damilakis, PhD Associate Professor and Chairman University of Crete, Iraklion, Crete, GREECE Estimation of bone status using X-rays Assessment

More information

Disclosure Information

Disclosure Information Coronary CTA Pearls and Pitfalls Ricardo C. Cury, MD, FSCCT, FAHA, FACC Chairman of Radiology Radiology Associates of South Florida Director of Cardiac Imaging Miami Cardiac and Vascular Institute Past-President

More information

Qualitative and Quantitative Assessment of Perfusion

Qualitative and Quantitative Assessment of Perfusion APCDE 2011 Qualitative and Quantitative Assessment of Perfusion Hyun Ju Yoon Chonnam National University Hospital Gwangju, Korea ISCHEMIC CASCADE Blood flow mismatch Perfusion defects on nuclear imaging,

More information

Triple Rule-out using 320-row-detector volume MDCT: A comparison of the wide volume and helical modes

Triple Rule-out using 320-row-detector volume MDCT: A comparison of the wide volume and helical modes Triple Rule-out using 320-row-detector volume MDCT: A comparison of the wide volume and helical modes Poster No.: C-0488 Congress: ECR 2012 Type: Authors: Keywords: DOI: Scientific Exhibit E.-J. Kang,

More information

Tc-99m Sestamibi/Tetrofosmin Stress-Rest Myocardial Perfusion Scintigraphy

Tc-99m Sestamibi/Tetrofosmin Stress-Rest Myocardial Perfusion Scintigraphy APPROVED BY: Director of Radiology Page 1 of 6 Tc-99m Sestamibi/Tetrofosmin Stress-Rest Myocardial Primary Indications: Evaluation of myocardial perfusion and viability in patients with known or suspected

More information

RAMA-EGAT Risk Score for Predicting Coronary Artery Disease Evaluated by 64- Slice CT Angiography

RAMA-EGAT Risk Score for Predicting Coronary Artery Disease Evaluated by 64- Slice CT Angiography RAMA-EGAT Risk Score for Predicting Coronary Artery Disease Evaluated by 64- Slice CT Angiography Supalerk Pattanaprichakul, MD 1, Sutipong Jongjirasiri, MD 2, Sukit Yamwong, MD 1, Jiraporn Laothammatas,

More information

Quality assurance of volumetric modulated arc therapy using Elekta Synergy

Quality assurance of volumetric modulated arc therapy using Elekta Synergy Acta Oncologica, 2009; 48: 11931197 ORIGINAL ARTICLE Quality assurance of volumetric modulated arc therapy using Elekta Synergy AKIHIRO HAGA 1, KEIICHI NAKAGAWA 1, KENSHIRO SHIRAISHI 1, SAORI ITOH 1, ATSURO

More information

PHYS 383: Applications of physics in medicine (offered at the University of Waterloo from Jan 2015)

PHYS 383: Applications of physics in medicine (offered at the University of Waterloo from Jan 2015) PHYS 383: Applications of physics in medicine (offered at the University of Waterloo from Jan 2015) Course Description: This course is an introduction to physics in medicine and is intended to introduce

More information

PET Guidance of Therapy for BNCT and in vivo B-10 imaging

PET Guidance of Therapy for BNCT and in vivo B-10 imaging INFN LNL Legnaro 17-19 Novembre 2009 Principles of Positron Emission Tomography and Radiopharmaceuticals PET Guidance of Therapy for BNCT and in vivo B-10 imaging Luca Menichetti, Ph.D C.N.R. Institute

More information

Assessment of cardiac function using myocardial perfusion imaging technique on SPECT with 99m Tc sestamibi

Assessment of cardiac function using myocardial perfusion imaging technique on SPECT with 99m Tc sestamibi Journal of Physics: Conference Series PAPER OPEN ACCESS Assessment of cardiac function using myocardial perfusion imaging technique on SPECT with 99m Tc sestamibi To cite this article: M R A Gani et al

More information

Introduction to Lymphatic Mapping

Introduction to Lymphatic Mapping Cancer Staging Introduction to Lymphatic Mapping Introduction to Lymphatic Mapping When a patient is given the diagnosis of cancer, one of the first questions to be answered is whether the cancer has spread

More information

FDG-18 PET/CT - radiation dose and dose-reduction strategy

FDG-18 PET/CT - radiation dose and dose-reduction strategy FDG-18 PET/CT - radiation dose and dose-reduction strategy Poster No.: C-1856 Congress: ECR 2014 Type: Authors: Keywords: DOI: Scientific Exhibit P. Nicholson, S. McSweeney, K. O'Regan; Cork/IE Radiation

More information

New Challenges in Nuclear Cardiology Practice

New Challenges in Nuclear Cardiology Practice New Challenges in Nuclear Cardiology Practice Brian G. Abbott, MD, FACC, FASNC, FAHA President, ASNC 2016 Associate Professor of Medicine Warren Alpert Medical School of Brown University Director, Cardiovascular

More information

A TREATMENT PLANNING STUDY COMPARING VMAT WITH 3D CONFORMAL RADIOTHERAPY FOR PROSTATE CANCER USING PINNACLE PLANNING SYSTEM *

