- [RADIOPHYSICS AND RADIOLOGICAL PROTECTION]
- [NUCLEAR MEDICINE]
- [HAEMATOLOGY AND HAEMOTHERAPY]
Ultra-low dose whole-body CT for attenuation correction in a dual tracer PET/CT protocol for multiple myeloma
Elena Prieto 1 , María José García-Velloso 2 , Jesús Dámaso Aquerreta 3 , Juan José Rosales 4 , Juan Fernando Bastidas 4 , Ignacio Soriano 5 , Leticia Irazola 6 , Paula Rodríguez-Otero 7 , Gemma Quincoces 8 , Josep María Martí-Climent 1
Purpose: To investigate within phantoms the minimum CT dose allowed for accurate attenuation correction of PET data and to quantify the effective dose reduction when a CT for this purpose is incorporated in the clinical setting.
Methods: The NEMA image quality phantom was scanned within a large parallelepiped container. Twenty-one different CT images were acquired to correct attenuation of PET raw data. Radiation dose and image quality were evaluated. Thirty-one patients with proven multiple myeloma who underwent a dual tracer PET/CT scan were retrospectively reviewed. 18F-fluorodeoxyglucose PET/CT included a diagnostic whole-body low dose CT (WBLDCT: 120 kV-80mAs) and 11C-Methionine PET/CT included a whole-body ultra-low dose CT (WBULDCT) for attenuation correction (100 kV-40mAs). Effective dose and image quality were analysed.
Results: Only the two lowest radiation dose conditions (80 kV-20mAs and 80 kV-10mAs) produced artifacts in CT images that degraded corrected PET images. For all the other conditions (CTDIvol ≥ 0.43 mGy), PET contrast recovery coefficients varied less than ± 1.2%. Patients received a median dose of 6.4 mSv from diagnostic CT and 2.1 mSv from the attenuation correction CT. Despite the worse image quality of this CT, 94.8% of bone lesions were identifiable.
Conclusion: Phantom experiments showed that an ultra-low dose CT can be implemented in PET/CT procedures without any noticeable degradation in the attenuation corrected PET scan. The replacement of the standard CT for this ultra-low dose CT in clinical PET/CT scans involves a significant radiation dose reduction.
CITATION Phys Med. 2021 Apr;84:1-9. doi: 10.1016/j.ejmp.2021.03.019. Epub 2021 Mar 31