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Total-body PET/CT using half-dose FDG and compared with conventional PET/CT using full-dose FDG in lung cancer

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

The purpose was to explore the effects of total-body PET/CT with half-dose 18F-FDG activity on image quality, compared with those of conventional PET/CT with clinical routine full-dose 18F-FDG in lung cancer.

Methods

Fifty-six primary lung cancer patients who underwent total-body PET/CT on a uEXPLORER scanner with half-dose (1.85 MBq/kg) 18F-FDG activity before treatment were retrospectively studied; among them, 28 patients were confirmed by postoperative pathologic examination and 28 patients by biopsy. After matching with the pathological study results, the other 28 patients with lung cancer who underwent surgery were selected for the full-dose (3.70 MBq/kg) group. Patients in the full-dose group were studied with a conventional uM780 PET/CT scanner. The acquisition time of the half-dose group was 15 min, split into 4-min and 2-min duration groups, which were all referred to as G15, G4 and G2, respectively. The PET/CT scanning speed in the full-dose group was 2 min/bed. Image quality was evaluated by subjective and objective analyses. The subjective analysis method was carried out with a 5-point scale (5-excellent, 1-poor). Objective analysis indicators of PET image quality included the SUVmax, SUVmean and signal-to-noise ratio (SNR) of the liver; the SUVmax and SUVmean of the blood pool; and the SUVmax and tumour-to-background ratio (TBR) of the lesions. G15 served as the reference for G2 and G4 to test lesion detectability.

Results

Image quality scores in G2 (4.3 ± 0.7) were significantly higher than those in the full-dose group (3.7 ± 0.6) (p = 0.004). The mean and SD of the image quality scores in G4 and G15 were 4.9 ± 0.2 and 5.0 ± 0.0, respectively. The liver SNR in G2 was significantly higher than that in the full-dose group; the corresponding SNR were 11.7 ± 1.5 and 8.3 ± 1.2 (p < 0.001), respectively. The liver SNR significantly increased with the time of acquisition among G2, G4 and G15 (11.1 ± 1.7, 15.2 ± 3.4 and 30.5 ± 6.0, all p < 0.05). G15 served as the reference, and all these lesions (100%) could be identified by G2 and G4.

Conclusion

Total-body PET/CT with half-dose 18F-FDG activity in G2 and G4 achieved comparable image quality to conventional PET/CT, and its image quality was better than that of conventional PET/CT with clinical routine full-dose 18F-FDG in lung cancer.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Funding

This study is supported by the National Science Foundation for Scholars of China (Grant No. 81871407 to Hongcheng Shi and Grant No. 81901796 to Hui Tan), the Shanghai Sailing Program Supported by Shanghai Science and Technology Commission (No. 19YF1408300 to Hui Tan) and Shanghai Municipal Key Clinical Specialty (No. shslczdzk03401), Three-year Action Plan of Clinical Skills andInnovation of Shanghai Hospital Development Center (No. SHDC2020CR3079B to Hongcheng Shi), and the shanghai Science and Technology Committee (No. 20DZ2201800).

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Author notes

  1. Hui Tan and Xiuli Sui contributed equally to this work.

Authors and Affiliations

  1. Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China

    Hui Tan, Xiuli Sui, Hongyan Yin, Haojun Yu, Yusen Gu, Shuguang Chen, Pengcheng Hu, Wujian Mao & Hongcheng Shi

  2. Nuclear Medicine Institute of Fudan University, Shanghai, 200032, China

    Hui Tan, Xiuli Sui, Hongyan Yin, Haojun Yu, Yusen Gu, Shuguang Chen, Pengcheng Hu, Wujian Mao & Hongcheng Shi

  3. Shanghai Institute of Medical Imaging, Shanghai, 200032, China

    Hui Tan, Xiuli Sui, Hongyan Yin, Haojun Yu, Yusen Gu, Shuguang Chen, Pengcheng Hu, Wujian Mao & Hongcheng Shi

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  1. Hui Tan
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Contributions

Hui Tan and Xiuli Sui were involved in the study design, data analysis and manuscript preparation. Hongyan yin and Wujian Mao helped with data processing. Haojun Yu, Yusen Gu and Shuguang Chen helped with image acquisition and processing. Pengcheng Hu helped with the revision of the manuscript. Hongcheng Shi designed the study and contributed to the data analysis and writing of the manuscript. All authors discussed the results and commented on the manuscript.

Corresponding author

Correspondence to Hongcheng Shi.

Ethics declarations

This study was approved by the Medical Ethics Committee of Zhongshan Hospital Fudan University (2019-029R), and informed consent was obtained from the half-dose group

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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This article is part of the Topical Collection on Oncology - Chest

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Tan, H., Sui, X., Yin, H. et al. Total-body PET/CT using half-dose FDG and compared with conventional PET/CT using full-dose FDG in lung cancer. Eur J Nucl Med Mol Imaging 48, 1966–1975 (2021). https://doi.org/10.1007/s00259-020-05091-4

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