RT Journal Article
SR Electronic
T1 Optimizing Imaging Protocols for Overweight and Obese Patients: A Lutetium Orthosilicate PET/CT Study
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP 603
OP 607
VO 46
IS 4
A1 Benjamin S. Halpern
A1 Magnus Dahlbom
A1 Martin A. Auerbach
A1 Christiaan Schiepers
A1 Barbara J. Fueger
A1 Wolfgang A. Weber
A1 Daniel H.S. Silverman
A1 Osman Ratib
A1 Johannes Czernin
YR 2005
UL http://jnm.snmjournals.org/content/46/4/603.abstract
AB High photon attenuation and scatter in obese patients affect image quality. The purpose of the current study was to optimize lutetium orthosilicate (LSO) PET image acquisition protocols in patients weighing ≥91 kg (200 lb). Methods: Twenty-five consecutive patients (16 male and 9 female) weighing ≥91 kg (200 lb; range, 91–168 kg [200–370 lb]) were studied with LSO PET/CT. After intravenous injection of 7.77 MBq (0.21 mCi) of 18F-FDG per kilogram of body weight, PET emission scans were acquired for 7 min/bed position. Single-minute frames were extracted from the 7 min/bed position scans to reconstruct 1–7 min/bed position scans for each patient. Three reviewers independently analyzed all 7 reconstructed whole-body images of each patient. A consensus reading followed in cases of disagreement. Thus, 175 whole-body scans (7 per patient) were analyzed for number of hypermetabolic lesions. A region-of-interest approach was used to obtain a quantitative estimate of image quality. Results: Fifty-nine hypermetabolic lesions identified on 7 min/bed position scans served as the reference standard. Interobserver concordance increased from 64% for 1 min/bed position scans to 70% for 3 min/bed position scans and 78% for 4 min/bed position scans. Concordance rates did not change for longer imaging durations. Region-of-interest analysis revealed that image noise decreased from 21% for 1 min/bed position scans to 14%, 13%, and 11% for, respectively, 4, 5, and 7 min/bed position scans. When compared with the reference standard, 14 lesions (24%) were missed on 1 min/bed position scans but only 2 (3%) on 4 min/bed position scans. Five minute/bed position scans were sufficient to detect all lesions identified on the 7 min/bed position scans. Conclusion: Lesion detectability and reader concordance peaked for 5 min/bed position scans, with no further diagnostic gain achieved by lengthening the duration of PET emission scanning. Thus, 5 min/bed position scans are sufficient for optimal lesion detection with LSO PET/CT in obese patients.