title: One year's clinical experience of 18F-FDG PET with a modified SPET camera using molecular coincidence detection.
abstract: High-quality positron emission tomographic (PET) cameras are expensive and, therefore, not available in many centres. To allow access to clinical 18F-fluorodeoxyglucose (18F-FDG) PET, we began working with an ADAC Vertex camera equipped with a molecular coincidence detection (MCD) module in February 1997. Here we give a preliminary assessment of the clinical utility of our approach. To date, 109 studies have been performed in MCD-mode using standardized protocols (99 oncology cases, 10 neurology cases). Twenty-eight cardiological and 15 other studies were performed using 511 keV collimators without attenuation correction. The average dose of 18F-FDG for MCD studies was 150 MBq, thus avoiding overloading the detectors; cardiac studies required 370 MBq. The results obtained were carefully compared with computed tomography, magnetic resonance imaging, myocardial perfusion scans, coronary angiography and conventional radiology. The results were compared on a patient basis, including histology, surgical notes, autopsy reports and follow-up data. Oncological studies were performed to assess malignancy in a particular lesion (n = 22), staging of cancer (n = 57) or to evaluate whether therapy had been successful or not (n = 20). Indications for conducting studies were categorized as appropriate (Ia) or adequate (Ib). For Ia category cases, the results were: true-positive = 31, true-negative = 12 and false-positive = 2. For Ib category cases, the corresponding figures were: true-positive = 18, true-negative = 10, false-positive = 3 and false-negative = 1. False-positive studies were a result of inflammatory disease or artefacts. Six cases with temporal lobe epilepsy were correctly identified. In cardiac studies, we also found a good correlation with clinical parameters (i.e. hibernating myocardium or scarred tissue). Altogether, this cost-effective set-up allows nuclear medicine institutions to obtain valuable data in clinical practice with a system used both for single photon emission tomography and PET.
authors.affiliation: Department of Nuclear Medicine, University of Innsbruck, Austria.
authors.forename: H
authors.initials: H
authors.lastname: Erler
authors.forename: J
authors.initials: J
authors.lastname: Zaknun
authors.forename: E
authors.initials: E
authors.lastname: Donnemiller
authors.forename: C
authors.initials: C
authors.lastname: Bacher-Stier
authors.forename: M
authors.initials: M
authors.lastname: Oberladstätter
authors.forename: G
authors.initials: G
authors.lastname: Riccabona
authors.forename: R
authors.initials: R
authors.lastname: Moncayo
mesh_terms: D003327:Coronary Disease / Q000000981:diagnostic imaging; D004827:Epilepsy / Q000000981:diagnostic imaging; D005069:Evaluation Studies as Topic; D019788:Fluorodeoxyglucose F18; D015902:Gamma Cameras; D006801:Humans; D009369:Neoplasms / Q000000981:diagnostic imaging; D009410:Nerve Degeneration / Q000000981:diagnostic imaging; D019275:Radiopharmaceuticals; D015899:Tomography, Emission-Computed, Single-Photon / Q000295:instrumentation*
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18