Half-dose versus full-dose F-18-FDG total-body PET/CT in patients with colorectal cancer

Purpose The purpose of this study was to investigate image quality and lesion detectability of half-dose (1.85 MBq/kg) F-18-fluorodeoxyglucose (FDG) total-body positron emission tomography/computed tomography (PET/CT) for colorectal cancer, full-dose (3.7 MBq/kg) F-18-FDG serving as a reference. Methods Fifty patients confirmed to have colorectal cancer who underwent total-body PET/CT with half-dose F-18-FDG were included. Another 50 colorectal cancer patients with 3.70 MBq/kg F-18-FDG activity were selected for the full-dose group. PET images in the half-dose group were scanned for 15 min and split into 1-, 2-, 3-, 4- and 10-min duration groups, denoted G1, G2, G3, G4 and G10, respectively. In the full-dose group, PET scanning was performed for 5 min, reconstructed with the first 0.5, 1, 2 and 5 min intervals, defined as G0.5', G1', G2' and G5', respectively. Subjective image quality was assessed with 5-point Likert scales. Objective image quality parameters included maximum standardized uptake values (SUVmax), mean standardized uptake values (SUVmean)and signal-to-noise ratio (SNR) of the liver, blood pool and muscle and SUVmax and tumor-to-background ratio (TBR) of lesions. Results In the two groups, the G3 and G2' images met clinical diagnosis requirements in terms of subjective image quality, with scores >= 3. There were no differences in terms of subjective and objective image quality between the groups (G1 and G0.5', G2 and G1', G4 and G2' and G10 and G5'). In the half-dose group, 56 colorectal lesions in 50 patients confirmed by surgical pathology were clearly visible in all groups. The number of FDG-avid lymph nodes was 37 in G1, 38 in G2 and 39 in the remaining half-dose groups. The number of missed metastatic liver lesions was 1 both in G1 and G2. Conclusions Total-body PET/CT with half-dose was feasible for diagnosing and staging colorectal cancer compared with full-dose F-18-FDG PET/CT. Moreover, for half-dose total-body PET/CT, a 3-min scan duration could maintain image quality and lesion detectability.