Head-to-head comparison of 18 F-sodium fluoride coronary PET imaging between a silicon photomultiplier with digital photon counting and conventional scanners

We compared silicone photomultipliers with digital photon counting (SiPM) and photomultiplier tubes (PMT) positron emission tomography (PET) in imaging coronary plaque activity with F-sodium fluoride ( F-NaF) and evaluated comprehensively SiPM PET reconstruction settings. In 25 cardiovascular disease patients (mean age 67 ± 12 years), we conducted F-NaF PET on a SiPM (Biograph Vision) and conventional PET (Discovery 710) on the same day as part of a prospective clinical trial (NCT03689946). Following administration of 250 MBq of F-NaF, patients underwent a contrast-enhanced CT angiography and a 30-min PET acquisition in list-mode on each PET consecutively. Image noise was defined as mean standard deviation of blood pool activity within the left atria. Target-to-background ratio (TBR) and signal-to-noise ratio (SNR) were measured within the whole-vessel tubular three-dimensional volumes of interest on the cardiac motion and attenuation-corrected F-NaF PET images using dedicated software. There were significant differences in image noise and background activity between the two PETs (Image noise (%), PMT: 7.6 ± 3.7 vs SiPM: 4.0 ± 2.3, P