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Rogasch JMM, Hofheinz F, van Heek L, Voltin CA, Boellaard R, Kobe C. Influences on PET Quantification and Interpretation. Diagnostics (Basel) 2022; 12:diagnostics12020451. [PMID: 35204542 PMCID: PMC8871060 DOI: 10.3390/diagnostics12020451] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 01/06/2022] [Accepted: 02/08/2022] [Indexed: 01/21/2023] Open
Abstract
Various factors have been identified that influence quantitative accuracy and image interpretation in positron emission tomography (PET). Through the continuous introduction of new PET technology—both imaging hardware and reconstruction software—into clinical care, we now find ourselves in a transition period in which traditional and new technologies coexist. The effects on the clinical value of PET imaging and its interpretation in routine clinical practice require careful reevaluation. In this review, we provide a comprehensive summary of important factors influencing quantification and interpretation with a focus on recent developments in PET technology. Finally, we discuss the relationship between quantitative accuracy and subjective image interpretation.
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Affiliation(s)
- Julian M. M. Rogasch
- Department of Nuclear Medicine, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 13353 Berlin, Germany;
- Berlin Institute of Health at Charité, Universitätsmedizin Berlin, 10178 Berlin, Germany
| | - Frank Hofheinz
- Institute of Radiopharmaceutical Cancer Research, Helmholtz Center Dresden-Rossendorf, 01328 Dresden, Germany;
| | - Lutz van Heek
- Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany; (L.v.H.); (C.-A.V.)
| | - Conrad-Amadeus Voltin
- Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany; (L.v.H.); (C.-A.V.)
| | - Ronald Boellaard
- Department of Radiology and Nuclear Medicine, Cancer Center Amsterdam (CCA), Amsterdam University Medical Center, Free University Amsterdam, 1081 HV Amsterdam, The Netherlands;
| | - Carsten Kobe
- Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany; (L.v.H.); (C.-A.V.)
- Correspondence: ; Tel.: +49-221-478-7534
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Chen W, Li Z, Shuai T, Qian L, Deng L, Liao K, Zhang K, Jia B, Song B. Qualitative and Quantitative Assessment of Abdominal and Pelvic CT Image Quality Using Iopromide With Different Concentrations of Iodine (300 and 370 mg I/mL). AJR Am J Roentgenol 2017; 209:904-910. [PMID: 28726507 DOI: 10.2214/ajr.16.17302] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVE The purpose of this study was to analyze the quality of MDCT images obtained using iopromide with two different concentrations of iodine (300 and 370 mg I/mL) in daily clinical settings. SUBJECTS AND METHODS Patients from 38 hospitals in China undergoing abdominal or pelvic CT with iopromide were prospectively recruited. MDCT was performed using iopromide with an iodine concentration of 300 or 370 mg I/mL. CT quality image was graded as excellent, good, adequate, and poor. Objective indicators were the contrast-to-noise ratio (CNR) and signal-to-noise ratio (SNR). Outcomes were compared according to organ studied, tumor type (benign vs malignant), saline usage, and type of MDCT (16-MDCT vs 64-MDCT). RESULTS A total of 4506 patients (63.7% men) with a mean (± SD) age of 56.3 ± 14.1 years and mean body mass index (weight in kilograms divided by the square of height in meters) of 23.2 ± 3.3 were included. Iopromide with 300 mg I/mL was used for 3042 patients (67.5%), and 370 mg I/mL was used for 1464 patients (32.2%). A total of 1847 scans (41.0%) had excellent image quality, 2454 (54.5%) had good quality, 176 (3.9%) had adequate quality, and 29 (0.6%) had poor quality. No differences were noted between CT scans that did or did not use saline, 16-MDCT versus 64-MDCT scans, and 300 versus 370 mg I/mL iopromide. Variations in the CNR and SNR were noted between the two iodine concentrations with respect to other parameters examined. CONCLUSION Iopromide with both concentrations of iodine provided acceptable image quality, though according to CNR and SNR, one or the other may provide better quality in different situations.
