Clinical performance of long axial field of view PET/CT: a head-to-head intra-individual comparison of the Biograph Vision Quadra with the Biograph Vision PET/CT

• Published in: European journal of nuclear medicine and molecular imaging Vol. 48; no. 8; pp. 2395 - 2404
• Main Authors: Alberts, Ian, Hünermund, Jan-Niklas, Prenosil, George, Mingels, Clemens, Bohn, Karl Peter, Viscione, Marco, Sari, Hasan, Vollnberg, Bernd, Shi, Kuangyu, Afshar-Oromieh, Ali, Rominger, Axel
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.07.2021; Springer Nature B.V
• Subjects: Background noise; Cardiology; Drug dosages; Equivalence; Field of view; Fluorine isotopes; Fluorodeoxyglucose F18; Humans; Image quality; Imaging; Integrals; Lesions; Medical imaging; Medical Oncology; Medicine; Medicine & Public Health; Motion; Noise; Nuclear Medicine; Oncology; Original; Original Article; Orthopedics; Patients; Pharmaceuticals; Physicians; Positron emission; Positron emission tomography; Positron Emission Tomography Computed Tomography; Prostate cancer; Radiochemistry; Radioisotopes; Radiology; Radiopharmaceuticals; Scanners; Scanning; Signal to noise ratio; Standard error; Statistical analysis; Target recognition; Technology; Tomography; Vision; Visual signals; Positron-emission-tomography; Digital PET; Total-body; Ultra-long FOV PET; PET/CT; Whole-body
• ISSN: 1619-7070; 1619-7089; 1619-7089
• DOI: 10.1007/s00259-021-05282-7

Purpose To investigate the performance of the new long axial field-of-view (LAFOV) Biograph Vision Quadra PET/CT and a standard axial field-of-view (SAFOV) Biograph Vision 600 PET/CT (both: Siemens Healthineers) system using an intra-patient comparison. Methods Forty-four patients undergoing routine oncological PET/CT were prospectively included and underwent a same-day dual-scanning protocol following a single administration of either 18 F-FDG ( n  = 20), 18 F-PSMA-1007 ( n  = 16) or 68 Ga-DOTA-TOC ( n  = 8). Half the patients first received a clinically routine examination on the SAFOV (FOV axial 26.3 cm) in continuous bed motion and then immediately afterwards on the LAFOV system (10-min acquisition in list mode, FOV axial 106 cm); the second half underwent scanning in the reverse order. Comparisons between the LAFOV at different emulated scan times (by rebinning list mode data) and the SAFOV were made for target lesion integral activity, signal to noise (SNR), target lesion to background ratio (TBR) and visual image quality. Results Equivalent target lesion integral activity to the SAFOV acquisitions (16-min duration for a 106 cm FOV) were obtained on the LAFOV in 1.63 ± 0.19 min (mean ± standard error). Equivalent SNR was obtained by 1.82 ± 1.00 min LAFOV acquisitions. No statistically significant differences ( p  > 0.05) in TBR were observed even for 0.5 min LAFOV examinations. Subjective image quality rated by two physicians confirmed the 10 min LAFOV to be of the highest quality, with equivalence between the LAFOV and the SAFOV at 1.8 ± 0.85 min. By analogy, if the LAFOV scans were maintained at 10 min, proportional reductions in applied radiopharmaceutical could obtain equivalent lesion integral activity for activities under 40 MBq and equivalent doses for the PET component of <1 mSv. Conclusion Improved image quality, lesion quantification and SNR resulting from higher sensitivity were demonstrated for an LAFOV system in a head-to-head comparison under clinical conditions. The LAFOV system could deliver images of comparable quality and lesion quantification in under 2 min, compared to routine SAFOV acquisition (16 min for equivalent FOV coverage). Alternatively, the LAFOV system could allow for low-dose examination protocols. Shorter LAFOV acquisitions (0.5 min), while of lower visual quality and SNR, were of adequate quality with respect to target lesion identification, suggesting that ultra-fast or low-dose acquisitions can be acceptable in selected settings.