Annals of Nuclear Medicine

, Volume 27, Issue 6, pp 508–514 | Cite as

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



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.


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).


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).


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.


F-18-FDG PET/CT Quality control 


Conflict of interest

None of the authors of the above manuscript has declared any conflict of interest within the last 3 years which may arise from being named as an author on the manuscript.


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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

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