在临床常规中实施个性化方案需要多样化的低剂量 PET/CT 扫描方案。本研究探讨了三分之一 (1/3) 剂量方案的临床可行性，并评估了基于 BMI 的 1/3 注射剂量进行 2-[18F]FDG PET/CT 成像的诊断图像质量和病变可检测性。 4 名癌症患者接受了全身 2-[18F]FDG PET/CT 检查，其中 37 名回顾性入组为全剂量组（3.7 MBq/kg），37 名前瞻性入组为 1/3 剂量组（1.23 MBq/kg） ）。 1/3剂量组按BMI分层，BMI< 25、25≤ BMI ≤ 29和BMI > 29的采集时间为5分钟（G5）、6分钟（G6）和8分钟（G8） ， 分别。对图像质量进行主观和客观评估，并对病变可检测性进行定量分析。1/3剂量和全剂量PET图像的主观评估在读者之间显示出很强的一致性(κ > 0.88)。在1/3剂量组中，Likert评分高于4。G5、G6和G8显示出相当的图像质量，其中G5表现出比G6和G8更高的病变明显性(p = 0.045)。客观评价显示1/3剂量组和全剂量组之间SUVmax、肝脏SUVmean和TBR没有显着差异(p>0.05)。在 1/3 剂量组和全剂量组之间，所有 BMI 类别的原发肿瘤 SUVmax、肝脏 SUVmean 和 TBR 没有观察到统计学差异。 1/3 剂量组 (93.24%, 193/207) 和全剂量组 (94.73%, 198/209) 之间的病变检出率没有显着差异 (p = 0.520)。 BMI 分层 1/3 剂量方案是一种可行的低剂量替代方案，其临床可接受的病变可检测性相当于全剂量方案，有可能扩大个性化方案的适用性。这项研究表明，[18F]FDG 全身 PET 的 BMI 分层 1/3 剂量方案与全剂量方案相比，/CT 产生了相当的输出，这符合剂量和 BMI 个性化的临床需求。目前，可用的个性化低剂量全身 PET/CT 方案有限，特别是对于不同 BMI 的患者。将放射性示踪剂剂量减少至标准的 1/3，证明了与全剂量相当的图像质量和病变可检测性。 BMI 分层 1/3 剂量方案是临床上可行的低剂量替代方案。© 2024。作者，获得欧洲放射学会的独家许可。

Implementing personalization protocol in clinical routine necessitates diverse low-dose PET/CT scan protocols. This study explores the clinical feasibility of one-third (1/3) dose regimen and evaluates the diagnostic image quality and lesion detectability of BMI-based 1/3-injection doses for 2-[18F]FDG PET/CT imaging.Seventy-four cancer patients underwent total-body 2-[18F]FDG PET/CT examination, with 37 retrospectively enrolled as full-dose group (3.7 MBq/kg) and 37 prospectively enrolled as the 1/3-dose group (1.23 MBq/kg). The 1/3-dose group was stratified by BMI, with an acquisition time of 5 min (G5), 6 min (G6), and 8 min (G8) for BMI < 25, 25 ≤ BMI ≤ 29, and BMI > 29, respectively. Image quality was subjectively and objectively assessed, and lesion detectability was quantitatively analyzed.Subjective assessments of 1/3-dose and full-dose PET images showed strong agreement among readers (κ > 0.88). In the 1/3-dose group, the Likert scores were above 4. G5, G6, and G8 showed comparable image quality, with G5 demonstrating higher lesion conspicuity than G6 and G8 (p = 0.045). Objective evaluation showed no significant differences in SUVmax, liver SUVmean and TBR between 1/3- and full-dose groups (p > 0.05). No statistical differences were observed in the SUVmax of primary tumor, SUVmean of liver and TBR across all BMI categories between the 1/3-dose and full-dose groups. Lesion detection rates showed no significant difference between the 1/3-dose (93.24%, 193/207) and full-dose groups (94.73%, 198/209) (p = 0.520).A BMI-stratified 1/3-dose regimen is a feasible low-dose alternative with clinically acceptable lesion detectability equivalent to full-dose protocol, potentially expanding the applicability of personalized protocols.This study demonstrated that BMI-stratified 1/3-dose regimens for [18F]FDG total-body PET/CT yielded equivalent outputs compared to the full-dose regimen, which aligns with clinical needs for personalization in dose and BMI.Currently, limited personalized low-dose total-body PET/CT protocols are available, particularly for patients with varied BMI. Reducing the radiotracer dose to 1/3 the standard demonstrated comparable image quality and lesion detectability equivalent to full dose. BMI-stratified 1/3-dose regimen is a clinically feasible low-dose alternative.© 2024. The Author(s), under exclusive licence to European Society of Radiology.