Comparison of image quality and lesion detection between digital and analog PET/CT

DA López-Mora, A Flotats, F Fuentes-Ocampo, V Camacho, A Fernández, A Ruiz, J Duch, M Sizova, A Domènech, M Estorch, I. Carrió

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29 Citations (Scopus)


© 2019, Springer-Verlag GmbH Germany, part of Springer Nature. Objective: The purpose of this study was to compare image quality and lesion detection capability between a digital and an analog PET/CT system in oncological patients. Materials and methods: One hundred oncological patients (62 men, 38 women; mean age of 65 ± 12 years) were prospectively included from January–June 2018. All patients, who accepted to be scanned by two systems, consecutively underwent a single day, dual imaging protocol (digital and analog PET/CT). Three nuclear medicine physicians evaluated image quality using a 4-point scale (−1, poor; 0, fair; 1, good; 2, excellent) and detection capability by counting the number of lesions with increased radiotracer uptake. Differences were considered significant for a p value <0.05. Results: Improved image quality in the digital over the analog system was observed in 54% of the patients (p = 0.05, 95% CI, 44.2–63.5). The percentage of interrater concordance in lesion detection capability between the digital and analog systems was 97%, with an interrater measure agreement of κ = 0.901 (p < 0.0001). Although there was no significant difference in the total number of lesions detected by the two systems (digital: 5.03 ± 10.6 vs. analog: 4.53 ± 10.29; p = 0.7), the digital system detected more lesions in 22 of 83 of PET+ patients (26.5%) (p = 0.05, 95% CI, 17.9–36.7). In these 22 patients, all lesions detected by the digital PET/CT (and not by the analog PET/CT) were < 10 mm. Conclusion: Digital PET/CT offers improved image quality and lesion detection capability over the analog PET/CT in oncological patients, and even better for sub-centimeter lesions.
Original languageEnglish
Pages (from-to)1383-1390
JournalEuropean Journal of Nuclear Medicine and Molecular Imaging
Publication statusPublished - 1 Jun 2019


  • Analog PET/CT
  • Digital PET/CT
  • Image quality
  • Lesion detection capability


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