Nuklearmedizin Nuklearmedizin nuk de-de Fri, 26 May 17 05:47:15 +0200 Ahead of print: Differences in sodium fluoride-18 uptake in the normal skeleton depending on the... Aim: The aim of this study was to evaluate the normal distribution of sodium fluoride-18 (NaF-18) and to clarify the differences in uptake according to location and the type of the bone using positron emission tomography (PET) / computed tomography (CT). Methods: We retrospectively reviewed NaF-18 PET/CT images from 30 patients with hip joint disorders. PET/CT scans were performed 40 min after injection of approximately 185 MBq of NaF-18. To evaluate the relationship between the distribution of NaF-18 uptake and bone density, we compared the maximum standardised uptake values (SUVmax) on PET and the Hounsfield Units (HUs) on CT of the lumbar vertebra, ilium, and proximal and distal femurs. Regions of interests were defined both outside and inside the cortical bone to measure whole bone and cancellous bone only, respectively. Results: The distribution of NaF-18 differed according to the skeletal site. The lumbar vertebra showed the highest SUVmax for both whole bone and cancellous bone, followed by the ilium, proximal femur, and distal femur. The bones differed significantly in SUVmax. The distal femur showed the highest HU, followed by the proximal femur, ilium, and vertebra. Profile curve analyses demonstrated that the cancellous bones showed higher SUVmax and lower HU than the cortical bones. Conclusions: Our results demonstrate the difference in NaF-18 uptake between cancellous and cortical bones, which may explain differences in uptake by location. NaF-18 uptake does not appear to be strongly correlated with bone density, but rather with bone turnover and blood flow.... S. Nawata (1), T. Kaneta (1), M. Ogawa (1), Y. Ishiwata (1), N. Kobayashi (2), A. Shishikura-Hino (1), K. Yoshida (1), Y. Inaba (2), T. Saito (2), T. Inoue (1) 27515 2017-05-10 12:56:21 Ahead of print: Prediction of renal cortical defect and scar using neutrophil-to-lymphocyte ratio in... Aim: This study is aimed to evaluate the predictive value of the neutrophil-to-lymphocyte ratio (NLR) for cortical defect on initial and follow-up Tc-99m dimercaptosuccinic acid (DMSA) scan in children with the first febrile urinary tract infection (UTI). Methods: We retrospectively enrolled 179 children with the first febrile UTI who underwent DMSA scan and laboratory tests. In patients with abnormal DMSA scan findings, follow-up DMSA scan was performed at least 6 months after the initial scan. All DMSA scans were classified as negative and positive cortical defects. Multiple logistic regression analyses were performed to identify the risk factors for cortical defect on initial and follow-up DMSA scan. Results: Cortical defects on initial DMSA scan were noted in 133 patients. Vesicoureteral reflux (VUR), white blood cell count, absolute neutrophil count, NLR, and serum C-reactive protein level were independent predictive factors for positive cortical defect on initial DMSA scan (p < 0.050). On follow-up DMSA scan, 24 of the 133 patients showed persistent cortical defects, and only VUR was significantly associated with persistent cortical defect (p = 0.002). In 84 patients who showed cortical defect on initial scan and absence of VUR, only NLR was significantly associated with persistent cortical defect on follow-up scan (p = 0.025). Conclusion: NLR was significantly associated with persistent cortical defect on follow-up DMSA scan in patients without VUR, as well as positive cortical defect on initial scan.... J. W. Lee (1, 2), J. S. Park (3), K. B. Park (3), G. H. Yoo (3), S. S. Kim (3), S. M. Lee (4) 27514 2017-05-10 