Patent Description:
For example, peptide receptor radionuclide therapy (PRRT) is an unsealed source radiotherapy used for treating neuroendocrine tumors (NETs) wherein the radiopharmaceutical is a cell-targeting protein or peptide combined with a radionuclide. When injected into the bloodstream the radio-peptide travels to and binds to NET cells, delivering a targeted high dose of radiation directly to the cancer cells. Octreotide (DOTATOC) and octreotate (DOTATATE), for example, are laboratory-made versions of the hormone that binds to somatostatin receptors on NETs. In PRRT, the somatostatin analogue is combined with a therapeutic dose of the radionuclide. Yttrium-<NUM> and Lutetium-<NUM> are commonly used radionuclides.

For patients with metastatic, somatostatin-receptor-<NUM> (SSTR2) NETs, targeted therapy using <NUM>Lu-DOTATATE has been found to greatly increase progression-free survival (PFS). Now that <NUM>Lu-DOTATATE has FDA approval it is quickly becoming the standard of care (SOC) for symptomatic NET patients and those with metastatic spread. FDA package instructions call for patients to receive a standardized regimen of four <NUM> GBq treatments, regardless of size, weight, gender, or patient health status. Under current SOC, in the United States the treatment is not personalized. However, studies show that personalized therapies can increase PFS and overall survival (OS) by over <NUM>% if treatments continue until dosing to the kidneys reaches <NUM> Gy (i.e., the recommend kidney OAR cutoff). Practical tools are needed to accurately assess dose to the OARs, and in particular the kidney, which is the main OAR for <NUM>% of NET patients receiving <NUM>Lu-DOTATATE therapy. These tools will enable treatment personalization and improve outcomes beyond the proposed SOC protocol. In <NUM>, there were ~<NUM>,<NUM> NET patients with an estimated incidence rate of new cases of <NUM>/<NUM>,<NUM> per year (over <NUM>,<NUM> new patients). Eighty-one percent of NETs are SSTR2 positive, so a need exists for improved <NUM>Lu-DOTATATE dosimetry. In addition, the teachings disclosed herein will be applicable to other promising theranostics protocols currently under development.

Medical research is striving towards individualized therapies and precision treatments. Standardized therapy is counter to the ideals of personalized medicine. For example, some patients may receive damaging levels of radiation to their kidneys (i.e., ><NUM> Gy) if they receive the SOC four <NUM> GBq doses of <NUM>Lu-DOTATATE. Knowing the actual dose to the kidneys is important because the kidneys are a main OAR in ~<NUM>% of patients. Other OARs include liver, spleen, and bone marrow. Without active monitoring, physicians will not know the dose to the kidneys or other OARs. In addition to avoiding potential harm to patients, and potentially more importantly, without dosimetry monitoring many patients will be underdosed. Recent studies indicate that patients who continued to receive <NUM>Lu-DOTATATE treatments until their kidney dose reached <NUM> Gy (i.e., <NUM> to <NUM> treatments) had ><NUM>% increase in PFS (i.e., <NUM> vs. <NUM> months) and OS (i.e., <NUM> vs. <NUM> months) than patients whose treatments stopped before their kidneys received <NUM> Gy.

Although <NUM>Lu-DOTATATE organ dosimetry is common in Europe and elsewhere in the world, it is currently not common in the United States. We believe this is due to the high costs for repeated SPECT/CT imaging to perform personalized dosimetry, and the costs and inconvenience to patients and their families associated with requiring additional clinic visits for dose monitoring.

For example, a protocol for PRRT may require a series of four PRRT treatments with <NUM>Lu-DOTATATE spaced approximately two months apart. The treatments may be performed as an outpatient procedure, or as an inpatient procedure requiring a hospital stay for several days. Each session typically starts with providing an anti-nausea medicine, followed by an amino acid solution delivered intravenously. The radionuclide is then injected, followed by additional amino acid solution.

For radionuclide theranostics, there is benefit to monitor the levels of radiation in patient organs (e.g., OARs) and in tumors in the patient's body, for days or weeks. Cancer cells overexpress the somatostatin receptor, which preferentially bind octreotide and target the radioactive compound directly at tumors. In addition to neuroendocrine tumors, PRRT and similar treatments using radioisotopes have been used to effectively treat bone metastases, thyroid cancers, and lymphomas.

<CIT> mentions garments and methods for monitoring radiation exposure.

