Imaging of musculoskeletal bacterial infections by [124I]FIAU-PET/CT.

BACKGROUND: Traditional imaging techniques for the localization and monitoring of bacterial infections, although reasonably sensitive, suffer from a lack of specificity. This is particularly true for musculoskeletal infections. Bacteria possess a thymidine kinase (TK) whose substrate specificity is distinct from that of the major human TK. The substrate specificity difference has been exploited to develop a new imaging technique that can detect the presence of viable bacteria. METHODOLOGY/PRINCIPAL FINDINGS: Eight subjects with suspected musculoskeletal infections and one healthy control were studied by a combination of [(124)I]FIAU-positron emission tomography and CT ([(124)I]FIAU-PET/CT). All patients with proven musculoskeletal infections demonstrated positive [(124)I]FIAU-PET/CT signals in the sites of concern at two hours after radiopharmaceutical administration. No adverse reactions with FIAU were observed. CONCLUSIONS/SIGNIFICANCE: [(124)I]FIAU-PET/CT is a promising new method for imaging bacterial infections.

PET/CT com 18-fluor-fluorodeoxiglucose no seguimento do melanoma maligno cutâneo

Introdução – O melanoma maligno cutâneo (MMC) é considerado uma das mais letais neoplasias e no seu seguimento recorre-se, para além dos exames clínicos e da análise de marcadores tumorais, a diversos métodos imagiológicos, como é o exame Tomografia por Emissão de Positrões/Tomografia Computorizada (PET/CT, do acrónimo inglês Positron Emission Tomography/Computed Tomography) com 18fluor-fluorodeoxiglucose (18F-FDG). O presente estudo tem como objetivo avaliar a utilidade da PET/CT relativamente à análise da extensão e à suspeita de recidiva do MMC, comparando os achados imagiológicos com os descritos em estudos CT. Metodologia – Estudo retrospetivo de 62 estudos PET/CT realizados em 50 pacientes diagnosticados com MMC. Excluiu-se um estudo cujo resultado era duvidoso (nódulo pulmonar). As informações relativas aos resultados dos estudos anatomopatológicos e dos exames imagiológicos foram obtidas através da história clínica e dos relatórios médicos dos estudos CT e PET/CT. Foi criada uma base de dados com os dados recolhidos através do software Excel e foi efetuada uma análise estatística descritiva. Resultados – Dos estudos PET/CT analisados, 31 foram considerados verdadeiros positivos (VP), 28 verdadeiros negativos (VN), um falso positivo (FP) e um falso negativo (FN). A sensibilidade, especificidade, o valor preditivo positivo (VPP), o valor preditivo negativo (VPN) e a exatidão da PET/CT para o estadiamento e avaliação de suspeita de recidiva no MMC são, respetivamente, 96,9%, 96,6%, 96,9%, 96,6% e 96,7%. Dos resultados da CT considerados na análise estatística, 14 corresponderam a VP, 12 a VN, três a FP e cinco a FN. A sensibilidade, especificidade, o VPP e o VPN e a exatidão da CT para o estadiamento e avaliação de suspeita de recidiva no MMC são, respetivamente, 73,7%, 80,0%, 82,4%, 70,6% e 76,5%. Comparativamente aos resultados CT, a PET/CT permitiu uma mudança na atitude terapêutica em 23% dos estudos. Conclusão – A PET/CT é um exame útil na avaliação do MMC, caracterizando-se por uma maior acuidade diagnóstica no estadiamento e na avaliação de suspeita de recidiva do MMC comparativamente à CT isoladamente.

