scholarly journals Evaluation of 18F-FDG PET/CT images acquired with a reduced scan time duration in lymphoma patients using the digital biograph vision

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Manuel Weber ◽  
Walter Jentzen ◽  
Regina Hofferber ◽  
Ken Herrmann ◽  
Wolfgang Peter Fendler ◽  
...  
Keyword(s):  
Radiation Exposure ◽  
Fdg Pet ◽  
Diagnostic Performance ◽  
Systemic Treatment ◽  
Time Duration ◽  
Tracer Activity ◽  
Scan Time ◽  
Pet Ct ◽  
Digital Pet ◽  
Fdg Pet Ct

Abstract Background The superior accuracy and sensitivity of 18F-FDG-PET/CT in comparison to morphological imaging alone leads to an upstaging in up to 30% of lymphoma patients. Novel digital PET/CT scanners might enable to reduce administered tracer activity or scan time duration while maintaining diagnostic performance; this might allow for a higher patient throughput or a reduced radiation exposure, respectively. In particular, the radiation exposure reduction is of interest due to the often young age and high remission rate of lymphoma patients. Methods Twenty patients with (suspected) lymphoma (6 for initial staging, 12 after systemic treatment, 2 in suspicion of recurrence) sequentially underwent 18F-FDG-PET/CT examinations on a digital PET/CT (Siemens Biograph Vision) with a total scan time duration of 15 min (reference acquisition protocol) and 5 min (reduced acquisition protocol) using continuous-bed-motion. Both data sets were reconstructed using either standalone time of flight (TOF) or in combination with point spread function (PSF), each with 2 and 4 iterations. Lesion detectability by blinded assessment (separately for supra- and infradiaphragmal nodal lesions and for extranodal lesions), lesion image quantification, and image noise were used as metrics to assess diagnostic performance. Additionally, Deauville Score was compared for all patients after systemic treatment. Results All defined regions were correctly classified in the images acquired with reduced emission time, and therefore, no changes in staging were observed. Lesion quantification was acceptable, that is, mean absolute percentage deviation of maximum and peak standardized uptake values were 6.8 and 6.4% (derived from 30 lesions). A threefold reduction of scan time duration led to an increase in image noise from 7.1 to 11.0% (images reconstructed with 4 iterations) and from 4.7 to 7.2% (images reconstructed with 2 iterations). No deviations in Deauville Score were observed. Conclusion These results suggest that scan time duration or administered tracer activity can be reduced threefold without compromising diagnostic performance. Especially a reduction of administered activity might allow for a lower radiation exposure and better health economics. Larger trials are warranted to confirm our results.

scholarly journals Evaluation of 18F-FDG PET/CT Images Acquired with a Reduced Scan Time Duration in Lymphoma Patients using the Digital Biograph Vision

2020 ◽  
Author(s):  
Manuel Weber ◽  
Walter Jentzen ◽  
Regina Hofferber ◽  
Ken Herrmann ◽  
Wolfgang Peter Fendler ◽  
...  
Keyword(s):  
Radiation Exposure ◽  
Fdg Pet ◽  
Diagnostic Performance ◽  
Systemic Treatment ◽  
Time Duration ◽  
Tracer Activity ◽  
Scan Time ◽  
Pet Ct ◽  
Digital Pet ◽  
Fdg Pet Ct

Abstract Background: The superior accuracy and sensitivity of 18F-FDG-PET/CT in comparison to morphological imaging alone leads to an upstaging in up to 30 % of lymphoma patients. Novel digital PET/CT scanners might enable to reduce administered tracer activity or scan time duration while maintaining diagnostic performance; this might allow for a higher patient throughput or a reduced radiation exposure, respectively. In particular, the radiation exposure reduction is of interest due to the often young age and high remission rate of lymphoma patients.Methods: Twenty patients with (suspected) lymphoma (6 for initial staging, 12 after systemic treatment, 2 in suspicion of recurrence) sequentially underwent 18F-FDG-PET/CT examinations on a digital PET/CT (Siemens Biograph Vision) with a total scan time duration of 15 minutes (reference acquisition protocol) and 5 minutes (reduced acquisition protocol) using continuous-bed-motion. Both data sets were reconstructed using either standalone time of flight (TOF) or in combination with point spread function (PSF), each with 2 and 4 iterations. Lesion detectability by blinded assessment (separately for supra- and infradiaphragmal nodal lesions and for extranodal lesions), lesion image quantification, and image noise were used as metrics to assess diagnostic performance. Additionally, Deauville Score was compared for all patients after systemic treatment.Results: All defined regions were correctly classified in the images acquired with reduced emission time, and therefore, no changes in staging were observed. Lesion quantification was acceptable, that is, mean absolute percentage deviation of maximum and peak standardized uptake values were 6.8% and 6.4% (derived from 30 lesions). A threefold reduction of scan time duration led to an increase in image noise from 7.1% to 11.0% (images reconstructed with 4 iterations) and from 4.7% to 7.2% (images reconstructed with 2 iterations). No deviations in Deauville Score were observed.Conclusion: These results suggest that scan time duration or administered tracer activity can be reduced threefold without compromising diagnostic performance. Especially a reduction of administered activity might allow for a lower radiation exposure and better health economics. Larger trials are warranted to confirm our results.