12:55:06 Ahead of print: A rare case of Marine-Lenhart syndrome with unilateral endocrine orbitopathy and... S. Stanzel (1), P. Gyürüs (2), E. Kresnik, R. Aigner (1) 27513 2017-05-10 09:47:55 Ahead of print: Cancer vaccination causes prolonged FDG accumulation in subcutaneous tissue K. Kahnert (1), D. Kauffmann-Guerrero (1), A. Tufman (1), A. Borgmeier (1), R. M. Huber (2), F. Berger (3) 27457 2017-04-21 11:20:28 Ahead of print: Integrated 68Ga-HBED-CC-PSMA-PET/MRI in patients with suspected recurrent prostate... Aim: Evaluate the diagnostic accuracy of 68Ga-labeled HBED-CC-PSMA-PET/MRI for detection of recurrent PCa in comparison to PET/CT. Methods: 48 patients with suspected recurrent PCa underwent PET/CT after injection of the 68Ga-HBED-CC-PSMA ligand followed by integrated PET/MRI. Image analysis was performed by nuclear medicine physicians and radiologists with respect to the detection of lymph node metastases, bone metastases and local recurrence of the tumour. Image quality was evaluated visually based on a three-point ordinal scale. Results: From 48 patients initially examined, 25 were finally eligible for qualitative and quantitative image evaluation. In 14 patients, neither PET/CT nor PET/MRI found tumour lesions, and 9 patients were excluded from image analysis due to a pronounced extinction artifact around the urinary bladder (halo). In comparison to 68Ga-HBED-CC-PSMA-PET/CT, 68Ga-HBED-CC-PSMA-PET/MRI identified 14 vs. 9 local recurrences in the prostate bed and 23 vs. 20 PET-positive lymph nodes, and 4 vs. 4 PET-positive bone lesions, respectively. While the improved detection of suspicious lymph nodes was primarily attributable to the PET component, the advantageous detection of tumour recurrences in the prostate bed was chiefly referable to the superior soft-tissue contrast of the MR component of integrated PET/MRI. Analysis of SUVmax revealed that 68Ga-HBED-CC-PSMA-PET/MRI provided significantly higher SUVmax compared to 68Ga-HBED-CC-PSMA-PET/CT (17.6, range 2.0–49.6, and 15.1, range 3.5–36.8, respectively, p = 0.0019). Conclusion: 68Ga-HBED-CC-PSMA-PET/MRI was found to be superior as compared to 68Ga-HBED-CC-PSMA-PET/CT in the detection of PSMA-expressing prostate bed recurrences.... S. Lütje (1), J. Cohnen (1), B. Gomez (1), J. Grüneisen (2), L. Sawicki (3), H. Rübben (4), A. Bockisch (1), L. Umutlu (2), T. D. Pöppel (1), A. Wetter (2) 27421 2017-04-12 10:07:12 Ahead of print: Extraction of 223Radium by haemodialysis after treatment of metastatic... Aim: 223Radium-dichloride (223Ra) administration is an upcoming therapeutic option in patients with castration-resistant metastatic prostate cancer (mCRPC), whose renal and faecal excretion of 223Ra has been primarily estimated from data of a phase-I clinical trial in patients with normal renal function. In the rare case of concomitant renal insufficiency requiring haemodialysis (HD), an estimation of the contamination of dialysate would be beneficial. Methods: The excretion of 223Ra and its concentration in the dialysate in a patient with mCRPC and end-stage renal disease was examined for six consecutive treatment cycles. Dialysate samples were measured using a commercial system with NaI-scintillation detector. Results: HD showed a residual activity level in the remaining dialysate. The excreted activity was a median of 46.1 kBq (range = 42.0– 83.4 kBq) and 11.2 kBq (range = 8.4– 19.9 kBq) for the first (24 h post injection p.i.) and second HD (96 h p.i.), respectively. The activity concentration decreased significantly from a median of 4.18 kBq/l (range = 2.98–5.14 kBq/l) to 0.85 kBq/l (range = 0.69– 1.31 kBq/l, p < 0.0001). For all consecutive time points, the activity concentration