Using SUV as a Guide to <sup>18</sup>F-FDG Dose Reduction

Cheng, De; Ersahin, Devrim; Staib, Lawrence H.; Latta, Daniele Della; Giorgetti, Alejandro; D’Errico, Francesco

doi:10.2967/jnumed.114.140129

Cited by 10 publications

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“…We administered an activity of 3.5 MBq/kg body weight that is lower to those used in prior [ 18 F]FDG/PET studies (4.8-5.2 MBq/kg of body weight [4]). However, while a lower signal to noise ratio can result from lower activity, no effect on SUV is expected [18]. In our protocol, we subsequently acquired PET/CT and PET/MRI.…”

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confidence: 99%

[18F]FDG uptake of the normal spinal cord in PET/MR imaging: comparison with PET/CT imaging

et al. 2020

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Background: The lack of visualization of the spinal cord hinders the evaluation of [ 18 F]Fluoro-deoxy-glucose (FDG) uptake of the spinal cord in PET/CT. By exploiting the capability of MRI to precisely outline the spinal cord, we performed a retrospective study aimed to define normal pattern of spinal cord [ 18 F]FDG uptake in PET/MRI. Methods: Forty-one patients with lymphoma without clinical or MRI signs of spinal cord or bone marrow involvement underwent simultaneous PET and MRI acquisition using Siemens Biograph mMR after injection of 3.5 MBq/kg body weight of [ 18 F]FDG for staging purposes. Using a custom-made software, we placed ROIs of 3 and 9 mm in diameter in the spinal cord, lumbar CSF, and vertebral marrow that were identified on MRI at 5 levels (C2, C5, T6, T12, and L3). The SUVmax, SUVmean, and the SUVmax and SUVmean normalized (NSUVmax and NSUVmean) to the liver were measured. For comparison, the same ROIs were placed in PET-CT images obtained immediately before the PET-MRI acquisition following the same tracer injection. Results: On PET/MRI using the 3 mm ROI, the following average (all level excluding L3) spinal cord median (1st and 3rd quartile) values were measured:

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Section: Discussionmentioning

confidence: 99%

[18F]FDG uptake of the normal spinal cord in PET/MR imaging: comparison with PET/CT imaging

et al. 2020

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“…The impact of a reduction of acquisition time on image quality or lesion detectability can be investigated by acquiring data in list mode, so that the raw data can be rebinned to simulate scans acquired with reduced acquisition times [13–15]. …”

Section: Introductionmentioning

confidence: 99%

Patient-specific optimisation of administered activity and acquisition times for 18F-FDG PET imaging

et al. 2017

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BackgroundThe purpose of this study is to identify a method for optimising the administered activity and acquisition time for 18F-FDG PET imaging, yielding images of consistent quality for patients with varying body sizes and compositions, while limiting radiation doses to patients and staff. Patients referred for FDG scans had bioimpedance measurements. They were injected with 3 MBq/kg of 18F up to 370 MBq and scanned on a Siemens Biograph mCT at 3 or 4 min per bed position. Data were rebinned to simulate 2- and 1-min acquisitions. Subjective assessments of image quality made by an experienced physician were compared with objective measurements based on signal-to-noise ratio and noise equivalent counts (NEC). A target objective measure of image quality was identified. The activity and acquisition time required to achieve this were calculated for each subject. Multiple regression analysis was used to identify expressions for the activity and acquisition time required in terms of easily measurable patient characteristics.ResultsOne hundred and eleven patients were recruited, and subjective and objective assessments of image quality were compared for 321 full and reduced time scans. NEC-per-metre was identified as the objective measure which best correlated with the subjective assessment (Spearman rank correlation coefficient 0.77) and the best discriminator for images with a subjective assessment of “definitely adequate” (area under the ROC curve 0.94). A target of 37 Mcount/m was identified. Expressions were identified in terms of patient sex, height and weight for the activity and acquisition time required to achieve this target. Including measurements of body composition in these expressions was not useful. Using these expressions would reduce the mean activity administered to this patient group by 66 MBq compared to the current protocol.ConclusionsExpressions have been identified for the activity and acquisition times required to achieve consistent image quality in FDG imaging with reduced patient and staff doses. These expressions might need to be adapted for other systems and reconstruction protocols.Electronic supplementary materialThe online version of this article (doi:10.1186/s13550-016-0250-3) contains supplementary material, which is available to authorized users.

