Vol 25, No 1 (2022)
Research paper
Published online: 2022-01-20

open access

Page views 5472
Article views/downloads 414
Get Citation

Connect on Social Media

Connect on Social Media

Optimal activity of [18F]FDG for Hodgkin lymphoma imaging performed on PET/CT camera with BGO crystals

Miroslaw Dziuk12, Ewa Witkowska-Patena12, Agnieszka Gizewska12, Andrzej Mazurek12, Anna Pieczonka3, Magdalena Koza1, Marina Gerszewska1, Zbigniew Podgajny3, Marta Chojnowska2
Pubmed: 35137937
Nucl. Med. Rev 2022;25(1):47-53.

Abstract

Background: We aimed to find the minimum feasible activity of fluorodeoxyglucose ([18F]FDG) in positron emission tomography/computed tomography (PET/CT) of Hodgkin lymphoma patients performed on a camera with bismuth germanate (BGO) crystals.

Material and methods: Ninety-one [18F]FDG PET/CT scans (each in seven Bayesian Penalized Likelihood [BPL] reconstructions with varying acquisition time per bed position — 2 min, 1.5 min, 1 min, 50 s, 40 s, 30 s, and 20 s) were independently assessed by three physicians to evaluate image quality. Mean administered activity was 3.0 ± 0.1 MBq/kg and mean uptake time was 54.0 ± 8.7 min. The series quality was subjectively marked on a 1–10 scale and then ranked 1–7 based on the mean mark. Interobserver rank correlation and intraclass correlation within each series for the three observers were calculated. Phantom studies were also performed to determine if reduced acquisition time can be directly translated into a reduced activity.

Results: Time series were marked and ranked unanimously — the longer the time of acquisition the higher the mark and rank. The interobserver agreement in the ranking was excellent (100%) with a kappa coefficient of 1.00 (95% CI [0.83–1.0]). The general intraclass correlation coefficient (agreement between the marks observers gave each time series) was very high (0.945, 95% CI [0.936–0.952]) and was higher the shorter the time per bed. According to all three observers only the series with 2 min and 1.5 min acquisition time were appropriate for assessment (mean mark ≥ 7). In phantom studies there was a linear correlation between time per bed, administered activity, and number of total prompts detected by a scanner. Hence, a reduction of acquisition time of 25% (from 2 min to 1.5 min) could be directly translated into a 25% activity reduction (from 3.0 to 2.25 MBq/kg).

Conclusions: In patients with HL, [18F]FDG activity can be reduced by up to 25% when using a BGO crystal camera, without substantial impact on image quality.

