Impact of total variation regularized expectation maximization reconstruction on the image quality of 68Ga-PSMA PET: a phantom and patient study

2021 ◽  
pp. 20201356
Author(s):  
Feng-Jiao Yang ◽  
Shu-Yue Ai ◽  
Runze Wu ◽  
Yang Lv ◽  
Hui-Fang Xie ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Image Quality ◽  
Total Variation ◽  
Expectation Maximization ◽  
Image Noise ◽  
Psma Pet ◽  
Pet Ct ◽  
Digital Pet ◽  
The Impact

Objectives: To investigate the impact of total variation regularized expectation maximization (TVREM) reconstruction on the image quality of 68Ga-PSMA-11 PET/CT using phantom and patient data. Methods: Images of a phantom with small hot sphere inserts and 20 prostate cancer patients were acquired with a digital PET/CT using list-mode and reconstructed with ordered subset expectation maximization (OSEM) and TVREM with seven penalisation factors between 0.01 and 0.42 for 2 and 3 minutes-per-bed (m/b) acquisition. The contrast recovery (CR) and background variability (BV) of the phantom, image noise of the liver, and SUVmax of the lesions were measured. Qualitative image quality was scored by two radiologists using a 5-point scale (1-poor, 5-excellent). Results: The performance of CR, BV, and image noise, and the gain of SUVmax was higher for TVREM 2 m/b groups with the penalization of 0.07 to 0.28 compared to OSEM 3 m/b group (all p < 0.05). The image noise of OSEM 3 m/b group was equivalent to TVREM 2 and 3 m/b groups with a penalization of 0.14 and 0.07, while lesions’ SUVmax increased 15 and 20%. The highest qualitative score was attained at the penalization of 0.21 (3.30 ± 0.66) for TVREM 2 m/b groups and the penalization 0.14 (3.80 ± 0.41) for 3 m/b group that equal to or greater than OSEM 3 m/b group (2.90 ± 0.45, p = 0.2 and p < 0.001). Conclusions: TVREM improves lesion contrast and reduces image noise, which allows shorter acquisition with preserved image quality for PSMA PET/CT. Advances in knowledge: TVREM reconstruction with optimized penalization factors can generate higher quality PSMA-PET images for prostate cancer diagnosis.

scholarly journals The Impact of 18F-DCFPyL PSMA PET-CT in the Management of Prostate Cancer Biochemical Recurrence

2021 ◽  
Vol 11 (11) ◽  
pp. 393-403
Author(s):  
Raquel García ◽  
Virginia Morillo ◽  
Pablo Sopena ◽  
Miguel R. Soler ◽  
María Rodríguez ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Biochemical Recurrence ◽  
Psma Pet ◽  
Pet Ct ◽  
The Impact

The Impact of 68Ga-PSMA PET/CT and PET/MRI on the Management of Prostate Cancer

Urology ◽  
2019 ◽  
Vol 130 ◽  
pp. 1-12 ◽  
Author(s):  
Manuela A. Hoffmann ◽  
Helmut J. Wieler ◽  
Christian Baues ◽  
Nicholas J. Kuntz ◽  
Ines Richardsen ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Psma Pet ◽  
Pet Ct ◽  
The Impact

Reply: “The Impact of 68Ga-PSMA PET/CT and PET/MRI on the Management of Prostate Cancer”

Urology ◽  
2019 ◽  
Vol 131 ◽  
pp. 262-263
Author(s):  
Manuela A. Hoffmann ◽  
Helmut J. Wieler ◽  
Christian Baues ◽  
Nicholas J. Kuntz ◽  
Ines Richardsen ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Psma Pet ◽  
Pet Ct ◽  
The Impact

scholarly journals The Impact of Varying Number of OSEM Iterations on Standardized Uptake Value and Image Quality of Discovery STE PET/CT Scanner

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 68s-68s
Author(s):  
B. Ali ◽  
A. Afshan ◽  
M.B. Kakakhel
Keyword(s):  
Image Quality ◽  
Standardized Uptake Value ◽  
Acquisition Time ◽  
List Mode ◽  
Ct Scanner ◽  
Matrix Size ◽  
Cold Lesion ◽  
Pet Ct ◽  
The Impact

