Oliveira R, Figueiredo L, Costa P
Medical Imaging and Radiotherapy Graduation Programme, School of Health - Polytechnic Institute of Porto, Portugal.
Radiology Department, School of Health - Polytechnic Institute of Porto, Portugal.
Radiography (Lond). 2023 Jan;29(1):145-151. doi: 10.1016/j.radi.2022.10.016. Epub 2022 Nov 10.
The use of medical imaging for diagnosis, staging and follow-up in Oncology context is incredibly important, being the use of [18F]-FDG PET/CT particularly advantageous in specific contexts like the case of obese patients. However, imaging the latter can be challenging sometimes, since their own body size may affect overall image quality and adds technical difficulties for the operator(s) performing the examination.
This research project was developed with the aim of analysing the current personal practices of Portuguese Nuclear Medicine Technologists (NMTs) in the adaptation of F-FDG PET/CT oncological protocols for obese patients and comparing the results with parameters referenced in literature. A non-experimental research study was conducted using a survey delivered online to NMTs through social media platforms (Facebook® and LinkedIn®) and by sending the link directly to contacts within the research team professional and personal networks.
Answers from a total of 26 participants were obtained, with 88.5% of participants admitting modifying technical protocols in examinations for obese patients. Changes in PET protocols included an increase in the administered activity (60.9%), an increase in scan time per individual bed position (69.6%) and the use of Time-of-Flight (TOF) technology whenever available. Protocol changes in CT included increasing the mA (82.6%), raising the KVp (47.8%), the application of iterative reconstruction (69.6%) and the use of automatic exposure control (AEC) (52.2%). The remaining parameters (pitch, algorithm, slice thickness, display FOV, gantry rotation time and energy acceptance window) were claimed not to be modified by around 90% of professionals.
Portuguese NMTs tend to change the [18F]-FDG PET/CT protocols for obese patients. However, while some of the parameters appear to be contradictory or redundant, others require further optimisation, especially in the CT component.
Efforts should be made to optimize acquisition protocols used in [18F]-FDG PET/CT scans for obese patients.
在肿瘤学领域，医学成像用于诊断、分期和随访极为重要，在肥胖患者等特定情况下，使用[18F]-FDG PET/CT尤其具有优势。然而，对肥胖患者进行成像有时可能具有挑战性，因为他们自身的体型可能会影响整体图像质量，并给进行检查的操作人员增加技术难度。
本研究项目旨在分析葡萄牙核医学技术人员（NMT）目前在调整针对肥胖患者的F-FDG PET/CT肿瘤学检查方案方面的个人实践，并将结果与文献中引用的参数进行比较。通过社交媒体平台（Facebook®和LinkedIn®）向NMT在线发放调查问卷，并将链接直接发送给研究团队专业和个人网络中的联系人，开展了一项非实验性研究。
共获得26名参与者的回复，88.5%的参与者承认在肥胖患者检查中修改了技术方案。PET方案的改变包括增加给药剂量（60.9%）、增加每个床位的扫描时间（69.6%）以及在可用时使用飞行时间（TOF）技术。CT方案的改变包括增加毫安（mA）（82.6%）、提高千伏峰值（KVp）（47.8%）、应用迭代重建（69.6%）以及使用自动曝光控制（AEC）（52.2%）。其余参数（螺距、算法、层厚、显示视野、机架旋转时间和能量接受窗口）约90%的专业人员声称未作修改。
葡萄牙NMT倾向于改变针对肥胖患者的[18F]-FDG PET/CT方案。然而，虽然一些参数似乎相互矛盾或多余，但其他参数需要进一步优化，尤其是在CT部分。
应努力优化用于肥胖患者的[18F]-FDG PET/CT扫描的采集方案。
