Introduction
Materials and methods
Review medical ethics committee
Patient inclusion
Patient number | Gender F = female M = male | Age (y) | EGFR mutation present, y = yes n = no | [18F]Afatinib scanning protocol | [15O]H2O scanning protocol |
---|---|---|---|---|---|
1 | M | 68 | Y | 1 | N |
2 | F | 69 | N | 2 | Y |
3 | M | 51 | Y | 2 | Y |
4 | M | 69 | Y | 2 | Y |
5 | F | 57 | Y | 2 | Y |
6 | F | 53 | Y | 3 | N |
7 | M | 71 | N | 3 | Y |
8 | M | 71 | N | 3 | Y |
9 | F | 47 | Y | 3 | Y |
10 | F | 68 | Y | 3 | Y |
[18F]Afatinib synthesis
PET/CT scanning
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All PET emission scans were acquired in list mode and reconstructed retrospectively using a 3-dimensional row-action maximum-likelihood algorithm into time frames with progressive increase in frame duration [15]. Reconstructions included all usual corrections, such as detector normalization, and decay, dead time, attenuation, randoms, and scatter corrections. For [15O]H2O, 26 frames were used (1 × 10, 8 × 5, 4 × 10, 2 × 15, 3 × 20, 2 × 30 and 6 × 60 s). For the 90-min [18F]afatinib scan (protocol 2), 22 frames were used (1 × 15, 3 × 5, 3 × 10, 4 × 60, 2 × 150, 2 × 300 and 7 × 600 s). For the 60-min [18F]afatinib scan (protocol 3), 19 frames were used (1 × 15, 3 × 5, 3 × 10, 4 × 60, 2 × 150, 2 × 300 and 4 × 600 s).
Blood sampling
Metabolite analysis
VOI definition
Input functions: metabolite and polar fraction correction
Kinetic analysis
Simplified measures
Statistical analysis
Results
Patient and scanning characteristics
Sample data
Pharmacokinetic model selection
Correlation between sampler-based input function and IDIF
Input functions not corrected for metabolites
Perfusion analysis
Simplified measures
Discussion
VOI definition
Pharmacokinetic modelling using arterial sampling and IDIF
Clinical implications
Conclusion
Acknowledgements
Ethics approval and consent to participate
Consent for publication
Competing interests
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E.A. van de Stadt declares she has no conflict of interest.