Abstract

We prospectively enrolled patients with neuroendocrine tumors (NETs). They underwent a single 68Ga-DOTA-TATE injection followed by dual imaging and were randomly scanned using first either the conventional or the silicon photomultiplier (SiPM) positron emission tomography/computed tomography (PET/CT), followed by imaging using the other system. A total of 94 patients, 44 men and 50 women, between 35 and 91 years old (mean ± SD: 63 ± 11.2), were enrolled. Fifty-two out of ninety-four participants underwent SiPM PET/CT first and a total of 162 lesions were detected using both scanners. Forty-two out of ninety-four participants underwent conventional PET/CT first and a total of 108 lesions were detected using both scanners. Regardless of whether SiPM-based PET/CT was used first or second, maximum standardized uptake value (SUVmax) of lesions measured on SiPM was on average 20% higher when comparing two scanners with all enrolled patients, and the difference was statistically significant. SiPM-based PET/CT detected 19 more lesions in 13 patients compared with conventional PET/CT. No lesions were only identified by conventional PET/CT. In conclusion, we observed higher SUVmax for lesions measured from SiPM PET/CT compared with conventional PET/CT regardless of the order of the scans. SiPM PET/CT allowed for identification of more lesions than conventional PET/CT. While delayed imaging can lead to higher SUVmax in cancer lesions, in the series of lesions identified when SiPM PET/CT was used first, this was not the case; therefore, the data suggest superior performance of the SiPM PET/CT scanner in visualizing and quantifying lesions.

Highlights

  • Positron emission tomography/computed tomography (PET/CT) plays a critical role in the management of oncologic patients

  • We previously reported the performance of a silicon photomultiplier (SiPM) PET/CT scanner (GE Discovery Molecular Insights—DMI PET/CT, GE Healthcare, Waukesha, WI, USA) [8] and compared it to conventional PET/CT scanners (GE Discovery 600 and GE Discovery 690) in cancer patients undergoing 2-Deoxy-2-[18F]fluoroglucose (FDG) imaging (9)

  • When Conventional PET/CT Was Used First Followed by SiPM

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Summary

Introduction

Positron emission tomography/computed tomography (PET/CT) plays a critical role in the management of oncologic patients. International guidelines recommend the use of PET/CT for the detection of primary as well as metastatic disease for many different tumors, depending on the tumor itself and on the specific radiotracer [1,2,3,4]. Photosensors are key elements of PET scanners, they adjust the light output of the system and convert it into a proportional electrical signal based on the amount of light the system senses at a particular location. PMTs have been used in previous generation PET scanners, and they are essential components in time of flight (ToF) PET detectors. They have some limitations that affect, in particular, reconstructed image signal-to-noise ratio (SNR) [6,7,8]

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