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Optimization of [18F]PSMA-1007 PET-CT using regularized reconstruction in patients with prostate cancer
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Background: Prostate-specific membrane antigen (PSMA) radiotracers such as [18 F]PSMA-1007 used with positron emission tomography-computed tomography (PET-CT) is promising for initial staging and detection of recurrent disease in prostate cancer patients. The block-sequential regularization expectation maximization algorithm (BSREM) is a new PET reconstruction algorithm, which provides higher image contrast while also reducing noise. The aim of the present study was to evaluate the influence of different acquisition times and different noise-suppressing factors in BSREM (β values) in [18 F]PSMA-1007 PET-CT regarding quantitative data as well as a visual image quality assessment. We included 35 patients referred for clinical [18 F]PSMA-1007 PET-CT. Four megabecquerels per kilogramme were administered and imaging was performed after 120 min. Eighty-four image series per patient were created with combinations of acquisition times of 1–4 min/bed position and β values of 300–1400. The noise level in normal tissue and the contrast-to-noise ratio (CNR) of pathological uptakes versus the local background were calculated. Image quality was assessed by experienced nuclear medicine physicians. Results: The noise level in the liver, spleen, and muscle was higher for low β values and low acquisition times (written as activity time products (ATs = administered activity × acquisition time)) and was minimized at maximum AT (16 MBq/kg min) and maximum β (1400). There was only a small decrease above AT 10. The median CNR increased slowly with AT from approximately 6 to 12 and was substantially lower at AT 4 and higher at AT 14–16. At AT 4–6, many images were regarded as being of unacceptable quality. For AT 8, β values of 700–900 were considered of acceptable quality. Conclusions: An AT of 8 (for example as in our study, 4 MB/kg with an acquisition time of 2 min) with a β value of 700 performs well regarding noise level, CNR, and visual image quality assessment.
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A low product of injected activity per kilogram and acquisition time per bed position results in excessive image noise and possibly increased false-positive rates and decreased reader confidence.
“A low product of the two factors results in excessive image noise and possibly increased rates of false-positive results and decreased reader confidence [76,143,144].”
From Influences on PET Quantification and Interpretation (2022) · cites this paper as [143]
The Results (page unavailable) show higher image noise and more images judged unacceptable at low activity–time products. The Methods define poor image quality to include noise-induced hotspots that mimic pathological uptake, supporting the possibility of false positives. The paper does not report decreased reader confidence. (LLM, conf=0.88)
Experimental — accuracy not yet measuredSeveral 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 [143]
For [18F]PSMA-1007, the Results (Quantitative assessment) report lower image noise with some reconstruction settings, and the Conclusion reports good CNR and visual image quality at the recommended settings. The paper does not report SNR specifically, and its study compares BSREM settings rather than demonstrating an overall improvement over another reconstruction method. The other tracers in the citing sentence have separate citations and are not attributed to this paper. (LLM, conf=0.84)
Experimental — accuracy not yet measuredTrägårdh et al. recommended 8 MBq/kg*min for [18F]F-PSMA-1007 based on the same scanner and PL reconstruction.
“Moreover, the authors recommended 8 MBq/kg*min for [18F]F-PSMA-1007 based on the same scanner and PL reconstruction [143].”
From Influences on PET Quantification and Interpretation (2022) · cites this paper as [143]
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Metadata
- Authors
- Trägårdh, E., Minarik, D., Brolin, G., Bitzén, U., Olsson, B., & Oddstig, J.
- Affiliations
- Lund University (SE)
- Corresponding author
- Trägårdh, Elin
- Venue
- EJNMMI Physics
- Published
- 2020-05-12
- Volume
- 7
- Issue
- 1
- Pages
- 31-31
- ISSN
- 2197-7364 (ISSN-L)
- PMC
- PMC7218038
- OpenAlex
- W3027957804
- Cited by
- 27
- References
- 20
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 5 · 2023: 6 · 2022: 7 · 2021: 5
- FWCI
- 2.19
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- EJNMMI Physics (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Lund University Publications (Lund University) (submittedVersion)
- Funders
- Knut och Alice Wallenbergs Stiftelse (-)
- Prostatacancerförbundet (-)
- Medicinska Fakulteten, Lunds Universitet (-)
- Region Skåne (-)
- Topics
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Medical Imaging Techniques and Applications
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Radiopharmaceutical Chemistry and Applications
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Radiation Dose and Imaging
- Keywords
- 18F-PSMA-1007, prostate-specific membrane antigen, prostate cancer, PET/CT, BSREM, PET image reconstruction, acquisition time, noise reduction, contrast-to-noise ratio, image quality
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