Investigating the limit of detectability of a positron emission mammography device: a phantom study.
Investigating the limit of detectability of a positron emission mammography device: a phantom study.
复制标题
研究正电子发射乳房X光检查装置的可检测性极限：一项模型研究。
DOI：
10.1118/1.3627149
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发表时间：
2011
期刊：
影响因子：
3.8
通讯作者：
O. Mawlawi
中科院分区：
文献类型：
--
作者：
N. Shkumat;A. Springer;C. Walker;E. Rohren;W. Yang;B. Adrada;E. Arribas;S. Carkaci;H. Chuang;L. Santiago;O. Mawlawi
目的
一种新的正电子发射乳房X射线摄影（PEM）装置（PEMFlex Solo II，Naviscan Inc.，San Diego，CA）最近被引入，并且其性能特征已经被记录。然而，尚未对其探测极限进行系统评估。这项工作的目的是调查使用一种新的，定制的乳房体模的这种新的PEM系统的可检测性的限制。
方法
构建了两组不同厚度（2、4、6和8 cm）的F-18灌注明胶乳房体模，使用和不使用不同直径（3-14.5 mm）[体积：0.15-3.3 cc]和放射性浓度与背景比（ACR）（2.7-58）的（空白）小无壳造影剂物体（2 mm厚圆盘）。对于具有对比对象的体模组，将圆盘置于体模内的中央，并在PEM设备上对两个体模组成像10 min。此外，在体模构建后的不同时间（0、90和150 min）重复扫描2和6 cm体模，以评价总放射性浓度（计数密度）对病变可检测性的影响。然后将来自每次体模扫描的每个对象分割并随机放置在相应的空白体模图像中。将得到的单个图像盲法呈现给7名医生观察员（2名核医学和5名乳腺成像放射科医生），并以二元方式进行评分（1-正确识别的对象，0-不正确）。计算病变可检测性的灵敏度、特异性和准确性，并生成不同体模厚度和计数密度的灵敏度与ACR和病变直径的关系图。
结果
所有变量的总体（平均）检测灵敏度为0.68（95% CI：[0.64，0.72]），相应的特异性为0.93 [0.87，0.98]，诊断准确性为0.72 [0.70，0.75]。最小可检测物体作为ACR的函数变化很大，灵敏度范围从最小病变尺寸（3 mm）的0.36 [0.29，0.44]到最大病变尺寸（14.5 mm）的0.80 [0.75，0.84]。
结论
该PEM系统的检测性能证明了其能够分辨具有低活性浓度比的小物体，这可能有助于识别早期乳腺癌。本研究的结果可用于将病变可检测性与肿瘤大小、ACR、计数率和乳腺厚度相关联。
PURPOSE
A new positron emission mammography (PEM) device (PEM Flex Solo II, Naviscan Inc., San Diego, CA) has recently been introduced and its performance characteristics have been documented. However, no systematic assessment of its limit of detectability has been evaluated. The aim of this work is to investigate the limit of detectability of this new PEM system using a novel, customized breast phantom.
METHODS
Two sets of F-18 infused gelatin breast phantoms of varying thicknesses (2, 4, 6, and 8 cm) were constructed with and without (blank) small, shell-less contrast objects (2 mm thick disks) of varying diameters (3-14.5 mm) [volumes: 0.15-3.3 cc] and activity concentration to background ratio (ACR) (2.7-58). For the phantom set with contrast objects, the disks were placed centrally inside the phantoms and both phantom sets were imaged for a period of 10 min on the PEM device. In addition, scans for the 2 and 6 cm phantoms were repeated at different times (0, 90, and 150 min) post phantom construction to evaluate the impact of total activity concentration (count density) on lesion detectability. Each object from each phantom scan was then segmented and placed randomly in a corresponding blank phantom image. The resulting individual images were presented blindly to seven physician observers (two nuclear medicine and five breast imaging radiologists) and scored in a binary fashion (1-correctly identified object, 0-incorrect). The sensitivity, specificity, and accuracy of lesion detectability were calculated and plots of sensitivity versus ACR and lesion diameters for different phantom thicknesses and count density were generated.
RESULTS
The overall (mean) detection sensitivity across all variables was 0.68 (95% CI: [0.64, 0.72]) with a corresponding specificity of 0.93 [0.87, 0.98], and diagnostic accuracy of 0.72 [0.70, 0.75]. The smallest detectable object varied strongly as a function of ACR, as sensitivity ranged from 0.36 [0.29, 0.44] for the smallest lesion size (3 mm) to 0.80 [0.75, 0.84] for the largest (14.5 mm).
CONCLUSIONS
The detectability performance of this PEM system demonstrated its ability to resolve small objects with low activity concentration ratios which may assist in the identification of early stage breast cancer. The results of this investigation can be used to correlate lesion detectability with tumor size, ACR, count rate, and breast thickness.
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