A Time Efficient Optical Model for GATE Simulation of a LYSO Scintillation Matrix Used in PET Applications

A time efficient optical model is proposed for GATE simulation of a LYSO scintillation matrix coupled to a photomultiplier. The purpose is to avoid the excessively long computation time when activating the optical processes in GATE. The usefulness of the model is demonstrated by comparing the simulated and experimental energy spectra obtained with the dual planar head equipment for dosimetry with a positron emission tomograph ( DoPET). The procedure to apply the model is divided in two steps. Firstly, a simplified simulation of a single crystal element of DoPET is used to fit an analytic function that models the optical attenuation inside the crystal. In a second step, the model is employed to calculate the influence of this attenuation in the energy registered by the tomograph. The use of the proposed optical model is around three orders of magnitude faster than a GATE simulation with optical processes enabled. A good agreement was found between the experimental and simulated data using the optical model. The results indicate that optical interactions inside the crystal elements play an important role on the energy resolution and induce a considerable degradation of the spectra information acquired by DoPET. Finally, the same approach employed by the proposed optical model could be useful to simulate a scintillation matrix coupled to a photomultiplier using single or dual readout scheme.

Abnormal resting state corticolimbic blood flow in depressed unmedicated patients with major depression: A 15O-H2O PET study

We investigated the differences in the resting state corticolimbic blood flow between 20 unmedicated depressed patients and 21 healthy comparisons. Resting state cerebral blood flow (CBF) was measured with H215O PET. Anatomical MRI scans were performed on an Elscint 1.9 T Prestige system for PET-MRI coregistration. Significant changes in cerebral blood flow indicating neural activity were detected using an ROI-free image subtraction strategy. In addition, the resting blood flow in patients was correlated with the severity of depression as measured by HAM-D scores. Depressed patients showed decreases in blood flow in right anterior cingulate (Brodmann areas 24 and 32) and increased blood flow in left and right posterior cingulate (Brodmann areas 23, 29, 30), left parahippocampal gyrus (Brodmann area 36), and right caudate compared with healthy volunteers. The severity of depression was inversely correlated with the left middle and inferior frontal gyri (Brodmann areas 9 and 47) and right medial frontal gyrus (Brodmann area 10) and right anterior cingulate (Brodmann areas 24, 32) blood flow, and directly correlated with the right thalamus blood flow. These findings support previous reports of abnormalities in the resting state blood flow in the limbic-frontal structures in depressed patients compared to healthy volunteers. Hum Brain Mapp, 2012. (C) 2011 Wiley Periodicals, Inc.

Specific PET-ligands for selected 5-HT and GABA A-receptor subtypes = PET-Liganden mit Spezifität für definierte 5-HT und GABA A-Rezeptor-Subtypen

