Prospective testing of clinical Cerenkov luminescence imaging against standard-of-care nuclear imaging for tumour location

• Published in: Nature biomedical engineering Vol. 6; no. 5; pp. 559 - 568
• Main Authors: Pratt, Edwin C., Skubal, Magdalena, Mc Larney, Benedict, Causa-Andrieu, Pamela, Das, Sudeep, Sawan, Peter, Araji, Abdallah, Riedl, Christopher, Vyas, Kunal, Tuch, David, Grimm, Jan
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01-05-2022; Nature Publishing Group
• Subjects: 59; 59/5; 59/78; 631/67/2321; 692/308/575; 692/4017; Biomedical and Life Sciences; Biomedical Engineering/Biotechnology; Biomedicine; Computed tomography; Deoxyglucose; Emitters; Enclosures; Fluorine isotopes; Fluorodeoxyglucose F18; Humans; Luminescence; Luminescent Measurements - methods; Lymph nodes; Medical imaging; Neoplasms - diagnostic imaging; Patients; Photon emission; Positron emission; Positron emission tomography; Positron Emission Tomography Computed Tomography; Positron-Emission Tomography - methods; Prospective Studies; Radiation therapy; Radioactive tracers; Tomography; Tumors
• ISSN: 2157-846X; 2157-846X
• DOI: 10.1038/s41551-022-00876-4

In oncology, the feasibility of Cerenkov luminescence imaging (CLI) has been assessed by imaging superficial lymph nodes in a few patients undergoing diagnostic
18
F-fluoro-2-deoxyglucose (
18
F-FDG) positron emission tomography/computed tomography (PET/CT). However, the weak luminescence signal requires the removal of ambient light. Here we report the development of a clinical CLI fiberscope with a lightproof enclosure, and the clinical testing of the setup using five different radiotracers. In an observational prospective trial (ClinicalTrials.gov identifier
NCT03484884
) involving 96 patients with existing or suspected tumours, scheduled for routine clinical FDG PET or
131
I therapy, the level of agreement of CLI with standard-of-care imaging (PET or planar single-photon emission CT) for tumour location was ‘acceptable’ or higher (≥3 in the 1–5 Likert scale) for 90% of the patients. CLI correlated with the concentration of radioactive activity, and captured therapeutically relevant information from patients undergoing targeted radiotherapy or receiving the alpha emitter
223
Ra, which cannot be feasibly imaged clinically. CLI could supplement radiological scans, especially when scanner capacity is limited.
Prospective testing of a clinical fiberscope with a lightproof enclosure for Cerenkov luminescence imaging using five different radiotracers showed satisfactory agreement with standard-of-care nuclear imaging for tumour location.