Leveraging Small Voxel with Optimal Acquisition Time for [F]mFBG Total-body PET/CT Imaging in Pediatric Patients with Neuroblastoma: a Preliminary Study

Overview

Journal Eur J Nucl Med Mol Imaging

Date 2025 Jan 31

PMID 39888420

Authors

Zhaoting Cheng

Xiaoyun Deng

Shuang Song

Yang Wu

Hongmei Tang

Sijuan Zou

Yuankai Zhu

Aiguo Liu

Xiaohua Zhu

Affiliations

Soon will be listed here.

Abstract

Purpose: The advent of total-body PET/CT presents an opportunity for significant advancements in imaging of neuroblastoma with [F]meta-fluorobenzylguanidine ([F]mFBG). Small voxel imaging has proven to have better lesion detectability but need enough radioactivity counts. This study aims to balance shortened acquisition times and small voxel reconstruction to keep sufficient image quality and diagnostic confidence on [F]mFBG total-body PET for neuroblastoma.

Methods: We retrospectively enrolled 33 pediatric patients with neuroblastoma who underwent 37 [F]mFBG total-body uEXPLORER PET/CT scans of 10-min duration. PET images were reconstructed with varying acquisition times (0.5-10 min) and three matrix sizes (192 × 192, 512 × 512 and 1024 × 1024). The subjective (scored on a 5-point scale) and objective image quality (signal-to-noise ratio, SNR) of all the sets of reconstructed images were analyzed by nuclear medicine physicians. For indeterminate lesions identified in the group of 192 × 192 matrix with the 10-min scan (G192-10), diagnostic confidence was further evaluated in images reconstructed with the 512 × 512 and 1024 × 1024 matrices (G512 and G1024).

Results: Of the 33 patients with 37 [F]mFBG PET/CT scans, 17 patients with 20 scans had positive [F]mFBG PET/CT findings. Sufficient subjective image quality was achieved with at least 2-min acquisition of 192 × 192 matrix and 4-min acquisition of 512 × 512 matrix (with all scores ≥ 3). SNR increased with longer acquisition times for the same voxel size, while decreased as voxel size shrunk. Although the Curie and SIOPEN scores remained consistent across G192, G512, and G1024-10 groups, the G512 groups with at least 2-min acquisition and G1024-10 showed significantly higher confidence scores for characterizing indeterminate lesions on the G192-10 images, with almost all indeterminate lesions being rated as very confident.

Conclusions: A matrix of 512 × 512 with a minimum of 4-min acquisition on [F]mFBG total-body PET/CT is recommended for sufficient image quality and improved diagnostic confidence, particularly in detecting indeterminate lesions.

References

Whittle S, Smith V, Doherty E, Zhao S, McCarty S, Zage P . Overview and recent advances in the treatment of neuroblastoma. Expert Rev Anticancer Ther. 2017; 17(4):369-386. DOI: 10.1080/14737140.2017.1285230. View

Maris J, Hogarty M, Bagatell R, Cohn S . Neuroblastoma. Lancet. 2007; 369(9579):2106-20. DOI: 10.1016/S0140-6736(07)60983-0. View

Wang P, Li T, Liu Z, Jin M, Su Y, Zhang J . [F]MFBG PET/CT outperforming [I]MIBG SPECT/CT in the evaluation of neuroblastoma. Eur J Nucl Med Mol Imaging. 2023; 50(10):3097-3106. DOI: 10.1007/s00259-023-06221-4. View

Pauwels E, Celen S, Vandamme M, Leysen W, Baete K, Bechter O . Improved resolution and sensitivity of [F]MFBG PET compared with [I]MIBG SPECT in a patient with a norepinephrine transporter-expressing tumour. Eur J Nucl Med Mol Imaging. 2020; 48(1):313-315. DOI: 10.1007/s00259-020-04830-x. View

Samim A, Blom T, Poot A, Windhorst A, Fiocco M, Tolboom N . [F]mFBG PET-CT for detection and localisation of neuroblastoma: a prospective pilot study. Eur J Nucl Med Mol Imaging. 2022; 50(4):1146-1157. PMC: 9931849. DOI: 10.1007/s00259-022-06063-6. View

Cherry S, Jones T, Karp J, Qi J, Moses W, Badawi R . Total-Body PET: Maximizing Sensitivity to Create New Opportunities for Clinical Research and Patient Care. J Nucl Med. 2017; 59(1):3-12. PMC: 5750522. DOI: 10.2967/jnumed.116.184028. View

