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Champendal M, Borg Grima K, Costa P, Andersson C, Baun C, Gorga RG, Murphy S, Kedves A, Santos A, Geao A. A scoping review of person-centred care strategies used in diagnostic Nuclear Medicine. Radiography (Lond) 2024; 30:448-456. [PMID: 38211452 DOI: 10.1016/j.radi.2023.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 11/28/2023] [Accepted: 12/19/2023] [Indexed: 01/13/2024]
Abstract
INTRODUCTION Person-centred care (PCC) emphasises the need for the health care professional to prioritise individual patient needs, thereby fostering a collaborative and emphatic environment that empowers patients to actively participate in their own care. This article will explore the purpose of PCC in Nuclear Medicine (NM), while discussing strategies that may be used to implement PCC during diagnostic NM examinations performed on adult patients. METHODS The scoping review was conducted in accordance with the Joanna Briggs Institute methodology. The search was performed on PubMed, Embase and Cinhal in June 2023 and included studies in English, Spanish, Portuguese and Italian. The research equation combined keywords and Medical Subject Heading terms (MeSH) related to person-centred care (PCC), for all types of nuclear medicine diagnostic examinations performed. Three independent review authors screened all abstracts and titles, and all eligible full-text publications were included in this scoping review. RESULTS Fifty-three articles, published between 1993 and 2022, met the inclusion criteria for this scoping review. Seven articles were published in 2015 while 56.6 % of all included studies were performed in Europe. Most studies (n = 39/53) focused on the patients only, with the identified patient benefits being: improve patient experience (67.9 %), increase patient comfort (13.2 %), increase patient knowledge (5.7 %), reduction of patient anxiety (9.4 %) and reduction of waiting/scan time (3.8 %). CONCLUSION The scoping review identified a lack of research investigating the use of person-centred care strategies in NM. Future research will focus on using an international survey to explore this topic in nuclear medicine departments overseas. IMPLICATIONS FOR PRACTICE By applying PCC principles, the NM professional can improve the patient care pathway and increase patient satisfaction, leading to enhanced clinical outcomes.
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Affiliation(s)
- M Champendal
- Department of Radiologic Medical Imaging Technology, School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne, Switzerland; European Federation of Radiographer Societies Nuclear Medicine Committee, Austria
| | - K Borg Grima
- University of Malta, Faculty of Health Sciences, Department of Radiography, Malta; European Federation of Radiographer Societies Nuclear Medicine Committee, Austria.
| | - P Costa
- Department of Nuclear Medicine, ESS, Polytechnic University of Porto, Porto, Portugal; European Federation of Radiographer Societies Nuclear Medicine Committee, Austria
| | - C Andersson
- Dept. of Surgical Sciences, Uppsala University Uppsala, Sweden; European Federation of Radiographer Societies Nuclear Medicine Committee, Austria
| | - C Baun
- Department of Nuclear Medicine, Odense University Hospital, Odense, Denmark; European Federation of Radiographer Societies Nuclear Medicine Committee, Austria
| | - R G Gorga
- Servei de Medicina Nuclear, Hospital Universitari Parc Taulí, Sabadell, Spain; European Federation of Radiographer Societies Nuclear Medicine Committee, Austria
| | - S Murphy
- Radiography and Diagnostic Imaging Unit, College of Health and Agricultural Sciences, School of Medicine, University College Dublin (UCD), Dublin, Ireland; European Federation of Radiographer Societies Nuclear Medicine Committee, Austria
| | - A Kedves
- University of Pécs Faculty of Engineering and Information Technology, Hungary; European Association of Nuclear Medicine Technologists Committee, Austria
| | - A Santos
- Nuclear Medicine Department, Hospital Cuf Descobertas, Lisbon, Portugal; European Association of Nuclear Medicine Technologists Committee, Austria
| | - A Geao
- Nuclear Medicine Department, Hospital Cuf Descobertas, Lisbon, Portugal; European Federation of Radiographer Societies Nuclear Medicine Committee, Austria
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Norikane T, Yamamoto Y, Takami Y, Murao M, Manabe Y, Imajo M, Oishi A, Maeda Y, Dobashi H, Nishiyama Y. Feasibility of whole-body 2-deoxy-2-[18F]fluoro-d-glucose positron emission tomography angiography using continuous bed motion in patients with vascular disease: a pilot study. Ann Nucl Med 2023:10.1007/s12149-023-01835-y. [DOI: 10.1007/s12149-023-01835-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 03/21/2023] [Indexed: 04/03/2023]
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3
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Parametric Imaging of Biologic Activity of Atherosclerosis Using Dynamic Whole-Body Positron Emission Tomography. JACC. CARDIOVASCULAR IMAGING 2022; 15:2098-2108. [PMID: 36481078 DOI: 10.1016/j.jcmg.2022.05.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 04/26/2022] [Accepted: 05/11/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND For molecular imaging of atherosclerotic vessel wall activity, tracer kinetic analysis may yield improved contrast versus blood, more robust quantitative parameters, and more reliable characterization of systems biology. OBJECTIVES The authors introduce a novel dynamic whole-body positron emission tomography (PET) protocol that is enabled by rapid continuous camera table motion, followed by reconstruction of parametric data sets using voxel-based Patlak graphical analysis. METHODS Twenty-five subjects were prospectively enrolled and underwent dynamic PET up to 90 minutes after injection of 2-[18F]fluoro-2-deoxy-D-glucose (FDG). Two sets of images were generated: 1) the established standard of static standardized uptake value (SUV) images; and 2) parametric images of the metabolic rate of FDG (MRFDG) using the Patlak plot-derived influx rate. Arterial wall signal was measured and compared using the volume-of-interest technique, and its association with hematopoietic and lymphoid organ signal and atherosclerotic risk factors was explored. RESULTS Parametric MRFDG images provided excellent arterial wall visualization, with elimination of blood-pool activity, and enhanced focus detectability and reader confidence. Target-to-background ratio (TBR) from MRFDG images was significantly higher compared with SUV images (2.6 ± 0.8 vs 1.4 ± 0.2; P < 0.0001), confirming improved arterial wall contrast. On MRFDG images, arterial wall signal showed improved correlation with hematopoietic and lymphoid organ activity (spleen P = 0.0009; lymph nodes P = 0.0055; and bone marrow P = 0.0202) and increased with the number of atherosclerotic risk factors (r = 0.49; P = 0.0138), where signal from SUV images (SUVmaxP = 0.9754; TBRmaxP = 0.8760) did not. CONCLUSIONS Absolute quantification of MRFDG is feasible for arterial wall using dynamic whole-body PET imaging. Parametric images provide superior arterial wall contrast, and they might be better suited to explore the relationship between arterial wall activity, systemic organ networks, and cardiovascular risk. This novel methodology may serve as a platform for future diagnostic and therapeutic clinical studies targeting the biology of arterial wall disease.