scholarly journals Evaluation of 18F-FDG PET/CT Images Acquired with a Reduced Scan Time Duration in Lymphoma Patients using the Digital Biograph Vision

2020 ◽  
Author(s):  
Manuel Weber ◽  
Walter Jentzen ◽  
Regina Hofferber ◽  
Ken Herrmann ◽  
Wolfgang Peter Fendler ◽  
...  
Keyword(s):  
Radiation Exposure ◽  
Fdg Pet ◽  
Diagnostic Performance ◽  
Systemic Treatment ◽  
Time Duration ◽  
Tracer Activity ◽  
Scan Time ◽  
Pet Ct ◽  
Digital Pet ◽  
Fdg Pet Ct

Abstract Background The superior accuracy and sensitivity of 18 F-FDG-PET/CT in comparison to morphological imaging alone leads to an upstaging in up to 30% of lymphoma patients. Novel digital PET/CT scanners might enable to reduce administered tracer activity or scan time duration while maintaining diagnostic performance; this might allow for a higher patient throughput or a reduced radiation exposure, respectively. In particular, the radiation exposure reduction is of interest due to the often young age and high remission rate of lymphoma patients. Methods Twenty patients with (suspected) lymphoma (6 for initial staging, 12 after systemic treatment, 2 in suspicion of recurrence) sequentially underwent 18 F-FDG-PET/CT examinations on a digital PET/CT (Siemens Biograph Vision) with a total scan time duration of 15 minutes (reference acquisition protocol) and 5 minutes (reduced acquisition protocol) using continuous-bed-motion. Both data sets were reconstructed using either standalone time of flight (TOF) or in combination with point spread function (PSF), each with 2 and 4 iterations. Lesion detectability by blinded assessment (separately for supra- and infradiaphragmal nodal lesions and for extranodal lesions), lesion image quantification, and image noise were used as metrics to assess diagnostic performance. Additionally, Deauville Score was compared for all patients after systemic treatment. Results All defined regions were correctly classified in the images acquired with reduced emission time, and therefore, no changes in staging were observed. Lesion quantification was acceptable, that is, mean absolute percentage deviation of maximum and peak standardized uptake values were 6.8% and 6.4% (derived from 30 lesions). A threefold reduction of scan time duration led to an increase in image noise from 7.1% to 11.0% (images reconstructed with 4 iterations) and from 4.7% to 7.2% (images reconstructed with 2 iterations). No deviations in Deauville Score were observed. Conclusion These results suggest that scan time duration or administered tracer activity can be reduced threefold without compromising diagnostic performance. Especially a reduction of administered activity might allow for a lower radiation exposure and better health economics. Larger trials are warranted to confirm our results.

scholarly journals Evaluation of 18F-FDG PET/CT Images Acquired with a Reduced Scan Time Duration in Lymphoma Patients using the Digital Biograph Vision

2021 ◽  
Author(s):  
Manuel Weber ◽  
Walter Jentzen ◽  
Regina Hofferber ◽  
Ken Herrmann ◽  
Wolfgang Peter Fendler ◽  
...  
Keyword(s):  
Radiation Exposure ◽  
Fdg Pet ◽  
Diagnostic Performance ◽  
Systemic Treatment ◽  
Time Duration ◽  
Tracer Activity ◽  
Scan Time ◽  
Pet Ct ◽  
Digital Pet ◽  
Fdg Pet Ct

