Scanner Design Considerations for Long Axial Field-of-View PET Systems

Daube-Witherspoon, Margaret E.; Cherry, Simon R.

doi:10.1016/j.cpet.2020.09.003

Cited by 12 publications

(8 citation statements)

References 48 publications

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“…Our group received and operated the world’s first clinical Biograph Vision Quadra (Siemens Healthineers) system at the Department for Nuclear Medicine, Inselspital in Bern, Switzerland in October 2020 ( https://www.swissinfo.ch/eng/world-s-fastest-full-body-scanner-turned-on-in-bern/46184876 ). Building upon the pioneering PennPET and uExplorer, the Biograph Vision Quadra (106 cm aFOV) occupies a middle-ground between standard FOV and total-body systems, capable of imaging the head to the mid-thighs for adult subjects in a single bed-position [ 30 – 32 ] and where sensitivity does not substantially improve beyond 100 cm, proving an economical use of space and detector material [ 25 , 27 , 29 ]. The footprint of this particular system also has the advantage that it can be installed into an examination room with the same dimensions as for a standard axial FOV (SAFOV) system, meaning that no complex or expensive infrastructure adjustments were necessary.…”

Section: Challenges and Opportunitiesmentioning

confidence: 99%

“…Cognisant of the fact that scanner sensitivity and image noise are important limiting factors in PET imaging, scanners have increasingly been designed with longer axial field-of-views (aFOV), such as the Biograph mCT (Siemens Healthineers, aFOV of 22 cm), Biograph Vision 600 (Siemens Healthineers, aFOV of 26.3 cm) [ 15 ] and the recently described GE Discovery MI PET/CT system (General Electric, aFOV of 30 cm) [ 24 ]. The combination of solid state detectors with increased aFOV coverage represents an important improvement upon the previous generation of scanners and demonstrates an increased photon sensitivity and peak noise equivalent count rate (NECR) [ 25 ]. However, such systems are still limited by the restriction of their FOV to one bed position, requiring continuous bed motion (CBM) for full-body coverage.…”

Section: Introductionmentioning

confidence: 99%

“…A substantial leap forward was made with the realisation of extended FOV PET systems, such as the PennPET Explorer (up to 140 cm aFOV) and the uExplorer (United Imaging, 194 cm aFOV) as well as the Biograph Vision Quadra as described earlier [ 26 – 28 ]. The design of these systems is based on pioneering work which surmounted a number of technical challenges [ 25 , 27 , 29 ]. Rather than representing an incremental improvement, these systems can be understood to represent a new, truly revolutionary design.…”

Section: Introductionmentioning

confidence: 99%

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Long-axial field-of-view PET/CT: perspectives and review of a revolutionary development in nuclear medicine based on clinical experience in over 7000 patients

et al. 2023

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Recently introduced long-axial field-of-view (LAFOV) PET/CT systems represent one of the most significant advancements in nuclear medicine since the advent of multi-modality PET/CT imaging. The higher sensitivity exhibited by such systems allow for reductions in applied activity and short duration scans. However, we consider this to be just one small part of the story: Instead, the ability to image the body in its entirety in a single FOV affords insights which standard FOV systems cannot provide. For example, we now have the ability to capture a wider dynamic range of a tracer by imaging it over multiple half-lives without detrimental image noise, to leverage lower radiopharmaceutical doses by using dual-tracer techniques and with improved quantification. The potential for quantitative dynamic whole-body imaging using abbreviated protocols potentially makes these techniques viable for routine clinical use, transforming PET-reporting from a subjective analysis of semi-quantitative maps of radiopharmaceutical uptake at a single time-point to an accurate and quantitative, non-invasive tool to determine human function and physiology and to explore organ interactions and to perform whole-body systems analysis. This article will share the insights obtained from 2 years’ of clinical operation of the first Biograph Vision Quadra (Siemens Healthineers) LAFOV system. It will also survey the current state-of-the-art in PET technology. Several technologies are poised to furnish systems with even greater sensitivity and resolution than current systems, potentially with orders of magnitude higher sensitivity. Current barriers which remain to be surmounted, such as data pipelines, patient throughput and the hindrances to implementing kinetic analysis for routine patient care will also be discussed.

