Abstract
Abstract
Objectives
Commercialized total-body PET scanners can provide high-quality images due to its ultra-high sensitivity. We compared the dynamic, regular static, and delayed 18F-fluorodeoxyglucose (FDG) scans to detect lesions in oncologic patients on a total-body PET/CT scanner.
Materials & methods
In all, 45 patients were scanned continuously for the first 60 min, followed by a delayed acquisition. FDG metabolic rate was calculated from dynamic data using full compartmental modeling, whereas regular static and delayed SUV images were obtained approximately 60- and 145-min post-injection, respectively. The retention index was computed from static and delayed measures for all lesions. Pearson’s correlation and Kruskal–Wallis tests were used to compare parameters.
Results
The number of lesions was largely identical between the three protocols, except MRFDG and delayed images on total-body PET only detected 4 and 2 more lesions, respectively (85 total). FDG metabolic rate (MRFDG) image-derived contrast-to-noise ratio and target-to-background ratio were significantly higher than those from static standardized uptake value (SUV) images (P < 0.01), but this is not the case for the delayed images (P > 0.05). Dynamic protocol did not significantly differentiate between benign and malignant lesions just like regular SUV, delayed SUV, and retention index.
Conclusion
The potential quantitative advantages of dynamic imaging may not improve lesion detection and differential diagnosis significantly on a total-body PET/CT scanner. The same conclusion applied to delayed imaging. This suggested the added benefits of complex imaging protocols must be weighed against the complex implementation in the future.
Clinical relevance
Total-body PET/CT was known to significantly improve the PET image quality due to its ultra-high sensitivity. However, whether the dynamic and delay imaging on total-body scanner could show additional clinical benefits is largely unknown. Head-to-head comparison between two protocols is relevant to oncological management.
Funder
Chinese Academy of Sciences
Key Laboratory for Magnetic Resonance and Multimodality Imaging of Guangdong Province
Shenzhen Science and Technology Innovation Committee
Guangdong Science and Technology Department
Medical Science and Technology Research Project of Henan Province
Medical Science and Technology Project of Zhejiang Province
Publisher
Springer Science and Business Media LLC
Subject
Radiology, Nuclear Medicine and imaging,Oncology,General Medicine,Radiological and Ultrasound Technology
Reference44 articles.
1. Boellaard R, Delgado-Bolton R, Oyen WJG, Giammarile F, Tatsch K, Eschner W, et al. FDG PET/CT: EANM procedure guidelines for tumour imaging: version 2.0. Eur J Nucl Med Mol Imaging. 2015;42:328–54.
2. Kinahan PE, Fletcher JW. Positron emission tomography-computed tomography standardized uptake values in clinical practice and assessing response to therapy. Semin Ultrasound, CT MRI. 2010;31:496–505.
3. Hamberg LM, Hunter GJ, Alpert NM, Choi NC, Babich JW, Fischman AJ. The dose uptake ratio as an index of glucose metabolism: Useful parameter or oversimplification? J Nucl Med. 1994;35:1308–12.
4. Cheebsumon P, Velasquez LM, Hoekstra CJ, Hayes W, Kloet RW, Hoetjes NJ, et al. Measuring response to therapy using FDG PET: Semi-quantitative and full kinetic analysis. Eur J Nucl Med Mol Imaging. 2011;38:832–42.
5. Cheng G, Alavi A, Lim E, Werner TJ, Del Bello CV, Akers SR. Dynamic changes of FDG uptake and clearance in normal tissues. Mol Imaging Biol. 2013;15:345–52.