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Ultra-low-activity total-body dynamic PET imaging allows equal performance to full-activity PET imaging for investigating kinetic metrics of 18F-FDG in healthy volunteers

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

To investigate the feasibility of ultra-low-activity total-body positron emission tomography (PET) dynamic imaging for quantifying kinetic metrics of 2-[18F]-fluoro-2-deoxy-D-glucose (18F-FDG) in normal organs and to verify its clinical relevance with full-activity imaging.

Methods

Dynamic total-body PET imaging was performed in 20 healthy volunteers, with eight using full activity (3.7 MBq/kg) of 18F-FDG and 12 using 10× activity reduction (0.37 MBq/kg). Image contrast, in terms of liver-to-muscle ratio (LMR), liver-to-blood ratio (LBR), and blood-to-muscle ratio (BMR) of radioactivity concentrations were assessed. A two-tissue compartment model was fitted to the time-to-activity curves in organs based on regions of interest (ROIs) delineation using PMOD, and constant rates (k1, k2, and k3) were generated. Kinetic constants, corresponding coefficients of variance (CoVs), image contrast, radiation dose, prompt counts, and data size were compared between full- and low-activity groups.

Results

All constant rates, corresponding CoVs, and image contrast in different organs were comparable with none significant differences between full- and ultra-low-activity groups. PET images in the ultra-low-activity group generated significantly lower effective radiation dose (median, 0.419 vs. 4.886 mSv, P < 0.001), reduced prompt counts (median, 2.79 vs. 55.68 billion, P < 0.001), and smaller data size (median, 71.11 vs. 723.18 GB, P < 0.001).

Conclusion

Total-body dynamic PET imaging using 10× reduction of injected activity could achieve relevant kinetic metrics of 18F-FDG and comparable image contrast with full-activity imaging. Activity reduction results in significant decrease of radiation dose and data size, rendering it more acceptable and easier for data reconstruction, transmission, and storage for clinical practice.

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Data availability

The dataset used and/or analyzed in the current study are available from the corresponding author on reasonable request.

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Funding

Our study was funded by the Training Program for Excellent Young Medical Talents of Zhongshan Hospital of Fudan University (grant number: 2019ZSYQ28), the Shanghai “Rising Stars of Medical Talent”–Youth Development Program (grant number: HWJRS2019-72), the Shanghai Municipal Key Clinical Specialty Project (grant number: SHSLCZDZK03401), the Major Science and Technology Projects for Major New Drug Creation (2019ZX09302001), the Shanghai Science and Technology Committee program (grant number: 20DZ2201800), and the Three-year Action Plan of Clinical Skills and Innovation of Shanghai Hospital Development Center (grant number: SHDC2020CR3079B).

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Authors and Affiliations

  1. Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, No. 180 Fenglin Road, Shanghai, 200032, People’s Republic of China

    Guobing Liu, Pengcheng Hu, Haojun Yu, Hui Tan, Yiqiu Zhang, Hongyan Yin, Yan Hu & Hongcheng Shi

  2. Institute of Nuclear Medicine, Fudan University, Shanghai, China

    Guobing Liu, Pengcheng Hu, Haojun Yu, Hui Tan, Yiqiu Zhang, Hongyan Yin, Yan Hu & Hongcheng Shi

  3. Shanghai Institute of Medical Imaging, Shanghai, China

    Guobing Liu, Pengcheng Hu, Haojun Yu, Hui Tan, Yiqiu Zhang, Hongyan Yin, Yan Hu & Hongcheng Shi

  4. Cancer Prevention and Treatment Center, Zhongshan Hospital, Fudan University, Shanghai, China

    Guobing Liu, Pengcheng Hu, Haojun Yu, Hui Tan, Yiqiu Zhang, Hongyan Yin, Yan Hu, Jianying Gu & Hongcheng Shi

  5. Department of Plastic surgery, Zhongshan Hospital, Fudan University, No. 180 Fenglin Road, Shanghai, 200032, People’s Republic of China

    Jianying Gu

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  1. Guobing Liu
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  7. Yan Hu
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Contributions

G. Liu and H. Yu had full access to the data and take responsibility for the integrity of the data. J. Gu, H. Shi, and Y. Zhang were responsible for the design of the study. G. Liu, P. Hu, H. Yin, and H. Tan were involved in data acquisition. G. Liu and Y. Hu were involved in data analysis. G. Liu and H. Shi drafted the manuscript, and all authors revised it critically.

Corresponding authors

Correspondence to Jianying Gu or Hongcheng Shi.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethics approval

This study was approved by the Ethics Committee of Zhongshan Hospital of Fudan University (approval number: IRB2015-098). Written informed consents were obtained from all participants.

Consent to participate

Written informed consents were obtained from included patients for participation of this study.

Consent for publication

The authors affirm that human research participants provided informed consent for the publication of the data and images in Fig. 1.

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Liu, G., Hu, P., Yu, H. et al. Ultra-low-activity total-body dynamic PET imaging allows equal performance to full-activity PET imaging for investigating kinetic metrics of 18F-FDG in healthy volunteers. Eur J Nucl Med Mol Imaging 48, 2373–2383 (2021). https://doi.org/10.1007/s00259-020-05173-3

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  • DOI: https://doi.org/10.1007/s00259-020-05173-3

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