Sedation-free pediatric [18F]FDG imaging on total-body PET/CT with the assistance of artificial intelligence

Introduction: While sedation is routinely used in pediatric PET examinations to preserve diagnostic quality, it often results in side effects and affects the bio-distribution of radiotracer.This study aims to investigate the feasibility of sedation-free pediatric PET imaging using ultra-fast total-body (TB) PET scanners and deep learning (DL)-based correction.

Methods: This retrospective study included TB PET (uExplorer) imaging of 35 sedated pediatric patients under four years old to determine the minimum effective scanning time. A DL-based correction method was applied to enhance PET quantification. Both quantitative and qualitative assessments were conducted to evaluate the image quality of ultra-fast DL-corrected PET. 5 non-sedated pediatric patients were subsequently used to validate the proposed approach.

Results: Comparisons between standard 300-second and ultra-fast 15-second imaging, CT-corrected and DL-corrected ultra-fast 15-second images, as well as DL-corrected ultra-fast 15-second images in non-sedated and sedated patients, showed no significant differences in qualitative scoring, lesion detectability, and quantitative Standard Uptake Value (SUV) (p>0.05).

Conclusions: This study demonstrates that pediatric PET imaging can be effectively performed without sedation by combining ultra-fast imaging techniques with a DL-based correction. This advancement in sedation-free ultra-fast PET imaging holds potential for broader clinical adoption.