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Sally F. Barrington,
Wendi Qian, Edward J. Somer,
Antonella Franceschetto,
Bruno Bagni,
Eva Brun,
Helén Almquist,
Annika Loft,
Liselotte Højgaard,
Massimo Federico,
Andrea Gallamini,
Paul Smith,
Peter Johnson,
John Radford,
Michael J. O’Doherty
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ABSTRACT: PurposeTo determine if PET reporting criteria for the Response Adapted Treatment in Hodgkin Lymphoma (RATHL) trial could enable satisfactory
agreement to be reached between ‘core’ laboratories operating in different countries.
MethodsFour centres reported scans from 50 patients with stage II–IV HL, acquired before and after two cycles of Adriamycin/bleomycin/vinblastine/dacarbazine.
A five-point scale was used to score response scans using ‘normal’ mediastinum and liver as reference levels. Centres read
scans independently of each other. The level of agreement between centres was determined assuming (1) that uptake in sites
involved at diagnosis that was higher than liver uptake represented disease (conservative reading), and (2) that uptake in
sites involved at diagnosis that was higher than mediastinal uptake represented disease (sensitive reading).
ResultsThere was agreement that the response scan was ‘positive’ or ‘negative’ for lymphoma in 44 patients with a conservative reading
and in 41 patients with a sensitive reading. Kappa was 0.85 (95% CI 0.74–0.96) for conservative reading and 0.79 (95% CI 0.67–0.90)
for sensitive reading. Agreement was reached in 46 and 44 patients after discussion for the conservative and sensitive readings,
respectively.
ConclusionThe criteria developed for reporting in the RATHL trial are sufficiently robust to be used in a multicentre setting.
KeywordsPositron emission tomography-Hodgkin lymphoma-Quality control/quality assurance-Clinical trial
European journal of nuclear medicine and molecular imaging 04/2012; 37(10):1824-1833. · 4.99 Impact Factor
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ABSTRACT: Teriparatide increases skeletal mass, bone turnover markers, and bone strength, but local effects on bone tissue may vary between skeletal sites. We used positron emission tomography (PET) to study (18)F-fluoride plasma clearance (K(i)) at the spine and standardized uptake values (SUVs) at the spine, pelvis, total hip, and femoral shaft in 18 postmenopausal women with osteoporosis. Subjects underwent a 1-hour dynamic scan of the lumbar spine and a 10-minute static scan of the pelvis and femurs at baseline and after 6 months of treatment with 20 µg/day teriparatide. Blood samples were taken to derive the arterial input function and lumbar spine K(i) values evaluated using a three-compartment model. SUVs were calculated for the spine, pelvis, total hip, and femoral shaft. After 6 months treatment with teriparatide, spine K(i) values increased by 24% (p = .0003), while other model parameters were unchanged except for the fraction of tracer going to bone mineral (k(3)/[k(2) + k(3)]), which increased by 23% (p = .0006). In contrast to K(i) , spine SUVs increased by only 3% (p = .84). The discrepancy between changes in K(i) and SUVs was explained by a 20% decrease in (18)F(-) plasma concentration. SUVs increased by 37% at the femoral shaft (p = .0019), 20% at the total hip (p = .032), and 11% at the pelvis (p = .070). Changes in bone turnover markers and BMD were consistent with previous trials. We conclude that the changes in bone formation rate during teriparatide treatment as measured by (18)F(-) PET differ at different skeletal sites, with larger increases in cortical bone than at trabecular sites.
Journal of bone and mineral research: the official journal of the American Society for Bone and Mineral Research 05/2011; 26(5):1002-11. · 6.04 Impact Factor
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[show abstract]
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ABSTRACT: Teriparatide increases skeletal mass, bone turnover markers and bone strength, but local effects on bone tissue may vary between skeletal sites. We used positron emission tomography (PET) to study (18)F-fluoride plasma clearance (Ki) at the spine and standardised uptake values (SUV) at the spine, pelvis, total hip and femoral shaft in 18 postmenopausal women with osteoporosis. Subjects underwent a 1-hour dynamic scan of the lumbar spine and a 10-minute static scan of the pelvis and femurs at baseline and after 6 months treatment with teriparatide 20 g/day. Blood samples were taken to derive the arterial input function and lumbar spine Ki values evaluated using a 3-compartment model. SUV values were calculated for the spine, pelvis, total hip and femoral shaft. After 6 months treatment with teriparatide spine Ki values increased by 24% (P=0.0003), while other model parameters were unchanged except for the fraction of tracer going to bone mineral [k(3)/(k(2)+k(3))], which increased by 23% (P=0.0006). In contrast to Ki spine SUV increased by only 3% (P=0.84). The discrepancy between changes in Ki and SUV was explained by a 20% decrease in (18)F- plasma concentration. SUV values increased by 37% at the femoral shaft (P=0.0019), 20% at the total hip (P=0.032), and 11% at the pelvis (P=0.070). Changes in bone turnover markers and BMD were consistent with previous trials. We conclude that the changes in bone formation rate during teriparatide treatment as measured by (18)F- PET differ at different skeletal sites, with larger increases in cortical bone than at trabecular sites. © 2010 American Society for Bone and Mineral Research.
