FDG-PET/CT (Ver.1.0) 1) 2) 3) 4) 3) 5) 2) 6) 1) 2) 3) 4) 5) 6)
18 F-FDG PET PET 29 (2): 195 235, 2009 PET PET/CT FDG-PET PET PET FDG-PET FDG-PET FDG PET 3.7 7.4 MBq/kg FDG 1 4 : 1 10 mm 2 4 : 1 (RC) 4 : 1 10 mm PET 2
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% 4 1 5.30 kbq/ml 3
18 F-FDG 10 mm 10 mm 60 ml 10 mm 18 F-FDG 4 1 4 1 10 mm FOV 5.30 kbq/ml 2.65 kbq/ml 12 0 1, 2, 3,, 10 1 1, 2, 3,, 10 2 1, 2, 3,, 10 30 1 12 PET Raw data 30 1 10 3 30 (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 1 0 1 10 3 3 1.5 10 mm NEC phantom > 10.4 (Mcounts) N 10 mm < 6.2 (%) Q H,10 mm / N 10 mm > 1.9 (%) 4
8.1 2 1 2 (Recovery Coefficient RC) 18 F-FDG 4 1 2 60 kg 222 MBq (3.7 MBq/kg) 1.325 kbq/ml 2 2.65 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 > 0.38 5
% % 5.1.4 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 > 0.38 18 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 > 10 18 F-FDG 4 : 1 10 mm N 10 mm < 6.2 Q 10 mm / N 10 mm > 1.9 NEC phantom > 10.4 10 mm 10 mm RC > 0.38 PET 6
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 1 1 8 65% 20% 8) 27% 9) 1 3.7 MBq/kg 1 kg/l 0.65 0.8 / 0.73 = 2.64 MBq/l 2.65 kbq/ml SUV 0.8 / 0.73 = 1.1 SUV 1.1 1.2 550 cm 2 60 kg (2.65 kbq/ml) (60 kg) FDG 3.7 MBq/kg 1 4 : 1 4 10 mm 2.65 kbq/ml 10 mm 50% 3 4 2 3 4 : 1 10 mm 10 mm 4 SUV SUV 1.1 4 0.38 FWHM = 10 mm 7
SUV = 1.7 10 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
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
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 1.5 2.5 (min) NEC phantom 10.4 (Mcounts) 95% 7.7 18.3 N 10 mm 6.2 95% 4.8 6.9 Q H,10 mm / N 10 mm 1.9 95% 1.5 2.8 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
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 = 0.97 10 mm RC > 0.38 FWHM < 10 mm 10 mm (FWHM) 10 mm RC > 0.38 7 PET (/CT) RC (Fig. 6) RC 10 mm > 0.38 5 5 30 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
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) 3.0 148 9 6.1% 3.0 NEC patient (17.5 3.0 vs. 23.8 9.6, p < 0.001) NEC density (0.28 0.07 vs. 0.45 0.23, p < 0.03) SNR (14.2 6.2 vs. 15.9 4.5, p = 0.28) WG NEC patient > 13 (Mcounts/m) NEC density > 0.2 (kcounts/cm 3 ) SNR > 10 Fig. 8 BMI 3.0 148 9 3.0 BMI (26.8 5.0 vs. 23.2 3.5, p = 0.004) 18 F-FDG PET 3.35 0.44, 3.37 0.35, 3.79 0.29, 3.57 0.27 and 3.28 0.17 (mean SD) 12
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 2-2001 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
(3) % (N 10 mm) N 10 mm NEMA NU 2-2001 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
(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: 480 486. 2) National Electrical Manufacturers Association. NEMA Standards Publication NU 2-2007: Performance Measurement of Positron Emission Tomographs. Rosslyn VA: National Electrical Manufacturers Association; 2007. 3) 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: 1734 1742. 4) Surti S, Karp JS. Imaging characteristics of a 3-dimensional GSO whole-body PET camera. J Nucl Med 2004; 45: 1040 1049. 5) 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 2-2001 standard. J Nucl Med 2004; 45: 813 821. 6) 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: 1683 1692. 7) Kemp BJ, Kim C, Williams JJ, Ganin A, Lowe VJ. NEMA NU 2-2001 performance measurements of an LYSO-based PET/CT system in 2D and 3D acquisition modes. J Nucl Med 2006; 47: 1960 1967. 8) 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: 699 706. 9) 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: 1630 1638. 10) National Electrical Manufacturers Association. NEMA Standards Publication NU 2-2001: Performance Measurement of Positron Emission Tomographs. Rosslyn VA: National Electrical Manufacturers Association; 2001. 15