title: Radiation Dosimetry of Whole-Body Dual-Tracer 18F-FDG and 11C-Acetate PET/CT for Hepatocellular Carcinoma.
abstract: Combined whole-body dual-tracer ((18)F-FDG and (11)C-acetate) PET/CT is increasingly used for staging hepatocellular carcinoma, with only limited studies investigating the radiation dosimetry data of these scans. The aim of the study was to characterize the radiation dosimetry of combined whole-body dual-tracer PET/CT protocols.
  
  
  
  Consecutive adult patients with hepatocellular carcinoma who underwent whole-body dual-tracer PET/CT scans were retrospectively reviewed with institutional review board approval. OLINDA/EXM 1.1 was used to estimate patient-specific internal dose exposure in each organ. Biokinetic models for (18)F-FDG and (11)C-acetate as provided by ICRP (International Commission on Radiological Protection) publication 106 were used. Standard reference phantoms were modified to more closely represent patient-specific organ mass. With patient-specific parameters, organ equivalent doses from each CT series were estimated using VirtualDose. Dosimetry capabilities for tube current modulation protocols were applied by integrating with the latest anatomic realistic models. Effective dose was calculated using ICRP publication 103 tissue-weighting coefficients for adult male and female, respectively.
  
  
  
  Fourteen scans were evaluated (12 men, 2 women; mean age ± SD, 60 ± 19.48 y). The patient-specific effective dose from (18)F-FDG and (11)C-acetate was 6.08 ± 1.49 and 1.56 ± 0.47 mSv, respectively, for male patients and 6.62 ± 1.38 and 1.79 ± 0.12 mSV, respectively, for female patients. The patient-specific effective dose of the CT component, which comprised 2 noncontrast whole-body scans, to male and female patients was 21.20 ± 8.94 and 14.79 ± 3.35 mSv, respectively. Thus, the total effective doses of the combined whole-body dual-tracer PET/CT studies for male and female patients were 28.84 ± 10.18 and 23.19 ± 4.61 mSv, respectively.
  
  
  
  Patient-specific parameters allow for more accurate estimation of organ equivalent doses. Considering the substantial radiation dose incurred, judicious medical justification is required with every whole-body dual-tracer PET/CT referral. Although radiation risks may have less impact for the population with cancer because of their reduced life expectancy, the information is of interest and relevant for both justification, to evaluate risk/benefit, and protocol optimization.
authors.affiliation: Department of Diagnostic Radiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
authors.forename: Dan
authors.initials: D
authors.lastname: Liu
authors.affiliation: Department of Diagnostic Radiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China dauerl@mskcc.org plkhong@hku.hk.
authors.forename: Pek-Lan
authors.initials: PL
authors.lastname: Khong
authors.affiliation: Department of Mechanical, Aerospace, and Nuclear Engineering, Rensselaer Polytechnic Institute, Troy, New York.
authors.forename: Yiming
authors.initials: Y
authors.lastname: Gao
authors.affiliation: Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York; and.
authors.forename: Usman
authors.initials: U
authors.lastname: Mahmood
authors.affiliation: Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York; and.
authors.forename: Brian
authors.initials: B
authors.lastname: Quinn
authors.affiliation: Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York; and.
authors.forename: Jean
authors.initials: J
authors.lastname: St Germain
authors.affiliation: Department of Mechanical, Aerospace, and Nuclear Engineering, Rensselaer Polytechnic Institute, Troy, New York.
authors.forename: X George
authors.initials: XG
authors.lastname: Xu
authors.affiliation: Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York; and Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York dauerl@mskcc.org plkhong@hku.hk.
authors.forename: Lawrence T
authors.initials: LT
authors.lastname: Dauer
mesh_terms: D000085:Acetates; D000368:Aged; D000369:Aged, 80 and over; D002250:Carbon Radioisotopes; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods*; D011849:Radioactive Tracers; D011874:Radiometry; D012189:Retrospective Studies; D012306:Risk; D051598:Whole Body Imaging
chemical_list: D000085:Acetates; D002250:Carbon Radioisotopes; D011849:Radioactive Tracers; D019788:Fluorodeoxyglucose F18
keywords: CT; PET/CT; dual tracer; effective dose; radiation exposure
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