Background: In PET imaging both quantitative and qualitative interpretations are used. Qualitative and quantitative interpretations depend upon PET/CT image quality that along with many biologic factors strongly depends upon image reconstruction parameters. Aim: The objective of this experimental work was to study the impact of one of the key reconstruction parameter, i.e., number of reconstruction iteration, on standardized uptake value and image quality of PET/CT scan. Methods: Images of NEMA IEC Image Quality Phantom were acquired in list mode for 10 mins on Discovery STE PET/CT scanner, using tumor to background ratio of 4:1 and 18F-FDG as radiotracer. List mode data were further transformed into data sets of varying acquisition time (0.5, 1.0, 1.5, 2.0, 2.5, 3.0, 3.5, 4.0, 4.5, 5.0 mins) per bed position. Transformed data set of 5.0 mins were used to study the impact of varying number of iterations (2, 3, 4, 5, 7, 10, 15, 20) using OSEM approach of iterative reconstruction. Standardized uptake value (SUV) and underestimation in SUV were calculated as quantitative measures, while hot lesion contrast, cold lesion contrast and background variability were calculated as qualitative measures. Results: Standardized uptake value, hot and cold lesion contrast, image spatial resolution and background variability showed increasing trend with increase in reconstruction iterations. Maximum increase of 20.25%, 16.33%, 9.79% and 6.88% was observed in SUV for 10 mm, 13 mm, 17 mm and 22 mm lesions as number of iteration change from 2 to 3. Smallest and the largest diameter lesions showed maximum underestimations of 54.67% and 8.20% at 2 iterations respectively. Percentage hot lesion contrast showed rapid increase as the number of iteration change from 2 to 7 and increased slowly afterward. Background variability range from 4.4% to 6.4%, 4.1%–5.7%, 3.6%–4.6%, 3%–3.8%, 2.7%–3.2%, 2.4%–2.7% for 10.0 mm, 13.0 mm, 17.0 mm, 22.0 mm, 28.0 mm and 37.0 mm sphere respectively. Conclusion: Optimized reconstruction parameters for routine clinical studies 3 iterations with image matrix size of 128 × 128 with filters FWHM of 6 mm and for high resolution studies 3 iterations image matrix size of 256×256 with filters FWHM of 6 mm.

scholarly journals Comparison of Image Quality and Spatial Resolution Between 18F, 68Ga and 64Cu Phantom Measurements Using a Digital Biograph Vision PET/CT

2022 ◽  
Author(s):  
Anja Braune ◽  
Liane Oehme ◽  
Robert Freudenberg ◽  
Frank Hofheinz ◽  
Jörg van den Hoff ◽  
...  
Keyword(s):  
Image Quality ◽  
Spatial Resolution ◽  
Ct Scans ◽  
Reconstruction Method ◽  
Recovery Coefficient ◽  
Positron Energy ◽  
Pet Ct ◽  
The Individual ◽  
The Impact

Abstract Background: The PET nuclide and reconstruction method can have a considerable influence on spatial resolution and image quality of PET/CT scans, which can, for example, influence the diagnosis in oncology. The individual impact of the positron energy of 18F, 68Ga and 64Cu on spatial resolution and image quality of PET/CT scans acquired using a clinical, digital scanner was compared. Furthermore, the impact of different reconstruction parameters on image quality and spatial resolution was evaluated for 18F-FDG PET/CT scans acquired with a scanner of the newest generation. Methods: PET/CT scans of a Jaszczak phantom and a NEMA PET body phantom, filled with 18F-FDG, 68Ga-HCl and 64Cu-HCl, respectively, were performed on a Siemens Biograph Vision. Images were assessed using spatial resolution and image quality (Recovery Coefficients (RC), coefficient of variation within the background, Contrast Recovery Coefficient (CRC), Contrast-Noise-Ratio (CNR), and relative count error in lung insert). In a subsequent analysis, the scan of the NEMA PET body phantom filled with 18F-FDG was reconstructed applying different parameters (with/without the application of Point Spread Function (PSF), Time of Flight (ToF) or post-filtering; matrix size). Spatial resolution and quantitative image quality were compared between reconstructions. Results: We found that image quality was comparable between 18F-FDG and 64Cu-HCl PET/CT measurements featuring similar maximal endpoint energy. In comparison, RC, CRC and CNR were worse in 68Ga-HCl data, despite similar count rates. Spatial resolution was up to 18 % worse in 68Ga-HCl compared to 18F-FDG images. Post-filtering of 18F-FDG acquisitions changed image quality the most and reduced spatial resolution by 52 % if a Gaussian filter with 5 mm FWHM was applied. ToF measurements especially improved the recovery of the smallest lesion (RCmean = 1.07 compared to 0.65 without ToF) and improved spatial resolution by 29 %.Conclusions: The positron energy of PET nuclides influences spatial resolution and image quality of digital PET/CT scans. Image quality of 68Ga-HCl PET/CT images was worse compared to 18F-FDG and 64Cu-HCl, respectively, despite similar count rates. Reconstruction parameters have a high impact on image quality and spatial resolution and should be considered when comparing images of different scanners or centers.

scholarly journals The Establishment of New Thresholds for PLND-Validated Clinical Nomograms to Predict Non-Regional Lymph Node Metastases: Using 68Ga-PSMA PET/CT as References

