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Related Concept Videos

Positron Emission Tomography01:29

Positron Emission Tomography

Positron emission tomography (PET) is a medical imaging technique involving radiopharmaceuticals — substances that emit short-lived radiation. Although the first PET scanner was introduced in 1961, it took 15 more years before radiopharmaceuticals were combined with the technique and revolutionized its potential.
One of the main requirements of a PET scan is a positron-emitting radioisotope, which is produced in a cyclotron and then attached to a substance used by the part of the body being...

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PET/CT acquisition and processing protocols in the Netherlands.

Dennis B M Dieckens1, Pepijn van Horssen2, Koen A J van Gils3

  • 1Department of Medical Physics, Albert Schweitzer Hospital, Dordrecht, Kingdom of the Netherlands.

EJNMMI Physics
|June 19, 2025
PubMed
Summary

Significant variations in PET/CT protocols and injected activity exist across Dutch hospitals, leading to substantial differences in patient radiation doses for common scans like FDG-WB and PSMA. These inconsistencies highlight a need for standardization in nuclear medicine imaging practices.

Keywords:
Image qualityOptimalisationPET/CT

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Area of Science:

  • Nuclear Medicine
  • Radiology
  • Medical Imaging

Background:

  • Positron Emission Tomography/Computed Tomography (PET/CT) is crucial for diagnosing and staging various diseases.
  • Standardization of acquisition and processing protocols is essential for consistent image quality and accurate patient management.
  • Existing literature suggests potential variability in PET/CT protocols, but comprehensive data from a national cohort is limited.

Purpose of the Study:

  • To assess the current variations in acquisition and processing protocols for four common PET/CT examinations in the Netherlands.
  • To analyze differences in injected activity, scan duration, and their correlation with scanner sensitivity across Dutch hospitals.
  • To quantify the impact of protocol variations on patient radiation dose.

Main Methods:

  • A nationwide survey was conducted among all Dutch nuclear medicine departments with PET/CT scanners.
  • Data on injected activity, acquisition times, and reconstruction/post-processing settings were collected for FDG-WB, [18F]F-PSMA, [68Ga]Ga-PSMA, and FDG-Brain PET/CT.
  • Analysis included weight-dependent injected activity, acquisition count statistics, and correlations with scanner performance (NEMA sensitivity).

Main Results:

  • Responses from 42 hospitals (58 PET/CT systems) revealed wide variations in injected activity and scan duration, even for identical scanner models and examination types.
  • Scanner sensitivity showed a moderate negative correlation with the injected activity × scan duration product for FDG-WB and FDG-Brain, but less so for [18F]F-PSMA and not significantly for [68Ga]Ga-PSMA.
  • Observed variations in injected activity resulted in patient radiation dose differences by factors of 4-5 for FDG-WB and FDG-Brain, and over 10 for PSMA tracers, persisting after accounting for other factors.

Conclusions:

  • Significant inconsistencies in PET/CT imaging protocols exist across Dutch hospitals, leading to substantial variations in patient radiation doses.
  • Protocol variations cannot be solely explained by differences in scanning or uptake times, indicating a need for further investigation into count statistics and processing settings.
  • Standardization of PET/CT protocols is recommended to ensure consistent diagnostic accuracy and minimize unnecessary radiation exposure.