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Assessing and reducing PET radiotracer infiltration rates: a single center experience in injection quality monitoring methods and quality improvement
Successful injection of radiolabeled compounds is critical for positron emission tomography (PET) imaging. A poor quality injection limits the tracer availability in the body and can impact diagnostic results. In this study, we attempt to quantify our infiltration rates, develop an actionable qualit...
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Published in: | BMC medical imaging 2020-01, Vol.20 (1), p.3-3, Article 3 |
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description | Successful injection of radiolabeled compounds is critical for positron emission tomography (PET) imaging. A poor quality injection limits the tracer availability in the body and can impact diagnostic results. In this study, we attempt to quantify our infiltration rates, develop an actionable quality improvement plan to reduce potentially compromised injections, and compare injection scoring to PET/CT imaging results.
A commercially available system that uses external radiation detectors was used to monitor and score injection quality. This system compares the time activity curves of the bolus relative to a control reading in order to provide a score related to the quality of the injection. These injection scores were used to assess infiltration rates at our facility in order to develop and implement a quality improvement plan for our PET imaging center. Injection scores and PET imaging results were reviewed to determine correlations between image-based assessments of infiltration, such as liver SUVs, and injection scoring, as well as to gather infiltration reporting statistics by physicians.
A total of 1033 injections were monitored at our center. The phase 1 infiltration rate was 2.1%. In decision tree analysis, patients 127.5 lbs. with non-antecubital injections were associated with lower quality injections. Our phase 2 infiltration rate was 1.9%. Comparison of injection score to SUV showed no significant correlation and indicated that only 63% of suspected infiltrations were visible on PET/CT imaging.
Developing a quality improvement plan and monitoring PET injections can lead to reduced infiltration rates. No significant correlation between reference SUVs and injection score provides evidence that determination of infiltration based on PET images alone may be limited. Results also indicate that the number of infiltrated PET injections is under-reported. |
doi_str_mv | 10.1186/s12880-020-0408-3 |
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A commercially available system that uses external radiation detectors was used to monitor and score injection quality. This system compares the time activity curves of the bolus relative to a control reading in order to provide a score related to the quality of the injection. These injection scores were used to assess infiltration rates at our facility in order to develop and implement a quality improvement plan for our PET imaging center. Injection scores and PET imaging results were reviewed to determine correlations between image-based assessments of infiltration, such as liver SUVs, and injection scoring, as well as to gather infiltration reporting statistics by physicians.
A total of 1033 injections were monitored at our center. The phase 1 infiltration rate was 2.1%. In decision tree analysis, patients < 132.5lbs were associated with infiltrations. Additional analyses suggested patients > 127.5 lbs. with non-antecubital injections were associated with lower quality injections. Our phase 2 infiltration rate was 1.9%. Comparison of injection score to SUV showed no significant correlation and indicated that only 63% of suspected infiltrations were visible on PET/CT imaging.
Developing a quality improvement plan and monitoring PET injections can lead to reduced infiltration rates. No significant correlation between reference SUVs and injection score provides evidence that determination of infiltration based on PET images alone may be limited. Results also indicate that the number of infiltrated PET injections is under-reported.</description><identifier>ISSN: 1471-2342</identifier><identifier>EISSN: 1471-2342</identifier><identifier>DOI: 10.1186/s12880-020-0408-3</identifier><identifier>PMID: 31924179</identifier><language>eng</language><publisher>England: BioMed Central Ltd</publisher><subject>Computed tomography ; Decision analysis ; Decision trees ; Detection equipment ; Diagnostic imaging ; Diagnostic systems ; Infiltration ; Infiltration (Hydrology) ; Infiltration rate ; Injection ; Injection quality ; Liver ; Medical imaging ; Medical schools ; Methods ; Monitoring ; Monitoring methods ; Patients ; PET ; Physicians ; Planning ; Positron emission ; Positron emission tomography ; Quality ; Quality control ; Quality improvement ; Quality management ; Radiation ; Radiation (Physics) ; Radiation detectors ; Radioactive tracers ; Sensors ; Sport utility vehicles ; Statistical analysis ; Time ; Tomography ; Tracers (Biology)</subject><ispartof>BMC medical imaging, 2020-01, Vol.20 (1), p.3-3, Article 3</ispartof><rights>COPYRIGHT 2020 BioMed Central Ltd.