In May 2018, the Biograph Vision PET/CT system was installed at the University Medical Center Groningen. This study evaluated the initial experiences with this new PET/CT system in terms of perceived image quality and semiquantitative analysis in comparison to the Biograph mCT as a reference. Methods: In total, 20 oncologic patients were enrolled and received a single 3 MBq/kg injected dose of 18 F-FDG followed by a dual-imaging PET scan. Ten patients were scanned on the Biograph mCT first, whereas the other 10 patients were scanned on the Biograph Vision first. The locally preferred clinically reconstructed images were blindly reviewed by 3 nuclear medicine physicians and scored (using a Likert scale of 1-5) on tumor lesion demarcation, overall image quality, and image noise. In addition, these clinically reconstructed images were used for semiquantitative analysis by measurement of SUVs in tumor lesions. Images acquired using reconstructions conform with the European Association of Nuclear Medicine Research Ltd. (EARL) specifications were also used for measurements of SUV in tumor lesions and healthy tissues for comparison between systems. Results: The 18 F-FDG dose received by the 14 men and 6 women (age range, 36-84; mean ± SD, 61 ± 16 y) ranged from 145 to 405 MBq (mean ± SD, 268 ± 59.3). Images acquired on the Biograph Vision were scored significantly higher on tumor lesion demarcation, overall image quality, and image noise than images acquired on the Biograph mCT (P , 0.001). The overall interreader agreement showed a Fleiss κ of 0.61 (95% confidence interval, 0.53-0.70). Furthermore, the SUVs in tumor lesions and healthy tissues agreed well (within 95%) between PET/CT systems, particularly when EARL-compliant reconstructions were used on both systems. Conclusion: In this initial study, the Biograph Vision showed improved image quality compared with the Biograph mCT in terms of lesion demarcation, overall image quality, and visually assessed signal-to-noise ratio. The 2 systems are comparable in semiquantitatively assessed image biomarkers in both healthy tissues and tumor lesions. Improved quantitative performance may, however, be feasible using the clinically optimized reconstruction settings.

The first Siemens Biograph Vision PET/CT system (Siemens Healthineers, Knoxville, USA) was installed at the University Medical Center Groningen. Improved performance of this system could allow for a reduction in activity administration and/or scan duration. This study evaluates the effects of reduced scan duration in oncological 18 F-FDG PET imaging on quantitative and subjective imaging parameters and its influence on clinical image reading. Methods: Patients referred for a clinical PET/CT scan were enrolled in this study, received a weightbased 18 F-FDG injected activity, and underwent a 180 seconds per bed position (s/bp) list-mode PET acquisition. Acquired PET data were reconstructed using the clinically vendor recommended reconstruction protocol (hereinafter referred to as Clinical), using the Clinical protocol with additional 2 mm Gaussian filtering (hereinafter referred to as Clinical+G2) as well as conform European Association of Nuclear Medicine Research Ltd (EARL) specifications using different scan durations per bed position (180, 120, 60, 30, and 10 s). Reconstructed images were quantitatively assessed for comparison of standardized uptake values (SUVs) and noise. In addition, Clinically reconstructed images were qualitatively evaluated by three nuclear medicine physicians. Results: In total, 30 oncological patients (22 men, 8 women; age 48-88, mean ± SD 67 ± 9.6 years) received a single weight-based (3 MBq/kg) 18 F-FDG injected activity (weight 45-123 kg, mean ± SD 81 ± 15; activity 135-380 MBq, mean ± SD 241 ± 46.5). Significant differences in lesion SUVmax were found between the 180 s/bp images and the 30 and 10 s/bp images reconstructed using the Clinical protocols, whereas no differences were found in lesion SUVpeak. EARL compliant images did not show differences in lesion SUVmax or SUVpeak between scan durations. Quantitative parameters showed minimal deviation (~5%) in the 60 s/bp images. Further subjective image quality assessment was therefore conducted using the 60 s/bp images. Qualitative assessment revealed the influence of personal by on September 17, 2020. For personal use only. jnm.snmjournals.org Downloaded from 3 preference on physicians' willingness to adopt the 60 s/bp images in clinical practice. Although quantitative PET parameters differed minimally, an increase in noise was observed. Conclusions: Using the Biograph Vision PET/CT for oncological 18 F-FDG imaging, scan duration and/or activity administration could be reduced by a factor of three or more when using the Clinical+G2 or the EARL compliant reconstruction protocol, respectively.

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