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Total-Body Dynamic PET/CT Imaging of Proton-Induced Activity and Biologic Washout After Proton Therapy.

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Τίτλος: Total-Body Dynamic PET/CT Imaging of Proton-Induced Activity and Biologic Washout After Proton Therapy.
Συγγραφείς: Tang H; Department of Nuclear Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China., Song S; Department of Nuclear Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China., Liu F; Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China., Xu J; Department of Nuclear Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China., Wu Y; Department of Nuclear Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China., Zheng R; Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China., Cheng Z; Department of Nuclear Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China., Wang S; United Imaging Healthcare, Shanghai, China., Zhu Y; Department of Nuclear Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China., Xiao Z; Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China., Zhu F; United Imaging Healthcare, Shanghai, China., Zheng H; Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China., Tao Z; Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China., Yuan X; Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; evazhu@vip.sina.com yuanxianglin@hust.edu.cn.; State Key Laboratory for Diagnosis and Treatment of Severe Zoonotic Infectious Disease, Wuhan, China; and.; National Medical Center for Major Public Health Events, Wuhan, China., Zhu X; Department of Nuclear Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; evazhu@vip.sina.com yuanxianglin@hust.edu.cn.; State Key Laboratory for Diagnosis and Treatment of Severe Zoonotic Infectious Disease, Wuhan, China; and.; National Medical Center for Major Public Health Events, Wuhan, China.
Πηγή: Journal of nuclear medicine : official publication, Society of Nuclear Medicine [J Nucl Med] 2026 Sep 02; Vol. 67 (9), pp. 1484-1490. Date of Electronic Publication: 2026 Sep 02.
Τύπος έκδοσης: Journal Article
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: Society of Nuclear Medicine Country of Publication: United States NLM ID: 0217410 Publication Model: Electronic Cited Medium: Internet ISSN: 1535-5667 (Electronic) Linking ISSN: 01615505 NLM ISO Abbreviation: J Nucl Med Subsets: MEDLINE
Imprint Name(s): Publication: Reston, VA : Society of Nuclear Medicine
Original Publication: [Chicago, Ill.] : S.N. Turiel & Assoc.
Ιατρικοί όροι (MeSH): Positron Emission Tomography Computed Tomography*/methods , Whole Body Imaging*/methods , Neoplasms*/diagnostic imaging , Neoplasms*/radiotherapy , Proton Therapy*, Humans ; Phantoms, Imaging ; Female ; Monte Carlo Method ; Male ; Protons ; Middle Aged ; Image Processing, Computer-Assisted ; Aged
Περίληψη: Off-line PET imaging after proton therapy is limited by transport delay and by the sensitivity and short axial field of view of conventional scanners, which hinder imaging at ultralow activity and characterization of whole-body biologic washout. We evaluated whether a near-room total-body PET/CT system could enable clinically practical imaging of proton-induced activity after treatment and its whole-body biologic washout. Methods: We conducted a series of phantom studies to evaluate the performance of total-body PET at ultralow activity with Monte Carlo (MC)-simulated activity distributions as references. Nineteen patients with solid tumors underwent off-line total-body dynamic PET/CT imaging shortly after proton therapy. Spatial correlation between PET and MC results was quantified using the Dice similarity coefficient (DSC) and normalized cross-correlation (NCC). Dynamic images were reconstructed, and time-activity curves were extracted from volumes of interest to analyze the dynamic behavior of proton-induced activity. Results: In phantom experiments, PET images showed close spatial correspondence to MC reference distributions under ultralow activity. In patients, the agreement between PET and MC was higher for relatively stationary targets, with a mean DSC/NCC of 0.81 ± 0.09/0.81 ± 0.09 for the brain and 0.81 ± 0.05/0.83 ± 0.08 for the breast. Dynamic total-body PET images revealed biologic washout and whole-body redistribution of isotope activity within and beyond the gross tumor volumes, showing enrichment within the cardiac blood pool, major blood vessels, and blood-rich organs, such as the spleen and liver. Conclusion: Near-room total-body PET/CT enabled interpretable imaging under ultralow activity after treatment. Dynamic total-body imaging additionally captured whole-body biologic washout of proton-induced activity through blood circulation, providing a foundation for future washout modeling and methodologic development for in vivo treatment assessment.
(© 2026 by the Society of Nuclear Medicine and Molecular Imaging.)
Contributed Indexing: Keywords: biologic washout kinetics; dynamic imaging; proton range verification; proton therapy; total-body PET/CT
Substance Nomenclature: 0 (Protons)
Entry Date(s): Date Created: 20260611 Date Completed: 20260902 Latest Revision: 20260902
Update Code: 20260903
DOI: 10.2967/jnumed.126.272338
PMID: 42276783
Βάση Δεδομένων: MEDLINE
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PubType: Academic Journal
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  Data: Total-Body Dynamic PET/CT Imaging of Proton-Induced Activity and Biologic Washout After Proton Therapy.
