scholarly journals SUV variability in EARL-accredited conventional and digital PET

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Daniëlle Koopman ◽  
Pieter L. Jager ◽  
Cornelis H. Slump ◽  
Siert Knollema ◽  
Jorn A. van Dalen
Keyword(s):  
Confidence Interval ◽  
Prospective Study ◽  
Relative Difference ◽  
Whole Body ◽  
Pet Scanning ◽  
Pet Ct ◽  
Digital Pet ◽  
Average Size ◽  
Pet Scanners ◽  
Pet Scans

Abstract Background A high SUV-reproducibility is crucial when different PET scanners are in use. We evaluated the SUV variability in whole-body FDG-PET scans of patients with suspected or proven cancer using an EARL-accredited conventional and digital PET scanner. In a head-to-head comparison we studied images of 50 patients acquired on a conventional scanner (cPET, Ingenuity TF PET/CT, Philips) and compared them with images acquired on a digital scanner (dPET, Vereos PET/CT, Philips). The PET scanning order was randomised and EARL-compatible reconstructions were applied. We measured SUVmean, SUVpeak, SUVmax and lesion diameter in up to 5 FDG-positive lesions per patient. The relative difference ΔSUV between cPET and dPET was calculated for each SUV-parameter. Furthermore, we calculated repeatability coefficients, reflecting the 95% confidence interval of ΔSUV. Results We included 128 lesions with an average size of 19 ± 14 mm. Average ΔSUVs were 6-8% with dPET values being higher for all three SUV-parameters (p < 0.001). ΔSUVmax was significantly higher than ΔSUVmean (8% vs. 6%, p = 0.002) and than ΔSUVpeak (8% vs. 7%, p = 0.03). Repeatability coefficients across individual lesions were 27% (ΔSUVmean and ΔSUVpeak) and 33% (ΔSUVmax) (p < 0.001). Conclusions With EARL-accredited conventional and digital PET, we found a limited SUV variability with average differences up to 8%. Furthermore, only a limited number of lesions showed a SUV difference of more than 30%. These findings indicate that EARL standardisation works. Trial registration This prospective study was registered on the 31th of October 2017 at ClinicalTrials.cov. URL: https://clinicaltrials.gov/ct2/show/NCT03457506?id=03457506&rank=1.

scholarly journals Focal Unspecific Bone Uptake on [18F]-psma-1007 Pet: A Multicenter Retrospective Evaluation of the Distribution, Frequency, and Quantitative Parameters of a Potential Pitfall in Prostate Cancer Imaging

2021 ◽  
Author(s):  
Hannes Grünig ◽  
Alexander Maurer ◽  
Yannick Thali ◽  
Zsofia Kovacs ◽  
Klaus Strobel ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Gleason Score ◽  
Tumor Size ◽  
Bone Uptake ◽  
Clinical Observations ◽  
Pet Ct ◽  
Digital Pet ◽  
Pet Scanners ◽  
Pet Scans

Abstract PurposeImproved logistics and availability led to a rapid increase in the use of [18F]-PSMA-1007 for prostate cancer PET imaging. Initial data suggests increased uptake in benign lesions compared to [68Ga]-PSMA-11, and clinical observations found increased unspecific bone uptake (UBU). We therefore investigate the frequency and characteristics of UBU in [18F]-PSMA-1007 PET.MethodsWe retrospectively analyzed [18F]-PSMA-1007 PET scans from four centers for the presence of UBU, defined as a focal mild-to-moderate uptake (SUVmax < 10.0) not obviously related to a benign or malignant cause. If present, up to three leading UBUs were quantified (SUVmax), localized, and correlated to clinical parameters, such as age, PSA, injected dose, Gleason-score, tumor size (T1–T4), and type of PET scanner (analog vs. digital). Additionally, clinical and imaging follow-up results and therapeutic impact were evaluated.ResultsUBUs were identified in 179 out of 348 patients (65.2%). The most frequent localizations were ribs (57.5%) and pelvis (24.8%). The frequency of UBUs was not associated with PSA, Gleason-score, tumor size, age, or the injected [18F]-PSMA-1007 dose. UBUs were significantly more frequent in images obtained with digital scanners (70.1%) than analog scanners (p=.0001). In 80 out of 179 patients (44.7%), the interpretation of UBUs was critical for therapeutic management and therefore considered clinically relevant. For 65 UBUs, follow-ups were available: three biopsies, three radiotherapies with PSA follow-up, and 59 cases with imaging. After follow-up UBUs were still considered unclear in 28 of 65 patients (43.1%), benign in 28 (43.1%), and malignant in nine (13.8%) patients.ConclusionUBUs occur in two-thirds of patients imaged with [18F]-PSMA-1007 PET/CT and are significantly more frequent on digital PET scanners than analog scanners. UBUs should be interpreted carefully to avoid over-staging.

