Activity Dose Reduction in 64Cu-DOTATATE PET in Patients with Neuroendocrine Neoplasms: Impact on Image Quality and Lesion Detection Ability

Loft, Mathias; Carlsen, Esben Andreas; Johnbeck, Camilla Bardram; Jensen, C. E.; Andersen, Flemming; Langer, Seppo W.; Oturai, Peter; Knigge, Ulrich; Kjær, Andreas

doi:10.1007/s11307-022-01706-4

Cited by 2 publications

(4 citation statements)

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“…We, herein, conducted a thorough analysis of scan duration and tracer dose in 18 The recent introduction of low-dose imaging on long axial field-of-view PET scanners has yielded very promising results regarding lesion detectability and image quality in many studies [44][45][46]. Besides, several PET tracers and novel strategies have also been explored to reduce the activity dose while maintaining image quality and lesion detection rate [29,30,47,48]. These low-dose PET studies primarily focused on image quality features such as SUV, standard deviation, signal-to-noise ratio (SNR), tumor-to-background ratio (TBR) and subjective rating.…”

Section: Discussionmentioning

confidence: 99%

“…Then, the injected dose for each PET scan duration group with relatively reduced dose levels of 10% (0.37 MBq/kg), 20% (0.74 MBq/kg), 33% (1.22 MBq/kg) and 50% (1.85 MBq/kg) were simulated by randomly selecting events in the original full count PET list mode data at the corresponding scan duration with the ratio of 0.10, 0.20, 0.33 and 0.50, respectively. Such procedures were also adopted by previous studies [26][27][28][29][30][31].…”

Section: Scan Duration and Tracer Dose Simulationmentioning

confidence: 99%

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Optimizing scan duration and tracer dose in radiomic analysis for 18F-FDG PET/MR brain cancer

Zhuang,

Qiu,

et al. 2024

Preprint

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Objectives: This study is to optimize scan duration and tracer dose in radiomic analysis for 18F-FDG PET/MR brain cancer. Methods: Seventeen patients with brain cancer underwent PET/MR scans with injection of 3.70 MBq/kg 18F-FDG. PET images were split into 5 (PETSD5), 10 (PETSD10), 15 (PETSD15), and 25 (PETSD25) min duration groups, and the injected dose for each group with 10% (PETD10%), 20% (PETD20%), 33% (PETD33%) and 50% (PETD50%) dose levels were then simulated. 93 radiomic features were extracted and ICC was calculated for each feature between groups, respectively. Results: ICC varied with the feature type, scan duration, and tracer dose. ICC for PETSD10, PETSD15, and PETSD25 in relation to PETSD5 showed an obviously decrease with the lengthen of scan duration and the reduction of tracer dose. ICC on PETD10%, PETD20%, PETD33%, and PETD50% in relation to full-dose PET gradually increased with the enlargement of tracer dose and the extending of scan duration. ICC on different combinations with respect to PETSD5 at full-dose presented similar trends in most features for PETSD10 at 50%, PETSD15 at 33%, and PETSD25 at 20%. Besides, 28 features were non-sensitive to different scan durations and/or dose levels. The intertations between features were slightly affected by different scan durations and/or dose levels, in which discrepancies were sensitive to the specific feature type. Conclusions: PETSD10 at 50% might be the clinically adaptable solution for 18F-FDG PET/MR brain cancer, showing reduced radiation burden, better compatibility and clinical feasibility. Changes in scan duration and/or tracer dose in PET should be approached with caution.

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Section: Discussionmentioning

confidence: 99%

Section: Scan Duration and Tracer Dose Simulationmentioning

confidence: 99%

Optimizing scan duration and tracer dose in radiomic analysis for 18F-FDG PET/MR brain cancer

Zhuang,

Qiu,

et al. 2024

Preprint

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“…The study is a continuation of our previously reported activity dose reduction PET investigation performed in patients with NENs (7). We retrospectively included the same 38 patients with NENs referred to a PET/CT acquisition, PET reconstruction, and generation of reduced-dose PET equivalents were performed as previously described (7). Patients were injected with approximately 200 MBq of 64 Cu-DOTATATE based on our clinical studies (15)(16)(17)(18).…”

Section: Patient Populationmentioning

confidence: 99%

“…One way to reduce the PETrelated radiation burden is by reducing the radiotracer activity dose. By analyzing simulated dose-reduced PET images, we previously demonstrated that the injected 64 Cu-DOTATATE activity could be reduced to approximately 100 MBq without loss of clinically relevant information (7). With activity dose reduction to less than 50 MBq, image quality was suboptimal and lesion detection sensitivity was low.…”

