Annals of Nuclear Medicine

, Volume 27, Issue 6, pp 508–514

Imaging quality of F-18-FDG PET/CT in the inpatient versus outpatient setting

  • Xuexian Yan
  • Jian Kang
  • Yanli Zhou
  • Ramisa Ehsan
  • Raghuveer Halkar
  • Kimberly E. Applegate
  • David M. Schuster
Original Article

DOI: 10.1007/s12149-013-0714-8

Cite this article as:
Yan, X., Kang, J., Zhou, Y. et al. Ann Nucl Med (2013) 27: 508. doi:10.1007/s12149-013-0714-8

Abstract

Objective

The purpose of this study is to investigate potential differences in the image quality of inpatient versus outpatient F-18-FDG PET/CT to provide evidence for appropriate policies and procedures to be promulgated on inpatient referrals.

Methods

100 consecutive inpatient and 100 outpatient F-18-FDG PET/CT scans were compared from the same time period and PET/CT scanner. Each study was evaluated for a subjective overall rating (optimal vs. suboptimal), and also by objective measurements (SUVmean) in four background structures (brain, blood pool, liver, and muscle).

Results

96 outpatient scans were rated optimal and 4 suboptimal whereas corresponding numbers for inpatient scans were 77 and 23 (p < 0.001). Of the objective indices, cerebellar SUV was significantly different in inpatient versus outpatient (5.3 vs. 6.9; p < 0.001) as well as suboptimal versus optimal rated groups (4.8 vs. 6.3; p < 0.001). While mean blood glucose was higher for inpatients (108.01 vs. 101.49 mg/dl; p = 0.017), it was not significantly different between optimal and suboptimal exams. Linear regression analysis between blood glucose levels and cerebellar uptake revealed an inverse relationship (R = −0.38, p < 0.001).

Conclusions

There was a significantly higher number of inpatient PET/CT scans rated as suboptimal in comparison to outpatient scans. Decreased cerebellar uptake was present in suboptimal rated studies and in inpatient studies. Altered biodistribution is thus a potential etiology of reduced scan quality among inpatients. These findings, if duplicated among other readers and centers, may form the basis of quality control recommendations for inpatient PET/CT ordering patterns.

Keywords

F-18-FDGPET/CTQuality control

Copyright information

© The Japanese Society of Nuclear Medicine 2013

Authors and Affiliations

  • Xuexian Yan
    • 1
    • 4
  • Jian Kang
    • 1
    • 2
  • Yanli Zhou
    • 1
    • 3
  • Ramisa Ehsan
    • 1
  • Raghuveer Halkar
    • 1
  • Kimberly E. Applegate
    • 1
  • David M. Schuster
    • 1
  1. 1.Department of RadiologyEmory University HospitalAtlantaUSA
  2. 2.Department of Biostatistics and Bioinformatics, Rollins School of Public HealthEmory UniversityAtlantaUSA
  3. 3.Division of Nuclear Cardiology, Department of Cardiology, The First Affiliated HospitalNanjing Medical UniversityNanjingChina
  4. 4.Department of Nuclear Medicine and PETSingapore General HospitalSingaporeSingapore