The standard reconstruction in the department where patients were recruited is a PSF reconstruction algorithm (HD; TrueX, Siemens Medical Solutions; 3 iterations and 21 subsets) without filtering. For the purpose of the present study, raw data were also reconstructed with the OSEM reconstruction algorithm (4 iterations and 8 subsets) and a PSF reconstruction algorithm (HD; TrueX, Siemens Medical Solutions; 3 iterations and 21 subsets) with a 7 mm Gaussian filter (PSF7). As shown in a previous study, this latter reconstruction leads to protocol-specific images with NEMA NU-2 phantom-based filtering that meet EANM quantitative harmonizing standards, therefore reducing reconstructiondependent variation in SUVs [12] (link). The OSEM reconstruction parameters met the EANM requirements regarding activity recovery. For all reconstructions, matrix size was 168 × 168 voxels, resulting in isotropic voxels of 4.07 × 4.07 × 4.07 mm 3 . Scatter and attenuation (using the associated CT) corrections were applied.
Truex
Manufactured by Siemens
Sourced in Germany
The TrueX is a laboratory equipment product offered by Siemens. It is designed to perform specific functions within a laboratory setting. The core function of the TrueX is to [PROVIDE CONCISE DESCRIPTION OF CORE FUNCTION WITHOUT EXTRAPOLATION].
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11 protocols using truex
1
Quantitative PET Imaging Harmonization Protocols
2
PET Image Reconstruction Protocols
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FDG-PET raw data were reconstructed with four algorithms and respective presets provided by the manufacturer: 3D-ordered subset expectation maximization (3D-OSEM; iterations, 2; subsets, 24), 3D-OSEM + time-of-flight analysis (3D-OSEM + TOF; iterations, 2; subsets, 21), iterative reconstruction with system-specific PSF modeling (PSF; Siemens TrueX®, ‘HD∙PET’; iterations, 2; subsets, 24), and PSF + TOF (Siemens ‘ultraHD∙PET’; iterations, 2; subsets, 21) [15 (link)]. The projection data were reconstructed with 3-mm slice thickness (rows, 200; columns, 200; voxel size, 4.1 × 4.1 × 3.0 mm). After reconstruction, a Gaussian filter (FWHM, 2 mm) was applied to all data. Attenuation correction CT raw data were reconstructed with a slice thickness of 3 mm and a filter for abdominal low-dose CT (convolution kernel, B30f).
3
PET Image Reconstruction Techniques
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PET raw data were reconstructed with the PSF reconstruction algorithm (HD; TrueX, Siemens Medical Solutions; 3 iterations and 21 subsets) without filtering (PSFallpass) [6 (link)] and with the 3D-OSEM reconstruction algorithm (4 iterations and 8 subsets). Scatter and attenuation corrections were carried out. For all HN PET reconstructions, matrix size was 256 × 256 (vs. 168 × 168 for WB acquisition), resulting in a 2.67 × 2.67 × 2.67 mm voxel size (small-voxels). For each PSFallpass or 3D-OSEM reconstruction, five datasets were reconstructed from this LM acquisition, from 2 to 10 min with a 2-min increment. Overall, ten HN PET data sets were obtained per patient.
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Standardized 18F-FDG PET/CT Imaging Protocol
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All patients underwent 18F-FDG PET/CT acquisitions using an integrated PET/CT scanner (Biograph 64 PET/CT scanner, Asahi-Siemens Medical Technologies, Tokyo). Before tracer injection, the patient fasted for at least 6 h. Following a blood glucose test to confirm blood glucose levels less than 150 mg/dL, PET images were acquired 60 min after an intravenous injection of 18F-FDG (4–5 MBq/kg). Emission scanning for 3 min per bed was carried out following the CT image acquisition for attenuation corrections.
The acquired datasets were corrected for attenuation, dead-time and scatter, and the images were reconstructed using a point spread function-based iterative algorithm (TrueX, Siemens) [18 (link)] with two iterations per 21 subsets with 512 × 512-pixel matrix, a matrix size of 168 × 168, a voxel size of 4.1 × 4.1 × 2.0 mm, and a Gaussian filter at 4.0- mm full-width at half-maximum. The transaxial and axial field of views were 58.5 cm and 21.6 cm, respectively.
The acquired datasets were corrected for attenuation, dead-time and scatter, and the images were reconstructed using a point spread function-based iterative algorithm (TrueX, Siemens) [18 (link)] with two iterations per 21 subsets with 512 × 512-pixel matrix, a matrix size of 168 × 168, a voxel size of 4.1 × 4.1 × 2.0 mm, and a Gaussian filter at 4.0- mm full-width at half-maximum. The transaxial and axial field of views were 58.5 cm and 21.6 cm, respectively.
5
Dual-Phase Brain FDG PET/CT Imaging Protocol
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PET/CT Image Reconstruction Protocol
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PET raw data were reconstructed using iterative reconstruction with system-specific point spread function (PSF) modelling and time of flight (TOF) analysis (Siemens TrueX®, UltraHD PET®; iterations: 2; subsets: 21). Projection data were reconstructed with a 5 mm slice thickness (rows: 512; columns: 512; voxel size: 1.5 × 1.5 × 5.0 mm). After reconstruction, a Gaussian filter (full width half maximum [FWHM], 2 mm) was applied. CT raw data were reconstructed with a slice thickness of 5 mm and a special filter for low-dose CT (convolution kernel, B19f).
