Algorithm for Reducing Overall Biological Detriment Caused by PET/CT: an Age-Based Study

Nucl Med Mol Imaging. 2023 Jun;57(3):137-144. doi: 10.1007/s13139-023-00788-4. Epub 2023 Feb 4.

Abstract

Purpose: This study is to use a simple algorithm based on patient's age to reduce the overall biological detriment associated with PET/CT.

Materials and methods: A total of 421 consecutive patients (mean age 64 ± 14 years) undergoing PET for various clinical indications were enrolled. For each scan, effective dose (ED in mSv) and additional cancer risk (ACR) were computed both in a reference condition (REF) and after applying an original algorithm (ALGO). The ALGO modified the mean dose of FDG and the PET scan time parameters; indeed, a lower dose and a longer scan time were reported in the younger, while a higher dose and a shorter scan time in the older patients. Moreover, patients were classified by age bracket (18-29, 30-60, and 61-90 years).

Results: The ED was 4.57 ± 0.92 mSv in the REF condition. The ACR were 0.020 ± 0.016 and 0.0187 ± 0.013, respectively, in REF and ALGO. The ACR for the REF and ALGO conditions were significantly reduced in males and females, although it was more evident in the latter gender (all p < 0.0001). Finally, the ACR significantly reduced from the REF condition to ALGO in all three age brackets (all p < 0.0001).

Conclusion: Implementation of ALGO protocols in PET can reduce the overall ACR, mainly in young and female patients.

Keywords: Additional cancer risk; Effective dose; FDG; PET; Radiation risk.