Biograph 40

Manufactured by Siemens

Sourced in Germany, United States

The Biograph 40 is a positron emission tomography (PET) scanner manufactured by Siemens. It is designed to acquire high-quality images of the human body for medical diagnostic purposes. The core function of the Biograph 40 is to detect and measure the distribution of radioactive tracer substances within the body, which can provide valuable information about the physiological and metabolic processes occurring in various organs and tissues.

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Biograph TruePoint 40 Biograph 40 system Biograph 40 Truepoint PET/CT scanner Biograph 40 True Point scanner Biograph 40 PET/CT Biograph 40 TruePoint with TrueV Biograph 40 TruePoint PET/CT camera Biograph mCT 40 Biograph 40 TruePoint PET/CT Biograph 40 TrueV HD

55 protocols using biograph 40

FDG-PET Imaging Protocol for Oncology

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According to the FDG-PET protocol, all patients fasted for at least 6 hours before the examination, and the 18F-FDG dose was 3.7 MBq/kg. 18F-FDG-PET images were acquired within the range of the orbit to the thigh using a BIOGRAPH 40 PET scanner (Siemens). The blood sugar levels were checked before the injection, and the scan was performed if blood sugar levels were < 150 mg/dL. The early and delayed phase images were obtained after 60 minutes and between 90 and 120 minutes, respectively. The FDG-PET data were reconstructed in a 168 × 168 matrix.
CT was performed using the same scanner (BIOGRAPH 40; Siemens) at 120 kV and 220 mAs (CARE Dose4D). The slice thickness was 3 mm, and the interval was 2 mm. MRI was performed on a 3-T system (Achieva; Philips, Best, The Netherlands) using a 32-channel cardiac coil. MR images were obtained with T1-weighted, T2-weighted, and STIR sequences in the coronal and axial planes, and diffusion images were also obtained, all of which represent MARS-MRI.

Kimura M., Kaku N., Kubota Y., Tagomori H, & Tsumura H. (2021). Fluorodeoxyglucose Positron-Emission Tomography/Computed Tomography and Magnetic Resonance Imaging for Adverse Local Tissue Reactions near Metal Implants after Total Hip Arthroplasty: A Preliminary Report. Clinics in Orthopedic Surgery, 13(3), 320-328.

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Comparing NSCLC Tumor Delineation Using PET-CT

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A total of 60 NSCLC patients who received stereotactic body radiation therapy (SBRT) were analyzed in this study following institutional review board (IRB) approval. All patients had PET-CT images for simulation and received follow-up CT images between 2 and 4 months after radiotherapy treatment. Fluorine 18-fluorodeoxyglucose (18F-FDG) PET and CT images were obtained using a dual PET/CT scanner (Siemens Biograph 40, Siemens Medical Solutions, Erlangen, Germany). All patients were injected with 370 BMq ± 10% of 18F-FDG with an uptake time of 90 min ± 10%. In all cases, subjects fasted for more than 4 h and had a blood glucose of less than 200 mg/dl. The gross tumor volume (GTV) for each of the PET and CT image datasets was separately delineated by three radiation oncologists on both CT and 18F-FDG PET images, with the guidance of the corresponding images in the other modality. All contouring was completed using VelocityAI (Varian Medical System, Inc., Palo Alto, CA). In this study, while physicians referred to the other modality to define the tumor contours on either PET or CT, they did not visualize the corresponding PET and CT scans at the same time using the software’s fusion feature. The reference standard for each scan was then generated by applying the STAPLE algorithm^{42 (link)} to the three manual delineations.

Zhong Z., Kim Y., Plichta K., Allen B.G., Zhou L., Buatti J, & Wu X. (2019). Simultaneous cosegmentation of tumors in PET‐CT images using deep fully convolutional networks. Medical Physics, 46(2), 619-633.