further decreased significantly (p < 0.0001). The activity concentration of dialysate from HD performed 125.4 h p.i. [95 % confidence interval = 120.5-130.4 h p.i.] reached the threshold for unrestricted waste disposal. Conclusion: The observed extraction of 223Ra by HD exceeded the data determined from the phase-I study. The activity concentration in the dialysate observed for the first HD's p.i. was above the threshold for unrestricted disposal of radioactive waste in Germany. Therefore, the specific requirement for waste handling has to be followed to fulfil the radiation protection regulations.... O. S. Großer (1), H. Wissel (1), T. Wallbaum (1), P. Genseke (1), D. Kupitz (1), J. Ricke (1), J. Ruf (2), H. Amthauer (1, 3) 27395 2017-04-06 13:47:32 56. Jahrestagung der Deutschen Gesellschaft für Nuklearmedizin 27385 2017-04-05 10:08:16 Ahead of print: Repeated peptide receptor radiotherapy in multiple recurrences of a metastasized... C. Brogsitter (1), K. Zöphel (1), G. Folprecht (2), G. Eisenhofer (3), J. Kotzerke (1) 27374 2017-03-30 14:11:21 Nuklearmedizin in Deutschland Ziel: Aktualisierte Darstellung des Spektrums nuklearmedizinischer in-vivo-Untersuchungen und Therapien aus offiziellen Statistiken zur ambulanten und stationären Patientenversorgung sowie von Trends in der Struktur der nuklearmedizinischen Versorgung in Deutschland. Methoden: Die Gesundheitsberichterstattung des Bundes, die Frequenzstatistik der Kassenärztlichen Bundesvereinigung und Statistiken der Bundesärztekammer wurden abgefragt und durch selektive Literaturrecherchen ergänzt. Ergebnisse: Weiterhin werden vornehmlich Schilddrüsen, Knochen und Herzen nuklearmedizinisch untersucht. Bei deutlich gestiegenem Einsatz von PET/CT und SPECT/CT sind einfache Szintigraphieleistungen rückläufig. Myokard-, Lungen-, Lymph- und Hirn-Szintigraphien werden zunehmend angefordert, Skelett- sowie Schilddrüsenszintigraphien gehen zurück. Die Inanspruchnahme nuklearmedizinischer Vertragsärzte stieg jährlich im Schnitt um 4 % (2009: 2 164 664; 2015: 2 687 359). Die Zahl vertragsärztlich tätiger Nuklearmediziner stieg deutlich an (2009: 756; 2015: 939; Zuwachs 24 %) und ist nach der Niederlassungssperre seit 2013 konstant. Der Frauenanteil bei nuklearmedizinischen Facharztanerkennungen nimmt zu (Anteil aktuell 46 %). In Krankenhäusern werden mehr PET(/CT)-Scanner (2009: 97; 2015: 125) und weniger Gammakameras (2009: 594; 2015: 550) betrieben. Die Zahl extrathyreoidaler (auch ambulanter) Therapien stieg weiter. Schlussfolgerung: Bei vermehrter Nutzung von Hybridtechnologien zeigt das nuklearmedizinische Spektrum positive Trends besonders bei Nuklearkardiologie, Neuronuklearmedizin und extrathyreoidalen Therapien. Diese Entwicklungen sind bei der Novellierung der Weiterbildungsordnung und der studentischen Lehre zu beachten.... D. Hellwig (1), J. Marienhagen (1), K. Menhart (1), J. Grosse (1) 27293 2017-03-07 08:00:52 Ahead of print: Incremental value of 99mTc-HYNIC-TOC SPECT/CT over whole-body planar scintigraphy... Aim: The aim of this study was to evaluate the additional value of 99mTc-HYNIC-TOC SPECT/CT over planar whole-body (WB) scintigraphy and SPECT alone in the detection and accurate localisation of neuroendocrine tumour (NET) lesions. Methods: This study included 65 patients with a definitive histological diagnosis of NET prior to scintigraphy. Planar WB scintigraphy, SPECT, and SPECT/CT images were acquired at 4 h post-administration of 670 MBq 99mTc-HYNIC-TOC. Additional SPECT images at 10 min after tracer administration were also acquired. Clinical and imaging follow-up findings were considered as the reference standards (minimum follow-up period, 15 months). Patient and lesion-based