Für diese Arbeit wurden sechs neue Benzodiazepinderivate, TC07, TC08, TC09, TC10, TC11 und TC12, hergestellt. Diese wurden mittels Radioligandenbindungsassay sowohl auf ihre Bindungseigenschaften für Membranen des Cerebellum, des Hippo-campus und des Cortex der Ratte hin untersucht, als auch für Membranen von HEK293 Zellen, die transient rekombinante GABAA Rezeptoren exprimierten. Zusätz-lich wurden kompetitive in situ Rezeptorautoradiographien an Rattenhirnschnitten mit den Liganden [3H]Ro15-4513 und [3H]R015-1788 durchgeführt. Zusammen ergaben sich aus diesen Experimenten deutliche Hinweise auf eine Selektivität der Verbindun-gen TC07, TC11 und TC12 für a5-Untereinheiten enthaltende GABAA Rezeptoren mit a5-Affinitäten im niedrigen nanomolaren Bereich. In vivo Bindungsexperimente in Ratten, mit [3H]Ro15-1788 als Tracer und TC07 als Kompetitor, ergaben, dass TC07 mehr [3H]Ro15-1788 im Vorderhirn als im Cerebellum verdrängt. Bezog man die regionale Verteilung der a5-Untereinheit des GABAA Rezep-tors im Rattenhirn mit ein – sehr wenige a5-Untereinheiten im Cerebellum, etwa 20 % der GABAA Rezeptor-Untereinheiten im Hippocampus – untermauerten diese Ergeb-nisse die Vermutung, TC07 könne a5-selektiv sein. Diese Daten bestätigten darü-berhinaus, dass TC07 die Blut-Hirn-Schranke passieren kann. Für elektrophysiologische Messungen mit TC07 und TC12 wurden die oben erwähnten transient transfizierten HEK293 Zellen verwendet, welche die GABAA Rezeptor Unte-reinheitenkombination a5b3g2 exprimierten. Das Dosis-Antwort Verhalten ergab keinen signifikanten Effekt für TC12. Die Daten von TC07 dagegen lassen auf einen schwach negativ modulatorischen Effekt schließen, was, zumindest theoretisch, die Möglichkeit eröffnet, TC07 auch als sogenannten cognitive enhancer einzusetzen. Der errechnete Ki-Wert lag in derselben Größenordnung wie der Ki-Wert, der anhand der Bindungsas-saydaten errechnet wurde. Insgesamt rechtfertigen die bisherigen Ergebnisse die radiochemische Markierung mit 18F von drei der sechs getesteten Verbindungen in der Reihenfolge TC07, TC12 und TC11. Des Weiteren wurde [18F]MHMZ, ein potentiell 5-HT2A selektiver Ligand und PET-Tracer einschließlich Vorläufer und Referenzverbindungen, mit hohen Ausbeuten syn-thetisiert (Herth, Debus et al. 2008). Autoradiographieexperimente mit Rattenhirn-schnitten zeigten hervorragende in situ Bindungseigenschaften der neuen Verbindung. Die Daten wiesen eine hohe Selektivität für 5-HT2A Rezeptoren in Verbindung mit einer niedrigen unspezifischen Bindung auf. [18F]MHMZ erfährt in vivo eine schnelle Metabo-lisierung, wobei ein polarer aktiver Metabolit entsteht, welcher vermutlich nicht die Blut-Hirn-Schranke passieren kann. Transversale, sagittale und coronale Kleintier-PET-Bilder des Rattenhirns zeigten eine hohe Anreicherung im frontalen Cortex und im Striatum, während im Cerebellum so gut wie keine Anreicherung festzustellen war. Diese Verteilung deckt sich mit der bekann-ten Verteilung der 5-HT2A Rezeptoren. Die in vivo Anreicherung scheint sich ebenfalls gut mit der Verteilung der in den Autoradiographieexperimenten gemessenen Bindung zu decken. Nach Berechnungen mit dem 4-Parameter Referenzgewebe Modell beträgt das Bindungspotential (BP) für den frontalen Cortex 1,45. Das Cortex zu Cerebellum Verhältnis wurde auf 2,7 nach 30 Minuten Messzeit bestimmt, was bemerkenswert nah an den von Lundkvist et al. für [11C]MDL 100907 publizierten Daten liegt. Abgesehen von der etwas niedrigeren Affinität waren die gemessenen in vitro, in situ und in vivo Daten denen von [3H]MDL 100907 und [11C]MDL 100907 sehr ähnlich, so dass wir ein [18F]Analogon in der Hand haben, das die bessere Selektivität von MDL 100907 verglichen mit Altanserin mit der längeren Halbwertszeit und den besse-ren Eigenschaften für die klinische Routine von 18F verglichen mit 11C verbindet. Die Ergebnisse von [18F]MHMZ rechtfertigenden weitere Experimente, um diesen Liganden für die klinische Routine am Menschen nutzbar zu machen.