</rights><rights>2020. This work is licensed under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>The Author(s). 2020</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c560t-2096b1d40fe4ffc2aeb0bf53fa4490567583014fdb8e555c016641db1b03e3cc3</citedby><cites>FETCH-LOGICAL-c560t-2096b1d40fe4ffc2aeb0bf53fa4490567583014fdb8e555c016641db1b03e3cc3</cites><orcidid>0000-0003-1324-5464</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6954558/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2341211413?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,25753,27924,27925,37012,37013,44590,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31924179$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Osborne, Dustin R</creatorcontrib><creatorcontrib>Acuff, Shelley N</creatorcontrib><creatorcontrib>Fang, Michael</creatorcontrib><creatorcontrib>Weaver, Melissa D</creatorcontrib><creatorcontrib>Fu, Yitong</creatorcontrib><title>Assessing and reducing PET radiotracer infiltration rates: a single center experience in injection quality monitoring methods and quality improvement</title><title>BMC medical imaging</title><addtitle>BMC Med Imaging</addtitle><description>Successful injection of radiolabeled compounds is critical for positron emission tomography (PET) imaging. A poor quality injection limits the tracer availability in the body and can impact diagnostic results. In this study, we attempt to quantify our infiltration rates, develop an actionable quality improvement plan to reduce potentially compromised injections, and compare injection scoring to PET/CT imaging results.
A commercially available system that uses external radiation detectors was used to monitor and score injection quality. This system compares the time activity curves of the bolus relative to a control reading in order to provide a score related to the quality of the injection. These injection scores were used to assess infiltration rates at our facility in order to develop and implement a quality improvement plan for our PET imaging center. Injection scores and PET imaging results were reviewed to determine correlations between image-based assessments of infiltration, such as liver SUVs, and injection scoring, as well as to gather infiltration reporting statistics by physicians.
A total of 1033 injections were monitored at our center. The phase 1 infiltration rate was 2.1%. In decision tree analysis, patients < 132.5lbs were associated with infiltrations. Additional analyses suggested patients > 127.5 lbs. with non-antecubital injections were associated with lower quality injections. Our phase 2 infiltration rate was 1.9%. Comparison of injection score to SUV showed no significant correlation and indicated that only 63% of suspected infiltrations were visible on PET/CT imaging.
Developing a quality improvement plan and monitoring PET injections can lead to reduced infiltration rates. No significant correlation between reference SUVs and injection score provides evidence that determination of infiltration based on PET images alone may be limited. Results also indicate that the number of infiltrated PET injections is under-reported.</description><subject>Computed tomography</subject><subject>Decision analysis</subject><subject>Decision trees</subject><subject>Detection equipment</subject><subject>Diagnostic imaging</subject><subject>Diagnostic systems</subject><subject>Infiltration</subject><subject>Infiltration (Hydrology)</subject><subject>Infiltration rate</subject><subject>Injection</subject><subject>Injection quality</subject><subject>Liver</subject><subject>Medical imaging</subject><subject>Medical schools</subject><subject>Methods</subject><subject>Monitoring</subject><subject>Monitoring methods</subject><subject>Patients</subject><subject>PET</subject><subject>Physicians</subject><subject>Planning</subject><subject>Positron emission</subject><subject>Positron emission tomography</subject><subject>Quality</subject><subject>Quality control</subject><subject>Quality improvement</subject><subject>Quality management</subject><subject>Radiation</subject><subject>Radiation (Physics)</subject><subject>Radiation detectors</subject><subject>Radioactive tracers</subject><subject>Sensors</subject><subject>Sport utility vehicles</subject><subject>Statistical analysis</subject><subject>Time</subject><subject>Tomography</subject><subject>Tracers 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and reducing PET radiotracer infiltration rates: a single center experience in injection quality monitoring methods and quality improvement</title><author>Osborne, Dustin R ; Acuff, Shelley N ; Fang, Michael ; Weaver, Melissa D ; Fu, Yitong</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c560t-2096b1d40fe4ffc2aeb0bf53fa4490567583014fdb8e555c016641db1b03e3cc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Computed