Activity Dose Reduction in 64Cu-DOTATATE PET in Patients with Neuroendocrine Neoplasms: Impact on Image Quality and Lesion Detection Ability

Purpose Patients with neuroendocrine neoplasms (NEN) engage in lifelong follow-up with frequent somatostatin receptor PET, e.g. [64Cu]Cu-DOTATATE PET, and continued measures to reduce radiation exposures should be in pursued in accordance with the as-low-as-reasonably-achievable (ALARA) principle. W...
Ausführliche Beschreibung

Purpose Patients with neuroendocrine neoplasms (NEN) engage in lifelong follow-up with frequent somatostatin receptor PET, e.g. [64Cu]Cu-DOTATATE PET, and continued measures to reduce radiation exposures should be in pursued in accordance with the as-low-as-reasonably-achievable (ALARA) principle. We therefore aimed to determine the lowest achievable [64Cu]Cu-DOTATATE dose while maintaining image quality and lesion detection rate. Procedures We included scans from 38 patients with NEN referred to routine [64Cu]Cu-DOTATATE PET/CT. Using reconstruction of under-sampled PET list-mode data, we simulated [64Cu]Cu-DOTATATE activity dose-reduced PET equivalents with median [range] 142 MBq [127;157], 95 MBq [85;105], and 48 MBq [42;52], corresponding to 75% ($ PET_{75%} $), 50% ($ PET_{50%} $), and 25% ($ PET_{25%} $) of the full-dose 191 MBq [169;209] ($ PET_{100%} $). Three blinded readers independently assessed image quality (scores 1–5), lesion confidence (scores 0–2), and counted lesions grouped by organs and regions. Number of lesions, proportions of patients with diagnostic image quality (reader-median image quality ≥ 4), diagnostic lesion confidence (reader-median lesion confidence ≥ 1), and per-patient sensitivities and specificities for organ-specific disease on $ PET_{75-25%} $ were compared with $ PET_{100%} $. Results The median [64Cu]Cu-DOTATATE activity dose could be reduced from 191 to 142 MBq without decline in diagnostic image quality (P = 0.62), diagnostic lesion confidence (P = 1.0), or number of lesions detected in major organs or regions (P = 0.19–0.71). Sensitivity and specificity for detection of liver disease were 100% (26/26 patients) and 100% (12/12), respectively, for both $ PET_{75%} $ and $ PET_{50%} $. Overall sensitivity for detection of NEN was 100% (26/26) for both $ PET_{75%} $ and $ PET_{50%} $, and overall specificities were 92% (11/12) and 100% (12/12) for $ PET_{75} $ and $ PET_{50} $, respectively. Following dose-blinded post hoc review, the $ PET_{75%} $ specificity was adjusted to 100% (12/12). Conclusions The [64Cu]Cu-DOTATATE activity dose can be reduced from 191 MBq to at least 142 MBq without losing image quality or lesion detection ability and further reduced to 95 MBq without loss of clinically relevant information. Ausführliche Beschreibung

Autor*in:	Loft, Mathias [verfasserIn] Carlsen, Esben A. Johnbeck, Camilla B. Jensen, Christoffer V. Andersen, Flemming L. Langer, Seppo W. Oturai, Peter Knigge, Ulrich Kjaer, Andreas

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2022

Anmerkung:	© World Molecular Imaging Society 2022

Übergeordnetes Werk:	Enthalten in: Molecular imaging & biology - Cham : Springer Nature Switzerland, 2002, 24(2022), 4 vom: 15. Feb., Seite 600-611
Übergeordnetes Werk:	volume:24 ; year:2022 ; number:4 ; day:15 ; month:02 ; pages:600-611

Links:	Volltext

DOI / URN:	10.1007/s11307-022-01706-4

Katalog-ID:	SPR047636513