Long axial field of view PET scanners: a road map to implementation and new possibilities

AbstractIn this contribution, several opportunities and challenges for long axial field of view (LAFOV) PET are described. It is an anthology in which the main issues have been highlighted. A consolidated overview of the camera system implementation, business and financial plan, opportunities and challenges is provided. What the nuclear medicine and molecular imaging community can expect from these new PET/CT scanners is the delivery of more comprehensive information to the clinicians for advancing diagnosis, therapy evaluation and clinical research.

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The effect of modern PET technology and techniques on the EANM paediatric dosage card

European Journal of Nuclear Medicine and Molecular Imaging ◽

10.1007/s00259-021-05635-2 ◽

2021 ◽

Author(s):

John Dickson ◽

Uta Eberlein ◽

Michael Lassmann

Keyword(s):

Image Quality ◽

Field Of View ◽

Published Data ◽

Axial Field ◽

Short Article ◽

Pet Ct ◽

Class B ◽

Total Body ◽

Bed Position ◽

Pet Scanners

Abstract Aim Recent advancements in PET technology have brought with it significant improvements in PET performance and image quality. In particular, the extension of the axial field of view of PET systems, and the introduction of semiconductor technology into the PET detector, initially for PET/MR, and more recently available long-field-of-view PET/CT systems (≥ 25 cm) have brought a step change improvement in the sensitivity of PET scanners. Given the requirement to limit paediatric doses, this increase in sensitivity is extremely welcome for the imaging of children and young people. This is even more relevant with PET/MR, where the lack of CT exposures brings further dose reduction benefits to this population. In this short article, we give some details around the benefits around new PET technology including PET/MR and its implications on the EANM paediatric dosage card. Material and methods Reflecting on EANM adult guidance on injected activities, and making reference to bed overlap and the concept of MBq.min bed−1 kg−1, we use published data on image quality from PET/MR systems to update the paediatric dosage card for PET/MR and extended axial field of view (≥ 25 cm) PET/CT systems. However, this communication does not cover the expansion of paediatric dosing for the half-body and total-body scanners that have recently come to market. Results In analogy to the existing EANM dosage card, new parameters for the EANM paediatric dosage card were developed (class B, baseline value: 10.7 MBq, minimum recommended activity 10 MBq). The recommended administered activities for the systems considered in this communication range from 11 MBq [18F]FDG for a child with a weight of 3 kg to 149 MBq [18F]FDG for a paediatric patient weight of 68 kg, assuming a scan of 3 min per bed position. The mean effective dose over all ages (1 year and older) is 2.85 mSv. Conclusion With this, recommendations for paediatric dosing are given for systems that have not been considered previously.

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Performance evaluation of the uEXPLORER Total-body PET/CT scanner based on NEMA NU 2-2018 with additional tests to characterize long axial field-of-view PET scanners

Journal of Nuclear Medicine ◽

10.2967/jnumed.120.250597 ◽

2020 ◽

pp. jnumed.120.250597 ◽

Cited By ~ 1

Author(s):

Benjamin A. Spencer ◽

Eric Berg ◽

Jeffrey P. Schmall ◽

Negar Omidvari ◽

Edwin K. Leung ◽

...

Keyword(s):

Performance Evaluation ◽

Field Of View ◽

Ct Scanner ◽

Axial Field ◽

Pet Ct ◽

Total Body ◽

Pet Scanners

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Effective count rates for PET scanners with reduced and extended axial field of view

Physics in Medicine and Biology ◽

10.1088/0031-9155/56/12/011 ◽

2011 ◽

Vol 56 (12) ◽

pp. 3629-3643 ◽

Cited By ~ 18

Author(s):

L R MacDonald ◽

R L Harrison ◽

A M Alessio ◽

W C J Hunter ◽

T K Lewellen ◽

...

Keyword(s):

Field Of View ◽

Axial Field ◽

Pet Scanners

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Characterization of the scatter component in large axial field-of-view PET scanners: a Monte Carlo simulation study

2018 IEEE Nuclear Science Symposium and Medical Imaging Conference Proceedings (NSS/MIC) ◽

10.1109/nssmic.2018.8824762 ◽

2018 ◽

Author(s):

Amir Ghabrial ◽

Daniel Franklin ◽

Habib Zaidi

Keyword(s):

Monte Carlo Simulation ◽

Monte Carlo ◽

Simulation Study ◽

Field Of View ◽

Axial Field ◽

Monte Carlo Simulation Study ◽

Pet Scanners

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Clinical performance of long axial field of view PET/CT: a head-to-head intra-individual comparison of the Biograph Vision Quadra with the Biograph Vision PET/CT

European Journal of Nuclear Medicine and Molecular Imaging ◽

10.1007/s00259-021-05282-7 ◽

2021 ◽

Author(s):

Ian Alberts ◽

Jan-Niklas Hünermund ◽

George Prenosil ◽

Clemens Mingels ◽

Karl Peter Bohn ◽

...

