[ 18 F]-PSMA-1007 PET imaging optimization and inter-rater reliability - a comparison of three different reconstructions read by four radiologists

Nucl Med Commun. 2024 May 1;45(5):389-395. doi: 10.1097/MNM.0000000000001823. Epub 2024 Feb 5.

Abstract

Objectives: To increase understanding of optimal imaging parameters [ 18 F]PSMA-1007 when imaging patients with prostate cancer and to determine interrater agreement using [ 18 F]PSMA-1007.

Methods: In this observational study, four independent physicians read reconstruction sets using bedtimes of 1, 2 and 3 minutes of patients undergoing [ 18 F]PSMA-1007. positron emission topography. Clear and equivocal lesions and their locations were recorded. Image noise was rated on a four-point scale. Lesion counts were compared using inter-class correlation whereas noise ratings were compared using generalized estimating equations. Repeated cases were used to assess intra-rater agreement.

Results: Sixty reconstruction sets of 16 consecutively examined participants were included. Participants had a mean age of 71.5 years, six of them were examined prior to any treatment, three had a history of radiotherapy and seven of prostatectomy. Median Gleason score of primary tumors was 7. Imaging was performed after a mean of 132 min using a mean 3.95 MBq/Kg body weight of [ 18 F] PSMA-1007. Neither the total number of lesions per location nor the proportion of equivocal lesions varied consistently between bedtimes. Inter-rater reliability scores varied depending on location from 0.40 to 1.0 and were similar for all bedtimes. Intra-rater reliability varied between 0.70 and 0.76 for the three different bedtimes. Noise ratings were significantly lower for 1 minute than 3 minutes per bed.

Conclusion: In the setting of [ 18 F]PSMA-1007 PET CT, 1, 2 and 3 minutes per bed produce similar results unlikely to affect clinical interpretation. Image noise ratings favor 2 and 3 minutes per bed.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Gallium Radioisotopes
  • Humans
  • Male
  • Niacinamide / analogs & derivatives*
  • Oligopeptides*
  • Positron Emission Tomography Computed Tomography / methods
  • Positron-Emission Tomography*
  • Prostatic Neoplasms* / pathology
  • Reproducibility of Results

Substances

  • PSMA-1007
  • Gallium Radioisotopes
  • Niacinamide
  • Oligopeptides