I-124-PET/US Fusion Imaging in Comparison to Conventional Diagnostics and Tc-99m Pertechnetate SPECT/US Fusion Imaging for the Function Assessment of Thyroid Nodules

Seifert, Philipp; Winkens, Thomas; Kühnel, Christian; Gühne, Falk; Freesmeyer, Martin

doi:10.1016/j.ultrasmedbio.2019.05.008

Cited by 24 publications

(25 citation statements)

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“…An accurate functional assessment in terms of correct nodule allocation is necessary to identify proper lesions for FNAC. In that regard, the addition of hybrid approaches such as Tc-99m-pertechnetate-SPECT/US and I-124-PET/US fusion imaging has been shown to be superior to CD alone [ 24 , 25 , 26 , 27 , 28 ]. The superimposition of metabolic and morphological images in real-time enables more accurate evaluations of even small or unfavourably located TN and increases the observers’ confidence in the functional assessment of TN, especially on I-124-PET/US fusion imaging.…”

Section: Discussionmentioning

confidence: 99%

“…Authors do not recommend the implementation of PET/US into the clinical routine as a standard examination method or to replace scintigraphy. I-124-PET/US fusion imaging is limited by the regional availability of PET/CT scanners, I-124 and suitable US devices with hybrid imaging software as well as by the personnel requirements including the skills needed for accurate fusion imaging and the time expenditure for PET/CT and PET/US examinations [ 27 , 28 ]. Effective whole-body doses of approximately 6.8 mSv derive from I-124-PET/CT scans [ 44 , 45 ].…”

Section: Discussionmentioning

confidence: 99%

“…Especially in case of multinodular goiter with closely neighbouring or unfavourably located lesions, the correct alignment of findings on the transversal and sagittal US images with the coronal scintigraphy scan can be challenging [ 11 ]. In order to overcome this limitation and to achieve accurate functional characterizations of TN, hybrid imaging approaches such as sensor-navigated Tc-99m-pertechnetate single photon emission computed tomography (SPECT)/US and sensor-navigated sodium iodine-124 (I-124) positron emission tomography (PET)/US have been introduced [ 24 , 25 , 26 , 27 ]. Particularly, I-124-PET/US proved to be superior in comparison to the conventional diagnostics (CD), comprising B-mode US and Tc-99m-pertechnetate scintigraphy, in a multi-observer study with >100 nuclear medicine physicians [ 28 ].…”

Section: Introductionmentioning

confidence: 99%

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Fusion iENA Scholar Study: Sensor-Navigated I-124-PET/US Fusion Imaging versus Conventional Diagnostics for Retrospective Functional Assessment of Thyroid Nodules by Medical Students

Freesmeyer

Winkens

Weissenrieder

et al. 2020

Sensors

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In conventional thyroid diagnostics, the topographical correlation between thyroid nodules (TN) depicted on ultrasound (US) in axial or sagittal orientation and coronally displayed scintigraphy images can be challenging. Sensor-navigated I-124-PET/US fusion imaging has been introduced as a problem-solving tool for ambiguous cases. The purpose of this study was to investigate the results of multiple unexperienced medical students (MS) versus multiple nuclear medicine physicians (MD) regarding the overvalue of I-124-PET/US in comparison to conventional diagnostics (CD) for the functional assessment of TN. Methods: Out of clinical routine, cases with ambiguous findings on CD were selected for I-124-PET/US fusion imaging. Sixty-eight digital patient case files (PCF) of 34 patients (CDonly and CD+PET/US PCF) comprising 66 TN were provided to be retrospectively evaluated by 70 MD and 70 MS, respectively. A total of 2174 ratings (32.9 per TN) were carried out: 555 ratings (8.4 per TN) for CDonly and 532 ratings (8.1 per TN) for CD+PET/US by each MD and MS. Results: Functional assessment revealed 8.5%/11.7% (n.s.) (16.4%/25.8% (p = 0.0002)), 41.8%/28.5% (p < 0.0001) (23.9%/17.9% (p = 0.0193)), 36.0%/30.5% (n.s.) (57.3%/53.9% (n.s.)), and 13.7%/29.4% (p < 0.0001) (2.4%/2.4% (n.s.)) hyperfunctioning, indifferent, hypofunctioning, and not rateable TNs for CDonly (CD+PET/US) and MD/MS, respectively. The respective rating confidence was indicated as absolute certain, quite certain, equivocal, uncertain, and not rateable in 11.7/3.4% (p < 0.0001) (44.9%/38.9% (p = 0.0541), 51.9%/26.7% (p < 0.0001) (46.2%/41.5% (n.s.)), 21.6%/29.0% (p = 0.0051) (6.2%/14.8% (p < 0.0001)), 1.1%/11.5% (p < 0.0001) (0.2%/2.3% (p = 0.0032)), and 13.7%/29.4% (p < 0.0001) (2.4%/2.4% (n.s.)) by MD/MS, respectively. There was a significant difference in the diversity of the observers’ functional assessment of TN (MD 0.84 vs. MS 1.02, p = 0.0006) and the respective confidence in functional assessment (MD 0.93 vs. MS 1.16, p < 0.0001) between MD and MS on CDonly, whereas CD+PET/US revealed weaker differences for both groups (MD 0.48 vs. MS 0.47, p = 0.57; and MD 0.66 vs. MS 0.83, p = 0.0437). With the additional application of I-124-PET/US, the rating diversity of both MD and MS markedly tends towards more consistency (p < 0.0001 in each case). Conclusion: The additional application of sensor-navigated I-124-PET/US fusion imaging significantly influenced the functional assessment of TN positively, especially for unexperienced observers.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Fusion iENA Scholar Study: Sensor-Navigated I-124-PET/US Fusion Imaging versus Conventional Diagnostics for Retrospective Functional Assessment of Thyroid Nodules by Medical Students

