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Respiratory-gated time-of-flight PET/CT during whole-body scan for lung lesions: feasibility in a routine clinical setting and quantitative analysis

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Abstract

Purpose

To demonstrate the feasibility of respiratory gating during whole-body scan for lung lesions in routine 18F-FDG PET/CT examinations using a time-of-flight (TOF)-capable scanner to determine the effect of respiratory gating on reduction of both misregistration (between CT and PET) and image blurring, and on improvement of the maximum standardized uptake value (SUVmax).

Materials and methods

Patients with lung lesions who received FDG PET/CT were prospectively studied. Misregistration, volume of PET (Vp), and SUVmax were compared between ungated and gated images. The difference in respiratory gating effects was compared between lesions located in the upper or middle lobes (UML) and the lower lobe (LL). The correlation between three parameters (% change in misregistration, % change in Vp, and lesion size) and % change in SUVmax was analyzed.

Results

The study population consisted of 60 patients (37 males, 23 females; age 68 ± 12 years) with lung lesions (2.5 ± 1.7 cm). Fifty-eight out of sixty respiratory gating studies were successfully completed with a total scan time of 20.9 ± 1.9 min. Eight patients’ data were not suitable for analysis, while the remaining 50 patients’ data were analyzed. Respiratory gating reduced both misregistration by 21.4 % (p < 0.001) and Vp by 14.2 % (p < 0.001). The SUVmax of gated images improved by 14.8 % (p < 0.001). The % change in misregistration, Vp, and SUVmax by respiratory gating tended to be larger in LL lesions than in UML lesions. The correlation with % change in SUVmax was stronger in % change in Vp (r = 0.57) than % change in misregistration (r = 0.35). There was no statistically significant correlation between lesion size and % change in SUVmax (r = −0.20).

Conclusions

Respiratory gating during whole-body scan in routine TOF PET/CT examinations is feasible and can reduce both misregistration and PET image blurring, and improve the SUVmax of lung lesions located primarily in the LL.

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Authors and Affiliations

  1. Department of Radiology, Ise Red Cross Hospital, 1-471-2 Funae, Ise, Mie, 516-8512, Japan

    Naohisa Suzawa

  2. Department of Radiology, Mie University Hospital, Tsu, Mie, Japan

    Yasutaka Ichikawa, Masaki Ishida, Yoya Tomita & Hajime Sakuma

  3. Department of Electronic and Computer Engineering, Ritsumeikan University, Kusatsu, Shiga, Japan

    Ryohei Nakayama

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  1. Naohisa Suzawa
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  2. Yasutaka Ichikawa
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  3. Masaki Ishida
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  4. Yoya Tomita
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  5. Ryohei Nakayama
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  6. Hajime Sakuma
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Correspondence to Naohisa Suzawa.

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The authors declare no conflicting financial interest and no funding. No potential conflicts of interest were disclosed.

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Suzawa, N., Ichikawa, Y., Ishida, M. et al. Respiratory-gated time-of-flight PET/CT during whole-body scan for lung lesions: feasibility in a routine clinical setting and quantitative analysis. Ann Nucl Med 30, 722–730 (2016). https://doi.org/10.1007/s12149-016-1118-3

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  • DOI: https://doi.org/10.1007/s12149-016-1118-3

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