Search

Peri-therapeutic (124)I-PET/CT is of interest as guidance for radioiodine therapy. Unfortunately, image quality is complicated by dead time effects and increased random coincidence rates from high (131)I-activities. A series of phantom experiments with clinically relevant (124)I/(131)I-activities were performed on a clinical PET/CT-system. Noise equivalent count rate (NECR) curves and quantitation accuracy were determined from repeated scans performed over several weeks on a decaying NEMA NU-2 1994 cylinder phantom initially filled with 25 MBq (124)I and 1250 MBq (131)I. Six spherical inserts with diameters 10-37 mm were filled with (124)I (0.45 MBq ml(-1)) and (131)I (22 MBq ml(-1)) and placed inside the background of the NEMA/IEC torso phantom. Contrast recovery, background variability and the accuracy of scatter and attenuation corrections were assessed at sphere-to-background activity ratios of 20, 10 and 5. Results were compared to pure (124)I-acquisitions. The quality of (124)I-PET images in the presence of high (131)I-activities was good and image quantification unaffected except at very high count rates. Quantitation accuracy and contrast recovery were uninfluenced at (131)I-activities below 1000 MBq, whereas image noise was slightly increased. The NECR peaked at 550 MBq of (131)I, where it was 2.8 times lower than without (131)I in the phantom. Quantitative peri-therapeutic (124)I-PET is feasible.

PET/CT with non-pure positron emitters is a highly valuable tool in immuno-PET and for pretherapeutic dosimetry. However, imaging is complicated by prompt gamma coincidences (PGCs) that add an undesired background activity to the images. Time-of-flight (TOF) reconstruction improves lesion detectability in (18)F-PET and can potentially also improve the signal-to-noise ratio in images acquired with non-pure positron emitters. Using the GE Discovery 690 PET/CT system, we evaluated the image quality with (55)Co, (86)Y and (124)I, and the effect of PGC-correction and TOF-reconstruction on image quality and quantitation in a series of phantom studies. PET image quality and quantitation for all isotopes were significantly affected by PGCs. The effect was most severe with (86)Y, and less, but comparable, with (55)Co and (124)I. PGC-correction improved the image quality and the quantitation accuracy dramatically for all isotopes, especially when the activity was limited to a few hot lesions in a warm background. In imaging situations, where high levels of activity were present in the background, activity concentrations were overestimated. TOF-reconstruction improved image quality in isolated lesions but worsened the accuracy of quantitation and uniformity in homogeneous activity distributions. Better modelling of PGCs in the scatter correction can potentially improve the situation.