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Evaluation of [(68)Ga]Ga-PSMA PET/CT images acquired with a reduced scan time duration in prostate cancer patients using the digital biograph vision
AIM: [(68)Ga]Ga-PSMA-11 PET/CT allows for a superior detection of prostate cancer tissue, especially in the context of a low tumor burden. Digital PET/CT bears the potential of reducing scan time duration/administered tracer activity due to, for instance, its higher sensitivity and improved time coi...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7914332/ https://www.ncbi.nlm.nih.gov/pubmed/33641046 http://dx.doi.org/10.1186/s13550-021-00765-y |
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author | Weber, Manuel Jentzen, Walter Hofferber, Regina Herrmann, Ken Fendler, Wolfgang Peter Conti, Maurizio Wetter, Axel Kersting, David Rischpler, Christoph Fragoso Costa, Pedro |
author_facet | Weber, Manuel Jentzen, Walter Hofferber, Regina Herrmann, Ken Fendler, Wolfgang Peter Conti, Maurizio Wetter, Axel Kersting, David Rischpler, Christoph Fragoso Costa, Pedro |
author_sort | Weber, Manuel |
collection | PubMed |
description | AIM: [(68)Ga]Ga-PSMA-11 PET/CT allows for a superior detection of prostate cancer tissue, especially in the context of a low tumor burden. Digital PET/CT bears the potential of reducing scan time duration/administered tracer activity due to, for instance, its higher sensitivity and improved time coincidence resolution. It might thereby expand [(68)Ga]Ga-PSMA-11 PET/CT that is currently limited by (68)Ge/(68)Ga-generator yield. Our aim was to clinically evaluate the influence of a reduced scan time duration in combination with different image reconstruction algorithms on the diagnostic performance. METHODS: Twenty prostate cancer patients (11 for biochemical recurrence, 5 for initial staging, 4 for metastatic disease) sequentially underwent [(68)Ga]Ga-PSMA-11 PET/CT on a digital Siemens Biograph Vision. PET data were collected in continuous-bed-motion mode with a mean scan time duration of 16.7 min (reference acquisition protocol) and 4.6 min (reduced acquisition protocol). Four iterative reconstruction algorithms were applied using a time-of-flight (TOF) approach alone or combined with point-spread-function (PSF) correction, each with 2 or 4 iterations. To evaluate the diagnostic performance, the following metrics were chosen: (a) per-region detectability, (b) the tumor maximum and peak standardized uptake values (SUVmax and SUVpeak), and (c) image noise using the liver’s activity distribution. RESULTS: Overall, 98% of regions (91% of affected regions) were correctly classified in the reduced acquisition protocol independent of the image reconstruction algorithm. Two nodal lesions (each ≤ 4 mm) were not identified (leading to downstaging in 1/20 cases). Mean absolute percentage deviation of SUVmax (SUVpeak) was approximately 9% (6%) for each reconstruction algorithm. The mean image noise increased from 13 to 21% (4 iterations) and from 10 to 15% (2 iterations) for PSF + TOF and TOF images. CONCLUSIONS: High agreement at 3.5-fold reduction of scan time in terms of per-region detection (98% of regions) and image quantification (mean deviation ≤ 10%) was demonstrated; however, small lesions can be missed in about 10% of patients leading to downstaging (T1N0M0 instead of T1N1M0) in 5% of patients. Our results suggest that a reduction of scan time duration or administered [(68)Ga]Ga-PSMA-11 activities can be considered in metastatic patients, where missing small lesions would not impact patient management. Limitations include the small and heterogeneous sample size and the lack of follow-up. |
format | Online Article Text |
