Clinical Cooperation Unit Nuclear Medicine, German Cancer Research Center, Im Neuenheimer Feld 280, D-69120, Heidelberg, Germany.
Eur J Nucl Med Mol Imaging. 2023 Sep;50(11):3354-3362. doi: 10.1007/s00259-023-06222-3. Epub 2023 Apr 20.
Long axial field of view (LAFOV) PET-CT scanners have been recently developed and are already in clinical use in few centers worldwide. Although still limited, the hitherto acquired experience with these novel systems highlights an increased sensitivity as their main advantage, which results in an increased lesion detectability. This attribute, alternatively, allows a reduction in PET acquisition time and/or administered radiotracer dose, while it renders delayed scanning of satisfying diagnostic accuracy possible. Another potential advantage of the new generation scanners is CT-less approaches for attenuation correction with the impact of marked reduction of radiation exposure, which may in turn lead to greater acceptance of longitudinal PET studies in the oncological setting. Further, the possibility for the first time of whole-body dynamic imaging, improved compartment modeling, and whole-body parametric imaging represent unique characteristics of the LAFOV PET-CT scanners. On the other hand, the advent of the novel LAFOV scanners is linked to specific challenges, such as the high purchase price and issues related to logistics and their optimal operation in a nuclear medicine department. Moreover, with regard to its research applications in oncology, the full potential of the new scanners can only be reached if different radiopharmaceuticals, both short and long-lived ones, as well as novel tracers, are available for use, which would, in turn, require the appropriate infrastructure in the area of radiochemistry. Although the novel LAFOV scanners are not yet widely used, this development represents an important step in the evolution of molecular imaging. This review presents the advantages and challenges of LAFOV PET-CT imaging for oncological applications with respect to static and dynamic acquisition protocols as well as to new tracers, while it provides an overview of the literature in the field.
长轴向视野（LAFOV）PET-CT 扫描仪最近已经开发出来，并在全球少数几个中心开始临床应用。尽管目前的经验还很有限，但这些新型系统的优势主要体现在更高的灵敏度，这使得病灶的检测能力得到了提高。这种属性可以减少 PET 采集时间和/或放射性示踪剂剂量，同时也使得延迟扫描获得满意的诊断准确性成为可能。新一代扫描仪的另一个潜在优势是无需 CT 即可进行衰减校正，从而显著降低辐射暴露，这可能会使纵向 PET 研究在肿瘤学领域得到更大的认可。此外，首次实现全身动态成像、改进的房室模型化以及全身参数成像，是 LAFOV PET-CT 扫描仪的独特特征。另一方面，新型 LAFOV 扫描仪的出现也带来了一些特定的挑战，例如高昂的购买价格以及与物流相关的问题，以及如何在核医学部门中优化其操作。此外，就其在肿瘤学中的研究应用而言，只有当新型扫描仪能够使用不同的放射性药物（包括短寿命和长寿命的放射性药物）以及新型示踪剂时，才能充分发挥其潜力，这反过来又需要在放射化学领域建立适当的基础设施。尽管新型 LAFOV 扫描仪尚未广泛应用，但这种发展代表了分子成像演进过程中的一个重要步骤。本文就静态和动态采集方案以及新型示踪剂方面，介绍了 LAFOV PET-CT 成像在肿瘤学应用中的优势和挑战，并对该领域的文献进行了综述。
