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Primary Mediastinal B Cell Lymphoma in the Positron-Emission Tomography Era Executive Summary of the American Radium Society Appropriate Use Criteria

Primary mediastinal B cell lymphoma (PMBCL) is a highly curable subtype of non-Hodgkin lymphoma that is diagnosed predominantly in adolescents and young adults. Consequently, long-term treatment-related morbidity is critical to consider when devising treatment strategies that include different chemoimmunotherapy strategies with or without radiation therapy. Furthermore, adaptive approaches using the end-of-chemotherapy (EOC) positron emission tomography (PET)/computed tomography (CT) scanning may help to determine which patients may benefit from additional therapies. We aimed to develop evidence-based guidelines for treating these patients.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

A heavy-ion production channel of 149 Tb via 63 Cu bombardment of 89 Y

We report the radionuclide 149 Tb (t 1/2 = 4.1 h) is a potential theranostic isotope which can simultaneously be used for targeted-alpha-particle therapy and positron-emission tomography. Feasibility experiments were performed to test a near-symmetric heavy-ion reaction of 63 Cu bombardment on monoisotopic 89 Y. The indirect reaction was studied to avoid isomer production. Offline gamma spectroscopy was used to quantify thick-target physical yields and experimental results show modest agreement to the fusion-evaporation code PACE4. A near-symmetric fission yield was also observed.

149Tb↗

Pulse shape measurements for neutron/gamma discrimination using the TOFPET2 ASIC

Many highly pixelated organic scintillator detection systems would benefit from independent readout of each scintillator pixel. Recent advances in Silicon Photomultiplier (SiPM) technology makes this goal feasible, however the data acquisition from potentially hundreds or thousands of channels requires a low-cost and compact solution. For pixelated neutron detection with organic scintillators, the capability to distinguish between neutron and gamma interactions using Pulse Shape Discrimination (PSD) is required along with pulse charge and time of arrival. The TOFPET2 ASIC from PETsys Electronics is a 64-channel readout chip providing pulse time and charge integration measurements from SiPMs, and is specifically designed for time-of-flight positron-emission tomography. Using an 8 × 8 array of 6 mm × 6 mm J-series SiPMs from SensL/OnSemi (ArrayJ-60035-64P-PCB), we have studied the energy and PSD performance of the TOFPET2 ASIC using a 4 × 4 array of 6 mm × 6 mm × 30 mm trans -Stilbene crystals from Inrad Optics and a custom SiPM routing board from PETsys Electronics. In conclusion, using a time-over-threshold method, we measure a maximum PSD figure-of-merit of approximately 1.2 at 478 keV (the Compton edge of 662 keV) for a J-series SiPM operating at an over-voltage of 3V.

47 OTHER INSTRUMENTATION↗

Evaluation of partial volume correction and analysis of longitudinal [ 18 F]GTP1 tau PET imaging in Alzheimer's disease using linear mixed-effects models

Purpose: We evaluated the impact of partial volume correction (PVC) methods on the quantification of longitudinal [ 18 F]GTP1 tau positron-emission tomography (PET) in Alzheimer's disease and the suitability of describing the tau pathology burden temporal trajectories using linear mixed-effects models (LMEM). Methods: We applied van Cittert iterative deconvolution (VC), 2-compartment, and 3-compartment, and the geometric transfer matrix plus region-based voxelwise methods to data acquired in an Alzheimer's disease natural history study over 18 months at a single imaging site. We determined the optimal PVC method by comparing the standardized uptake value ratio change (%ΔSUVR) between diagnostic and tau burden–level groups and the longitudinal repeatability derived from the LMEM. The performance of LMEM analysis for calculating %ΔSUVR was evaluated in a natural history study and in a multisite clinical trial of semorinemab in prodromal to mild Alzheimer's disease by comparing results to traditional per-visit estimates. Results: The VC, 2-compartment, and 3-compartment PVC methods had similar performance, whereas region-based voxelwise overcorrected regions with a higher tau burden. The lowest within-subject variability and acceptable group separation scores were observed without PVC. The LMEM-derived %ΔSUVR values were similar to the per-visit estimates with lower variability. Conclusion: The results indicate that the tested PVC methods do not offer a clear advantage or improvement over non-PVC images for the quantification of longitudinal [ 18 F]GTP1 PET data. LMEM offers a robust framework for the longitudinal tau PET quantification with low longitudinal test–retest variability. Clinical trial registration: NCT02640092 and NCT03289143.

60 APPLIED LIFE SCIENCES↗

Low-dose high-resolution $\mathrm{TOF}$-$\mathrm{PET}$ using ionization-activated multi-state low-$\mathrm{Z}$ detector media

We propose PET scanners using low atomic number media that undergo a persistent local change of state along the paths of the Compton recoil electrons. Measurement of the individual scattering locations and angles, deposited energies, and recoil electron directions allows using the kinematical constraints of the 2-body Compton scattering process to perform a statistical time-ordering of the scatterings, with a high probability of precisely identifying where the gamma first interacted in the detector. In these cases the Line-of-Response is measured with high resolution, determined by the underlying physics processes and not the detector segmentation. There are multiple such media that act through different mechanisms. As an example in which the change of state is quantum-mechanical through a change in molecular configuration, rather than thermodynamic, as in a bubble chamber, we present simulations of a two-state photoswitchable organic dye, a ‘Switchillator’, that is activated to a fluorescent-capable state by the ionization of the recoil electrons. The activated state is persistent, and can be optically excited multiple times to image individual activated molecules. Energy resolution is provided by counting the activated molecules. Location along the LOR is implemented by large-area time-of-flight MCP-PMT photodetectors with single photon time resolution in the tens of ps and sub-mm spatial resolution. Simulations indicate a large reduction of dose.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗

Production and purification of 43Sc and 47Sc from enriched [46Ti]TiO2 and [50Ti]TiO2 targets

Abstract The radioscandium isotopes, 43 Sc and 47 Sc, compose a promising elementally matched theranostic pair that can be used for the development of imaging and therapeutic radiopharmaceuticals with identical structures. This study aimed to investigate the production of high radionuclidic purity 43 Sc from enriched [ 46 Ti]TiO 2 targets and 47 Sc from enriched [ 50 Ti]TiO 2 targets and establish a target recycling technique. Enriched [ 46 Ti]TiO 2 targets were irradiated with 18 MeV protons, and enriched [ 50 Ti]TiO 2 targets were bombarded with 24 MeV protons. 43 Sc and 47 Sc were purified using ion chromatography attaining recovery yields of 91.7 ± 7.4% and 89.9 ± 3.9%, respectively. The average radionuclidic purity for 43 Sc was 98.8 ± 0.3% and for 47 Sc 91.5 ± 0.6%, while the average recovery of enriched titanium target material was 96 ± 4.0%. The highest apparent molar activity for [ 43 Sc]Sc-DOTA was 23.2 GBq/µmol and 3.39 GBq/µmol for [ 47 Sc]Sc-DOTA. This work demonstrates the feasibility of using enriched recycled [ 46 Ti]TiO 2 and [ 50 Ti]TiO 2 targets to produce high purity 43 Sc and 47 Sc as an elementally matched theranostic isotope pair.

38 RADIATION CHEMISTRY, RADIOCHEMISTRY, AND NUCLEA↗