Abstract
BackgroundThe aim of this study was to compare liver and oncologic lesion standardized uptake values (SUV) obtained through two different reconstruction protocols, GE’s newest clinical lesion detection protocol (Q.Clear) and the EANM Research Ltd (EARL) harmonization protocol, and to assess the clinical relevance of potential differences and possible implications for daily clinical practice using the PERCIST lesional inclusion criteria.NEMA phantom recovery coefficients (RC) and SUV normalized for lean body mass (LBM), referred to as SUV normalized for LBM (SUL), of liver and lesion volumes of interest were compared between the two reconstruction protocols. Head-to-toe PET/CT examinations and raw data from 64 patients were retrospectively retrieved. PET image reconstruction was carried out twice: once optimized for quantification, complying with EARL accreditation requirements, and once optimized for lesion detection, according to GE’s Q.Clear reconstruction settings.ResultsThe two reconstruction protocols showed different NEMA phantom RC values for different sphere sizes. Q.Clear values were always highest and exceeded the EARL accreditation maximum for smaller spheres. Comparison of liver SULmean showed a statistically significant but clinically irrelevant difference between both protocols. Comparison of lesion SULpeak and SULmax showed a statistically significant, and clinically relevant, difference of 1.64 and 4.57, respectively.ConclusionsFor treatment response assessment using PERCIST criteria, the harmonization reconstruction protocol should be used as the lesion detection reconstruction protocol using resolution recovery systematically overestimates true SUL values.
Highlights
The aim of this study was to compare liver and oncologic lesion standardized uptake values (SUV) obtained through two different reconstruction protocols, GE’s newest clinical lesion detection protocol (Q.Clear) and the European Association of Nuclear Medicine (EANM) Research Ltd (EARL) harmonization protocol, and to assess the clinical relevance of potential differences and possible implications for daily clinical practice using the PERCIST lesional inclusion criteria
For treatment response assessment using PERCIST criteria, the harmonization reconstruction protocol should be used as the lesion detection reconstruction protocol using resolution recovery systematically overestimates true SUV normalized for LBM (SUL) values
The aim of this study was to compare liver and oncologic lesion SUV values obtained through two different reconstruction protocols: GE’s newest clinical lesion detection protocol (Q.Clear) and the EANM Research Ltd (EARL) harmonization protocol, using the PERCIST lesional inclusion criteria
Summary
The aim of this study was to compare liver and oncologic lesion standardized uptake values (SUV) obtained through two different reconstruction protocols, GE’s newest clinical lesion detection protocol (Q.Clear) and the EANM Research Ltd (EARL) harmonization protocol, and to assess the clinical relevance of potential differences and possible implications for daily clinical practice using the PERCIST lesional inclusion criteria. Several guidelines have been published and updated that make recommendations about the entire scan and analysis process, e.g., patient preparation, SUV normalization, and VOI positioning [1, 5,6,7] Besides these guidelines, several FDG-PET/CT accreditation programmes exist, a.o. the American College of Radiology (ACR) accreditation program [8]. Proposed solutions include performing both reconstructions independently, using one for visual (diagnostic) assessment and the other for quantitative assessment [10] Another possible solution is to apply two PET reconstruction protocols in a single image processing procedure [11]. The latter proposed solution was developed into proprietary software and has been validated in a multicentre study [12]
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