Dose Reduction in Pediatric Molecular Imaging

降低儿科分子成像中的剂量 项目摘要 医学成像引起的辐射暴露已成为一个公共安全问题。核医学 成像提供了有关生理过程的潜在救命信息。这样的成像特别是 有价值的儿童和婴儿，其中快速和明确的诊断发育或病理 对这些患者的健康来说，担忧是必不可少的。我们的总体目标是减少儿科患者的吸收率 在保持甚至提高核医学图像诊断质量的同时，还可以提供更高的剂量。减少以下剂量 儿科患者尤其重要，因为这类患者由于 他们的组织对辐射的敏感性以及随机辐射效应可能出现的较长时间段。我们 将通过以下方式实现这一总体目标：1.优化图像采集、重建和处理方法以 以尽可能低的管理活动获得最佳的图像质量；2.基于图像的收集 儿科患者常用药物的药代动力学数据；3.我们将开发在线工具来比较 不同体重和身高患者在不同剂量给药活动下的剂量和图像质量 和使用当前共识指南获得的图像质量指标；4.调查 目标1和目标3中取得的结果与仪器的变化有关。总而言之，这些目标将产生重大影响 用于分子成像程序的儿科患者的剂量。目标1和目标2将提供评估所需的数据 协商一致的指南是否导致所有儿科患者的剂量减少。我们已经在上一篇文章中演示了 最佳剂量减少(即，保持诊断图像质量的减少)需要 同时考虑患者的身高和体重。AIM 3将提供工具，使专业组织能够 严格评估并可能改进或提供共识剂量指南的替代方案。任何指南或剂量- 努力保持诊断图像质量的减少工作将容易受到成像仪器的影响 可变性。在目标4中，我们审查了这种变化对已经建立的共识指导方针和 还介绍了我们建议通过目标1-3开发的优化方案。通过使用最先进的计算 模拟、图像质量评估和辐射剂量测量工具(其中许多工具是由 研究人员)，这项拨款申请中提出的工作将在更多的情况下应用剂量减少方法 严谨且经过科学验证的态度。我们预期建议的研究完成后， 分子影像社区引进并结合临床实际，实施儿科 在当前指导方针的基础上有实质性改进并指向未来的减少剂量的方法 技术进步可以带来更大的剂量减少，同时改善诊断 图像质量。

Dose Reduction in Pediatric Molecular Imaging Project Summary The radiation exposure resulting from medical imaging has become a public safety concern. Nuclear medicine imaging provides potentially life-saving information regarding physiological processes. Such imaging is particularly valuable in children and infants wherein the rapid and unequivocal diagnosis of developmental or pathological concerns is essential for the health of these patients. Our overall objective is to reduce pediatric patient absorbed dose while maintaining and even improving the diagnostic quality of nuclear medicine images. Dose reduction for pediatric patients is particularly important since such patients are at increased risk owing to the enhanced radiosensitivity of their tissues and the longer time-period over which stochastic radiation effects may manifest. We will accomplish this overall objective by: 1. Optimizing image acquisition, reconstruction, and processing methods to achieve the best image quality at the lowest possible administered activity; 2. Collecting imaging-based pharmacokinetic data for agents commonly used in pediatric patients; 3. We will develop online tools that compare dose and image quality for patients of different weights and heights at different administered activities with dose and image quality metrics obtained using the current consensus guidelines and; 4., investigate the sensitivity of the results obtained in aims 1 and 3 to changes in instrumentation. Collectively, these aims will substantially impact dosing of pediatric patients for molecular imaging procedures. Aims 1 and 2 will provide the data needed to evaluate whether consensus guidelines lead to dose reduction for all pediatric patients. We already demonstrated in the prior grant period that optimal dose reduction (i.e., reduction that preserves diagnostic image quality) requires an accounting of both patient height and weight. Aim 3 will provide the tools to enable professional organizations to rigorously evaluate and likely refine or provide alternatives to consensus dose guidelines. Any guideline or dose- reduction effort that endeavors to maintain diagnostic image quality will be susceptible to imaging instrumentation variability. In Aim 4, we examine the impact of this variability on both already established consensus guidelines and also on the optimization scheme that we propose to develop via aims 1-3. By using state-of-the-art computational simulation, image quality evaluation, and radiation dosimetry tools (many of which were developed by the investigators), the work proposed in this grant application will apply dose reduction methods in a much more rigorous and scientifically validated manner. We expect that completion of the proposed studies will allow the molecular imaging community to introduce and, consistent with the realities of clinical practice, implement pediatric dose-reduction approaches that substantially improve upon current guidelines and that also point to future technological advances that could yield even greater dose-reduction while simultaneously improving diagnostic image quality.