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European Journal of Nuclear Medicine and Molecular Imaging

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01-10-2021 | Original Article

Image quality and lesion detectability in low-dose pediatric ¹⁸F-FDG scans using total-body PET/CT

Authors: Yu-Mo Zhao, Ying-He Li, Tao Chen, Wei-Guang Zhang, Lin-Hao Wang, Jiatai Feng, Chenwei Li, Xu Zhang, Wei Fan, Ying-Ying Hu

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 11/2021

Abstract

Purpose

To investigate the effects of dose reduction on image quality and lesion detectability of oncological ¹⁸F-FDG total-body PET/CT in pediatric oncological patients and explore the minimum threshold of administered tracer activity.

Methods

A total of 33 pediatric patients (weight 8.5–58.5 kg; age 0.8–17.6 years) underwent total-body PET/CT using uEXPLORER scanner with an ¹⁸F-FDG administered dose of 3.7 MBq/kg and an acquisition time of 600 s were retrospectively enrolled. Low-dose images (0.12–1.85 MBq/kg) were simulated by truncating the list-mode PET data to reducing count density. Subjective image quality was rated on a 5-point scale. Semi-quantitative uptake metrics for low-dose images were assessed using region-of-interest (ROI) analysis of healthy liver and suspected lesions and were compared with full-dose images. The micro-lesion detectability was compared among the dose-dependent PET images.

Results

Our analysis shows that sufficient subjective image quality and lesion conspicuity could be maintained down to 1/30th (0.12 MBq/kg) of the administered dose of ¹⁸F-FDG, where good image quality scores were given to 1/2- and 1/10- dose groups. The image noise was significantly more deranged than the overall quality and lesion conspicuity in 1/30- to 1/10-dose groups (all p < 0.05). With reduced doses, quantitative analysis of ROIs showed that SUV_max and SD in the liver increased gradually (p < 0.05), but SUV_max in the lesions and lesion-to-background ratio (LBR) showed no significant deviation down to 1/30-dose. One hundred percent of the ¹⁸F-FDG-avid micro-lesions identified in full-dose images were localized down to 1/15-dose images, while 97% of the lesion were localized in 1/30-dose images.

Conclusion

The total-body PET/CT might significantly decrease the administered dose upon maintaining the image quality and diagnostic performance of micro-lesions in pediatric patients. Data suggests that using total-body PET/CT, optimal image quality could be achieved with an administered dose-reduction down to 1/10-dose (0.37 MBq/kg).

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Title: Image quality and lesion detectability in low-dose pediatric 18F-FDG scans using total-body PET/CT
Authors: Yu-Mo Zhao
Ying-He Li
Tao Chen
Wei-Guang Zhang
Lin-Hao Wang
Jiatai Feng
Chenwei Li
Xu Zhang
Wei Fan
Ying-Ying Hu
Publication date: 01-10-2021
Publisher: Springer Berlin Heidelberg
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 11/2021
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-021-05304-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Image quality and lesion detectability in low-dose pediatric ¹⁸F-FDG scans using total-body PET/CT

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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