Reducing Radiation Exposure to Paediatric Patients Undergoing [18F]FDG-PET/CT Imaging

Abstract Purpose To investigate the possibility of reducing the injected activity for whole-body [18F]FDG-PET/CT studies of paediatric oncology patients and to assess the usefulness of time-of-flight (TOF) acquisition on PET image quality at reduced count levels. Procedures Twenty-nine paediatric oncology patients (12F/17M, 3–18 years old (median age 13y), weight 45±20 kg, BMI 19±4 kg/m2), who underwent routine whole-body PET/CT examinations on a Siemens Biograph mCT TrueV system with TOF capability (555ps) were included in this study. The mean injected activity was 156 ± 45 MBq (3.8 ± 0.8 kg/MBq) and scaled to patient weight. The raw data was collected in listmode (LM) format and pre-processed to simulate reduced levels of [18F]FDG activity (75, 50, 35, 20 and 10% of the original counts) by randomly removing events from the original LM data. All data were reconstructed using the vendor-specific e7-tools with standard OSEM only, with OSEM plus resolution recovery (PSF). The reconstructions were repeated with added TOF (TOF) and PSF+TOF. The benefit of TOF together with the reduced count levels was evaluated by calculating the gains in signal-to-noise ratio (SNR) in the liver and contrast-to-noise ratio (CNR) in all PET-positive lesions before and after TOF employed at every simulated reduced count level. Finally, the PSF+TOF images at 50, 75 and 100% of counts were evaluated clinically on a 5-point scale by three nuclear medicine physicians. Results The visual inspection of the reconstructed images did not reveal significant differences in image quality between 75 and 100% count levels for PSF+TOF. The improvements in SNR and CNR were the greatest for TOF reconstruction and PSF combined. Both SNR and CNR gains did increase linearly with the patients BMI for both OSEM only and PSF reconstruction. These benefits were observed until reducing the counts to 50 and 35% for SNR and CNR, respectively. Conclusions The benefit of using TOF was noticeable when using 50% or greater of the counts when evaluating the CNR and SNR. For [18F]FDG-PET/CT, whole-body paediatric imaging the injected activity can be reduced to 75% of the original dose without compromising PET image quality.

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The Impact of Acquisition Time on Image Quality in Whole-Body 18F-FDG PET/CT for Cancer Staging

Journal of Nuclear Medicine Technology ◽

10.2967/jnmt.112.103291 ◽

2012 ◽

Vol 40 (4) ◽

pp. 255-258 ◽

Cited By ~ 8

Author(s):

D. Hausmann ◽

D. J. Dinter ◽

M. Sadick ◽

J. Brade ◽

S. O. Schoenberg ◽

...

Keyword(s):

Image Quality ◽

Fdg Pet ◽

Cancer Staging ◽

Whole Body ◽

Acquisition Time ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct ◽

The Impact

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Total-body 18F-FDG PET/CT scan in oncology patients: how fast could it be?

European Journal of Nuclear Medicine and Molecular Imaging ◽

10.1007/s00259-021-05357-5 ◽

2021 ◽

Author(s):

Pengcheng Hu ◽

Yiqiu Zhang ◽

Haojun Yu ◽

Shuguang Chen ◽

Hui Tan ◽

...

Keyword(s):

Ct Scan ◽

Fdg Pet ◽

Oncology Patients ◽

Pet Ct ◽

18F Fdg ◽

Total Body ◽

Fdg Pet Ct ◽

Pet Ct Scan

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Low positive yield from routine inclusion of the brain in whole-body 18F-FDG PET/CT imaging for noncerebral malignancies

Nuclear Medicine Communications ◽

10.1097/mnm.0b013e32836066c0 ◽

2013 ◽

Vol 34 (6) ◽

pp. 540-543 ◽

Cited By ~ 8

Author(s):

Kuruva Manohar ◽

Anish Bhattacharya ◽

Bhagwant R. Mittal

Keyword(s):

Fdg Pet ◽

Ct Imaging ◽

Whole Body ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct ◽

The Brain

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Comparison of the diagnostic performance and impact on management of 18F-FDG PET/CT and whole-body MRI in multiple myeloma

European Journal of Nuclear Medicine and Molecular Imaging ◽

10.1007/s00259-020-05182-2 ◽

2021 ◽

Author(s):

Olwen Westerland ◽

◽

Ashik Amlani ◽

Christian Kelly-Morland ◽

Michal Fraczek ◽

...

Keyword(s):

