Total-Body PET/Computed Tomography Highlights in Clinical Practice

Sui, Xiuli; Liu, Guobing; Hu, Pengcheng; Chen, Shuguang; Yu, Haojun; Wang, Ying; Shi, Hongcheng

doi:10.1016/j.cpet.2020.09.007

Cited by 28 publications

(35 citation statements)

References 7 publications

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“…On the basis of the results from the two cohorts, we propose a 5-8 min acquisition protocol as an optimized universal scheme for the clinical application of total-body PET/CT at half-dose FDG, which is within the recommended range (3-10 min) proposed by Sui et al [19]. Indeed, our study showed a gradient of acquisition times for different clinical needs.…”

Section: Discussionsupporting

confidence: 52%

Optimizing Acquisition Times for Total-Body Positron-Emission Tomography/Computed Tomography with Half-Dose 18F-Fluorodeoxyglucose in Oncology Patients

He¹,

Gu²,

Yu³

et al. 2021

Preprint

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Purpose The present study aimed to explore the boundary of acquisition time and propose an optimized acquisition time for total-body positron emission tomography (PET)/computed tomography (CT) oncological imaging using half-dose 18F-fluorodeoxyglucose (FDG) activity based on clinical diagnostic needs. Methods In this retrospective study, an exploration cohort (October 2019 to December 2019) of 46 oncology patients was first studied. The acquisition time for all patients was 15 min and the acquired images were reconstructed and further split into 15-, 8-, 5-, 3-, 2, 1-min duration groups (abbreviated as G15, G8, G5, G3, G2, and G1). The image quality and lesion detectability of reconstructed PET images with different acquisition times were evaluated subjectively (5-point scale, lesion-detection rate) and objectively (standardized uptake values, target-to-background ratio). In the same way, the filtered protocols were further validated in a cohort of 147 oncology patients (December 2019 to June 2021). Results In the exploration dataset, the subjective scores for G1, G2, G3, G5, and G8 were 2.0 ± 0.2, 2.8 ± 0.3, 3.1 ± 0.2, 3.9 ± 0.3, and 4.1 ± 0.2, respectively. Two cases in G1 were rated as 1 point. No significant difference in scores was observed between G5 and G8 (p = 0.89). In general, groups with a longer acquisition time showed lower background uptake and lesion conspicuity. Compared with G15, lesion-detection rate significantly reduced to 85.3% in G1. In the validation dataset, the subjective score was 2.9 ± 0.2 for G2, 3.0 ± 0.0 for G3, 3.5 ± 0.4 for G5, 4.0 ± 0.2 for G8, and 4.5 ± 0.4 for Gs. Only the scores between G2 and G3 were not significantly different (p > 0.99). The detection rates (204 lesions) significantly reduced to 94.1-89.7% in G3 and G2 (all p < 0.001). Conclusion A 2-min acquisition protocol provided acceptable performance in certain groups and specific medical situations. And protocols with acquisition times ≥ 5 min could provide comparable lesion detectability as regular protocols, showing better compatibility and feasibility with clinical practice.

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Section: Discussionsupporting

confidence: 52%

Optimizing Acquisition Times for Total-Body Positron-Emission Tomography/Computed Tomography with Half-Dose 18F-Fluorodeoxyglucose in Oncology Patients

He¹,

Gu²,

Yu³

et al. 2021

Preprint

Self Cite

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“…These claims were successfully demonstrated through a series of well-designed studies and publications over the last 2 years [4,[6][7][8][9][10][11]. Indeed, this state-of-the-art scanner possesses many advantages over previously developed PET/CT scanners.…”

