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75 protocols using biograph 16

1

Retrospective Head and Neck Cancer Study

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The human data used in this study was obtained from a retrospective study of HNC patients with SCC of the oral cavity, oropharynx, hypopharynx, and larynx, treated with curative radio(chemo)therapy at Oslo University Hospital between 2007 and 2013 (53 (link)). The study was approved by the Regional Ethics Committee and the Institutional Review Board. 18F-fluorodeoxyglucose (FDG) PET/CT imaging was performed at baseline on a Siemens Biograph 16 (Siemens Healthineers GmbH, Erlangen, Germany) with a RT compatible flat table and RT fixation mask. Only the RT planning contrast-enhanced CT images were included in our present work and patients who did not receive contrast agent were excluded from the analysis, resulting in a dataset of 197 patients. This set of patients has previously been described and analyzed in two separate auto-segmentation studies (29 (link), 34 (link)). Further details on the imaging protocol can be found in (29 (link)).
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2

Diagnosing Colorectal Cancer with PET/CT

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For the present study, we defined ‘advanced adenoma’ as adenomas with a diameter of >10 mm and high-grade dysplasia adenoma/mucosal cancer. ‘Advanced lesions’ were defined as invasive cancers and advanced adenomas. ‘Obstructive colorectal cancer’ was defined as cases in which the colonoscope could not reach the cecum because of cancer-related obstruction or stenosis.
The PET/CT was performed after the patients completed a fast of ≥4 h, and their blood glucose levels were measured before the FDG administration to ensure that they were within the normal range. All patients received 185 MBq of FDG, and the uptake period was defined as 60 min. The PET/CT was performed using a Siemens Biograph 16 (Siemens Healthcare, Berlin, Germany), with the following imaging parameters: slice thickness of 1.5 mm, total scale time of 30 sec, tube current-time of 50 mAs, and tube potential of 120 kV. The SUV was defined as the concentration of FDG in the tissue or lesion of interest, and was calculated as SUV = concentration [MBq/g] / (injected dose [MBq] / patients body weight [g]). The SUVmax was defined as the maximum SUV value in a region of interest (13 (link)), and we defined malignancy as focal FDG uptake above the level of the surrounding tissue with an SUV of >3.5 (1 (link)).
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3

PET/CT Imaging of Head and Neck Squamous Cell Carcinoma

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In all 22 patients, an 18F-FDG-PET/CT (Siemens Biograph 16, Siemens Medical Solutions, Erlangen, Germany) was performed from the skull to the upper thigh after a fasting period of at least 6 h. Application of 18F-FDG was performed intravenously with a body-weight-adapted dose (4 MBq/kg, range: 168–427 MBq, mean ± SD: 281 ± 62.2 MBq). PET/CT image acquisition started on average 76 min (range 60–90 min) after 18F-FDG application. Low-dose CT was used for attenuation correction of the PET data.
The acquired PET/CT datasets were evaluated by a board-certified nuclear medicine practitioner and a board-certified radiologist with substantial PET/CT experience in oncological image interpretation. PET/CT image analysis was performed on a dedicated workstation at Hermes Medical Solutions, Sweden. For each tumor, the maximum and mean SUV (SUVmax; SUVmean) were determined from PET images (Figure 1). Prior to this, the tumor margins of the HNSCC were identified on CT images and fused PET/CT images, and a polygonal volume of interest (VOI) that include the entire lesion in the axial, sagittal, and coronal planes was placed in the PET dataset (SUVmax threshold 40%).
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4

FDG-PET/CT Imaging of Brain Function

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All 34 patients underwent 18F‐FDG‐PET using a combined 16‐slice PET/CT scanner (Biograph 16; Siemens, Erlangen, Germany). None of the patients had any seizures within the 24 h prior to the examination or during the scan.
After the patients had fasted >6 h, their blood glucose levels were measured before the administration of 18F‐FDG, which involved the intravenous injection of 4–6 MBq/kg 18F‐FDG 40 min before the start of the brain PET/CT scan. For the emission scans (15 min/bed position; matrix 336 × 336; pixel size, 0.89 × 0.89 mm) of the brain PET/CT protocol (one bed position; field of view [FOV] 30.0 cm axial) in 3D mode, a standard PET/CT bed with a built‐in head holder was used.
The structural 3D T1‐weighted MR images for the spatial normalization process were obtained by the following protocol: repetition time/echo time, 7.18/3.46 ms; flip angle, 10°; effective slice thickness, 0.6 mm with no gap; 300 slices; matrix, 384 × 384; FOV, 26.1 × 26.1 cm.
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5

