Ces radiol. 2025, 79(3):168-174 | DOI: 10.55095/CesRadiol2025/020

Dynamic PET/CT on the brink of clinical applicationReview article

Gregor Horňák¹, Jaroslav Ptáček², Libuše Quinn¹

¹ Klinika nukleární medicíny LF UP a FN, Olomouc

² Oddělení lékařské fyziky a radiační ochrany LF UP a FN, Olomouc Korespondenční adresa:

The interpretation of PET imaging has traditionally relied on static images acquired after a predefined uptake period. Image quantification is typically based on the standardized uptake value (SUV). However, a major limitation of this approach is that the SUV does not directly reflect the underlying biological processes; it merely represents the normalized tracer concentration in a given voxel at the time of image acquisition. Moreover, SUV-based imaging tends to exhibit low contrast in regions with high radiotracer activity.

Assuming irreversible radiotracer uptake in the target tissue, dynamic PET imaging enables advanced image reconstruction based on the Patlak model. The resulting multiparametric PET images provide quantitative estimates of the net influx rate and the apparent distribution volume, allowing for the separation of trapped and free tracer activity in the measured signal.

Multiparametric PET offers potential advantages, including improved quantitative reliability, enhanced lesion detectability, and the possible differentiation between benign and malignant lesions. Nevertheless, its broader clinical adoption remains limited due to the technical complexity and time demands of both acquisition and analysis, despite the availability of new (semi-)automated tools.

Keywords: metabolic rate, oncology, PET imaging, Patlak analysis.

Received: August 30, 2025; Accepted: August 31, 2025; Published: December 1, 2025  Show citation