PET/CT was performed 50 min after an intravenous injection of 3.5 MBq/kg FDG via an already secured peripheral venous catheter. Images from the head to the mid-thigh were acquired in three-dimensional (3D) mode at 2 min per bed position in the supine position using a PET/CT scanner (Discovery ST Elite, GE Healthcare, Waukesha, WI, USA) with a 16-slice Light-Speed CT component. All participants fasted for 6 h before undergoing PET/CT, and all participants had fasting blood glucose levels of <150 mg/dl before the injection. Non-contrast-enhanced CT images (140 kVp, 100–200 mAs) were acquired in the helical mode using a 3.75-mm slice thickness. The acquired data were reconstructed using a standard vendor-provided ordered subset expectation maximization algorithm (VUE point plus). CT, PET, and PET/CT images were all reviewed.
Discovery st elite
Manufactured by GE Healthcare
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The Discovery ST Elite is a positron emission tomography (PET) imaging system designed for clinical and research applications. It is capable of acquiring high-quality PET data to support medical diagnosis and treatment monitoring.
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11 protocols using discovery st elite
1
FDG-PET/CT Imaging Protocol for Metabolic Evaluation
2
68Ga-DOTATOC PET/CT Imaging Protocol
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PET/CT scanning was performed using a combined PET/CT scanner (Discovery ST Elite; GE Healthcare, Waukesha, WI, USA). This system integrates a PET scanner with multidetector-row CT (16 detectors) and permits acquisition of co-registered CT and PET images during a single examination. For DOTATOC-PET/CT scanning, approximately 130 MBq of 68Ga-DOTATOC was injected intravenously, and whole-body PET/CT scanning was performed approximately 60 min after injection. Just before the PET/CT scanning, patients were requested to void the bladder. Initially, starting at the level of the thigh, the low-dose CT scans were acquired during shallow breathing, and scanning included the area from the upper thigh to the skull. Immediately after CT, a PET emission scan was acquired with an acquisition time of 3 min per bed position. For one patient in group A and two patients in group C, diagnostic CT scans were also performed 30 and 90 s after intravenous administration of 100 mL iopromide (Iopamiron 300; Nihon Beyer, Osaka, Japan) with an injection rate of 3 mL/s. The total acquisition time was 20–30 min. Unenhanced CT data were used for attenuation correction, and images were reconstructed using a commercial three-dimensional iterative reconstruction algorithm called VUE Point Plus (matrix 128 × 128, interval 3.27 mm, 2 iterations, 14 subsets).
3
Thyroid Dysfunction Evaluation Using PET/CT
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This study was approved by the ethical review board of the University of Tokyo Hospital. Adults who visited our hospital for whole-body medical screening between November 2006 and November 2017 were enrolled in the study. All participants provided written informed consent that their medical images could be used for research purposes. As part of the screening program, PET/CT scans were performed using single-type scanners (Discovery ST Elite, GE Healthcare). Whole-body non-contrast CT images were acquired using the following parameters: field of view (FOV), 500 mm; matrix size, 512 × 512; voxel size, 0.98 × 0.98 × 1.25 mm. The PET images were acquired with the following parameters: FOV, 700 mm; matrix size, 128 × 128; voxel size, 5.47 × 5.47 × 3.25 mm.
Hypothyroidism and hyperthyroidism, defined as elevated and decreased thyroid-stimulating hormone (TSH) levels, respectively, are usually diagnosed based on blood test results. These can be defined as subclinical dysfunctions when T4 is within the normal range and overt dysfunctions when T4 is outside the reference values (decreased for hypothyroidism and increased for hyperthyroidism) (7 (link), 8 (link)). The normal ranges were set to 0.45–4.5 μIU/mL for TSH and 0.8–1.7 ng/dL for T4. In all cases, thyroid hormone levels were determined using blood tests performed on the same day as the PET/CT scan.
Hypothyroidism and hyperthyroidism, defined as elevated and decreased thyroid-stimulating hormone (TSH) levels, respectively, are usually diagnosed based on blood test results. These can be defined as subclinical dysfunctions when T4 is within the normal range and overt dysfunctions when T4 is outside the reference values (decreased for hypothyroidism and increased for hyperthyroidism) (7 (link), 8 (link)). The normal ranges were set to 0.45–4.5 μIU/mL for TSH and 0.8–1.7 ng/dL for T4. In all cases, thyroid hormone levels were determined using blood tests performed on the same day as the PET/CT scan.
4
FDG-PET Brain Scan for Epilepsy
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The FDG-PET brain scan was performed on a discovery ST Elite PET/CT scanner (GE Medical Systems, Milwaukee, WI, USA) at Hiroshima-Heiwa Clinic, to evaluate focal abnormalities in regional cerebral metabolic rate (rCMR). Low rCMR indicates areas of hypometabolism, suggestive of the epileptogenic foci14 (link). The area of hypometabolism was visually confirmed and its validation was determined through discussion at a preoperative PMC.