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confidence: 94%

“…Third, aside from the pharmacokinetic studies shown here, the differences in 18 F-FDG avidity within the tumor may also be analyzed to investigate tumor heterogeneity. In a recent proof-of-principle case study, 60-min dynamic total-body PET/CT scans of cancer patients were carried out [7]. It was found that the time-activity curves (TACs) extracted from regions-of-interest in different areas of the tumor mass indicated high heterogeneity: although tracer (i.e., 18 F-FDG) delivery was likely the same across the tumor mass, the 18 F-FDG uptake rate in different areas of the tumor was quite different.…”

mentioning

confidence: 99%

“…It was found that the time-activity curves (TACs) extracted from regions-of-interest in different areas of the tumor mass indicated high heterogeneity: although tracer (i.e., 18 F-FDG) delivery was likely the same across the tumor mass, the 18 F-FDG uptake rate in different areas of the tumor was quite different. Fourth, with the exceptional sensitivity and temporal resolution, dynamic whole-body PET scans can also enable radiotracer angiography, which may become a one-stop shop for a wealth of information and eliminate unnecessary CT or MR angiography procedures in various clinical settings [7]. Fifth, such ultra-low-activity dynamic and static PET/CT scans will require validation in large cancer patient cohorts, similar to a recent study reported by the same group which used half-dose (1.85 MBq/kg) of 18 F-FDG, and was able to get better quality PET/CT images than that of conventional PET/CT with fullactivity 18 F-FDG in lung cancer patients [8].…”

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confidence: 99%

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Dynamic PET imaging with ultra-low-activity of 18F-FDG: unleashing the potential of total-body PET

Lan

Fan

et al. 2021

Eur J Nucl Med Mol Imaging

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“…In November 2018, the first human images from the uEXPLORER scanner were presented at a totalbody PET workshop, which were acquired at the Department of Nuclear Medicine, Zhongshan Hospital, Fudan University (Shanghai, China) [4]. Within a short period of time, a series of studies were reported to investigate the potential and future clinical applications of this total-body scanner [4,[9][10][11][12][13][14][15][16][17][18][19][20]. In one recent study, it was concluded that a fast PET protocol with a 30-45 s acquisition time in the uEX-PLORER PET/CT can provide equivalent image quality as the conventional digital uMI 780 PET/CT (United Imaging Healthcare Co., Ltd.) with longer clinical acquisition settings.…”

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confidence: 99%

First clinical experience of 106 cm, long axial field-of-view (LAFOV) PET/CT: an elegant balance between standard axial (23 cm) and total-body (194 cm) systems

Lan

Younis

et al. 2021

Eur J Nucl Med Mol Imaging

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Conventional PET/CT scanners with standard axial field-ofview (SAFOV) usually cover around 23-26 cm [1,2]. Over the last decade, however, there has been tremendous effort in the development of long axial field-of-view (LAFOV) PET/ CT scanners, and several of them have entered the clinical arena [3][4][5]. It is well recognized that, with LAFOV PET/ CT scanners, one could image better (e.g. reconstruct at higher resolution and detect smaller lesions), image faster, image longer after tracer injection, and image gently (e.g., at a much lower radiopharmaceutical dose than usual, which will enable more PET scans in the children population, as well as more repeated scans in the adult population) [1].In the July issue of European Journal of Nuclear Medicine and Molecular Imaging, a superbly designed and executed study on the first clinical implementation of a LAFOV PET/CT scanner was reported by Dr. Rominger and colleagues from Bern University Hospital, University of Bern, Switzerland [5]. This is a prospective, nonrandomized, dual-arm crossover, comparative imaging study with a clearly stated hypothesis and inclusion/exclusion criteria. The number of patients needed for the study (> 40) was calculated to provide robust statistical analysis. In addition, three PET tracers ( 18 F-FDG, 18 F-PSMA-1007, and 68 Ga-DOTA-TOC) and 2 PET isotopes ( 18 F and 68 Ga)This article is part of the Topical Collection on Technology.

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Total-Body PET/Computed Tomography Highlights in Clinical Practice

Cited by 28 publications

References 7 publications

Optimizing Acquisition Times for Total-Body Positron-Emission Tomography/Computed Tomography with Half-Dose 18F-Fluorodeoxyglucose in Oncology Patients

Optimizing Acquisition Times for Total-Body Positron-Emission Tomography/Computed Tomography with Half-Dose 18F-Fluorodeoxyglucose in Oncology Patients

Dynamic PET imaging with ultra-low-activity of 18F-FDG: unleashing the potential of total-body PET

First clinical experience of 106 cm, long axial field-of-view (LAFOV) PET/CT: an elegant balance between standard axial (23 cm) and total-body (194 cm) systems

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