Multiple Myeloma ◽

Clinical Data ◽

Bone Disease ◽

Fdg Pet ◽

Diagnostic Performance ◽

Whole Body ◽

Bone Lesions ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct

Abstract Purpose Comparative data on the impact of imaging on management is lacking for multiple myeloma. This study compared the diagnostic performance and impact on management of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) and whole-body magnetic resonance imaging (WBMRI) in treatment-naive myeloma. Methods Forty-six patients undergoing 18F-FDG PET/CT and WBMRI were reviewed by a nuclear medicine physician and radiologist, respectively, for the presence of myeloma bone disease. Blinded clinical and imaging data were reviewed by two haematologists in consensus and management recorded following clinical data ± 18F-FDG PET/CT or WBMRI. Bone disease was defined using International Myeloma Working Group (IMWG) criteria and a clinical reference standard. Per-patient sensitivity for lesion detection was established. McNemar test compared management based on clinical assessment ± 18F-FDG PET/CT or WBMRI. Results Sensitivity for bone lesions was 69.6% (32/46) for 18F-FDG PET/CT (54.3% (25/46) for PET component alone) and 91.3% (42/46) for WBMRI. 27/46 (58.7%) of cases were concordant. In 19/46 patients (41.3%) WBMRI detected more focal bone lesions than 18F-FDG PET/CT. Based on clinical data alone, 32/46 (69.6%) patients would have been treated. Addition of 18F-FDG PET/CT to clinical data increased this to 40/46 (87.0%) patients (p = 0.02); and WBMRI to clinical data to 43/46 (93.5%) patients (p = 0.002). The difference in treatment decisions was not statistically significant between 18F-FDG PET/CT and WBMRI (p = 0.08). Conclusion Compared to 18F-FDG PET/CT, WBMRI had a higher per patient sensitivity for bone disease. However, treatment decisions were not statistically different and either modality would be appropriate in initial staging, depending on local availability and expertise.

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POSITRON EMISSION TOMOGRAPHY WITH 18F -FDG IN THE DIAGNOSIS OF PROSTHETIC HEART VALVE ENDOCARDITIS

Emergency Cardiology and Cardiovascular Risks ◽

10.51922/2616-633x.2021.5.2.1151 ◽

2021 ◽

Vol 5 (1) ◽

pp. 1151-1160

Author(s):

A.S. Lukashevich ◽

Keyword(s):

Computed Tomography ◽

Positron Emission Tomography ◽

Fdg Pet ◽

Prosthetic Heart Valve ◽

Emission Tomography ◽

Whole Body ◽

Positron Emission ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct

Purpose. The purpose of the article is to evaluate the diagnostic significance of positron emission tomography / computed tomography with 18F -fluorodeoxyglucose (18F -FDG PET/CT) for the diagnosis of prosthetic endocarditis. Methods of research. The study included 82 patients with suspected prosthetic endocarditis in accordance with the criteria proposed by Duke University [1-5]. The patients received hospital treatment at the State Institution RSPC "Cardiology" from January 2016 to March 2021. The study was of a prospective, non-randomized, single-center cohort design. The duration of the monitor period was 12 months from the moment of patients’ inclusion in the study. Whole-body positron emission tomography / computed tomography (PET/CT) examinations were performed in 82 patients. 27 patients were selected for surgical treatment. Conservative treatment group included 16 patients. 27 patients were selected into the observation group, they were suspected to have prosthetic heart valve infection in the primary referral and underwent PET/CT scanning, according to which the diagnosis of prosthetic endocarditis was excluded. The event under the study did not develop in this group during the year of observation. Results and conclusion. The history of infective endocarditis was not statistically significant and did not increase the risk of developing prosthetic endocarditis in the sample presented. The Duke criteria are less reliable in establishing the diagnosis of prosthetic endocarditis. The median number of days from the date of the first prosthesis implantation to the onset of prosthetic endocarditis was about 4 years. This study revealed that the development of the infectious process in the area of the prosthesis was noted in a more distant postoperative period compared to literature data. Histological confirmation of infection was noted in 100% (27 patients) of cases in reoperated patients. The presence of a more formidable complication such as valve ring abscess located mainly in the projection of the aortic valve ring was quite common in both groups. Presepsin and Interleukin-6 have a statistically significant (U = 394,50 p = 0,01 and U = 94,50 p = 0.004) value in the prognosis of prosthetic endocarditis. Considering the data obtained from ROC analysis, it can be said that the cut-off point at which it is possible to diagnose prosthetic endocarditis based on PETCT is 2.85. The presented methods for the interpretation of whole-body FDG-PET/CT images of patients with suspected infectious complications after cardiac surgery, as well as with the presence of prosthetic endocarditis, show high sensitivity and specificity.

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Leydig cell tumor of the testis: an incidental finding at 18F-FDG PET/CT imaging

Egyptian Journal of Radiology and Nuclear Medicine ◽

10.1186/s43055-021-00646-3 ◽

2021 ◽

Vol 52 (1) ◽

Author(s):

Almalki Yassir

Keyword(s):

Leydig Cell ◽

Fdg Pet ◽

Chronic Rejection ◽

Ct Imaging ◽

The Body ◽

Whole Body ◽

Pet Ct ◽

18F Fdg ◽

The Right ◽

Fdg Pet Ct

Abstract Background Leydig cell tumors (LCTs) represent the most common form of stromal tumors. We reported the 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) findings of a patient with testicular LCT. Case presentation A 50-year-old man with a history of end-stage renal disease and renal transplantation 19 years ago. One year earlier, he started to have a chronic rejection. During the investigation to determine the cause of chronic rejection, a suspicious lesion in the graft with a collection around it was seen on ultrasound (US) images, raising the possibility of post-transplant lymphoproliferative disorder (PTLD). The patient was referred for further evaluation by whole body 18F-FDG PET/CT imaging. The image finding revealed an incidental hypermetabolic focal lesion in the right testicle—no other specific findings in the remaining parts of the body nor definitive FDG avid lymphadenopathy to suggest PTLD. Testicular US was requested and showed a well-defined right-sided heterogeneous hypoechoic intratesticular focal mass at the upper pole of the right testis with significant internal vascularity on the color Doppler imaging. The patient underwent a right radical orchidectomy, and the tumor was pathologically confirmed as an LCT. Conclusion In our case, 18F-FDG-PET/CT has been helpful in incidentally detecting this rare testicular tumor in a patient with suspected PTLD.

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