Influence of PET/CT-introduction on PET scanning frequency and indications

2007 ◽  
Vol 46 (02) ◽  
pp. 57-64 ◽  
Author(s):  
A. Bockisch ◽  
S. M. Eschmann ◽  
B. J. Krause ◽  
R. Rödel ◽  
R. Tiling ◽  
...  
Keyword(s):  
Cancer Staging ◽  
Radiotherapy Planning ◽  
University Hospitals ◽  
New Developments ◽  
Pet Scanning ◽  
Pet Ct ◽  
Scanning Frequency ◽  
Disease Entities ◽  
Quantitative Changes ◽  
Pet Scans

Summary Aim: To evaluate the influence of the introduction of combined PET/CT scanners into clinical routine. This investigation addresses the quantitative changes between PET/CT and stand alone PET. Methods: The study included all examinations performed on stand alone PET- or PET/CTscanners within 12 month prior to and after implementation of PET/CT. The final data analysis included five university hospitals and a total number of 15 497 exams. We distinguished exams on stand alone tomographs prior to and after installation of the combined device as well as PET/CT scans particularly with regard to disease entities. Various further parameters were investigated. Results: The overall number of PET scans (PET and PET/CT) rose by 146% while the number of scans performed on stand alone scanners declined by 22%. Only one site registered an increase in stand alone PET. The number of exams for staging in oncology increased by 196% while that of cardiac scans decreased by 35% and the number of scans in neurology rose by 47%. The use of scans for radiotherapy planning increased to 7% of all PET/CT studies. The increase of procedures for so-called classic PET oncology indications was moderate compared to the more common tumors. An even greater increase was observed in some rare entities. Conclusions: The introduction of PET/CT led to more than a doubling of overall PET procedures with a main focus on oncology. Some of the observed changes in scanning frequency may be caused by a rising availability of new radiotracers and advancements of competing imaging methods. Nevertheless the evident increase in the use of PET/CT for the most common tumour types demonstrates its expanding role in cancer staging. The combination of molecular and morphologic imaging has not only found its place but is still gaining greater importance with new developments in technology and radiochemistry.

Response-Adapted Therapy for Diffuse Large B-Cell Non-Hodgkin's Lymphoma (DLBCL)Based On Early [18F] FDG-PET Scanning: An Eastern Cooperative Oncology Group Study (E3404)

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 687-687 ◽  
Author(s):  
Lode J. Swinnen ◽  
Hailun Li ◽  
Andrew Quon ◽  
Randy D. Gascoyne ◽  
Erik A. Ranheim ◽  
...  
Keyword(s):  
Overall Survival ◽  
Confidence Interval ◽  
B Cell ◽  
Research Funding ◽  
B Cell Lymphoma ◽  
Pet Scan ◽  
Pet Scanning ◽  
End Of Treatment ◽  
Pet Ct ◽  
Large B Cell

Abstract Abstract 687 Background: A persistently positive PET scan after just a few cycles of therapy is predictive of a poor clinical outcome in diffuse large B-cell lymphoma (DLBCL). Prior data suggested that about one third of patients remain PET positive after 2–4 cycles, with ≤ 20% 2 year progression-free survival (PFS) for such patients. A response-adapted strategy was studied in E3404 to test the hypothesis that an early treatment change to four cycles of R-ICE might reduce the treatment failure rate of patients whose PET scan remained positive after an initial 3 cycles of R-CHOP. Study Design: Previously untreated patients with DLBCL stage III, IV, or bulky II, with measurable disease, HIV negative, and with adequate organ reserve, were eligible. PET/CT scan was performed before treatment and again after 3 cycles of R-CHOP. A fourth cycle of R-CHOP was given while the scan was centrally reviewed and scored as either positive or negative for FDG-avid tumor by a single reviewer using criteria based on modifications of the Harmonization Criteria. Persistently PET-positive patients received 4 cycles of R-ICE, while PET-negative patients received 2 more cycles of R-CHOP, for a total of 6 cycles. PET/CT was performed again at the end of treatment. A ≥45% 2 year PFS for mid-treatment PET- positive patients was viewed as a promising result, with 88% power if 33 such patients were accrued. Total accrual of 99 patients was therefore planned. Results: Of 100 patients accrued, 78 were eligible; all but 1 ineligibility was based on central pathology review. Fifty-eight were male; median age was 62 years (20–74); 13% IPI 0–1, 31% IPI 2, 37% IPI 3, and 19% IPI 4–5. Seventy-four of 78 (95%) patients completed the first 3 cycles of R-CHOP. Of 72 patients continuing treatment, 67 (93%) completed protocol treatment: 83% of mid-treatment PET-positive and 93% of PET-negative patients. Of 74 patients undergoing mid-treatment PET scan, 12 (16%) were scored as positive, and 62 (84%) as negative. At the end of treatment, 13% were scored as positive, and 87% as negative. Two-year PFS, from the time of study entry, was 72% among all eligible patients. Two year PFS from the time of mid-treatment PET scan was 45% (90% CI, 21–67%) for patients scored as mid-treatment PET-positive, and 77% (90% CI 67–85%) for patients scored as mid-treatment PET-negative. The 80% confidence interval (corresponding to a test with a one-sided type I error of 10%) did not include the null hypothesis of 25%, implying that the results met the pre-specified threshold. Among all 78 eligible patients, 10 have died (13%); 5-year overall survival was 87% (90% CI 78–92%) Three-year overall survival was 67% (90% CI 40–84%) for mid-treatment PET-positive patients, and 93% (90% CI 85–97%) for mid-treatment PET-negative patients. Conclusions: The 2-year PFS for mid-treatment PET-positive patients met the threshold to be considered promising, but the confidence interval was wider than expected due to the small patient number. In addition, the inter-observer variability in the interpretation of mid-treatment PET scans as a binary variable in this study (studied and reported separately in Horning SJ et al. Blood 2010) implies that treatment modification based on early PET scanning should remain confined to clinical trials. Disclosures: Swinnen: Celgene: Consultancy; Genentech: Research Funding. Quon:Genentech: Research Funding. Advani:Pharmacyclics: Research Funding. Kahl:Roche/Genentech: Consultancy; Celgene: Consultancy; Cell Therapeutics: Consultancy; Janssen: Consultancy; GSK: Consultancy; Gilead: Consultancy. Horning:Genentech: Employment; Roche: stock, stock Other.