Keyword(s):

Image Quality ◽

Low Dose ◽

Clinical Performance ◽

Visual Image ◽

Target Lesion ◽

Field Of View ◽

List Mode ◽

Axial Field ◽

Individual Comparison ◽

Pet Ct

Abstract Purpose To investigate the performance of the new long axial field-of-view (LAFOV) Biograph Vision Quadra PET/CT and a standard axial field-of-view (SAFOV) Biograph Vision 600 PET/CT (both: Siemens Healthineers) system using an intra-patient comparison. Methods Forty-four patients undergoing routine oncological PET/CT were prospectively included and underwent a same-day dual-scanning protocol following a single administration of either 18F-FDG (n = 20), 18F-PSMA-1007 (n = 16) or 68Ga-DOTA-TOC (n = 8). Half the patients first received a clinically routine examination on the SAFOV (FOVaxial 26.3 cm) in continuous bed motion and then immediately afterwards on the LAFOV system (10-min acquisition in list mode, FOVaxial 106 cm); the second half underwent scanning in the reverse order. Comparisons between the LAFOV at different emulated scan times (by rebinning list mode data) and the SAFOV were made for target lesion integral activity, signal to noise (SNR), target lesion to background ratio (TBR) and visual image quality. Results Equivalent target lesion integral activity to the SAFOV acquisitions (16-min duration for a 106 cm FOV) were obtained on the LAFOV in 1.63 ± 0.19 min (mean ± standard error). Equivalent SNR was obtained by 1.82 ± 1.00 min LAFOV acquisitions. No statistically significant differences (p > 0.05) in TBR were observed even for 0.5 min LAFOV examinations. Subjective image quality rated by two physicians confirmed the 10 min LAFOV to be of the highest quality, with equivalence between the LAFOV and the SAFOV at 1.8 ± 0.85 min. By analogy, if the LAFOV scans were maintained at 10 min, proportional reductions in applied radiopharmaceutical could obtain equivalent lesion integral activity for activities under 40 MBq and equivalent doses for the PET component of <1 mSv. Conclusion Improved image quality, lesion quantification and SNR resulting from higher sensitivity were demonstrated for an LAFOV system in a head-to-head comparison under clinical conditions. The LAFOV system could deliver images of comparable quality and lesion quantification in under 2 min, compared to routine SAFOV acquisition (16 min for equivalent FOV coverage). Alternatively, the LAFOV system could allow for low-dose examination protocols. Shorter LAFOV acquisitions (0.5 min), while of lower visual quality and SNR, were of adequate quality with respect to target lesion identification, suggesting that ultra-fast or low-dose acquisitions can be acceptable in selected settings.

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Feasibility of late acquisition [68Ga]Ga-PSMA-11 PET/CT using a long axial field-of-view PET/CT scanner for the diagnosis of recurrent prostate cancer—first clinical experiences

European Journal of Nuclear Medicine and Molecular Imaging ◽

10.1007/s00259-021-05438-5 ◽

2021 ◽

Author(s):

Ian Alberts ◽

George Prenosil ◽

Clemens Mingels ◽

Karl Peter Bohn ◽

Marco Viscione ◽

...

Keyword(s):

Image Quality ◽

Case Series ◽

Likert Scale ◽

Target Lesion ◽

Field Of View ◽

Ct Scanner ◽

Axial Field ◽

Retrospective Case ◽

Imaging Quality ◽

Pet Ct

Abstract Purpose While acquisition of images in [68 Ga]Ga-PSMA-11 following longer uptake times can improve lesion uptake and contrast, resultant imaging quality and count statistics are limited by the isotope’s half-life (68 min). Here, we present a series of cases demonstrating that when performed using a long axial field-of-view (LAFOV) PET/CT system, late imaging is feasible and can even provide improved image quality compared to regular acquisitions. Methods In this retrospective case series, we report our initial experiences with 10 patients who underwent standard imaging at 1 h p.i. following administration of 192 ± 36 MBq [68 Ga]Ga-PSMA-11 with additional late imaging performed at 4 h p.i. Images were acquired in a single bed position for 6 min at 1 h p.i. and 16 min p.i. at 4 h p.i. using a LAFOV scanner (106 cm axial FOV). Two experienced nuclear medicine physicians reviewed all scans in consensus and evaluated overall image quality (5-point Likert scale), lesion uptake in terms of standardised uptake values (SUV), tumour to background ratio (TBR) and target-lesion signal to background noise (SNR). Results Subjective image quality as rated on a 5-point Likert scale was only modestly lower for late acquisitions (4.2/5 at 4 h p.i.; 5/5 1 h p.i.), TBR was significantly improved (4 h: 3.41 vs 1 h: 1.93, p < 0.001) and SNR was improved with borderline significance (4 h: 33.02 vs 1 h: 24.80, p = 0.062) at later imaging. Images were obtained with total acquisition times comparable to routine examinations on standard axial FOV scanners. Conclusion Late acquisition in tandem with a LAFOV PET/CT resulted in improvements in TBR and SNR and was associated with only modest impairment in subjective visual imaging quality. These data show that later acquisition times for [68 Ga]Ga-PSMA-11 may be preferable when performed on LAFOV systems.

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