DOI: 10.1007/s00259-016-3571-6Pages: 662-669

The reconstruction algorithm used for [68Ga]PSMA-HBED-CC PET/CT reconstruction significantly influences the number of detected lymph node metastases and coeliac ganglia

1. RWTH University Hospital Aachen, Department of Nuclear Medicine

2. Maastricht UMC+, Department of Nuclear Medicine

3. Radiology Institute “Aachen Land”

4. University Hospital Giessen and Marburg, Department of Nuclear Medicine

5. Ulm University, Department of Nuclear Medicine

Correspondence to:
Thomas Krohn
Tel: +49-731-500 613 01




To investigate whether the numbers of lymph node metastases and coeliac ganglia delineated on [68Ga]PSMA-HBED-CC PET/CT scans differ among datasets generated using different reconstruction algorithms.


Data were constructed using the BLOB-OS-TF, BLOB-OS and 3D-RAMLA algorithms. All reconstructions were assessed by two nuclear medicine physicians for the number of pelvic/paraaortal lymph node metastases as well the number of coeliac ganglia. Standardized uptake values (SUV) were also calculated in different regions.


At least one [68Ga]PSMA-HBED-CC PET/CT-positive pelvic or paraaortal lymph node metastasis was found in 49 and 35 patients using the BLOB-OS-TF algorithm, in 42 and 33 patients using the BLOB-OS algorithm, and in 41 and 31 patients using the 3D-RAMLA algorithm, respectively, and a positive ganglion was found in 92, 59 and 24 of 100 patients using the three algorithms, respectively. Quantitatively, the SUVmean and SUVmax were significantly higher with the BLOB-OS algorithm than with either the BLOB-OS-TF or the 3D-RAMLA algorithm in all measured regions (p < 0.001 for all comparisons). The differences between the SUVs with the BLOB-OS-TF- and 3D-RAMLA algorithms were not significant in the aorta (SUVmean, p = 0.93; SUVmax, p = 0.97) but were significant in all other regions (p < 0.001 in all cases). The SUVmean ganglion/gluteus ratio was significantly higher with the BLOB-OS-TF algorithm than with either the BLOB-OS or the 3D-RAMLA algorithm and was significantly higher with the BLOB-OS than with the 3D-RAMLA algorithm (p < 0.001 in all cases).


The results of [68Ga]PSMA-HBED-CC PET/CT are affected by the reconstruction algorithm used. The highest number of lesions and physiological structures will be visualized using a modern algorithm employing time-of-flight information.

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  • Accepted: Nov 9, 2016
  • Online: Nov 29, 2016

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