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1 FDG-PET/CT (Ver.1.0) 1) 2) 3) 4) 3) 5) 2) 6) 1) 2) 3) 4) 5) 6)
2 18 F-FDG PET PET 29 (2): , 2009 PET PET/CT FDG-PET PET PET FDG-PET FDG-PET FDG PET MBq/kg FDG 1 4 : 1 10 mm 2 4 : 1 (RC) 4 : 1 10 mm PET 2
3 FDG-PET NEC Patient NEC 1) density SNR PET PET/CT PET/CT 3D 2D NEMA 2001 NU-2 Standard 2,10) 4 18 F-FDG PET 4 : 1 10 mm 1 10 PET 10 mm 4 : 1 18 F-FDG 5.30 kbq/ml 5% kbq/ml 3
4 18 F-FDG 10 mm 10 mm 60 ml 10 mm 18 F-FDG mm FOV 5.30 kbq/ml 2.65 kbq/ml , 2, 3,, , 2, 3,, , 2, 3,, PET Raw data (1) (2) (NEC phantom) (3) 10 mm % (Q H,10 mm) (4) % (N 10 mm) (2) (3) (4) PET 10 mm PET PET Invert Gray scale SUV = 0 SUV = 4 10 mm 2 10 mm mm NEC phantom > 10.4 (Mcounts) N 10 mm < 6.2 (%) Q H,10 mm / N 10 mm > 1.9 (%) 4
5 (Recovery Coefficient RC) 18 F-FDG kg 222 MBq (3.7 MBq/kg) kbq/ml kbq/ml 30 ROI ROI j (RC j) RC j = C j / C 37 mm (NEC phantom) % (Q H,10 mm) % (N 10 mm) 10 mm FWHM 10 mm 8.2 RC 10 mm >
6 % % NEC phantom > 10.4 (Mcounts) N 10 mm < 6.2 (%) Q H,10 mm / N 10 mm > 1.9 (%) 10 mm PET NEC patient NEC density SNR ROI RC 10 mm > F-FDG PET CT NEC patient NEC density SNR 3 ROI (Fig. 1) Fig. 1 How to place ROI over the liver. NEC patient > 13 NEC density > 0.2 SNR > F-FDG 4 : 1 10 mm N 10 mm < 6.2 Q 10 mm / N 10 mm > 1.9 NEC phantom > mm 10 mm RC > 0.38 PET 6
7 NEC patient > 13 NEC density > 0.2 SNR > 10 NEC NEC 3) 4) 400 kev 40% 5,6) lutetium ( 176 Lu) 3D 7) NEMA PET FDG 3.7 MBq/kg % 20% 8) 27% 9) MBq/kg 1 kg/l / 0.73 = 2.64 MBq/l 2.65 kbq/ml SUV 0.8 / 0.73 = 1.1 SUV cm 2 60 kg (2.65 kbq/ml) (60 kg) FDG 3.7 MBq/kg 1 4 : mm 2.65 kbq/ml 10 mm 50% : 1 10 mm 10 mm 4 SUV SUV FWHM = 10 mm 7
8 SUV = mm SUV = 1.7 PET/CT CT BMI BMI 5 PET/CT 7 (Aquiduo Biograph LSO Discovery ST, Discovery STE Discovery STEP SET3000-BCT/L SET3000-G/X) PET/CT 4 : 1 10 mm 10 mm 9 Fusion Viewer2.0 (NMP) Fig. 2, 10 mm Fig. 2 Fig. 2 Relationship of scanning duration and visualization score of 10-mm sphere in Phantom experiment No. 1 (A: 5.30 kbq/ml, B: 2.65 kbq/ml). Symbols represent camera models. 8
9 Fig. 3 Relationship between visualization score and NEC phantom (A, B), N 10 mm (C, D), and Q H,10 mm/n 10 mm (E, F) in Phantom experiment No. 1 for 5.30 kbq/ml (A, C, E) and 2.65 kbq/ml (B, D, F). Symbols represent camera models. 9
10 Fig. 3 NEC phantom N 10 mm Q H,10 mm / N 10 mm 10 mm NEC phantom N 10 mm NEC phantom N 10 mm Q H,10 mm Q H,10 mm N 10 mm PET ROI 10 mm 10 mm 7 PET/CT (min) NEC phantom 10.4 (Mcounts) 95% N 10 mm % Q H,10 mm / N 10 mm % Fig. 4 A representative PET image acquired in noise-free condition in Phantom experiment No. 2, on which RCs were measured. Fig. 5 Simulated image of digital body phantom generated with a Gaussian filter of 10 mm FWHM isotropic image resolution. Fig. 6 Recovery coefficients (RCs) obtained in noise-free scans in Phantom experiment No. 2. Symbols represent camera models: Aquiduo, Biograph LSO, Discovery ST, Discovery ST-E, Discovery ST-EP, SET-3000BCT/L, SET-3000 G/X. 10
11 10 mm PET (/CT) RC Fig. 4 1 FWHM RC 3 FWHM = 10 mm (Fig. 5) RC RC 10 mm = 0.38 RC 13 mm = 0.52 RC 17 mm = 0.72 RC 22 mm = 0.88 RC 28 mm = mm RC > 0.38 FWHM < 10 mm 10 mm (FWHM) 10 mm RC > PET (/CT) RC (Fig. 6) RC 10 mm > PET PET 5 5: 4: 3: 2: 1: Fig. 7 (A) Scatter plots of visual score against NEC patient, (B) NEC density, and (C) Liver SNR. Each plot represents a subject. Linear regression lines are shown for each graph. 11
