Rescue Protocol to Improve the Image Quality of 18F-FDG PET/CT Myocardial Metabolic Imaging

Introduction: 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) plays a key role in oncology, and it is now being used increasingly to diagnose, characterize, and monitor disease activity in inflammatory disorders, including vasculitis. Unfortunately, its role in the management of vasculitis is still not well-defined, and clinicians are often unsure how this metabolic imaging technique should be used in these diseases, although its usefulness in diagnosing large-vessel vasculitis has been clearly demonstrated. Materials and methods: We reviewed the literature about the use of PET/CT in the management of vasculitis in an attempt to identify the applications and the limitations of this technique in clinical practice. Results and discussion: Our literature review revealed that 18F-FDG PET/CT is a useful tool for diagnosing vasculitis (especially when the symptoms of the disease are non-specific); guiding biopsy procedures (areas with high glucose consumption); evaluating disease extension; and monitoring treatment responses. The main limitations of this method are the relatively low spatial resolution of the tomograph, which can lead to false-negative results in the presence of small-vessel vasculitis, and risk of false positive results, especially those related to the presence of atherosclerosis and to post-treatment vascular remodeling.

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Randomized Controlled Trial Examining Effects of Web-Based Information on Patient Satisfaction and Image Quality in 18F-FDG PET/CT Examinations

Journal of Nuclear Medicine Technology ◽

10.2967/jnmt.118.213116 ◽

2018 ◽

Vol 47 (1) ◽

pp. 39-46

Author(s):

Camilla Andersson ◽

Carlos Trampal Pulido ◽

Håkan Ahlström ◽

Birgitta Johansson

Keyword(s):

Randomized Controlled Trial ◽

Patient Satisfaction ◽

Image Quality ◽

Fdg Pet ◽

Controlled Trial ◽

Web Based ◽

Randomized Controlled ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct

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The Effect of Electroencephalography Leads on Image Quality in Cerebral Perfusion SPECT and 18F-FDG PET/CT

Journal of Nuclear Medicine Technology ◽

10.2967/jnmt.117.207621 ◽

2018 ◽

Vol 46 (4) ◽

pp. 359-361

Author(s):

Lulu Zhang ◽

Stephanie P. Yen ◽

Marc A. Seltzer ◽

George P. Thomas ◽

Kristen Willis ◽

...

Keyword(s):

Image Quality ◽

Fdg Pet ◽

Cerebral Perfusion ◽

Pet Ct ◽

Perfusion Spect ◽

18F Fdg ◽

Fdg Pet Ct

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A critical appraisal of the quality of 18F-FDG PET/CT guidelines in oncology using the AGREE II tool: A EuroAIM initiative

European Journal of Radiology ◽

10.1016/j.ejrad.2020.108930 ◽

2020 ◽

Vol 126 ◽

pp. 108930

Author(s):

Valeria Romeo ◽

Arnaldo Stanzione ◽

Valeria Gaudieri ◽

Carmela Nappi ◽

Renato Cuocolo ◽

...

Keyword(s):

Fdg Pet ◽

Critical Appraisal ◽

Agree Ii ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct ◽

Agree Ii Tool

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Could Different Hydration Protocols Affect the Quality of 18F-FDG PET/CT Images?

Journal of Nuclear Medicine Technology ◽

10.2967/jnmt.110.081265 ◽

2011 ◽

Vol 39 (2) ◽

pp. 77-82 ◽

Cited By ~ 8

Author(s):

L. Ceriani ◽

S. Suriano ◽

T. Ruberto ◽

L. Giovanella

Keyword(s):

Fdg Pet ◽

Ct Images ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct

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Metabolic Imaging Phenotype Using Radiomics of [18F]FDG PET/CT Associated with Genetic Alterations of Colorectal Cancer

Molecular Imaging and Biology ◽

10.1007/s11307-018-1225-8 ◽

2018 ◽

Vol 21 (1) ◽

pp. 183-190 ◽

Cited By ~ 7

Author(s):

Shang-Wen Chen ◽

Wei-Chih Shen ◽

William Tzu-Liang Chen ◽

Te-Chun Hsieh ◽

Kuo-Yang Yen ◽

...

Keyword(s):

Colorectal Cancer ◽

Fdg Pet ◽

Genetic Alterations ◽

Metabolic Imaging ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct

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Ultrashort-acting insulin may improve on 18F-FDG PET/CT image quality in patients with uncontrolled diabetic mellitus

Nuclear Medicine Communications ◽

10.1097/mnm.0b013e32836066a2 ◽

2013 ◽

Vol 34 (6) ◽

pp. 527-532 ◽

Cited By ~ 4

Author(s):

Hee-Sung Song ◽

Joon-Kee Yoon ◽

Su Jin Lee ◽

Seok-Ho Yoon ◽

Kyung-Sook Jo ◽

...

Keyword(s):

Image Quality ◽

Fdg Pet ◽

Ct Image ◽

Diabetic Mellitus ◽

Acting Insulin ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct ◽

Ct Image Quality

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Heterogeneous Response to Immunotherapy in a Patient with Tonsillar Squamous Cell Carcinoma Assessed by 18F-FDG PET/CT

Diagnostics ◽

10.3390/diagnostics11020348 ◽

2021 ◽

Vol 11 (2) ◽

pp. 348

Author(s):

Artor Niccoli Asabella ◽

Anna Giulia Nappi ◽

Orsola Trani ◽

Angela Sardaro ◽

Giuseppe Rubini

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Fdg Pet ◽

Metabolic Imaging ◽

Drug Discontinuation ◽

Platinum Based Chemotherapy ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct

Tonsillar carcinoma is the second most common malignancy of the head and neck region, with Squamous Cell Carcinoma (TSCC) as the most common histological type (>90%). For the advanced stage of TSCC, radiotherapy with or without platinum-based chemotherapy is the only therapeutic option. Immuno-checkpoint inhibitors (ICIs), in particular Nivolumab, considerably improves clinical management of these patients, but the response can be unpredictable. Difficulties can be encountered in evaluating response to immunotherapy, especially with morphological imaging, which can show an atypical response, such as pseudo-progression, leading to a premature discontinuation. Conversely, metabolic imaging can guide a more properly therapeutic decision. We present a case of a 71-year-old man affected by TSCC, treated with chemotherapy, radiotherapy, and Nivolumab as the last line of treatment. Pre- and post-immunotherapy 18F-FDG PET/CT showed an impressive response, avoiding early drug discontinuation and ensuring better management of this patient.

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

Molecular Imaging and Biology ◽

10.1007/s11307-021-01601-4 ◽

2021 ◽

Author(s):

Hunor Kertész ◽

Thomas Beyer ◽

Kevin London ◽

Hamda Saleh ◽

David Chung ◽

...

Keyword(s):

Image Quality ◽

Fdg Pet ◽

Signal To Noise Ratio ◽

Paediatric Oncology ◽

Whole Body ◽

Oncology Patients ◽

Pet Ct ◽

18F Fdg ◽

Noise Ratio ◽

Fdg Pet Ct

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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