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confidence: 99%

An Investigation of Lesion Detection Accuracy for Artificial Intelligence–Based Denoising of Low-Dose⁶⁴Cu-DOTATATE PET Imaging in Patients with Neuroendocrine Neoplasms

et al. 2023

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Frequent somatostatin receptor PET, for example, 64 Cu-DOTATATE PET, is part of the diagnostic work-up of patients with neuroendocrine neoplasms (NENs), resulting in high accumulated radiation doses. Scanrelated radiation exposure should be minimized in accordance with the as-low-as-reasonably achievable principle, for example, by reducing injected radiotracer activity. Previous investigations found that reducing 64 Cu-DOTATATE activity to below 50 MBq results in inadequate image quality and lesion detection. We therefore investigated whether image quality and lesion detection of less than 50 MBq of 64 Cu-DOTATATE PET could be restored using artificial intelligence (AI). Methods: We implemented a parameter-transferred Wasserstein generative adversarial network for patients with NENs on simulated low-dose 64 Cu-DOTA-TATE PET images corresponding to 25% (PET 25% ), or about 48 MBq, of the injected activity of the reference full dose (PET 100% ), or about 191 MBq, to generate denoised PET images (PET AI ). We included 38 patients in the training sets for network optimization. We analyzed PET intensity correlation, peak signal-to-noise ratio (PSNR), structural similarity index (SSIM), and mean-square error (MSE) of PET AI /PET 100% versus PET 25% /PET 100% . Two readers assessed Likert scale-defined image quality (1, very poor; 2, poor; 3, moderate; 4, good; 5, excellent) and identified lesion-suspicious foci on PET AI and PET 100% in a subset of the patients with no more than 20 lesions per organ (n 5 33) to allow comparison of all foci on a 1:1 basis. Detected foci were scored (C 1 , definite lesion; C 0 , lesion-suspicious focus) and matched with PET 100% as the reference. True-positive (TP), false-positive (FP), and false-negative (FN) lesions were assessed. Results: For PET AI /PET 100% versus PET 25% /PET 100% , PET intensity correlation had a goodness-of-fit value of 0.94 versus 0.81, PSNR was 58.1 versus 53.0, SSIM was 0.908 versus 0.899, and MSE was 2.6 versus 4.7. Likert scale-defined image quality was rated good or excellent in 33 of 33 and 32 of 33 patients on PET 100% and PET AI , respectively . Total number of detected lesions was 118 on PET 100% and 115 on PET AI . Only 78 PET AI lesions were TP, 40 were FN, and 37 were FP, yielding detection sensitivity (TP/(TP1FN)) and a false discovery rate (FP/(TP1FP)) of 66% (78/118) and 32% (37/115), respectively. In 62% (23/37) of cases, the FP lesion was scored C 1 , suggesting a definite lesion. Conclusion: PET AI improved visual similarity with PET 100% compared with PET 25% , and PET AI and PET 100% had similar Likert scaledefined image quality. However, lesion detection analysis performed by physicians showed high proportions of FP and FN lesions on PET AI , highlighting the need for clinical validation of AI algorithms.

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Activity Dose Reduction in 64Cu-DOTATATE PET in Patients with Neuroendocrine Neoplasms: Impact on Image Quality and Lesion Detection Ability

Cited by 2 publications

References 23 publications

Optimizing scan duration and tracer dose in radiomic analysis for 18F-FDG PET/MR brain cancer

Optimizing scan duration and tracer dose in radiomic analysis for 18F-FDG PET/MR brain cancer

An Investigation of Lesion Detection Accuracy for Artificial Intelligence–Based Denoising of Low-Dose⁶⁴Cu-DOTATATE PET Imaging in Patients with Neuroendocrine Neoplasms

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Activity Dose Reduction in 64Cu-DOTATATE PET in Patients with Neuroendocrine Neoplasms: Impact on Image Quality and Lesion Detection Ability

Cited by 2 publications

References 23 publications

Optimizing scan duration and tracer dose in radiomic analysis for 18F-FDG PET/MR brain cancer

Optimizing scan duration and tracer dose in radiomic analysis for 18F-FDG PET/MR brain cancer

An Investigation of Lesion Detection Accuracy for Artificial Intelligence–Based Denoising of Low-Dose64Cu-DOTATATE PET Imaging in Patients with Neuroendocrine Neoplasms

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An Investigation of Lesion Detection Accuracy for Artificial Intelligence–Based Denoising of Low-Dose⁶⁴Cu-DOTATATE PET Imaging in Patients with Neuroendocrine Neoplasms