Submitted by Renorbio (renorbioba@ufba.br) on 2017-07-06T14:52:02Z No. of bitstreams: 1 DEFINIÇÃO DE PROTOCOLOS DE PET-CT (defesa) (FINAL-crip).pdf: 2587129 bytes, checksum: ee0e1f775d6ec22cc7dc9aead962cb89 (MD5) / Approved for entry into archive by Uillis de Assis Santos (uillis.assis@ufba.br) on 2017-07-06T15:21:56Z (GMT) No. of bitstreams: 1 DEFINIÇÃO DE PROTOCOLOS DE PET-CT (defesa) (FINAL-crip).pdf: 2587129 bytes, checksum: ee0e1f775d6ec22cc7dc9aead962cb89 (MD5) / Made available in DSpace on 2017-07-06T15:21:56Z (GMT). No. of bitstreams: 1 DEFINIÇÃO DE PROTOCOLOS DE PET-CT (defesa) (FINAL-crip).pdf: 2587129 bytes, checksum: ee0e1f775d6ec22cc7dc9aead962cb89 (MD5) / A crescente disponibilidade de equipamentos de alta performance, software de reconstrução e métodos quantitativos tem proporcionado novas oportunidades para a melhoria das imagens e gestão dos pacientes. A busca por estratégias eficazes de redução da dose, sem comprometer o diagnóstico, tem se tornado uma parte essencial para otimização de protocolos. Este estudo descreve um método para se obter alta qualidade das imagens clínicas com aquisições de PET/CT com FDG-F18 relacionando a geometria do paciente, regime de dose, protocolos de aquisição de imagens e técnicas de processamento. Dados de aquisição de 58 indivíduos adultos de ambos os sexos foram avaliados retrospectivamente. Imagens do fígado foram adquiridas em modo-lista durante 360 s em um equipamento de PET/CT de alto desempenho. As imagens foram reconstruídas com intervalo de 30s. Foram avaliadas as relações entre os diferentes parâmetros indivíduo-dependentes, qualidade dos dados e da imagem. A taxa de ruído equivalente e o coeficiente de variação foram utilizados como métricas. Com base nas relações mais fortes entre estes parâmetros, foram identificados protocolos de aquisição otimizados e regimes de administração de atividade para diferentes métodos de reconstrução. Foi encontrada a relação mais forte da qualidade dos dados entre NECR e a massa corpórea, sendo o aumento da massa corpórea capaz de causar uma redução exponencial do NECR (R² = 0,72). Encontramos também uma relação entre qualidade de imagem e massa corpórea (R² = 0,82 para reconstruções OSEM3D e R² = 0,86 nas reconstruções PSF, p <0,001). Se um regime linear dose é utilizado, aumentando FDG- F18 proporcionalmente a massa, a qualidade da imagem degrada com o aumento da massa corpórea do paciente quando um mesmo tempo de aquisição é usado. A adoção de protocolos diferentes para três faixas de massa corporal (<60 kg, 60-90 kg, > 90 kg) na rotina clínica permite melhor qualidade de imagem com tanto PSF e métodos de reconstrução OSEM3D. Em conclusão, foi demonstrada neste estudo uma metodologia para determinar o tempo de aquisição das imagens, a partir da atividade de FDG-F18 administrada, a fim de obter imagens de alto padrão de qualidade. Este método oferece uma oportunidade para se realizar procedimentos de PET/CT mais custo-eficazes e com redução da dose de radiação. / The increasing availability of high performance equipment, reconstruction software and quantitative methods have provided new opportunities to improve image capturing and management of patients. Currently, new and effective strategies that reduce dose exposure, yet do not compromise diagnostics are underway and have become essential to protocol optimization. This study describes a method to achieve consistent clinical image quality in 18F-FDG scans accounting for patient habitus, dose regimen, image acquisition and processing techniques. Data was acquired from 58 adults, male and female, which were evaluated retrospectively. Images of the liver were acquired in list-mode during 360 s on a high-performance PET/CT scanner. The scans were reconstructed at incremental 30 s intervals and correlations between different patient-dependent parameters (PDP) and image and data quality were evaluated. Patient Noise Equivalent Count Rate (NECR) and coefficient of variation (CV) were used as metrics in our analysis. Based on the strongest PDP correlations, optimized acquisition protocols and dose regimens were identified for different reconstruction methods. Results: The strongest correlation of patient data quality was found between NECR per unit activity (NECRN) and body mass (BM): increasing BM causes NECRN to decrease exponentially (R² = 0.72). Patient body mass was also found to be the strongest PDP determinant of image quality (R² = 0.82 in OSEM3D and R² = 0.86 in PSF, p < 0.001). If a linear dose regimen is used, increasing 18F-FDG proportionally to BM, image quality degrades with increasing patient body mass when standard acquisition time is used. The adoption of different schemes for three body mass ranges (< 60 kg, 60–90 kg, > 90 kg) in clinical routine allows improved image quality with both PSF and OSEM3D reconstruction methods. In conclusion, this study has demonstrated a methodology for determining the time of image acquisition from FDG- F18 activity administered in order to obtain high quality standard images. The proposed methodology may be used by PET/CT centers to develop protocols to standardize PET/CT imaging procedures, and achieve better patient management and cost-effective operations and at a reduced radiation dose.

