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Comparative study of physiological FDG uptake in small structures between silicon photomultiplier-based PET and conventional PET

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Abstract

Objective

Silicon photomultiplier-based positron emission tomography/computed tomography (SiPM-PET/CT) has the superior spatial resolution to conventional PET/CT (cPET/CT). This head-to-head comparison study compared the images of physiological 18F-fluorodeoxyglucose (FDG) accumulation in small-volume structures between SiPM-PET/CT and cPET/CT in patients scanned with both modalities, and we investigated whether the thresholds that are reported to be useful for differentiating physiological accumulations from malignant lesions can also be applied to SiPM-PET/CT.

Methods

We enrolled 21 consecutive patients with head and neck malignancies who underwent whole-body FDG-PET/CT for initial staging or a follow-up evaluation (October 2020 to March 2022). After being injected with FDG, all patients underwent PET acquisition on both Vereos PET-CT and Gemini TF64 PET-CT systems (both Philips Healthcare) in random order. For each patient, the maximum standardized uptake value (SUVmax) was measured in the pituitary gland, esophagogastric junction (EGJ), adrenal glands, lumbar enlargement of the spinal cord, and epididymis. We measured the liver SUVmean and the blood pool SUVmean to calculate the target-to-liver ratio (TLR) and the target-to-blood ratio (TBR), respectively. Between-groups differences in each variable were examined by a paired t-test. We also investigated whether there were cases of target uptake greater than the reported threshold for distinguishing pathological from physiological accumulations.

Results

Data were available for 19 patients. Ten patients were in Group 1, i.e., the patients who underwent SiPM-PET first, and the remaining nine patients who underwent cPET first were in Group 2. In the SiPM-PET results, the SUVmax of all targets was significantly higher than that obtained by cPET in all patients, and this tendency was also observed when the patients were divided into Groups 1/2. The TLRs of all targets were significantly higher in SiPM-PET than in cPET in all patients, and SiPM-PET also showed significantly higher TBRs for all targets except the EGJ (p = 0.052).

Conclusions

The physiological uptake in the small structures studied herein showed high accumulation on SiPM-PET. Our results also suggest that the thresholds reported for cPET to distinguish pathological accumulations likely lead to false-positive findings in SIPM-PET evaluations.

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Data availability

All data used to support the findings of this study are included within the article.

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Acknowledgements

We thank Ronee Asad (Philips Japan, Tokyo) and Piotr J. Maniawski (Philips Healthcare, Cleveland, OH, USA) for their great support.

Funding

This study was partially supported by grants from the Japan Society for the Promotion of Science (JSPS) KAKENHI (no. 20K16781) and Japan's MEXT KAKENHI (no. 18K18412).

Author information

Authors and Affiliations

  1. Department of Diagnostic Imaging, Hokkaido University Graduate School of Medicine, Kita 15 Nishi 7, Kita-Ku, Sapporo, Hokkaido, 060-8638, Japan

    Shiro Watanabe, Kenji Hirata, Junki Takenaka, Naoto Wakabayashi & Kohsuke Kudo

  2. Department of Nuclear Medicine, Hokkaido University Hospital, Kita 14 Nishi 5, Kita-Ku, Sapporo, Hokkaido, 060-8648, Japan

    Shiro Watanabe, Kenji Hirata, Junki Takenaka & Naoto Wakabayashi

  3. Division of Medical AI Education and Research, Hokkaido University Graduate School of Medicine, Sapporo, Japan

    Kenji Hirata & Kohsuke Kudo

  4. Division of Medical Imaging and Technology, Hokkaido University Hospital, Sapporo, Japan

    Keiichi Magota

  5. Philips Japan, Ltd., Tokyo, Japan

    Daiki Shinyama

  6. Department of Radiation Oncology, Hokkaido University Hospital, Sapporo, Japan

    Koichi Yasuda

  7. Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan

    Akihiro Homma

  8. Global Center for Biomedical Science and Engineering, Faculty of Medicine, Hokkaido University, Sapporo, Japan

    Kohsuke Kudo

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  1. Shiro Watanabe
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  2. Kenji Hirata
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Corresponding author

Correspondence to Kenji Hirata.

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Daiki Shinyama was an employee of Philips Japan, Ltd. The other authors declare no conflicts of interest in regard to this manuscript.

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Watanabe, S., Hirata, K., Magota, K. et al. Comparative study of physiological FDG uptake in small structures between silicon photomultiplier-based PET and conventional PET. Ann Nucl Med 38, 131–138 (2024). https://doi.org/10.1007/s12149-023-01884-3

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  • DOI: https://doi.org/10.1007/s12149-023-01884-3

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