Prototype software for the clinical evaluation of In-111 SPECT-CT dotatate images conducted prior to and immediately after Y-90 dotatate radionuclide therapy

Hogg, P; Swire, V; Orlinksi, M; Blindell, P; Vinjamuri, S; Szczepura, K

Abstract

Aim and Background
Neuroendocrine tumours (NETs) are heterogenous and
frequently express cell membrane specific peptide receptors such as somatostatin
receptors (SSTRs). Radiolabelled receptor binding of somatostatin analogues can
guide radioactivity to tissues which express SSTRs; this approach can be used for
diagnosis and treatment. There is strong evidence to support the management of
NETs with targeted radionuclide therapy (eg Y-90 dotatate) as it is suggested this is
considered efficacious for patients with inoperable or multisite disease; similarly In111 SPECT-CT dotatate imaging is said to have value for pre- radionuclide therapy
patient evaluation and also for post- therapy where treatment response can be
assessed. The pre- and post- images need careful scrutiny; this requires making
notes of lesions pre- and post- in regard of parameters such as size, location, level
of uptake and whether a response to treatment has occurred. The clinical decision
about progression or otherwise has to be robust and to assist the physician we
have created prototype software. This poster outlines the design principles of that
software.Materials and methods Java was selected as the development tool
because of its platform independence. Image data is imported using Interfile
format and aligned pre- and post- SPECT-CT images are displayed alongside each
other so that direct comparisons can be made. Image display functionality is
provided (eg CT windowing; nuclear medicine image thresholding) to allow the user
the ability to adjust image presentation. Various tools are provided to record the
parameters / information required for clinical decision making; as part of the
iterative design process these were evaluated using an anthropomorphic (lungman)
SPECT-CT chest phantom. In that evaluation specific software design principles
assessed objectivity users’ ability to utilize various iterations of the tools against
known standards.Results and conclusionsThe software allows the user to ‘mark’
lesions pre- and post- therapy and the computer records: x, y, z coordinates; size;
visual impression of intensity as well as an objective measure; free text comments;
etc. Once the user is satisfied then the ‘report button’ generates two outputs: one
file that can be imported to a spreadsheet for later analysis; another file which
summarises concisely pre- and post- therapy disease states. Initial assessment of
the prototype was conducted using the lungman phantom; present analysis
involves testing on real clinical cases. We now have a promising software prototype
which we anticipate will be used on a larger sample of In-111 SPECT-CT dotatate
patients.

Citation

Hogg, P., Swire, V., Orlinksi, M., Blindell, P., Vinjamuri, S., & Szczepura, K. (2011). Prototype software for the clinical evaluation of In-111 SPECT-CT dotatate images conducted prior to and immediately after Y-90 dotatate radionuclide therapy. European Journal of Nuclear Medicine and Molecular Imaging, 38(Sup. 2), S447. https://doi.org/10.1007/s00259-011-1913-y

• Journal Article Type: Conference Paper
• Conference Name: European Association of Nuclear Medicine (EANM) 2011
• Conference Location: Birmingham, UK
• End Date: Oct 19, 2011
• Publication Date: Sep 24, 2011
• Deposit Date: Feb 26, 2021
• Journal: European Journal of Nuclear Medicine and Molecular Imaging
• Print ISSN: 1619-7070
• Electronic ISSN: 1619-7089
• Publisher: Springer Verlag
• Volume: 38
• Issue: Sup. 2
• Pages: S447
• DOI: https://doi.org/10.1007/s00259-011-1913-y
• Publisher URL: https://doi.org/10.1007/s00259-011-1913-y
• Related Public URLs: http://link.springer.com/journal/259
• Additional Information: Event Type : Conference