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Meier JG, Diab RH, Connor TM, Mawlawi OR. Impact of low injected activity on data driven respiratory gating for PET/CT imaging with continuous bed motion. J Appl Clin Med Phys 2022; 23:e13619. [PMID: 35481961 PMCID: PMC9121057 DOI: 10.1002/acm2.13619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 02/25/2022] [Accepted: 03/28/2022] [Indexed: 11/25/2022] Open
Abstract
Data driven respiratory gating (DDG) in positron emission tomography (PET) imaging extracts respiratory waveforms from the acquired PET data obviating the need for dedicated external devices. DDG performance, however, degrades with decreasing detected number of coincidence counts. In this paper, we assess the clinical impact of reducing injected activity on a new DDG algorithm designed for PET data acquired with continuous bed motion (CBM_DDG) by evaluating CBM_DDG waveforms, tumor quantification, and physician's perception of motion blur in resultant images. Forty patients were imaged on a Siemens mCT scanner in CBM mode. Reduced injected activity was simulated by generating list mode datasets with 50% and 25% of the original data (100%). CBM_DDG waveforms were compared to that of the original data over the range between the aortic arch and the center of the right kidney using the Pearson correlation coefficient (PCC). Tumor quantification was assessed by comparing the maximum standardized uptake value (SUVmax) and peak SUV (SUVpeak) of reconstructed images from the various list mode datasets using elastic motion deblurring (EMDB) reconstruction. Perceived motion blur was assessed by three radiologists of one lesion per patient on a continuous scale from no motion blur (0) to significant motion blur (3). The mean PCC of the 50% and 25% dataset waveforms was 0.74 ± 0.18 and 0.59 ± 0.25, respectively. In comparison to the 100% datasets, the mean SUVmax increased by 2.25% (p = 0.11) for the 50% datasets and by 3.91% (p = 0.16) for the 25% datasets, while SUVpeak changes were within ±0.25%. Radiologist evaluations of motion blur showed negligible changes with average values of 0.21, 0.3, and 0.28 for the 100%, 50%, and 25% datasets. Decreased injected activities degrades the resultant CBM_DDG respiratory waveforms; however this decrease has minimal impact on quantification and perceived image motion blur.
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Affiliation(s)
- Joseph G Meier
- Department of Imaging Physics, MD Anderson Cancer Center, Houston, USA.,MD Anderson Cancer Center UTHealth Science Center, Houston Graduate School of Biomedical Sciences, Houston, Texas, USA
| | - Radwan H Diab
- Department of Internal Medicine, Kansas University School of Medicine, Wichita, Kansas, USA
| | - Trevor M Connor
- Department of Imaging Physics, MD Anderson Cancer Center, Houston, USA
| | - Osama R Mawlawi
- Department of Imaging Physics, MD Anderson Cancer Center, Houston, USA.,MD Anderson Cancer Center UTHealth Science Center, Houston Graduate School of Biomedical Sciences, Houston, Texas, USA
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Kumamoto K, Sato H, Tsutsui Y, Awamoto S, Yamashita Y, Baba S, Sasaki M. Continuous bed motion in a silicon photomultiplier-based scanner provides equivalent spatial resolution and image quality in whole body PET images at similar acquisition times using the step-and-shoot method. J Nucl Med Technol 2022; 50:jnmt.121.263240. [PMID: 35440474 DOI: 10.2967/jnmt.121.263240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 03/23/2022] [Indexed: 11/16/2022] Open
Abstract
This study investigated the spatial resolution and image quality of the continuous bed motion (CBM) method in a sensitive silicon photomultiplier (SiPM)-based positron emission tomography (PET)/computed tomography (CT) system compared with the traditional step-and-shoot (SS) method. Methods: Siemens Biograph Vision was used in this study. Data acquisition using the SS method was performed for 3 min per bed. In the CBM method, the bed speed ranged from 0.5 to 3.3 mm/s. The acquisition time equivalent to the SS method was 1.1 mm/s for 2-bed ranges and 0.8 mm/s for seven-bed ranges. The spatial resolution was investigated using 18F point sources and evaluated using the full width at half maximum. Image quality was investigated using a National Electrical Manufacturers Association International Electrotechnical Commission body phantom with six spheres 10-, 13-, 17-, 22-, 28-, and 37-mm inner diameters. The radioactivity concentration ratio of the 18F solution in all spheres and the background was approximately 4:1. The detectability of each sphere was visually evaluated on a five-step score. Image quality was physically evaluated using the noise equivalent count rate (NECphantom), contrast percentage of the 10-mm hot sphere (QH,10mm), background variability percentage (N10mm), and contrast-noise ratio (QH,10mm/N10mm). Results: The spatial resolution was not affected by the difference of acquisition methods and bed speeds. The detectability of the 10-mm sphere with a bed speed of 2.2 mm/s or faster was significantly inferior to that of the SS 2-bed method. In evaluating image quality, no significant difference in the contrast percentage was observed among the acquisition methods and speeds in the CBM method. However, the increasing bed speed in the CBM method increased the N10mm and decreased the NECphantom. When comparing the SS 2-bed method with the CBM method at 0.8 mm/s, no significant differences in all parameters were observed. Conclusion: In a SiPM-based PET/CT scanner, the CBM method provides equivalent spatial resolution and image quality in whole body PET images with same acquisition time using the SS method.
