scholarly journals The effect of reduced scan time on response assessment FDG-PET/CT imaging using Deauville score in patients with lymphoma

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Charlotte Hornnes ◽  
Annika Loft ◽  
Liselotte Højgaard ◽  
Flemming Littrup Andersen
Keyword(s):  
Image Quality ◽  
Hodgkin Lymphoma ◽  
Fdg Pet ◽  
Response Assessment ◽  
Acquisition Time ◽  
List Mode ◽  
Deauville Score ◽  
Scan Time ◽  
Pet Ct ◽  
Fdg Pet Ct

Abstract Purpose [18F]Fluoro-deoxy-glucose positron emission tomography/computed tomography (FDG-PET/CT) is used for response assessment during therapy in Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL). Clinicians report the scans visually using Deauville criteria. Improved performance in modern PET/CT scanners could allow for a reduction in scan time without compromising diagnostic image quality. Additionally, patient throughput can be increased with increasing cost-effectiveness. We investigated the effects of reducing scan time of response assessment FDG-PET/CT in HL and NHL patients on Deauville score (DS) and image quality. Methods Twenty patients diagnosed with HL/NHL referred to a response assessment FDG-PET/CT were included. PET scans were performed in list-mode with an acquisition time of 120 s per bed position(s/bp). From PET list-mode data images with full acquisition time of 120 s/bp and shorter acquisition times (90, 60, 45, and 30 s/bp) were reconstructed. All images were assessed by two specialists and assigned a DS. We estimated the possible savings when reducing scan time using a simplified model based on assumed values/costs for our hospital. Results There were no significant changes in the visually assessed DS when reducing scan time to 90 s/bp, 60 s/bp, 45 s/bp, and 30 s/bp. Image quality of 90 s/bp images were rated equal to 120 s/bp images. Coefficient of variance values for 120 s/bp and 90 s/bp images was significantly < 15%. The estimated annual savings to the hospital when reducing scan time was 8000-16,000 €/scanner. Conclusion Acquisition time can be reduced to 90 s/bp in response assessment FDG-PET/CT without compromising Deauville score or image quality. Reducing acquisition time can reduce costs to the clinic.

scholarly journals Feasibility of equivalent performance of 3D TOF [18F]-FDG PET/CT with reduced acquisition time using clinical and semiquantitative parameters

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Julia Pilz ◽  
Lukas Hehenwarter ◽  
Georg Zimmermann ◽  
Gundula Rendl ◽  
Gregor Schweighofer-Zwink ◽  
...  
Keyword(s):  
Image Quality ◽  
Fdg Pet ◽  
Lesion Detection ◽  
Whole Body ◽  
Body Region ◽  
Acquisition Time ◽  
Routine Practice ◽  
Short Acquisition Time ◽  
Pet Ct ◽  
Fdg Pet Ct

Abstract Background High-performance time-of-flight (TOF) positron emission tomography (PET) systems have the capability for rapid data acquisition while preserving diagnostic image quality. However, determining a reliable and clinically applicable cut-off of the acquisition time plays an important role in routine practice. This study aimed to assess the diagnostic equivalence of short acquisition time of 57 with routine 75 seconds per bed position (s/BP) of [18F]-fluoro-deoxy-glucose (FDG) PET. Phantom studies applying EARL criteria suggested the feasibility of shortened acquisition time in routine clinical imaging by 3D TOF PET/CT scanners. Ninety-six patients with melanoma, lung or head and neck cancer underwent a standard whole-body, skull base-to-thigh or vertex-to-thigh [18F]-FDG PET/CT examination using the 3D TOF Ingenuity TF PET/CT system (Philips, Cleveland, OH). The [18F]-FDG activity applied was equal to 4MBq per kg body weight. Retrospectively, PET list-mode data were used to calculate a second PET study per patient with a reduced acquisition time of 57 s instead of routine 75 s/BP. PET/CT data were reconstructed using a 3D OSEM TOF algorithm. Blinded patient data were analysed by two nuclear medicine physicians. The number of [18F]-FDG-avid lesions per body region (head&neck, thorax, abdomen, bone, extremity) and image quality (grade 1–5) were evaluated. Semiquantitative analyses were performed by standardized uptake value (SUV) measurements using 3D volume of interests (VOI). The visual and semiquantitative diagnostic equivalence of 214 [18F]-FDG-avid lesions were analysed in the routine standard (75 s/BP) as well as the calculated PET/CT studies with short acquisition time. Statistical analyses were performed by equivalence testing and Bland–Altman plots. Results Lesion detection rate per patient’s body region agreed in > 98% comparing 57 s/BP and 75 s/BP datasets. Overall image quality was determined as equal or superior to 75 s in 80% and 69%, respectively. In the semiquantitative lesion-based analyses, a significant equivalence was found between the 75 s/BP and 57 s/BP PET/CT images both for SUVmax (p = 0.004) and SUVmean (p = 0.003). Conclusion The results of this study demonstrate significant clinical and semiquantitative equivalence between short acquisition time of 57 s/BP and standard 75 s/BP 3D TOF [18F]-FDG PET/CT scanning, which may improve the patient’s workflow in routine practice.

