Hirji Hassan, Sullivan Keith, Lasker Imran, Sharif Mhd S., Nunes Andre, Shepherd Chris, Wong Wai-lup, Sanghera Bal
Northwick Park Hospital, Department of Rheumatology, London, England
University of Hertfordshire, London, England
Mol Imaging Radionucl Ther. 2019 Mar 19;28(1):1-7. doi: 10.4274/mirt.galenos.2018.88528.
To determine if unexpected aorta uptake seen in some patients is influenced by popular modern reconstruction algorithms using semi-quantitative and qualitative analysis.
Twenty-five consecutive patients without suspected vascular disease were selected for F-FDG positron emission tomography/ computed tomography (PET/CT) scanning and images of the aorta were created using iterative reconstruction (IT), IT + time of flight (TOF), IT + TOF + point spread function correction (referred collectively as UHD) with and without metal artefact reduction (MAR) algorithms. An experienced radiologist created aorta and blood pool (BP) regions of interests then copied these to all reconstructions for accurate positioning before recording target aorta standardized-uptake-values (SUV) and background BP SUV. Furthermore, target-to-background ratio (TBR) was defined by aorta SUV-to-BP SUV ratio for more analysis.
For aorta SUV with IT, IT + TOF, UHD, UHD + MAR reconstructions the mean ± standard deviation recorded were 2.15±0.43, 2.25±0.51, 2.25±0.45 and 2.09±0.4, respectively. Values for BP SUV were 1.61±0.31, 1.58±0.28, 1.58±0.28 and 1.47±0.25, respectively. Likewise, for TBR these were 1.35±0.19, 1.43±0.21, 1.43±0.19, 1.43±0.18, respectively. ANOVA analysis revealed no significant differences for aorta SUV (F(0.86) p=0.46), BP SUV (F(1.22) p=0.31) or TBR (F(0.99) p=0.4). However, the qualitative visual analysis revealed significant differences between IT + TOF with UHD (p=0.02) or UHD + MAR (p=0.02).
Reconstruction algorithm effect on aorta SUV or BP SUV or TBR was not statistically significant. However, qualitative visual analysis showed significant differences between IT + TOF as compared with UHD or UHD + MAR reconstructions. Harmonization of techniques with a larger patient cohort is recommended in future clinical trials.
通过半定量和定性分析，确定部分患者中意外出现的主动脉摄取是否受流行的现代重建算法影响。
连续选取25例无疑似血管疾病的患者进行F-FDG正电子发射断层扫描/计算机断层扫描（PET/CT），使用迭代重建（IT）、IT +飞行时间（TOF）、IT + TOF +点扩散函数校正（统称为超高清（UHD））算法，分别在有和没有金属伪影减少（MAR）算法的情况下创建主动脉图像。一位经验丰富的放射科医生创建主动脉和血池（BP）感兴趣区，然后将其复制到所有重建图像中以准确定位，随后记录目标主动脉标准化摄取值（SUV）和背景BP SUV。此外，通过主动脉SUV与BP SUV的比值定义目标与背景比值（TBR），以进行更多分析。
对于采用IT、IT + TOF、UHD、UHD + MAR重建的主动脉SUV，记录的均值±标准差分别为2.15±0.43、2.25±0.51、2.25±0.45和2.09±0.4。BP SUV的值分别为1.61±0.31、1.58±0.28、1.58±0.28和1.47±0.25。同样，TBR分别为1.35±0.19、1.43±0.21、1.43±0.19、1.43±0.18。方差分析显示，主动脉SUV（F(0.86) p = 0.46）、BP SUV（F(1.22) p = 0.31）或TBR（F(0.99) p = 0.4）无显著差异。然而，定性视觉分析显示，IT + TOF与UHD（p = 0.02）或UHD + MAR（p = 0.02）之间存在显著差异。
重建算法对主动脉SUV、BP SUV或TBR的影响无统计学意义。然而，定性视觉分析显示，与UHD或UHD + MAR重建相比，IT + TOF之间存在显著差异。建议在未来的临床试验中纳入更多患者以统一技术。