analyses of the efficacies of the imaging modalities were performed. Results: While 38 patients exhibited metastasis of NETs, 27 presented no evidence of metastasis. Upon patient-based analysis, the sensitivity and specificity of SPECT/CT were found to be 88.9 and 79.3 %, respectively. The diagnostic accuracies of WB scintigraphy, 4h-SPECT, and SPECT/CT were 72.3, 73.8, and 84.6 %, respectively. The area under curve (AUC) value for SPECT/CT (0.84) was the highest, followed by those for 4h-SPECT (0.75) and WB scintigraphy (0.74). The accuracy and AUC values of SPECT/CT were significantly better compared to those of WB scintigraphy (p < 0.001), 10 min-SPECT (p < 0.001), and 4 h-SPECT (p = 0.001). The findings of SPECT/CT led to the change in treatment plan of 11 patients (16.9 %). Conclusion: The sensitivity and diagnostic accuracy of SPECT/CT in the evaluation of NET lesions outperforms planar WB imaging or SPECT alone.... M. Trogrlic (1), S. Težak (1) 27128 2017-02-06 08:16:32 Ahead of print: 18F-FDG PET/CT in the detection of asymptomatic malignant melanoma recurrence Aim: To evaluate the diagnostic accuracy of FDG PET/CT in the detection of asymptomatic recurrence in patients with malignant melanoma who have had resection of their primary lesion. We also aimed to determine the pattern and factors predisposing to disease recurrence. Methods: Patients with malignant melanoma who have had surgical resection of their disease and without any clinical evidence of disease recurrence were followed-up with FDG PET/CT. The diagnostic accuracy of FDG PET/CT, pattern of recurrence and factors predictive of disease recurrence were determined. Results: A total of 144 patients were followed-up for a median period of 50.50 months. Asymptomatic recurrence was seen in 37 patients (25.7 %) with a median time to recurrence of 20 months. Lymph node was the commonest site of asymptomatic recurrence. Sex, tumour depth, histology type and presence of nodal metastasis were significant predictors of tumour recurrence. Age, race, site of primary lesion, type of lymph node resection were not significant predictors of disease recurrence. Race has a significant effect on the histological subtype of tumour (nodular maligna was more common in Caucasian while acral lentiginous was more prevalent in the Blacks) and the site of the primary lesion (lower limb in Blacks and trunk in Caucasians). Sensitivity, specificity and accuracy of FDG PET/CT for the detection of disease recurrence were 94.5 %, 87.6 % and 89.6 % respectively. Conclusion: FDG PET/CT is a suitable modality for early detection of asymptomatic recurrence of malignant melanoma. Asymptomatic recurrence most commonly occurs in lymph nodes. Sex, nodal metastasis and tumour pathologic features are predictors of recurrence.... I. Lawal (1), T. Lengana (1), K. Ololade (1), T. Boshomane (1), F. Reyneke (1), M. Modiselle (1), M. Vorster (1), M. Sathekge (1) 27127 2017-02-03 09:18:31 Twins in spirit part IV – [177Lu] high affinity DOTATATE Aim: Besides the use of somatostatin analogues, small molecules like sunitinib and everolimus as well as conventional chemotherapy, peptide receptor radiotherapy (PRRT) using radiolabelled somatostatin analogues has gained an important role in the treatment of inoperable, metastasized neuroendocrine tumours (NET). There are various radiotracers in use. Based on our experience with the PET tracer [68Ga]DOTA-3-iodo-Tyr3-octreotate ([68Ga]HA-DOTATATE), a DOTATATE derivative with an increased binding affinity to hsst5, the current retrospective analysis is exploring the therapeutic potential of [177Lu]HA-DOTATATE. Methods: Eighteen patients with metastatic NET (G1/G2) were treated using [177Lu]DOTATATE and/or [177Lu]HA-DOTATATE, and dosimetric results of both tracers were compared. Results: Using [177Lu]HA-DOTATATE, a mean tumour dose of 5.34 Gy/GBq (median 2.53 Gy/GBq; range 0.89–33.3 Gy/GBq) was achieved, while [177Lu]DOTATATE delivered a tumour dose of 5.53 Gy/GBq (median 2.70 Gy/GBq; range 0.44–15.3 Gy/GBq). Organ doses for [177Lu]HA-DOTATATE vs. [177Lu]DOTATATE were as follows: kidney 2.31 ± 0.85 vs. 2.03 ± 0.96 Gy/GBq, liver 1.06 ± 0.79 vs. 1.67 ± 1.73 Gy/GBq, spleen 3.89 ± 4.04 vs. 4.50 ± 3.69 Gy/GBq and whole body 0.16 ± 0.10 Gy/GBq vs. 0.15 ± 0.08 Gy/GBq. Tumour-to-kidney dose ratio was slightly higher for [177Lu]DOTATATE (2.4 ± 5.6) compared to [177Lu]HA-DOTATATE (1.5 ± 3.6). Conclusion: Both tracers showed marked inter-patient variation in their dosimetry, and no significant differences in dosimetry of [177Lu]HA-DOTATATE and [177Lu]DOTATATE were observed when taking all patients into account. Thus, [177Lu]HA-DOTATATE appears viable for PRRT, although it was marginally inferior regarding kidney dose and tumour-to-kidney dose ratio compared to the established [177Lu]DOTATATE.... C. Brogsitter (1), H. Hartmann (1), G. Wunderlich (1), M. Schottelius (2), H.-J. Wester (2), J. Kotzerke (1) 27099 2017-01-31 08:45:54 Prevalence of thyroid disorders in elderly people in Germany Aim: In a screening study on people of working age the prevalence of morphological thyroid disorders was 33.1 %. It is not known precisely whether this further increases after retirement. The present study aimed to establish whether the increase in the prevalence of morphological and functional thyroid disorders continues beyond working age in elderly citizens. Methods: 223 participants were recruited in an institute for geriatric rehabilitative medicine. All patients were screened by thyroid ultrasound, measurement of serum levels of thyroid hormones and thyroid related autoantibodies as well as measurement of urinary iodine excretion. Results: The median thyroid volume was 17 ml (range 4–41 ml) in men and 16 ml (range 0.4–73 ml) in women. 27/59 (46 %) of the men (median age [range]: 77 [58–87] years) and 85/139 (61 %) of the women (median age [range]: 77 [52–97] years), or a total of 112/198 (57 %) residents, showed morphological thyroid abnormalities. There was no clear increase with age. 85 % of the participants without a history of thyroid treatment were euthyroid. 12 % showed a subclinical hyperthyroidism whereas 1 % showed a biochemically manifest hyperthyroidism. 2 % were biochemically hypothyroid. Tg-antibodies was elevated in 10 (5 %) and TPO-antibodies in 18 (9 %) of the patients. Median iodine excretion was 129 µg/l. 41.5 % of the patients showed iodine excretion values below 100 µg/l whereas only 7 % of the patients showed a severe iodine deficiency with an excretion below 50 µg/l. Conclusion: Compared to a previously described population of working age, the prevalence of morphological thyroid disorders does not further increase above the age of 65; thyroid function abnormalities in this iodine sufficient screening population were relatively rare.... F. A. Verburg (1, 2), I. Grelle (1), K. Tatschner (3), C. Reiners (1), M. Luster (2) 27092 2017-01-26 08:29:12 Diagnostic value of additional 68Ga-PSMA-PET before 223Ra-dichloride therapy in patients with... Purpose: Medical imaging plays an important role in selecting patients with metastatic castration-resistant prostate cancer for 223Ra-dichloride therapy of bone metastases. The purpose of this study was to investigate whether 68Ga-PSMA-PET has incremental value over conventional imaging for selecting patients suitable for 223Ra-dichloride therapy. Methods: In 27 consecutive patients