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@ARTICLE{Kersting:265117,
      author       = {D. Kersting$^*$ and W. Jentzen$^*$ and D. Jeromin$^*$ and
                      I.-A. Mavroeidi$^*$ and M. Conti and F. Büther and K.
                      Herrmann$^*$ and C. Rischpler$^*$ and R. Hamacher$^*$ and W.
                      P. Fendler$^*$ and R. Seifert$^*$ and P. F. Costa$^*$},
      title        = {{L}esion {Q}uantification {A}ccuracy of {D}igital 90{Y}
                      {PET} {I}maging in the {C}ontext of {D}osimetry in
                      {S}ystemic {F}ibroblast {A}ctivation {P}rotein {I}nhibitor
                      {R}adionuclide {T}herapy.},
      journal      = {Journal of nuclear medicine},
      volume       = {64},
      number       = {2},
      issn         = {0097-9058},
      address      = {New York, NY},
      publisher    = {Soc.},
      reportid     = {DKFZ-2023-00279},
      pages        = {329 - 336},
      year         = {2023},
      abstract     = {Therapy with 90Y-labeled fibroblast activation protein
                      inhibitors (90Y-FAPIs) was recently introduced as a novel
                      treatment concept for patients with solid tumors. Lesion and
                      organ-at-risk dosimetry is part of assessing treatment
                      efficacy and safety and requires reliable quantification of
                      tissue uptake. As 90Y quantification is limited by the low
                      internal positron-electron pair conversion rate, the
                      increased effective sensitivity of digital silicon
                      photomultiplier-based PET/CT systems might increase
                      quantification accuracy and, consequently, allow for
                      dosimetry in 90Y-FAPI therapy. The aim of this study was to
                      explore the conditions for reliable lesion image
                      quantification in 90Y-FAPI radionuclide therapy using a
                      digital PET/CT system. Methods: Two tumor phantoms were
                      filled with 90Y solution using different sphere activity
                      concentrations and a constant signal-to-background ratio of
                      40. The minimum detectable activity concentration was
                      determined, and its dependence on acquisition time (15 vs.
                      30 min per bed position) and smoothing levels (all-pass vs.
                      5-mm gaussian filter) was investigated. Quantification
                      accuracy was evaluated at various activity concentrations to
                      estimate the minimum quantifiable activity concentration
                      using contour-based and oversized volume-of-interest-based
                      quantification approaches. A $±20\%$ deviation range
                      between image-derived and true activity concentrations was
                      regarded as acceptable. Tumor dosimetry for 3 patients
                      treated with 90Y-FAPI is presented to project the phantom
                      results to clinical scenarios. Results: For a lesion size of
                      40 mm and a clinical acquisition time of 15 min, both
                      minimum detectable and minimum quantifiable activity
                      concentrations were 0.12 MBq/mL. For lesion sizes of greater
                      than or equal to 30 mm, accurate quantification was feasible
                      for detectable lesions. Only for the smallest 10-mm sphere,
                      the minimum detectable and minimum quantifiable activity
                      concentrations differ substantially (0.43 vs. 1.97 MBq/mL).
                      No notable differences between the 2 quantification
                      approaches were observed. For the investigated tumors,
                      absorbed dose estimates with reliable accuracy were
                      achievable. Conclusion: For lesion sizes and activity
                      concentrations that are expected to be observed in patients
                      treated with 90Y-FAPI, quantification with reasonable
                      accuracy is possible. Further dosimetry studies are needed
                      to thoroughly investigate the efficacy and safety of
                      90Y-FAPI therapy.},
      keywords     = {Humans / Positron Emission Tomography Computed Tomography /
                      Yttrium Radioisotopes: therapeutic use / Positron-Emission
                      Tomography: methods / Neoplasms: diagnostic imaging /
                      Neoplasms: radiotherapy / Neoplasms: drug therapy /
                      Fibroblasts / Gallium Radioisotopes / 90Y (Other) / FAPI
                      therapy (Other) / PET (Other) / minimum detectable activity
                      (Other) / quantification accuracy (Other) / Yttrium
                      Radioisotopes (NLM Chemicals) / Gallium Radioisotopes (NLM
                      Chemicals)},
      cin          = {ED01},
      ddc          = {610},
      cid          = {I:(DE-He78)ED01-20160331},
      pnm          = {899 - ohne Topic (POF4-899)},
      pid          = {G:(DE-HGF)POF4-899},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:35981898},
      doi          = {10.2967/jnumed.122.264338},
      url          = {https://inrepo02.dkfz.de/record/265117},
}