A TREATMENT PLANNING STUDY COMPARING VMAT WITH 3D CONFORMAL RADIOTHERAPY FOR PROSTATE CANCER USING PINNACLE PLANNING SYSTEM * Romanian Reports in Physics, Vol. 66, No. 2, P. 394 400, 2014 A TREATMENT PLANNING STUDY COMPARING VMAT WITH 3D CONFORMAL RADIOTHERAPY FOR PROSTATE CANCER USING PINNACLE PLANNING SYSTEM * D. ADAM 1,2,

More information

SHIELDING TECHNIQUES FOR CURRENT RADIATION THERAPY MODALITIES

SHIELDING TECHNIQUES FOR CURRENT RADIATION THERAPY MODALITIES SHIELDING TECHNIQUES FOR CURRENT RADIATION THERAPY MODALITIES MELISSA C. MARTIN, M.S., FACR, FAAPM PRESIDENT AAPM - 2017 PRESIDENT - THERAPY PHYSICS INC., GARDENA, CA MELISSA@THERAPYPHYSICS.COM AAPM Spring

More information

EDUCATION ON THE STANDS PROGRAMME

EDUCATION ON THE STANDS PROGRAMME Monday 12 June EDUCATION ON THE STANDS PROGRAMME 9.30 Carestream RIS, PACS & VNA users 9.30 Phllips Dose reduction and workflow improvement with Philips SkyFlow We will explain the function of digital

More information

Adriano Duatti Department of Chemical and Pharmaceutical Sciences University of Ferrara Via L. Borsari, 46, Ferrara, Italy

Adriano Duatti Department of Chemical and Pharmaceutical Sciences University of Ferrara Via L. Borsari, 46, Ferrara, Italy Adriano Duatti Department of Chemical and Pharmaceutical Sciences University of Ferrara Via L. Borsari, 46, 44121 Ferrara, Italy dta@unife.it adriano.duatti@unife.it Summary Approved tracers for myocardial

More information

Implementation of the 2012 ACR CT QC Manual in a Community Hospital Setting BRUCE E. HASSELQUIST, PH.D., DABR, DABSNM ASPIRUS WAUSAU HOSPITAL

Implementation of the 2012 ACR CT QC Manual in a Community Hospital Setting BRUCE E. HASSELQUIST, PH.D., DABR, DABSNM ASPIRUS WAUSAU HOSPITAL Implementation of the 2012 ACR CT QC Manual in a Community Hospital Setting BRUCE E. HASSELQUIST, PH.D., DABR, DABSNM ASPIRUS WAUSAU HOSPITAL Conflict of Interest Disclaimer Employee of Aspirus Wausau

More information

Diagnostic and Prognostic Value of Coronary Ca Score

Diagnostic and Prognostic Value of Coronary Ca Score Diagnostic and Prognostic Value of Coronary Ca Score Dr. Ghormallah Alzahrani Cardiac imaging division, Adult Cardiology department Prince Sultan Cardiac Center ( PSCC) Madina, June 2 Coronary Calcium

More information

CARDIAC MRI. Cardiovascular Disease. Cardiovascular Disease. Cardiovascular Disease. Overview

CARDIAC MRI. Cardiovascular Disease. Cardiovascular Disease. Cardiovascular Disease. Overview CARDIAC MRI Dr Yang Faridah A. Aziz Department of Biomedical Imaging University of Malaya Medical Centre Cardiovascular Disease Diseases of the circulatory system, also called cardiovascular disease (CVD),

More information

M. J. Maryanski, Three Dimensional BANG Polymer Gel Dosimeters AAPM'99, CE Course

M. J. Maryanski, Three Dimensional BANG Polymer Gel Dosimeters AAPM'99, CE Course Three Dimensional BANG Polymer Gel Dosimeters Marek J. Maryanski MGS Research, Inc. Guilford, CT Educational objectives: Describe the need for high-resolution 3D dosimetry in 3D CRT. Explain the physics

More information

This house believes that the use of Functional Imaging for treatment planning of head and neck tumors needs to be carefully considered.

This house believes that the use of Functional Imaging for treatment planning of head and neck tumors needs to be carefully considered. This house believes that the use of Functional Imaging for treatment planning of head and neck tumors needs to be carefully considered. IMRT for Head and Neck Tumors Vincent GREGOIRE, M.D., Ph.D., Hon.