abstract: Alzheimer’s Disease (AD), a neurodegenerative disease is a progressive disease that affects the brain gradually with time and worsens. Reliable and early diagnosis of AD and its prodromal stages (i.e. Mild Cognitive Impairment(MCI)) is essential. Fluorodeoxyglucose (FDG) positron emission tomography (PET) measures the decline in the regional cerebral metabolic rate for glucose, offering a reliable metabolic biomarker even on presymptomatic AD patients. PET scans provide functional information that is unique and unavailable using other types of imaging. The computational efficacy of FDG-PET data alone, for the classification of various Alzheimer’s Diagnostic categories (AD, MCI (LMCI, EMCI), Control) has not been studied. This serves as motivation to correctly classify the various diagnostic categories using FDG-PET data. Deep learning has recently been applied to the analysis of structural and functional brain imaging data. This thesis is an introduction to a deep learning based classification technique using neural networks with dimensionality reduction techniques to classify the different stages of AD based on FDG-PET image analysis. This thesis develops a classification method to investigate the performance of FDG-PET as an effective biomarker for Alzheimer's clinical group classification. This involves dimensionality reduction using Probabilistic Principal Component Analysis on max-pooled data and mean-pooled data, followed by a Multilayer Feed Forward Neural Network which performs binary classification. Max pooled features result into better classification performance compared to results on mean pooled features. Additionally, experiments are done to investigate if the addition of important demographic features such as Functional Activities Questionnaire(FAQ), gene information helps improve performance. Classification results indicate that our designed classifiers achieve competitive results, and better with the additional of demographic features. / Dissertation/Thesis / Masters Thesis Computer Science 2017

L’imagerie en oncologie a fait des progrès considérables ces dernières années avec l’introduction du CT scan spiralé, de la résonance magnétique, de la mammographie digitalisée et du PET scan. Des combinaisons de différentes techniques ont vu le jour, telles que le PET/CT, et améliorent encore les possibilités de stadification de la maladie cancéreuse ainsi que le monitoring de son évolution dans le temps, et notamment sous traitement.Parallèlement, de grands progrès thérapeutiques ont étés réalisés en oncologie, en particulier le développement de médicaments « ciblés » dont l’efficacité dépend de l’expression par la cellule tumorale d’une molécule cible jouant un rôle important dans sa survie et/ou sa prolifération. L’expression de la molécule cible est une condition nécessaire mais pas suffisante pour observer une réponse au traitement ciblé :l’échec de ce dernier peut aussi s’expliquer par des altérations moléculaires en amont ou en aval de la « cible ».Le cancer du sein dit « HER2 positif » représente 20 à 25% des cancers du sein. Celui-ci est caractérisé par l’expression membranaire, en quantités importantes, d’une protéine, appelée HER2, qui lui confère une biologie agressive et un mauvais pronostic. L’expression de HER2 au niveau de la tumeur, déterminée en routine clinique par immunohistochimie et/ou par hybridation in situ en fluorescence, est le seul biomarqueur validé aujourd’hui dans le cancer du sein HER2 positif pour prédire l’efficacité des traitements ciblés anti-HER2. Cette prédiction est toutefois peu satisfaisante en termes de valeur prédictive positive (50% environ). Après une revue de la litérature sur les études d’imagerie fonctionnelle, peu nombreuses, réalisées dans le cancer du sein HER2 positif, nous avons décidé d’explorer le rôle de l’imagerie moléculaire avec la technologie PET/CT dans l’individualisation de la prise en charge du cancer du sein HER2 positif avec deux radio traceurs (FDG et zirconium89-trastuzumab), et ce, dans deux contextes cliniques distincts :dans la maladie précoce soumise à un traitement neoadjuvant et dans le contexte métastatique, en cas de traitement par le T-DM1. / Doctorat en Sciences médicales (Médecine) / info:eu-repo/semantics/nonPublished

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京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第22739号 / 医博第4657号 / 新制||医||1046(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 武藤 学, 教授 佐藤 俊哉, 教授 椛島 健治 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DGAM

