Impact of a Bayesian penalized likelihood reconstruction algorithm on image quality in novel digital PET/CT: clinical implications for the assessment of lung tumors

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Abstract

Background

The aim of this study was to evaluate and compare PET image reconstruction algorithms on novel digital silicon photomultiplier PET/CT in patients with newly diagnosed and histopathologically confirmed lung cancer. A total of 45 patients undergoing 18F-FDG PET/CT for initial lung cancer staging were included. PET images were reconstructed using ordered subset expectation maximization (OSEM) with time-of-flight and point spread function modelling as well as Bayesian penalized likelihood reconstruction algorithm (BSREM) with different β-values yielding a total of 7 datasets per patient. Subjective and objective image assessment with all image datasets was carried out, including subgroup analyses for patients with high dose (> 2.0 MBq/kg) and low dose (≤ 2.0 MBq/kg) of 18F-FDG injection regimen.

Results

Subjective image quality ratings were significantly different among all different reconstruction algorithms as well as among BSREM using different β-values only (both p < 0.001). BSREM with a β-value of 600 was assigned the highest score for general image quality, image sharpness, and lesion conspicuity. BSREM reconstructions resulted in higher SUV _max of lung tumors compared to OSEM of up to + 28.0% ( p < 0.001). BSREM reconstruction resulted in higher signal-/ and contrast-to-background ratios of lung tumor and higher signal-/ and contrast-to-noise ratio compared to OSEM up to a β-value of 800. Lower β-values (BSREM ₄₅₀) resulted in the best image quality for high dose 18F-FDG injections, whereas higher β-values (BSREM ₆₀₀) lead to the best image quality in low dose 18F-FDG PET/CT ( p < 0.05).

Conclusions

BSREM reconstruction algorithm used in digital detector PET leads to significant increases of lung tumor SUV _max, signal-to-background ratio, and signal-to-noise ratio, which translates into a higher image quality, tumor conspicuity, and image sharpness.

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Most cited references 15

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Preoperative staging of non-small-cell lung cancer with positron-emission tomography.

H Groen, J V Houte, Randall J. Pruim … (2000)

Determining the stage of non-small-cell lung cancer often requires multiple preoperative tests and invasive procedures. Whole-body positron-emission tomography (PET) may simplify and improve the evaluation of patients with this tumor. We prospectively compared the ability of a standard approach to staging (computed tomography [CT], ultrasonography, bone scanning, and, when indicated, needle biopsies) and one involving PET to detect metastases in mediastinal lymph nodes and at distant sites in 102 patients with resectable non-small-cell lung cancer. The presence of mediastinal metastatic disease was confirmed histopathologically. Distant metastases that were detected by PET were further evaluated by standard imaging tests and biopsies. Patients were followed postoperatively for six months by standard methods to detect occult metastases. Logistic-regression analysis was used to evaluate the ability of PET and CT to identify malignant mediastinal lymph nodes. The sensitivity and specificity of PET for the detection of mediastinal metastases were 91 percent (95 percent confidence interval, 81 to 100 percent) and 86 percent (95 percent confidence interval, 78 to 94 percent), respectively. The corresponding values for CT were 75 percent (95 percent confidence interval, 60 to 90 percent) and 66 percent (95 percent confidence interval, 55 to 77 percent). When the results of PET and CT were adjusted for each other, only PET results were positively correlated with the histopathological findings in mediastinal lymph nodes (P<0.001). PET identified distant metastases that had not been found by standard methods in 11 of 102 patients. The sensitivity and specificity of PET for the detection of both mediastinal and distant metastatic disease were 95 percent (95 percent confidence interval, 88 to 100 percent) and 83 percent (95 percent confidence interval, 74 to 92 percent), respectively. The use of PET to identify the stage of the disease resulted in a different stage from the one determined by standard methods in 62 patients: the stage was lowered in 20 and raised in 42. PET improves the rate of detection of local and distant metastases in patients with non-small-cell lung cancer.

