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The reconstruction algorithm used for [68Ga]PSMA-HBED-CC PET/CT reconstruction significantly influences the number of detected lymph node metastases and coeliac ganglia

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

To investigate whether the numbers of lymph node metastases and coeliac ganglia delineated on [68Ga]PSMA-HBED-CC PET/CT scans differ among datasets generated using different reconstruction algorithms.

Methods

Data were constructed using the BLOB-OS-TF, BLOB-OS and 3D-RAMLA algorithms. All reconstructions were assessed by two nuclear medicine physicians for the number of pelvic/paraaortal lymph node metastases as well the number of coeliac ganglia. Standardized uptake values (SUV) were also calculated in different regions.

Results

At least one [68Ga]PSMA-HBED-CC PET/CT-positive pelvic or paraaortal lymph node metastasis was found in 49 and 35 patients using the BLOB-OS-TF algorithm, in 42 and 33 patients using the BLOB-OS algorithm, and in 41 and 31 patients using the 3D-RAMLA algorithm, respectively, and a positive ganglion was found in 92, 59 and 24 of 100 patients using the three algorithms, respectively. Quantitatively, the SUVmean and SUVmax were significantly higher with the BLOB-OS algorithm than with either the BLOB-OS-TF or the 3D-RAMLA algorithm in all measured regions (p < 0.001 for all comparisons). The differences between the SUVs with the BLOB-OS-TF- and 3D-RAMLA algorithms were not significant in the aorta (SUVmean, p = 0.93; SUVmax, p = 0.97) but were significant in all other regions (p < 0.001 in all cases). The SUVmean ganglion/gluteus ratio was significantly higher with the BLOB-OS-TF algorithm than with either the BLOB-OS or the 3D-RAMLA algorithm and was significantly higher with the BLOB-OS than with the 3D-RAMLA algorithm (p < 0.001 in all cases).

Conclusion

The results of [68Ga]PSMA-HBED-CC PET/CT are affected by the reconstruction algorithm used. The highest number of lesions and physiological structures will be visualized using a modern algorithm employing time-of-flight information.

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Authors and Affiliations

  1. Department of Nuclear Medicine, RWTH University Hospital Aachen, Aachen, Germany

    Thomas Krohn, Anita Birmes, Oliver H. Winz, Natascha I. Drude, Felix M. Mottaghy, Florian F. Behrendt & Frederik A. Verburg

  2. Department of Nuclear Medicine, Maastricht UMC+, Maastricht, The Netherlands

    Felix M. Mottaghy

  3. Radiology Institute “Aachen Land”, Würselen, Germany

    Florian F. Behrendt

  4. Department of Nuclear Medicine, University Hospital Giessen and Marburg, Marburg, Germany

    Frederik A. Verburg

  5. Department of Nuclear Medicine, Ulm University, Albert-Einstein-Allee 23, 89081, Ulm, Germany

    Thomas Krohn

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  1. Thomas Krohn
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  2. Anita Birmes
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  7. Frederik A. Verburg
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Corresponding author

Correspondence to Thomas Krohn.

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Conflicts of interest

F.A.V. is a consultant to Bayer Healthcare and SanofiGenzyme and has received speaker honoraria from Diasorin. F.M.M. and F.F.B. have received research support and speaker fees from Bayer. The other authors declare no conflicts of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the principles of the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. This was a retrospective study; for this type of study formal consent is not required.

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Krohn, T., Birmes, A., Winz, O.H. et al. The reconstruction algorithm used for [68Ga]PSMA-HBED-CC PET/CT reconstruction significantly influences the number of detected lymph node metastases and coeliac ganglia. Eur J Nucl Med Mol Imaging 44, 662–669 (2017). https://doi.org/10.1007/s00259-016-3571-6

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  • DOI: https://doi.org/10.1007/s00259-016-3571-6

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