12 Fig. 8 Scatter plots of visual score against BMI. NEC patient NEC density SNR Fig. 7 NEC patient 0.47 (p < 0.001) NEC density 0.57 (p < 0.001) SNR 0.27 (p = 0.01) % 3.0 NEC patient ( vs , p < 0.001) NEC density ( vs , p < 0.03) SNR ( vs , p = 0.28) WG NEC patient > 13 (Mcounts/m) NEC density > 0.2 (kcounts/cm 3 ) SNR > 10 Fig. 8 BMI BMI ( vs , p = 0.004) 18 F-FDG PET , , , and (mean SD) 12
13 1. (1) (NEC phantom) NEC phantom (1) (T + S) 2 NEC phantom = (1 SF) 2 [Mcounts] (1) (T + S) + (1 + k)fr S a f = πr 2 SF T + S T S R k 1 0 f S a cm 2 CT r cm (2) 10 mm % (Q H,10 mm) Q H,10 mm NEMA NU Standard Q H,10 mm (2) ROI 10 mm ROI pixel 1 mm ROI C H,10 mm C B,10 mm 1 Q H,10 mm = 100 [%] (2) a H a B 1 C H,10 mm 10 mm ROI C B,10 mm 10 mm ROI (n = 12) a H Bq/ml a B Bq/ml 13
14 (3) % (N 10 mm) N 10 mm NEMA NU Standard N 10 mm (3) SD 10 mm N 10 mm = 100 [%] (3) C B,10 mm SD 10 mm 10 mm ROI (4) SD 10 mm = K (C B,10 mm,k C B,10 mm) 2 (K 1) (4) k = 1 K = 60 1 cm 2 cm 5 12 ROI 2. NEC patient (5) NEC density (7) CT NEC patient n i = 1 NEC i NEC patient = [Mcounts/m] (5) x/100 (P i R i) 2 NEC i = (1 SF) 2 [Mcounts] (6) (P i R i) + (1 + k)r i P i i (Mcounts) R i i (Mcounts) n x (cm) k 1 0 NEC density n i = 1 V patient NEC i NEC density = 1000 [kcounts/cm 3 ] (7) NEC i (6) V patient (cm 3 ) 14
15 (21-5-2) PET 1) Mizuta T, Senda M, Okamura T, Kitamura K, Inaoka Y, Takahashi M, et al. NEC density and liver ROI S/N Ratio for image quality control of whole-body FDG-PET scans: comparison with visual assessment. Mol Imaging Biol 2009 Nov Dec; 11: ) National Electrical Manufacturers Association. NEMA Standards Publication NU : Performance Measurement of Positron Emission Tomographs. Rosslyn VA: National Electrical Manufacturers Association; ) Mawlawi O, Podoloff DA, Kohlmyer S, Williams JJ, Stearns CW, Culp RF, et al. Performance characteristics of a newly developed PET/CT scanner using NEMA standards in 2D and 3D modes. J Nucl Med 2004; 45: ) Surti S, Karp JS. Imaging characteristics of a 3-dimensional GSO whole-body PET camera. J Nucl Med 2004; 45: ) Erdi YE, Nehmeh SA, Mulnix T, Humm JL, Watson CC. PET performance measurements for an LSO-based combined PET/CT scanner using the National Electrical Manufacturers Association NU standard. J Nucl Med 2004; 45: ) Teräs M, Tolvanen T, Johansson JJ, Williams JJ, Knuuti J. Performance of the new generation of whole-body PET/CT scanners: Discovery STE and Discovery VCT. Eur J Nucl Med Mol Imaging 2007; 34: ) Kemp BJ, Kim C, Williams JJ, Ganin A, Lowe VJ. NEMA NU performance measurements of an LYSO-based PET/CT system in 2D and 3D acquisition modes. J Nucl Med 2006; 47: ) Mejia AA, Nakamura T, Masatoshi I, Hatazawa J, Masaki M, Watanuki S. Estimation of absorbed doses in humans due to intravenous administration of fluorine-18-fluorodeoxyglucose in PET studies. J Nucl Med 1991; 32: ) Hentschel M, Brink I. Lean body mass-based standardized uptake value, derived from a predictive equation, might be misleading in PET studies. Eur J Nucl Med Mol Imaging 2002; 29: ) National Electrical Manufacturers Association. NEMA Standards Publication NU : Performance Measurement of Positron Emission Tomographs. Rosslyn VA: National Electrical Manufacturers Association;
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