Evaluation of Low-dose Whole-body FDG PET with SiPM-based PET/CT Scanner: Visual and Semi-quantitative Analyses Using Random Sampling from Full-dose Scan Data

Abstract

Sensitivity and count rate performance of the latest PET/CT scanners with a silicon photomultiplier (SiPM) have been substantially improved compared to scanners with a photomultiplier tube (PMT), thereby promising a low-dose whole-body PET scan with maintaining image quality. However, it is ethically difficult to verify the low-dose protocol in actual clinical settings. In this study, we investigated the effect of dose reduction on reconstructed images by using a low-dose simulation technique, i.e., reducing the number of events from the acquired data. For 21 subjects who underwent whole-body 18F-FDG PET examination with an SiPM-based PET/CT scanner, Biograph Vision (Siemens Healthineers, Erlangen, Germany), at a dosage of 3.5 MBq/kg and a continuous bed motion speed of 1.1 mm/sec (the standard protocol in our hospital), the number of events in acquired list data (100%; "full-dose") was reduced to 50%, 25%, 12.5%, and 6.25% ("low-dose"). The low-dose reconstructed images were evaluated visually and physically with reference to the full-dose images. The physical evaluation was performed by calculating differences in SUVmax at abnormal uptake (n=54) between the full-dose and low-dose images. The 25% data images were visually acceptable, and the difference in SUVmax between the 100% and 25% data images was 9.8±13.5%. Our results suggest that Biograph Vision is a feasible method to reduce conventional dose with the potential use of 25% data images.