Diffusion-weighted MRI compared to FDG PET-CT in the staging and response assessment of Hodgkin lymphoma

2011 ◽  
Vol 156 (5) ◽  
pp. 557-557 ◽  
Author(s):  
Maria Marzolini ◽  
Wai L. Wong ◽  
Kirit Ardeshna ◽  
Anwar Padhani ◽  
Shirley D’Sa
Keyword(s):  
Hodgkin Lymphoma ◽  
Fdg Pet ◽  
Response Assessment ◽  
Diffusion Weighted Mri ◽  
Diffusion Weighted ◽  
Pet Ct ◽  
Fdg Pet Ct

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

2012 ◽  
Vol 40 (4) ◽  
pp. 255-258 ◽  
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

18F-FDG PET/CT for response assessment in Hodgkin lymphoma undergoing immunotherapy with checkpoint inhibitors

2018 ◽  
Vol 60 (2) ◽  
pp. 367-375 ◽  
Author(s):  
Angelo Castello ◽  
Fabio Grizzi ◽  
Dorina Qehajaj ◽  
Daoud Rahal ◽  
Fabio Lutman ◽  
...  
Keyword(s):  
Hodgkin Lymphoma ◽  
Fdg Pet ◽  
Checkpoint Inhibitors ◽  
Response Assessment ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

scholarly journals FDG-PET/CT in intensive care patients with bloodstream infection

Critical Care ◽  
2021 ◽  
Vol 25 (1) ◽  
Author(s):  
Jordy P. Pijl ◽  
Mark Londema ◽  
Thomas C. Kwee ◽  
Maarten W. N. Nijsten ◽  
Riemer H. J. A. Slart ◽  
...  
Keyword(s):  
Intensive Care ◽  
Image Quality ◽  
Fdg Pet ◽  
Diagnostic Yield ◽  
Unknown Origin ◽  
Intensive Care Patients ◽  
Pet Ct ◽  
Infection Focus ◽  
Focus Of Infection ◽  
Fdg Pet Ct

