Description:
Aim: To evaluate the performance of a state-of-the-art digital (dPET/CT) and long
field-of-view (LAFOV) positron emission/computer tomography (PET/CT) system
and to quantify how this translates into improved image quality, lesion detection,
diagnostic certainty, lower dose, faster examinations and improved dynamic
range. In doing so, some of the first evidence for these novel systems is provided.
Methods: This thesis presents five studies which evaluate state-of-the-art
dPET/CT systems by means of a matched-pair comparison of a digital with an
analogue system, their performance and influence on diagnostic certainty and
interrater reliability, the feasibility of reduced applied radiopharmaceutical
activities in digital systems, the clinical performance of a novel LAFOV PET/CT
system and the feasibility of using these for late acquisition of images for the
diagnosis of recurrent prostate cancer.
Results: dPET/CT systems revealed higher detection rate compared to an
analogue PET/CT system as well as improved interrater reliability and diagnostic
certainty. dPET/CT systems allow for 75% reduction in applied
radiopharmaceutical activity or scan time. LAFOV PET/CT furnish orders of
magnitude increases in count density, the possibility to reduce the total
examination time to 30s or reductions in applied activity as well as the ability to
examine at much later time points once multiple half-lives have elapsed without
detriment to image quality.
Conclusion: Digital and LAFOV PET/CT systems exhibit improved performance
when compared to analogue and short-axial field-of-view systems, with
demonstrated improvement in clinically relevant outcomes such as improved
detection rate and diagnostic certainty.