5
FDG-PET Imaging for Lung Cancer Evaluation
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In our institute, all patients with lung cancer had undergone FDG-PET before surgery. However, patients with blood glucose levels of 150 mg/dL or more were excluded from positron emission tomography/computed tomography (PET/CT) acquisition. All PET/CT examinations were performed using a dedicated PET/CT scanner (Discovery ST Elite; GE Healthcare, Tokyo, Japan). PET/CT scanning was performed at 60 minutes after the intravenous injection of 150 to 220 MBq of 18FDG (FDGscan, Universal Giken, Nihon Mediphysics, Tokyo, Japan). The regions of interest (ROI) were placed three-dimensionally over the lung cancer nodules. A semi-quantitative analysis of the images was performed by measuring the SUVmax of the lesions. The SUV was calculated based on the following equation:
6
Integrated cPET/CT Imaging Protocol
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We performed cPET/CT with an integrated PET/CT scanner; Discovery ST Elite (GE Healthcare, Waukesha, WI, United States). CT parameters were as follows: 120 kVp, 3.75-mm slice thickness, 500-mm transaxial FOV and 512 × 512 image matrix. PET parameters were as follows: 3.27-mm slice thickness, 700-mm transaxial FOV, 250-mm axial FOV, 128 × 128 image matrix, and 2.14-mm Gaussian post-reconstruction image filter, and scan duration of 15 minutes. TOF-reconstruction was not available for cPET.
Attenuation correction was performed using CT data. All cPET images were reconstructed with a three-dimensional (3D) ordered subsets expectation-maximization algorithm called VUE Point Plus (4 iterations, 12 subsets, matrix size of 192 × 192, voxel size of 3.3 × 3.3 × 3.3 mm, and postfiltering at 2 mm full width at half maximum (FWHM)). The sensitivity is 8.8 cps/kBq [21] .
Attenuation correction was performed using CT data. All cPET images were reconstructed with a three-dimensional (3D) ordered subsets expectation-maximization algorithm called VUE Point Plus (4 iterations, 12 subsets, matrix size of 192 × 192, voxel size of 3.3 × 3.3 × 3.3 mm, and postfiltering at 2 mm full width at half maximum (FWHM)). The sensitivity is 8.8 cps/kBq [21] .
7
Quantitative [11C]TGN-020 PET/CT Imaging
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The [11C]TGN-020 PET/computed tomography (CT) scan was acquired using a combination PET/CT scanner (Discovery ST Elite, GE Healthcare). Low-dose CT scans were performed in helical mode with 120 kVp, 50 mA, helical thickness of 3.75 mm, and 15 cm field of view positioned in the region of the cerebrum. [11C]TGN-020 (160-272 MBq, 2.2-4.2 MBq/kg body weight) was administered intravenously in 2 min by syringe pump (PHD2000, Harvard, Cambridge, Massachusetts). PET emission data were acquired over 30 min in 3-dimensional (3D) statistic mode, from 10 min after the administration of [11C]TGN-020, with a 25.6 cm axial field of view. The emission scans were reconstructed with a 128× 128× 47 matrix (a voxel size of 2.0× 2.0× 3.27 mm) using a 3D ordered subset expectation maximization iterative reconstruction algorithm (2 iterations and 28 subsets) after attenuation correction using the CT data. All PET images were transferred to a workstation Xeleris 3.1 (GE Healthcare) for analysis. Tissue activity concentration was expressed as the standardized uptake value (SUV), g/ml, corrected for subject's body weight and administrated dose of radioactivity.
8
PET Imaging Acquisition Protocol for Cerebral Scans
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PET imaging was performed using a combined PET/CT scanner (Discovery ST Elite, GE Healthcare, Schenectady NY, USA) with a 15-cm field of view (FOV) positioned in the region of the cerebrum. For correcting photon attenuation, a low-dose CT scan was acquired in helical mode with the following parameters: 120 kV, 50 mA, 0.8 s per tube rotation, slice thickness of 3.75 mm with intervals of 3.27 mm, pitch of 0.875, and a table speed of 17.5 mm/rotation. During the scanning procedure, the participant’s head was rested on a foam-cushioned headrest, and a head strap was used to minimize head movement. All PET emission scans were normalized for detector inhomogeneity and corrected for random coincidences, dead time, scattered radiation, and photon attenuation. These scans were reconstructed using three-dimensional ordered-subset expectation maximization (3D-OSEM) with two iterations and 28 subsets to obtain superior visual quality images, allowing manual definition of regions of interest (ROIs). For the reconstruction algorithms, the data were collected in a 128 × 128 × 47 matrix with a voxel size of 2.0 × 2.0 × 3.27 mm.
9
PET/CT Imaging Protocol for 18F-FDG Whole-Body Scans
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PET scanning was performed using a combined PET/CT scanner (Discovery ST Elite; GE Healthcare). All patients fasted for 4 h or more before the administration of 18 F-FDG. Whole-body PET scanning, from the level of the thigh to that of the head, was started approximately 60 min after injection of a dose of 3.7 MBq/kg of 18 F-FDG. CT scans of the same areas were acquired, using approximately 30 mAs of current time product. Both PET and CT scans were obtained under conditions of shallow breathing. PET images were reconstructed with CT-derived attenuation correction using an iterative reconstruction algorithm (2 iterations, 12 subsets).
10
PET/CT Scanning Protocol for MET Tracer
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PET/CT scanning was performed using a combined PET/CT scanner (Discovery ST Elite; GE Healthcare, Waukesha, Wisconsin, USA). This system integrates a PET scanner with a multidetector-row CT scanner (16 detectors). PET/CT scanning was performed at 15-34 min (mean 26 min) after intravenous injection of 441-906 MBq of MET. The scanning range was from the neck to the thorax.
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