More information

MPI Overview. Artifacts and Pitfalls in MPI. Acquisition and Processing. Peeyush Bhargava MD, MBA

MPI Overview. Artifacts and Pitfalls in MPI. Acquisition and Processing. Peeyush Bhargava MD, MBA Artifacts and Pitfalls in MPI MPI Overview Peeyush Bhargava MD, MBA www.nuclearmd.com ~ 40% of all Nuclear Medicine Procedures ~ 9 million procedures every year in US >95% are SPECT,

More information

Stereotactic Radiosurgery. Extracranial Stereotactic Radiosurgery. Linear accelerators. Basic technique. Indications of SRS

Stereotactic Radiosurgery. Extracranial Stereotactic Radiosurgery. Linear accelerators. Basic technique. Indications of SRS Stereotactic Radiosurgery Extracranial Stereotactic Radiosurgery Annette Quinn, MSN, RN Program Manager, University of Pittsburgh Medical Center Using stereotactic techniques, give a lethal dose of ionizing

More information

Emerging Referral Patterns for Whole-Body Diffusion Weighted Imaging (WB-DWI) in an Oncology Center

Emerging Referral Patterns for Whole-Body Diffusion Weighted Imaging (WB-DWI) in an Oncology Center Emerging Referral Patterns for Whole-Body Diffusion Weighted Imaging (WB-DWI) in an Oncology Center Poster No.: C-1296 Congress: ECR 2014 Type: Scientific Exhibit Authors: G. Petralia 1, G. Conte 1, S.

More information

Basics of nuclear medicine

Basics of nuclear medicine Basics of nuclear medicine Prof. dr. Davor Eterović Prof. dr. Vinko Marković Radioisotopes are used both in diagnostics and in therapy Diagnostics gamma emitters are used since gamma rays can penetrate

More information

Additional Questions for Review 2D & 3D

Additional Questions for Review 2D & 3D Additional Questions for Review 2D & 3D 1. For a 4-field box technique, which of the following will deliver the lowest dose to the femoral heads? a. 100 SSD, equal dmax dose to all fields b. 100 SSD, equal

More information

GATE MONTE CARLO DOSIMETRY SIMULATION OF MARS SPECTRAL CT

GATE MONTE CARLO DOSIMETRY SIMULATION OF MARS SPECTRAL CT GATE MONTE CARLO DOSIMETRY SIMULATION OF MARS SPECTRAL CT R Aamir, C Lowe, J Damet, P Carbonez, A P H Butler, N Schleich, N G Anderson MARFO, Emmanuel Geant4 User Workshop 2017, Wollongong Overview MARS

More information

HST.582J / 6.555J / J Biomedical Signal and Image Processing Spring 2007

HST.582J / 6.555J / J Biomedical Signal and Image Processing Spring 2007 MIT OpenCourseWare http://ocw.mit.edu HST.582J / 6.555J / 16.456J Biomedical Signal and Image Processing Spring 2007 For information about citing these materials or our Terms of Use, visit: http://ocw.mit.edu/terms.

More information

Discovery ALCYONE. the dream is alive. Bernard SONGY, David LUSSATO, Mohamed GUERNOU November, 24, 2009

Discovery ALCYONE. the dream is alive. Bernard SONGY, David LUSSATO, Mohamed GUERNOU November, 24, 2009 Discovery ALCYONE at CCN: the dream is alive Bernard SONGY, David LUSSATO, Mohamed GUERNOU November, 24, 2009 Nuclear Medicine at CCN Department created in 1988 by Antoine BLASCO and Florence VIGONI 3

More information

Non Contrast MRA. Mayil Krishnam. Director, Cardiovascular and Thoracic Imaging University of California, Irvine

Non Contrast MRA. Mayil Krishnam. Director, Cardiovascular and Thoracic Imaging University of California, Irvine Non Contrast MRA Mayil Krishnam Director, Cardiovascular and Thoracic Imaging University of California, Irvine No disclosures Non contrast MRA-Why? Limitations of CTA Radiation exposure Iodinated contrast

More information

Pre-treatment and in-vivo dosimetry of Helical Tomotherapy treatment plans using the Dosimetry Check system

Pre-treatment and in-vivo dosimetry of Helical Tomotherapy treatment plans using the Dosimetry Check system Pre-treatment and in-vivo dosimetry of Helical Tomotherapy treatment plans using the Dosimetry Check system E. Mezzenga, * E. Cagni, A. Botti, M. Orlandi and M. Iori Medical Physics Unit, IRCCS Arcispedale

More information

Non-Invasive Techniques

Non-Invasive Techniques Non-Invasive Techniques Key: Does not hurt the organism Psychology 372 Physiological Psychology Steven E. Meier, Ph.D. Listen to the audio lecture while viewing these slides or view the video presentation

More information

Image-guided adaptive radiation therapy : retrospective study and assessment of clinical workflow

Image-guided adaptive radiation therapy : retrospective study and assessment of clinical workflow The University of Toledo The University of Toledo Digital Repository Theses and Dissertations 2013 Image-guided adaptive radiation therapy : retrospective study and assessment of clinical workflow Jason

More information

Technological leapfrogging at a hospital near you What s going on and why it matters?

Technological leapfrogging at a hospital near you What s going on and why it matters? Technological leapfrogging at a hospital near you What s going on and why it matters? Antonis Kalemis, PhD MBA Philips - Advanced Molecular Imaging Snr Manager, Clinical Science AIPES (European Association

More information

Small field diode dosimetry

Small field diode dosimetry Small field diode dosimetry Parham Alaei, Ph.D. Department of Radiation Oncology University of Minnesota NCCAAPM Symposium-October 10, 2013 1 Diodes as beam data collection detectors Diodes as in vivo

More information