Advantages of SiPM-based digital PET/CT technology in nuclear medicine clinical practice: a systematic review– part 2

Purpose Novel digital PET/CT (dPET) scanners with silicon photomultipliers (SiPM) present multiple technical improvements compared to analog PET (aPET) systems. This systematic review aimed to summarize the current literature evidence about the clinical advantages offered by dPET technology. Methods The PubMed/MEDLINE and Embase databases were systematically queried according to the PRISMA guidelines. Full texts were screened for eligibility and the methodological quality was evaluated by four independent authors using the CASP Diagnostic Study checklist. Results 81 out of 510 articles were included (39 related to the non-oncologic setting). In patients with primary hyperparathyroidism, dPET has shown a significantly higher detection rate for hyperfunctioning glands, especially subcentimetric. dPET has also shown a higher image quality and diagnostic accuracy compared to aPET in the visual and semiquantitative assessment of metabolic impairment in patients with suspected neurodegenerative diseases. The enhanced quantification of dPET has also been leveraged in cardiovascular diseases, where 82Rb dPET myocardial blood-flow assessment has shown potential to further advance the diagnostic and prognostic role of molecular imaging in coronary artery disease. Finally, dPET has allowed to optimize imaging protocols through reduced administered activities and/or scan times: a 3/3.5-fold reduced scan time was proven feasible in FDG/DOTA/PSMA imaging, thus allowing to limit radiation exposure, lower imaging costs and increase patient throughput. Conclusions dPET has shown improved diagnostic performance compared to aPET in multiple non-oncological settings owing to its higher detection rates, enhanced image quality and accurate quantification. dPET also enabled more personalized imaging protocols through reduced administered activities and/or scan times.