Abstract
The aim of the study was to assess the quality and reproducibility of reducing the injected [18F] sodium fluoride ([18F]NaF) dose while maintaining diagnostic imaging quality in bone imaging in a preclinical skeletal model using digital photon counting PET (dPET) detector technology. Beagles (n = 9) were administered three different [18F]NaF doses: 111 MBq (n = 5), 20 MBq (n = 5), and 1.9 MBq (n = 9). Imaging started ≃45 min post-injection for ≃30 min total acquisition time. Images were reconstructed using Time-of-Flight, ultra-high definition (voxel size of 1 × 1 × 1 mm3), with 3 iterations and 3 subsets. Point spread function was modeled and Gaussian filtering was applied. Skeleton qualitative and quantitative molecular image assessment was performed. The overall diagnostic quality of all images scored excellent (61%) and acceptable (39%) by all the reviewers. [18F]NaF SUVmean showed no statistically significant differences among the three doses in any of the region of interest assessed. This study demonstrated that a 60-fold [18F]NaF dose reduction was not significantly different from the highest dose, and it had not significant effect on overall image quality and quantitative accuracy. In the future, ultra-low dose [18F]NaF dPET/CT imaging may significantly decrease PET radiation exposure to preclinical subjects and personnel.
Highlights
Sodium Fluoride ([18F]NaF) Positron Emission Tomography—Computed Tomography (PET/computed tomography (CT)) is used clinically in oncology patients to detect and characterize osteoblastic metastatic lesions [1,2,3,4], as well as to aid visualization of atherosclerotic calcifications and plaques in patients with cardiovascular disease [5,6,7]
This study demonstrates that a 60-fold sodium fluoride ([18F]NaF) dose (ULD) reduction did not significantly differ in image quality and quantification compared to the standard dose (SD) in a healthy canine model
No digital photon counting PET (dPET) imaging study received an insufficient or not acceptable score. These results indicate that ultra-low dose (ULD) [18F]NaF dPET image quality was comparable to SD and even low dose (LD) [18F]NaF dPET images (Table 2)
Summary
Sodium Fluoride ([18F]NaF) Positron Emission Tomography—Computed Tomography (PET/CT) is used clinically in oncology patients to detect and characterize osteoblastic metastatic lesions [1,2,3,4], as well as to aid visualization of atherosclerotic calcifications and plaques in patients with cardiovascular disease [5,6,7]. When compared with 99mTc-MDP gamma scintigraphy, [18F]NaF PET has higher sensitivity, superior image resolution, and improved target-to-background ratio [24]. Hybrid imaging modalities such as PET/CT and PET/Magnetic Resonance Imaging (MRI) are currently used for assessing bone metabolism [22,23,24,25]. It is believed that significant reductions in PET radiotracer doses will benefit pediatric subjects/patients and those subjects/patients participating in longitudinal studies with multiple serial PET studies by reducing cumulative radiation exposure [29, 30]. Comprehensive preclinical [18F]NaF dose reduction studies in translational large animal models and its impact on overall PET image quality are missing
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