Impact of a deep progressive reconstruction algorithm on low-dose or fast-scan PET image quality and Deauville score in patients with lymphoma.

Abstract

Background: A deep progressive learning method for PET image reconstruction named deep progressive reconstruction (DPR) method was developed and presented in previous works. It has been shown in previous study that the DPR with one-third duration can maintain the image quality as OSEM with standard dose (3.7 MBq/kg). Subsequent studies have shown we can reduce the administered activity of ¹⁸F-FDG by up to 2/3 in a real-world deployment with DPR. The aim of this study is to assess the impact of the use of DPR on Deauville score (DS) and clinical interpretation of PET/CT in patients with lymphoma.

Methods: A total of 87 lymphoma patients (age, 45.1 ± 14.9 years) who underwent ¹⁸F-FDG PET imaging for during or post-treatment follow-up from November 2020 to February 2024 were prospectively enrolled. The patients were randomly assigned to two groups, including the 1/3 standard dose group and the standard dose group. Forty-four patients were injected with 1/3 standard dose (1.23 MBq/kg) and scanned for 6 min per bed and were reconstructed: ordered-subsets expectation maximization (OSEM) with 6 min per bed (OSEM_6 min_1/3), OSEM_2 min_1/3 and DPR_2 min_1/3. Forty-three patients were scanned according to the standard protocol (3.7 MBq/kg) and were reconstructed: OSEM with 2 min per bed (OSEM_2 min_full), OSEM_40 s_full and DPR_40 s_full. Additionally, the conventional 5-point scale measurement analysis was performed and DS for lymphoma were determined in different groups. Wilcoxon signed-rank test was used to compare the mean values of liver SUVmax and mediastinal blood pool (MBP) SUVmax in each group. Likert scale and DS were evaluated using Wilcoxon signed rank test.

Results: The patients with OSEM_6 min_1/3 and DPR_2 min_1/3 showed good image quality with 5(5,5) and 5(4,5) of Likert scoring, as well as the patients with OSEM_2 min_full and DPR_40 s_full. No significant difference was found between the OSEM_6 min_1/3 and DPR_2 min_1/3 groups in terms of liver SUVmax and MBP SUVmax (P = 0.452 and 0.430), as well as the patients with OSEM_2 min_full and DPR_40 s_full (P = 0.105 and 0.638). No significant difference was found between the OSEM_6 min_1/3 and DPR_2 min_1/3 groups in terms of lesion SUVmax (P = 0.080). There was a significant differences in lesion SUVmax between OSEM-2 min_full with DPR-40 s_full (P = 0.027). The DS results were consistent (100%) between OSEM-6 min_1/3 with DPR_2 min_1/3, and between OSEM-2 min_full with DPR-40 s_full, respectively.

Conclusions: DPR reconstruction demonstrated feasibility in reducing PET injection dose or scanning time, while ensuring the preservation of image quality and DS for during or post-treatment follow-up patients with lymphoma.