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Section: Challenges and Opportunitiesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Long-axial field-of-view PET/CT: perspectives and review of a revolutionary development in nuclear medicine based on clinical experience in over 7000 patients

et al. 2023

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“…Current uptake times for FDG scanning are a trade‐off between its slow uptake in cancer cells, clearance from background and the sensitivity of current PET systems which limit the uptake time to about 1‐hour post‐injection due to noise constraints. With the substantially increased sensitivity of Long AFOV PET/CT, extending uptake times to over an hour for FDG patients is possible and can be expected to improve the contrast of lesions 12 . However, such a change would require additional uptake rooms to maintain the same patient throughput as current PET/CT systems.…”

Section: Pet/ct Workflowsmentioning

confidence: 99%

The potential advantages and workflow challenges of long axial field of view PET/CT

Chen

Rae

Kench

et al. 2023

J of Medical Radiation Sci

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Recently developed Long (≥100 cm) axial field of view (AFOV) PET/CT scanners are capable of producing images with higher signal‐to‐noise ratio, or performing faster whole‐body acquisitions, or scanning with lower radiation dose to the patient, compared with conventional PET/CT scanners. These benefits, which arise due to their substantially higher, by more than an order of magnitude, geometric efficiency, have been well described in the recent literature. The introduction of Long AFOV PET/CT technology into the clinic also has important implications for the design and workflow of PET/CT facilities and their effects on radiation exposure to staff and patients. Maximising the considerable benefits of this technology requires a thorough understanding of the relationships between these factors to optimise workflows while appropriately managing radiation exposure. This article reviews current knowledge on PET/CT facility design, workflows and their effects on radiation exposure, identifies gaps in the literature and discusses the challenges that need to be considered with the introduction of Long AFOV PET/CT into the clinic.

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“…Zhang et al observed in the uEXPLORER total-body PET-scanner worsening axial resolution with increasing MRD since oblique lines-of-response (LOR) are more likely to be scattered in the patient with longer MRD [ 7 ]. Therefore, fast time-of-flight (TOF) resolution and accurate scatter correction are crucial to avoid misinterpretation of the coincident events [ 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

Impact of the new ultra-high sensitivity mode in a long axial field-of-view PET/CT

et al. 2023

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Objective Long axial field-of-view (LAFOV) PET/CT showed improved performance resulting from higher sensitivity. The aim was to quantify the impact of using the full acceptance angle (UHS) in image reconstructions with the Biograph Vision Quadra LAFOV PET/CT (Siemens Healthineers) compared to the limited acceptance angle (high sensitivity mode, HS). Methods 38 oncological patients examined on a LAFOV Biograph Vision Quadra PET/CT were analysed. 15 patients underwent [18F]FDG-PET/CT, 15 patients underwent [18F]PSMA-1007 PET/CT, and 8 patients underwent [68Ga]Ga-DOTA-TOC PET/CT. Signal-to-noise ratio (SNR) and standardised uptake values (SUVmean/max/peak) were used to compare UHS and HS with different acquisition times. Results The SNR was significantly higher for UHS compared to HS over all acquisition times (SNR UHS/HS [18F]FDG: 1.35 ± 0.02, p < 0.001; [18F]PSMA-1007: 1.25 ± 0.02, p < 0.001; [68Ga]Ga-DOTA-TOC: 1.29 ± 0.02, p < 0.001). Conclusion UHS showed significantly higher SNR opening the possibility of halving short acquisition times. This is of advantage in further reduction of whole-body PET/CT acquisition.

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Scanner Design Considerations for Long Axial Field-of-View PET Systems

Cited by 12 publications

References 48 publications

Long-axial field-of-view PET/CT: perspectives and review of a revolutionary development in nuclear medicine based on clinical experience in over 7000 patients

Long-axial field-of-view PET/CT: perspectives and review of a revolutionary development in nuclear medicine based on clinical experience in over 7000 patients

The potential advantages and workflow challenges of long axial field of view PET/CT

Impact of the new ultra-high sensitivity mode in a long axial field-of-view PET/CT

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