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<p>Demarcation of small pancreatic and metastatic abdominal lesions is challenging due to the noisy background. We evaluated the impact of time-of-flight (TOF) in conjunction with TrueX (= point spread function (PSF)-based algorithm) or Q.Clear (= Bayesian penalized likelihood reconstruction algorithm) in dual-phase (DP) <sup>18</sup>F-FDG-PET/CT on image quality (IQ) and lesion detection rate in staging suspected pancreatic cancer. This prospective single-center study included 120 patients. A total of 908 lesions were evaluated by three board-certified nuclear medicine physicians. IQ, SUV<sub>max</sub>, and lesion volume (V) of pancreatic lesions, lymph node metastases, organ metastases, and other benign lesions were compared between TOF and non-TOF. All pancreatic lesions were histopathologically confirmed, and all other lesions were confirmed either histopathologically or radiologically. IQ and lesion demarcation were scored on a 6-point Likert-type scale. Overall IQ and demarcation of pancreatic lesions (PLD) were very good in TOF-images (overall IQ, non-TOF, 2.2; TOF, 1.8, <i>P</i> = 0.017; PLD, non-TOF, 2.6, TOF, 2.2, <i>P</i> &lt; 0.001). Thirty-four additional lesions in 23 (19%) patients were detected using TOF alone (mean [SD] SUV<sub>max</sub> 4.6 [1.5]; mean [SD] V 2.6 cm<sup>3</sup> [1.3]). 18/23 metastatic lesions identified with TOF alone led to treatment change in 8 patients. SUV<sub>max</sub> was significantly increased (<i>P</i>&lt; 0.001), whereas V was significantly decreased in TOF images (<i>P</i> = 0.002). Application of TOF poses additional value in detecting small pancreatic and metastatic lesions, which has an impact on further treatment, avoiding unnecessary surgery.</p>

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Diagnostic accuracy of dual-phase 18F-FDG PET/CT using time-of-flight reconstruction algorithm in conjunction with TrueX or Q.Clear in staging suspected pancreatic cancer

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年7月14日

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  • Susanne Stanzel,
  • Tina Nazerani-Zemann,
  • Friedrich Weitzer,
  • Roland Weinke,
  • Elisabeth Plhak,
  • Reingard Maria Aigner

摘要

Demarcation of small pancreatic and metastatic abdominal lesions is challenging due to the noisy background. We evaluated the impact of time-of-flight (TOF) in conjunction with TrueX (= point spread function (PSF)-based algorithm) or Q.Clear (= Bayesian penalized likelihood reconstruction algorithm) in dual-phase (DP) 18F-FDG-PET/CT on image quality (IQ) and lesion detection rate in staging suspected pancreatic cancer. This prospective single-center study included 120 patients. A total of 908 lesions were evaluated by three board-certified nuclear medicine physicians. IQ, SUVmax, and lesion volume (V) of pancreatic lesions, lymph node metastases, organ metastases, and other benign lesions were compared between TOF and non-TOF. All pancreatic lesions were histopathologically confirmed, and all other lesions were confirmed either histopathologically or radiologically. IQ and lesion demarcation were scored on a 6-point Likert-type scale. Overall IQ and demarcation of pancreatic lesions (PLD) were very good in TOF-images (overall IQ, non-TOF, 2.2; TOF, 1.8, P = 0.017; PLD, non-TOF, 2.6, TOF, 2.2, P < 0.001). Thirty-four additional lesions in 23 (19%) patients were detected using TOF alone (mean [SD] SUVmax 4.6 [1.5]; mean [SD] V 2.6 cm3 [1.3]). 18/23 metastatic lesions identified with TOF alone led to treatment change in 8 patients. SUVmax was significantly increased (P< 0.001), whereas V was significantly decreased in TOF images (P = 0.002). Application of TOF poses additional value in detecting small pancreatic and metastatic lesions, which has an impact on further treatment, avoiding unnecessary surgery.