Image-based dosimetry for 225Ac-PSMA-I&T therapy using quantitative SPECT
Astrid Gosewisch, M. Schleske, F.J. Gildehaus, I. Berg, Lena Kaiser, Julia Brosch-Lenz, P. Bartenstein, Andrei Todica, Harun Ilhan, Guido Böning
Abstract
Purpose!#!After a decade of PET/MR, the case of attenuation correction (AC) remains open. The initial four-compartment (air, water, fat, soft tissue) Dixon-based AC scheme has since been expanded with several features, the latest being MR field-of-view extension and a bone atlas. As this potentially changes quantification, we evaluated the impact of these features in PET AC in prostate cancer patients.!##!Methods!#!Two hundred prostate cancer patients were examined with either !##!Results!#!High correlation and no visually perceivable differences between all evaluated methods (r > 0.996) were found. The mean relative difference in lesion uptake of !##!Conclusions!#!Based on these results and the encountered bone atlas registration inaccuracy, we deduce that including bones and extending the MR field-of-view did not introduce clinically significant differences in PSMA diagnostic accuracy and tracer uptake quantification in prostate cancer pelvic lesions, facilitating the analysis of serial studies respectively. However, in the absence of ground truth data, we advise against atlas-based methods when comparing serial scans for bone lesions.