Publications

The journal Frontiers in Medicine, Nuclear Medicine section, publishes a case report from Carilion Clinic highlighting the impact of an FDG PET/CT radiotracer injection infiltration on patient management.

“Dose extravasation in PET/CT has the potential of reducing image quality and affecting accurate SUV quantification. These case studies demonstrate how the ability to accurately identify, measure and implement a process improvement program to reduce dose extravasations can ultimately have a positive impact on patient outcomes in PET/CT.” Full Text

“Analysis of time activity curves from both detectors indicate that use of these detectors can provide specific information about a particular radioactive sphere infusion procedure. Data can be used to optimize techniques for a given Y90 therapy device or used to train radiology residents on proper technique. This method can also provide near real-time confirmation of a successful complete delivery of the desired patient dose which may also maximize therapy efficacy and improve patient outcomes.”
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“A combination of deep learning techniques and TACs from external sensors is a novel approach which can play a significant role in classifying infiltrated injections. With the date constraint factor, the highest accuracy achieved was in the range of 70%. However, the system could identify the good injections with 85% accuracy and with 90% accuracy when using only the original data. Future work aims at training the network with sufficient date with improved mode to achieve better accuracy.” Full Text

“Since infiltrations can resolve during uptake and as the standard imaging FOV does not always capture the injection site, many infiltrations may go undetected. Infiltrations result in underestimated SUVs that can impact patient care emphasizing that it is important to monitor injection quality. Thus, identifying contributing factors associated with infiltrations may help stimulate quality improvements, reduce infiltration rates, and potentially improve patient care.”
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“Even when the injection site was out of the field of view, the time–activity curves could still detect and characterize infiltration. Our initial experience showed that the quality assurance information obtained from the device helped reduce the rate and severity of infiltration.” Full Text

Two presentations at the SNMMI annual meeting discuss results from using the Lucerno system at Saint Louis University, with abstracts published on
Prolonged Venous Stasis and
a Pilot Quality Improvement Study .

“Topical sensors applied near the injection site provide dynamic information from the time of FDG administration through the uptake period and may be useful in detecting infiltrations regardless of PET image field of view. This dynamic information may also complement the static PET image to better characterize the true extent of infiltrations.” Full Text (subscription required).

“Further development of this technique may result in routine use of dynamic PET imaging to obtain improved quantitative imaging and more robust data comparison between patients.” Full Text

“The presented device from Lucerno Dynamics, LLC, shows potential for use as a non-invasive method for determining arterial input functions for dynamic PET studies. This system may also obviate the need for “on the bed” injections and long 1 hour acquisitions to obtain image derived input functions. Further analysis is required to compare these methods with arterial blood sampling techniques.” Full Text