Review

. 2025 Feb;52(3):1038-1049.

doi: 10.1007/s00259-024-06968-4. Epub 2024 Nov 9.

Expert consensus on workflow of PET/CT with long axial field-of-view

Guobing Liu^#^{1

2

3}, Yushen Gu^#^{4

1

2

3}, Martina Sollini^#^{5

6}, Alexandra Lazar⁵, Florent L Besson^{7

8}, Sijin Li⁹, Zhifang Wu⁹, Lorenzo Nardo¹⁰, Akram Al-Ibraheem^{11

12}, Jiefu Zheng¹³, Harshad R Kulkarni^{14

15}, Axel Rominger¹⁶, Wei Fan¹⁷, Xiaohua Zhu¹⁸, Xinming Zhao¹⁹, Hubing Wu²⁰, Jianjun Liu²¹, Biao Li²², Zhaoping Cheng²³, Ruimin Wang²⁴, Baixuan Xu²⁴, Denis Agostini²⁵, Han Tang^{3

26}, Lijie Tan^{3

26}, Zhi Yang²⁷, Li Huo^{28

29}, Jianying Gu^{30

31

32

33}, Hongcheng Shi^{34

35

36

37

38

39}

Affiliations

¹ Shanghai Institute of Medical Imaging, Shanghai, 200032, P.R. China.
² Institute of Nuclear Medicine, Fudan University, Shanghai, 200032, P.R. China.
³ Cancer Prevention and Treatment Center, Zhongshan Hospital, Fudan University, Shanghai, 200032, P.R. China.
⁴ Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, P.R. China.
⁵ Vita-Salute San Raffaele University, Via Olgettina 58, 20132, Milan, Italy.
⁶ Department of Nuclear Medicine, IRCCS Ospedale San Raffaele, Via Olgettina 60, 20132, Milan, Italy.
⁷ Department of Nuclear Medicine-Molecular Imaging, Hôpitaux Universitaires Paris-Saclay, AP-HP, DMU Smart Imaging, CHU Bicêtre, Paris, France and Université Paris-Saclay, Commissariat À L'énergie Atomique Et Aux Énergies Alternatives (CEA), Centre National de La Recherche Scientifique (CNRS), InsermBioMaps, Orsay, France.
⁸ Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France.
⁹ Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Collaborative Innovation Center for Molecular Imaging Precision Medicine, Taiyuan, 030001, P.R. China.
¹⁰ Department of Radiology, University of California Davis, Sacramento, CA, 95819, USA.
¹¹ Department of Nuclear Medicine and PET/CT, King Hussein Cancer Center (KHCC), Al-Jubeiha, Amman, 11941, Jordan.
¹² Department of Radiology and Nuclear Medicine, School of Medicine, University of Jordan, Amman, 11942, Jordan.
¹³ Division of Nuclear Medicine and Molecular Imaging, Department of Radiology and Medical Imaging, University of Virginia School of Medicine, 1215 Lee Street, Charlottesville, VA, 22908-0170, USA.
¹⁴ BAMF Health, Grand Rapids, MI, 49503, USA.
¹⁵ Department of Radiology, Michigan State University College of Human Medicine, East Lansing, MI, 48824, USA.
¹⁶ Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 18, CH-3010, Bern, Switzerland.
¹⁷ Department of Nuclear Medicine, Sun Yat-Sen University Cancer Center, No. 651 Dongfengdong Road, Guangzhou, 510060, P.R. China.
¹⁸ Department of Nuclear Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Ave, Wuhan, 430030, P.R. China.
¹⁹ Department of Nuclear Medicine, The Fourth Hospital of Hebei Medical University, Shijiazhuang, 050011, Hebei Province, P.R. China.
²⁰ Nanfang PET Center, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue North, Guangzhou, 510515, P.R. China.
²¹ Department of Nuclear Medicine, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, No. 160 PuJian Road, Shanghai, 200127, P.R. China.
²² Department of Nuclear Medicine, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, No. 197 Ruijin Er Road, Shanghai, 200025, P.R. China.
²³ Department of Nuclear Medicine, The First Affiliated Hospital of Shandong First Medical University, No. 16766 Jingshi Road, Jinan, 250014, Shandong, P.R. China.
²⁴ Department of Nuclear Medicine, The First Medical Centre, Chinese PLA General Hospital, Beijing, 100853, P.R. China.
²⁵ Department of Nuclear Medicine, University Hospital of Caen and Normandie Université, EA, 4650, Caen, France.
²⁶ Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, 200032, P.R. China.
²⁷ Key Laboratory of Carcinogenesis and Translational Research, (Ministry of Education/Beijing), NMPA Key Laboratory for Research and Evaluation of Radiopharmaceuticals, Department of Nuclear Medicine, Peking University Cancer Hospital & Institute, Beijing, 100142, P.R. China.
²⁸ Department of Nuclear Medicine, Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Beijing, 100730, P.R. China.
²⁹ Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730, P.R. China.
³⁰ Cancer Prevention and Treatment Center, Zhongshan Hospital, Fudan University, Shanghai, 200032, P.R. China. gu.jianying@zs-hospital.sh.cn.
³¹ Department of Plastic Surgery, Zhongshan Hospital, Fudan University, Shanghai, 200032, P.R. China. gu.jianying@zs-hospital.sh.cn.
³² Department of Plastic Surgery, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, 361015, P.R. China. gu.jianying@zs-hospital.sh.cn.
³³ Clinical Research Center for Precision Medicine of Abdominal Tumor of Fujian Province, Xiamen, 361015, P.R. China. gu.jianying@zs-hospital.sh.cn.
³⁴ Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, P.R. China. shi.hongcheng@zs-hospital.sh.cn.
³⁵ Shanghai Institute of Medical Imaging, Shanghai, 200032, P.R. China. shi.hongcheng@zs-hospital.sh.cn.
³⁶ Institute of Nuclear Medicine, Fudan University, Shanghai, 200032, P.R. China. shi.hongcheng@zs-hospital.sh.cn.
³⁷ Cancer Prevention and Treatment Center, Zhongshan Hospital, Fudan University, Shanghai, 200032, P.R. China. shi.hongcheng@zs-hospital.sh.cn.
³⁸ Clinical Research Center for Precision Medicine of Abdominal Tumor of Fujian Province, Xiamen, 361015, P.R. China. shi.hongcheng@zs-hospital.sh.cn.
³⁹ Department of Nuclear Medicine, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, 361015, P.R. China. shi.hongcheng@zs-hospital.sh.cn.