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Assessing Tumor Response with [18F]-FLT-PET

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All subjects underwent baseline radiological tumor assessment by conventional CT imaging of any region of known or suspected disease and [18F]-FLT-PET imaging occurred after the first dose of pembrolizumab, within 28 days of administration. [18F]-FLT was produced in the PET/radiochemistry facility at CUMC under PET cGMP conditions as approved by the Food and Drug Administration through investigational new drug number 122435. Synthesis of this radiotracer was carried out using a novel synthesis module obtained from Neptis, SA (Belgium).
Study participants were administered approximately 185 MBq (5 mCi) of ¹⁸F-FLT intravenously. A PET/CT scan was performed after an approximately 30-minute wait time (+/− 60 minutes). PET/CT scans were performed on Siemens Biograph 40 (Siemens - Erlangen, Germany) with a 40-detector helical CT. PET/CT image acquisition followed standard procedure in our PET Center, and the entire body from vertex to toes was imaged. PET acquisition time was based on patient weight.
Repeat whole body [18F]-FLT-PET imaging was performed at week 6 using the same instrument and image acquisition protocol as baseline. Repeat CT imaging of all areas of known or suspected disease was performed at week 12 also utilizing the same instrument and image acquisition protocols as baseline. Response assessment of CT imaging was performed using iRECIST.

Yeh R., Trager M.H., Rizk E.M., Finkel G., Barker L., Carvajal R.D., Geskin L.J., Schwartz G.K., Schwartz L., Dercle L, & Saenger Y.M. (2020). FLT-PET at 6 weeks predicts response assessed by CT at 12 weeks in melanoma patients treated with pembrolizumab. Clinical nuclear medicine, 45(4), 267-275.

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Standardized Radiation Beam Delivery Protocol

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A CT (Siemens Biograph 40, Siemens Healthcare, Malvern, PA, USA) scan (slice thickness 1 mm) of the experimental set-up was made for accurate treatment planning (Figure 1). 10 megavolt (MV) FF beams were delivered at a dose rate of 4 Gy/min, 10 MV FFF beams at 4 or 24 Gy/min using a Varian TrueBeam accelerator (Varian Medical Systems, Palo Alto, CA, USA). For FF beams, the dose per pulse at the depth of the maximum dose (d max ) was found to be 0.03 and 0.056 cGy/pulse, respectively, for low and high dose rate 10 MV photon beams. Th e dose per pulse at d max for 10 MV FFF beams equals 0.13 cGy/pulse and was found to be independent of the nominal dose rate (Kry et al. 2012) . For each uniform dose level, treatment planning was performed with the Anisotropic Analytical Algorithm (AAA [10.0.28], Eclipse, Varian Medical Systems) calculation model with a dose calculation grid resolution of 1 mm. Polymethylmetacrylate (PMMA, 2 cm) dose build-up was used for calculations and irradiation. Surface (cells) source distance was kept at 96.4 cm for both beam schedules. FF and FFF beams were delivered using a 20 ϫ 20 cm or 8 ϫ 8 cm irradiation fi eld respectively, with the center of jig (FF) or the center of the dish (FFF) at the isocenter of the beam. Th is setup resulted in 88.6 and 102.8 monitor units per Gy for FF and FFF beams, respectively.

Dubois L., Biemans R., Reniers B., Bosmans G., Trani D., Podesta M., Kollaard R., Rouschop K.M., Theys J., Vooijs M., Pruschy M., Verhaegen F, & Lambin P. (2015). High dose rate and flattening filter free irradiation can be safely implemented in clinical practice. International journal of radiation biology, 91(10).