Synthese und Evaluierung von [18 F]-Fluormethyltosylat als prosthetische Gruppe für die 18 F-Fluormethylierung von ZNS-Liganden für die PET

Die 11C-Methylierung von Radioliganden ist eine weit verbreitete Markierungsstrategie für PET-Liganden. Aber die kurze Halbwertszeit des Kohlenstoff-11 von 20,3 Minuten limitiert seinen Nutzen. Daher ist die 18F-Fluoralkylierung eine Möglichkeit, Fluor-18, das eine Halbwertszeit von 109,8 Minuten hat, in Target-Moleküle einzuführen. Während die 18F-Fluorethylierung eine weitverbreitete Markierungsstrategie ist, wird die 18F-Fluormethylierung bisher nur selten angewendet. Eine Ursache dafür ist die geringe Stabilität der 18F-Fluormethylgruppe in vivo. Durch Substitution des Wasserstoffs in der 18F-Fluormethylgruppe durch Deuterium kann deren Stabilität jedoch deutlich erhöht werden. Dadurch kann die 18F-Fluormethylierung eine wichtige Synthesestrategie für ZNS-Liganden sein, bei denen große strukturelle Varianz zum Einführen des Fluor-18 nicht möglich ist. rnAls prosthetische Gruppen zur 18F-Fluormethylierung wurden [18F]Fluormethyltosylat und [18F]Fluor-[d2]methyltosylat mit radiochemischen Ausbeuten bis zu 50% synthetisiert. Die Reaktionsbedingungen der 18F-Fluormethylierung mit d2-[18F]FMT und die Abtrennung der Radioliganden wurden an einer Modellverbindungen und den drei Zielstrukturen [18F]Fluor-[d2]methylharmol, [18F]Fluor-[d2]methyl-MH.MZ und [18F]Fluor-[d2]methylflumazenil optimiert. Es konnten radiochemischen Ausbeuten zwischen 25 und 60% erzielt werden. rnMit allen drei ZNS-Liganden wurden Kleintier-PET-Studien durchgeführt. Das d2-[18F]FMH zeigte eine schnelle und 1,5fach höhere Anreicherung im Hirn innerhalb der ersten fünf Minuten als die Vergleichssubstanz [18F]FEH. Für d2-[18F]FM-MH.MZ wurde in vivo eine höhere spezifische Anreicherung des Radiotracers im frontalen Cortex beobachtet als bei der 18F-fluorethylierten Vergleichssubstanz. Für das [18F]Fluor-[d2]methylflumazenil konnte keine Aufnahme ins Hirn festgestellt werden, sondern es kam zur vollständigen Zersetzung des Radioliganden durch Defluorierung. d2-[18F]FMH und d2-[18F]FM-MH.MZ waren bei physiologischen Bedingungen zu mehr als 90% stabil.rn

Is there a need for dedicated bone imaging in addition to 18F-FDG PET/CT imaging in pediatric sarcoma patients?

Many children with sarcomas undergo whole body 2-deoxy-2-((18)F)fluoro-D-glucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) and technetium methylene diphosphonate ((99)Tc-MDP) studies. It is unknown whether the combination of both tests results in more accurate detection of bone lesions than (18)F-FDG- PET/CT alone.

(18)F-Immuno-PET: Determination of Anti-CD66 Biodistribution in a Patient with High-Risk Leukemia

The monoclonal antibody anti-CD66 labeled with (99m)Tc is widely used as Scintimun((R)) granulocyte for bone marrow immunoscintigraphy. Further, recently performed clinical radioimmunotherapy studies with [(90)Y]Y-anti-CD66 proved to be suitable for the treatment of hematologic malignancies. Before radioimmunotherapy with [(90)Y]Y-anti-CD66, dosimetric estimations are required to minimize radiotoxicity and determine individual applicable activities. Planar imaging, using gamma-emitting radionuclides, is conventionally carried out to estimate the absorbed organ doses. In contrast, immuno-PET (positron emission tomography) enables the quantification of anti-CD66 accumulation and provides better spatial and temporal resolution. Therefore, in this study, a semiautomated radiosynthesis of [(18)F] F-anti-CD66 was developed, using the (18)F-acylation agent, N-succinimidyl-4-[(18)F]fluorobenzoate ([(18)F]SFB). As a proof of concept, an intraindividual comparison between PET and conventional scintigraphy, using (18)F- and (99m)Tc-labeled anti-CD66 in 1 patient with high-risk leukemia, is presented. Both labeled antibodies displayed a similar distribution pattern with high preferential uptake in bone marrow. Urinary excretion of [(18)F] F-anti-CD66 was increased and bone marrow uptake reduced, in comparison to [(99m)Tc]Tc-anti-CD66. Nevertheless, PET-based dosimetry with [(18)F] F-anti-CD66 could provide additional information to support conventional scintigraphy. Moreover, [(18)F]F-anti-CD66 is ideally suited for bone marrow imaging using PET.

