Abstract
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.
Highlights
The role of combined positron emission tomography (PET) and computer tomography (CT) imaging in the diagnosis and follow-up of cancer patients is well established
We focused on patients with neuroendocrine neoplasms (NENs) grades 1 and 2 (Ki67 proliferation indices
Five patients with NENs grades 1 and 2 had both an analog and a digital PET/CT performed within 6 months with unchanged lesion numbers and sizes on the CT of the analog and digital PET/CT
Summary
The role of combined positron emission tomography (PET) and computer tomography (CT) imaging in the diagnosis and follow-up of cancer patients is well established. From the introduction of PET scanners in the 1970s, vast improvements in both PET hardware and software have increased the sensitivity of the modality many fold. Significant improvement in image reconstruction has followed from the inclusion of time-of-flight (TOF) and pointspread-function (PSF) correction, resulting in improved image contrast, spatial resolution and signal-to-noise ratios [1,2,3]. Clinical PET scanners have taken a large leap forward with the introduction of digital solid-state detectors. In a standardized phantom measurement study, the image contrast was >77% better on a digital PET/CT scanner compared with an analog counterpart [4]. The increased detector sensitivity allows for faster image acquisition with a retained signal-to-noise ratio [5]. The increased scanner sensitivity can be traded for a reduced radiopharmaceutical dose, reducing the radiation burden on the patients [6]
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