^# Contributed equally.

PMID: 39520515
DOI: 10.1007/s00259-024-06968-4

Review

Expert consensus on workflow of PET/CT with long axial field-of-view

Guobing Liu et al. Eur J Nucl Med Mol Imaging. 2025 Feb.

. 2025 Feb;52(3):1038-1049.

doi: 10.1007/s00259-024-06968-4. Epub 2024 Nov 9.

Authors

Affiliations

¹ Shanghai Institute of Medical Imaging, Shanghai, 200032, P.R. China.
² Institute of Nuclear Medicine, Fudan University, Shanghai, 200032, P.R. China.
³ Cancer Prevention and Treatment Center, Zhongshan Hospital, Fudan University, Shanghai, 200032, P.R. China.
⁴ Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, P.R. China.
⁵ Vita-Salute San Raffaele University, Via Olgettina 58, 20132, Milan, Italy.
⁶ Department of Nuclear Medicine, IRCCS Ospedale San Raffaele, Via Olgettina 60, 20132, Milan, Italy.
⁷ Department of Nuclear Medicine-Molecular Imaging, Hôpitaux Universitaires Paris-Saclay, AP-HP, DMU Smart Imaging, CHU Bicêtre, Paris, France and Université Paris-Saclay, Commissariat À L'énergie Atomique Et Aux Énergies Alternatives (CEA), Centre National de La Recherche Scientifique (CNRS), InsermBioMaps, Orsay, France.
⁸ Université Paris-Saclay, School of Medicine, Le Kremlin-Bicêtre, France.
⁹ Department of Nuclear Medicine, First Hospital of Shanxi Medical University, Collaborative Innovation Center for Molecular Imaging Precision Medicine, Taiyuan, 030001, P.R. China.
¹⁰ Department of Radiology, University of California Davis, Sacramento, CA, 95819, USA.
¹¹ Department of Nuclear Medicine and PET/CT, King Hussein Cancer Center (KHCC), Al-Jubeiha, Amman, 11941, Jordan.
¹² Department of Radiology and Nuclear Medicine, School of Medicine, University of Jordan, Amman, 11942, Jordan.
¹³ Division of Nuclear Medicine and Molecular Imaging, Department of Radiology and Medical Imaging, University of Virginia School of Medicine, 1215 Lee Street, Charlottesville, VA, 22908-0170, USA.
¹⁴ BAMF Health, Grand Rapids, MI, 49503, USA.
¹⁵ Department of Radiology, Michigan State University College of Human Medicine, East Lansing, MI, 48824, USA.
¹⁶ Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 18, CH-3010, Bern, Switzerland.
¹⁷ Department of Nuclear Medicine, Sun Yat-Sen University Cancer Center, No. 651 Dongfengdong Road, Guangzhou, 510060, P.R. China.
¹⁸ Department of Nuclear Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Ave, Wuhan, 430030, P.R. China.
¹⁹ Department of Nuclear Medicine, The Fourth Hospital of Hebei Medical University, Shijiazhuang, 050011, Hebei Province, P.R. China.
²⁰ Nanfang PET Center, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue North, Guangzhou, 510515, P.R. China.
²¹ Department of Nuclear Medicine, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, No. 160 PuJian Road, Shanghai, 200127, P.R. China.
²² Department of Nuclear Medicine, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, No. 197 Ruijin Er Road, Shanghai, 200025, P.R. China.
²³ Department of Nuclear Medicine, The First Affiliated Hospital of Shandong First Medical University, No. 16766 Jingshi Road, Jinan, 250014, Shandong, P.R. China.