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Tsai YJ, Lu Y, Wu J, Liu H, Schleyer P, Casey M, Liu C. Performance Evaluation of Amplitude and Phase Respiratory Gating Methods on Continuous-Bed-Motion Whole-Body PET Studies. IEEE TRANSACTIONS ON RADIATION AND PLASMA MEDICAL SCIENCES 2022. [DOI: 10.1109/trpms.2021.3075383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Büther F, Jones J, Seifert R, Stegger L, Schleyer P, Schäfers M. Clinical Evaluation of a Data-Driven Respiratory Gating Algorithm for Whole-Body PET with Continuous Bed Motion. J Nucl Med 2020; 61:1520-1527. [PMID: 32060218 DOI: 10.2967/jnumed.119.235770] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 01/30/2020] [Indexed: 12/13/2022] Open
Abstract
Respiratory gating is the standard to prevent respiration effects from degrading image quality in PET. Data-driven gating (DDG) using signals derived from PET raw data is a promising alternative to gating approaches requiring additional hardware (e.g., pressure-sensitive belt gating [BG]). However, continuous-bed-motion (CBM) scans require dedicated DDG approaches for axially extended PET, compared with DDG for conventional step-and-shoot scans. In this study, a CBM-capable DDG algorithm was investigated in a clinical cohort and compared with BG using optimally gated (OG) and fully motion-corrected (elastic motion correction [EMOCO]) reconstructions. Methods: Fifty-six patients with suspected malignancies in the thorax or abdomen underwent whole-body 18F-FDG CBM PET/CT using DDG and BG. Correlation analyses were performed on both gating signals. Besides static reconstructions, OG and EMOCO reconstructions were used for BG and DDG. The metabolic volume, SUVmax, and SUVmean of lesions were compared among the reconstructions. Additionally, the quality of lesion delineation in the different PET reconstructions was independently evaluated by 3 experts. Results: The global correlation coefficient between BG and DDG signals was 0.48 ± 0.11, peaking at 0.89 ± 0.07 when scanning the kidney and liver region. In total, 196 lesions were analyzed. SUV measurements were significantly higher in BG-OG, DDG-OG, BG-EMOCO, and DDG-EMOCO than in static images (P < 0.001; median SUVmax: static, 14.3 ± 13.4; BG-EMOCO, 19.8 ± 15.7; DDG-EMOCO, 20.5 ± 15.6; BG-OG, 19.6 ± 17.1; and DDG-OG, 18.9 ± 16.6). No significant differences between BG-OG and DDG-OG or between BG-EMOCO and DDG-EMOCO were found. Visual lesion delineation was significantly better in BG-EMOCO and DDG-EMOCO than in static reconstructions (P < 0.001); no significant difference was found when comparing BG and DDG for either EMOCO or OG reconstruction. Conclusion: DDG-based motion compensation of CBM PET acquisitions outperforms static reconstructions, delivering qualities comparable to BG approaches. The new algorithm may be a valuable alternative for CBM PET systems.
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Affiliation(s)
- Florian Büther
- Department of Nuclear Medicine, University Hospital Münster, Münster, Germany
| | | | - Robert Seifert
- Department of Nuclear Medicine, University Hospital Münster, Münster, Germany
| | - Lars Stegger
- Department of Nuclear Medicine, University Hospital Münster, Münster, Germany
| | | | - Michael Schäfers
- Department of Nuclear Medicine, University Hospital Münster, Münster, Germany.,European Institute for Molecular Imaging, University of Münster, Münster, Germany
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8
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Laudicella R, Baratto L, Minutoli F, Baldari S, Iagaru A. Malignant Cutaneous Melanoma: Updates in PET Imaging. Curr Radiopharm 2020; 13:14-23. [PMID: 31749439 DOI: 10.2174/1874471012666191015095550] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 01/20/2019] [Accepted: 07/17/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Cutaneous malignant melanoma is a neoplasm whose incidence and mortality are dramatically increasing. 18F-FDG PET/CT gained clinical acceptance over the past 2 decades in the evaluation of several glucose-avid neoplasms, including malignant melanoma, particularly for the assessment for distant metastases, recurrence and response to therapy. OBJECTIVE To describe the advancements of nuclear medicine for imaging melanoma with particular attention to 18F-FDG-PET and its current state-of-the-art technical innovations. METHODS A comprehensive search strategy was used based on SCOPUS and PubMed databases. From all studies published in English, we selected the articles that evaluated the technological insights of 18FFDG- PET in the assessment of melanoma. RESULTS State-of-the-art silicon photomultipliers based detectors ("digital") PET/CT scanners are nowadays more common, showing technical innovations that may have beneficial implications for patients with melanoma. Steady improvements in detectors design and architecture, as well as the implementation of both software and hardware technology (i.e., TOF, point spread function, etc.), resulted in significant improvements in PET image quality while reducing radiotracer dose and scanning time. CONCLUSION Recently introduced digital PET detector technology in PET/CT and PET/MRI yields higher intrinsic system sensitivity compared with the latest generation analog technology, enabling the detection of very small lesions with potential impact on disease outcome.
