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Respiratory-gated PET imaging with reduced acquisition time for suspect malignancies: the first experience in application of total-body PET/CT

  • Nuclear Medicine
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

This study aimed to investigate the performance of respiratory-gating imaging with reduced acquisition time using the total-body positron emission tomography/computed tomography (PET/CT) scanner.

Methods

Imaging data of 71 patients with suspect malignancies who underwent total-body 2-[18F]-fluoro-2-deoxy-D-glucose PET/CT for 15 min with respiration recorded were analyzed. For each examination, four reconstructions were performed: Ungated-15, using all coincidences; Ungated-5, using data of the first 5 min; Gated-15 using all coincidences but with respiratory gating; and Gated-6 using data of the first 6 min with respiratory gating. Lesions were quantified and image quality was evaluated; both were compared between the four image sets.

Results

A total of 390 lesions were found in the thorax and upper abdomen. Lesion detectability was significantly higher in gated-15 (97.2%) than in ungated-15 (93.6%, p = 0.001) and ungated-5 (92.3%, p = 0.001), but comparable to Gated-6 (95.9%, p = 0.993). A total of 131 lesions were selected for quantitative analyses. Lesions in Gated-15 presented significantly larger standardized uptake values, tumor-to-liver ratio, and tumor-to-blood ratio, but smaller metabolic tumor volume, compared to those in Ungated-15 and Ungated-5 (all p < 0.001). These differences were more obvious in small lesions and in lesions from sites other than mediastinum/retroperitoneum. However, these indices were not significantly different between Gated-15 and Gated-6. Higher, but acceptable, image noise was identified in gated images than in ungated images.

Conclusions

Respiratory-gating imaging with reduced scanning time using the total-body PET/CT scanner is superior to ungated imaging and can be used in the clinic.

Key Points

• In PET imaging, respiratory gating can improve lesion presentation and detectability but requires longer imaging time.

• This single-center study showed that the total-body PET scanner allows respiratory-gated imaging with reduced and clinically acceptable scanning time.

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Abbreviations

AFOV:

Axial field of view

MTV:

Metabolic tumor volume

PET/CT:

Positron emission tomography/computed tomography

SNR:

Signal-to-noise ratio

SUV:

Standardized uptake value

TBR:

Tumor-to-blood ratio

TLR:

Tumor-to-liver ratio

VOI:

Volume of interest

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Funding

This study was funded by the Shanghai “Rising Stars of Medical Talent”–Youth Development Program (grant number: HWJRS2019-72 to G.L.), the Shanghai Municipal Key Clinical Specialty Project (grant number: SHSLCZDZK03401 to H.S.), the Major Science and Technology Projects for Major New Drug Creation (grant number: 2019ZX09302001 to H.S.), the Shanghai Science and Technology Committee Program (grant number: 20DZ2201800 to H.S.), the Three-year Action Plan of Clinical Skills and Innovation of Shanghai Hospital Development Center (grant number: SHDC2020CR3079B to H.S.), and the Next Generation Information Infrastructure Construction Project founded by Shanghai Municipal Commission of Economy and Informatization (grant number: 201901014 to H.S.).

Author information

Author notes

  1. Guobing Liu and Shuguang Chen contributed equally to this article.

Authors and Affiliations

  1. Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, No. 180 in Fenglin Road, Shanghai, 200032, China

    Guobing Liu, Shuguang Chen, Yan Hu & Hongcheng Shi

  2. Institute of Nuclear Medicine, Fudan University, Shanghai, 200032, China

    Guobing Liu, Shuguang Chen, Yan Hu & Hongcheng Shi

  3. Shanghai Institute of Medical Imaging, Shanghai, 200032, China

    Guobing Liu, Shuguang Chen, Yan Hu & Hongcheng Shi

  4. Cancer Prevention and Treatment Center, Zhongshan Hospital, Fudan University, Shanghai, 200032, China

    Guobing Liu, Shuguang Chen, Yan Hu & Hongcheng Shi

  5. Central Research Institute, United Imaging Healthcare Group Co., Ltd., Shanghai, 201807, China

    Shuangliang Cao, Xinlan Yang & Yun Zhou

Authors
  1. Guobing Liu
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  2. Shuguang Chen
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  3. Yan Hu
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  4. Shuangliang Cao
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  5. Xinlan Yang
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  6. Yun Zhou
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  7. Hongcheng Shi
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Corresponding author

Correspondence to Hongcheng Shi.

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Guarantor

The scientific guarantor of this publication is Hongcheng Shi.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

One of the authors has significant statistical expertise.

Informed consent

Written informed consent was obtained from all patients in this study.

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Institutional Review Board approval was obtained.

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• prospective

• diagnostic

• performed at one institution

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Liu, G., Chen, S., Hu, Y. et al. Respiratory-gated PET imaging with reduced acquisition time for suspect malignancies: the first experience in application of total-body PET/CT. Eur Radiol 33, 3366–3376 (2023). https://doi.org/10.1007/s00330-022-09369-z

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  • DOI: https://doi.org/10.1007/s00330-022-09369-z

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