University of Health Sciences, Prof. Dr. CemilTaşcıoğlu Hospital, Department of Nuclear Medicine, İstanbul, Turkey.
Hell J Nucl Med. 2024 May-Aug;27(2):85-92. doi: 10.1967/s002449912721. Epub 2024 Aug 6.
This study was carried out to understand whether Q.Clear and ordered subset expectation maximization (OSEM), reconstruction algorithms used in fluorine-18-fluorodeoxyglucose (F-FDG) positron emission tomography/computed tomography (PET/CT) applications, and parameters such as time of flight (TOF) and point spread function (PSF) cause different results in semi-quantitative measurements.
Raw PET data of 264 patients who were referred to F-FDG PET/CT imaging with the purpose of evaluation of known or suspicious malignant disease were reconstructed separately with Q.Clear (GE Healthcare), a BPL, an OSEM algorithm, PSF (SharpIR®) and TOF (VUE Point FX®) methods. Each patient's liver, mediastinal blood pool, metabolic tumor volume (MTV), total lesion glycolysis (TLG), and standardized uptake values (SUV) (SUVmax, SUVmean, and SUVpeak) of a total of 264 lesions selected from the patients were performed.
β350+ToF yielded higher measurement results than all other variables for all of the lesion SUVmax, lesion SUVmean, L/AP SUVmax, and L/AP SUVmean parameters. OSEM+ToF and OSEM+TOF+PSF algorithms yielded higher mean and median SUVmax values for the reference structures (liver and mediastinum) and for lesions SUVmax and SUVmean values were statistically significantly lower than the β350+ToF method. The method with the lowest mean value for the L/Liver SUVmax variable was OSEM+ToF 4iter16ss (mean=1.76), while the method with the highest mean value was β350+ToF (mean=2.26). β350+ToF was the reconstruction method with the highest ratios for L/AP SUVmax and SUVmean for both lesions below and above 1 cm. β350+ToF algorithm had also statistically significantly higher results for these variables compared to all other parameters in malignant lesions.
When comparing F-FDG PET/CT images, the use of different reconstruction algorithms may lead to misleading results, especially in the evaluation of response to treatment of malignancies.
本研究旨在了解氟-18-氟代脱氧葡萄糖（F-FDG）正电子发射断层扫描/计算机断层扫描（PET/CT）应用中使用的 Q.Clear 和有序子集期望最大化（OSEM）重建算法以及飞行时间（TOF）和点扩散函数（PSF）等参数是否会导致半定量测量结果的差异。
对 264 例因已知或疑似恶性疾病而行 F-FDG PET/CT 成像的患者的原始 PET 数据分别采用 Q.Clear（GE Healthcare）、BPL、OSEM 算法、PSF（SharpIR®）和 TOF（VUE Point FX®）方法进行重建。对每位患者的肝脏、纵隔血池、代谢肿瘤体积（MTV）、总病变糖酵解（TLG）和从患者中选择的 264 个病变的标准化摄取值（SUV）（SUVmax、SUVmean 和 SUVpeak）进行了分析。
对于所有病变 SUVmax、病变 SUVmean、L/AP SUVmax 和 L/AP SUVmean 参数，β350+TOF 均比其他所有变量的测量结果更高。OSEM+TOF 和 OSEM+TOF+PSF 算法对参考结构（肝脏和纵隔）的平均和中位数 SUVmax 值更高，而病变 SUVmax 和 SUVmean 值显著低于β350+TOF 方法。L/Liver SUVmax 变量的平均值最低的方法是 OSEM+TOF 4iter16ss（平均值=1.76），而平均值最高的方法是β350+TOF（平均值=2.26）。β350+TOF 是病变大小在 1cm 以下和以上时 L/AP SUVmax 和 SUVmean 的比值最高的重建方法。与所有其他参数相比，β350+TOF 算法在恶性病变中也具有更高的统计学意义。
在比较 F-FDG PET/CT 图像时，不同重建算法的使用可能会导致误导性结果，尤其是在评估恶性肿瘤治疗反应时。