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Affiliation(s)
- Riccardo Laudicella
- Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, Nuclear Medicine Unit, University of Messina, Messina ME, Italy
| | - Lucia Baratto
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Stanford University, United States
| | - Fabio Minutoli
- Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, Nuclear Medicine Unit, University of Messina, Messina ME, Italy
| | - Sergio Baldari
- Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, Nuclear Medicine Unit, University of Messina, Messina ME, Italy
| | - Andrei Iagaru
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Stanford University, United States
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Meier JG, Erasmus JJ, Gladish GW, Peterson CB, Diab RH, Mawlawi OR. Characterization of continuous bed motion effects on patient breathing and respiratory motion correction in PET/CT imaging. J Appl Clin Med Phys 2019; 21:158-165. [PMID: 31816183 PMCID: PMC6964757 DOI: 10.1002/acm2.12785] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 10/29/2019] [Accepted: 11/12/2019] [Indexed: 01/22/2023] Open
Abstract
Continuous bed motion (CBM) was recently introduced as an alternative to step‐and‐shoot (SS) mode for PET/CT data acquisition. In CBM, the patient is continuously advanced into the scanner at a preset speed, whereas in SS, the patient is imaged in overlapping bed positions. Previous investigations have shown that patients preferred CBM over SS for PET data acquisition. In this study, we investigated the effect of CBM versus SS on patient breathing and respiratory motion correction. One hundred patients referred for PET/CT were scanned using a Siemens mCT scanner. Patient respiratory waveforms were recorded using an Anzai system and analyzed using four methods: Methods 1 and 2 measured the coefficient of variation (COV) of the respiratory cycle duration (RCD) and amplitude (RCA). Method 3 measured the respiratory frequency signal prominence (RSP) and method 4 measured the width of the HDChest optimal gate (OG) window when using a 35% duty cycle. Waveform analysis was performed over the abdominothoracic region which exhibited the greatest respiratory motion and the results were compared between CBM and SS. Respiratory motion correction was assessed by comparing the ratios of SUVmax, SUVpeak, and CNR of focal FDG uptake, as well as Radiologists’ visual assessment of corresponding image quality of motion corrected and uncorrected images for both acquisition modes. The respiratory waveforms analysis showed that the RCD and RCA COV were 3.7% and 33.3% lower for CBM compared to SS, respectively, while the RSP and OG were 30.5% and 2.0% higher, respectively. Image analysis on the other hand showed that SUVmax, SUVpeak, and CNR were 8.5%, 4.5%, and 3.4% higher for SS compared to CBM, respectively, while the Radiologists’ visual comparison showed similar image quality between acquisition modes. However, none of the results showed statistically significant differences between SS and CBM, suggesting that motion correction is not impacted by acquisition mode.
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Affiliation(s)
- Joseph G Meier
- Department of Imaging Physics - Unit 1352, MD Anderson Cancer Center, Houston, TX, USA.,MD Anderson Cancer Center UTHealth Science Center at Houston Graduate School of Biomedical Sciences, Houston, TX, USA
| | - Jeremy J Erasmus
- Thoracic Imaging Department - Unit 1478, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Gregory W Gladish
- Thoracic Imaging Department - Unit 1478, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Christine B Peterson
- Biostatistics Department - Unit 1411, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Radwan H Diab
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Osama R Mawlawi
- Department of Imaging Physics - Unit 1352, MD Anderson Cancer Center, Houston, TX, USA.,MD Anderson Cancer Center UTHealth Science Center at Houston Graduate School of Biomedical Sciences, Houston, TX, USA
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10
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Sommerlath Sohns JM, Kröhn H, Schöde A, Derlin T, Haverich A, Schmitto JD, Bengel FM. 18F-FDG PET/CT in Left-Ventricular Assist Device Infection: Initial Results Supporting the Usefulness of Image-Guided Therapy. J Nucl Med 2019; 61:971-976. [PMID: 31806770 DOI: 10.2967/jnumed.119.237628] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 11/11/2019] [Indexed: 02/07/2023] Open
Abstract
Accurate definition of the extent and severity of left-ventricular assist device (LVAD) infection may facilitate therapeutic decision making and targeted surgical intervention. Here, we explore the value of 18F-FDG PET/CT for guidance of patient management. Methods: Fifty-seven LVAD-carrying patients received 85 whole-body 18F-FDG PET/CT scans for the work-up of device infection. Clinical follow-up was obtained for up to 2 y. Results: PET/CT showed various patterns of infectious involvement of the 4 LVAD components: driveline entry point (77% of patients), subcutaneous driveline path (87%), pump pocket (49%), and outflow tract (58%). Driveline smears revealed Staphylococcus or Pseudomonas strains as the underlying pathogen in most cases (48 and 34%, respectively). At receiver-operating-characteristic analysis, an 18F-FDG SUV of more than 2.5 was most accurate to identify smear-positive driveline infection. Infection of 3 or all 4 LVAD components showed a trend toward lower survival than did infection of 2 or fewer components (P = 0.089), whereas involvement of thoracic lymph nodes was significantly associated with an adverse outcome (P = 0.001 for nodal SUV above vs. below median). Finally, patients who underwent early surgical revision within 3 mo after PET/CT (n = 21) required significantly less inpatient hospital care during follow-up than did those receiving delayed surgical revision (n = 11; P < 0.05). Conclusion: Whole-body 18F-FDG PET/CT identifies the extent of LVAD infection and predicts adverse outcome. Initial experience suggests that early image-guided surgical intervention may facilitate a less complicated subsequent course.
