TY - JOUR
T1 - Lesion detection in 18F-sodium fluoride bone imaging
T2 - a comparison of attenuation-corrected versus nonattenuation-corrected PET reconstructions from modern PET-CT systems
AU - Bebbington, Natalie Anne
AU - Zacho, Helle Damgaard
AU - Holdgaard, Paw Christian
N1 - Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2022/1/1
Y1 - 2022/1/1
N2 - OBJECTIVES: An earlier study demonstrated comparable lesion detection between attenuation-corrected (AC) and nonattenuation-corrected (NAC) 18F-sodium fluoride (NaF) PET images, which is relevant for computed tomography (CT) radiation dose-saving. However, this finding may not be applicable to newer systems. The aim was to compare lesion detection between AC and NAC NaF PET images on modern PET-CT systems.METHODS: One expert and one nonexpert observer retrospectively surveyed NaF PET data in 25 breast cancer patients. At both lesion and patient level, each observer classified bone abnormalities as malignant, equivocal or benign, from NAC and AC PET images in the absence of CT. Expert interpretation of NaF PET-CT with the review of all diagnostic imaging/pathology reports for at least the subsequent 12 months provided reference standard metastases status at the patient level. Two-tailed Wilcoxon signed-rank tests measured statistically significant differences in total lesion detection between AC and NAC PET. Quadratic-weighted kappa score measured agreement in patient metastases status between observers.RESULTS: On a lesion-basis, AC PET images showed significantly more lesions than NAC for both the expert (122 versus 96; P = 0.002) and nonexpert (146 versus 132; P = 0.036) observers, with a large number of patients demonstrating disparity between AC and NAC images. For metastases status at the patient level without CT, NAC PET showed slightly better diagnostic accuracy than AC due to fewer false-positive results, as fewer lesions were identified.CONCLUSION: AC PET data provided superior lesion detection to NAC in NaF bone examinations and are thus required for clinical interpretation.
AB - OBJECTIVES: An earlier study demonstrated comparable lesion detection between attenuation-corrected (AC) and nonattenuation-corrected (NAC) 18F-sodium fluoride (NaF) PET images, which is relevant for computed tomography (CT) radiation dose-saving. However, this finding may not be applicable to newer systems. The aim was to compare lesion detection between AC and NAC NaF PET images on modern PET-CT systems.METHODS: One expert and one nonexpert observer retrospectively surveyed NaF PET data in 25 breast cancer patients. At both lesion and patient level, each observer classified bone abnormalities as malignant, equivocal or benign, from NAC and AC PET images in the absence of CT. Expert interpretation of NaF PET-CT with the review of all diagnostic imaging/pathology reports for at least the subsequent 12 months provided reference standard metastases status at the patient level. Two-tailed Wilcoxon signed-rank tests measured statistically significant differences in total lesion detection between AC and NAC PET. Quadratic-weighted kappa score measured agreement in patient metastases status between observers.RESULTS: On a lesion-basis, AC PET images showed significantly more lesions than NAC for both the expert (122 versus 96; P = 0.002) and nonexpert (146 versus 132; P = 0.036) observers, with a large number of patients demonstrating disparity between AC and NAC images. For metastases status at the patient level without CT, NAC PET showed slightly better diagnostic accuracy than AC due to fewer false-positive results, as fewer lesions were identified.CONCLUSION: AC PET data provided superior lesion detection to NAC in NaF bone examinations and are thus required for clinical interpretation.
KW - NaF
KW - PET-CT
KW - attenuation correction
KW - bone
KW - fluoride
KW - lesion detection
KW - Positron Emission Tomography Computed Tomography
U2 - 10.1097/MNM.0000000000001487
DO - 10.1097/MNM.0000000000001487
M3 - Journal article
C2 - 34887371
SN - 0143-3636
VL - 43
SP - 78
EP - 85
JO - Nuclear Medicine Communications
JF - Nuclear Medicine Communications
IS - 1
ER -