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Research ArticleImaging

Improving the Detection of Small Lesions Using a State-of-the-Art Time-of-Flight PET/CT System and Small-Voxel Reconstructions

Daniëlle Koopman, Jorn A. van Dalen, Martine C. M. Lagerweij, Hester Arkies, Jaep de Boer, Ad H. J. Oostdijk, Cornelis H. Slump and Pieter L. Jager
Journal of Nuclear Medicine Technology March 2015, 43 (1) 21-27; DOI: https://doi.org/10.2967/jnmt.114.147215
Daniëlle Koopman
1MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands
2Department of Nuclear Medicine, Isala Hospital, Zwolle, The Netherlands; and
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Jorn A. van Dalen
3Department of Medical Physics, Isala Hospital, Zwolle, The Netherlands
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Martine C. M. Lagerweij
3Department of Medical Physics, Isala Hospital, Zwolle, The Netherlands
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Hester Arkies
2Department of Nuclear Medicine, Isala Hospital, Zwolle, The Netherlands; and
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Jaep de Boer
2Department of Nuclear Medicine, Isala Hospital, Zwolle, The Netherlands; and
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Ad H. J. Oostdijk
2Department of Nuclear Medicine, Isala Hospital, Zwolle, The Netherlands; and
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Cornelis H. Slump
1MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands
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Pieter L. Jager
2Department of Nuclear Medicine, Isala Hospital, Zwolle, The Netherlands; and
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  • FIGURE 1.
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    FIGURE 1.

    18F-FDG PET images of NEMA phantom (A and B) and microphantom (C and D) using standard-voxel reconstruction (A and C) and small-voxel reconstructions (B and D). Sphere sizes for NEMA phantom were 10, 13, 17, 22, 28, and 37 mm, inner diameter, and sphere sizes for microphantom were 4, 5, 6, and 8 mm, inner diameter. For all spheres with diameter of 13 mm or less, contrast is clearly increased using small-voxel reconstruction. Moreover, smallest microphantom sphere cannot be distinguished from background on standard-voxel reconstruction (C), yet it can be detected on small-voxel reconstruction (D).

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    FIGURE 2.

    CRCmean (A) and CRCmax (B) for phantom spheres using standard- and small-voxel reconstructions, with relative changes (%) for both parameters presented in plot C and D. For small spheres (≤13 mm), we found increases for CRCmean and CRCmax using small-voxel reconstruction, with highest relative increases for 5- and 6-mm small spheres. As 4-mm small spheres could not be distinguished from background on standard-voxel reconstruction, no relative CRC changes were determined.

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    FIGURE 3.

    Relative changes in SUVmax (A) and SNRmax (B) for all 66 included lesions using small-voxel reconstruction instead of standard-voxel reconstruction. Average changes in SUVmax and SNRmax across all lesions were 32% and 27%, respectively. For lesions smaller than 0.75 mL, we found average SUVmax and SNRmax increases of 44% and 46%, respectively.

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    FIGURE 4.

    Transverse 18F-FDG PET images using standard-voxel reconstruction (A) and small-voxel reconstruction (B). Lesion in left lung (volume, 0.68 mL) with SUVmax of 2.6 using standard-voxel reconstruction increased with 54% to 4.0 using small-voxel reconstruction. SNRmax increased with 115% (from 3.1 to 6.6). ROIs used for background measurements are illustrated by black circles.

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    FIGURE 5.

    Coronal 18F-FDG PET images with standard-voxel reconstruction (A) and small-voxel reconstruction (B). SUVmax of lesion in right hilar region (volume, 0.50 mL) with SUVmax of 3.0 using standard-voxel reconstruction increased with 46% to 4.4 on small-voxel reconstruction (black arrow). SNRmax increased with 77% (from 9.8 to 13.3).

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    TABLE 1

    CRCmean, CRCmax, SNRmean, and SNRmax for 10 Phantom Spheres for Both Voxel Reconstructions, Including Relative Changes (%)

    Microphantom sphere diameter (mm)NEMA phantom sphere diameter (mm)
    Parameter4568101317222837
    CRCmean
     StandardN/A0.020.060.140.250.380.620.670.710.75
     Small0.030.040.120.250.370.450.650.690.730.71
     %N/A84%84%79%46%19%5%3%3%−6%
    CRCmax
     StandardN/A0.030.110.200.430.650.991.010.961.00
     Small0.060.100.240.440.720.850.970.960.991.00
     %N/A239%118%115%68%31%−2%−4%2%0%
    SNRmean
     StandardN/A516564263104112118124
     Small9103064425274798380
     %N/A87%85%79%0%−18%−28%−29%−30%−35%
    SNRmax
     StandardN/A8285271108165167161166
     Small1427611128297110110113114
     %N/A242%119%116%15%−10%−33%−35%−30%−31%
    • Standard = standard-voxel reconstruction (4 × 4 × 4 mm); N/A = not applicable; small = small-voxel reconstruction (2 × 2 × 2 mm).

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Journal of Nuclear Medicine Technology: 43 (1)
Journal of Nuclear Medicine Technology
Vol. 43, Issue 1
March 1, 2015
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Improving the Detection of Small Lesions Using a State-of-the-Art Time-of-Flight PET/CT System and Small-Voxel Reconstructions
Daniëlle Koopman, Jorn A. van Dalen, Martine C. M. Lagerweij, Hester Arkies, Jaep de Boer, Ad H. J. Oostdijk, Cornelis H. Slump, Pieter L. Jager
Journal of Nuclear Medicine Technology Mar 2015, 43 (1) 21-27; DOI: 10.2967/jnmt.114.147215

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Improving the Detection of Small Lesions Using a State-of-the-Art Time-of-Flight PET/CT System and Small-Voxel Reconstructions
Daniëlle Koopman, Jorn A. van Dalen, Martine C. M. Lagerweij, Hester Arkies, Jaep de Boer, Ad H. J. Oostdijk, Cornelis H. Slump, Pieter L. Jager
Journal of Nuclear Medicine Technology Mar 2015, 43 (1) 21-27; DOI: 10.2967/jnmt.114.147215
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Keywords

  • 18F-FDG PET
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  • small-voxel reconstruction
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