Implementation of quadratic dose protocol for 18F-FDG whole-body PET imaging using a BGO-based PET/CT scanner, GE Discovery ST

Document Type: Original Article

Authors

1 School of Health Sciences, Health Campus, Universiti Sains Malaysia, Kelantan, Malaysia

2 Nuclear Medicine Department, Institut Kanser Negara, Putrajaya, Malaysia

Abstract

Introduction: The ability of quadratic dose protocol to maintain a good quality image for an overweight and obese patient is well reported. However, a practical approach to the implementation of this protocol in whole-body imaging in Malaysia is currently lacking. Hence, the aim of this study is to derive the quadratic dose formula that suits our PET system.
Methods: Whole-body PET imaging protocol was performed using NEMA 2012/IEC 2008 phantom. Two dose protocols were adhered, namely linear and quadratic dose protocol. A PET Discovery ST, which is BGO-based PET system was used in this study. This study was guided by technical guidelines published by Koopman et al. Finally, a comparative analysis between the effective dose yielded by linear and quadratic dose protocols was performed.
Results:Implementation of quadratic dose protocol using our PET system lengthen the scanning time to 226 s, as compared to 150 s currently used in the linear dose protocol. Meanwhile, the findings revealed that the quadratic dose protocol led to a greater effective dose for the body weight of 62 kg and above. These findings were observed in all the five groups of patient studied.
Conclusion: In conclusion, a successful trial of the quadratic dose protocol on our PET system has been established. Despite the long acquisition time and greater effective dose, implementation of quadratic dose protocol is necessary for better quantification of the image, as well as ensuring constant image quality across all patients, especially overweight and obese patients.

Keywords

Main Subjects


  1. Reilly D, Ensslin N, Smith HJr, Nelson G, Kreiner S. Passive nondestructive assay of nuclear materials. Washington, DC: Los Alamos National Laboratory; 1991.
  2. Nagaki A, Onoguchi M, Matsutomo N. Patient weight-based acquisition protocols to optimize (18)F-FDG PET/CT image quality. J Nucl Med Technol. 2011 Jun;39(2):72-6.
  3. Boellaard R, O'Doherty MJ, Weber WA, Mottaghy FM, Lonsdale MN, Stroobants SG, Oyen WJ, Kotzerke J, Hoekstra OS, Pruim J, Marsden PK, Tatsch K, Hoekstra CJ, Visser EP, Arends B, Verzijlbergen FJ, Zijlstra JM, Comans EF, Lammertsma AA, Paans AM, Willemsen AT, Beyer T, Bockisch A, Schaefer-Prokop C, Delbeke D, Baum RP, Chiti A, Krause BJ. FDG PET and PET/CT: EANM procedure guidelines for tumour PET imaging: version 1.0. Eur J Nucl Med Mol Imaging. 2010 Jan;37(1):181-200.
  4. Cheng DW, Ersahin D, Staib LH, Della Latta D, Giorgetti A, d'Errico F. Using SUV as a guide to 18F-FDG dose reduction. J Nucl Med. 2014 Dec;55(12):1998-2002.
  5. Ghanem MA, Kazim NA, Elgazzar AH. Impact of obesity on nuclear medicine imaging. J Nucl Med Technol. 2011 Mar;39(1):40-50.
  6. Masuda Y, Kondo C, Matsuo Y, Uetani M, Kusakabe K. Comparison of imaging protocols for 18F-FDG PET/CT in overweight patients: optimizing scan duration versus administered dose. J Nucl Med. 2009 Jun;50(6):844-8.
  7. Yoshida E, Kitamura K, Nishikido F, Shibuya K, Hasegawa T, Yamaya T, Inadama N, Murayama H. Feasibility study of a highly sensitive LaBr3 PET scanner based on the DOI-dependent extended-energy window. Nucl Instrum Methods Phys Res A. 2009;604(1-2):363-5.
  8. Fakhri GE, Santos PA, Badawi RD, Holdsworth CH, Abbeele ADVD, Kijewski MF. Impact of acquisition geometry, image processing, and patient size on lesion detection in whole-body 18F-FDG PET. J Nucl Med Technol. 2007;48(12):1951–60.
  9. de Groot EH, Post N, Boellaard R, Wagenaar NR, Willemsen AT, van Dalen JA. Optimized dose regimen for whole-body FDG-PET imaging. EJNMMI Res. 2013 Aug 12;3(1):63.
  10. Everaert H, Vanhove C, Lahoutte T, Muylle K, Caveliers V, Bossuyt A, Franken PR. Optimal dose of 18F-FDG required for whole-body PET using an LSO PET camera. Eur J Nucl Med Mol Imaging. 2003 Dec;30(12):1615-9.
  11. Tatsumi M, Clark PA, Nakamoto Y, Wahl RL. Impact of body habitus on quantitative and qualitative image quality in whole-body FDG-PET. Eur J Nucl Med Mol Imaging. 2003;30(1):40-5.
  12. Koopman D, van Osch JA, Jager PL, Tenbergen CJ, Knollema S, Slump CH, van Dalen JA. Technical note: how to determine the FDG activity for tumour PET imaging that satisfies European guidelines. EJNMMI Phys. 2016 Dec;3(1):22.
  13. Nagaki A, Onoguchi M, Matsutomo N. Patient weight-based acquisition protocols to optimize 18F-FDG PET/CT image quality. J Nucl Med Technol. 2011;39(2):72-6.
  14. Lois C, Jakoby BW, Long MJ, Hubner KF, Barker DW, Casey ME, Conti M, Panin VY, Kadrmas DJ, Townsend DW. An assessment of the impact of incorporating time-of-flight information into clinical PET/CT imaging. J Nucl Med. 2010 Feb;51(2):237-45.
  15. Taniguchi T, Akamatsu G, Kasahara Y, Mitsumoto K, Baba S, Tsutsui Y, Himuro K, Mikasa S, Kidera D, Sasaki M. Improvement in PET/CT image quality in overweight patients with PSF and TOF. Ann Nucl Med. 2015 Jan;29(1):71-7.
  16. Tong S, Alessio AM, Kinahan PE. Image reconstruction for PET/CT scanners: past achievements and future challenges. Imaging Med. 2010;2(5):529-45.
  17. Halpern BS, Dahlbom M, Auerbach MA, Schiepers C, Fueger BJ, Weber WA, Silverman DH, Ratib O, Czernin J. Optimizing imaging protocols for overweight and obese patients: a lutetium orthosilicate PET/CT study. J Nucl Med. 2005 Apr;46(4):603-7.
  18. Melcher CL. Scintillation crystals for PET. J Nucl Med. 2000 Jun;41(6):1051-5.