Clinical applications of long axial field-of-view PET/CT scanners in oncology

Purpose: To provide a comprehensive overview of the current main applications of long axial field-of-view (LAFOV) PET/CT in oncology. Methods: Relevant studies published from 2017 up to September 2022 were selected by searching Scopus, PubMed, and Web of Science. The following data were extracted: characteristics of studies and patients, technical aspects, and usefulness of the LAFOV PET/CT in the oncological setting. Selected imaging studies were analyzed using a modified version of the Critical Appraisal Skills Programme (CASP). Results: Seventeen papers were finally selected: 12 (70.6%) were retrospective, while 5 (29.4%) were prospective, with an overall number of 877 included patients. Most of the studies (14/17, 82.4%) employed [18F]-FDG as a radiopharmaceutical agent, 2 papers used [68Ga]-PSMA-11 and 1 employed mixed tracers. Eleven studies were focused on protocols at low/ultra-low activity or with fast/ultra-fast scanning time, 3 papers compared the performance of LAFOV PET/CT scanners with that of conventional (standard axial field-of-view/SAFOV) devices, 4 were total-body PET dynamic studies. Conclusions: LAFOV PET/CT showed superior diagnostic performance than traditional SAFOV devices, allowing reduced activity/time and dynamic protocols. The applications of this novel technology in some clinical settings, mainly the pediatric population, are promising but should be a topic of future investigations.