Quantitative Bildgebung für die Dosimetrie mit SPECT/CT

Zusammenfassung

Die möglichst genaue Bestimmung von in Tumoren und kritischen Organen aufgenommenen Aktivitäten ist eine der Grundvoraussetzungen für die Planung und Überwachung der molekularen Radiotherapie mithilfe von interner Dosimetrie. Aufgrund zahlreicher Verbesserungen im Bereich der Hardware, v. a. aber auch im Bereich der Rekonstruktionssoftware, ist die SPECT/CT-Bildgebung zu einer der am besten geeigneten und am weitesten verbreiteten Bildgebungsmethoden für die Abschätzung von Organaktivitäten und Aktivitätsverteilungen geworden. Trotz ihres großen Potenzials hat die SPECT/CT-Bildgebung jedoch immer noch mit einer Reihe von Schwierigkeiten zu kämpfen, die eine volumenbasierte Bestimmung von Organaktivitäten erschweren. Insbesondere sind die Umrechnung von Impuls- in Aktivitätsverteilung, die Korrektur von Partialvolumeneffekten, sowie die Standardisierung von Aufnahme- und Rekonstruktionsprotokollen immer noch Gegenstand der Forschung.

In dieser Arbeit werden zunächst die wichtigsten Prinzipien der quantitativen SPECT/CT-Bildgebung vorgestellt, und anschließend einige Vorschläge und Hilfestellungen für die praktische Umsetzung gegeben.

Abstract

For planning and dosimetric monitoring of radiopharmaceutical therapies, an accurate determination of the amount of radiopharmaceutical in tumors or organs at risk is an important pre-requisite. Due to advances in hard- and software, especially in image reconstruction, SPECT/CT has become the standard method for determining the activity distribution throughout the patient’s body and for quantifying the absolute amount of activity at organ level.

Despite these recent advancements, some difficulties and unsolved problems still exist. For example, camera calibration, compensation of partial volume effects, and standardized acquisition and reconstruction protocols are fields of ongoing research.

In this work, the basic principles of quantitative imaging with SPECT/CT are briefly introduced. Additionally, protocols for absolute quantitative SPECT/CT in clinical practice are proposed.

Schlüsselwörter

SPECT/CT-Bildgebung - SPECT/CT-Kalibrierung - Genauigkeit quantitativer SPECT/CT - quantitative nuklearmedizinische Bildgebung - Dosimetrie mit SPECT/CT

Keywords

SPECT/CT imaging - SPECT/CT calibration - accuracy of quantitative SPECT/CT - quantitative nuclear medicine Imaging - SPECT/CT-based dosimetry

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