. 2021 Oct;48(11):3378-3385.

doi: 10.1007/s00259-021-05304-4. Epub 2021 Mar 18.

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

Yu-Mo Zhao^#^{1

2}, Ying-He Li^#^{1

2}, Tao Chen^{1

2}, Wei-Guang Zhang^{1

2}, Lin-Hao Wang^{1

2}, Jiatai Feng³, Chenwei Li³, Xu Zhang^{4

5}, Wei Fan^{6

7}, Ying-Ying Hu^{8

9}

Affiliations

¹ State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China.
² Department of Nuclear Medicine, Sun Yat-Sen University Cancer Center, 651 Dongfengdong Road, Guangzhou, 510060, Guangdong, China.
³ Central research institute, United Imaging Healthcare, Shanghai, China.
⁴ State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China. zhangx2@sysucc.org.cn.
⁵ Department of Nuclear Medicine, Sun Yat-Sen University Cancer Center, 651 Dongfengdong Road, Guangzhou, 510060, Guangdong, China. zhangx2@sysucc.org.cn.
⁶ State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China. fanwei@sysucc.org.cn.
⁷ Department of Nuclear Medicine, Sun Yat-Sen University Cancer Center, 651 Dongfengdong Road, Guangzhou, 510060, Guangdong, China. fanwei@sysucc.org.cn.
⁸ State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China. huyy@sysucc.org.cn.
⁹ Department of Nuclear Medicine, Sun Yat-Sen University Cancer Center, 651 Dongfengdong Road, Guangzhou, 510060, Guangdong, China. huyy@sysucc.org.cn.

^# Contributed equally.

PMID: 33738519
DOI: 10.1007/s00259-021-05304-4

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

Yu-Mo Zhao et al. Eur J Nucl Med Mol Imaging. 2021 Oct.

. 2021 Oct;48(11):3378-3385.

doi: 10.1007/s00259-021-05304-4. Epub 2021 Mar 18.

Authors

Yu-Mo Zhao^#^{1

2}, Ying-He Li^#^{1

2}, Tao Chen^{1

2}, Wei-Guang Zhang^{1

2}, Lin-Hao Wang^{1

2}, Jiatai Feng³, Chenwei Li³, Xu Zhang^{4

5}, Wei Fan^{6

7}, Ying-Ying Hu^{8

9}

Affiliations

¹ State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China.
² Department of Nuclear Medicine, Sun Yat-Sen University Cancer Center, 651 Dongfengdong Road, Guangzhou, 510060, Guangdong, China.
³ Central research institute, United Imaging Healthcare, Shanghai, China.
⁴ State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China. zhangx2@sysucc.org.cn.
⁵ Department of Nuclear Medicine, Sun Yat-Sen University Cancer Center, 651 Dongfengdong Road, Guangzhou, 510060, Guangdong, China. zhangx2@sysucc.org.cn.
⁶ State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China. fanwei@sysucc.org.cn.
⁷ Department of Nuclear Medicine, Sun Yat-Sen University Cancer Center, 651 Dongfengdong Road, Guangzhou, 510060, Guangdong, China. fanwei@sysucc.org.cn.
⁸ State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China. huyy@sysucc.org.cn.
⁹ Department of Nuclear Medicine, Sun Yat-Sen University Cancer Center, 651 Dongfengdong Road, Guangzhou, 510060, Guangdong, China. huyy@sysucc.org.cn.

^# Contributed equally.

PMID: 33738519
DOI: 10.1007/s00259-021-05304-4

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).

Keywords: 18F-FDG; Low-dose; Pediatric; Total-body PET/CT.

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

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

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