One of the challenges associated with molecular radiotherapies is that patients can dramatically differ in their ability to absorb the radioactive molecules and/or in their ability to flush the radioactive molecules from their body. Knowing this, physicians may personalize treatments by monitoring absorbed radiation dosage at both the tumor site and at OARs. Unfortunately, repeated imaging of radionuclides is costly and time consuming for patients. There exists a great need to lessen the monitoring and treatment-adjusting burden on both patients and physicians, while also improve quality of care, and quality of life.

The invention is defined according to the claims. The invention provides a method for detecting radiation emitted from one or more organs in a body undergoing internal radionuclide therapy, and transmitting signals characterizing the detected radiation, comprising: providing a garment (<NUM>) configured to be secured around the body during positron emission tomography-computed tomography (PET/CT) and to permit imaging a portion of the body through the garment (<NUM>), wherein the garment (<NUM>) further comprises grid markings that are configured to be visible in computed tomography images through the garment (<NUM>); marking the body with a plurality of fiducial markers (<NUM>); attaching the garment (<NUM>) to the body in a repeatable position using the fiducial markers (<NUM>); imaging the body with the garment (<NUM>) in the repeatable position using a PET/CT scanner to generate images showing the organs and the grid markings; fixing a plurality of radiation detectors (<NUM>) to the garment (<NUM>) in locations based on the image obtained from the PET/CT scanner, wherein the detectors (<NUM>) are positioned to detect radiation emitted from the organ, wherein the detectors (<NUM>) are operatively connectable to the computer and configured to transmit signals characterizing the radiation detected by the detectors (<NUM>) to the computer; and attaching the garment (<NUM>) to the body in the repeatable position after the body has been injected with a radionuclide and transmitting signals corresponding to the radiation detected by the detectors (<NUM>) to the computer.

In one embodiment, the step of attaching the garment (<NUM>) to the body is performed periodically after the body has been injected with a radionuclide.

In one embodiment, the step of attaching the garment (<NUM>) to the body is performed at least three days after the body has been injected with a radionuclide.

In one embodiment, the garment (<NUM>) further comprises a transmitter (<NUM>) operatively connected to the plurality of detectors (<NUM>) and configured to wirelessly transmit the signals corresponding to the radiation detected by the detectors (<NUM>) to the computer.

In one embodiment, the one or more organs comprises a kidney.

In one embodiment, the garment (<NUM>) comprises a belt or a vest.

Described herein is a garment for detecting organ radioactivity concentrations in organs of a body undergoing a targeted radionuclide therapy, which includes a covering that permits PET/CT imaging therethrough and includes CT-visible guides, a plurality of radiation detectors, and wiring connecting the radiation detectors to a power and data control system. During use the garment is wrapped around and secured to the body. The guides are formed from a material that is visible in a computed tomography images. The plurality of radiation detectors are attached to the covering in a configuration customized for the body.

The power and data control system may be configured to wirelessly transmit the data from the detectors to a remote service provider.

A plurality of positioning features may be incorporated into the covering and operable to facilitate attaching the garment to the body in a repeatable position, for example, the positioning features may be apertures or windows that are configured to overlie corresponding fiducial markers on the body.

The radiation detectors may be individually wired to the power and data control system.

The radiation detectors may include a container formed from a material that blocks ionizing radiation, for example lead, and the container defines an aperture into the container. A crystal scintillator and a silicon photomultiplier may be operably connected and disposed in the container opposite the aperture. For example, the crystal scintillator may be gadolinium aluminum gallium garnet doped with cerium.

The radiation detectors may be collimated spectroscopy counters.

The power and data control system may include a power supply, a receiver configured to receive radiation detection signals from the plurality of radiation detectors, and a transmitter configured to transmit the received signals.

The plurality of detectors may be disposed in a sparse array.

Also described herein is a wearable dosimetry device for detecting radiation emitted from an organ in a body which may include a flexible support that wraps around a body, a guide on the flexible support that is visible in computed tomography images of the device, a plurality of radiation detectors fixed to the flexible support, a processor fixed to the flexible support and in signal communication with the detectors, a wireless transmitter configured to receive data from the processor and to transmit the received data to a receiver, and an electrical power supply configured to provide electrical power to the plurality of detectors, to the processor, and to the wireless transmitter.

The flexible support may further comprise a plurality of windows configured to aide in precise positioning of the wearable device to the organ.

The plurality of detectors may be arranged in a sparse array on the flexible support.