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Affiliation(s)
| | - Hannah Kröhn
- Department of Nuclear Medicine, Hannover Medical School, Hannover, Germany; and
| | - Alexandra Schöde
- Department of Cardiothoracic, Transplant, and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - Thorsten Derlin
- Department of Nuclear Medicine, Hannover Medical School, Hannover, Germany; and
| | - Axel Haverich
- Department of Cardiothoracic, Transplant, and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - Jan D Schmitto
- Department of Cardiothoracic, Transplant, and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - Frank M Bengel
- Department of Nuclear Medicine, Hannover Medical School, Hannover, Germany; and
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11
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Das SK, McGurk R, Miften M, Mutic S, Bowsher J, Bayouth J, Erdi Y, Mawlawi O, Boellaard R, Bowen SR, Xing L, Bradley J, Schoder H, Yin FF, Sullivan DC, Kinahan P. Task Group 174 Report: Utilization of [ 18 F]Fluorodeoxyglucose Positron Emission Tomography ([ 18 F]FDG-PET) in Radiation Therapy. Med Phys 2019; 46:e706-e725. [PMID: 31230358 DOI: 10.1002/mp.13676] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Revised: 04/30/2019] [Accepted: 06/06/2019] [Indexed: 02/03/2023] Open
Abstract
The use of positron emission tomography (PET) in radiation therapy (RT) is rapidly increasing in the areas of staging, segmentation, treatment planning, and response assessment. The most common radiotracer is 18 F-fluorodeoxyglucose ([18 F]FDG), a glucose analog with demonstrated efficacy in cancer diagnosis and staging. However, diagnosis and RT planning are different endeavors with unique requirements, and very little literature is available for guiding physicists and clinicians in the utilization of [18 F]FDG-PET in RT. The two goals of this report are to educate and provide recommendations. The report provides background and education on current PET imaging systems, PET tracers, intensity quantification, and current utilization in RT (staging, segmentation, image registration, treatment planning, and therapy response assessment). Recommendations are provided on acceptance testing, annual and monthly quality assurance, scanning protocols to ensure consistency between interpatient scans and intrapatient longitudinal scans, reporting of patient and scan parameters in literature, requirements for incorporation of [18 F]FDG-PET in treatment planning systems, and image registration. The recommendations provided here are minimum requirements and are not meant to cover all aspects of the use of [18 F]FDG-PET for RT.
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Affiliation(s)
- Shiva K Das
- Department of Radiation Oncology, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Ross McGurk
- Department of Radiation Oncology, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Moyed Miften
- Department of Radiation Oncology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Sasa Mutic
- Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO, USA
| | - James Bowsher
- Department of Radiation Oncology, Duke University Medical Center, Durham, NC, USA
| | - John Bayouth
- Human Oncology, University of Wisconsin, Madison, WI, USA
| | - Yusuf Erdi
- Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Osama Mawlawi
- Department of Imaging Physics, University of Texas, M D Anderson Cancer Center, Houston, TX, USA
| | - Ronald Boellaard
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - Stephen R Bowen
- Department of Radiation Oncology, University of Washington, Seattle, WA, USA
| | - Lei Xing
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA, USA
| | - Jeffrey Bradley
- Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO, USA
| | - Heiko Schoder
- Molecular Imaging and Therapy Service, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Fang-Fang Yin
- Department of Radiation Oncology, Duke University Medical Center, Durham, NC, USA
| | - Daniel C Sullivan
- Department of Radiology, Duke University School of Medicine, Durham, NC, USA
| | - Paul Kinahan
- Department of Radiology, University of Washington, Seattle, WA, USA
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12
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Pan T, Einstein SA, Kappadath SC, Grogg KS, Lois Gomez C, Alessio AM, Hunter WC, El Fakhri G, Kinahan PE, Mawlawi OR. Performance evaluation of the 5-Ring GE Discovery MI PET/CT system using the national electrical manufacturers association NU 2-2012 Standard. Med Phys 2019; 46:3025-3033. [PMID: 31069816 DOI: 10.1002/mp.13576] [Citation(s) in RCA: 75] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 03/12/2019] [Accepted: 04/17/2019] [Indexed: 11/05/2022] Open
Abstract
