PT - JOURNAL ARTICLE AU - Joyce Van Sluis AU - Ronald Boellaard AU - Johan de Jong AU - Antoon Willemsen AU - Ananthi Somasundaram AU - Paul van Snick AU - Ronald Borra AU - Rudi Dierckx AU - Gilles Stormezand AU - Andor Glaudemans AU - Walter Noordzij TI - Performance characteristics and quantitative clinical evaluation of the digital Siemens Biograph Vision PET/CT DP - 2019 May 01 TA - Journal of Nuclear Medicine PG - 109--109 VI - 60 IP - supplement 1 4099 - http://jnm.snmjournals.org/content/60/supplement_1/109.short 4100 - http://jnm.snmjournals.org/content/60/supplement_1/109.full SO - J Nucl Med2019 May 01; 60 AB - 109Objectives: The first digital Siemens Biograph Vision PET/CT system (Siemens Healthineers, Knoxville, USA) was installed at the University Medical Center Groningen, the Netherlands. Objectives of this study are (1) to test the performance of the new Biograph Vision according to the NEMA NU 2-2012 standard with additional tests (time of flight (ToF) resolution and coregistration accuracy) according to the NEMA NU 2-2018 standard, and to test compliance to the European Association of Nuclear Medicine (EANM) Research Ltd (EARL) harmonization criteria, (2) to explore initial clinical experience in terms of perceived image quality and semi-quantitative analysis, using visual assessment and image biomarkers of lesions and healthy tissues. Methods: The new PET/CT features silicon photomultipier (SiPM)-based detectors with 3.2 mm lutetium oxyorthosilicate crystals fully covering the SiPM detector elements. PET components consist of eight rings of 38 detector blocks, resulting in an axial field of view (FOV) of 26.1 cm. Spatial resolution, sensitivity, count rate performance, accuracy of attenuation and scatter correction, image quality, ToF resolution, and coregistration accuracy were evaluated according to the NEMA NU 2-2012 and NEMA NU 2-2018 standards. Furthermore, EARL performance measurements were conducted on the Biograph Vision to evaluate its ability to meet EARL harmonization guidelines. In addition, patients referred for an oncological PET scan were enrolled for image quality assessment and semi-quantitative analysis. Patients received a single 18F-FDG injected dose of 3 MBq/kg body weight followed by a dual-imaging PET protocol. PET images were acquired at 60 and 90 min post injection in a balanced order of system use; Biograph mCT at 60 min and Biograph Vision at 90 min, and vice versa. Vendor recommended reconstructions were blindly reviewed by three nuclear medicine physicians and scored 1-5 on lesion demarcation, overall image quality, and image noise. For semi-quantitative analysis, the reconstructions conform EARL specifications were used for measurements of standardized uptake values (SUVs) in tumor lesions and healthy tissues for comparison between systems. NEMA performance measurements and image quality assessments were directly compared with test results and images acquired on an analog Biograph mCT. Results: The Biograph Vision showed a transverse spatial resolution at Full Width Half Maximum of 3.6 mm at 1 cm offset of the center of the FOV and a NEMA sensitivity of 16.4 kcps/MBq. ToF resolution varied from 210 to 215 ps as count-rate increased up to the peak NECR and overall image contrast ranged from 77.2% to 89.8%. Furthermore, the system was able to comply with EARL SUV recovery criteria. In addition, a total of 20 oncological patients (14 men and 6 women; 36- to 84-years-old, mean ± SD 61 ± 16) were enrolled and received a single 18F-FDG injection ranging from 145-405 MBq (mean ± SD 268 ± 59.3). Images acquired on the Biograph Vision were scored significantly higher on lesion demarcation, overall image quality, and image noise compared to images acquired on the Biograph mCT (P < 0.001). The overall interobserver agreement showed a Fleiss kappa of 0.61 (95% CI 0.53 - 0.70). There was excellent agreement (within 95%) in SUVs measured in lesions and healthy tissues between PET/CT systems when using EARL compliant reconstructions. Conclusions: The Biograph Vision outperforms the analog Biograph mCT and the system is able to meet European harmonizing performance standards. Initial experience indicates the Biograph Vision also outperforms its analog predecessor in terms of perceived image quality. Comparable quantitative performance in both healthy tissues and lesions was seen between systems when using an EARL harmonized reconstruction protocol. The improved performance suggests that a reduction in dose and/or scan duration as well as improved small lesion detection could be achieved in future clinical practice.