The plurality of detectors may each include a lead container having a first face defining an aperture configured to face the body, and providing access to an interior of the container, and an assembly comprising a scintillator crystal and a photomultiplier disposed on a wall opposite the aperture.

A known challenge in unsealed source radiotherapy is monitoring the radioactive dose of organs and/or tumors, which requires patients to return multiple times to the medical service provider for longitudinal imaging to determine organ dosimetry. Organ dosimetry provides a basis for determining the amount of additional therapeutic dose that a patient can receive. Some radiotherapies, for example, peptide receptor radionuclide therapy (PRRT), are approved for every patient receiving the same standard dosing (e.g., for <NUM>Lu-DOTATATE, four treatment doses of <NUM> mCi each). Studies have shown, however, that for some patients the approved dosing will deliver an unsafe dose to the patient's organs, and for other patients more than four treatment doses may be safely used before organ toxicity is a problem. Monitoring the washout of radionuclides (e.g., the organ radioactivity concentrations) in a patient would allow the actual dosing for organs at risk (OARs) and for tumors, to be calculated. Determining (or estimating) the actual dosing would allow an optimal treatment plan to be personalized to the individual patient. For example, some treatment protocols for PRRT require patients to undergo <NUM>-<NUM> imaging sessions after receiving the radionuclide for each treatment, for example, at <NUM> hours, <NUM> hours, and <NUM> hours from the injection of the radionuclide, to obtain organ dosimetry measurements. Multiple visits to a medical facility can be expensive and burdensome to the patient and to the medical facility.

A personalized dosimetry garment is disclosed that is configured to measure and report radioactive emissions from user organ, tumor, and/or other regions of interest. The garment may be used at home, obviating the need for at least some longitudinal clinic visits. For example, in some cases a quantitative SPECT/CT scan is performed at the clinic shortly after injecting the radiopharmaceutical (e.g., approximately <NUM> hours after dose administration), but additional clinical imaging (for example, at <NUM> and <NUM> days after injection) are not obtained. Rather, subsequent dosimetry data is obtained from the personalized garment. The garment may include, for example, <NUM>-<NUM> small radiation detectors placed at locations that are determined based on the user's anatomy. The garment wraps around the user, for example, in the form of a belt, vest, or other wrap. Including detectors and electronics, the garment may be relatively light weight, for example, weighing less than <NUM> grams (<NUM> pounds).

The garment allows radiation washout measurements (organ radioactivity concentrations) to be taken over many days at the user's home, and allows for more frequent monitoring. For example, measurements may be obtained daily. For PRRT applications, for example, daily measurements for between <NUM> to <NUM> days would allow for more accurate estimation of <NUM>Lu-DOTATATE dosimetry from the kidneys than current procedures, for example, taking three or four nuclear medicine clinical images spaced days apart. The garment requires only a few minutes to position on the user. In some embodiments an entire measurement and reporting procedure may require less than six minutes to complete. A particularly preferred garment includes battery operated electronics for data acquisition (e.g., detectors and related amplifier electronics), storage, and transmission. For example, the garment may include wireless communication capabilities, configured to send encrypted data to a secure website. The garment may further provide feedback to allow medical staff to remotely monitor if the user is wearing the device and using it properly. Therefore, the medical staff may contact the user to address issues if problems occur. A further advantage of daily monitoring is that the loss of <NUM> or <NUM> recordings will not significantly reduce accuracy of the organ (e.g., kidney) dosimetry estimates. The garment disclosed herein may be produced relatively inexpensively making it very feasible as a piece of home-use durable medical equipment. While the garment is customized for each user, the individual components, for example, the radiation detectors and electronics may be reusable.

A method and system is disclosed that allows more frequent measurements to be taken, optionally over a longer period of time, to better characterize the washout of the radiotracer from organs and/or tumors of interest, while greatly reducing the costs and burden to the user, by permitting users to obtain organ and/or tumor radiation data from home, at more frequent intervals, and to transmit the data to the service provider.

A garment <NUM> as described herein is shown in <FIG>. In this example the garment <NUM> is a vest. The garment <NUM> is illustrated in a worn configuration in <FIG>, and in an open configuration in <FIG>. The garment <NUM> is operable to detect radiation emitted from organs and/or tumors in the wearer of the garment <NUM>. The disclosed system is configured to measure or estimate the washout of radioactivity from the organs (organs at risk) and/or tumors. It is contemplated that a garment as described herein may be configured to measure radiation in any targeted region of interest in the wearer.