The GE Discovery MI PET/CT system has a modular digital detector design allowing three, four, or five detector block rings that extend the axial field-of-view (FOV) from 15 to 25 cm in 5 cm increments. This study investigated the performance of the 5-ring system and compared it to 3- and 4-ring systems; the GE Discovery IQ system that uses conventional photomultiplier tubes; and the GE Signa PET/MR system that has a reduced transaxial FOV. METHODS PET performance was evaluated at three different institutions. Spatial resolution, sensitivity, counting rate performance, accuracy, and image quality were measured in accordance with National Electrical Manufacturers Association NU 2-2012 standards. The mean energy resolution, mean timing resolution, and PET/CT subsystem alignment were also measured. Phantoms were used to determine the effects of varying acquisition time and reconstruction parameters on image quality. Retrospective patient scans were reconstructed with various scan durations to evaluate the impact on image quality. RESULTS Results from all three institutions were similar. Radial/tangential/axial full width at half maximum spatial resolution measurements using the filtered back projection algorithm were 4.3/4.3/5.0 mm, 5.5/4.6/6.5 mm, and 7.4/5.0/6.6 mm at 1, 10, and 20 cm from the center of the FOV, respectively. Measured sensitivity at the center of the FOV (20.84 cps/kBq) was significantly higher than systems with reduced axial FOV. The peak noise-equivalent counting rate was 266.3 kcps at 20.8 kBq/ml, with a corresponding scatter fraction of 40.2%. The correction accuracy for count losses up to the peak noise-equivalent counting rate was 3.6%. For the 10-, 13-, 17-, 22-, 28-, and 37-mm spheres, contrast recoveries in the image quality phantom were measured to be 46.2%, 54.3%, 66.1%, 71.1%, 85.3%, and 89.3%, respectively. The mean energy and timing resolution were 9.55% and 381.7 ps, respectively. Phantom and patient images demonstrated excellent image quality, even at short acquisition times or low injected activity. CONCLUSION Compared to other PET/CT models, the extended axial FOV improved the overall PET performance of the 5-ring GE Discovery MI scanner. This system offers the potential to reduce scan times or injected activities through increased sensitivity.
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Affiliation(s)
- Tinsu Pan
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Samuel A Einstein
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - Kira S Grogg
- Gordon Center for Medical Imaging, Massachusetts General Hospital, Boston, MA, USA
| | - Cristina Lois Gomez
- Gordon Center for Medical Imaging, Massachusetts General Hospital, Boston, MA, USA
| | - Adam M Alessio
- Department of Computational Mathematics, Science, and Engineering, Michigan State University, East Lansing, MI, USA
| | - William C Hunter
- Department of Radiology, School of Medicine, University of Washington, Seattle, WA, USA
| | - Georges El Fakhri
- Gordon Center for Medical Imaging, Massachusetts General Hospital, Boston, MA, USA
| | - Paul E Kinahan
- Department of Radiology, School of Medicine, University of Washington, Seattle, WA, USA
| | - Osama R Mawlawi
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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13
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Yamamoto H, Takemoto S, Maebatake A, Karube S, Yamashiro Y, Nakanishi A, Murakami K. Verification of image quality and quantification in whole-body positron emission tomography with continuous bed motion. Ann Nucl Med 2019; 33:288-294. [PMID: 30707349 DOI: 10.1007/s12149-019-01334-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 01/14/2019] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Whole-body dynamic imaging using positron emission tomography (PET) facilitates the quantification of tracer kinetics. It is potentially valuable for the differential diagnosis of tumors and for the evaluation of therapeutic efficacy. In whole-body dynamic PET with continuous bed motion (CBM) (WBDCBM-PET), the pass number and bed velocity are key considerations. In the present study, we aimed to investigate the effect of a combination of pass number and bed velocity on the quantitative accuracy and quality of WBDCBM-PET images. METHODS In this study, WBDCBM-PET imaging was performed at a body phantom using seven bed velocity settings in combination with pass numbers. The resulting image quality was evaluated. For comparing different acquisition settings, the dynamic index (DI) was obtained using the following formula: [P/S], where P represents the pass number, and S represents the bed velocity (mm/s). The following physical parameters were evaluated: noise equivalent count at phantom (NECphantom), percent background variability (N10 mm), percent contrast of the 10 mm hot sphere (QH, 10 mm), the QH, 10 mm/N10 mm ratio, and the maximum standardized uptake value (SUVmax). Furthermore, visual evaluation was performed. RESULTS The NECphantom was equivalent for the same DI settings regardless of the bed velocity. The N10 mm exhibited an inverse correlation (r < - 0.89) with the DI. QH,10 mm was not affected by DI, and a correlation between QH,10 mm/N10 mm ratio and DI was found at all the velocities (r > 0.93). The SUVmax of the spheres was not influenced by the DI. The coefficient of variations caused by bed velocity decreased in larger spheres. There was no significant difference between the bed velocities on visual evaluation. CONCLUSION The quantitative accuracy and image quality achieved with WBDCBM-PET was comparable to that achieved with non-dynamic CBM, regardless of the pass number and bed velocity used during imaging for a given acquisition time.