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Amyloid PET Imaging Protocol Using 18F-Florbetaben

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Amyloid PET data were acquired using a Biograph 40 PET/CT scanner (Siemens, Knoxville, Tenn, USA). Each participant underwent PET scans between 90 and 110 minutes after injection of 185 MBq of ^{18 (link)}F-florbetaben. An ordered subset expectation-maximization algorithm was used to reconstruct PET data.
All MRI images were normalized to a T1-weighted MRI template, and then each PET image was co-registered with each normalized MRI image. The automated anatomic labeling atlas^{18 (link)} was used to obtain volume of interest (VOI) quantitative values. Standardized uptake value ratio (SUVR) is calculated as the degree of radiotracer uptake of a region of interest relative to a reference region and is the most common quantitative method used to calculate amyloid deposition levels in AD. We calculated SUVR using whole cerebellum as a reference region to determine the level of Aβ deposition in each VOI region.

Lee K., Lee Y.M., Park J.M., Lee B.D., Moon E., Jeong H.J., Suh H., Kim H.J., Pak K, & Choi K.U. (2022). The Relationship of Plasma Transthyretin Level with Global or Regional Amyloid Beta Burden in Subjects with Amnestic Mild Cognitive Impairment: Cross-Sectional Amyloid PET Study. Psychiatry and Clinical Psychopharmacology, 32(1), 4-8.

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Standardized 18F-FDG PET/CT Imaging Protocol

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The ¹⁸F-FDG PET/CT examinations were performed using a Biograph Duo or Biograph 40 PET/CT system (Siemens Healthcare, Erlangen, Germany) from the skull base to the proximal thigh in a supine position. The patients were required to fast for a minimum of 4 h before the ¹⁸F-FDG injection. After injection of approximately 185.0–370.0 MBq of ¹⁸F-FDG, the patients rested for about 1 h before imaging. PET acquisition time was 2 min/bed position in three-dimensional mode, and images were reconstructed using the ordered subsets expectation maximization algorithm (14 subsets, 6 iterations) and point spread function correction model. The low-dose CT transmission scan was acquired with 140 kVp and 25 mAs and 2 mm slice thickness. PET images were displayed in a 168 × 168 matrix (pixel size 4.07 × 4.07 mm, slice thickness 2.0 mm). The reconstructed PET/CT images were reviewed by nuclear medicine radiologists (YTat, HS, and TM).

Tatewaki Y., Terao C.M., Ariake K., Saito R., Mutoh T., Shimomura H., Motoi F., Mizuma M., Odagiri H., Unno M, & Taki Y. (2021). Defining the Optimal Method for Measuring Metabolic Tumor Volume on Preoperative 18F-Fluorodeoxyglucose-Positron Emission Tomography/Computed Tomography as a Prognostic Predictor in Patients With Pancreatic Ductal Adenocarcinoma. Frontiers in Oncology, 11, 646141.

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PET-CT Imaging of [18F]HX4 Tracer Uptake

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All patients underwent a pre-treatment planning CT (pCT) with a personalized immobilization mask. [18F] HX4 PET-CT images were acquired pre-treatment (median 4 days before start RTx, range 1–16) as well as during RTx (median 13 days after start RTx, range 3–17 days) using high-resolution full-ring PET/CT scanners (Philips Gemini 16 and Siemens Biograph 40 scanner). Static PET images of the head and neck area in the same immobilization mask were acquired 4 h after intravenous administration of an average (±SD) dose of 427 ± 55 MBq [18F] HX4 in the NCT01347281 trial and 386 ± 25 MBq [18F] HX4 in the NCT01504815 trial.
The images were reconstructed using scanner-specific parameters in accordance with each facility’s standard procedure, including at least attenuation and scatter correction.
The 4 h post-injection (p.i.) time point is related to a plateau phase in tracer uptake associated with optimal imaging properties [15] (link). More details regarding the acquisition parameters/protocol and scanner types are presented in Appendix A.

Sanduleanu S., Hamming-Vrieze O., Wesseling F.W., Even A.J., Hoebers F.J., Hoeben A., Vogel W.V., Tesselaar M.E., Parvin D., Bartelink H, & Lambin P. (2020). [18F]-HX4 PET/CT hypoxia in patients with squamous cell carcinoma of the head and neck treated with chemoradiotherapy: Prognostic results from two prospective trials. Clinical and Translational Radiation Oncology, 23, 9-15.