The garment <NUM> includes a flexible substrate or covering <NUM> that engages the user <NUM> securely such that the garment <NUM> will resist or avoid shifting relative to the user <NUM> during use, for example, with a closure mechanism <NUM> for securing the garment <NUM> to the user <NUM>, for example, hook and loops fastener, belts and clasps, or other fastening means as are known in the art. The covering <NUM> may be customized to the user, or may be produced in a number of standard sizes, with a suitable size selected and optionally adapted to the particular user.

A plurality of radiation detectors <NUM> are supported by the covering <NUM>, oriented inwardly in selectable locations. The plurality of detectors <NUM> may be arranged in a sparse array wherein the locations of the detectors <NUM> are customized to the user's <NUM> anatomy, in particular considering the location of the user's organs, and the location of any tumors of interest. A wiring system <NUM> connects the radiation detectors <NUM> to a power and data control system <NUM> that may be partially or fully integrated into the garment <NUM> or separate from the garment <NUM>. For example, the radiation detectors <NUM> may be individually wired to the control system <NUM>. Alternatively, a wiring network may be incorporated into the garment <NUM>. Other wiring options are known and will be obvious to persons of skill in the art. Although the garment <NUM> may be configured to support radiation detectors <NUM> at locations substantially anywhere on the garment <NUM>, in some applications the garment may be configured to support detectors <NUM> over a more limited region of the garment.

One or more components of the system <NUM> may be separate from the garment <NUM>. It is contemplated that the garment <NUM> may be made in separable parts. For example, the garment <NUM> may include an outer covering <NUM> that defines a recess on an interior side, and an inner portion, for example, a circuit board assembly that incorporates the detectors <NUM> and is supported in the covering recess. The garment <NUM> may include an array of ports or recesses on an interior surface that are configured to selectively receive and retain the radiation detectors <NUM>.

The garment <NUM> includes a mechanism to facilitate positioning the garment <NUM> to the user <NUM> accurately and reproducibly at a desired location on the user <NUM>. For example, a plurality of fiducial markers <NUM> may be applied to the user (e.g., temporary tattoos) in desired locations to provide guides for positioning the vest <NUM>. The garment <NUM> may include a plurality of apertures or windows <NUM>. The fiducial markers <NUM> are configured to align with the windows <NUM> and to be visible therethrough when the garment <NUM> is in the desired position on the user <NUM>. The user may don the garment <NUM>, align the windows <NUM> with the fiducial markers <NUM>, and secure the garment <NUM> with the closure mechanism <NUM>.

The garment <NUM> further includes radiopaque markings or guides <NUM>, e.g., a CT-visible grid. The guides <NUM> are configured to be visible in CT images. Preferably, the guides <NUM> are substantially transparent to photons having energy greater than <NUM> keV. The guides <NUM> are therefore visible in CT images of the user <NUM> wearing the garment <NUM> (e.g., with the garment <NUM> worn in the desired, repeatable or reproducible position), such that the guides <NUM> are visible in images of the user's <NUM> organs in PET/CT images of the user <NUM> wearing the garment <NUM>. These images are used to register the location of the user's organs (e.g., OARs) with the garment <NUM> such that an optimal number and location for the detectors <NUM> may be determined for installation of the detectors <NUM>. In many applications the imaging with the guides <NUM> for registering the organs will not require a separate image scan. For example, typically when preparing for <NUM>Lu-DOTATATE therapy the patient first receives a <NUM>Ga-Dotatate PET/CT (positron emission tomography/computed tomography) scan to ensure the tumors are SSTR2 positive. The garment <NUM> may be worn during this pre-treatment imaging scan (without the detectors <NUM>), and these images may be used to register the user's organs with the garment <NUM>.

The radiation detectors <NUM> are operatively connected to the power and data control system <NUM>, for example, through direct wiring <NUM>. The system <NUM> may include a power source <NUM>, for example, batteries configured to provide power to the detectors <NUM> and other components, a receiver and/or processor <NUM> operably connected to receive data from the plurality of detectors <NUM>, and a transmitter <NUM> configured to transmit the received data, for example, wirelessly and/or through phone lines (not shown). Optionally, a display <NUM> is provided that may include various indicators. For example, indicators may be provided to (i) indicate if the garment <NUM> is properly positioned on the user, (ii) indicate when data is being received, (iii) indicate an elapsed time or remaining time for obtaining data, (iv) indicate when data is being transmitted, or (v) indicate when data has been received and verified by a remote receiver, etc..

