Cheng Zhaoting, Deng Xiaoyun, Song Shuang, Wu Yang, Tang Hongmei, Zou Sijuan, Zhu Yuankai, Liu Aiguo, Zhu Xiaohua
Department of Nuclear Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Ave, Wuhan, 430030, China.
National Center for Major Public Health Events, 1095 Jiefang Ave, Wuhan, 430030, China.
Eur J Nucl Med Mol Imaging. 2025 Jan 31. doi: 10.1007/s00259-025-07098-1.
The advent of total-body PET/CT presents an opportunity for significant advancements in imaging of neuroblastoma with [F]meta-fluorobenzylguanidine ([F]mFBG). Small voxel imaging has proven to have better lesion detectability but need enough radioactivity counts. This study aims to balance shortened acquisition times and small voxel reconstruction to keep sufficient image quality and diagnostic confidence on [F]mFBG total-body PET for neuroblastoma.
We retrospectively enrolled 33 pediatric patients with neuroblastoma who underwent 37 [F]mFBG total-body uEXPLORER PET/CT scans of 10-min duration. PET images were reconstructed with varying acquisition times (0.5-10 min) and three matrix sizes (192 × 192, 512 × 512 and 1024 × 1024). The subjective (scored on a 5-point scale) and objective image quality (signal-to-noise ratio, SNR) of all the sets of reconstructed images were analyzed by nuclear medicine physicians. For indeterminate lesions identified in the group of 192 × 192 matrix with the 10-min scan (G192-10), diagnostic confidence was further evaluated in images reconstructed with the 512 × 512 and 1024 × 1024 matrices (G512 and G1024).
Of the 33 patients with 37 [F]mFBG PET/CT scans, 17 patients with 20 scans had positive [F]mFBG PET/CT findings. Sufficient subjective image quality was achieved with at least 2-min acquisition of 192 × 192 matrix and 4-min acquisition of 512 × 512 matrix (with all scores ≥ 3). SNR increased with longer acquisition times for the same voxel size, while decreased as voxel size shrunk. Although the Curie and SIOPEN scores remained consistent across G192, G512, and G1024-10 groups, the G512 groups with at least 2-min acquisition and G1024-10 showed significantly higher confidence scores for characterizing indeterminate lesions on the G192-10 images, with almost all indeterminate lesions being rated as very confident.
A matrix of 512 × 512 with a minimum of 4-min acquisition on [F]mFBG total-body PET/CT is recommended for sufficient image quality and improved diagnostic confidence, particularly in detecting indeterminate lesions.
全身PET/CT的出现为使用[F]间氟苄胍（[F]mFBG）对神经母细胞瘤进行成像带来了显著进展的机遇。小体素成像已被证明具有更好的病变可检测性，但需要足够的放射性计数。本研究旨在平衡缩短采集时间和小体素重建，以在[F]mFBG全身PET对神经母细胞瘤成像时保持足够的图像质量和诊断信心。
我们回顾性纳入了33例患有神经母细胞瘤的儿科患者，他们接受了37次时长为10分钟的[F]mFBG全身uEXPLORER PET/CT扫描。PET图像采用不同的采集时间（0.5 - 10分钟）和三种矩阵大小（192×192、512×512和1024×1024）进行重建。所有重建图像集的主观（采用5分制评分）和客观图像质量（信噪比，SNR）由核医学医师进行分析。对于在192×192矩阵且扫描时间为10分钟的组（G192 - 10）中识别出的不确定病变，在采用512×512和1024×1024矩阵重建的图像（G512和G1024）中进一步评估诊断信心。
在33例患者的37次[F]mFBG PET/CT扫描中，17例患者的20次扫描有阳性[F]mFBG PET/CT表现。对于192×192矩阵至少采集2分钟以及512×512矩阵至少采集4分钟，可实现足够的主观图像质量（所有评分≥3）。对于相同体素大小，SNR随采集时间延长而增加，随体素大小缩小而降低。尽管G192、G512和G1024 - 10组的居里和SIOPEN评分保持一致，但G512组至少采集2分钟以及G1024 - 10组在对G192 - 10图像上的不确定病变进行特征描述时显示出显著更高的信心评分，几乎所有不确定病变被评为非常有信心。
建议在[F]mFBG全身PET/CT上采用512×512矩阵并至少采集4分钟，以获得足够的图像质量并提高诊断信心，特别是在检测不确定病变方面。
