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Cited by 73Medical Imaging Techniques and ApplicationsRadiation Dose and ImagingLung Cancer Diagnosis and Treatment

Impact of a Bayesian penalized likelihood reconstruction algorithm on image quality in novel digital PET/CT: clinical implications for the assessment of lung tumors

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Messerli, Michael, Stolzmann, Paul, Egger-Sigg, Michèle, Trinckauf, Josephine, D’Aguanno, Stefano, Burger, Irene A., von Schulthess, Gustav K., Kaufmann, Philipp A. +1 more·2018·EJNMMI Physics
DOI 10.1186/s40658-018-0223-xPMC PMC6156690
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Abstract

The aim of this study was to evaluate and compare PET image reconstruction algorithms on novel digital silicon photomultiplier PET/CT in patients with newly diagnosed and histopathologically confirmed lung cancer. A total of 45 patients undergoing 18F-FDG PET/CT for initial lung cancer staging were included. PET images were reconstructed using ordered subset expectation maximization (OSEM) with time-of-flight and point spread function modelling as well as Bayesian penalized likelihood reconstruction algorithm (BSREM) with different β -values yielding a total of 7 datasets per patient. Subjective and objective image assessment with all image datasets was carried out, including subgroup analyses for patients with high dose (> 2.0 MBq/kg) and low dose (≤ 2.0 MBq/kg) of 18F-FDG injection regimen. Subjective image quality ratings were significantly different among all different reconstruction algorithms as well as among BSREM using different β -values only (both p < 0.001). BSREM with a β -value of 600 was assigned the highest score for general image quality, image sharpness, and lesion conspicuity. BSREM reconstructions resulted in higher SUV max of lung tumors compared to OSEM of up to + 28.0% ( p < 0.001). BSREM reconstruction resulted in higher signal-/ and contrast-to-background ratios of lung tumor and higher signal-/ and contrast-to-noise ratio compared to OSEM up to a β -value of 800. Lower β -values (BSREM 450 ) resulted in the best image quality for high dose 18F-FDG injections, whereas higher β -values (BSREM 600 ) lead to the best image quality in low dose 18F-FDG PET/CT ( p < 0.05). BSREM reconstruction algorithm used in digital detector PET leads to significant increases of lung tumor SUV max , signal-to-background ratio, and signal-to-noise ratio, which translates into a higher image quality, tumor conspicuity, and image sharpness.

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  • Inter-method SUV differences may no longer be significant at beta values of 300 to 600, which have been rated as optimal for visual reading of [18F]FDG-PET images by human readers.

    “However, this difference is directly dependent on the user-defined penalization factor beta during PL reconstruction, and at beta values of 300 to 600, which have been rated as optimal for visual reading of [18F]FDG-PET images by human readers [107,112,113], inter-method SUV differences may no longer be significant [41,108,111].”

    From Influences on PET Quantification and Interpretation (2022) · cites this paper as [112]

    The Results report that readers preferred β values of 450 or 600, depending on FDG dose. But Table 5 in the Results shows that tumor SUVmax differed significantly between both OSEM reconstructions and BSREM at β values of 350, 450, and 600 (all p < 0.001). Thus, this paper does not support the claim that inter-method SUV differences may cease to be significant at those values. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • In low-count conditions, the tendency to prefer smooth, low-noise images with beta values >600 over sharper images could become even more evident.

    “In low-count conditions, this tendency to prefer smooth, low-noise images with beta values >600 over “sharper” images could become even more evident [112,170].”

    From Influences on PET Quantification and Interpretation (2022) · cites this paper as [112]

    The Discussion and Results report that readers’ preferred reconstruction shifted from β=450 to β=600 in patients receiving lower 18F-FDG doses, consistent with a preference for greater noise control. They do not establish a preference for β values >600 in low-count conditions; the reported shift ends at 600. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • Several studies on subjective image quality in whole-body [18F]FDG-PET with PL reconstruction found that image quality was highest at beta values of 450 (to 600) despite lower lesion contrast recovery or image sharpness at these beta values compared to lower values.

    “Several studies on subjective image quality in whole-body [18F]FDG-PET with PL reconstruction found that image quality was highest at beta values of 450 (to 600) despite lower lesion CR or “image sharpness” at these beta values compared to lower values [41,108,112,175,179].”

    From Influences on PET Quantification and Interpretation (2022) · cites this paper as [112]

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    Experimental — accuracy not yet measured

  • PL reconstruction has repeatedly been shown to increase conspicuity and detection rates of pulmonary lesions, even compared to OSEM with PSF and/or TOF.

    “PL reconstruction has repeatedly been shown to increase conspicuity and detection rates of pulmonary lesions, even compared to OSEM with PSF and/or TOF [112,113,164,173,174].”

    From Influences on PET Quantification and Interpretation (2022) · cites this paper as [112]

    The Discussion reports greater lung-tumor lesion conspicuity with BSREM (a penalized-likelihood reconstruction method) than with OSEM; the Methods specify OSEM comparisons using PSF and TOF. The paper reports image-quality ratings and tumor uptake, but does not establish higher pulmonary-lesion detection rates. Its single study also does not, by itself, establish the claim that this has been shown repeatedly. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • Several authors have reported improved SNR and image quality with PL reconstruction for different radiopharmaceuticals, including [18F]FDG, [18F]F-PSMA-1007, [68Ga]Ga-PSMA-11, [68Ga]Ga-DOTATATE, and 89Zr-labelled tracers.

    “several authors have reported improved SNR and image quality with different radiopharmaceuticals, such as [18F]FDG [107,112,113], [18F]F-PSMA-1007 [143], [68Ga]Ga-PSMA-11 [169,170], [68Ga]Ga-DOTATATE [171] or 89Zr-labelled tracers [172].”

    From Influences on PET Quantification and Interpretation (2022) · cites this paper as [112]

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Cites

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Authors
Messerli, M., Stolzmann, P., Egger-Sigg, M., Trinckauf, J., D’Aguanno, S., Burger, I. A., von Schulthess, G. K., Kaufmann, P. A., & Huellner, M. W.
Affiliations
University of Zurich (CH)
Corresponding author
Messerli, Michael
ORCID
Venue
EJNMMI Physics
Publisher
Springer Science and Business Media LLC
Published
2018-09-26
Volume
5
Issue
1
Pages
27-27
ISSN
2197-7364 (ISSN-L)
DOI
10.1186/s40658-018-0223-x
PMC
PMC6156690
OpenAlex
W2888114287
Cited by
73
References
1
Citations by year
2026: 6 · 2025: 3 · 2024: 7 · 2023: 11 · 2022: 10 · 2021: 14 · 2020: 10 · 2019: 10 · 2018: 1 · 2012: 1
FWCI
6.05
Type
journal article
Language
en
Open access
Licence
Locations
  • EJNMMI Physics (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Zurich Open Repository and Archive (University of Zurich) (acceptedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Zurich Open Repository and Archive (University of Zurich) (submittedVersion, cc-by)
  • Zurich Open Repository and Archive (University of Zurich)
Funders
GE Healthcare (Institutional grants from GE Healthcare (unrelated to current study))
Topics
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Medical Imaging Techniques and Applications
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Radiation Dose and Imaging
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Lung Cancer Diagnosis and Treatment
Keywords
Bayesian penalized likelihood reconstruction, BSREM, OSEM, lung cancer staging, 18F-FDG PET, PET image quality, SUVmax, signal-to-background ratio, signal-to-noise ratio, time-of-flight PET

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