Journal of bone and mineral research: the official journal of the American Society for Bone and Mineral Research 12/2010; · 6.04 Impact Factor
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Sally F Barrington,
Wendi Qian, Edward J Somer,
Antonella Franceschetto,
Bruno Bagni,
Eva Brun,
Helén Almquist,
Annika Loft,
Liselotte Højgaard,
Massimo Federico,
Andrea Gallamini,
Paul Smith,
Peter Johnson,
John Radford,
Michael J O'Doherty
[show abstract]
[hide abstract]
ABSTRACT: To determine if PET reporting criteria for the Response Adapted Treatment in Hodgkin Lymphoma (RATHL) trial could enable satisfactory agreement to be reached between 'core' laboratories operating in different countries.
Four centres reported scans from 50 patients with stage II-IV HL, acquired before and after two cycles of Adriamycin/bleomycin/vinblastine/dacarbazine. A five-point scale was used to score response scans using 'normal' mediastinum and liver as reference levels. Centres read scans independently of each other. The level of agreement between centres was determined assuming (1) that uptake in sites involved at diagnosis that was higher than liver uptake represented disease (conservative reading), and (2) that uptake in sites involved at diagnosis that was higher than mediastinal uptake represented disease (sensitive reading).
There was agreement that the response scan was 'positive' or 'negative' for lymphoma in 44 patients with a conservative reading and in 41 patients with a sensitive reading. Kappa was 0.85 (95% CI 0.74-0.96) for conservative reading and 0.79 (95% CI 0.67-0.90) for sensitive reading. Agreement was reached in 46 and 44 patients after discussion for the conservative and sensitive readings, respectively.
The criteria developed for reporting in the RATHL trial are sufficiently robust to be used in a multicentre setting.
European Journal of Nuclear Medicine 10/2010; 37(10):1824-33. · 4.53 Impact Factor
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ABSTRACT: We have investigated improvements to PET-MR image registration offered by PET-CT scanning. Ten subjects with suspected soft-tissue sarcomas were scanned with an in-line PET-CT and a clinical MR scanner. PET to CT, CT to MR and PET to MR image registrations were performed using a rigid-body external marker technique and rigid and non-rigid voxel-similarity algorithms. PET-MR registration was also performed using transformations derived from the registration of CT to MR. The external marker technique gave fiducial registration errors of 2.1 mm, 5.1 mm and 5.3 mm for PET-CT, PET-MR and CT-MR registration. Target registration errors were 3.9 mm, 9.0 mm and 9.3 mm, respectively. Voxel-based algorithms were evaluated by measuring the distance between corresponding fiducials after registration. Registration errors of 6.4 mm, 14.5 mm and 9.5 mm, respectively, for PET-CT, PET-MR and CT-MR were observed for rigid-body registration while non-rigid registration gave errors of 6.8 mm, 16.3 mm and 7.6 mm for the same modality combinations. The application of rigid and non-rigid CT to MR transformations to accompanying PET data gives significantly reduced PET-MR errors of 10.0 mm and 8.5 mm, respectively. Visual comparison by two independent observers confirmed the improvement over direct PET-MR registration. We conclude that PET-MR registration can be more accurately and reliably achieved using the hybrid technique described than through direct rigid-body registration of PET to MR.
Physics in Medicine and Biology 01/2008; 52(23):6991-7006. · 2.83 Impact Factor
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Edward J Somer
Nuclear Medicine Communications 09/2006; 27(8):601-2. · 1.40 Impact Factor
