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EJNMMI Research
Published in: EJNMMI Research 1/2020

01-12-2020 | Positron Emission Tomography | Original research

Standardized image quality for 68Ga-DOTA-TATE PET/CT

Authors: Christina P. W. Cox, Marcel Segbers, Laura H. Graven, Tessa Brabander, Daniëlle M. E. van Assema

Published in: EJNMMI Research | Issue 1/2020

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Abstract

Background

Positron emission tomography (PET) imaging with 68Gallium labeled somatostatin analogues (68Ga-DOTA-SSA) plays a key role in neuroendocrine tumor management. The impact of patient size on PET image quality is not well known for PET imaging with 68Ga-DOTA-SSA. The aim of this study is to propose a dose regimen based on patient size that optimizes image quality and yields sufficient image quality for diagnosis.

Methods

Twenty-one patients (12 males, 9 females) were prospectively included for 68Gallium-DOTA-Tyr3-Octreotate (68Ga-DOTA-TATE) PET/CT, which was acquired in whole body list mode using 6 min per bed position (mbp). The list-mode events were randomly sampled to obtain 1 to 6 mbp PET reconstructions. For semi-quantitative assessment of image quality, the signal-to-noise ratio (SNR) was measured in the liver. The SNR normalized (SNRnorm) for administered activity and mbp was correlated with body mass, length, body mass index, body mass/length, and lean body mass. Three experienced nuclear medicine physicians visually graded image quality using a 4-point scale, and categorically scored the number of somatostatin-receptor positive lesions for each reconstruction. To investigate the impact of image quality on lesion quantification, the mean, maximum, and peak standardized uptake values (SUVs) of one abdominal lesion were measured in the 1 to 6 mbp PET reconstructions.

Results

Of all patient-dependent parameters, body mass showed the strongest correlation (R2 = 0.6) with SNRnorm. Lesion detectability analysis showed no significant difference for 3-5 mbp compared with the complete 6 mbp PET reconstruction. The SUV measurements showed no significant (p > 0.05) differences across the reconstructions. Visual assessment revealed that an SNR of 6.2 results in PET scans with moderate to good image quality. A non-linear expression was derived to calculate the required (dose × acquisition time) product (DTP) for the chosen SNR level of 6.2 that would yield a more constant image quality.

Conclusion

Body mass can be used to predict 68Ga-DOTA-TATE PET image quality. The proposed non-linear dose regimen based on body mass standardizes the image quality while maintaining sufficient image quality for diagnosis.
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Metadata
Title
Standardized image quality for 68Ga-DOTA-TATE PET/CT
Authors
Christina P. W. Cox
Marcel Segbers
Laura H. Graven
Tessa Brabander
Daniëlle M. E. van Assema
Publication date
01-12-2020
Publisher
Springer Berlin Heidelberg
Published in
EJNMMI Research / Issue 1/2020
Electronic ISSN: 2191-219X
DOI
https://doi.org/10.1186/s13550-020-0601-y

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