Abstract Background 2-Deoxy-2-[18F]fluoro-D-glucose (FDG) positron emission tomography (PET)/computed tomography (CT) is an advanced imaging technique that can be used to examine the whole body for an infection focus in a single examination in patients with bloodstream infection (BSI) of unknown origin. However, literature on the use of this technique in intensive care patients is scarce. The purpose of this study was to evaluate the diagnostic yield of FDG-PET/CT in intensive care patients with BSI. Methods In this retrospective cohort study, all intensive care patients from our Dutch university medical center who had culture-proven BSI between 2010 and 2020 and underwent FDG-PET/CT to find the focus of infection were included. Diagnostic performance was calculated and logistic regression analysis was performed to evaluate the association between FDG-PET/CT outcome and C-reactive protein level (CRP), leukocyte count, duration of antibiotic treatment, duration of ICU stay, quality of FDG-PET/CT, and dependency on mechanical ventilation. In addition, the impact of FDG-PET/CT on clinical treatment was evaluated. Results 30 intensive care patients with BSI were included. In 21 patients, an infection focus was found on FDG-PET/CT which led to changes in clinical management in 14 patients. FDG-PET/CT achieved a sensitivity of 90.9% and specificity of 87.5% for identifying the focus of infection. Poor quality of the FDG-PET images significantly decreased the likelihood of finding an infection focus as compared to reasonable or good image quality (OR 0.16, P = 0.034). No other variables were significantly associated with FDG-PET/CT outcome. No adverse events during the FDG-PET/CT procedure were reported. Conclusion FDG-PET/CT has a high diagnostic yield for detecting the infection focus in patients with BSI admitted to intensive care. Poor PET image quality was significantly associated with a decreased likelihood of finding the infection focus in patients with BSI. This could be improved by adequate dietary preparation and cessation of intravenous glucose and glucose-regulating drugs. Recent advances in PET/CT technology enable higher image quality with shorter imaging time and may contribute to routinely performing FDG-PET/CT in intensive care patients with BSI of unknown origin.

scholarly journals FDG-PET/CT for the Management of Post-Chemotherapy Residual Mass in Hodgkin lymphoma

Cancers ◽  
2021 ◽  
Vol 13 (16) ◽  
pp. 3952
Author(s):  
Andrea Gallamini ◽  
Michał Kurlapski ◽  
Jan Maciej Zaucha
Keyword(s):  
Treatment Outcome ◽  
Hodgkin Lymphoma ◽  
Fdg Pet ◽  
Quantitative Methods ◽  
Present Review ◽  
Response To Treatment ◽  
Published Evidence ◽  
Pet Ct ◽  
Fdg Pet Ct

In the present review, the authors report the published evidence on the use of functional imaging with FDG-PET/CT in assessing the final response to treatment in Hodgkin lymphoma. Despite a very high overall Negative Predictive Value of post-chemotherapy PET on treatment outcome ranging from 94% to 86%, according to different treatment intensity, the Positive Predicting Value proved much lower (40–25%). In the present review the Authors discuss the role of PET to guide consolidation RT over a RM after different chemotherapy regimens, both in early and in advanced-stage disease. A particular emphasis is dedicated to the peculiar issue of the qualitative versus semi-quantitative methods for End-of Therapy PET scan interpretation. A short hint will be given on the role of FDG-PET to assess the treatment outcome after immune checkpoint inhibitors.

scholarly journals FDG PET/CT to detect bone marrow involvement in the initial staging of patients with aggressive non-Hodgkin lymphoma: results from the prospective, multicenter PETAL and OPTIMAL>60 trials

2021 ◽  
Author(s):  
Dominic Kaddu-Mulindwa ◽  
Bettina Altmann ◽  
Gerhard Held ◽  
Stephanie Angel ◽  
Stephan Stilgenbauer ◽  
...  
Keyword(s):  
Bone Marrow ◽  
B Cell ◽  
Hodgkin Lymphoma ◽  
Predictive Value ◽  
Fdg Pet ◽  
Bone Marrow Involvement ◽  
Non Hodgkin Lymphoma ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
Initial Staging