scholarly journals New probe for the improvement of the Spatial Resolution in total-body PET (PROScRiPT)

2021 ◽  
Vol 253 ◽  
pp. 09004
Author(s):  
A. Ros ◽  
L. Barrientos ◽  
M. Borja-Lloret ◽  
J.V. Casaña ◽  
E. Muñoz ◽  
...  
Keyword(s):  
Spatial Resolution ◽  
Whole Body ◽  
Ct Scanner ◽  
Scintillation Crystal ◽  
Pet Ct ◽  
Energy Peak ◽  
Extended Field ◽  
Total Body ◽  
Bed Position ◽  
Pet Scanners

In recent decades, PET scanners have been widely used for diagnosis and treatment monitoring in nuclear medicine. The continuous effort of the scientific community has led to improvements in scanner performance. Total-body PET is one of the latest upgrades in PET scanners. These kinds of scanners are able to scan the whole body of the patient with a single bed position, since the scanner tube is long enough for the patient to fit inside. While these scanners show unprecedented efficiency and extended field-of-view, a drawback is their low spatial resolution compared to dedicated scanners. In order to improve the spatial resolution of specific areas when measuring with a total-body PET scanner, the IRIS group at IFIC-Valencia is developing a probe. The proposed setup of the probe contains a monolithic scintillation crystal and a SiPM. The signal of the probe is read out by a TOFPET2 ASIC from PETsys, which has shown good performance for PET in terms of spatial and time resolutions. Furthermore, the PETsys technology generates a trigger signal that will be used to time synchronise the probe and the scanner. The proof-of-concept of the probe will be tested in a Preclinical Super Argus PET/CT scanner for small animals located at IFIC. Preliminary simulations of the scanner and the probe under ideal conditions show a slight improvement in the position reconstruction compared to the data obtained with the scanner, therefore we expect a considerable improvement when using the probe in a total-body PET scanner. Characterisation tests of the probe have been performed with a 22Na point-like source, obtaining an energy resolution of 9.09% for the 511 keV energy peak and a temporal resolution of 619 ps after time walk correction. The next step of the project is to test the probe measuring in temporal coincidence with the scanner.

scholarly journals Initial Experience with 64Cu-DOTATATE Digital PET of Patients with Neuroendocrine Neoplasms: Comparison with Analog PET

Diagnostics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 350
Author(s):  
Mathias Loft ◽  
Camilla B. Johnbeck ◽  
Esben A. Carlsen ◽  
Helle H. Johannesen ◽  
Peter Oturai ◽  
...  
Keyword(s):  
Emission Tomography ◽  
Acquisition Time ◽  
Neuroendocrine Neoplasms ◽  
Ct Scanner ◽  
Siemens Biograph ◽  
Positron Emission ◽  
Pet Ct ◽  
Digital Pet ◽  
Image Acquisition Time ◽  
Pet Scanners

The recent introduction of solid-state detectors in clinical positron emission tomography (PET) scanners has significantly improved image quality and spatial resolution and shortened acquisition time compared to conventional analog PET scanners. In an initial evaluation of the performance of our newly acquired Siemens Biograph Vision 600 PET/CT (digital PET/CT) scanner for 64Cu-DOTATATE imaging, we compared PET/CT acquisitions from patients with neuroendocrine neoplasms (NENs) grades 1 and 2 and stable disease on CT who were scanned on both our Siemens Biograph 128 mCT PET/CT (analog PET/CT) and digital PET/CT within 6 months as part of their routine clinical management. Five patients fulfilled the criteria and were included in the analysis. The digital PET acquisition time was less than 1/3 of the analog PET acquisition time (digital PET, mean (min:s): 08:20 (range, 07:59–09:45); analog PET, 25:28 (24:39–28:44), p < 0.001). All 44 lesions detected on the analog PET with corresponding structural correlates on the CT were also found on the digital PET performed 137 (107–176) days later. Our initial findings suggest that digital 64Cu-DOTATATE PET can successfully be performed in patients with NENs using an image acquisition time of only 1/3 of what is used for an analog 64Cu-DOTATATE PET.

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