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Purpose <p>This study aimed to establish and evaluate two evidence-based reconstruction protocols for [<sup>18</sup>F]fluciclovine PET on a high-resolution dedicated head PET system: a time-efficient protocol for routine clinical use, and a high-quality protocol designed to maximize small-lesion detectability.</p> Methods <p>A brain-tumor phantom (target-to-background ratio, 5:1) was scanned on a dedicated head PET scanner (BresTome, Shimadzu). Using a 60-min list-mode acquisition, parameters were optimized for two visually defined pathways (10-min clinical-efficiency; 30-min high-quality). The optimization sequence involved optimizing the relaxation factor (<i>β</i>) using mean percent contrast (%contrast<sub>mean</sub>), followed by a comparison of post-reconstruction filters (non-local means [NLM] and Gaussian) by maximizing a local contrast-to-noise ratio (CNR), guided by the Rose criterion. The final protocols were evaluated against Japanese brain-tumor phantom criteria for key performance metrics, including maximum percent contrast (%contrast<sub>max</sub>), relative recovery coefficient (RC), quantitative accuracy (SUV<sub>TOT</sub>), and uniformity (SD<sub>ΔSUVmean</sub>).</p> Results <p>Two distinct protocols were established. The 10-min clinical-efficiency protocol was optimized with <i>β</i> = 60 and an NLM filter (intensity 1.5), which provided the best CNR for the 7.5-mm sphere. The 30-min high-quality protocol was optimized with <i>β</i> = 70 and an NLM filter (intensity 1.0), which yielded the highest CNR for the 5-mm sphere. The 30-min protocol was required for enhanced visibility of the 5-mm sphere. Both protocols met the Japanese criteria for %contrast<sub>max</sub>, relative RC, and SUV<sub>TOT</sub>, whereas SD<sub>ΔSUVmean</sub> did not meet the criterion. Supplementary reconstructions of the full 60-min dataset met the SD<sub>ΔSUVmean</sub> criterion. In two representative clinical cases, application of the optimized protocols yielded clinically interpretable images with clear visualization of tumor uptake.</p> Conclusion <p>This study establishes a dual-pathway framework for [<sup>18</sup>F]fluciclovine PET. We recommend the 30-min high-quality protocol (<i>β</i> = 70, NLM intensity = 1.0) as the preferred option when feasible to maximize small-lesion detectability. The 10-min clinical-efficiency protocol (<i>β</i> = 60, NLM intensity = 1.5) serves as a practical, time-saving alternative for patients with limited tolerance. This approach provides a foundation for personalizing clinical protocols based on specific imaging needs and highlights the importance of standardizing uniformity assessment using an appropriate longer-duration reference acquisition for modern high-resolution PET systems.</p>

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Phantom-based optimization of [18F]fluciclovine neuro-oncology imaging on a high-resolution dedicated head PET system: dual-pathway reconstruction protocols

  • 期刊论文

  • 发表日期：

    2026年5月11日

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  • Takuro Shiiba,
  • Hiroyuki Azuma,
  • Kento Maeda,
  • Shingo Tanahashi,
  • Masanori Watanabe,
  • Kosuke Yamashita,
  • Masakazu Tsujimoto,
  • Shigeo Ohba,
  • Yoshitaka Inui,
  • Hiroshi Toyama

摘要

Purpose

This study aimed to establish and evaluate two evidence-based reconstruction protocols for [18F]fluciclovine PET on a high-resolution dedicated head PET system: a time-efficient protocol for routine clinical use, and a high-quality protocol designed to maximize small-lesion detectability.

Methods

A brain-tumor phantom (target-to-background ratio, 5:1) was scanned on a dedicated head PET scanner (BresTome, Shimadzu). Using a 60-min list-mode acquisition, parameters were optimized for two visually defined pathways (10-min clinical-efficiency; 30-min high-quality). The optimization sequence involved optimizing the relaxation factor (β) using mean percent contrast (%contrastmean), followed by a comparison of post-reconstruction filters (non-local means [NLM] and Gaussian) by maximizing a local contrast-to-noise ratio (CNR), guided by the Rose criterion. The final protocols were evaluated against Japanese brain-tumor phantom criteria for key performance metrics, including maximum percent contrast (%contrastmax), relative recovery coefficient (RC), quantitative accuracy (SUVTOT), and uniformity (SDΔSUVmean).

Results

Two distinct protocols were established. The 10-min clinical-efficiency protocol was optimized with β = 60 and an NLM filter (intensity 1.5), which provided the best CNR for the 7.5-mm sphere. The 30-min high-quality protocol was optimized with β = 70 and an NLM filter (intensity 1.0), which yielded the highest CNR for the 5-mm sphere. The 30-min protocol was required for enhanced visibility of the 5-mm sphere. Both protocols met the Japanese criteria for %contrastmax, relative RC, and SUVTOT, whereas SDΔSUVmean did not meet the criterion. Supplementary reconstructions of the full 60-min dataset met the SDΔSUVmean criterion. In two representative clinical cases, application of the optimized protocols yielded clinically interpretable images with clear visualization of tumor uptake.

Conclusion

This study establishes a dual-pathway framework for [18F]fluciclovine PET. We recommend the 30-min high-quality protocol (β = 70, NLM intensity = 1.0) as the preferred option when feasible to maximize small-lesion detectability. The 10-min clinical-efficiency protocol (β = 60, NLM intensity = 1.5) serves as a practical, time-saving alternative for patients with limited tolerance. This approach provides a foundation for personalizing clinical protocols based on specific imaging needs and highlights the importance of standardizing uniformity assessment using an appropriate longer-duration reference acquisition for modern high-resolution PET systems.