Article available in PDF format

View PDF Download PDF file

References

  1. Murgu SD. Diagnosing and staging lung cancer involving the mediastinum. Chest. 2015; 147(5): 1401–1412.
  2. Saraste A, Barbato E, Capodanno D, et al. Imaging in ESC clinical guidelines: chronic coronary syndromes. Eur Heart J Cardiovasc Imaging. 2019; 20(11): 1187–1197.
  3. Cheson BD, Fisher RI, Barrington SF, et al. Recommendations for initial evaluation, staging, and response assessment of Hodgkin and non-Hodgkin lymphoma: the Lugano classification. J Clin Oncol. 2014; 32(27): 3059–3068.
  4. van Waarde A, Marcolini S, de Deyn PP, et al. PET Agents in Dementia: An Overview. Semin Nucl Med. 2021; 51(3): 196–229.
  5. Delbeke D, Coleman RE, Guiberteau MJ, et al. Procedure guideline for tumor imaging with 18F-FDG PET/CT 1.0. J Nucl Med. 2006; 47(5): 885–895.
  6. Brix G, Lechel U, Glatting G, et al. Radiation exposure of patients undergoing whole-body dual-modality 18F-FDG PET/CT examinations. J Nucl Med. 2005; 46(4): 608–613.
  7. Quinn B, Dauer Z, Pandit-Taskar N, et al. Radiation dosimetry of 18F-FDG PET/CT: incorporating exam-specific parameters in dose estimates. BMC Med Imaging. 2016; 16(1): 41.
  8. Boellaard R, Delgado-Bolton R, Oyen WJG, et al. FDG PET/CT: EANM procedure guidelines for tumour imaging: version 2.0. Eur J Nucl Med Mol Imaging. 2015; 42(2): 328–354.
  9. Daube-Witherspoon ME, Karp JS, Casey ME, et al. PET Performance Measurements Using the NEMA NU 2-2001 Standard. J Nucl Med. Society of Nuclear Medicine. 2002; 43(10): 1398–409.
  10. Watson CC, Casey ME, Bendriem B, et al. Optimizing injected dose in clinical PET by accurately modeling the counting-rate response functions specific to individual patient scans. J Nucl Med. 2005; 46(11): 1825–1834.
  11. de Groot EH, Post N, Boellaard R, et al. Optimized dose regimen for whole-body FDG-PET imaging. EJNMMI Res. 2013; 3(1): 63.
  12. Chang T, Chang G, Kohlmyer S, et al. Effects of injected dose, BMI and scanner type on NECR and image noise in PET imaging. Phys Med Biol. 2011; 56(16): 5275–5285.
  13. Makris NE, Huisman MC, Kinahan PE, et al. Evaluation of strategies towards harmonization of FDG PET/CT studies in multicentre trials: comparison of scanner validation phantoms and data analysis procedures. Eur J Nucl Med Mol Imaging. 2013; 40(10): 1507–1515.
  14. Karp JS, Surti S, Daube-Witherspoon ME, et al. Benefit of time-of-flight in PET: experimental and clinical results. J Nucl Med. 2008; 49(3): 462–470.
  15. Vallot D, Caselles O, Chaltiel L, et al. A clinical evaluation of the impact of the Bayesian penalized likelihood reconstruction algorithm on PET FDG metrics. Nucl Med Commun. 2017; 38(11): 979–984.
  16. Reynés-Llompart G, Gámez-Cenzano C, Romero-Zayas I, et al. Performance Characteristics of the Whole-Body Discovery IQ PET/CT System. J Nucl Med. 2017; 58(7): 1155–1161.
  17. Morzenti S, Ponti ED, Guerra L, et al. Performance evaluation of the Discovery IQ - GE PET/CT scanner according to NEMA NU2-2012 standard. J Nucl Med. Society of Nuclear Medicine. 2015; 56: 1846.
  18. Howard BA, Morgan R, Thorpe MP, et al. Comparison of Bayesian penalized likelihood reconstruction versus OS-EM for characterization of small pulmonary nodules in oncologic PET/CT. Ann Nucl Med. 2017; 31(8): 623–628.
  19. Teoh EJ, McGowan DR, Bradley KM, et al. Novel penalised likelihood reconstruction of PET in the assessment of histologically verified small pulmonary nodules. Eur Radiol. 2016; 26(2): 576–584.
  20. Teoh EJ, McGowan DR, Schuster DM, et al. Bayesian penalised likelihood reconstruction (Q.Clear) of F-fluciclovine PET for imaging of recurrent prostate cancer: semi-quantitative and clinical evaluation. Br J Radiol. 2018; 91(1085): 20170727.
  21. Sampaio Vieira T, Borges Faria D, Azevedo Silva F, et al. The Impact of a Bayesian Penalized Likelihood Reconstruction Algorithm on the Evaluation of Indeterminate Pulmonary Nodules by Dual-Time Point 18F-FDG PET/CT. Clin Nucl Med. 2017; 42(7): e352–e354.
  22. Tonkopi E, Ross AA, MacDonald A. JOURNAL CLUB: CT dose optimization for whole-body PET/CT examinations. AJR Am J Roentgenol. 2013; 201(2): 257–263.
  23. Slomka PJ, Pan T, Germano G. Recent Advances and Future Progress in PET Instrumentation. Semin Nucl Med. 2016; 46(1): 5–19.
  24. Jakoby B, Bercier Y, Watson C, et al. Performance Characteristics of a New LSO PET/CT Scanner With Extended Axial Field-of-View and PSF Reconstruction. IEEE Transactions on Nuclear Science. 2009; 56(3): 633–639.
  25. Teoh EJ, McGowan DR, Macpherson RE, et al. Phantom and Clinical Evaluation of the Bayesian Penalized Likelihood Reconstruction Algorithm Q.Clear on an LYSO PET/CT System. J Nucl Med. 2015; 56(9): 1447–1452.
  26. Ahn S, Ross SG, Asma E, et al. Quantitative comparison of OSEM and penalized likelihood image reconstruction using relative difference penalties for clinical PET. Phys Med Biol. 2015; 60(15): 5733–5751.
  27. Witkowska-Patena E, Budzyńska A, Giżewska A, et al. Ordered subset expectation maximisation vs Bayesian penalised likelihood reconstruction algorithm in 18F-PSMA-1007 PET/CT. Ann Nucl Med. 2020; 34(3): 192–199.
  28. Prieto E, García-Velloso MJ, Rodríguez-Fraile M, et al. Significant dose reduction is feasible in FDG PET/CT protocols without compromising diagnostic quality. Phys Med. 2018; 46: 134–139.
  29. Murray I, Kalemis A, Glennon J, et al. Time-of-flight PET/CT using low-activity protocols: potential implications for cancer therapy monitoring. Eur J Nucl Med Mol Imaging. 2010; 37(9): 1643–1653.