Alavi A, Saboury B, Nardo L, Zhang V, Wang M, Li H . Potential and Most Relevant Applications of Total Body PET/CT Imaging. Clin Nucl Med. 2021; 47(1):43-55. DOI: 10.1097/RLU.0000000000003962. View

Hu H, Huang Y, Sun H, Zhou K, Jiang L, Zhong J . A proper protocol for routine F-FDG uEXPLORER total-body PET/CT scans. EJNMMI Phys. 2023; 10(1):51. PMC: 10495295. DOI: 10.1186/s40658-023-00573-4. View

Qi C, Sui X, Yu H, Wang S, Hu Y, Sun H . Phantom study and clinical application of total-body F-FDG PET/CT imaging: How to use small voxel imaging better?. EJNMMI Phys. 2024; 11(1):17. PMC: 10869323. DOI: 10.1186/s40658-023-00597-w. View

10.

Borgwardt L, Brok J, Andersen K, Madsen J, Gillings N, Fosbol M . Performing [F]MFBG Long-Axial-Field-of-View PET/CT Without Sedation or General Anesthesia for Imaging of Children with Neuroblastoma. J Nucl Med. 2024; 65(8):1286-1292. PMC: 11294065. DOI: 10.2967/jnumed.123.267256. View

11.

Ismailani U, Buchler A, Farber G, Pekosak A, Farber E, MacMullin N . Cardiac Sympathetic Positron Emission Tomography Imaging with -[F]Fluorobenzylguanidine is Sensitive to Uptake-1 in Rats. ACS Chem Neurosci. 2021; 12(22):4350-4360. DOI: 10.1021/acschemneuro.1c00575. View

12.

Sonni I, Baratto L, Park S, Hatami N, Srinivas S, Davidzon G . Initial experience with a SiPM-based PET/CT scanner: influence of acquisition time on image quality. EJNMMI Phys. 2018; 5(1):9. PMC: 5904089. DOI: 10.1186/s40658-018-0207-x. View

13.

Yanik G, Parisi M, Shulkin B, Naranjo A, Kreissman S, London W . Semiquantitative mIBG scoring as a prognostic indicator in patients with stage 4 neuroblastoma: a report from the Children's oncology group. J Nucl Med. 2013; 54(4):541-8. PMC: 5503147. DOI: 10.2967/jnumed.112.112334. View

14.

Sharp S, Trout A, Weiss B, Gelfand M . MIBG in Neuroblastoma Diagnostic Imaging and Therapy. Radiographics. 2016; 36(1):258-78. DOI: 10.1148/rg.2016150099. View

15.

Grueneisen J, Beiderwellen K, Heusch P, Gratz M, Schulze-Hagen A, Heubner M . Simultaneous positron emission tomography/magnetic resonance imaging for whole-body staging in patients with recurrent gynecological malignancies of the pelvis: a comparison to whole-body magnetic resonance imaging alone. Invest Radiol. 2014; 49(12):808-15. DOI: 10.1097/RLI.0000000000000086. View

16.

Beiderwellen K, Grueneisen J, Ruhlmann V, Buderath P, Aktas B, Heusch P . [(18)F]FDG PET/MRI vs. PET/CT for whole-body staging in patients with recurrent malignancies of the female pelvis: initial results. Eur J Nucl Med Mol Imaging. 2014; 42(1):56-65. DOI: 10.1007/s00259-014-2902-8. View

17.

Monclair T, Brodeur G, Ambros P, Brisse H, Cecchetto G, Holmes K . The International Neuroblastoma Risk Group (INRG) staging system: an INRG Task Force report. J Clin Oncol. 2008; 27(2):298-303. PMC: 2650389. DOI: 10.1200/JCO.2008.16.6876. View

18.

Hu P, Zhang Y, Yu H, Chen S, Tan H, Qi C . Total-body F-FDG PET/CT scan in oncology patients: how fast could it be?. Eur J Nucl Med Mol Imaging. 2021; 48(8):2384-2394. DOI: 10.1007/s00259-021-05357-5. View

19.

Zhang Y, Hu P, He Y, Yu H, Tan H, Liu G . Ultrafast 30-s total-body PET/CT scan: a preliminary study. Eur J Nucl Med Mol Imaging. 2022; 49(8):2504-2513. DOI: 10.1007/s00259-022-05838-1. View

20.

Zhang Y, Hu P, Wu R, Gu Y, Chen S, Yu H . The image quality, lesion detectability, and acquisition time of F-FDG total-body PET/CT in oncological patients. Eur J Nucl Med Mol Imaging. 2020; 47(11):2507-2515. DOI: 10.1007/s00259-020-04823-w. View