Performance of digital PET/CT compared with conventional PET/CT in oncologic patients: a prospective comparison study

Area of Science:

• Nuclear medicine
• Medical imaging
• Oncology

Background:

• Digital PET (dPET) systems offer improved lesion detectability over conventional PET (cPET) systems.
• High-resolution imaging is crucial for accurate cancer staging and restaging.

Purpose of the Study:

• To prospectively compare the performance of high-resolution dPET with high- and standard-resolution cPET in cancer patients.
• To evaluate the impact of acquisition order on scanner performance.

Main Methods:

• 212 cancer patients underwent FDG-PET/CT on both dPET and cPET scanners in a randomized order.
• Three reconstructions were compared: standard-resolution cPET, high-resolution cPET, and high-resolution dPET.
• Experienced readers blindly assessed and ranked image reconstructions based on lesion detection and diagnostic confidence.

Main Results:

• High-resolution dPET demonstrated superior lesion detection and diagnostic confidence compared to both cPET resolutions (p < 0.001).
• Readers preferred high-resolution dPET in 90% of cases, versus 44% for high-resolution cPET and 1% for standard-resolution cPET (p < 0.001).
• When dPET was acquired first, no significant difference in preference was observed between high-resolution dPET and high-resolution cPET (p = 0.41).

Conclusions:

• High-resolution dPET systems outperform cPET systems in lesion detection and reader confidence for cancer staging.
• When dPET is acquired first, high-resolution cPET with a prolonged FDG uptake time shows comparable performance.
• Prolonged FDG uptake time can enhance the diagnostic utility of high-resolution cPET, offering a potential alternative.