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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
Main Authors: Osborne, Dustin R, Acuff, Shelley N, Fang, Michael, Weaver, Melissa D, Fu, Yitong
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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.
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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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