2021 ◽  
Vol 11 ◽  
Author(s):  
Jianhua Jiao ◽  
Zhiyong Quan ◽  
Jingliang Zhang ◽  
Weihong Wen ◽  
Jun Qin ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Lymph Node ◽  
High Risk ◽  
Lymph Nodes ◽  
Clinical Decision Making ◽  
Care Hospital ◽  
Pelvic Region ◽  
Psma Pet ◽  
Pet Ct ◽  
The Impact

PurposePLND (pelvic lymph node dissection)-validated nomograms are widely accepted clinical tools to determine the necessity of PLND by predicting the metastasis of lymph nodes (LNMs) in pelvic region. However, these nomograms are in lacking of a threshold to predict the metastasis of extrareolar lymph nodes beyond pelvic region, which is not suitable for PLND. The aim of this study is to evaluate a threshold can be set for current clinical PLND-validated nomograms to predict extrareolar LN metastases beyond pelvic region in high-risk prostate cancer patients, by using 68Ga-PSMA PET/CT as a reference to determine LN metastases (LNMs).Experimental DesignWe performed a retrospective analysis of 57 high-risk treatment-naïve PC patients in a large tertiary care hospital in China who underwent 68Ga-PSMA-617 PET/CT imaging. LNMs was detected by 68Ga-PSMA-617 PET/CT and further determined by imaging follow-up after anti-androgen therapy. The pattern of LN metastatic spread of PC patients were evaluated and analyzed. The impact of 68Ga-PSMA PET/CT on clinical decisions based on three clinical PLND-validated nomograms (Briganti, Memorial Sloan Kettering Cancer Center, Winter) were evaluated by a multidisciplinary prostate cancer therapy team. The diagnostic performance and the threshold of these nomograms in predicting extrareolar LNMs metastasis were evaluated via receiver operating characteristic (ROC) curve analysis.ResultsLNMs were observed in 49.1% of the patients by 68Ga-PSMA PET/CT, among which 65.5% of LNMs were pelvic-regional and 34.5% of LNMs were observed in extrareolar sites (52.1% of these were located above the diaphragm). The Briganti, MSKCC and Winter nomograms showed that 70.2%-71.9% of the patients in this study need to receive ePLND according to the EAU and NCCN guidelines. The LN staging information obtained from 68Ga-PSMA PET/CT would have led to changes of planned management in 70.2% of these patients, including therapy modality changes in 21.1% of the patients, which were mainly due to newly detected non-regional LNMs. The thresholds of nomograms to predict non-regional LNMs were between 64% and 75%. The PC patients with a score &gt;64% in Briganti nomogram, a score &gt;75% in MSKCC nomogram and a score &gt;67% in Winter nomogram were more likely to have non-regional LNMs. The AUCs (Area under curves) of the clinical nomograms (Briganti, MSKCC and Winter) in predicting non-regional LNMs were 0.816, 0.830 and 0.793, respectively.ConclusionsBy using 68Ga-PSMA PET/CT as reference of LNM, the PLND-validated clinical nomograms can not only predict regional LNMs, but also predict non-regional LNMs. The additional information from 68Ga-PSMA PET/CT may provide added benefit to nomograms-based clinical decision-making in more than two-thirds of patients for reducing unnecessary PLND. We focused on that a threshold can be set for current clinical PLND-validated nomograms to predict extrareolar LN metastases with an AUC accuracy of about 80% after optimizing the simple nomograms which may help to improve the efficiency for PC therapy significantly in clinical practice.

The Impact of Patient’s Body Habitus on PET Image Quality in Digital and Analogic PET/CT

2020 ◽  
Author(s):  
Kathleen Weyts ◽  
Elske Quak ◽  
Idlir Licaj ◽  
Charline Lasnon ◽  
Renaud Ciappuccini ◽  
...  
Keyword(s):  
Image Quality ◽  
Fdg Pet ◽  
Pearson Correlation ◽  
Linear Regression Analysis ◽  
Acquisition Time ◽  
Body Habitus ◽  
Pet Ct ◽  
Digital Pet ◽  
Bed Position ◽  
The Impact

