Clinical evaluation of reconstruction and acquisition time for pediatric 18F-FDG brain PET using digital PET/CT.

Background: 18F-2-fluoro-2-deoxyglucose (FDG) positron emission tomography (PET) plays an important role in the diagnosis, evaluation and treatment of childhood epilepsy. The selection of appropriate acquisition and reconstruction parameters, however, can be challenging with the introduction of adva...

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Published in:Pediatric Radiology Vol. 50; no. 7; pp. 966 - 973
Main Authors: Shkumat, Nicholas A., Vali, Reza, Shammas, Amer
Format: research tables/charts Journal Article
Published: Springer Nature Jun2020
Online Access:View this record in EBSCOhost
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      dt: Jun2020
      vid: 50
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      pub: Springer Nature
      place: New York, New York
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        atl: Clinical evaluation of reconstruction and acquisition time for pediatric 18F-FDG brain PET using digital PET/CT.
      aug:
        au:
          Shkumat, Nicholas A.
          Vali, Reza
          Shammas, Amer
        affil: Department of Diagnostic Imaging, The Hospital for Sick Children, 555 University Ave., Suite 2175A, M5G 1X8, Toronto, ON, Canada
      sug:
        subj:
          Epilepsy
          Retrospective Design
          Image Interpretation, Computer Assisted
          Fludeoxyglucose F 18
          Radiopharmaceuticals
          Child
          Infant
          Adolescence
          Female
          Time Factors
          Child, Preschool
          Male
          Human
          Child: 6-12 years
          Infant: 1-23 months
          Adolescent: 13-18 years
          Child, Preschool: 2-5 years
          Female
          Male
      ab: Background: 18F-2-fluoro-2-deoxyglucose (FDG) positron emission tomography (PET) plays an important role in the diagnosis, evaluation and treatment of childhood epilepsy. The selection of appropriate acquisition and reconstruction parameters, however, can be challenging with the introduction of advanced hardware and software functionalities.Objective: To quantify the diagnostic performance of a block-sequential regularized expectation maximization (BSREM) tool and reduced effective counts in brain PET/CT for pediatric epilepsy patients on a digital silicon photomultiplier system.Materials and Methods: We included 400 sets of brain PET/CT images from 25 pediatric patients (0.5-16 years old) in this retrospective study. Patient images were reconstructed with conventional iterative techniques or BSREM with varied penalization factor (β), at varied acquisition time (45 s, 90 s, 180 s, 300 s) to simulate reduced count density. Two pediatric nuclear medicine physicians reviewed images in random order - blinded to patient, reconstruction method and imaging time - and scored technical quality (noise, spatial resolution, artifacts), clinical quality (image quality of the cortex, basal ganglia and thalamus) and overall diagnostic satisfaction on a 5-point scale.Results: Reconstruction with BSREM improved quality and clinical scores across all count levels, with the greatest benefits in low-count conditions. Image quality scores were greatest at 300-s acquisition times with β=500 (overall; noise; artifacts; image quality of the cortex, basal ganglia and thalamus) or β=200 (spatial resolution). No statistically significant difference in the highest graded reconstruction was observed between imaging at 180 s and 300 s with an appropriately implemented penalization factor (β=350-500), indicating that a reduction in dose or acquisition time is feasible without reduction in diagnostic satisfaction.Conclusion: Clinical evaluation of pediatric 18F-FDG brain PET image quality was shown to be diagnostic at reductions of count density by 40% using BSREM with a penalization factor of β=350-500. This can be accomplished while maintaining confidence of achieving a diagnostic-quality image.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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