Comparison of Image Quality and Semi-quantitative Measurements with Digital PET/CT and Standard PET/CT from Different Vendors

Abstract

Purpose: This study aimed to evaluate the concordance and equivalence of results between the newly acquired digital PET/CT(dPET) and the standard PET/CT (sPET) to investigate possible differences in visual and semi-quantitative analyses. Methods: A total of 30 participants were enrolled and underwent a single 18F-FDG injection followed by dual PET/CT scans, by a dPET scan, and immediately after by the sPET scan or vice versa. Two readers reviewed overall image quality using a 5-point scale and counted the number of suggestive 18F-FDG avid lesions. The SUV values were measured in the background organs and in hypermetabolic target lesions. Additionally, we objectively evaluated image quality using the liver signal-to-noise ratio (SNR). Results: The dPET identified 4 additional 18F-FDG avid lesions in 3 of 30 participants with improved visual image quality. The standard deviations of SUV of the background organs were significantly lower with DigitalPET than with sPET, and dPET could acquire images with better SNR (11.13 ± 2.01 vs. 8.71 ± 1.32, P < 0.001). The reliability of SUV values between scanners showed excellent agreement. Bland-Altman plot analysis of 81 lesions showed an acceptable agreement between scanners for most of the SUVmax and SUVpeak values. No relationship between the SUV values and time delays of dual PET/CT acquisition was found. Conclusions: The dPET provides improved image quality and lesion detectability than the sPET. The semi-quantitative values of the two PET/CT systems of different vendors are comparable. This pilot study will be an important basis for possible interchangeable use of either system in clinical practice.