²⁴ Department of Nuclear Medicine, The First Medical Centre, Chinese PLA General Hospital, Beijing, 100853, P.R. China.
²⁵ Department of Nuclear Medicine, University Hospital of Caen and Normandie Université, EA, 4650, Caen, France.
²⁶ Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, 200032, P.R. China.
²⁷ Key Laboratory of Carcinogenesis and Translational Research, (Ministry of Education/Beijing), NMPA Key Laboratory for Research and Evaluation of Radiopharmaceuticals, Department of Nuclear Medicine, Peking University Cancer Hospital & Institute, Beijing, 100142, P.R. China.
²⁸ Department of Nuclear Medicine, Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Beijing, 100730, P.R. China.
²⁹ Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730, P.R. China.
³⁰ Cancer Prevention and Treatment Center, Zhongshan Hospital, Fudan University, Shanghai, 200032, P.R. China. gu.jianying@zs-hospital.sh.cn.
³¹ Department of Plastic Surgery, Zhongshan Hospital, Fudan University, Shanghai, 200032, P.R. China. gu.jianying@zs-hospital.sh.cn.
³² Department of Plastic Surgery, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, 361015, P.R. China. gu.jianying@zs-hospital.sh.cn.
³³ Clinical Research Center for Precision Medicine of Abdominal Tumor of Fujian Province, Xiamen, 361015, P.R. China. gu.jianying@zs-hospital.sh.cn.
³⁴ Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, P.R. China. shi.hongcheng@zs-hospital.sh.cn.
³⁵ Shanghai Institute of Medical Imaging, Shanghai, 200032, P.R. China. shi.hongcheng@zs-hospital.sh.cn.
³⁶ Institute of Nuclear Medicine, Fudan University, Shanghai, 200032, P.R. China. shi.hongcheng@zs-hospital.sh.cn.
³⁷ Cancer Prevention and Treatment Center, Zhongshan Hospital, Fudan University, Shanghai, 200032, P.R. China. shi.hongcheng@zs-hospital.sh.cn.
³⁸ Clinical Research Center for Precision Medicine of Abdominal Tumor of Fujian Province, Xiamen, 361015, P.R. China. shi.hongcheng@zs-hospital.sh.cn.
³⁹ Department of Nuclear Medicine, Zhongshan Hospital (Xiamen), Fudan University, Xiamen, 361015, P.R. China. shi.hongcheng@zs-hospital.sh.cn.

^# Contributed equally.

PMID: 39520515
DOI: 10.1007/s00259-024-06968-4

Abstract

Purpose: Positron emission tomography/computed tomography (PET/CT) imaging has been widely used in clinical practice. Long axial field-of-view (LAFOV) systems have enhanced clinical practice by leveraging their technological advantages and have emerged as the new state-of-the-art PET imaging modalities. A consensus was conducted to explore expert views in this emerging field to comprehensively elucidate the proposed workflow in LAFOV PET/CT examinations and highlight the potential challenges inherent in the workflow.

Methods: A multidisciplinary task group formed by 28 experts from six countries over the world discussed and approved the consensus based on the published guidelines, peer-reviewed articles of LAFOV PET/CT, and the collective experience from clinical practice. This consensus focuses on the workflow that allows for a broader range of imaging protocols of LAFOV PET/CT, catering to diverse patient needs and in line with precision medicine principles.