Abstract Purpose Fluorine-18 fluorodeoxyglucose positron emission tomography combined with computed tomography (FDG PET/CT) is the standard for staging aggressive non-Hodgkin lymphoma (NHL). Limited data from prospective studies is available to determine whether initial staging by FDG PET/CT provides treatment-relevant information of bone marrow (BM) involvement (BMI) and thus could spare BM biopsy (BMB). Methods Patients from PETAL (NCT00554164) and OPTIMAL>60 (NCT01478542) with aggressive B-cell NHL initially staged by FDG PET/CT and BMB were included in this pooled analysis. The reference standard to confirm BMI included a positive BMB and/or FDG PET/CT confirmed by targeted biopsy, complementary imaging (CT or magnetic resonance imaging), or concurrent disappearance of focal FDG-avid BM lesions with other lymphoma manifestations during immunochemotherapy. Results Among 930 patients, BMI was detected by BMB in 85 (prevalence 9%) and by FDG PET/CT in 185 (20%) cases, for a total of 221 cases (24%). All 185 PET-positive cases were true positive, and 709 of 745 PET-negative cases were true negative. For BMB and FDG PET/CT, sensitivity was 38% (95% confidence interval [CI]: 32–45%) and 84% (CI: 78–88%), specificity 100% (CI: 99–100%) and 100% (CI: 99–100%), positive predictive value 100% (CI: 96–100%) and 100% (CI: 98–100%), and negative predictive value 84% (CI: 81–86%) and 95% (CI: 93–97%), respectively. In all of the 36 PET-negative cases with confirmed BMI patients had other adverse factors according to IPI that precluded a change of standard treatment. Thus, the BMB would not have influenced the patient management. Conclusion In patients with aggressive B-cell NHL, routine BMB provides no critical staging information compared to FDG PET/CT and could therefore be omitted. Trial registration NCT00554164 and NCT01478542

scholarly journals Automated quantification of baseline imaging PET metrics on FDG PET/CT images of pediatric Hodgkin lymphoma patients

2020 ◽  
Vol 7 (1) ◽  
Author(s):  
Amy J. Weisman ◽  
Jihyun Kim ◽  
Inki Lee ◽  
Kathleen M. McCarten ◽  
Sandy Kessel ◽  
...  
Keyword(s):  
Hodgkin Lymphoma ◽  
Correlation Coefficient ◽  
Pet Imaging ◽  
Fdg Pet ◽  
Relative Difference ◽  
Ct Images ◽  
Imaging Features ◽  
Pediatric Hodgkin Lymphoma ◽  
Pet Ct ◽  
Fdg Pet Ct

Abstract Purpose For pediatric lymphoma, quantitative FDG PET/CT imaging features such as metabolic tumor volume (MTV) are important for prognosis and risk stratification strategies. However, feature extraction is difficult and time-consuming in cases of high disease burden. The purpose of this study was to fully automate the measurement of PET imaging features in PET/CT images of pediatric lymphoma. Methods 18F-FDG PET/CT baseline images of 100 pediatric Hodgkin lymphoma patients were retrospectively analyzed. Two nuclear medicine physicians identified and segmented FDG avid disease using PET thresholding methods. Both PET and CT images were used as inputs to a three-dimensional patch-based, multi-resolution pathway convolutional neural network architecture, DeepMedic. The model was trained to replicate physician segmentations using an ensemble of three networks trained with 5-fold cross-validation. The maximum SUV (SUVmax), MTV, total lesion glycolysis (TLG), surface-area-to-volume ratio (SA/MTV), and a measure of disease spread (Dmaxpatient) were extracted from the model output. Pearson’s correlation coefficient and relative percent differences were calculated between automated and physician-extracted features. Results Median Dice similarity coefficient of patient contours between automated and physician contours was 0.86 (IQR 0.78–0.91). Automated SUVmax values matched exactly the physician determined values in 81/100 cases, with Pearson’s correlation coefficient (R) of 0.95. Automated MTV was strongly correlated with physician MTV (R = 0.88), though it was slightly underestimated with a median (IQR) relative difference of − 4.3% (− 10.0–5.7%). Agreement of TLG was excellent (R = 0.94), with median (IQR) relative difference of − 0.4% (− 5.2–7.0%). Median relative percent differences were 6.8% (R = 0.91; IQR 1.6–4.3%) for SA/MTV, and 4.5% (R = 0.51; IQR − 7.5–40.9%) for Dmaxpatient, which was the most difficult feature to quantify automatically. Conclusions An automated method using an ensemble of multi-resolution pathway 3D CNNs was able to quantify PET imaging features of lymphoma on baseline FDG PET/CT images with excellent agreement to reference physician PET segmentation. Automated methods with faster throughput for PET quantitation, such as MTV and TLG, show promise in more accessible clinical and research applications.

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