Long-term follow-up of metabolic activity in human alveolar echinococcosis using FDG-PET

AIM: [(18)F]fluoro-deoxyglucose positron-emission-tomography (FDG-PET) detects metabolic activity in alveolar echinococcosis (AE). The slow changes in metabolic and morphological characteristics require long-term follow-up of patients. This is the first study to evaluate metabolic activity over may years, hereby assessing the utility of FDG-PET for the evaluation of disease progression and response to treatment. PATIENTS, METHODS: 15 patients received a follow-up FDG-PET combined with computed tomography (integrated PET/CT) with a median of 6.5 years after the first PET in 1999. Number and location of enhanced metabolic activity in the area of AE lesions was determined. Quantification of intensity of metabolic activity was assessed by calculation of mean standardized uptake values. RESULTS: AE lesions in 11/15 patients had been metabolically inactive initially, but only two showed permanent inactivity over the course of 81 months. Interestingly, in two patients metabolic activity was newly detected after 80 and 82 months. Benzimidazole treatment was intermittently discontinued in seven cases. Persisting activity at FDG-PET demanded continued benzimidazole treatment in four patients. Neither treatment duration, lesional size, calcifications nor regressive changes correlated with metabolic activity. CONCLUSION: Treatment responses are heterogeneous and vary from progressive disease despite treatment to long-term inactive disease with discontinued treatment. Lack of metabolic activity indicates suppressed parasite activity and is not equivalent to parasite death. However, metabolic activity may remain suppressed for years, allowing for temporary treatment discontinuation. Relapses are reliably detected with PET and restarting benzimidazole treatment prevents parasite expansion.

Nondermatomal somatosensory deficits in patients with chronic pain disorder: clinical findings and hypometabolic pattern in FDG-PET

Patients with chronic pain disorders often show somatosensory disturbances that are considered to be functional. This paper aims at a more precise clinical description and at a documentation of functional neuroimaging correlates of this phenomenon. We examined 30 consecutive patients with unilaterally accentuated chronic pain not explained by persistent peripheral tissue damage and ipsilateral somatosensory disturbances including upper and lower extremities and trunk. The patients were assessed clinically and with conventional brain CT or MRI scan. In the last 11 patients functional neuroimaging was carried out (18-fluordeoxyglucose positron emission tomography=FDG-PET). Depressive symptoms were assessed with the Hamilton depression scale (HAMD-17) and pain intensity was rated with a visual analogue scale for pain (VAS). All patients suffered from mild to moderate depressive symptoms. All patients had experienced a prolonged antecedent phase of severe emotional distress; most of them remembered a "trigger episode of somatic pain" on the affected side. Somatosensory deficits were a replicable hyposensitivity to touch and heat perception of nondermatomal distribution. Conventional imaging procedures (brain CT or MRI scans) showed no structural changes. However, in 11 patients functional imaging with FDG-PET showed a significant hypometabolic pattern of changes in cortical and subcortical areas, mainly in the post-central gyrus, posterior insula, putamen, and anterior cingulate cortex. In summary, pain-related nondermatomal somatosensory deficits (NDSDs) are a phenomenon involving biological as well as psychosocial factors with replicable neuroperceptive clinical findings and a complex neurodysfunctional pattern in the FDG-PET.