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PET-CT Phantom Imaging Protocol

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Five spheres in the phantom (with diameters 1.3 cm, 1.7 cm, 2.2 cm, 2.8 cm, and 3.7 cm) were filled with tap water to mimic cold lesion imaging. The phantom was set up and aligned in a supine position on PET-CT system (Biograph 40, Siemens, Memphis, Tennessee, USA) for imaging as shown in Figure 1a. PET-CT images of the phantom were acquired in 3 min (one bed position) and displayed in 512 × 512 matrix. Transaxial image slice centering on the spheres as shown in Figure 1b was selected for the analysis.

Francis H., Amuasi J.H., Kwame K.A, & Vangu M.D. (2016). Quantitative Assessment of Radionuclide Uptake and Positron Emission Tomography-computed Tomography Image Contrast. World Journal of Nuclear Medicine, 15(3), 167-172.

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Whole-body PET Imaging with 124I-PGN650

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All PET imaging was performed with a Siemens Biograph-40 positron emission tomography/computed tomography (PET/CT) scanner (Siemens Heathineers, Knoxville, Tennessee). The planned dosage of approximately 140 MBq (3.8 mCi) of ¹²⁴I-PGN650 was administered over 5 minutes, after which patients were imaged at approximately 1 hour, ∼3 hours, and at either 24 hours or 48 hours post-injection by a whole-body PET procedure from head to upper thigh. In order to limit radiation exposure to the thyroid that could result from the formation of free ¹²⁴I-iodide by the metabolism of ¹²⁴I-PGN650, patients received saturated potassium iodide solution, 2 drops orally 3 times per day, beginning 1 hour before ¹²⁴I-PGN650 administration, for a total of 8 days. At each imaging session, a spiral CT for attenuation correction (120 kVp, 50 mAs effective) was obtained from the top of the skull through the upper thighs, with the patient supine. Immediately after the attenuation CT scan, emission images beginning at the top of the skull and proceeding caudally through the upper thighs were obtained (1-10 minutes per bed position). Imaging was performed over 6 to 7 bed positions with a total imaging duration of no more than 1 hour. Images were reconstructed with 3D-Ordered-Subset Estimation-Maximization (OSEM) with 3 iterations, 24 subsets, and a post-reconstruction Gaussian filter of 5 mm.

Laforest R., Dehdashti F., Liu Y., Frye J., Frye S., Luehmann H., Sultan D., Shan J.S., Freimark B.D, & Siegel B.A. (2017). First-in-Man Evaluation of 124I-PGN650: A PET Tracer for Detecting Phosphatidylserine as a Biomarker of the Solid Tumor Microenvironment. Molecular Imaging, 16, 1536012117733349.

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Preclinical PET Imaging of Liver Tumors

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Rabbits were anesthetized with a ketamine/xylazine combination, and fresh rabbit VX2 tumor tissue was transplanted into each rabbit's liver, as previously described [24 (link)]. Two weeks later, these rabbits and mice with orthotopic liver tumors were intravenously injected with ⁶⁸Ga-MHI-148 at a dose of 0.5 mCi/kg for rabbits and 5 μCi/g for mice. After 1 h, PET/CT imaging was performed using a Biograph 40 (Siemens, Bonn, GER) for rabbits and Mediso Nano (NSW, Australia) for mice. Nuclear tissue was fixed with 4% formalin for histopathological analysis.

Zhang C., Zhao Y., Zhao N., Tan D., Zhang H., Chen X., Zhang H., An J., Shi C, & Li M. (2018). NIRF Optical/PET Dual-Modal Imaging of Hepatocellular Carcinoma Using Heptamethine Carbocyanine Dye. Contrast Media & Molecular Imaging, 2018, 4979746.

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