Abstract Background The superior accuracy and sensitivity of 18 F-FDG-PET/CT in comparison to morphological imaging alone leads to an upstaging in up to 30% of lymphoma patients. Novel digital PET/CT scanners might enable to reduce administered tracer activity or scan time duration while maintaining diagnostic performance; this might allow for a higher patient throughput or a reduced radiation exposure, respectively. In particular, the radiation exposure reduction is of interest due to the often young age and high remission rate of lymphoma patients. Methods Twenty patients with (suspected) lymphoma (6 for initial staging, 12 after systemic treatment, 2 in suspicion of recurrence) sequentially underwent 18 F-FDG-PET/CT examinations on a digital PET/CT (Siemens Biograph Vision) with a total scan time duration of 15 minutes (reference acquisition protocol) and 5 minutes (reduced acquisition protocol) using continuous-bed-motion. Both data sets were reconstructed using either standalone time of flight (TOF) or in combination with point spread function (PSF), each with 2 and 4 iterations. Lesion detectability by blinded assessment (separately for supra- and infradiaphragmal nodal lesions and for extranodal lesions), lesion image quantification, and image noise were used as metrics to assess diagnostic performance. Additionally, Deauville Score was compared for all patients after systemic treatment. Results All defined regions were correctly classified in the images acquired with reduced emission time, and therefore, no changes in staging were observed. Lesion quantification was acceptable, that is, mean absolute percentage deviation of maximum and peak standardized uptake values were 6.8% and 6.4% (derived from 30 lesions). A threefold reduction of scan time duration led to an increase in image noise from 7.1% to 11.0% (images reconstructed with 4 iterations) and from 4.7% to 7.2% (images reconstructed with 2 iterations). No deviations in Deauville Score were observed. Conclusion These results suggest that scan time duration or administered tracer activity can be reduced threefold without compromising diagnostic performance. Especially a reduction of administered activity might allow for a lower radiation exposure and better health economics. Larger trials are warranted to confirm our results.

scholarly journals Evaluation of 18F-FDG PET/CT Images Acquired with a Reduced Scan Time Duration in Lymphoma Patients using the Digital Biograph Vision

2020 ◽  
Author(s):  
Manuel Weber ◽  
Walter Jentzen ◽  
Regina Hofferber ◽  
Ken Herrmann ◽  
Wolfgang Peter Fendler ◽  
...  
Keyword(s):  
Radiation Exposure ◽  
Fdg Pet ◽  
Diagnostic Performance ◽  
Systemic Treatment ◽  
Time Duration ◽  
Tracer Activity ◽  
Scan Time ◽  
Pet Ct ◽  
Digital Pet ◽  
Fdg Pet Ct

Abstract Background: The superior accuracy and sensitivity of 18F-FDG-PET/CT in comparison to morphological imaging alone leads to an upstaging in up to 30 % of lymphoma patients. Novel digital PET/CT scanners might enable to reduce administered tracer activity or scan time duration while maintaining diagnostic performance; this might allow for a higher patient throughput or a reduced radiation exposure, respectively. In particular, the radiation exposure reduction is of interest due to the often young age and high remission rate of lymphoma patients.Methods: Twenty patients with (suspected) lymphoma (6 for initial staging, 12 after systemic treatment, 2 in suspicion of recurrence) sequentially underwent 18F-FDG-PET/CT examinations on a digital PET/CT (Siemens Biograph Vision) with a total scan time duration of 15 minutes (reference acquisition protocol) and 5 minutes (reduced acquisition protocol) using continuous-bed-motion. Both data sets were reconstructed using either standalone time of flight (TOF) or in combination with point spread function (PSF), each with 2 and 4 iterations. Lesion detectability by blinded assessment (separately for supra- and infradiaphragmal nodal lesions and for extranodal lesions), lesion image quantification, and image noise were used as metrics to assess diagnostic performance. Additionally, Deauville Score was compared for all patients after systemic treatment.Results: All defined regions were correctly classified in the images acquired with reduced emission time, and therefore, no changes in staging were observed. Lesion quantification was acceptable, that is, mean absolute percentage deviation of maximum and peak standardized uptake values were 6.8% and 6.4% (derived from 30 lesions). A threefold reduction of scan time duration led to an increase in image noise from 7.1% to 11.0% (images reconstructed with 4 iterations) and from 4.7% to 7.2% (images reconstructed with 2 iterations). No deviations in Deauville Score were observed.Conclusion: These results suggest that scan time duration or administered tracer activity can be reduced threefold without compromising diagnostic performance. Especially a reduction of administered activity might allow for a lower radiation exposure and better health economics. Larger trials are warranted to confirm our results.

scholarly journals The Multicenter Italian Trial Assesses the Performance of FDG-PET /CT Related to Pre-Test Cancer Risk in Patients with Solitary Pulmo n ary Nodules and Introduces a Segmental Thoracic Diagnostic Strategy

2020 ◽  
Vol 13 (3) ◽  
pp. 243-248
Author(s):  
Marco Spadafora ◽  
Laura Evangelista ◽  
Salvatore Fiordoro ◽  
Francesco Porcaro ◽  
Marilena Sicignano ◽  
...  
Keyword(s):  
Cancer Risk ◽  
Radiation Exposure ◽  
Fdg Pet ◽  
Whole Body ◽  
Predictive Values ◽  
Fdg Uptake ◽  
Scan Time ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