referred for 223Ra-dichloride therapy additional 68Ga-PSMA-PET/CT was performed and tracer distribution was evaluated systematically with respect to the detection of visceral metastases and bone metastases with inadequate uptake on bone scintigraphy. Results: In 4 patients (15 %) 68Ga-PSMA-PET revealed previously unknown visceral metastases (3 liver, 1 adrenal gland), which changed the therapeutic decision in 2 cases. PET revealed more extended tumour involvement in the bone compared to bone scintigraphy in 9 patients (33 %). In 3 of these, the mismatch was extensive enough to question suitability for 223Ra-dichloride therapy. Conclusions: Additional 68Ga-PSMA-PET as a gatekeeper between conventional staging and 223Ra-dichloride therapy can provide valuable additional information with regard to visceral metastases and tumour manifestations without adequate bone mineral turnover. It may lead to a change in therapeutic management in a significant number of patients and should therefore be considered in future clinical trials.... A. Bräuer (1), K. Rahbar (1), J. Konnert (1), M. Bögemann (2), L. Stegger (1) 27035 2017-01-11 09:15:26 Polymyalgia rheumatica detected by SPECT/CT using 99mTc-labeled monoclonal antibody Fab'-fragments A. Frölich (1), I. Schwarze (2), C. Neumann (1) 27027 2016-12-22 13:20:32 Fragen zum Beitrag „Radioiodtherapie bei benignen Schilddrüsenerkrankungen“ 26966 2016-12-06 10:28:56 Erratum to: Li B, Zhang M, Jin J. Unusual FDG uptakes of mesenteric brown adipose tissue in a... 26964 2016-12-06 09:52:58 Erratum zu: Schütze C et al. Kons tanzprüfung der Systemlinearität von Aktivimetern mittels 99mTc.... 26965 2016-12-06 09:52:58 Metastatic epithelioid sarcoma revealed with 18F-FDG PET/CT imaging B. Dirlik Serim (1), B. Vatankulu (2), M. Halaç (2), S. Dikici (3), F. Kantarcı (3), K. Sönmezoğlu (2) 26963 2016-12-06 09:52:58 Radioiodtherapie bei benignen Schilddrüsenerkrankungen (Version 5) Die Version 5 der Leitlinie zur Radioiodtherapie bei benignen Schilddrüsenerkrankungen ist ein Update der Version 4, die im Jahr 2007 durch die Deutsche Gesellschaft für Nuklearmedizin (DGN) in Abstimmung mit der Deutschen Gesellschaft für Endokrinologie (DGE, Sektion Schilddrüse) und der Deutschen Gesellschaft für Allgemein- und Viszeralchirurgie (DGAV) publiziert worden war. Die Leitlinie ist mit den Empfehlungen der European Association of Nuclear Medicine (EANM) harmonisiert worden. Nach der „Richtlinie Strahlenschutz in der Medizin“ ist die „rechtfertigende Indikation“ zur Radioiodtherapie durch einen fachkundigen Arzt („Fachkunde in der Therapie mit offenen radioaktiven Stoffen“) zu stellen. Daher werden Indikationen zur Radioiodtherapie und alternative Behandlungsmöglichkeiten in dieser Leitlinie diskutiert. Die Leitlinie wurde von einer repräsentativen Expertengruppe im informellen Konsens verabschiedet und entspricht damit einer Verfahrensanweisung der ersten Stufe (S1) nach den Kriterien der Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF).... M. Dietlein (1), F. Grünwald (2), M. Schmidt (1), P. Schneider (3), F. A. Verburg (4), M. Luster (5) 26961 2016-12-06 09:52:58 Der hoch-normale fT4-Spiegel ist mit Vorhofflimmern assoziiert M. Dietlein (1), A. Drzezga (1) 26962 2016-12-06 09:52:58 Diagnosis of chronic osteomyelitis by combined 99mTc-bone and 99mTc-anti-granulocyte scintigraphy A. Frölich (1), G. Knoll (2), M. Bähre (3), C. Neumann (1) 26960 2016-12-06 09:52:57 [68Ga]PSMA-HBED-CC PET/CT to differentiate between diffuse bone metastases of prostate cancer and... F. Behrendt (1), T. Krohn (1), F. Mottaghy (1), F. A. Verburg (1) 26959 2016-12-06 09:52:57 Open Access: Myocardial perfusion SPECT 2015 in Germany Aim: The working group Cardiovascular Nuclear Medicine of the German Society of Nuclear Medicine presents the results of the 7th survey of myocardial perfusion SPECT (MPS) of the reporting year 2015. Method: 268 questionnaires (173 practices [PR], 67 hospitals [HO], 28 university hospitals [UH]) were evaluated. Results of the last survey from 2012 are set in squared brackets. Results: MPS of 121 939 [105 941] patients were reported. 