Image quality and lesion detectability in low-dose pediatric 18F-FDG scans using total-body PET/CT

Author(s):  
Yu-Mo Zhao ◽  
Ying-He Li ◽  
Tao Chen ◽  
Wei-Guang Zhang ◽  
Lin-Hao Wang ◽  
...  
2020 ◽  
Vol 47 (11) ◽  
pp. 2507-2515 ◽  
Author(s):  
Yi-Qiu Zhang ◽  
Peng-Cheng Hu ◽  
Run-Ze Wu ◽  
Yu-Shen Gu ◽  
Shu-Guang Chen ◽  
...  

2021 ◽  
Author(s):  
Ying-Ying Hu ◽  
Yu-Mo Zhao ◽  
Tao Chen ◽  
Wei-Guang Zhang ◽  
Lin-Hao Wang ◽  
...  

Abstract Purpose: To investigate the effects of dose reduction on image quality and lesion detectability of oncological 18F-FDG total-body PET/CT in paediatric oncological patients, and explore the minimum threshold of administered tracer activity.Methods: A total of 33 paediatric patients (weight, 8.5–58.5 kg; age 0.8–17.6 years) underwent total-body PET/CT using uEXPLORER scanner with an 18F-FDG administered dose of 3.7 MBq/kg and an acquisition time of 600 s were retrospectively enrolled. Low-dose images (0.12 – 1.85 MBq/kg) were simulated by truncating the list-mode PET data to reducing count density. Subjective image quality was rated on a 5-point scale. Semi-quantitative uptake metrics for low-dose images were assessed using region-of-interest (ROI) analysis of healthy liver and suspected lesions and were compared to full-dose images. The micro-lesion detectability was compared among the dose-dependent PET images.Results: Our analysis shows that sufficient subjective image quality and lesion conspicuity could be maintained down to 1/30th (0.12 MBq/kg) of the administered dose of 18F-FDG, where good image quality scores were given to 1/2- and 1/10- dose groups. The image noise was significantly more deranged than the overall quality and lesion conspicuity in 1/30- to 1/10-dose groups (all P < 0.05). With reduced doses, quantitative analysis of ROIs showed that SUVmax and SD in the liver increased gradually (P < 0.05), but SUVmax in the lesions and lesion-to-background ratio (LBR) showed no significant deviation down to 1/30-dose. 100% of the 18F-FDG-avid micro-lesions identified in full-dose images were localised down to 1/15-dose images; while 97% of the lesion were localized in 1/30-dose images.Conclusion: The total-body PET/CT might significantly decrease the administered dose upon maintaining the image quality and diagnostic performance of micro-lesions in paediatric patients. Data suggests that using total-body PET/CT, optimal image quality could be achieved with an administered dose-reduction down to 1/10-dose (0.37 MBq/kg).


2021 ◽  
Author(s):  
Jie Xiao ◽  
Haojun Yu ◽  
Hongyan Yin ◽  
Guobin Liu ◽  
Yan Hu ◽  
...  

Abstract Purpose To explore the feasibility of a low dose regimen with short acquisition time of 68Ga-DOTATATE total-body PET/CT without compromising image quality of patients with NETs. Methods Fifty-seven consecutive NETs patients who underwent 68Ga-DOTATATE total-body PET/CT, with a low dose regimen (0.8-1.2 MBq/kg) of 68Ga-DOTATATE and acquisition time of 10 min prior to any treatment, were enrolled in the present study. The PET data were split into 1 min, 2 min, 3 min, 4 min, 5 min, 8 min and 10 min reconstruction groups, referenced as R1, R2, R3, R4, R5, R8 and R10. The subjective evaluation of image quality was scored in 5-point Likert scale based on three aspects: the overall impression of the image quality, the image noise, the lesion detectability. The objective image quality was assessed by the signal-to-noise ratio of liver (SNRL), the coefficient of variation (CV), the SUVmax, SUVmean, SD of liver, mediastinal blood pool and lesion, the tumor-liver ratio (TLR), the tumor-mediastinal blood pool-ratio (TMR) of lesion. Results The sufficient subjective image quality with a score of 3.44±0.53 could be obtained at 3 min acquisition duration, with a kappa value of 0.90. In quantitative analysis, the value of SNRL is over 10 in all reconstruction groups. As the acquisition time increases, SNRL was increased and CV was decreased within 3 min, while SNRL and CV showed no significant different between R4-R10. There was no significant different in TMR and TLR of lesion between R1-R10 (all p < 0.05). Referenced as PET images of R10, 90 SSTR-positive lesions are identified, and all those lesions are found in the R1-R10 groups (100%).Conclusion The low-dose (0.8-1.2 MBq/kg) 68Ga-DOTATATE total-body PET/CT not only shortens acquisition time, but maintains a sufficient image quality for the NETs patients.


