The reconstruction algorithm used for [68Ga]PSMA-HBED-CC PET/CT reconstruction significantly influences the number of detected lymph node metastases and coeliac ganglia

  • Thomas Krohn
  • Anita Birmes
  • Oliver H. Winz
  • Natascha I. Drude
  • Felix M. Mottaghy
  • Florian F. Behrendt
  • Frederik A. Verburg
Original Article

DOI: 10.1007/s00259-016-3571-6

Cite this article as:
Krohn, T., Birmes, A., Winz, O.H. et al. Eur J Nucl Med Mol Imaging (2017) 44: 662. doi:10.1007/s00259-016-3571-6
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Abstract

Purpose

To investigate whether the numbers of lymph node metastases and coeliac ganglia delineated on [68Ga]PSMA-HBED-CC PET/CT scans differ among datasets generated using different reconstruction algorithms.

Methods

Data were constructed using the BLOB-OS-TF, BLOB-OS and 3D-RAMLA algorithms. All reconstructions were assessed by two nuclear medicine physicians for the number of pelvic/paraaortal lymph node metastases as well the number of coeliac ganglia. Standardized uptake values (SUV) were also calculated in different regions.

Results

At least one [68Ga]PSMA-HBED-CC PET/CT-positive pelvic or paraaortal lymph node metastasis was found in 49 and 35 patients using the BLOB-OS-TF algorithm, in 42 and 33 patients using the BLOB-OS algorithm, and in 41 and 31 patients using the 3D-RAMLA algorithm, respectively, and a positive ganglion was found in 92, 59 and 24 of 100 patients using the three algorithms, respectively. Quantitatively, the SUVmean and SUVmax were significantly higher with the BLOB-OS algorithm than with either the BLOB-OS-TF or the 3D-RAMLA algorithm in all measured regions (p < 0.001 for all comparisons). The differences between the SUVs with the BLOB-OS-TF- and 3D-RAMLA algorithms were not significant in the aorta (SUVmean, p = 0.93; SUVmax, p = 0.97) but were significant in all other regions (p < 0.001 in all cases). The SUVmean ganglion/gluteus ratio was significantly higher with the BLOB-OS-TF algorithm than with either the BLOB-OS or the 3D-RAMLA algorithm and was significantly higher with the BLOB-OS than with the 3D-RAMLA algorithm (p < 0.001 in all cases).

Conclusion

The results of [68Ga]PSMA-HBED-CC PET/CT are affected by the reconstruction algorithm used. The highest number of lesions and physiological structures will be visualized using a modern algorithm employing time-of-flight information.

Keywords

Prostate cancer PSMA PET/CT PSMA-HBED-CC Reconstruction algorithm Staging 

Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Thomas Krohn
    • 1
    • 5
  • Anita Birmes
    • 1
  • Oliver H. Winz
    • 1
  • Natascha I. Drude
    • 1
  • Felix M. Mottaghy
    • 1
    • 2
  • Florian F. Behrendt
    • 1
    • 3
  • Frederik A. Verburg
    • 1
    • 4
  1. 1.Department of Nuclear MedicineRWTH University Hospital AachenAachenGermany
  2. 2.Department of Nuclear MedicineMaastricht UMC+MaastrichtThe Netherlands
  3. 3.Radiology Institute “Aachen Land”WürselenGermany
  4. 4.Department of Nuclear MedicineUniversity Hospital Giessen and MarburgMarburgGermany
  5. 5.Department of Nuclear MedicineUlm UniversityUlmGermany