Purpose: The Italian Tailored Assessment of Lung Indeterminate Accidental Nodule (ITALIAN) trial is a trial drawn to determine the performance of 18F-FDG-PET/CT in patients with solitary pulmonary nodules (SPN), stratified for a different kind of risk. An additional end-point was to compare the diagnostic information and estimated dosimetry, provided by a segmental PET/CT (s-PET/CT) acquisition instead of a whole body PET/CT (wb-PET/CT), in order to evaluate if segmental thoracic PET/CT can be used in patients with SPN. Methods: 18F-FDG PET/CT of 502 patients, stratified for pre-test cancer risk, was retrospectively analyzed. FDG uptake in SPN was assessed by a 4-point scoring (4PS) system and a semiquantitative analysis using the ratio between SUVmax in SPN and SUVmean in mediastinal blood pool (BP), and between SUVmax in SPN and SUVmean in the liver (L). Histopathology and/or follow-up data were used as a standard of reference. Data obtained on the thoracic part of wb-PET/CT, defined as s - PET/CT, were compared with those deriving from wb-PET/CT. Results: SPNs were malignant in 180 patients (36%), benign in 175 (35%), and indeterminate in 147 (29%). The 355 patients diagnosed with a definitive SPN nature (malignant or benign) were considered for the analysis of PET performance. Sensitivity, specificity, positive (PPV) and negative (NPV) predictive values, and accuracy were 85.6%, 85.7%, 86%, 85.2%, and 85.6%, respectively. Sensitivity and PPV were higher in intermediate and high-risk patients. : 18F-FDG uptake indicative of thoracic and extra-thoracic lesions was detectable in 13% and 3% of the patients. Compared to wb-PET/CT, s-PET/CT could save about 2/3 of 18F-FDG dose, radiation exposure or scan-time, without affecting the clinical impact of PET/CT. Conclusion: In patients with SPN, the pre-test likelihood of malignancy stratification allows to better define PET clinical setting and its diagnostic power. In subjects with low-intermediate pre-test likelihood of malignancy, s-PET/CT might be planned in advance. The adoption of this segmental strategy could reduce radiation exposure, scan-time, and might allow individually targeted protocols.

Diagnostic performance of 18F-FDG PET/CT, ultrasonography and MRI

2014 ◽  
Vol 53 (03) ◽  
pp. 89-94 ◽  
Author(s):  
D. H. Lee ◽  
J.-K Yoon ◽  
S. J. Lee ◽  
T. H. Kim ◽  
D. K. Kang ◽  
...  
Keyword(s):  
Lymph Node ◽  
Fdg Pet ◽  
Axillary Lymph Node ◽  
Diagnostic Performance ◽  
Axillary Lymph ◽  
Diagnostic Ability ◽  
Node Metastasis ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

SummaryThe aim of this study was to evaluate the diagnostic abilities of 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) compared with those of ultrasonography and magnetic resonance imaging (MRI) for axillary lymph node staging in breast cancer patients. Patients, methods: Pre- operative 18F-FDG PET/non-contrast CT, ultrasonography and MRI were performed in 215 women with breast cancer. Axillary lymph node dissection was performed in all patients and the diagnostic performance of each modality was evaluated using histopathologic assessments as the reference standard. ROC curves were compared to evaluate the diagnostic ability of several imaging modalities (i. e., ultrasonography, MRI and 18F-FDG PET/CT). Results: In total, 132 patients (61.4%) had axillary lymph node metastasis. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for the detection of axillary lymph node metastasis were 72.3%, 77.3%, 66.7%, 81.6%, 75.3% for ultrasonography, 67.5%, 78.0%, 65.9%, 79.2%, 74.0% for MRI, and 62.7%, 88.6%, 77.6%, 79.1%, 78.6% for 18F-FDG PET/CT, respectively. There was no significant difference in diagnostic ability among the imaging modalities (i.e., ultrasonography, MRI and 18F-FDG PET/CT). The diagnostic ability of 18F-FDG PET/CT was significantly improved by combination with MRI (p = 0.0002) or ultrasonography (p < 0.0001). The combination of 18F-FDG PET/CT with ultrasonography had a similar diagnostic ability to that of all three modalities combined (18F-FDG PET/CT+ultraso- nography+MRI, p = 0.05). Conclusion: The diagnostic performance of 18F-FDG PET/CT for detection of axillary node metastasis was not significantly different from that of ultrasonography or MRI in breast cancer patients. Combining 18F-FDG PET/CT with ultrasonography or MRI could improve the diagnostic performance compared to 18F-FDG PET/CT alone.

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

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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