The radiation detector <NUM> may be a crystal scintillation detector. An example of the radiation detector <NUM> is shown in <FIG> and in cross section in <FIG>. The detector <NUM> includes a small enclosure, for example, a lead enclosure formed from side walls <NUM>, a front wall <NUM> having an aperture <NUM>, and a wall <NUM> opposite the front wall <NUM>. For example, the aperture <NUM> may be <NUM> in diameter. The aperture may be smaller or larger, for example, between <NUM> and <NUM>. A crystal scintillator <NUM>, for example, gadolinium aluminum gallium garnet doped with cerium (GAGG(Ce)), is disposed in the container with a silicon photomultiplier (SiPM) <NUM> and disposed opposite the aperture <NUM>. It will be appreciated by persons of skill in the art that the detectors <NUM> may function as collimated, miniature, spectroscopy counters. The orientation of the detector <NUM> may be adjustable, for example, to control and optimize the orientation of the apertures <NUM> in the detectors <NUM>. The radiation detectors may have capability beyond energy discriminating and counting capabilities, for example, imaging capabilities, e.g., photon position sensing capability to determine photon interaction positions. Other types of radiation detectors are contemplated, as are known in the art, for example, electronic personal dosimeters, such as PIN dosimeters, MOSFET dosimeters, and the like. The photon-positioning capability of the detectors <NUM> provides additional advantages for the garment <NUM>. For example, photon position information may be used to determine or confirm the position of the garment <NUM> with respect to the user's organs, for example, to aid in interpreting the data received from the detectors <NUM> (e.g., such that the received data may be properly interpreted, even if the garment is not accurately positioned) and/or to determine and alert the user if the garment <NUM> is not properly positioned.

Although the preferred garment described herein includes a customized, sparse array of radiation detectors <NUM>, a garment in accordance with the present disclosure may include a dense array of detectors <NUM>, for example, a rectangular array of detectors <NUM>. However, the sparse array of detectors <NUM> with placement customized for the user, provides many advantages, including reduced weight, cost, and complexity.

Refer now to <FIG>, which presents an example of a method <NUM> of providing a customized garment <NUM> for obtaining radiation washout data for organs and/or tumors. The method includes providing a garment <NUM>, for example, a vest, belt, or wrap, having a CT-visible grid and locating features <NUM>, wherein at least a portion of the garment is transparent to high energy photons. In a current embodiment, the user is marked with a plurality of fiducial markers <NUM> that are configured to cooperate with the garment to facilitate placing the garment on the user at a desired and repeatable position. The garment is placed on the user in the repeatable position <NUM> using the fiducial markers. It is contemplated by the present invention that other methods may be used to position the garment on the user in a repeatable position, for example, providing a rigid outer shell that is customized to the user.

With the garment in place, a CT image of the user is obtained <NUM> with the grid visible in the images, allowing the user's organs (visible in the CT or PET/CT image) to be registered to the garment grid. A customized optimal number and placement of radiation detectors for the garment is then determined <NUM>. For example, in a current method simulation studies using Monte Carlo simulations are performed to optimize the detector placement based on the user-specific anatomy. Monte Carlo simulations are well known in within the skill in the art. The radiation detectors are then attached to the garment and configured to detect radiation from at least one organ (or tumor) of the user <NUM>.

<FIG> presents an example of a method <NUM> for obtaining washout data for organs and/or tumors using the garment <NUM> in accordance with the present invention. The radiopharmaceutical may be administered to the user <NUM>, for example, by injection or orally. A quantitative image of the user, for example a SPECT/CT image, is obtained shortly after the radiopharmaceutical is administered <NUM> (e.g., <NUM> hours after administration). Immediately or shortly after the quantitative imaging, the garment <NUM> is positioned on the user in the repeatable position <NUM>. Dosimetry information, i.e., detected radiation data is obtained from the garment <NUM>, as discussed above. Data from the radiation detectors in the garment are correlated with the quantitative image results <NUM>.

In subsequent days the user periodically (e.g., daily) dons the garment in the repeatable position <NUM>. For example, in the present invention this step may be done at the user's home. The user wears the garment in the repeatable position for a relatively short period of time, for example two to five minutes. Data from the plurality of detectors <NUM> in the garment <NUM> are transmitted to the medical service provider after each period <NUM>. For example, the data may be transmitted directly from the power and data control system <NUM>, for example, via WI-FI® or through a cellular network.

