Exploration of Optimal Reconstruction Parameters for 18F-FDG Total-body PET/CT with Ultra-low Activity Injection

Abstract

\n PURPOSE To explorer the optimal reconstruction parameters in oncologic 18 F-FDG total-body PET/CT studies with ultra-low activity injection. METHODS A total of 204 reconstructed PET images of 34 patients with a total of 58 lesions were analyzed by two experienced nuclear medicine physicians. Images were reconstructed with ordered subset expectation maximization (OSEM) algorithm (2 and 3 iterations) including time-of-flight (TOF) and point spread function (PSF) corrections and regularization ordered subset expectation maximization (ROSEM) (b-values of 0.3, 0.4, 0.5, and 0.6). General image quality was assessed using the five-point method including overall image quality, image clarity, noise, and lesion conspicuity. Image noise, signal-to-noise ratio, lesion size, SUVmax, SUVpeak and T/N were quantitatively analyzed by the third reader who did not participate in subjective image assessment. RESULTS In objective image quality indicators, noise decreased and a continuous increase of SNR with incremental β-values (0.3,0.4, 0.5 and 0.6) compared with OSEM3. In subjective image quality, OSEM2, ROSEM0.5 and ROSEM0.6 scored higher (all P<0.001) in overall image quality, image contrast and noise. The scores of ROSEM reconstructions were all higher in lesion conspicuity compared with OSEM3 (all P<0.001). In lesion detectability, SUVmax, SUVpeak and T/N increase with β value of ROSEM increase. Compared with OSEM3, there was a negative correlation between lesion size and the percentage increase of SUVpeak in OSEM2 and ROSEM reconstructions (all P<0.01). CONCLUSION In clinical practice, we recommended OSEM reconstruction with 3 iterations with a relatively short reconstruction time and we recommend ROSEM algorithm with b of 0.5 when reconstruction time is not considered.