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“…Previous studies suggested the effective dose from PET/CT to be in the range of 10-30 mSv, depending on the activity of 18 F-FDG injected (0.02 mSv/MBq, according to International Commission on Radiological Protection publication 106) and the CT protocol (1-20 mSv) (3)(4)(5)(6)(7). In light of recent evidence that radiation exposure from medical imaging may carry a risk of cancer (1,2,7), we determined that a dose reduction from 555 MBq (15 mCi) to 370 MBq (10 mCi) does not affect SUV max semiquantification or image quality (8). However, we suspected that dose could be reduced further without affecting SUV semiquantification or image quality using our standard PET data acquisition of 3 min per bed position.…”

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Determining the Minimal Required Radioactivity of ¹⁸F-FDG for Reliable Semiquantification in PET/CT Imaging: A Phantom Study

Chen

Ménard

Cheng

2016

J. Nucl. Med. Technol.

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In pursuit of as-low-as-reasonably-achievable (ALARA) doses, this study investigated the minimal required radioactivity and corresponding imaging time for reliable semiquantification in PET/CT imaging. Methods: Using a phantom containing spheres of various diameters (3.4, 2.1, 1.5, 1.2, and 1.0 cm) filled with a fixed 18 F-FDG concentration of 165 kBq/mL and a background concentration of 23.3 kBq/mL, we performed PET/CT at multiple time points over 20 h of radioactive decay. The images were acquired for 10 min at a single bed position for each of 10 half-lives of decay using 3-dimensional list mode and were reconstructed into 1-, 2-, 3-, 4-, 5-, and 10-min acquisitions per bed position using an ordered-subsets expectation maximum algorithm with 24 subsets and 2 iterations and a gaussian 2-mm filter. SUV max and SUV avg were measured for each sphere. Results: The minimal required activity (±10%) for precise SUV max semiquantification in the spheres was 1.8 kBq/mL for an acquisition of 10 min, 3.7 kBq/mL for 3-5 min, 7.9 kBq/mL for 2 min, and 17.4 kBq/mL for 1 min. The minimal required activity concentration-acquisition time product per bed position was 10-15 kBq/mL⋅min for reproducible SUV measurements within the spheres without overestimation. Using the total radioactivity and counting rate from the entire phantom, we found that the minimal required total activity-time product was 17 MBq⋅min and the minimal required counting rate-time product was 100 kcps⋅min. Conclusion: Our phantom study determined a threshold for minimal radioactivity and acquisition time for precise semiquantification in 18 F-FDG PET imaging that can serve as a guide in pursuit of achieving ALARA doses.Key Words: PET; phantom; dosimetry; dose reduction; acquisition time; standard uptake value J Nucl Med Technol 2016; 44:26-30 DOI: 10.2967/jnmt.115.165258 There is a growing trend to minimize ionizing radiation exposure, particularly from diagnostic medical imaging involving x-rays and internal radiation from administration of radionuclides. Recent evidence from a retrospective largecohort study of over 178,600 U.K. residents who were exposed to radiation from CT scans in childhood found that a cumulative dose of more than 30 mGy to red bone marrow from as few as 5-10 head CT scans in children younger than 15 y carried a relative risk of 3.18 for leukemia as compared with a cumulative dose of less than 5 mGy. For brain cancer, a cumulative dose of 50-74 mGy to brain from as few as 2-3 head CT scans carried a relative risk of 2.82, as compared with those receiving a cumulative dose of less than 5 mGy (1). In a study of 680,000 Australians exposed to CT scans in childhood and adolescence, Mathews et al. found an incidence rate ratio of 1.24 for all cancers, with an observed dose-response relation of 0.16 per additional CT scan using an estimated average effective radiation dose of 4.5 mSv per scan (2).18 F-FDG PET/CT has been widely used for oncologic and cardiac imaging, with radiation exposure being derived from the injected dose of radiot...

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Using SUV as a Guide to ¹⁸F-FDG Dose Reduction

Cited by 10 publications

References 13 publications

[18F]FDG uptake of the normal spinal cord in PET/MR imaging: comparison with PET/CT imaging

[18F]FDG uptake of the normal spinal cord in PET/MR imaging: comparison with PET/CT imaging

Patient-specific optimisation of administered activity and acquisition times for 18F-FDG PET imaging

Determining the Minimal Required Radioactivity of ¹⁸F-FDG for Reliable Semiquantification in PET/CT Imaging: A Phantom Study

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Using SUV as a Guide to 18F-FDG Dose Reduction

Cited by 10 publications

References 13 publications

[18F]FDG uptake of the normal spinal cord in PET/MR imaging: comparison with PET/CT imaging

[18F]FDG uptake of the normal spinal cord in PET/MR imaging: comparison with PET/CT imaging

Patient-specific optimisation of administered activity and acquisition times for 18F-FDG PET imaging

Determining the Minimal Required Radioactivity of 18F-FDG for Reliable Semiquantification in PET/CT Imaging: A Phantom Study

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Using SUV as a Guide to ¹⁸F-FDG Dose Reduction

Determining the Minimal Required Radioactivity of ¹⁸F-FDG for Reliable Semiquantification in PET/CT Imaging: A Phantom Study