Freesmeyer

Winkens

Weissenrieder

et al. 2020

Sensors

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“…It remains unclear if appropriate anatomical landmarks, which are necessary for the creation of a stitched EFOV dataset, can be determined in human subjects. In previous clinical studies investigating fusion imaging in human thyroid glands, the trachea, the hyoid bone, cervical vertebral bodies, and calcified nodules (if applicable), were described as suitable landmarks for the alignment of CT and US images [41]. These constant anatomical structures might be suitable landmarks for the presented stitching method as well.…”

Section: Discussionmentioning

confidence: 99%

Stitching of 3D ultrasound datasets for the determination of large thyroid volumes – phantom study part II: mechanically-swept probes

Seifert¹,

Winkens²,

Knichel³

et al. 2019

Med Ultrason

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Aims: To investigate the feasibility and accuracy of 3D-US extended field of view volumetric analyses acquired with mechanically-swept ultrasound probes with different measurement methods for large volume thyroid phantoms.Materials and methods: Fifteen thyroid phantoms with different shapes (regular, nodular, thickened isthmus) and volumes (50-400 mL) were created. Two different mechanically-swept US probes were used for the separate scanning of the left and right lobes: convex and linear probe. After specific modifications, the 3D-US datasets were stitched together to an extended field of view using predefined landmarks. Volumetric analyses were performed by conventional ellipsoid model and manual tracing methods. The correspondence of measured and reference volumes was calculated using Pearson’s correlation coefficients and limits of agreement according to Bland and Altman.Results: The C-probe proved feasible for the acquisition and processing of the three-dimensional ultrasound extended field of view images; very high levels of agreement (correlation coefficients for volume analyses: 0.9843-0.9992) were observed for all shapes and volumes investigated. The manual tracing method showed superior results in comparison to the ellipsoid model, but was more time consuming. The linear probe was only applicable for the 50 mL phantoms due to its limited field of view.Conclusions: The investigated mechanically-swept convex probe was suitable for the three-dimensional ultrasound extended field of view stitching of large volume thyroid phantoms. Accurate volume analyses could be carried out. The mechanically-swept linear probe is limited to a maximum of 50 m

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“…B. randständig oder dorsal im Schilddrüsenparenchym) häufig Unsicherheiten hinsichtlich der szintigrafischen Charakterisierung, was zu einer relevanten Interobserver-Variabilität führen kann. Hinsichtlich der genannten Limitationen zeigten sich hochsignifikant bessere Ergebnisse, wenn eine ergänzende [ 124 I]-PET/US-Fusionsbildgebung durchgeführt wurde [51,52]. So konnten z.…”

Section: Spectunclassified

Die „Standard“-Schilddrüsenszintigrafie – ist sie noch zeitgemäß?

Görges

Bockisch

Seifert

2020

Der Nuklearmediziner

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ZusammenfassungAus fachfremder Sicht wird der Stellenwert der „konventionellen“ Schilddrüsenszintigrafie zur Klärung diverser thyreologischer Fragestellungen international mittlerweile weit niedriger eingeschätzt, als dies dem hierzulande tätigen Nuklearmediziner bewusst ist. Dieser Aufsatz gibt einen Überblick über häufig geäußerte Kritikpunkte an der Schilddrüsenszintigrafie und möchte einiges hierzu klarstellen sowie in berechtigten Fällen fundierte Gegenargumente liefern. In diesem Rahmen wird ein Überblick über die weiterhin bestehenden Indikationen gegeben, es werden aber auch Aspekte angeschnitten, bei denen Verbesserungsbedarf besteht. Abschließend erfolgt eine Aussicht auf zukünftige Perspektiven und Weiterentwicklungen der funktionellen Charakterisierung von thyreoidalem Gewebe.

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I-124-PET/US Fusion Imaging in Comparison to Conventional Diagnostics and Tc-99m Pertechnetate SPECT/US Fusion Imaging for the Function Assessment of Thyroid Nodules

Cited by 24 publications

References 44 publications

Fusion iENA Scholar Study: Sensor-Navigated I-124-PET/US Fusion Imaging versus Conventional Diagnostics for Retrospective Functional Assessment of Thyroid Nodules by Medical Students

Fusion iENA Scholar Study: Sensor-Navigated I-124-PET/US Fusion Imaging versus Conventional Diagnostics for Retrospective Functional Assessment of Thyroid Nodules by Medical Students

Stitching of 3D ultrasound datasets for the determination of large thyroid volumes – phantom study part II: mechanically-swept probes

Die „Standard“-Schilddrüsenszintigrafie – ist sie noch zeitgemäß?

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