id | pubmed-7914332 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-79143322021-03-15 Evaluation of [(68)Ga]Ga-PSMA PET/CT images acquired with a reduced scan time duration in prostate cancer patients using the digital biograph vision Weber, Manuel Jentzen, Walter Hofferber, Regina Herrmann, Ken Fendler, Wolfgang Peter Conti, Maurizio Wetter, Axel Kersting, David Rischpler, Christoph Fragoso Costa, Pedro EJNMMI Res Original Research AIM: [(68)Ga]Ga-PSMA-11 PET/CT allows for a superior detection of prostate cancer tissue, especially in the context of a low tumor burden. Digital PET/CT bears the potential of reducing scan time duration/administered tracer activity due to, for instance, its higher sensitivity and improved time coincidence resolution. It might thereby expand [(68)Ga]Ga-PSMA-11 PET/CT that is currently limited by (68)Ge/(68)Ga-generator yield. Our aim was to clinically evaluate the influence of a reduced scan time duration in combination with different image reconstruction algorithms on the diagnostic performance. METHODS: Twenty prostate cancer patients (11 for biochemical recurrence, 5 for initial staging, 4 for metastatic disease) sequentially underwent [(68)Ga]Ga-PSMA-11 PET/CT on a digital Siemens Biograph Vision. PET data were collected in continuous-bed-motion mode with a mean scan time duration of 16.7 min (reference acquisition protocol) and 4.6 min (reduced acquisition protocol). Four iterative reconstruction algorithms were applied using a time-of-flight (TOF) approach alone or combined with point-spread-function (PSF) correction, each with 2 or 4 iterations. To evaluate the diagnostic performance, the following metrics were chosen: (a) per-region detectability, (b) the tumor maximum and peak standardized uptake values (SUVmax and SUVpeak), and (c) image noise using the liver’s activity distribution. RESULTS: Overall, 98% of regions (91% of affected regions) were correctly classified in the reduced acquisition protocol independent of the image reconstruction algorithm. Two nodal lesions (each ≤ 4 mm) were not identified (leading to downstaging in 1/20 cases). Mean absolute percentage deviation of SUVmax (SUVpeak) was approximately 9% (6%) for each reconstruction algorithm. The mean image noise increased from 13 to 21% (4 iterations) and from 10 to 15% (2 iterations) for PSF + TOF and TOF images. CONCLUSIONS: High agreement at 3.5-fold reduction of scan time in terms of per-region detection (98% of regions) and image quantification (mean deviation ≤ 10%) was demonstrated; however, small lesions can be missed in about 10% of patients leading to downstaging (T1N0M0 instead of T1N1M0) in 5% of patients. Our results suggest that a reduction of scan time duration or administered [(68)Ga]Ga-PSMA-11 activities can be considered in metastatic patients, where missing small lesions would not impact patient management. Limitations include the small and heterogeneous sample size and the lack of follow-up. Springer Berlin Heidelberg 2021-02-28 /pmc/articles/PMC7914332/ /pubmed/33641046 http://dx.doi.org/10.1186/s13550-021-00765-y Text en © The Author(s) 2021 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Original Research Weber, Manuel Jentzen, Walter Hofferber, Regina Herrmann, Ken Fendler, Wolfgang Peter Conti, Maurizio Wetter, Axel Kersting, David Rischpler, Christoph Fragoso Costa, Pedro Evaluation of [(68)Ga]Ga-PSMA PET/CT images acquired with a reduced scan time duration in prostate cancer patients using the digital biograph vision |
title | Evaluation of [(68)Ga]Ga-PSMA PET/CT images acquired with a reduced scan time duration in prostate cancer patients using the digital biograph vision |
title_full | Evaluation of [(68)Ga]Ga-PSMA PET/CT images acquired with a reduced scan time duration in prostate cancer patients using the digital biograph vision |
title_fullStr | Evaluation of [(68)Ga]Ga-PSMA PET/CT images acquired with a reduced scan time duration in prostate cancer patients using the digital biograph vision |
title_full_unstemmed | Evaluation of [(68)Ga]Ga-PSMA PET/CT images acquired with a reduced scan time duration in prostate cancer patients using the digital biograph vision |
title_short | Evaluation of [(68)Ga]Ga-PSMA PET/CT images acquired with a reduced scan time duration in prostate cancer patients using the digital biograph vision |
title_sort | evaluation of [(68)ga]ga-psma pet/ct images acquired with a reduced scan time duration in prostate cancer patients using the digital biograph vision |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7914332/ https://www.ncbi.nlm.nih.gov/pubmed/33641046 http://dx.doi.org/10.1186/s13550-021-00765-y |
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