Evaluation of pediatric malignancies using total-body PET/CT with half-dose [18F]-FDG,European Journal of Nuclear Medicine and Molecular Imaging

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Evaluation of pediatric malignancies using total-body PET/CT with half-dose [18F]-FDG
European Journal of Nuclear Medicine and Molecular Imaging ( IF 8.6 ) Pub Date : 2022-07-05 , DOI: 10.1007/s00259-022-05893-8
Wanqi Chen _{1,

2} , Lei Liu _{1,

2} , Yinghe Li _{1,

2} , Shatong Li _{1,

2} , Zhijian Li _{1,

2} , Weiguang Zhang _{1,

2} , Xu Zhang _{1,

2} , Runze Wu ₃ , Debin Hu ₃ , Hongyan Sun ₃ , Yun Zhou ₃ , Wei Fan _{1,

2} , Yumo Zhao _{1,

2} , Yizhuo Zhang _{1,

4} , Yingying Hu _{1,

2}

Affiliation

Purpose

To explore the impact of a true half dose of [¹⁸F]-FDG on image quality in pediatric oncological patients undergoing total-body PET/CT and investigate short acquisition times with half-dose injected activity.

Methods

One hundred pediatric oncological patients who underwent total-body PET/CT using the uEXPLORER scanner after receiving a true half dose of [¹⁸F]-FDG (1.85 MBq/kg) were retrospectively enrolled. The PET images were first reconstructed using complete 600-s data and then split into 300-s, 180-s, 60-s, 40-s, and 20-s duration groups (G600 to G20). The subjective analysis was performed using 5-point Likert scales. Objective quantitative metrics included the maximum standard uptake value (SUV_max), SUV_mean, standard deviation (SD), signal-to-noise ratio (SNR), and SNR_norm of the background. The variabilities in lesion SUV_mean, SUV_max, and tumor-to-background ratio (TBR) were also calculated.

Results

The overall image quality scores in the G600, G300, G180, and G60 groups were 4.9 ± 0.2, 4.9 ± 0.3, 4.4 ± 0.5, and 3.5 ± 0.5 points, respectively. All the lesions identified in the half-dose images were localized in the G60 images, while 56% of the lesions could be clearly identified in the G20 images. With reduced acquisition time, the SUV_max and SD of the backgrounds were gradually increased, while the TBR values showed no statistically significant differences among the groups (all p > 0.1). Using the half-dose images as a reference, the variability in the lesion SUV_max gradually increased from the G180 to G20 images, while the lesion SUV_mean remained stable across all age groups. SNR_norm was highly negatively correlated with age.

Conclusion

Total-body PET/CT with a half dose of [¹⁸F]-FDG (1.85 MBq/kg, estimated whole-body effective dose: 1.76–2.57 mSv) achieved good performance in pediatric patients, with sufficient image quality and good lesion conspicuity. Sufficient image quality and lesion conspicuity could be maintained at a fast scanning time of 60 s with half-dose activity.

中文翻译：

使用半剂量 [18F]-FDG 的全身 PET/CT 评估儿科恶性肿瘤

目的

探讨真正半剂量 [ ¹⁸ F]-FDG 对接受全身 PET/CT 的儿科肿瘤患者图像质量的影响，并研究半剂量注射活动的短采集时间。

方法

^{100 名接受真正半剂量 [ 18} F]-FDG (1.85 MBq/kg)后使用 uEXPLORER 扫描仪接受全身 PET/CT 的儿科肿瘤患者被回顾性纳入。PET 图像首先使用完整的 600 秒数据重建，然后分成 300 秒、180 秒、60 秒、40 秒和 20 秒持续时间组（G600 到 G20）。使用 5 点李克特量表进行主观分析。客观定量指标包括最大标准摄取值 (SUV _max )、SUV_平均值、标准偏差 (SD)、信噪比 (SNR) 和背景的 SNR_范数。病灶SUV _mean , SUV _max的变异，还计算了肿瘤背景比（TBR）。

结果

G600、G300、G180 和 G60 组的总体图像质量得分分别为 4.9 ± 0.2、4.9 ± 0.3、4.4 ± 0.5 和 3.5 ± 0.5 分。半剂量图像中识别出的所有病灶在 G60 图像中均定位，而在 G20 图像中可以清楚地识别出 56% 的病灶。随着采集时间的减少，背景的 SUV_最大值和 SD 逐渐增加，而 TBR 值在各组之间没有统计学差异（所有p > 0.1）。使用半剂量图像作为参考，病变 SUV_最大值的变异性从 G180 到 G20 图像逐渐增加，而病变 SUV_平均值在所有年龄组中保持稳定。信噪比_范数与年龄高度负相关。