Abstract Background: New digital versus analogic PET has higher temporal resolution and more stable count rate, potentially limiting the degradation of PET image quality in larger patients. We wanted to describe the influence of patient’s body habitus on [18F]FDG PET image quality primary in digital PET/CT and analogic PET/CT.Results:We studied retrospectively the relation between patient’s weight, BMI, fatty massand PET image quality, described by the coefficient of variance in the liver (CVliv) and visually.177 unique patient exams on digital PET/CT (weight 35-127 kg; BMI 15-44 kg/m2) were performed with 2 protocols (protocol 1: N=52: 3MBq (0,08mCi)/kg [18F]FDG; 2minutes/bed position; 2iterations10subsets; 2mm diameter voxels and protocol 2: N=125: 4MBq (0,11mCi) /kg [18F]FDG; 1min/bed position; 4iterations4subsets; 2mm voxels).74 unique patient exams were analyzed on analogic PET/CT (weight 38-130 kg; BMI 14-52 kg/m2; with one protocol: 4MBq (0,11mCi)/kg [18F]FDG; 2min40sec/bedposition for BMI<25 and 3min40sec for BMI ≥25; 3iterations21subsets; 4mm voxels).Uni-and multivariable linear regression analysis showed positive association of CVliv with weight, BMI, fatty mass (p£0.009) and male sex (p£0,03) for both camera’s, with good fit in CVliv versus weight model on digital PET/CT (R2 up to 0.62). 4MBq (0,11mCi) protocol on digital PET/CT versus analogic PET/CT obtained lower CVliv on digital PET/CT in patients <70kg, without a difference if 70-<90kg and in Pearson correlation coefficients (p=0,26) despite substantially longer acquisition time for analogic PET/CT. For digital PET/CT CVliv increased similarly with weight for both protocols, up to 26% [95% Confidence Interval 2-56%] for ³90 kg versus <70kg, but overall CVliv values were lower in 4MBq (0,11mCi) protocol 2.Also visually PET image quality decreased with habitus on each camera (p£0.001) and was lower in females on digital PET/CT only (p=0,04).Conclusions:[18F]FDG PET image quality decreases with weight and enlarging body habitus on digital and analogic PET/CT imposing further optimization and harmonization also in digital PET/CT. This is important for clinical routine, but also (multicentric) research and development of artificial intelligence software.

The Impact of PSMA PET-CT on Treatment Decisions in Prostate Cancer – Early Experience in a Single Centre

2020 ◽  
Vol 32 (5) ◽  
pp. e133-e134
Author(s):  
C. Rooney ◽  
A. Henry ◽  
A. Cole ◽  
J. O’Sullivan ◽  
D. Mitchell ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Early Experience ◽  
Treatment Decisions ◽  
Single Centre ◽  
Psma Pet ◽  
Pet Ct ◽  
The Impact

scholarly journals The Impact of68Ga-PSMA PET/CT on Management Intent in Prostate Cancer: Results of an Australian Prospective Multicenter Study

2017 ◽  
Vol 59 (1) ◽  
pp. 82-88 ◽  
Author(s):  
Paul J. Roach ◽  
Roslyn Francis ◽  
Louise Emmett ◽  
Edward Hsiao ◽  
Andrew Kneebone ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Multicenter Study ◽  
Prospective Multicenter Study ◽  
Psma Pet ◽  
Pet Ct ◽  
The Impact

scholarly journals Evaluation of 18F-DCFPyL PSMA PET/CT for Prostate Cancer: A Meta-Analysis

2021 ◽  
Vol 10 ◽  
Author(s):  
Ke-Hao Pan ◽  
Jin-Feng Wang ◽  
Chun-Ying Wang ◽  
Abdul Aziz Nikzad ◽  
Fang Q. Kong ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Meta Analysis ◽  
Inclusion Criteria ◽  
Ct Diagnosis ◽  
Clinical Value ◽  
Positron Emission ◽  
Psma Pet ◽  
Pet Ct ◽  
Specific Membrane

BackgroundTo systematically review the clinical value of 18F-DCFPyL prostate-specific membrane antigen positron emission tomography/computed tomography (PSMA PET/CT) in the diagnosis of prostate cancer (PCa).MethodsLiterature concerning 18F-DCFPyL PSMA PET/CT in the diagnosis of prostate cancer published from 2015 to 2020 was electronically searched in the databases including PubMed and Embase. Statistical analysis was carried out with STATA 15 software, and the quality of included studies was tested with quality assessment of diagnostic accuracy studies (QUADAS) items. The heterogeneity of the included data was tested.ResultsIn total, nine pieces of literature involving 426 patients met the inclusion criteria. The heterogeneity of the study group was not obvious. The SEN, SPE, LR+, LR−, DOR as well as AUC of 18F-DCFPyL PSMA PET/CT diagnosis of prostate cancer were 0.91, 0.90, 8.9, 0.10, 93, and 0.93. The pooled DR of 18F-DCFPyL labeled PSMA PET/CT in PCa was 92%. The pooled DR was 89% for PSA≥0.5 ng/ml and 49% for PSA &lt; 0.5ng/ml.Conclusion18F-DCFPyL PSMA PET/CT had good sensitivity and specificity for the diagnosis of prostate cancer. The DR of 18F-DCFPyL PSMA PET/CT was correlated with PSA value. Further large-sample, high-quality studies were needed.

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