Isabel Rauscher1, Wolfgang P Fendler2,3, Thomas A Hope4, Andrew Quon3, Stephan G Nekolla5, Jeremie Calais3, Antonia Richter5, Bernhard Haller6, Ken Herrmann2,3, Wolfgang A Weber5, Johannes Czernin3, Matthias Eiber5,3. 1. Department of Nuclear Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany isabel.rauscher@tum.de. 2. Department of Nuclear Medicine, University Hospital Essen, Essen, Germany. 3. Ahmanson Translational Imaging Division, Department of Molecular and Medical Pharmacology, UCLA Medical Center, Los Angeles, California. 4. Department of Radiology and Biomedical Imaging, University of California, San Francisco, California; and. 5. Department of Nuclear Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany. 6. Institute of Medical Informatics, Statistics and Epidemiology, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany.
Abstract
Our purpose was to define a clinically useful lower limit of injected dose for 68Ga-prostate-specific membrane antigen (PSMA)-11 PET/CT imaging of prostate cancer. Methods: 68Ga-PSMA-11 PET/CT was performed on 11 patients. PET was acquired in list mode and reconstructed using a 3-min full acquisition, a 2-min acquisition, and a 1-min acquisition to generate images obtained with three thirds (standard dose), two thirds (low dose), and one third (very low dose) of the injected dose, respectively. Overall image quality (5-point scale) was assessed, and the detectability of PSMA-positive lesions was determined by 3 readers and compared with the reference standard. Results: Image quality declined with decreasing dose (mean score of 4.1 ± 0.4 for the standard dose, 3.4 ± 0.7 for the low dose, and 1.9 ± 0.4 for the very low dose; all P < 0.05). Readers 1, 2, and 3 correctly identified the lesions (n = 21) at a rate of 100%, 100%, and 95% with the standard dose; 95%, 81%, and 90% with the low dose; and 71%, 76%, and 59% with the very low dose, respectively. Conclusion: 68Ga-PSMA-11 dose reduction is not feasible without a negative impact on image quality and lesion detectability.
Our purpose was to define a clinically useful lower limit of injected dose for 68Ga-prostate-specific membrane antigen (PSMA)-11 PET/CT imaging of prostate cancer. Methods: 68Ga-PSMA-11 PET/CT was performed on 11 patients. PET was acquired in list mode and reconstructed using a 3-min full acquisition, a 2-min acquisition, and a 1-min acquisition to generate images obtained with three thirds (standard dose), two thirds (low dose), and one third (very low dose) of the injected dose, respectively. Overall image quality (5-point scale) was assessed, and the detectability of PSMA-positive lesions was determined by 3 readers and compared with the reference standard. Results: Image quality declined with decreasing dose (mean score of 4.1 ± 0.4 for the standard dose, 3.4 ± 0.7 for the low dose, and 1.9 ± 0.4 for the very low dose; all P < 0.05). Readers 1, 2, and 3 correctly identified the lesions (n = 21) at a rate of 100%, 100%, and 95% with the standard dose; 95%, 81%, and 90% with the low dose; and 71%, 76%, and 59% with the very low dose, respectively. Conclusion: 68Ga-PSMA-11 dose reduction is not feasible without a negative impact on image quality and lesion detectability.
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