PET-CT-guided interventions in the management of FDG-positive lesions in patients suffering from solid malignancies: initial experiences

Positron emission tomography-computed tomography (PET-CT) has gained widespread acceptance as a staging investigation in the diagnostic workup of malignant tumours and may be used to visualize metabolic changes before the evolution of morphological changes. To make histology of PET findings without distinctive structural changes available for treatment decisions, we developed a protocol for multimodal image-guided interventions using an integrated PET-CT machine. We report our first experience in 12 patients admitted for staging and restaging of breast cancer, non-small cell lung cancer, cervical cancer, soft tissue sarcoma, and osteosarcoma. Patients were repositioned according to the findings in PET-CT and intervention was planned based on a subsequent single-bed PET-CT acquisition of the region concerned. The needle was introduced under CT guidance in a step-by-step technique and correct needle position in the centre of the FDG avid lesion was assured by repetition of a single-bed PET-CT acquisition before sampling. The metabolically active part of lesions was accurately targeted in all patients and representative samples were obtained in 92%. No major adverse effects occurred. We conclude that PET-CT guidance for interventions is feasible and may be promising to optimize the diagnostic yield of CT-guided interventions and to make metabolically active lesions without morphological correlate accessible to percutaneous interventions.

Limited predictive value of FDG-PET for response assessment in the preoperative treatment of esophageal cancer: results of a prospective multi-center trial (SAKK 75/02)

BACKGROUND: Only responding patients benefit from preoperative therapy for locally advanced esophageal carcinoma. Early detection of non-responders may avoid futile treatment and delayed surgery. PATIENTS AND METHODS: In a multi-center phase ll trial, patients with resectable, locally advanced esophageal carcinoma were treated with 2 cycles of induction chemotherapy followed by chemoradiotherapy (CRT) and surgery. Positron emission tomography with 2[fluorine-18]fluoro-2-deoxy-d-glucose (FDG-PET) was performed at baseline and after induction chemotherapy. The metabolic response was correlated with tumor regression grade (TRG). A decrease in FDG tumor uptake of less than 40% was prospectively hypothesized as a predictor for histopathological non-response (TRG > 2) after CRT. RESULTS: 45 patients were included. The median decrease in FDG tumor uptake after chemotherapy correlated well with TRG after completion of CRT (p = 0.021). For an individual patient, less than 40% decrease in FDG tumor uptake after induction chemotherapy predicted histopathological non-response after completion of CRT, with a sensitivity of 68% and a specificity of 52% (positive predictive value 58%, negative predictive value 63%). CONCLUSIONS: Metabolic response correlated with histopathology after preoperative therapy. However, FDG-PET did not predict non-response after induction chemotherapy with sufficient clinical accuracy to justify withdrawal of subsequent CRT and selection of patients to proceed directly to surgery.

Positron emission mammography in the diagnosis of breast cancer. Is maximum PEM uptake value a valuable threshold for malignant breast cancer detection?

AIM To evaluate the diagnostic value (sensitivity, specificity) of positron emission mammography (PEM) in a single site non-interventional study using the maximum PEM uptake value (PUVmax). PATIENTS, METHODS In a singlesite, non-interventional study, 108 patients (107 women, 1 man) with a total of 151 suspected lesions were scanned with a PEM Flex Solo II (Naviscan) at 90 min p.i. with 3.5 MBq 18F-FDG per kg of body weight. In this ROI(region of interest)-based analysis, maximum PEM uptake value (PUV) was determined in lesions, tumours (PUVmaxtumour), benign lesions (PUVmaxnormal breast) and also in healthy tissues on the contralateral side (PUVmaxcontralateral breast). These values were compared and contrasted. In addition, the ratios of PUVmaxtumour / PUVmaxcontralateral breast and PUVmaxnormal breast / PUVmaxcontralateral breast were compared. The image data were interpreted independently by two experienced nuclear medicine physicians and compared with histology in cases of suspected carcinoma. RESULTS Based on a criteria of PUV>1.9, 31 out of 151 lesions in the patient cohort were found to be malignant (21%). A mean PUVmaxtumour of 3.78 ± 2.47 was identified in malignant tumours, while a mean PUVmaxnormal breast of 1.17 ± 0.37 was reported in the glandular tissue of the healthy breast, with the difference being statistically significant (p < 0.001). Similarly, the mean ratio between tumour and healthy glandular tissue in breast cancer patients (3.15 ± 1.58) was found to be significantly higher than the ratio for benign lesions (1.17 ± 0.41, p < 0.001). CONCLUSION PEM is capable of differentiating breast tumours from benign lesions with 100% sensitivity along with a high specificity of 96%, when a threshold of PUVmax >1.9 is applied.

