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Clinical Implications of Different Image Reconstruction Parameters for Interpretation of Whole-Body PET Studies in Cancer Patients

Heiko Schöder, MD1, Yusuf E. Erdi, DSc2, Kenneth Chao, BS1, Mithat Gonen, PhD3, Steven M. Larson, MD1 and Henry W.D. Yeung, MD1

1 Department of Radiology/Nuclear Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York
2 Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, New York
3 Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York



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  		FIGURE 1. Phantom studies. Correlation between true activity concentration in sphere and measured activity using IR or FBP. (A) Average activity concentration in ROI. (B) Maximum activity concentration. Solid line indicates the line of identity.

 


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  		FIGURE 2. SUV measurements in urinary bladder (A) and liver (B). SUV max and SUV avg derived form FBP+MAC images were significantly lower than those from IR+SAC images.

 


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  		FIGURE 3. SUV max and SUV avg for tumor lesions. Values derived from FBP+MAC images were consistently and significantly lower than those measured on IR+SAC images.

 


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  		FIGURE 4. Comparison of SUV measurements from FBP+MAC images and IR+SAC images; dotted line indicates line of identity. There is systematic underestimation of activity concentrations measured on FBP images as compared with IR images.

 


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  		FIGURE 5. Patient example: Coronal PET images of 65-y-old female with diffuse large B-cell lymphoma in abdomen. ROIs are placed in liver, urinary bladder, and tumor. SUV max and SUV avg are lower for all 3 locations when derived from FBP+MAC images as compared with IR+SAC images. Arrows point to ROIs in liver, tumor in abdomen, and urinary bladder.

 


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  		FIGURE 6. Patient example: Images reconstructed with FBP+MAC. Effect of different filters for smoothing of transmission data and effect of varying cutoff parameters. L = liver; T = tumor; nonquant = nonquantitative filter. Values are SUV max. Patient example in bottom left is used for clinical purpose.

 


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  		FIGURE 7. Patient example: Images reconstructed with IR+SAC. Effect of changes in number of iterations and subsets for IR on SUV. First number indicates number of iterations; second number indicates number of subsets. L = liver; T = tumor. Values are SUV max. Patient example in middle is used for clinical purpose.

 




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