Whole-Body 18F-FDG PET/CT: The Need for a Standardized Field of View-A Referring-Physician Aid
Whole-Body 18F-FDG PET/CT: The Need for a Standardized Field of View-A Referring-Physician Aid
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DOI：
10.2967/jnmt.109.073353
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发表时间：
2010-09-01
影响因子：
1.3
通讯作者：
Osman, Medhat M.
中科院分区：
文献类型：
--
作者：
Huston, Scott F.;Abdelmalik, Amir G.;Osman, Medhat M.
解剖学和功能成像模式的 PET/CT 融合正在不断发展，并迅速在临床传播。全身 PET/CT 协议选择的成像视野 (FOV) 并未标准化，并且因机构而异。对“全身”一词的误用，以及通过减少扫描时间来增加日常研究数量的压力，导致了标准化的缺乏。本研究的目的是评估私人和学术 PET 中心全身 PET/CT 方案所选择的视野和手臂定位的变化。方法：对 200 项连续的全身 F-18-FDG PET/CT 研究进行 FOV 回顾性审查：50 项研究来自私人固定站点，50 项研究来自 2 个独立的私人移动站点（每个站点 25 项连续研究），100 项研究来自固定大学站点：50 项在实施覆盖头顶到脚底的真正全身方案之前和之后 50 项。数据分为 5 种不同的解剖扫描长度：颅底到大腿上部、颅底到大腿中部、头顶到大腿上部、头顶到大腿中部以及真实的全身。研究进一步分为两种患者手臂位置：向上和向下。结果：私人固定和移动站点仅识别出 2 类解剖扫描长度：颅底到大腿中部，以及头顶到大腿上部。在大学现场，在实施真正的全身协议之前，确定了 5 种不同的解剖扫描长度；实施后，仅识别出真实的全身扫描长度。私人固定部位的患者手臂 100% 处于下降状态。在私人移动网站上，患者的手臂在 72% 的时间里向上，在 28% 的时间里向下。在大学现场，患者的手臂有 54% 的时间是向上的，有 46% 的时间是向下的。在实施真正的全身方案后，同一部位的患者手臂有 58% 的时间向上抬起，42% 的时间向下。总体而言，患者手臂向上的时间为 46%，向下的时间为 54%。结论：继续使用“全身”一词会产生误导，因为它通常可能不包括大脑、头骨或上肢和下肢的重要部分。 PET/CT 解剖扫描长度不仅在一个部位与下一个部位之间存在差异，而且在各个部位内也存在差异。医疗保险和医疗补助服务中心目前有不同的程序术语代码，区分颅底到大腿上部和覆盖头骨顶部到脚底的真正全身，从而强调需要标准化描述 PET/CT 扫描长度的术语。
PET/CT fusion of anatomic and functional imaging modalities is in evolution, with rapid clinical dissemination. The imaged field of view (FOV) selected for whole-body PET/CT protocols is not standardized and varies by institution. Misuse of the term whole body, as well as the pressure to increase the number of daily studies by reducing scanning time, contributes to the lack of standardization. The purpose of this study was to evaluate variations in the FOV and arm positioning selected for whole-body PET/CT protocols at private, as well as academic, PET centers. Methods: Two hundred consecutive whole-body F-18-FDG PET/CT studies were retrospectively reviewed for FOV: 50 studies from a private stationary site, 50 studies from 2 separate private mobile sites (25 consecutive studies from each), and 100 studies from a stationary university site: 50 before and 50 after implementation of a true whole-body protocol covering the top of the head through the bottom of the feet. Data were categorized into 5 different anatomic scan lengths: base of skull to upper thigh, base of skull to mid thigh, top of head to upper thigh, top of head to mid thigh, and true whole-body. Studies were further categorized into 2 patient arm positions: up and down. Results: The private stationary and mobile sites had only 2 categories of anatomic scan lengths identified: base of skull to mid thigh, and top of head to upper thigh. At the university site, before implementation of a true whole-body protocol, the 5 different anatomic scan lengths were identified; after implementation, only the true whole-body scan length was identified. Patients' arms in the private stationary sites were down 100% of the time. At the private mobile sites, patients' arms were up 72% of the time and down 28% of the time. At the university site, patients' arms were up 54% of the time and down 46% of the time. The same site, after implementation of a true whole-body protocol, had patients' arms up 58% of the time and down 42% of the time. Overall, patients' arms were up 46% of the time and down 54% of the time. Conclusion: The continued use of the term whole body is misleading because frequently it may not include the brain, skull, or significant portions of the upper and lower extremities. PET/CT anatomic scan length varied not only from one site to the next but also within individual sites. The Centers for Medicare and Medicaid Services have different current procedural terminology codes distinguishing between base of skull to upper thigh and true whole-body covering the top of the skull to the bottom of the feet, thus underscoring the need to standardize the terminology used in describing PET/CT scan length.