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Optimised PET reconstruction of the head and neck area: improved diagnostic accuracy

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

Reconstruction parameters are an important factor in PET image quality. In the head and neck area, where the level of photon attenuation is relatively low, standard whole-body reconstruction (SWR) parameters may lead to suboptimal results. The purpose of this study was to evaluate the impact of optimised head and neck reconstruction (OHR) parameters on image quality and diagnostic accuracy, using pathology as the gold standard.

Methods

SWR parameters consisted of 2 iterations, 8 subsets and a 6-mm Gaussian filter. Predetermined OHR parameters were 4 iterations, 16 subsets and a 5-mm Gaussian filter, generating images with increased spatial and contrast resolution but also with increased noise. SWR- and OHR-based FDG-PET images of 28 patients with malignancies in the head and neck area were evaluated for primary tumour and pathological lymph nodes. Diagnostic accuracy was determined by histopathological verification after lymph node dissection.

Results

Using OHR, sensitivity for detection of a primary tumour increased from 92% to 100%. Eleven additional lymph nodes were visualised in eight patients, resulting in an increased sensitivity for lymph node metastases from 11% to 44%. Specificity decreased from 89% to 74% owing to visualisation of small reactive lymph nodes. In total, using OHR, FDG-PET diagnosis improved in six patients (21%) at the expense of three additional false positives for lymph node metastasis (11%). Primary tumour SUVmax increased by 42%, indicating enhanced contrast resolution.

Conclusion

Image reconstruction adapted to low photon attenuation in the head and neck area may improve image quality and the diagnostic value of FDG-PET, despite a slightly higher false positive rate attributable to the fact that visualisation of FDG accumulation in benign reactive lymph nodes is also enhanced.

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Authors and Affiliations

  1. Department of Nuclear Medicine (565), Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands

    Wouter V. Vogel, Jorn A. van Dalen & Wim J. G. Oyen

  2. Department of Otorhinolaryngology and Head and Neck Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands

    Bart M. Wensing & Frank J. A. van den Hoogen

  3. Department of Medical Technology Assessment, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands

    Paul F. M. Krabbe

Authors
  1. Wouter V. Vogel
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  2. Bart M. Wensing
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  3. Jorn A. van Dalen
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  4. Paul F. M. Krabbe
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  5. Frank J. A. van den Hoogen
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  6. Wim J. G. Oyen
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Correspondence to Wouter V. Vogel.

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Vogel, W.V., Wensing, B.M., van Dalen, J.A. et al. Optimised PET reconstruction of the head and neck area: improved diagnostic accuracy. Eur J Nucl Med Mol Imaging 32, 1276–1282 (2005). https://doi.org/10.1007/s00259-005-1849-1

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  • DOI: https://doi.org/10.1007/s00259-005-1849-1

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