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Affiliation(s)
- Hideo Yamamoto
- Department of Radiology, Juntendo University School of Medicine, 3-1-3, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
| | - Shota Takemoto
- Department of Radiology, Juntendo University School of Medicine, 3-1-3, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Akira Maebatake
- Department of Radiology, Juntendo University School of Medicine, 3-1-3, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Shuhei Karube
- Department of Radiology, Juntendo University School of Medicine, 3-1-3, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Yuki Yamashiro
- Department of Radiology, Juntendo University School of Medicine, 3-1-3, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Atsushi Nakanishi
- Department of Radiology, Juntendo University School of Medicine, 3-1-3, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Koji Murakami
- Department of Radiology, Juntendo University School of Medicine, 3-1-3, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
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14
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Leahy R, Boellaard R, Zaidi H. Whole‐body parametric
PET
imaging will replace conventional image‐derived
PET
metrics in clinical oncology. Med Phys 2018; 45:5355-5358. [DOI: 10.1002/mp.13266] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 10/22/2018] [Accepted: 10/23/2018] [Indexed: 01/26/2023] Open
Affiliation(s)
- Richard Leahy
- Signal and Image Processing Institute University of Southern California Los Angeles CA 90089USA
| | - Ronald Boellaard
- Department of Radiology and Nuclear Medicine Amsterdam University Medical Centers Location VUMC AmsterdamThe Netherlands
- Department of Nuclear Medicine and Molecular Imaging University of Groningen University Medical Center Groningen Groningen The Netherlands
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15
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Effects of breathing motion on PET acquisitions: step and shoot versus continuous bed motion. Nucl Med Commun 2018; 39:665-671. [PMID: 29672464 DOI: 10.1097/mnm.0000000000000852] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Continuous bed motion (CBM) acquisition recently became available in whole-body PET/CT scanners in addition to the conventional step and shoot (S&S) acquisition. In this work, we compared the image quality between these acquisition methods using a phantom simulating periodic motion to mimic motion from patient breathing in a controlled manner. METHODS PET image quality was assessed using the National Electrical Manufacturers Association IQ torso phantom filled with an F-FDG solution using a 4 : 1 target-to-background ratio. The phantom was scanned in two states: no motion (stationary) and with periodic motion in the axial direction with a displacement ±10 mm from the initial position. Both S&S and CBM scans were repeated 10 times in an alternating order, whereby the acquisition duration of each scan was adjusted to make the true counts approximately comparable to compensate for the decaying F-FDG. RESULTS The recovery coefficient analysis showed that in the stationary state, the 10 mm sphere recovery did not show any difference between S&S and CBM. With motion, the recovery coefficient was lower by ∼40% for both modes of acquisition. In addition, the image-based volume analysis of the 10 mm sphere showed 1.67 (1.57-1.69) cm for S&S and 1.73 (1.66-1.83) cm for CBM (P=0.13), and there was no difference between two modes. Our study indicated that when the acquisition conditions for S&S and CBM (equivalent net trues, identical phantom motion, and identical CT image used for PET corrections) were controlled carefully, these acquisition modes resulted in equivalent image quality.
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16
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Siman W, Kappadath SC. Comparison of Step-and-Shoot and Continuous-Bed-Motion PET Modes of Acquisition for Limited-View Organ Scans. J Nucl Med Technol 2017; 45:290-296. [PMID: 29042468 DOI: 10.2967/jnmt.117.195438] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2017] [Accepted: 08/31/2017] [Indexed: 01/20/2023] Open
Abstract
Continuous-bed-motion (CBM) acquisition mode has been made commercially available in PET/CT scanners. CBM mode is designed for whole-body imaging, with a long scan length (multiple axial fields of view [aFOVs]) and short acquisition duration (2-3 min/aFOV). PET/CT has recently been used after 90Y-microsphere therapy to quantify 90Y activity distribution in the liver. Here we compared counting efficiencies along the bed-motion direction (z-axis) between CBM and step-and-shoot (SS) acquisition modes for limited-view organ scans, such as 90Y PET/CT liver studies, that have short scan lengths (≤2 aFOVs) and long acquisition durations (10-30 min/aFOV). Methods: The counting efficiencies, that is, analytic sensitivities, in SS mode (single-aFOV and multiple-aFOV scans) and CBM mode were theoretically derived and experimentally validated using a cylindric 68Ge phantom. The sensitivities along the z-axis were compared between the SS and CBM modes. Results: The analytic and experimental count profiles were in good agreement, validating the analytic models. For fixed scan durations, the overall coincidence counting efficiency in CBM mode was lower (∼60%) than those in SS modes, and the maximum sensitivity in CBM mode was 50% or less of that in 1-aFOV SS mode and 100% or less of that in 2-aFOV SS mode. Conclusion: The ability of CBM mode to tailor-fit the PET/CT scan length and local scan duration is not realized in studies with a short scan length (≤30 cm) and long scan duration (20 min/aFOV for the scanner). SS acquisition mode is preferable to CBM mode for limited-view organ and count-starved scans, such as 90Y PET/CT liver scans, because of the higher counting efficiency of SS mode, which leads to better image quality and quantification precision.
