Initial Clinical Experience with the Canon Cartesion Prime Digital PET/CT

Introduction: Cartesion Prime is the latest digital PET/CT system developed by Canon Medical Systems Corporation (Otawara, Japan). The features of the scanner include 27cm axial field-of-view, SiPM technology with complete coverage and 1:1 coupling to the scintillator crystals, and 260 ps timing resolution. It is also currently the only commercial digital PET/CT using air-cooling technology. The first Cartesion Prime was installed at SDMI in October 2019.

Methods: To evaluate the performance of the scanner, 24 clinical patients (23 whole-body and 1 brain) were injected with ¹⁸F-FDG and scanned on both Cartesion Prime and a reference system (a current-generation, PMT-based PET/CT). Each patient was scanned on the reference PET/CT first using the clinical protocol and then brought to the Cartesion Prime and scanned again. On Cartesion Prime a very low dose CT scan was used and the PET scan time was reduced. The PET/CT images from the reference system were reviewed by radiologists and used for the care of the patient. The protocol was approved by IRB.

Results: The BMI of the patients ranges between 20.9 and 43.6 kg/m². Injected dose ranges between 403 and 555 MBq. Average uptake time on the reference system and Cartesion Prime are 58 and 93 minutes respectively (range: 49-68 and 80-106 minutes respectively). Average total whole-body PET scan time on the reference system and Cartesion Prime are 18.6 and 8.4 minutes respectively (range: 14.6-24 and 7.5-9 minutes respectively). Despite the reduced dose in the patient due to longer uptake time and reduced scan time, the image quality on Cartesion Prime is comparable and in some cases superior to the images of the same patient scanned on the reference system.

Conclusions: This study is the first clinical experience of the new Cartesion Prime digital PET/CT. Preliminary results suggest that PET dose and scan time can be reduced while maintaining or improving image quality using the digital PET/CT, compared to the current-generation PMT-based PET/CT. It is feasible to acquire routine ¹⁸F-FDG whole-body scan in less than 10 minutes. Future research include optimizing the scan and reconstruction protocols to further reduce total scan time and/or injected dose.

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