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Novel penalised likelihood reconstruction of PET in the assessment of histologically verified small pulmonary nodules

Eugene J. Teoh, Daniel McGowan, Kevin Bradley … (2015)

Objectives Investigate the effect of a novel Bayesian penalised likelihood (BPL) reconstruction algorithm on analysis of pulmonary nodules examined with 18F-FDG PET/CT, and to determine its effect on small, sub-10-mm nodules. Methods 18F-FDG PET/CTs performed for nodule evaluation in 104 patients (121 nodules) were retrospectively reconstructed using the new algorithm, and compared to time-of-flight ordered subset expectation maximisation (OSEM) reconstruction. Nodule and background parameters were analysed semi-quantitatively and visually. Results BPL compared to OSEM resulted in statistically significant increases in nodule SUVmax (mean 5.3 to 8.1, p 10 mm (n = 90, mean 42 %) (p = 0.025). Increase in signal-to-noise was higher in nodules ≤10 mm (224 %, mean 12 to 27) compared to >10 mm (165 %, mean 28 to 46). When applying optimum SUVmax thresholds for detecting malignancy, the sensitivity and accuracy increased using BPL, with the greatest improvements in nodules ≤10 mm. Conclusion BPL results in a significant increase in signal-to-background and signal-to-noise compared to OSEM. When semi-quantitative analyses to diagnose malignancy are applied, higher SUVmax thresholds may be warranted owing to the SUVmax increase compared to OSEM. Key Points • Novel Bayesian penalised likelihood PET reconstruction was applied for lung nodule evaluation. • This was compared to current standard of care OSEM reconstruction. • The novel reconstruction generated significant increases in lung nodule signal-to-background and signal-to-noise. • These increases were highest in small, sub-10-mm pulmonary nodules. • Higher SUV max thresholds may be warranted when using semi-quantitative analyses to diagnose malignancy.

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Design Features and Mutual Compatibility Studies of the Time-of-Flight PET Capable GE SIGNA PET/MR System

Craig S Levin, Sri Maramraju, Mohammad Khalighi … (2016)

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Author and article information

Contributors

Michael Messerli: +41-44-255 18 18 , michael.messerli@usz.ch

Journal

Journal ID (nlm-ta): EJNMMI Phys

Journal ID (iso-abbrev): EJNMMI Phys

Title: EJNMMI Physics

Publisher: Springer International Publishing (Cham )

ISSN (Electronic): 2197-7364

Publication date (Electronic): 26 September 2018

Publication date PMC-release: 26 September 2018

Publication date Collection: December 2018

Volume: 5

Electronic Location Identifier: 27

Affiliations

[1 ]Department of Nuclear Medicine, University Hospital Zurich/University of Zurich, Ramistrasse 100, 8091 Zurich, Switzerland

[2 ]Department of Pathology and Molecular Pathology, University Hospital Zurich/University of Zurich, Zurich, Switzerland

[3 ]GE Medical Systems (Schweiz) AG, Glattbrugg, Switzerland

Article

Publisher ID: 223

DOI: 10.1186/s40658-018-0223-x

PMC ID: 6156690

PubMed ID: 30255439

SO-VID: 182bdc03-52a8-4fbf-be19-a6670ffb0d38

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

History

Date received : 9 April 2018

Date accepted : 29 July 2018

Funding

Funded by: FundRef http://dx.doi.org/10.13039/100006775, GE Healthcare;

Award ID: Institutional grants from GE Healthcare (unrelated to current study)

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Keywords: positron-emission tomography,lung cancer,image reconstruction,pet/ct,image quality enhancement

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Keywords: positron-emission tomography, lung cancer, image reconstruction, pet/ct, image quality enhancement

Impact of a Bayesian penalized likelihood reconstruction algorithm on image quality in novel digital PET/CT: clinical implications for the assessment of lung tumors

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Most cited references 15

Preoperative staging of non-small-cell lung cancer with positron-emission tomography.

Novel penalised likelihood reconstruction of PET in the assessment of histologically verified small pulmonary nodules

Design Features and Mutual Compatibility Studies of the Time-of-Flight PET Capable GE SIGNA PET/MR System

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