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Abbreviated scan protocols to capture 18F-FDG kinetics for long axial FOV PET scanners

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

Abstract

Purpose

Kinetic parameters from dynamic 18F-fluorodeoxyglucose (FDG) imaging offer complementary insights to the study of disease compared to static clinical imaging. However, dynamic imaging protocols are cumbersome due to the long acquisition time. Long axial field-of-view (LAFOV) PET scanners (> 70 cm) have two advantages for dynamic imaging over clinical PET scanners with a standard axial field-of-view (SAFOV; 16–30 cm). The large axial coverage enables multi-organ dynamic imaging in a single bed position, and the high sensitivity may enable clinically routine abbreviated dynamic imaging protocols.

Methods

In this work, we studied two abbreviated protocols using data from a 65-min dynamic 18F-FDG scan: (A) dynamic imaging immediately post-injection (p.i.) for variable durations, and (B) dynamic imaging immediately p.i. for variable durations plus a 1-h p.i. (5-min-long) datapoint. Nine cancer patients were imaged on the Biograph Vision Quadra (Siemens Healthineers). Time-activity curves over the lesions (N = 39) were fitted using the Patlak graphical analysis and a 2-tissue-compartment (2C, k4 = 0) model for variable scan durations (5–60 min). Kinetic parameters from the complete dataset served as the reference. Lesions from all cancers were grouped into low, medium, and high flux groups, and bias and precision of Ki (Patlak) and Ki, K1, k2, and k3 (2C) were calculated for each group.

Results

Using only early dynamic data with the 2C (or Patlak) model, accurate quantification of Ki required at least 50 (or 55) min of dynamic data for low flux lesions, at least 30 (or 40) min for medium flux lesions, and at least 15 (or 20) min for high flux lesions to achieve both 10% bias and precision. The addition of the final (5-min) datapoint allowed for accurate quantification of Ki with a bias and precision of 10% using only 10–15 min of early dynamic data for either model.

Conclusion

Dynamic imaging for 10–15 min immediately p.i. followed by a 5-min scan at 1-h p.i can accurately and precisely quantify 18F-FDG on a long axial FOV scanner, potentially allowing for more widespread use of dynamic 18F-FDG imaging.

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Funding

This work was supported by the following grants: NIH R01 CA225874 and NIH R01 C113941, along with a research contract between the University of Pennsylvania and Siemens Medical Solutions and a research agreement between Insel Gruppe AG, Bern, Switzerland, and Siemens Healthcare AG, Zürich, Switzerland.

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Authors and Affiliations

  1. Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA

    Varsha Viswanath, Austin R. Pantel, Margaret E. Daube-Witherspoon & Joel S. Karp

  2. Advanced Clinical Imaging Technology, Siemens Healthcare AG, Lausanne, Switzerland

    Hasan Sari

  3. Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, 18, 3010, Bern, Switzerland

    Hasan Sari, Clemens Mingels, Ian Alberts, Kuangyu Shi & Axel Rominger

  4. Siemens Medical Solutions, USA Inc., Knoxville, TN, USA

    Maurizio Conti & Lars Eriksson

  5. Department of Oncology and Pathology, Medical Radiation Physics, Karolinska Institutet, Stockholm, Sweden

    Lars Eriksson

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  1. Varsha Viswanath
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Corresponding author

Correspondence to Margaret E. Daube-Witherspoon.

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Ethics approval

The local Institutional Review Board approved the study (KEK 2019–02193) and written informed consent was obtained from all patients. The study was performed in accordance with the declaration of Helsinki.

Competing interests

HS is a full-time employee of Siemens Healthineers AG. LE and MC are full time employees of Siemens Medical Solutions USA, Inc. AR has received research support and speaker honoraria from Siemens Healthineers. ILA declares no conflict of interest. The other authors have no relevant financial or non-financial interests to disclose.

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Viswanath, V., Sari, H., Pantel, A.R. et al. Abbreviated scan protocols to capture 18F-FDG kinetics for long axial FOV PET scanners. Eur J Nucl Med Mol Imaging 49, 3215–3225 (2022). https://doi.org/10.1007/s00259-022-05747-3

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  • DOI: https://doi.org/10.1007/s00259-022-05747-3

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