PET/CT Imaging of [18F]FDG and [68Ga]Pentixafor

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[18F]FDG -PET/CT imaging was performed using a Biograph 16 PET/CT scanner (CTI-Siemens, Erlangen, Germany). After a fasting period of at least 4 h, 3 MBq [18F]FDG per kilogram body weight were injected intravenously. After a waiting period of 60 min post injection the PET/CT acquisition was performed. PET images (slice thickness 5 mm) were corrected for random coincidences, decay, scatter and attenuation and reconstructed iteratively using the ordered subsets expectation maximization algorithm (OSEM) with 4 iterations and 8 subsets. [68Ga]-Pentixafor-PET/CT was performed the same way with an activity of 1.5 MBq [68Ga]-Pentixafor-PET/CT per kilogram body weight without fasting.
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6

Standardized FDG-PET/CT Imaging Protocol

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All FDG-PET/CT studies were performed 60-90 min after intravenous administration of 558±48 MBq of FDG and after fasting for at least 4 hours. The scanner used for all subjects was a Siemens Biograph-16 fitted with high resolution crystals (HD-PET). Scanner was cross calibrated between the dose calibrator and scanner and I clocks were synchronized. The PET-CT protocol started with CT images acquired from the head to upper thigh. A whole-body emission PET scan of the same region followed at 3 min per table position at a resolution of 220×220. The PET and CT images were co-registered using the positional information from the table and patient. Attenuation corrections of PET images were performed using the CT data. PET images were reconstructed with an iterative reconstruction with ordered-subset expectation maximization algorithm.
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7

PET/CT Imaging Protocol for FDG Biodistribution

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Combined PET/CT imaging was performed using a non-TOF (Time of Flight) tomography (Biograph 16, Siemens). All patients fasted for at least 6 hours prior and were preconditioned to have a blood glucose level <150 mg/dl at the time of injection of FDG. 18F-FDG-PET/CT acquisition was performed 60±10 min. after intravenous (i.v.) injection of an average dose of 5 MBq/Kg of 18F-FDG. A non-contrast enhanced CT scan from the base of the skull to the upper thighs was acquired for anatomical localisation and attenuation correction of PET images, with the following parameters: 120–140 kV, 4 mm slice thickness. PET data were acquired in 3D mode immediately after the CT scan, taken for 2–3 minutes at each bed position. PET images were reconstructed by the TrueX algorithm, that employs a system matrix with point spread function modelling, with three iterations and 21 subsets. After reconstruction the images were filtered by a Gaussian filter with a full width at half maximum of 4 mm. PET images were finally corrected for attenuation using data from the CT scan.
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8

Breast Cancer FDG-PET/CT Imaging Protocol

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Ninety-four patients with breast cancer underwent FDG-PET/CT imaging before and after chemotherapy prior to surgical resection. PET/CT was performed after at least 5 h of fasting, and FDG (3.8 MBq/kg) was administered intravenously. Then, a whole-body PET/CT scan (Biograph16, Siemens, Erlangen, Germany) was acquired 75 min after FDG injection. Two radiologists/nuclear medicine physicians independently evaluated the PET/CT images.
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9

PET/CT Protocol for Tumor Staging

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PET/CT examination was conducted in all patients with an integrated PET/CT scanner (Biograph-16, Siemens, Germany). Patients fasted for at least 6 h before the examination and then would be injected with 18F-fluorodeoxyglucose. After 40 min, images were obtained from the plane of skull to the groin level. The SUVmax of the primary tumor and suspicious lymph node were determined by drawing a region of interest around it.
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10

FDG-PET/CT Imaging in Advanced NSCLC CRT

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In both groups (Standard and Consolidation CRT), all patients underwent baseline PET/CT prior to CRT. Following CRT completion, PET/CT was performed at 6 weeks and at 12 weeks after radiotherapy completion. All PET/CT scans were obtained after IV injection of 370 MBq of 2-fluorine-18-fluoro-2-deoxy-D-glucose (FDG) under a 6–12 h fasting period. Fasting serum glucose levels were measured 10–15 min before FDG injection according to standardized protocol. Data were acquired using a dedicated LSO-PET/CT scanner (Biograph 16, SIEMENS, IL) as previously described [14 (link)].
Whole body imaging was carried out in all patients covering from the base of skull to the proximal portion of thighs. Imaging was qualitatively interpreted by a single experienced observer (nuclear radiologist expert) who was unaware of the patients’ clinical-assessment status at baseline or following CRT.
SUVmax were recorded for primary tumors in all studies (baseline, 6-week and 12-week).
PET/CT information was compared between patients undergoing standard and extended CRT (with consolidation chemotherapy). (Fig. 1).

CRT regimens and PET/CT timing during treatment. a Standard CRT regimen – 54Gy of radiation associated to 2 cycles of 5FU based chemotherapy; b Consolidation CRT regimen – 54Gy of radiation associated to 6 cycles of 5FU based chemotherapy

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