EXPLORER: Changing the molecular imaging paradigm with total-body PET/CT (Conference Presentation)

Positron emission tomography (PET) is the highest sensitivity technique for human whole-body imaging studies. However, current clinical PET scanners do not make full use of the available signal, as they only permit imaging of a 15-25 cm segment of the body at one time. Given the limited sensitive region, whole-body imaging with clinical PET scanners requires relatively long scan times and subjects the patient to higher than necessary radiation doses. The EXPLORER initiative aims to build a 2-meter axial length PET scanner to allow imaging the entire subject at once, capturing nearly the entire available PET signal. EXPLORER will acquire data with ~40-fold greater sensitivity leading to a six-fold increase in reconstructed signal-to-noise ratio for imaging the total body. Alternatively, total-body images with the EXPLORER scanner will be able to be acquired in ~30 seconds or with ~0.15 mSv injected dose, while maintaining current PET image quality. The superior sensitivity will open many new avenues for biomedical research. Specifically for cancer applications, high sensitivity PET will enable detection of smaller lesions. Additionally, greater sensitivity will allow imaging out to 10 half-lives of positron emitting radiotracers. This will enable 1) metabolic ultra-staging with FDG by extending the uptake and clearance time to 3-5 hours to significantly improve contrast and 2) improved kinetic imaging with short-lived radioisotopes such as C-11, crucial for drug development studies. Frequent imaging studies of the same subject to study disease progression or to track response to therapy will be possible with the low dose capabilities of the EXPLORER scanner. The low dose capabilities will also open up new imaging possibilities in pediatrics and adolescents to better study developmental disorders. This talk will review the basis for developing total-body PET, potential applications, and review progress to date in developing EXPLORER, the first total-body PET scanner.