[18F]Fluorodeoxyglucose ([18F]FDG) Positron Emission Tomography/Computed Tomography (PET/CT) imaging is a powerful tool in the diagnosis of cancer and subsequent treatment planning. New state-of-the-art PET/CT scanners have the capacity to generate images of superb quality. The new scanners feature detectors with increased sensitivity and a new generation of reconstruction algorithms that produce higher quality images than the scanners they are replacing. In addition to the scanner, the scan duration, amount of administered [18F]FDG activity, and the anatomy of the patients themselves are also determining factors of image quality. There is evidence suggesting that [18F]FDG PET image quality is significantly reduced for larger patients, jeopardizing lesion detection. Two possible solutions to this problem are to (i) increase injected activity or (ii) increase scan duration. Increasing scan duration is preferable but not always possible in a busy clinic. Increasing injected activity is necessary but a proper scaling regimen with patient size must be determined in order to achieve consistent image quality. The aim of the work presented in this thesis was to achieve higher quantification accuracy and consistent image quality for all patients scanned with [18F]FDG PET. Because quantitative PET/CT images require corrections for image degrading effects, for which attenuation correction is the main contributor and is performed based on CT images, the first step in this project was to develop software tools to automate the analysis of phantom images for CT quality assurance. The next step was to optimize the reconstruction parameters for whole body [18F]FDG PET based on a phantom experiment. Finally, a retrospective study was conducted using patient [18F]FDG PET images to characterize the relationship between patient anatomical characteristics and image quality. This work concludes by suggesting optimized reconstruction parameters and a scaling regimen for injected [18F]FDG activity. With the implementation of these recommendations it can be possible to obtain images with increased quantitative value while delivering less dose to patients and maintaining a uniform level of image quality between different patients. / Graduate

Fluorodeoxyglucose Positron Emission Tomography (FDG PET) and Magnetic Resonance Imaging (MRI) are commonly used in a clinical setting as an examination in Alzheimer’s Disease (AD) patients. FDG PET is an imaging tool to evaluate hypometabolism; meanwhile, the MRI observes the brain volume. However, it is still unclear which examination better reflects the tau tangles, which have been known as the hallmark’s pathology of AD. Therefore, this study was conducted to compare FDG PET and MRI in assessing tau pathology in AD, by utilizing a database from the Alzheimer’s Disease Neuroimaging Initiative (ADNI). The presence of tau tangles was confirmed by using the Tau-PET images. In total, 275 cognitively impaired subjects were included as well as a subgroup of 147 subjects with positive amyloid status. Based on the analysis, it was observed that higher Tau-PET is significantly associated with FDG PET hypometabolism and MRI atrophy. A similar result was also seen in the amyloid positive subgroups. By comparing the spearman’s correlation coefficients, it was found that that the correlation was stronger between Tau PET and FDG PET (r=-0.414, p&lt;0.001, and r=-0.475, p&lt;0.001 in the positive amyloid subgroup) compared to Tau-PET and MRI (r=-0.331, p&lt;0.001 and r=-0.440, p&lt;0.001 in the positive amyloid subgroup). Inconclusion, FDG PET better reflects the tau pathology compared to MRI in AD.

Background: Breast cancer is the second most common cancer in adults and the most frequent cancer diagnosed in women. In South Africa, breast cancer accounts for 38.5% of cancers diagnosed in women. Since the presence, extent and location of distant metastases is one important prognostic factor in locally advanced breast cancer (LABC), accurate staging at diagnosis is crucial to ensure patients receive the appropriate treatment. Increasing evidence shows that the use of 18F-FDG PET/CT for disease staging of LABC may improve diagnostic sensitivity. Aim: To prospectively assess the difference in diagnostic accuracy between whole-body PET/PET-CT and conventional imagine (CI) for staging LABC. Methods: A total of 42 participants with clinical stage III and a select few stage II breast cancer underwent both 18F-FDG PET/CT and CI. Results: 18F-FDG PET/CT found significantly more (p=0.0077) distant metastatic sites than CI (36% vs. 21%). 18F-FDG PET/CT upstaged 9 (21.4%) of patients from clinical stage IIIa to stage IIIc, and changed management of 54% of patients. Thirty-eight percent (38%) of the patients had their clinical stage unchanged. One of 5 suspected metastatic sites 18F FDG PET/CT was positive for malignancy on biopsy. Conclusion: The 18F-FDG PET/CT is useful for staging locally advanced non-inflammatory infiltrating ductal carcinoma of the breast. Use of 18F-FDG PET/CT was superior to conventional imaging in assessing metastatic mediastinal lymphadenopathy, but with a poor specificity. The use of 18F-FDG PET/CT in LABC is useful, with the biopsy of isolated suspicious lesions for metastasis increasing its accuracy.

京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第18451号 / 医博第3906号 / 新制||医||1004(附属図書館) / 31329 / 京都大学大学院医学研究科医学専攻 / (主査)教授 福山 秀直, 教授 村井 俊哉, 教授 平岡 眞寛 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DGAM

京都大学 / 0048 / 新制・論文博士 / 博士(医学) / 乙第13120号 / 論医博第2133号 / 新制||医||1023(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 高橋 淳, 教授 村井 俊哉, 教授 林 康紀 / 学位規則第4条第2項該当 / Doctor of Medical Science / Kyoto University / DFAM