Total-Body 18F-FDG PET/CT: More Choices to Promote Clinical Scanning Efficiency

Background The study aims to maximize clinical scan efficiency for Total-body (TB) ¹⁸ F-FDG PET/CT systems by optimizing scan strategies based on theoretical models and clinical experience from a single center. Results This prospective study include two parts. The first part involved simulation experiments using theoretical models to maximize patient throughput and/or minimizing radiotracer activity across four clinical scanning scenarios: fixed working time, predetermined radiotracer activity, integration of various injection dose regimens for a fixed number of patients, and incorporation of dynamic scans into routine static scans within a fixed working time. The optimal scan strategies for these scenarios were then proposed. The second part validated the estimated throughput results through high-throughput tests performed in the real clinical settings with an fixed working time of 8 hours. Under a fixed working time of 8 hours, the theoretical patient throughput for full-dose, half-dose, 1/3-dose, and 1/10-dose injection regimens was 60, 48, 43, 30 patients, respectively. The corresponding real clinical throughput achieved was 60, 49, 48, 28 patients. For a total ¹⁸ F-FDG activity of 37,000 to 148,000 MBq (1 to 4 Ci), the 1/3 dose injection regimen yielded the highest patient throughput, ranging 52 to 72 patients. Strategically combining various injection dose regimens could reduce radiotracer activity consumption. Additionally, placing full-dose dynamic scans after routine static scans for full-dose, half-dose, and 1/3 dose, and before 1/10 dose, proved to ba more economical strategies. Conclusions Optimized scan strategies for typical clinical scenarios of TB ¹⁸ F-FDG PET/CT systems were proposed, which could promote clinical scan efficiency and accommodate diverse clinical requirements.