98 % [95 %] of all MPS were performed with Tc-99m radiopharmaceuticals and 2 % [5 %] with Tl-201. 78 % [79 %] of all patients were studied in PR, 14 % [15 %] in HO, and 8 % [6 %] in UH. A pharmacological stress test was performed in 43 % [39 %] (22 % [24 %] adenosine, 20 % [9 %] regadenoson, 1 % [6 %] dipyridamole or dobutamine). Attenuation correction was applied in 25 % [2009: 10 %] of MPS. Gated SPECT was performed in 78 % [70 %] of all rest MPS, in 80 % [73 %] of all stress and in 76 % [67 %] of all stress and rest MPS. 53 % [33 %] of all nuclear medicine departments performed MPS scoring by default, whereas 24 % [41 %] did not apply any quantification. 31 % [26 %] of all departments noticed an increase in their counted MPS and 29 % [29 %] no changes. Data from 89 departments which participated in all surveys showed an increase in MPS count of 11.1 % (PR: 12.2 %, HO: 4.8 %, UH: 18.4 %). 70 % [60 %] of the MPS were requested by ambulatory care cardiologists. Conclusion: The 2015 MPS survey reveals a high-grade adherence of routine MPS practice to current guidelines. The positive trend in MPS performance and number of MPS already observed in 2012 continues. Educational training remains necessary in the field of SPECT scoring.... O. Lindner (1), W. Burchert (1), W. Schäfer (2), M. Hacker (3) 26956 2016-12-02 09:40:05 Treatment planning in PRRT based on simulated PET data and a PBPK model Aim: To investigate the accuracy of treatment planning in peptide-receptor radionuclide therapy (PRRT) based on simulated PET data (using a PET noise model) and a physiologically based pharmacokinetic (PBPK) model. Methods: The parameters of a PBPK model were fitted to the biokinetic data of 15 patients. True mathematical phantoms of patients (MPPs) were the PBPK model with the fitted parameters. PET measurements after bolus injection of 150 MBq 68Ga-DOTATATE were simulated for the true MPPs. PET noise with typical noise levels was added to the data (i.e. c = 0.3 [low], 3, 30 and 300 [high]). Organ activity data in the kidneys, tumour, liver and spleen were simulated at 0.5, 1 and 4 h p.i. PBPK model parameters were fitted to the simulated noisy PET data to derive the PET-predicted MPPs. Therapy was simulated assuming an infusion of 3.3 GBq of 90Y-DOTATATE over 30 min. Time-integrated activity coefficients (TIACs) of simulated therapy in tumour, kidneys, liver, spleen and remainder were calculated from both, true MPPs (true TIACs) and predicted MPPs (predicted TIACs). Variability v between true TIACs and predicted TIACs were calculated and analysed. Variability ≤ 10 % was considered to be an accurate prediction. Results: For all noise level, variabilities for the kidneys, liver, and spleen showed an accurate prediction for TIACs, e.g. c = 300: vkidney = (5 ± 2)%, vliver = (5 ± 2)%, vspleen = (4 ± 2)%. However, tumour TIAC predictions were not accurate for all noise levels, e.g. c = 0.3: vtumour = (8 ± 5)%. Conclusion: PET-based treatment planning with kidneys as the dose limiting organ seems possible for all reported noise levels using an adequate PBPK model and previous knowledge about the individual patient.... D. Hardiansyah (1, 2), W. Guo (1), A. A. Attarwala (1, 2), P. Kletting (3), F. M. Mottaghy (4, 5), G. Glatting (1, 3) 26922 2016-11-25 09:19:53