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Are lesion features reproducible between 18F-FDG PET/CT images when acquired on analog or digital PET/CT scanners?

European Radiology volume 31, pages 3071–3079 (2021)Cite this article

Abstract

Objectives

To compare lesion features extracted from 18F-FDG PET/CT images acquired on analog and digital scanners, on consecutive imaging data from the same subjects.

Methods

Whole-body 18F-FDG PET/CT images from 55 oncological patients were acquired twice after a single 18F-FDG injection, with a digital and an analog PET/CT scanner, alternately. Twenty-nine subjects were examined first on the digital, and 26 first on the analog equipment. Image reconstruction was performed using manufacturer standard clinical protocols and protocols that fulfilled EARL1 specifications. Twenty-five features based on lesion standardized uptake value (SUV) and geometry were assessed. To compare these features, intraclass correlation coefficient (ICC), relative difference (RD), absolute value of RD (|RD|), and repeatability coefficient (RC) were used.

Results

In total, 323 18F-FDG avid lesions were identified. High agreement (ICC > 0.75) was obtained for most of the lesion features pulled out from both scanners’ imaging data, especially when reconstruction protocols fulfilled EARL1 specifications. For EARL1 reconstruction images, the features frequently used in clinics, SUVmax, SUVpeak, SUVmean, metabolic tumor volume, and total lesion glycolysis, reached an ICC of 0.92, 0.95, 0.87, 0.98, and 0.98, and a median RD (digital-analog) of 3%, 5%, 4%, − 3% and 1%, respectively. Using standard reconstruction protocols, the ICC were 0.84, 0.93, 0.80, 0.98, and 0.98, and the RD were 20%, 11%, 13%, − 7%, and 7%, respectively.

Conclusion

Under controlled acquisition and reconstruction parameters, most of the features studied can be used for research and clinical work. This is especially important for multicenter studies and patient follow-ups.

Key Points

• Using manufacturer standard clinical reconstruction protocols, lesions SUV was significantly higher when using the digital scanner, especially the SUVmax that was approximately 20% higher.

• High agreement was obtained for the majority of the lesion features when using reconstruction protocols that fulfilled EARL1 specifications.

• Longitudinal patient studies can be performed interchangeably between digital and analog scanners when both fulfill EARL1 specifications.

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Abbreviations

|RD|:

Absolute value of RD

FWHM:

Full width at half maximum

ICC:

Intraclass correlation coefficient

MTV:

Metabolic tumor volume

RC:

Repeatability coefficient

RD:

Relative difference

ROI:

Region of interest

SUV:

Standardized uptake value

TLG:

Total lesion glycolysis

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Acknowledgments

We are grateful to the patients who took part in the study. We would also like to thank Dr John Lee from the Communications Department at Champalimaud Centre for the Unknown, for his help in the English editing, and all staff from the Nuclear Medicine-Radiopharmacology department at Champalimaud Foundation.

Funding

The authors state that this work has not received any funding.

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Authors and Affiliations

  1. Nuclear Medicine - Radiopharmacology, Champalimaud Centre for the Unknown, Champalimaud Foundation, Av. Brasília, 1400-038, Lisbon, Portugal

    Cláudia S. Constantino, Francisco P. M. Oliveira, Mariana Silva, Carla Oliveira, Joana C. Castanheira, Ângelo Silva, Sofia C. Vaz & Durval C. Costa

  2. Physics Department, NOVA School of Science and Technology, Lisbon, Portugal

    Cláudia S. Constantino & Pedro Vieira

Authors
  1. Cláudia S. Constantino
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  2. Francisco P. M. Oliveira
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  3. Mariana Silva
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  4. Carla Oliveira
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  5. Joana C. Castanheira
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  6. Ângelo Silva
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  7. Sofia C. Vaz
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  8. Pedro Vieira
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  9. Durval C. Costa
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Corresponding author

Correspondence to Cláudia S. Constantino.

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Guarantor

The scientific guarantor of this publication is Durval C. Costa, MD, MSc, PhD, FRCR, head of Nuclear Medicine-Radiopharmacology department at Champalimaud Foundation, Lisbon, Portugal.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

One of the authors has significant statistical expertise (Francisco P. M. Oliveira is an experienced statistician; he has a degree in Mathematics, a MSc in Computational Methods, and a PhD in Biomedical Engineering). No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Ethical approval

Institutional Review Board approval was obtained.

Methodology

• prospective

• cross-sectional and observational study

• performed at one institution

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Constantino, C.S., Oliveira, F.P.M., Silva, M. et al. Are lesion features reproducible between 18F-FDG PET/CT images when acquired on analog or digital PET/CT scanners?. Eur Radiol 31, 3071–3079 (2021). https://doi.org/10.1007/s00330-020-07390-8

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  • DOI: https://doi.org/10.1007/s00330-020-07390-8

Keywords

  • 18F-FDG PET/CT
  • Computer-assisted image analysis
  • Image reconstruction
  • Diagnostic imaging
  • Reproducibility of results