Long axial field-of-view (AFOV) PET-CT instruments have significantly higher sensitivity than conventional PET scanners allowing for reduced scan time and/or reduced radiotracer dose. The long axial coverage also permits multi-organ dynamic imaging with fine temporal sampling. In this manuscript, we discuss how the technical advantages of long AFOV PET instruments are being realized in the clinic and exploited in research studies. We describe some practical considerations for these systems in the clinic, as well as their benefits beyond the clinic. We consider alternate scanner designs to mitigate the high cost of long AFOV systems currently in use and describe how deep learning is being applied to long AFOV PET studies to reduce image noise allowing for even shorter scans to minimize motion, aid in dynamic imaging applications and image generation. We conclude with some ideas on what future developments may be on the horizon for long AFOV PET.
Keywords: Deep learning; Long axial field-of-view PET; PET/CT; Reconstruction; Total body PET; Whole-body dynamic imaging.
© The Author(s) 2026. Published by Oxford University Press on behalf of the British Institute of Radiology.