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Dual-phase FDG-PET: delayed acquisition improves hepatic detectability of pathological uptake

FDG-PET nella identificazione di lesioni epatiche: miglioramento della sensibilità con acquisizione tardiva

  • Abdominal Radiology/Radiologia Addominale
  • Published:
La radiologia medica Aims and scope Submit manuscript

Abstract

Purpose

The aim of this study was to evaluate whether the acquisition of delayed images could improve the detectability of liver pathological uptakes.

Materials and methods

Ninety-five consecutive patients with suspected liver metastases underwent a dual-phase positron emission tomography (PET) scan. All patients underwent a whole-body PET/computed tomography (CT) scan (PET-1) acquired 1 h post [18F]fluorodeoxyglucose (FDG) injection, and a liver PET/CT scan [that is, one or two fields of view (FOV) of the upper abdomen; PET-2] acquired 2 h postinjection. In all cases, image reconstruction was performed as 3D reconstruction algorithm Fourier rebinning (FORE) iterative, FOV 50 cm, image matrix size 128×128. Both studies were evaluated qualitatively and semiquantitatively [background standard uptake values (SUV)mean of the liver, lesion SUVmax and SUVmean and ratio SUVmean lesion/background).

Results

Thirty-seven of 95 patients (38.9%) presented liver lesions at both PET-1 and PET-2 exams, whereas there were two (2.2%) only at PET-2. Eighty-one liver lesions were identified at both PET studies, whereas there were nine (11.1%) only at PET-2. Furthermore, at PET-2, we had a statistically significant reduction of SUVmean background values (p<0.001, Wilcoxon test) and a concomitant increase of SUVmean lesion values (p<0.001, Wilcoxon test), ratio lesion to background (p<0.001, Wilcoxon test).

Conclusions

Acquisition of delayed images improved the hepatic detection of pathological FDG uptake.

Riassunto

Obiettivo

Scopo di questo studio è stato quello di valutare se in pazienti con sospette secondarietà epatiche, la riacquisizione di immagini, 2 ore dopo la somministrazione del radiofarmaco (tardiva), comporta un miglioramento della sensibilità dell’esame PET.

Materiali e metodi

Sono stati inclusi 95 pazienti consecutivi con sospette metastasi epatiche. Tutti hanno eseguito esame PET/TC total body 1 ora dopo la somministrazione di FDG (PET-1). In tutti i casi, 2 ore dopo l’iniezione, è stata eseguita una seconda acquisizione mirata sull’addome superiore (PET-2). La ricostruzione delle immagini è stata eseguita con algoritmo 3D FORE iterativo (FOV 50 cm, dimensione della matrice 128×128). Entrambi gli esami sono stati valutati qualitativamente e semi-quantitativamente (SUVmedio fondo del fegato, SUVmax e SUVmedio della lesione e rapporto SUVmedio lesione/fondo).

Risultati

Trentasette dei 95 pazienti (38,9%) hanno presentato anomale iperfissazioni di radiofarmaco a livello epatico in entrambi gli esami PET; 2 pazienti (2,2%) sono risultati positivi solo in PET-2. Entrambi gli esami hanno messo in evidenza 81 lesioni epatiche, mentre altre 9 (11,1%) sono state evidenziate solo con l’esame PET-2. Inoltre in PET-2 si notava una riduzione significativa del SUVmedio del fondo (p<0,001, Wilcoxon test) ed un contemporaneo aumento del SUVmedio della lesione (p<0,001, Wilcoxon test) e del rapporto lesione/fondo (p<0,001, Wilcoxon test).

Conclusioni

La riacquisizione tardiva di immagini PET aumenta la capacità dell’esame PET di identificare fissazioni patologiche di FDG a livello epatico.

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Authors and Affiliations

  1. Centro PET, IRMET S.p.A., Via Onorato Vigliani, 89/A, 10135, Torino, Italy

    V. Arena, A. Skanjeti, A. Douroukas & E. Pelosi

  2. SCDU Medicina Nucleare, ASO S. Giovanni Battista, Torino, Italy

    R. Casoni & E. Pelosi

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  1. V. Arena
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  2. A. Skanjeti
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  3. R. Casoni
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  4. A. Douroukas
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  5. E. Pelosi
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Correspondence to E. Pelosi.

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Arena, V., Skanjeti, A., Casoni, R. et al. Dual-phase FDG-PET: delayed acquisition improves hepatic detectability of pathological uptake. Radiol med 113, 875–886 (2008). https://doi.org/10.1007/s11547-008-0287-0

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  • DOI: https://doi.org/10.1007/s11547-008-0287-0

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