BACKGROUND 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. METHODS 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. RESULTS 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. CONCLUSIONS 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.

中文翻译：

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评估和减少PET放射性示踪剂的渗透率：在注射质量监控方法和质量改进方面有一个中心经验。

背景技术成功地注射放射性标记的化合物对于正电子发射断层扫描（PET）成像至关重要。劣质注射会限制体内示踪剂的利用率，并可能影响诊断结果。在这项研究中，我们尝试量化渗透率，制定可行的质量改进计划以减少潜在的进样量，并将进样评分与PET / CT成像结果进行比较。方法使用使用外部辐射探测器的可商购系统来监测和评分注射质量。该系统比较弹丸相对于对照读数的时间活动曲线，以提供与注射质量有关的分数。这些注射分数用于评估我们工厂的渗透率，以便为我们的PET成像中心制定和实施质量改进计划。审查注射评分和PET成像结果，以确定基于图像的浸润评估（例如肝SUV）与注射评分之间的相关性，并收集医师的浸润报告统计数据。结果我们中心共监测了1033次注射。第一阶段的渗透率为2.1％。在决策树分析中，<132.5lbs的患者与浸润有关。其他分析建议患者> 127.5磅。非肘关节注射与低质量注射有关。我们的第二阶段渗透率为1.9％。SUV注射评分的比较显示无显着相关性，表明在PET / CT成像中仅可见63％的可疑浸润。结论制定质量改进计划并监测PET注射量可导致渗透率降低。参考SUV与注射分数之间无显着相关性，提供的证据表明仅基于PET图像进行浸润的测定可能会受到限制。结果还表明，浸润的PET注射次数未充分报告。参考SUV与注射分数之间无显着相关性，提供的证据表明仅基于PET图像进行浸润的测定可能会受到限制。结果还表明渗透的PET注射数量被低报。参考SUV与注射分数之间无显着相关性，提供的证据表明仅基于PET图像进行浸润的测定可能会受到限制。结果还表明，浸润的PET注射次数未充分报告。