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Affiliation(s)
- Wendy Siman
- Department of Radiology, University of Tennessee Medical Center, Knoxville, Tennessee.,University of Tennessee Graduate School of Medicine, Knoxville, Tennessee
| | - S Cheenu Kappadath
- Department of Imaging Physics, University of Texas MD Anderson Cancer Center, Houston, Texas; and .,University of Texas Graduate School of Biomedical Sciences, Houston, Texas
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17
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Comparison of image quality between step-and-shoot and continuous bed motion techniques in whole-body 18F-fluorodeoxyglucose positron emission tomography with the same acquisition duration. Ann Nucl Med 2017; 31:686-695. [PMID: 28815414 DOI: 10.1007/s12149-017-1200-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 08/06/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE This study aimed to compare the qualities of whole-body positron emission tomography (PET) images acquired by the step-and-shoot (SS) and continuous bed motion (CBM) techniques with approximately the same acquisition duration, through phantom and clinical studies. METHODS A body phantom with 10-37 mm spheres was filled with 18F-fluorodeoxyglucose (FDG) solution at a sphere-to-background radioactivity ratio of 4:1 and acquired by both techniques. Reconstructed images were evaluated by visual assessment, percentages of contrast (%Q H) and background variability (%N) in accordance with the Japanese guideline for oncology FDG-PET/computed tomography (CT). To evaluate the variability of the standardized uptake value (SUV), the coefficient of variation (CV) for both maximum SUV and peak SUV was examined. Both the SUV values were additionally compared with those of standard images acquired for 30 min, and their accuracy was evaluated by the %difference (%Diff). In the clinical study, whole-body 18F-FDG PET/CT images of 60 patients acquired by both techniques were compared for liver signal-to-noise ratio (SNRliver), CV at end planes, and both SUV values. RESULTS In the phantom study, the visual assessment and %Q H values of the two techniques did not differ from each other. However, the %N values of the CBM technique were significantly higher than those of the SS technique. Additionally, the CV and %Diff for both SUV values in the CBM images tended to be slightly higher than those in SS images. In the clinical study, the SNRliver values of CBM images were significantly lower than those of SS images, although the CV at the end planes in CBM images was significantly lower than those in SS images. In the Bland-Altman analysis for both SUV values, the mean differences were close to 0, and most lesions exhibited SUVs within the limits of agreement. CONCLUSIONS The CBM technique exhibited slightly lesser uniformity in the center plane than the SS technique. Additionally, in the phantom study, the CV and %Diff of SUV values in CBM images tended to be slightly higher than those of SS images. However, since these differences were subtle, they might be negligible in clinical settings.
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18
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van der Vos CS, Koopman D, Rijnsdorp S, Arends AJ, Boellaard R, van Dalen JA, Lubberink M, Willemsen ATM, Visser EP. Quantification, improvement, and harmonization of small lesion detection with state-of-the-art PET. Eur J Nucl Med Mol Imaging 2017; 44:4-16. [PMID: 28687866 PMCID: PMC5541089 DOI: 10.1007/s00259-017-3727-z] [Citation(s) in RCA: 133] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Accepted: 05/09/2017] [Indexed: 01/09/2023]
Abstract
In recent years, there have been multiple advances in positron emission tomography/computed tomography (PET/CT) that improve cancer imaging. The present generation of PET/CT scanners introduces new hardware, software, and acquisition methods. This review describes these new developments, which include time-of-flight (TOF), point-spread-function (PSF), maximum-a-posteriori (MAP) based reconstruction, smaller voxels, respiratory gating, metal artefact reduction, and administration of quadratic weight-dependent 18F-fluorodeoxyglucose (FDG) activity. Also, hardware developments such as continuous bed motion (CBM), (digital) solid-state photodetectors and combined PET and magnetic resonance (MR) systems are explained. These novel techniques have a significant impact on cancer imaging, as they result in better image quality, improved small lesion detectability, and more accurate quantification of radiopharmaceutical uptake. This influences cancer diagnosis and staging, as well as therapy response monitoring and radiotherapy planning. Finally, the possible impact of these developments on the European Association of Nuclear Medicine (EANM) guidelines and EANM Research Ltd. (EARL) accreditation for FDG-PET/CT tumor imaging is discussed.
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Affiliation(s)
- Charlotte S van der Vos
- Department of Radiology and Nuclear Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands
- MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands
| | - Daniëlle Koopman
- MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands
- Department of Nuclear Medicine, Isala Hospital, Zwolle, The Netherlands
| | - Sjoerd Rijnsdorp
- Department of Medical Physics, Catharina Hospital, Eindhoven, The Netherlands
| | - Albert J Arends
- Department of Medical Physics, Catharina Hospital, Eindhoven, The Netherlands
| | - Ronald Boellaard
- Department of Nuclear Medicine & Molecular Imaging, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - Jorn A van Dalen
- Department of Nuclear Medicine, Isala Hospital, Zwolle, The Netherlands
- Department of Medical Physics, Isala, Zwolle, The Netherlands
| | - Mark Lubberink
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
- Department of Medical Physics, Uppsala University Hospital, Uppsala, Sweden
| | - Antoon T M Willemsen
- Department of Nuclear Medicine & Molecular Imaging, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Eric P Visser
- Department of Radiology and Nuclear Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands.
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19
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Acuff SN, Osborne D. Clinical Workflow Considerations for Implementation of Continuous-Bed-Motion PET/CT. J Nucl Med Technol 2016; 44:55-8. [PMID: 27102661 DOI: 10.2967/jnmt.116.172171] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Accepted: 02/22/2016] [Indexed: 11/16/2022] Open
Abstract
Within the last 3 y, a new type of technology has emerged for PET imaging that uses a continuous-bed-motion (CBM) acquisition. For technologists, this type of acquisition requires some modifications of the standard approach to PET protocols and imaging workflows. There are several key aspects of CBM that technologists need to learn and understand when transitioning from traditional step-and-shoot PET imaging to this new technology, including differences in acquisition type, image quality, and protocol setup as well as the impact that CBM can have on workflow. This article explains how CBM differs from step and shoot and focuses on the issues critical for technologists to know when first using this technology.
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Affiliation(s)
- Shelley N Acuff
- Department of Radiology, University of Tennessee Graduate School of Medicine, University of Tennessee Medical Center, Knoxville, Tennessee
| | - Dustin Osborne
- Department of Radiology, University of Tennessee Graduate School of Medicine, University of Tennessee Medical Center, Knoxville, Tennessee
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