FDG-PET Intra-tratamiento como valor pronóstico en el tratamiento del linfoma Hodgkin

Introducción: La utilización de regímenes de tratamiento más individualizados requiere de mejores sistemas de estratificación temprana en Linfoma Hodgkin (LH). El estudio Tomografía por Emisión de Positrones utilizando 2-[18F] fluoro-2-deoxi-Dglucosa (FDG-PET) intra-tratamiento podría jugar un rol muy importante en esta evaluación. Objetivo: Determinar el valor pronóstico del FDG-PET intra-tratamiento en pacientes con LH para predecir sobrevida libre de progresión y sobrevida global. Material y método: El estudio fue llevado a cabo en el Servicio de Hematología del Hospital Central de Mendoza incluyendo pacientes con diagnóstico de LH confirmados por histología. De acuerdo al estadio y sitio de presentación, los pacientes recibieron quimioterapia sola o la combinación de radioterapia y quimioterapia, con el uso del esquema ABVD (adriamicina, bleomicina, vinblastina y dacarbazina) como protocolo estándar. Los estudios FDG-PET fueron practicados como parte de la evaluación intra-tratamiento y a la finalización. Resultados: En total fueron evaluados 8 pacientes, Sexo: F/M: 4/4, Edad: 18-58 años (Mediana: 29 años), Estadios: IIB:1, IIIA:2, IIIB:1, IVA:1, IVB:3, regiones nodales: 2-10 (Mediana:4), compromiso extranodal: 4/8, síntomas B: 5/8, enfermedad bulky 2/8 . Subtipos: Escleronodular: 6/8, Celularidad mixta: 1/8, Depleción linfocítica: 1/8. IPS: 1: 3/8 2: 3/8 3: 1/8 4: 0/8 ≥ 5: 1/8. Tratamientos: ABVD x 6: 6/8, ABVD x 6 + Radioterapia: 2/8. PET intermedio: 8/8 negativos (6/8 PET 3, 2/8 PET 2). PET final: 7/8 PET negativo, 1/8 PET positivo. Recaída: 1/8 (10° mes). Seguimiento: 11-37 meses (mediana de 24 meses). Discusión y Conclusiones: Al momento actual el FDG-PET intra-tratamiento demostró tener un importante valor predictivo negativo dado que todos los pacientes, menos uno, se encuentran en remisión completa sin progresión de enfermedad. Resta aún determinar el rol que esta herramienta pueda tener en el futuro en la terapia adaptada al riesgo de pacientes con LH.

Characterization and Test of a Data Acquisition System for PET

A small Positron Emission Tomography demonstrator based on LYSO slabs and Silicon Photomultiplier matrices is under construction at the University and INFN of Pisa. In this paper we present the characterization results of the read-out electronics and of the detection system. Two SiPM matrices, composed by 8 × 8 SiPM pixels, 1.5 mm pitch, have been coupled one to one to a LYSO crystals array. Custom Front-End ASICs were used to read the 64 channels of each matrix. Data from each Front-End were multiplexed and sent to a DAQ board for the digital conversion; a motherboard collects the data and communicates with a host computer through a USB port. Specific tests were carried out on the system in order to assess its performance. Futhermore we have measured some of the most important parameters of the system for PET application.