Villavicencio, Facundo L. (2021) Evaluación de factibilidad y adquisición de imágenes para acreditar el PET/CT de INTECNUS según los nuevos estándares de calidad EARL/EANM / Feasibility evaluation and image acquisition to achieve the new EARL/EANM quality standards accreditation for the INTECNUS PET/CT device. Maestría en Física Médica, Universidad Nacional de Cuyo, Instituto Balseiro.
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Resumen en español
La tomografía por emisión de positrones es una técnica de imágenes de uso cada vez más extenso para el diagnóstico de diversas patologías, entre ellas oncológicas, cardiológicas y neurológicas. Además permite valorar la extensión de la enfermedad y evaluar la eficacia del tratamiento instaurado [1]. Las imágenes PET utilizan radiotrazadores marcados con radionúclidos emisores de positrones, los cuales son administrados al paciente por vía endovenosa [2]. El ¹⁸F-FDG es un análogo de la glucosa y es el radiofármaco más utilizado debido al incremento del metabolismo de la glucosa en células tumorales [3]. La tomografía por emisión de positrones es además una técnica de imágenes cuantitativas, dado que el valor de captación estándar (SUV) es una medida de la concentración de actividad en un tiempo dado t0 permitiendo realizar el seguimiento de la patología y evaluar la respuesta al tratamiento de los pacientes [4]. A pesar de ser un valor estandarizado a nivel global, la confiabilidad del valor del SUV es a menudo cuestionada debido a que se encuentra sujeto a demasiadas fuentes de variabilidad [5]. Se han estudiado y documentado la variabilidad y reproducibilidad de este parámetro, así como los factores que influyen en él como biomarcador de imágenes PET [6]. Para que el valor de SUV de imágenes adquiridas en estudios multicéntricos pueda ser comparable, se requiere de la armonización del rendimiento de los equipos PET [5,6]. En el presente trabajo se propuso evaluar la factibilidad técnica para cumplir con los nuevos estándares EARL 2 de la Asociación Europea de Medicina Nuclear, se plantearon los protocolos de adquisición que otorguen los coeficientes de recuperación de contraste dentro de los límites de tolerancia más óptimos y se obtuvieron las imágenes según los procedimientos de acreditación [7]. Finalmente, los resultados fueron evaluados y utilizados para realizar la acreditación internacional del equipo GE – Discovery 710 PET/CT del servicio de medicina nuclear de INTECNUS. Se exploraron distintas combinaciones de parámetros de adquisición y reconstrucción de las imágenes hasta que se encontró aquella que resultó óptima para los fines de este trabajo. Con estos parámetros armonizados se evaluaron diferentes casos clínicos, obteniéndose una mejor cuantificación de SUV, lo que permite a su vez una mejora en la detectabilidad de lesiones pequeñas, en comparación con las imágenes obtenidas con el protocolo previo al proceso de acreditación.
Resumen en inglés
Positron emission tomographic imaging is increasingly used to diagnose oncological, cardiological and neurological diseases, among others. It makes it also possible to assess the extent of the disease and to evaluate the effectiveness of the established treatment [1]. The contrast in PET images is obtained by using radiotracers labeled with positron-emitting radionuclides, which are administered intravenously to the patients [2]. ¹⁸F-FDG is the most widely used radiopharmaceutical, due to being a glucose analog, and being its metabolism increased in tumor cells [3]. In addition, this technique offers quantitative images by means of the standardized uptake value (SUV), which is a measure of radioactivity concentrations at a certain time and leads to patient follow-up and evaluation of the treatment response [4]. Despite the popularity of SUV, its reliability is often questioned because it is subject to many sources of variability [5]. The variability and reproducibility of this parameter and the factors that influence it as an image biomarker have been studied and documented [6]. SUV values, in order to be comparable in multicenter studies, require harmonization of the performance of PET devices [5,6]. This thesis goals were to evaluate: (1) the technical feasibility to achieve the new EARL 2 standards of the European Association of Nuclear Medicine and (2) the acquisition protocols leading to contrast recovery coefficients within the optimal tolerance limits were set and images according to the accreditation procedures were obtained [7]. Finally, the results were evaluated and used to carry out the international accreditation for the GE - Discovery 710 PET/CT INTECNUS Nuclear Medicine equipment. Different combinations of image acquisition and reconstruction parameters were explored to achieve the goals of this thesis. With these harmonized parameters, different clinical cases were evaluated, obtaining a better SUV quantification and lesion detectability, in comparison to the images obtained by using the prior established protocol.
| Tipo de objeto: | Tesis (Maestría en Física Médica) |
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| Palabras Clave: | Computerized tomography; Tomografía computarizada; [International accreditation; Acreditación internacional; Harmonization; Armonización; Positron emission tomography; Tomografía por emisión de positrones; Contrast Recovery Coefficient; Coeficiente de recuperación de contraste] |
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| Materias: | Medicina > Medicina nuclear |
| Divisiones: | Centro Integral de Medicina Nuclear y Radioterapia. Fundación INTECNUS |
| Código ID: | 1034 |
| Depositado Por: | Tamara Cárcamo |
| Depositado En: | 14 Jun 2022 16:15 |
| Última Modificación: | 14 Jun 2022 16:15 |
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