Results: This consensus describes the workflows and imaging protocols of LAFOV PET/CT for various imaging scenarios including routine static imaging, dynamic imaging, low-activity imaging, fast imaging, prolonged imaging, delayed imaging, and dual-tracer imaging. In addition, imaging reconstruction and reviewing specific to LAFOV PET/CT imaging, as well as the main challenges facing installation and application of LAFOV PET/CT scanner were also summarized.

Conclusion: This consensus summarized the various imaging workflow, imaging protocol, and challenges of LAFOV PET/CT imaging, aiming to enhance the clinical and research applications of these scanners.

Keywords: Expert consensus; Imaging protocols; Imaging workflow; Long axial field-of-view; Positron emission tomography/computed tomography (PET/CT); Total-body imaging.

PubMed Disclaimer

Conflict of interest statement

Declarations. Conflict of interest: Zhongshan Hospital affiliated to Fudan University has a strategic partnership with United Imaging Healthcare (UIH) and professor Hongcheng Shi has been commonly invited to offer a lecture to UIH. UC Davis has a research agreement and a sales-based revenue-sharing agreement with United Imaging Healthcare. UIH partially supports a fellowship training program at UC Davis. Harshad Kulkarni from BAMF Health is part of the Speaker bureau of United Imaging within the past 2 years. Some investigator-initiated research projects at BAMF Health were funded by United Imaging. Axel Rominger receives speaker honoraria from Siemens and has research agreement ongoing. Martina Sollini is a member of the EJNMMI Editorial Board and an Associate Editor for the “Artificial intelligence, machine learning and radiomics” section of Cancer Imaging. Other authors declare no conflict of interest regarding this article. Ethics approval: Institutional Review Board approval was not required because this is a expert consensus. Consent to participate: Not applicable. Consent for publication: Not applicable.

Cited by

Total-body ¹⁸F-FDG PET/CT: more choices to promote clinical scanning efficiency.
Xiao J, Chen S, Hou X, Yu H, Liu S, Gu T, Liu G, Ge Q, Wang J, Shi H. Xiao J, et al. EJNMMI Res. 2025 Aug 2;15(1):99. doi: 10.1186/s13550-025-01290-y. EJNMMI Res. 2025. PMID: 40751859 Free PMC article.
Ultra-low dose imaging in a standard axial field-of-view PET.
Lima T, Gomes CV, Fargier P, Strobel K, Leimgruber A. Lima T, et al. EJNMMI Rep. 2025 Jul 21;9(1):25. doi: 10.1186/s41824-025-00261-9. EJNMMI Rep. 2025. PMID: 40685465 Free PMC article.

References

1. Boellaard R, Delgado-Bolton R, Oyen WJ, Giammarile F, Tatsch K, Eschner W, et al. FDG PET/CT: EANM procedure guidelines for tumour imaging: version 2.0. Eur J Nucl Med Mol Imaging. 2015;42:328–54.
1. Stauss J, Franzius C, Pfluger T, Juergens KU, Biassoni L, Begent J, et al. Guidelines for 18F-FDG PET and PET-CT imaging in paediatric oncology. Eur J Nucl Med Mol Imaging. 2008;35(8):1581–8. - PubMed
1. Fendler WP, Eiber M, Beheshti M, Bomanji J, Calais J, Ceci F, et al. PSMA PET/CT: joint EANM procedure guideline/SNMMI procedure standard for prostate cancer imaging 2.0. Eur J Nucl Med Mol Imaging. 2023;50(5):1466–86.
1. Guedj E, Varrone A, Boellaard R, Albert NL, Barthel H, van Berckel B, et al. EANM procedure guidelines for brain PET imaging using [18F]FDG, version 3. Eur J Nucl Med Mol Imaging. 2022;49(2):632–51. - PubMed
1. Hope TA, Allen-Auerbach M, Bodei L, Calais J, Dahlbom M, Dunnwald LK, et al. SNMMI Procedure Standard/EANM Practice Guideline for SSTR PET: Imaging Neuroendocrine Tumors. J Nucl Med. 2023;64(2):204–10. - PubMed

Publication types

Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions

Grants and funding

LinkOut - more resources

Full Text Sources
- Springer

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Expert consensus on workflow of PET/CT with long axial field-of-view

Affiliations

Expert consensus on workflow of PET/CT with long axial field-of-view

Authors

Affiliations

Abstract

Conflict of interest statement

Similar articles

Cited by

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Abstract

Conflict of interest statement

Similar articles

Cited by

References

Publication types

MeSH terms

Related information

Grants and funding

LinkOut - more resources

Full Text Sources