2008 ◽  
Vol 47 (01) ◽  
pp. 37-42 ◽  
Author(s):  
T. Pfluger ◽  
V. Schneider ◽  
M. Hacker ◽  
N. Bröckel ◽  
D. Morhard ◽  
...  

SummaryAim: Assessment of the clinical benefit of i.v. contrast enhanced diagnostic CT (CE-CT) compared to low dose CT with 20 mAs (LD-CT) without contrast medium in combined [18F]-FDG PET/CT examinations in restaging of patients with lymphoma. Patients, methods: 45 patients with non-Hodgkin lymphoma (n = 35) and Hodgkin's disease (n = 10) were included into this study. PET, LD-CT and CECT were analyzed separately as well as side-by-side. Lymphoma involvement was evaluated separately for seven regions. Indeterminate diagnoses were accepted whenever there was a discrepancy between PET and CT findings. Results for combined reading were calculated by rating indeterminate diagnoses according the suggestions of either CT or PET. Each patient had a clinical follow-up evaluation for >6 months. Results: Region-based evaluation suggested a sensitivity/specificity of 66/93% for LD-CT, 87%/91% for CE-CT, 95%/96% for PET, 94%/99% for PET/LD-CT and 96%/99% for PET/CE-CT. The data for PET/CT were obtained by rating indeterminate results according to the suggestions of PET, which turned out to be superior to CT. Lymphoma staging was changed in two patients using PET/ CE-CT as compared to PET/LD-CT. Conclusion: Overall, there was no significant difference between PET/LD-CT and PET/CE-CT. However, PET/CE-CT yielded a more precise lesion delineation than PET/LD-CT. This was due to the improved image quality of CE-CT and might lead to a more accurate investigation of lymphoma.


Author(s):  
Pengcheng Hu ◽  
Yiqiu Zhang ◽  
Haojun Yu ◽  
Shuguang Chen ◽  
Hui Tan ◽  
...  

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e20549-e20549
Author(s):  
Hui Liu ◽  
Xu Zhang ◽  
Hui Liu ◽  
Bo Qiu ◽  
DaQuan Wang ◽  
...  

e20549 Background: Total body positron emission tomography (PET) of uExplorer enables imaging of highly quantitative parameters beyond the standardized uptake value (SUV). The aim of this prospective study is to assess the dynamic changes of 2-deoxy-2-[18F]fluoro-D-glucose ([18F]FDG) uptake in characterizing tumor heterogeneity of non-small cell lung cancer (NSCLC). Methods: Sixteen NSCLC patients were prospectively enrolled in a prospective study (NCT04654234, GASTO-1067) between September 2020 and December 2020. All patients underwent a dynamic total-body 18F-FDG PET/CT scan before any treatment. The primary lung tumor, metastatic regional lymph node and inflammatory lymph node were manually delineated by a nuclear medicine physician and a radiation oncologist. Total Body PET was acquired between 0 – 60 mins after the injection of FDG from the subject’s feet. We compared lesion heterogeneity and different image-derived PET metrics including the SUV-mean, Patlak-derived influx rate constant (Ki) and distribution volume (DV). Results: The SUV-mean and Ki-mean of primary lung tumor and metastatic lymph node were significantly higher than inflammatory lymph node (p < 0.001), while there was no significantly different of DV(p > 0.05). By the scatter plot of SUV-mean and Ki-mean of primary lung tumor, 9 patients had been separated into high dynamic FDG metabolic (H-DFM) group and 7 in low DFM(L-DFM) group. The SUV-mean(p = 0.0002) and Ki-mean(p = 0.0002) of primary lung tumor were significantly higher in H-DFM group, whereas there is no difference in metastatic lymph node of both group. Interestingly, the SUV-mean and Ki-mean of primary lung tumor were higher than that of metastatic lymph node(p = 0.0002) in H-DFM group. On the contrast, the SUV-mean and Ki-mean of primary lung tumor were lower than that of metastatic lymph node(p = 0.05) in L-DFM group. There is no significant difference of DV-mean among primary lung tumor, metastatic lymph node and inflammatory lymph node in both arms. Conclusions: The results demonstrated that dynamic parameters from total body PET scan has the potential of providing complementary information of tumor heterogeneity in NSCLC than conventional static SUV imaging. The characteristics of H-DFM and L-DFM group could be taken into account for evaluation of further treatment response.


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