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Comparison between silicon photomultiplier-based and conventional PET/CT in patients with suspected lung cancer—a pilot study

Economou Lundeberg, Johan ; Oddstig, Jenny LU ; Bitzén, Ulrika LU and Trägårdh, Elin LU (2019) In EJNMMI Research 9(1).
Abstract

Background: Lung cancer is one of the most common cancers in the world. Early detection and correct staging are fundamental for treatment and prognosis. Positron emission tomography with computed tomography (PET/CT) is recommended clinically. Silicon (Si) photomultiplier (PM)-based PET technology and new reconstruction algorithms are hoped to increase the detection of small lesions and enable earlier detection of pathologies including metastatic spread. The aim of this study was to compare the diagnostic performance of a SiPM-based PET/CT (including a new block-sequential regularization expectation maximization (BSREM) reconstruction algorithm) with a conventional PM-based PET/CT including a conventional ordered subset expectation... (More)

Background: Lung cancer is one of the most common cancers in the world. Early detection and correct staging are fundamental for treatment and prognosis. Positron emission tomography with computed tomography (PET/CT) is recommended clinically. Silicon (Si) photomultiplier (PM)-based PET technology and new reconstruction algorithms are hoped to increase the detection of small lesions and enable earlier detection of pathologies including metastatic spread. The aim of this study was to compare the diagnostic performance of a SiPM-based PET/CT (including a new block-sequential regularization expectation maximization (BSREM) reconstruction algorithm) with a conventional PM-based PET/CT including a conventional ordered subset expectation maximization (OSEM) reconstruction algorithm. The focus was patients admitted for 18F-fluorodeoxyglucose (FDG) PET/CT for initial diagnosis and staging of suspected lung cancer. Patients were scanned on both a SiPM-based PET/CT (Discovery MI; GE Healthcare, Milwaukee, MI, USA) and a PM-based PET/CT (Discovery 690; GE Healthcare, Milwaukee, MI, USA). Standardized uptake values (SUV) and image interpretation were compared between the two systems. Image interpretations were further compared with histopathology when available. Results: Seventeen patients referred for suspected lung cancer were included in our single injection, dual imaging study. No statically significant differences in SUVmax of suspected malignant primary tumours were found between the two PET/CT systems. SUVmax in suspected malignant intrathoracic lymph nodes was 10% higher on the SiPM-based system (p = 0.026). Good consistency (14/17 cases) between the PET/CT systems were found when comparing simplified TNM staging. The available histology results did not find any obvious differences between the systems. Conclusion: In a clinical setting, the new SiPM-based PET/CT system with a new BSREM reconstruction algorithm provided a higher SUVmax for suspected lymph node metastases compared to the PM-based system. However, no improvement in lung cancer detection was seen.

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Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Analogue PET, BSREM, Digital PET, Lung cancer, TNM stage
in
EJNMMI Research
volume
9
issue
1
article number
35
publisher
BioMed Central
external identifiers
  • scopus:85072125101
ISSN
2191-219X
DOI
10.1186/s13550-019-0504-y
language
English
LU publication?
yes
id
86261c58-a39c-4b28-8627-7fd091c5c72d
date added to LUP
2019-10-07 16:45:03
date last changed
2019-11-25 09:35:07
@article{86261c58-a39c-4b28-8627-7fd091c5c72d,
  abstract     = {<p>Background: Lung cancer is one of the most common cancers in the world. Early detection and correct staging are fundamental for treatment and prognosis. Positron emission tomography with computed tomography (PET/CT) is recommended clinically. Silicon (Si) photomultiplier (PM)-based PET technology and new reconstruction algorithms are hoped to increase the detection of small lesions and enable earlier detection of pathologies including metastatic spread. The aim of this study was to compare the diagnostic performance of a SiPM-based PET/CT (including a new block-sequential regularization expectation maximization (BSREM) reconstruction algorithm) with a conventional PM-based PET/CT including a conventional ordered subset expectation maximization (OSEM) reconstruction algorithm. The focus was patients admitted for <sup>18</sup>F-fluorodeoxyglucose (FDG) PET/CT for initial diagnosis and staging of suspected lung cancer. Patients were scanned on both a SiPM-based PET/CT (Discovery MI; GE Healthcare, Milwaukee, MI, USA) and a PM-based PET/CT (Discovery 690; GE Healthcare, Milwaukee, MI, USA). Standardized uptake values (SUV) and image interpretation were compared between the two systems. Image interpretations were further compared with histopathology when available. Results: Seventeen patients referred for suspected lung cancer were included in our single injection, dual imaging study. No statically significant differences in SUV<sub>max</sub> of suspected malignant primary tumours were found between the two PET/CT systems. SUV<sub>max</sub> in suspected malignant intrathoracic lymph nodes was 10% higher on the SiPM-based system (p = 0.026). Good consistency (14/17 cases) between the PET/CT systems were found when comparing simplified TNM staging. The available histology results did not find any obvious differences between the systems. Conclusion: In a clinical setting, the new SiPM-based PET/CT system with a new BSREM reconstruction algorithm provided a higher SUV<sub>max</sub> for suspected lymph node metastases compared to the PM-based system. However, no improvement in lung cancer detection was seen.</p>},
  author       = {Economou Lundeberg, Johan and Oddstig, Jenny and Bitzén, Ulrika and Trägårdh, Elin},
  issn         = {2191-219X},
  language     = {eng},
  number       = {1},
  publisher    = {BioMed Central},
  series       = {EJNMMI Research},
  title        = {Comparison between silicon photomultiplier-based and conventional PET/CT in patients with suspected lung cancer—a pilot study},
  url          = {http://dx.doi.org/10.1186/s13550-019-0504-y},
  doi          = {10.1186/s13550-019-0504-y},
  volume       = {9},
  year         = {2019},
}