It will be appreciated by persons of skill in the art that the disclosure and teachings herein may be applied to other procedures and therapies. In particular, a customized, monitoring and data transmitting garment in accordance with the present disclosure may be applied to any method or treatment that requires obtaining localized radiation emission estimates from internal locations in a body.

For example, another contemplated application is proton beam therapy dose and position monitoring. In this application the garment may be a circular hoop around a patient. During proton therapy for cancer treatment, a beam of protons is directed to the region in the patient containing the tumor. The protons "pile up" in the Bragg peak (a peak on the Bragg curve plotting the energy loss of ionizing radiation during travel through matter), allowing for localization of the protons by positioning the Bragg peak at the tumor position. In proton beam therapy the protons are specifically directed to cells within the Bragg peak, and therefore spares much of the healthy tissue along the path of the beam. This is opposed to the external beam radiotherapy that utilizes high-energy photons, where all tissue in the path of the beam, including healthy tissue, is irradiated and subject to damage.

Determining the trajectory of the proton beam and the location of the Bragg peak is a non-trivial task. During proton beam therapy it is useful to have real-time tracking of the position of the Bragg peak. If the position of the Bragg peak is not accurately determined, the proton therapy can damage healthy tissue and leave a tumor untreated.

During proton therapy, some of the proton interactions generate positrons that can be imaged using the techniques of positron emission tomography (PET). There have been attempts to use PET for Bragg peak localization, with some success. However, PET systems are expensive and generally require a full ring of sensors to generate an image.

Adapting the teachings described above, a patient wears a garment (e.g., in a ring or cylinder geometry) with custom positioned detectors. The detector positions in the garment are optimized to image positrons for estimating the location of the Bragg peak in the patient's body using PET methodologies. In this configuration, the output from the vest is a real-time image or indicator of the position of the Bragg peak. This image can be superimposed on a CT scan of the patient for real-time tracking and positioning of the proton beam Bragg Peak. In this application the garment itself may be standardized for different patients, but the detectors positions are customized to the user, to provide optimal detection during the proton beam therapy.

In another example, the garment may be used to perform dynamic PET (Dynamic PET) imaging. In conventional (static) PET imaging, a patient is injected with a radiotracer and placed in the PET scanner for imaging, typically approximately an hour after the radiotracer injection, to image the regions where the radiotracer has accumulated.

In Dynamic PET imaging the user is injected with the radiotracer while within the scanner, allowing the scanner to visualize the change in radiotracer concentration over time. A common goal for Dynamic PET imaging is to draw a region of interest (ROI) around a tumor and monitor how the concentration of radiotracer changes over time. This gives additional information of the tumor metabolism that is generally not available with the standard static PET imaging. However Dynamic PET requires additional workforce in the clinic, determination of an input function (i.e., blood activity concentration over time), more time on the scanner, produces much noisier images than static PET, and is significantly more expensive than static PET. For these reasons, Dynamic PET is not used regularly.

Claim 1:
A method for detecting radiation emitted from one or more organs in a body undergoing internal radionuclide therapy, and transmitting signals characterizing the detected radiation, the method comprising
providing a garment (<NUM>) configured to be secured around the body during positron emission tomography-computed tomography (PET/CT) and to permit imaging a portion of the body through the garment (<NUM>), wherein the garment (<NUM>) further comprises grid markings that are configured to be visible in computed tomography images through the garment (<NUM>);
marking the body with a plurality of fiducial markers (<NUM>);
attaching the garment (<NUM>) to the body in a repeatable position using the fiducial markers (<NUM>);
imaging the body with the garment (<NUM>) in the repeatable position using a PET/CT scanner to generate images showing the organs and the grid markings;
fixing a plurality of radiation detectors (<NUM>) to the garment (<NUM>) in locations based on the image obtained from the PET/CT scanner, wherein the detectors (<NUM>) are positioned to detect radiation emitted from the organ, and
wherein the detectors (<NUM>) are operatively connectable to the computer and configured to transmit signals characterizing the radiation detected by the detectors (<NUM>) to the computer; and
attaching the garment (<NUM>) to the body in the repeatable position after the body has been injected with a radionuclide and transmitting signals corresponding to the radiation detected by the detectors (<NUM>) to the computer.