7
FDG-PET/CT Imaging Protocol for Normoglycemic Patients
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A biograph mCT PET/CT system (Siemens Healthcare) was used according to a standard clinical protocol [12 (link)]. Patients were instructed to have no caloric intake for 4 h prior to FDG administration. All patients were normoglycaemic (blood glucose below 150 mg/dL) at the time of FDG injection. After the injection of a weight-based dose of FDG (4.0 MBq/kg), patients rested for 60 min in a dark quiet room to allow for tissue uptake. PET scans were performed for 10 min using 3D acquisition and time-of-flight technology. The crystal of the PET/CT system was lutetium oxyorthosilicate, and the imaging matrix was 400 × 400. Each dataset consisted of 90 transaxial PET images with a 2-mm slice thickness and a 256-mm field-of-view (voxel: 2 × 2 × 2 mm3). CT for attenuation correction was acquired for each patient with the same protocol (120 kVp, 50–135 mAs, detector 64 rows × 1.2 mm). Images were reconstructed using a time-of-flight and commercially available technique, the TrueX (Siemens) technique, with an all-pass filter (iteration, 8; subsets, 21).
8
FDG PET/CT Imaging with UFH
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FDG PET/CT data were acquired using a Biograph 64 True Point PET scanner with TrueV (Siemens Healthcare, Tokyo). Each patient fasted for at least 18 h before imaging. FBS levels were checked before the FDG injection. Approximately 4.5 MBq/kg of FDG was intravenously administrated under a resting condition. A static PET scan was performed 60 min after the administration of FDG. Intravenous preadministration of UFH was applied in the 25 patients at both the initial scan and the second scan: 5 patients only at the initial scan and 2 patients only at the second scan. Six patients did not receive a UFH injection at any scan.
The acquired datasets were corrected for attenuation by low-dose CT images and were reconstructed using a point-spread function-based iterative algorithm (TrueX; Siemens) with two iterations per 21 subsets, a matrix size of 168 × 168, a voxel size of 4.1 × 4.1 × 2.0 mm, and a Gaussian filter at 4.0 mm full width at half maximum. The transaxial and axial fields of view were 58.5 cm and 21.6 cm, respectively.
The acquired datasets were corrected for attenuation by low-dose CT images and were reconstructed using a point-spread function-based iterative algorithm (TrueX; Siemens) with two iterations per 21 subsets, a matrix size of 168 × 168, a voxel size of 4.1 × 4.1 × 2.0 mm, and a Gaussian filter at 4.0 mm full width at half maximum. The transaxial and axial fields of view were 58.5 cm and 21.6 cm, respectively.
9
Retrospective Analysis of 68Ga-PSMA-11 PET/CT Imaging
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We retrospectively analyzed the 68 Ga-PSMA-11 PET/CT images of prostate cancer patients who had undergone renal function testing (creatinine) within 14 d of imaging. All images were obtained in the Nuclear Medicine Department at Dresden Municipal Hospital.
Tracer Production and Image Acquisition 68 Ga-PSMA-11 was radiolabeled with an automated module (Scintomics GRP) as described previously (24) .
Whole-body PSMA PET/CT images were obtained using a Biograph 16 PET/CT camera (Siemens Healthineers) approximately 60 min after intravenous injection of 100-150 MBq (2.7-4.0 mCi) of 68 Ga-PSMA-11.
Before PET image acquisition, a low-dose, unenhanced CT scan from vertex to mid thigh was obtained for attenuation correction, anatomic localization, and gross anatomic correlation. The CT parameters included 16 mAs, 120 kV, a 0.8 pitch, 0.5s, 20 3 0.6 mm collimation, and a 5-mm reconstructed slice thickness.
The PET acquisition time was 3 min per bed position. The images were corrected for attenuation on the basis of the CT data, reconstructed using an iterative algorithm (Siemens TrueX), and reformatted, as well as fused online into transaxial, coronal, and sagittal views with Syngo Via MM Oncology VB40 (Siemens Healthineers).
Tracer Production and Image Acquisition 68 Ga-PSMA-11 was radiolabeled with an automated module (Scintomics GRP) as described previously (24) .
Whole-body PSMA PET/CT images were obtained using a Biograph 16 PET/CT camera (Siemens Healthineers) approximately 60 min after intravenous injection of 100-150 MBq (2.7-4.0 mCi) of 68 Ga-PSMA-11.
Before PET image acquisition, a low-dose, unenhanced CT scan from vertex to mid thigh was obtained for attenuation correction, anatomic localization, and gross anatomic correlation. The CT parameters included 16 mAs, 120 kV, a 0.8 pitch, 0.5s, 20 3 0.6 mm collimation, and a 5-mm reconstructed slice thickness.
The PET acquisition time was 3 min per bed position. The images were corrected for attenuation on the basis of the CT data, reconstructed using an iterative algorithm (Siemens TrueX), and reformatted, as well as fused online into transaxial, coronal, and sagittal views with Syngo Via MM Oncology VB40 (Siemens Healthineers).
10
PET/CT Imaging of Fluoride Biodistribution
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The studies were performed on 2 PET/CT scanners (Biograph True-Point 64 and Biograph 16; Siemens Healthcare) 45 min after a 3.7 MBq/kg intravenous injection of 18 F-sodium fluoride. PET whole-body images (from the skull to the feet) were acquired in 3-dimensional mode at a rate of 90 s/bed position and then underwent iterative reconstruction (2 iterations of 8 subsets and a gaussian filter) or TrueX (Siemens) reconstruction plus time-offlight reconstruction (2 iterations of 21 subsets with a gaussian filter). The CT acquisition parameters included a slice thickness of 5 mm, 120 kV, or CARE Dose4D (Siemens), with no intravenous CT contrast administration.
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