tomography</topic><topic>Decision analysis</topic><topic>Decision trees</topic><topic>Detection equipment</topic><topic>Diagnostic imaging</topic><topic>Diagnostic systems</topic><topic>Infiltration</topic><topic>Infiltration (Hydrology)</topic><topic>Infiltration rate</topic><topic>Injection</topic><topic>Injection quality</topic><topic>Liver</topic><topic>Medical imaging</topic><topic>Medical schools</topic><topic>Methods</topic><topic>Monitoring</topic><topic>Monitoring methods</topic><topic>Patients</topic><topic>PET</topic><topic>Physicians</topic><topic>Planning</topic><topic>Positron emission</topic><topic>Positron emission tomography</topic><topic>Quality</topic><topic>Quality control</topic><topic>Quality improvement</topic><topic>Quality management</topic><topic>Radiation</topic><topic>Radiation (Physics)</topic><topic>Radiation detectors</topic><topic>Radioactive tracers</topic><topic>Sensors</topic><topic>Sport utility vehicles</topic><topic>Statistical analysis</topic><topic>Time</topic><topic>Tomography</topic><topic>Tracers (Biology)</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Osborne, Dustin R</creatorcontrib><creatorcontrib>Acuff, Shelley N</creatorcontrib><creatorcontrib>Fang, Michael</creatorcontrib><creatorcontrib>Weaver, Melissa D</creatorcontrib><creatorcontrib>Fu, 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Michael</au><au>Weaver, Melissa D</au><au>Fu, Yitong</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Assessing and reducing PET radiotracer infiltration rates: a single center experience in injection quality monitoring methods and quality improvement</atitle><jtitle>BMC medical imaging</jtitle><addtitle>BMC Med Imaging</addtitle><date>2020-01-10</date><risdate>2020</risdate><volume>20</volume><issue>1</issue><spage>3</spage><epage>3</epage><pages>3-3</pages><artnum>3</artnum><issn>1471-2342</issn><eissn>1471-2342</eissn><abstract>Successful injection of radiolabeled compounds is critical for positron emission tomography (PET) imaging. A poor quality injection limits the tracer availability in the body and can impact diagnostic results. In this study, we attempt to quantify our infiltration rates, develop an actionable quality improvement plan to reduce potentially compromised injections, and compare injection scoring to PET/CT imaging results.
A commercially available system that uses external radiation detectors was used to monitor and score injection quality. This system compares the time activity curves of the bolus relative to a control reading in order to provide a score related to the quality of the injection. These injection scores were used to assess infiltration rates at our facility in order to develop and implement a quality improvement plan for our PET imaging center. Injection scores and PET imaging results were reviewed to determine correlations between image-based assessments of infiltration, such as liver SUVs, and injection scoring, as well as to gather infiltration reporting statistics by physicians.
A total of 1033 injections were monitored at our center. The phase 1 infiltration rate was 2.1%. In decision tree analysis, patients < 132.5lbs were associated with infiltrations. Additional analyses suggested patients > 127.5 lbs. with non-antecubital injections were associated with lower quality injections. Our phase 2 infiltration rate was 1.9%. Comparison of injection score to SUV showed no significant correlation and indicated that only 63% of suspected infiltrations were visible on PET/CT imaging.
Developing a quality improvement plan and monitoring PET injections can lead to reduced infiltration rates. No significant correlation between reference SUVs and injection score provides evidence that determination of infiltration based on PET images alone may be limited. Results also indicate that the number of infiltrated PET injections is under-reported.</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>31924179</pmid><doi>10.1186/s12880-020-0408-3</doi><tpages>1</tpages><orcidid>https://orcid.org/0000-0003-1324-5464</orcidid><oa>free_for_read</oa></addata></record> |
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subjects | Computed tomography Decision analysis Decision trees Detection equipment Diagnostic imaging Diagnostic systems Infiltration Infiltration (Hydrology) Infiltration rate Injection Injection quality Liver Medical imaging Medical schools Methods Monitoring Monitoring methods Patients PET Physicians Planning Positron emission Positron emission tomography Quality Quality control Quality improvement Quality management Radiation Radiation (Physics) Radiation detectors Radioactive tracers Sensors Sport utility vehicles Statistical analysis Time Tomography Tracers (Biology) |
title | Assessing and reducing PET radiotracer infiltration rates: a single center experience in injection quality monitoring methods and quality improvement |
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