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Record W4414654640 · doi:10.2967/jnmt.125.269555

Clinical Evaluation of BSREM Reconstruction in Pediatric Oncology Using [ <sup>18</sup> F]FDG PET/CT

2025· article· en· W4414654640 on OpenAlex
Nicholas Shkumat, Reza Vali, Amer Shammas

Why this work is in the frame

A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.

affAt least one author lists a Canadian institution in the pinned OpenAlex snapshot.

Bibliographic record

VenueJournal of Nuclear Medicine Technology · 2025
Typearticle
Languageen
FieldMedicine
TopicMedical Imaging Techniques and Applications
Canadian institutionsSickKids FoundationHospital for Sick ChildrenUniversity of Toronto
Fundersnot available
KeywordsIterative reconstructionImage qualityPediatric oncologyRegularization (linguistics)Image resolutionRetrospective cohort studyReconstruction algorithm

Abstract

fetched live from OpenAlex

Recent technologic advancements in PET, including silicon photomultipliers and block-sequential regularized expectation maximization (BSREM) tools, have allowed for renewed assessment of the optimal acquisition and reconstruction parameters in pediatric imaging. This work evaluates the performance of BSREM reconstruction and varied count density (CD) in digital [<sup>18</sup>F]FDG PET/CT to investigate the feasibility of reducing the injected activity or duration of acquisition in children with cancer. <b>Methods:</b> Five hundred unique reconstructions from 20 pediatric patients evaluated with PET/CT per clinical standard of care (SOC) were included in this retrospective study. Three-dimensional, whole-body imaging was acquired on a silicon photomultiplier PET/CT system in list mode with time-of-flight modeling. Imaging volumes were reconstructed with varying time per bed position (180, 120, 90, 60, and 45 s) to simulate a range of CDs using conventional iterative techniques (ordered-subset expectation maximization) and BSREM with varied regularization strength (β, 175–700). Two pediatric nuclear medicine physicians individually scored all studies, with patient information, reconstruction method, and CD concealed, rating technical quality and overall diagnostic satisfaction on a 5-point Likert scale. Quantitative SUV measurements on all reconstructions were compared with the clinical SOC. <b>Results:</b> Reconstruction with BSREM with a β of 500 or greater significantly improved overall scores across all CDs when compared with ordered-subset expectation maximization. Noise performance improved after application of a higher regularization parameter. Spatial resolution (sharpness) was greatest with a β of 350. Mean overall image quality at 25% CD using a β of 500 or greater was considered diagnostic. Mean liver and blood-pool SUV-to-noise ratio performed best with the highest β and CD. SUV<sub>max</sub> behavior was complex, varying with reconstruction strength and CD, with measurements at β of 500 or greater differing from the SOC by no more than 15% across all CDs, and specific combinations varying by 10% or less. <b>Conclusion:</b> Clinical evaluation of whole-body [<sup>18</sup>F]FDG PET/CT in pediatric patients was diagnostic at all reductions in CD when using BSREM with a β of 500 or greater. Quantitative performance was variable, yet SUV<sub>max</sub> differences of 10% or less were achievable with the appropriate selection of acquisition and reconstruction parameters. This study found that customized imaging parameters can reduce injected activity (radiation dose) and imaging time to best suit the pediatric patient.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.004
metaresearch head score (Gemma)0.003
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Other design · Consensus signal: none
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.707
Threshold uncertainty score0.514

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0040.003
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0010.000
Bibliometrics0.0020.001
Science and technology studies0.0000.001
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.001
Insufficient payload (model declined to judge)0.0000.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.087
GPT teacher head0.457
Teacher spread0.370 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it