Popis: |
Digital PET systems (dPET) improve lesion detectability as compared to PET systems with conventional photomultiplier tubes (cPET). We prospectively studied the performance of high-resolution digital PET scans in patients with cancer, as compared with high- and standard-resolution conventional PET scans, taking the acquisition order into account.We included 212 patients with cancer, who were referred for disease staging or restaging. All patients underwent FDG-PET/CT on a dPET scanner and on a cPET scanner in a randomized order. The scans were acquired immediately after each other. Three image reconstructions were generated: 1) standard-resolution (4 × 4 × 4 mmOn high-resolution dPET, the PET readers detected more lesions or they had a higher diagnostic confidence than on high- and standard-resolution cPET (p 0.001). High-resolution dPET was preferred in 90% of the cases, as compared to 44% for high-resolution cPET and 1% for standard-resolution cPET (p 0.001). However, for the subgroup of patients where dPET was made first (n = 103, 61 ± 10 min after FDG administration) and cPET was made second (93 ± 15 min after FDG administration), no significant difference in preference was found between the high-resolution cPET and dPET reconstructions (p = 0.41).DPET scanners in combination with high-resolution reconstructions clinically outperform cPET scanners with both high- and standard-resolution reconstructions as the PET readers identified more FDG-avid lesions, their diagnostic confidence was increased, and they visually preferred dPET. However, when dPET was made first, high-resolution dPET and high-resolution cPET showed similar performance, indicating the positive effect of a prolonged FDG uptake time. Therefore, high-resolution cPET in combination with a prolonged FDG uptake time can be considered as an alternative. |