Extending the clinical capabilities of short- and long-lived positron-emitting radionuclides through high sensitivity PET/CT

Abstract

This review describes the main benefits of using long axial field of view (LAFOV) PET in clinical applications. As LAFOV PET is the latest development in PET instrumentation, many studies are ongoing that explore the potentials of these systems, which are characterized by ultra-high sensitivity. This review not only provides an overview of the published clinical applications using LAFOV PET so far, but also provides insight in clinical applications that are currently under investigation. Apart from the straightforward reduction in acquisition times or administered amount of radiotracer, LAFOV PET also allows for other clinical applications that to date were mostly limited to research, e.g., dual tracer imaging, whole body dynamic PET imaging, omission of CT in serial PET acquisition for repeat imaging, and studying molecular interactions between organ systems. It is expected that this generation of PET systems will significantly advance the field of nuclear medicine and molecular imaging.

Long Versus Short Axial Field of View Immuno-PET/CT: Semiquantitative Evaluation for89Zr-Trastuzumab

“…A similar direct comparison of the 2 systems has shown that, for shorter-lived tracers (labeled with 18 F or 68 Ga), LAFOV PET provided a liver signal-to-noise ratio equivalent to that of SAFOV PET but with an approximately 8-9 times reduction in scan duration (14). The intraindividual comparison of the 5 double-scanned patients in the present study confirms this result for a long-lived 89 Zr-labeled tracer, as the COV for a liver VOI of the 30-min SAFOV scans was in the same range as that of 3-and 5-min LAFOV scans.…”

“…The introduction of PET/CT systems with silicon photomultipliers and time-of-flight image reconstruction capabilities already has improved the signal-to-noise ratio of PET measurements, which, in turn, has led to a reduction in scan duration or activity administration (9)(10)(11)(12). The more recent introduction of PET systems with a long axial field of view (LAFOV), with their increased sensitivity (13), further improves the signal-to-noise ratio (14,15), leading to several new opportunities in clinical practice and research (16)(17)(18). To use these new-generation of PET/CT systems efficiently, it is necessary to optimize scan protocols and understand the impact of various parameters on SUVs.…”

Clinical Theranostics in Recurrent Gliomas: A Review

“…Future studies should provide data on radiotracer dose calculation based on constructed NECR-dosage curves. Furthermore, a reduction in the required radiotracer dose will occur when advances in PET technology, such as long-axial field-of-view PET, are applied to recurrent glioma patients [60].…”

Expert opinions in nuclear medicine: Finding the “holy grail” in infection imaging

“…More recently, the next game-changing technology is the large axial field of view (LAFOV) PET/CT camera, with a substantial increase in sensitivity, hereby allowing for faster scanning and/or an important reduction in injected activity, hence radiation burden (23,24). The first LAFOV PET/CT cameras have now been installed in larger nuclear medicine departments.…”