Dual-Input Kinetic Modeling in Dynamic PET: Clinical Evaluation of the Impact of Time-of-Flight Imaging

Abstract

Dynamic 18F-FDG PET has the promise of noninvasively measuring liver inflammation by means of tracer kinetic modeling. A unique feature of dynamic liver PET is that dual-input kinetic modeling is required for considering the dual-blood supply to the liver. While time-of-flight (TOF) reconstruction is expected to improve kinetic quantification over non-TOF imaging, it is unclear how the improvement by TOF interacts with tracer kinetic modeling and if the benefit of TOF can be transferred into improving the correlation of PET biomarkers with histopathology. In this paper, we investigate the impact of TOF imaging on conventional single-input kinetic modeling and new dual-input kinetic modeling using patient data of liver imaging and histopathological data. The results have shown that TOF imaging has a minimal effect on single-input kinetic modeling but is more impactful on the dual-input kinetic modeling approach. Combined use of the dual-input model and TOF is crucial for improving the correlation of the PET biomaker with liver inflammation.