Regularized reconstruction of digital time-of-flight 68Ga-PSMA-11 PET/CT for the detection of recurrent disease in prostate cancer patients
Open accessAbstract
Accurate localization of recurrent prostate cancer (PCa) is critical, especially if curative therapy is intended.With the aim to optimize target-to-background uptake ratio in 68 Ga-PSMA-11 PET, we investigated the image quality and quantitative measures of regularized reconstruction by block-sequential regularized expectation maximization (BSREM). Methods:The study encompassed retrospective reconstruction and analysis of 20 digital time-of-flight (TOF) PET/CT examinations acquired 60 min post injection of 2 MBq/kg of 68 Ga-PSMA-11 in PCa patients with biochemical relapse after primary treatment.Reconstruction by ordered-subsets expectation maximization (OSEM; 3 iterations, 16 subsets, 5 mm gaussian postprocessing filter) and BSREM (β-values of 100-1600) were used, both including TOF and point spread function (PSF) recovery.Background variability (BV) was measured by placing a spherical volume of interest in the right liver lobe and defined as the standard deviation divided by the mean standardized uptake value (SUV).The image quality was evaluated in terms of signal-to-noise ratio (SNR) and signal-to-background ratio (SBR), using SUVmax of the lesions.A visual assessment was performed by four observers.Results: OSEM reconstruction produced images with a BV of 15%, whereas BSREM with a β-value above 300 resulted in lower BVs than OSEM (36% with β 100, 8% with β 1300).Decreasing the acquisition duration from 2 to 1 and 0.5 min per bed position increased BV for both reconstruction methods, although BSREM with β-values equal to or higher than 800 and 1200, respectively, kept the BV below 15%.In comparison of BSREM with OSEM, the mean SNR improved by 25 to 66% with an increasing β-value in the range of 200-1300, whereas the mean SBR decreased with an increasing β-value, ranging from 0 to 125% with a β-value of 100 and 900, respectively.Decreased acquisition duration resulted in β-values of 800 to 1000 and 1200 to 1400 for 1 and 0.5 min per bed position, respectively, producing improved image quality measures compared with OSEM at a full acquisition duration of 2 min per bed position.The observer study showed a slight overall preference for BSREM β 900 although the interobserver variability was high.Conclusion: BSREM image reconstruction with β-values in the range of 400-900 resulted in lower BV and similar or improved SNR and SBR in comparison with OSEM.Key words: 68 Ga-PSMA-11, prostate cancer, PET/CT,
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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 [170]
The Results (page unavailable) report a slight overall preference for β 900, with high interobserver variability, and show that higher β values reduced noise during shorter acquisitions. The paper does not report observer preferences under those shorter, lower-count conditions, so it does not establish that the preference would become more evident. (LLM, conf=0.84)
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 [170]
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- Authors
- Lindström, E., Velikyan, I., Regula, N., Alhuseinalkhudhur, A., Sundin, A., Sörensen, J., & Lubberink, M.
- Affiliations
- Uppsala University (SE)
- Corresponding author
- Lindström, Elin
- ORCID
- Venue
- Theranostics
- Publisher
- Ivyspring International Publisher
- Published
- 2019
- Volume
- 9
- Issue
- 12
- Pages
- 3476-3484
- ISSN
- 1838-7640 (ISSN-L)
- PMC
- PMC6587171
- OpenAlex
- W2951519500
- Cited by
- 32
- References
- 17
- Citations by year
- 2026: 2 · 2024: 4 · 2023: 6 · 2022: 8 · 2021: 5 · 2020: 6 · 2018: 1
- FWCI
- 3.14
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by-nc
- Locations
- Theranostics (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Uppsala University Publications (Uppsala University) (submittedVersion, other-oa)
- Funders
- Cancerfonden (2016/835)
- Akademiska Sjukhuset
- Uppsala Universitet
- Topics
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Medical Imaging Techniques and Applications
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Prostate Cancer Diagnosis and Treatment
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Radiopharmaceutical Chemistry and Applications
- Keywords
- 68Ga-PSMA-11, prostate cancer, recurrent disease detection, OSEM, image reconstruction, background variation, signal-to-background ratio, signal-to-noise ratio, acquisition time, point spread function, biochemical recurrence, PSMA PET imaging, SUVmax
- MeSH terms
- Positron Emission Tomography Computed Tomography, Aged, Gallium Isotopes, Gallium Radioisotopes, Humans, Image Processing, Computer-Assisted, Male, Membrane Glycoproteins, Middle Aged, Neoplasm Recurrence, Local, Organometallic Compounds, Prostatic Neoplasms, Retrospective Studies, Radiopharmaceuticals
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