Current progress and future perspectives in total-body positron emission tomography/computed tomography. Part II: Clinical applications

Total-body positron emission tomography (TB-PET) has significantly advanced from initial conception to global commercial availability. The high sensitivity of TB-PET has led to superior lesion detection, thereby expanding the range of clinical applications. TB-PET technology offers several advantages: (a) It enables the detection of small lesions, facilitating precise cancer staging and targeted cancer formulation. (b) The technology shortens the acquisition time while maintaining the quality of diagnostic images. (c) TB-PET allows for a reduction in the amount of administered radiotracer, which minimizes image noise, reduces the effective radiation dose to patients, and enhances staff safety. (d) The scanner supports the development of new tracers and the dynamic imaging of these tracers throughout the entire body. (e) TB-PET accommodates delayed scanning, which has been shown to improve the detection of small and previously undetected malignant lesions by enhancing the clearance in areas of significant background activity. (f) Owing to its high-quality images, TB-PET is suitable for parametric imaging, which offers several advantages over conventional standardized uptake value imaging. However, TB-PET still faces several challenges. There is a lack of consensus on the optimal dose and scan duration for clinical diagnosis using TB-PET. Additionally, unified standards for parametric imaging via TB-PET are yet to be established, and the full clinical significance of this technology remains under-explored. The accompanying review (Part 1) covers TB-PET data manipulation and analysis.