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Feasibility of (18)F-Fluorodeoxyglucose radiotracer dose reduction in simultaneous carotid PET/MR imaging
Mootaz Eldib1, Jason Bini1, Olivier Lairez2
1Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai New York, New York ; Department of Biomedical Engineering, The City College of New York New York.
Abstract:
The purpose of this study was to develop and validate low dose (18)F-FDG-PET acquisition protocols for detection of inflamed carotid plaques specifically for simultaneous PET/MR imaging. The hypothesis was that increasing the duration of the PET acquisition to match that of the MR acquisition might allow for the use of lower levels of the radiotracer, while preserving quantification and image quality. Seven subjects were scanned twice at least one week apart on a simultaneous PET/MR scanner using either the standard clinical dose of (18)F-FDG (373 ± 63 MBq) for 8 minutes or a low dose (93 ± 17 MBq) for 75 minutes. A maximum absolute percent difference of only 4.17% and 7.49% in the left and right carotid TBR was found between the standard dose and four time points of the low dose acquisitions (8, 24, 45, 75 minutes). Only the 8-minute low dose PET data was significantly different in terms of SNR (P = 0.009; % difference = -51%) and qualitative image quality evaluation (P = 0.0005; % difference = -45%). Our preliminary findings indicate that up to 75% reduction of the clinical standard (18)F-FDG dose could be achieved using the proposed acquisition scheme while maintaining accurate quantification and SNR.
Insights
This study developed low-dose (18)F-FDG-PET protocols for PET/MR imaging of carotid plaques. A 75% dose reduction was achieved with extended acquisition times, maintaining accurate quantification and signal-to-noise ratio.
Area of Science:
- Medical Imaging
- Nuclear Medicine
- Cardiovascular Imaging
Background:
- Inflamed carotid plaques are a significant risk factor for stroke.
- Positron Emission Tomography/Magnetic Resonance Imaging (PET/MR) offers advanced capabilities for plaque characterization.
- Standard Fluorodeoxyglucose (FDG) doses in PET/MR may not be optimal for plaque detection.
Purpose of the Study:
- To develop and validate low-dose (18)F-FDG-PET acquisition protocols for simultaneous PET/MR imaging.
- To assess if extended PET acquisition duration can compensate for reduced radiotracer dose.
- To maintain quantification accuracy and image quality for inflamed carotid plaque detection.
Main Methods:
- Seven subjects underwent dual PET/MR scans with standard (373 ± 63 MBq, 8 min) and low (93 ± 17 MBq, 75 min) (18)F-FDG doses.
- Low-dose scans were analyzed at multiple time points (8, 24, 45, 75 min).
- Tumor-to-background ratio (TBR), signal-to-noise ratio (SNR), and qualitative image quality were compared.
Main Results:
- Low-dose PET acquisitions (up to 75 min) showed minimal differences in carotid TBR (≤7.49%) compared to standard dose.
- Only the 8-minute low-dose acquisition significantly reduced SNR (-51%) and qualitative image quality (-45%).
- A reduction of up to 75% in (18)F-FDG dose is feasible with the proposed protocol.
Conclusions:
- Extended low-dose (18)F-FDG PET acquisition protocols are effective for simultaneous PET/MR imaging of carotid plaques.
- This approach allows for significant radiotracer dose reduction while preserving quantitative accuracy and image quality.
- Optimized protocols can enhance the safety and efficiency of PET/MR in cardiovascular imaging.