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  Data: <searchLink fieldCode="AU" term="%22Tang+H%22">Tang H</searchLink>; Department of Nuclear Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.<br /><searchLink fieldCode="AU" term="%22Song+S%22">Song S</searchLink>; Department of Nuclear Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.<br /><searchLink fieldCode="AU" term="%22Liu+F%22">Liu F</searchLink>; Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.<br /><searchLink fieldCode="AU" term="%22Xu+J%22">Xu J</searchLink>; Department of Nuclear Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.<br /><searchLink fieldCode="AU" term="%22Wu+Y%22">Wu Y</searchLink>; Department of Nuclear Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.<br /><searchLink fieldCode="AU" term="%22Zheng+R%22">Zheng R</searchLink>; Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.<br /><searchLink fieldCode="AU" term="%22Cheng+Z%22">Cheng Z</searchLink>; Department of Nuclear Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.<br /><searchLink fieldCode="AU" term="%22Wang+S%22">Wang S</searchLink>; United Imaging Healthcare, Shanghai, China.<br /><searchLink fieldCode="AU" term="%22Zhu+Y%22">Zhu Y</searchLink>; Department of Nuclear Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.<br /><searchLink fieldCode="AU" term="%22Xiao+Z%22">Xiao Z</searchLink>; Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.<br /><searchLink fieldCode="AU" term="%22Zhu+F%22">Zhu F</searchLink>; United Imaging Healthcare, Shanghai, China.<br /><searchLink fieldCode="AU" term="%22Zheng+H%22">Zheng H</searchLink>; Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.<br /><searchLink fieldCode="AU" term="%22Tao+Z%22">Tao Z</searchLink>; Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.<br /><searchLink fieldCode="AU" term="%22Yuan+X%22">Yuan X</searchLink>; Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; evazhu@vip.sina.com yuanxianglin@hust.edu.cn.; State Key Laboratory for Diagnosis and Treatment of Severe Zoonotic Infectious Disease, Wuhan, China; and.; National Medical Center for Major Public Health Events, Wuhan, China.<br /><searchLink fieldCode="AU" term="%22Zhu+X%22">Zhu X</searchLink>; Department of Nuclear Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; evazhu@vip.sina.com yuanxianglin@hust.edu.cn.; State Key Laboratory for Diagnosis and Treatment of Severe Zoonotic Infectious Disease, Wuhan, China; and.; National Medical Center for Major Public Health Events, Wuhan, China.
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  Data: <searchLink fieldCode="JN" term="%220217410%22">Journal of nuclear medicine : official publication, Society of Nuclear Medicine</searchLink> [J Nucl Med] 2026 Sep 02; Vol. 67 (9), pp. 1484-1490. <i>Date of Electronic Publication: </i>2026 Sep 02.
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  Data: <i>Publication</i>: Reston, VA : Society of Nuclear Medicine<br /><i>Original Publication</i>: [Chicago, Ill.] : S.N. Turiel & Assoc.
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  Data: Off-line PET imaging after proton therapy is limited by transport delay and by the sensitivity and short axial field of view of conventional scanners, which hinder imaging at ultralow activity and characterization of whole-body biologic washout. We evaluated whether a near-room total-body PET/CT system could enable clinically practical imaging of proton-induced activity after treatment and its whole-body biologic washout. Methods: We conducted a series of phantom studies to evaluate the performance of total-body PET at ultralow activity with Monte Carlo (MC)-simulated activity distributions as references. Nineteen patients with solid tumors underwent off-line total-body dynamic PET/CT imaging shortly after proton therapy. Spatial correlation between PET and MC results was quantified using the Dice similarity coefficient (DSC) and normalized cross-correlation (NCC). Dynamic images were reconstructed, and time-activity curves were extracted from volumes of interest to analyze the dynamic behavior of proton-induced activity. Results: In phantom experiments, PET images showed close spatial correspondence to MC reference distributions under ultralow activity. In patients, the agreement between PET and MC was higher for relatively stationary targets, with a mean DSC/NCC of 0.81 ± 0.09/0.81 ± 0.09 for the brain and 0.81 ± 0.05/0.83 ± 0.08 for the breast. Dynamic total-body PET images revealed biologic washout and whole-body redistribution of isotope activity within and beyond the gross tumor volumes, showing enrichment within the cardiac blood pool, major blood vessels, and blood-rich organs, such as the spleen and liver. Conclusion: Near-room total-body PET/CT enabled interpretable imaging under ultralow activity after treatment. Dynamic total-body imaging additionally captured whole-body biologic washout of proton-induced activity through blood circulation, providing a foundation for future washout modeling and methodologic development for in vivo treatment assessment.<br /> (© 2026 by the Society of Nuclear Medicine and Molecular Imaging.)
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  Data: <i>Keywords: </i>biologic washout kinetics; dynamic imaging; proton range verification; proton therapy; total-body PET/CT
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