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Affiliation(s)
- Weixia Chen
- 1 Department of Radiology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan Province, P. R. China 610041
| | - Zhenlin Li
- 1 Department of Radiology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan Province, P. R. China 610041
| | - Tao Shuai
- 1 Department of Radiology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan Province, P. R. China 610041
| | - Lingling Qian
- 1 Department of Radiology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan Province, P. R. China 610041
| | - Liping Deng
- 1 Department of Radiology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan Province, P. R. China 610041
| | - Kai Liao
- 1 Department of Radiology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan Province, P. R. China 610041
| | - Kai Zhang
- 1 Department of Radiology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan Province, P. R. China 610041
| | - Bangsheng Jia
- 1 Department of Radiology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan Province, P. R. China 610041
| | - Bin Song
- 1 Department of Radiology, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan Province, P. R. China 610041
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Behrendt FF, Lensing C, Keil S, Mottaghy FM, Verburg FA. No clinically relevant differences between positron emission tomography (PET) reconstructions based on low-dose or contrast-enhanced CT in combined integrated multiphase 18F-Fluorethylcholine PET/CT for prostate cancer. J Med Imaging Radiat Oncol 2016; 60:498-505. [DOI: 10.1111/1754-9485.12481] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2016] [Accepted: 04/30/2016] [Indexed: 11/27/2022]
Affiliation(s)
- Florian F Behrendt
- Department of Nuclear Medicine; RWTH Aachen University Hospital; Aachen Germany
- Radiology Institute ‘Aachen Land’; Würselen Germany
| | - Carina Lensing
- Department of Nuclear Medicine; RWTH Aachen University Hospital; Aachen Germany
| | - Sebastian Keil
- Department of Diagnostic and Interventional Radiology; RWTH Aachen University Hospital; Aachen Germany
| | - Felix M Mottaghy
- Department of Nuclear Medicine; RWTH Aachen University Hospital; Aachen Germany
- Department of Nuclear Medicine; Maastricht University Medical Center; Maastricht The Netherlands
| | - Frederik A Verburg
- Department of Nuclear Medicine; RWTH Aachen University Hospital; Aachen Germany
- Department of Nuclear Medicine; Maastricht University Medical Center; Maastricht The Netherlands
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Verburg FA, Apitzsch J, Lensing C, Kuhl CK, Pietsch H, Mottaghy FM, Behrendt FF. Body surface area adapted iopromide 300mg/ml versus 370mg/ml contrast medium injection protocol: Influence on quantitative and clinical assessment in combined PET/CT. Eur J Radiol 2013; 82:2348-52. [DOI: 10.1016/j.ejrad.2013.09.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2013] [Revised: 09/12/2013] [Accepted: 09/14/2013] [Indexed: 10/26/2022]
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Biermann M, Schwarzlmüller T, Fasmer KE, Reitan BC, Johnsen B, Rosendahl K. Is there a role for PET-CT and SPECT-CT in pediatric oncology? Acta Radiol 2013; 54:1037-45. [PMID: 23319723 DOI: 10.1258/ar.2012.120616] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
During the last decade, hybrid imaging has revolutionized nuclear medicine. Multimodal camera systems, integrating positron emission tomography (PET) or single photon emission computed tomography (SPECT) with computed tomography (CT) now combine the contrast provided by tumor-avid radioactive drugs with the anatomic precision of CT. While PET-CT to a great extent has replaced single-modality PET in adult oncology, the use of PET-CT in children has been controversial, since even the lowest dose CT protocols adds approximately 2 mSv to the radiation dose of about 4 mSv from the PET-study with F-18-fluorodeoxyglucose (F-18-FDG). The article describes the current techniques used, discusses radiation doses and gives an overview of current indications for PET-CT and SPECT-CT in children. Hybrid imaging with a tumor-avid radioactive drug provides extremely high contrast between tumor and background tissues, while the CT component helps to locate the lesion anatomically. Currently both PET-CT and SPECT-CT play a role in pediatric oncology; PET-CT using F-18-FDG particularly for staging and follow-up of lymphoma and brain cancer, bone and soft tissue sarcomas; SPECT-CT with I-123-metaiodobenzylguanidine (MIBG) for tumors of the sympathetic nervous system such as neuroblastoma and pheochromocytoma while the remaining neuroendocrine tumors are imaged with radioactively labeled somatostatin analogues. To reduce radiation dose, a low-dose CT in combination with ultrasound and/or magnetic resonance imaging for the assessment of anatomy is often preferred.
