[Cancer detection with whole-body FDG PET images without attenuation correction]

Area of Science:

• Nuclear medicine
• Medical imaging
• Oncology

Background:

• Whole-body positron emission tomography (PET) with 2-deoxy-2-[18F]fluoro-D-glucose (FDG) is a valuable tool for cancer detection.
• Transmission scans are typically used for attenuation correction in PET imaging.
• However, transmission scans significantly increase acquisition time, limiting their clinical practicality for whole-body studies.

Purpose of the Study:

• To evaluate the diagnostic utility of uncorrected whole-body FDG-PET images for cancer detection.
• To determine if transmission scans are essential for identifying lesions in routine clinical whole-body PET imaging.

Main Methods:

• Thirty-two patients with suspected or known cancer underwent whole-body FDG-PET scans with transmission imaging.
• Both transmission-corrected and uncorrected PET images were reconstructed and visually inspected for lesion detection.
• A total of 106 true-positive lesions were identified on corrected images.

Main Results:

• Nearly all true-positive lesions (104/106, 98.1%) were recognizable on uncorrected images.
• Image artifacts and attenuation effects in uncorrected images did not significantly impede lesion identification in most cases.
• One case of breast cancer showed a missed metastatic lymph node on uncorrected images due to severe artifacts.

Conclusions:

• Uncorrected whole-body FDG-PET images demonstrate high accuracy for cancer detection, comparable to corrected images.
• The elimination of transmission scans could streamline whole-body PET imaging protocols.
• Uncorrected images may be sufficient for routine clinical cancer detection, potentially improving efficiency.