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PET Lung Ventilation/Perfusion Imaging Using 68Ga Aerosol (Galligas) and 68Ga-Labeled Macroaggregated Albumin

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Book cover Theranostics, Gallium-68, and Other Radionuclides

Part of the book series: Recent Results in Cancer Research ((RECENTCANCER,volume 194))

Abstract

Pulmonary imaging using ventilation/perfusion (V/P) single-photon emission tomography (V/P scan) with Tc-99m-labeled radiotracers is a well-established diagnostic tool for clinically suspected pulmonary embolism (PE). Ga-68 aerosol (Galligas) and Ga-68-labeled macroaggregated albumin (MAA) are potential tracers for positron emission tomography (PET) lung V/P imaging and could display an advantage over conventional V/P scans in terms of sensitivity and specificity. After radiochemical and animal studies, the clinical applicability of Ga-68 aerosol (Galligas) and Ga-68-labeled MAA was investigated in an exploratory study in patients with clinical suspicion of PE. PET scans were acquired using a 16-slice Gemini TF positron emission tomography/computed tomography (PET/CT) scanner. The acquisition protocol included low-dose computed tomography (CT) for attenuation correction (AC). Dosimetry calculations and continuative phantom measurements were performed. Structural analyses showed no modification of the particles due to the labeling process. In addition, in vitro experiments showed stability of Ga-68 MAA in various media. As expected, Ga-68-labeled human serum albumin microspheres (HSAM) were completely retained in the lung of the animals. In clinical use, PET lung ventilation and perfusion imaging using Ga-68 aerosol (Galligas) and Ga-68-labeled MAA was successful in all cases. In one case a clinically suspected PE could be detected and verified. The administered activity of Ga-68 aerosol (Galligas) and Ga-68-labeled MAA may be reduced by more than 50%, resulting in comparable radiation exposure to conventional V/P scans. In conclusion, Ga-68 aerosol (Galligas) and Ga-68-labeled MAA are efficient substitutes for clinical use and could be an interesting alternative with high accuracy for lung V/P imaging with Tc-99m-labeled radiotracers, especially in times of Mo-99 shortages and increasing use and spread of PET/CT scanners and Ga-68 generators, respectively.

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Notes

  1. 1.

    Operating Instructions GMP Produced 68Ga Generator iThemba LABS (Somerset West, South Africa), distributed by IDB Holland (Baarle-Nassau, The Netherlands).

Abbreviations

AC:

Attenuation correction

CT:

Computed tomography

CTA:

Computed tomography angiography

cGMP:

Current good manufacturing practice

DLP:

Dose–length product

DOTA:

1,4,7,10-Tetraazacyclododecane-1,4,7,10-tetraacetic acid (chelate)

DVT:

Deep vein thrombosis

EANM:

European Association of Nuclear Medicine

HSA:

Human serum albumin

HSAM:

Human serum albumin microspheres

HU:

Hounsfield unit

ICRP:

International Commission on Radiological Protection

ITLC:

Instant thin-layer chromatography

MAA:

Macroaggregated albumin

NEC:

Noise-equivalent count

OSEM:

Ordered-subsets expectation maximization (reconstruction)

PE:

Pulmonary embolism

PET:

Positron emission tomography

PET/CT:

Positron emission tomography/computed tomography

RNP:

Radionuclide purity

ROI:

Region of interest

rpm:

Revolutions per minute

SEM:

Scanning electron microscopy

SPECT:

Single-photon emission computed tomography

SUV:

Standardized uptake value

VOI:

Volumes of interest

V/P:

Ventilation/perfusion

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Authors and Affiliations

  1. Department of Nuclear Medicine, University Medical Centre, Johannes Gutenberg-University, Langenbeckstraße 1, 55131, Mainz, Germany

    S. J. Ament, S. Maus, H. Reber, H. G. Buchholz, N. Bausbacher, F. Graf, M. Miederer & M. Schreckenberger

  2. Institute of Pathology, University Medical Centre, Johannes Gutenberg-University, Mainz, Germany

    C. Brochhausen

Authors
  1. S. J. Ament
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  2. S. Maus
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  3. H. Reber
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  4. H. G. Buchholz
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  5. N. Bausbacher
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  6. C. Brochhausen
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  7. F. Graf
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  8. M. Miederer
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  9. M. Schreckenberger
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Corresponding author

Correspondence to S. J. Ament .

Editor information

Editors and Affiliations

  1. , THERANOSTICS Center for Molecular,, ENETS Center of Excellence, Zentralklinik Bad Berka, Bad Berka, 99437, Germany

    Richard P. Baum

  2. Inst. Kernchemie, Universität Mainz, Fritz-Straßmann-Weg 2, Mainz, 55128, Germany

    Frank Rösch

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Ament, S. et al. (2013). PET Lung Ventilation/Perfusion Imaging Using 68Ga Aerosol (Galligas) and 68Ga-Labeled Macroaggregated Albumin. In: Baum, R., Rösch, F. (eds) Theranostics, Gallium-68, and Other Radionuclides. Recent Results in Cancer Research, vol 194. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-27994-2_22

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  • DOI: https://doi.org/10.1007/978-3-642-27994-2_22

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-27993-5

  • Online ISBN: 978-3-642-27994-2

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