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Affiliation(s)
- Martin Biermann
- Nuclear Medicine and PET Center,
Department of Radiology, Haukeland University Hospital, Bergen
- Section for Radiology, Department of
Surgical Sciences, University of Bergen, Bergen
| | - Thomas Schwarzlmüller
- Nuclear Medicine and PET Center,
Department of Radiology, Haukeland University Hospital, Bergen
| | | | - Bernt C Reitan
- Nuclear Medicine and PET Center,
Department of Radiology, Haukeland University Hospital, Bergen
| | - Boel Johnsen
- Nuclear Medicine and PET Center,
Department of Radiology, Haukeland University Hospital, Bergen
| | - Karen Rosendahl
- Section for Radiology, Department of
Surgical Sciences, University of Bergen, Bergen
- Section for Pediatric Radiology,
Department of Radiology, Haukeland University Hospital, Bergen, Norway
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Bernstine H, Sopov V, Yefremov N, Nidam M, Gabbai M, Sosna J, Groshar D. Comparison of 80 and 120 kVp contrast-enhanced CT for attenuation correction in PET/CT, using quantitative analysis and reporter assessment of PET image quality. Clin Radiol 2013; 69:e17-24. [PMID: 24156801 DOI: 10.1016/j.crad.2013.08.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2013] [Revised: 07/24/2013] [Accepted: 08/06/2013] [Indexed: 12/13/2022]
Abstract
AIM To determine the effect of low tube voltage on positron-emission tomography (PET) image quality, quantitative analysis, and radiation dose in a combined PET/computed tomography (CT) study in patients with normal body mass index (BMI). MATERIALS AND METHODS One hundred and twenty-nine examinations performed in 46 patients (mean age 57 years), who had at least two separate studies were retrospectively evaluated; at least one with 120 kVp and one with 80 kVp. Three independent readers reviewed all PET images and graded the image quality. PET signal and noise were recorded on the liver, spleen, fat, bone marrow, and aorta. CT dose index (CTDI) and the dose-length product (DLP) were used for CT radiation dose estimation. A mixed-effects model analysis was used for comparison of estimated radiation dose and PET data. RESULTS There was a significant decrease of 15% in the radiation dose estimates between 80 and 120 kVp (DLP 946.2 ± 189 versus 1157.0 ± 236, respectively; p < 0.001). There was an increase of 12% in PET signal in the normal liver with 80 kVp. The average score of PET image quality obtained between 80 and 120 kVp was 4.85 ± 0.42 versus 4.90 ± 0.27, respectively (p = 0.47). CONCLUSION PET/80 kVp CT has no statistically significant difference in the PET image quality and quantitative analysis compared to PET/120 kVp and may be used in selected patients to reduce the radiation dose.
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Affiliation(s)
- H Bernstine
- Department of Nuclear Medicine, Rabin Medical Center, Petah Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - V Sopov
- Department of Nuclear Medicine, Rabin Medical Center, Petah Tikva, Israel
| | - N Yefremov
- Department of Nuclear Medicine, Rabin Medical Center, Petah Tikva, Israel
| | - M Nidam
- Department of Nuclear Medicine, Rabin Medical Center, Petah Tikva, Israel
| | - M Gabbai
- Department of Radiology, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - J Sosna
- Department of Radiology, Hadassah Hebrew University Medical Center, Jerusalem, Israel; Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - D Groshar
- Department of Nuclear Medicine, Rabin Medical Center, Petah Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Nuclear Medicine, Assuta Medical Center, Tel Aviv, Israel.
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Verburg FA, Kuhl CK, Pietsch H, Palmowski M, Mottaghy FM, Behrendt FF. The influence of different contrast medium concentrations and injection protocols on quantitative and clinical assessment of FDG–PET/CT in lung cancer. Eur J Radiol 2013; 82:e617-22. [DOI: 10.1016/j.ejrad.2013.06.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Accepted: 06/29/2013] [Indexed: 10/26/2022]
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Guignard R, Zwarthoed C, Borra A, Darcourt J, Gallamini A. PET scan integration in lymphoma management. Int J Hematol Oncol 2013. [DOI: 10.2217/ijh.13.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
SUMMARY Despite a marked improvement in lymphoma treatment outcome, current prognostic models, relying on a pretreatment set of static clinical variables, appear unable to support a risk-adapted therapeutic strategy. On the other hand, functional imaging with 18F-fluoro-2-deoxy-D-glucose (FDG)-PET proved to be a reliable tool to dynamically assess tumor FDG uptake changes during and after treatment. In this article we aim to review the prognostic value of FDG-PET in all the stages of Hodgkin’s and non-Hodgkin’s lymphoma management, without the intent to address the diagnostic value of PET or to replace available consensus guidelines. In particular we focused on two critical issues: the cost–effectiveness of PET in the overall strategy of lymphoma diagnosis and treatment; and ongoing clinical trials adopting an interim PET-based strategy to modulate treatment intensity based on PET results. Finally, new trends in multimodality imaging, as well as in new radiopharmaceutical tracers, are briefly reviewed.
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Affiliation(s)
- Renaud Guignard
- Nuclear Medicine Department, 33 Avenue Valombrose, 06189 Nice Cedex 2, Centre Antoine Lacassagne, Nice, France.
| | - Colette Zwarthoed
- Nuclear Medicine Department, 33 Avenue Valombrose, 06189 Nice Cedex 2, Centre Antoine Lacassagne, Nice, France
| | - Anna Borra
- Hematology Department, Centre Antoine Lacassagne, Nice, France
| | - Jacques Darcourt
- Nuclear Medicine Department, 33 Avenue Valombrose, 06189 Nice Cedex 2, Centre Antoine Lacassagne, Nice, France
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Contrast medium injection protocol adjusted for body surface area in combined PET/CT. Eur Radiol 2013; 23:1970-7. [DOI: 10.1007/s00330-013-2781-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2012] [Revised: 12/21/2012] [Accepted: 01/06/2013] [Indexed: 10/27/2022]
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