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

Suzawa, Naohisa; Ichikawa, Yasutaka; Ishida, Masaki; Tomita, Yoya; Nakayama, Ryohei; Sakuma, Hajime

doi:10.1007/s12149-016-1118-3

Cited by 12 publications

(4 citation statements)

References 21 publications

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“…These results are consistent with previous studies assessing respiratory gating. Indeed, authors reported an increase of the value of SUVmax ranging from 7 to 159% for lung lesions, especially for lung cancer ( 14 – 18 ). In our study, increase value of SUVmax ranged from −19 to 168%.…”

Section: Discussionmentioning

confidence: 99%

Feasibility of Systematic Respiratory-Gated Acquisition in Unselected Patients Referred for 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography

et al. 2018

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ObjectiveRespiratory motion in 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) induces blurred images, leading to errors in location and quantification for lung and abdominal lesions. Various methods have been developed to correct for these artifacts, and most of current PET/CT scanners are equipped with a respiratory gating system. However, they are not routinely performed because their use is time-consuming. The aim of this study is to assess the feasibility and quantitative impact of a systematic respiratory-gated acquisition in unselected patients referred for FDG PET/CT, without increasing acquisition time.MethodsPatients referred for a FDG PET/CT examination to the nuclear medicine department of Brest University Hospital were consecutively enrolled, during a 3-month period. Cases presenting lung or liver uptakes were analyzed. Two sets of images were reconstructed from data recorded during a unique acquisition with a continuous table speed of 1 mm/s of the used Biograph mCT Flow PET/CT scanner: standard free-breathing images, and respiratory-gated images. Lesion location and quantitative parameters were recorded and compared.ResultsFrom October 1 2015 to December 31 2015, 847 patients were referred for FDG PET/CT, 741 underwent a respiratory-gated acquisition. Out of them, 213 (29%) had one or more lung or liver uptake but 82 (38%) had no usable respiratory-gated signal. Accordingly, 131 (62%) patients with 183 lung or liver uptakes were analyzed. Considering the 183 lesions, 140 and 43 were located in the lungs and the liver, respectively. The median (IQR) difference between respiratory-gated images and non-gated images was 18% (4−32) for SUVmax, increasing to 30% (14−57) in lower lobes for lung lesions, and −18% (−40 to −4) for MTV (p < 0.05). Technologists’ active personal dosimetry and mean total examinations duration were not statistically different between periods with and without respiratory gating.ConclusionThis study showed that a systematic respiratory-gated acquisition without increasing acquisition time is feasible in a daily routine and results in a significant impact on PET quantification. However, clinical impact on patient management remains to be determined.

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Section: Discussionmentioning

confidence: 99%

Feasibility of Systematic Respiratory-Gated Acquisition in Unselected Patients Referred for 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography

et al. 2018

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“…They reported smaller tumour volumes on 4D PET/CT than at 3D PET/CT but with motion freeze demonstrating significantly smaller volumes than both 3D and 4D PET/CT. Suzawa et al studied the use of respiratory gated time of flight (TOF) PET/CT in the analysis of lung lesions [26]. The principle of TOF PET/CT is that instead of traditional PET/CT where the annihilated positron can be located to a line of response the location can be more accurately located along this line due to calculating the times of arrival of the two 511KeV photons.…”

Section: I) Impact On Gtvmentioning

confidence: 99%

Effectiveness of Respiratory-gated Positron Emission Tomography/Computed Tomography for Radiotherapy Planning in Patients with Lung Carcinoma – A Systematic Review

et al. 2018

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The use of 4D PET/CT leads to differences in target volume delineation compared with 3D PET/CT. These differences vary depending upon technique and the clinical impact currently remains uncertain. Correlation of pretreatment target volumes generated at 3D and 4D PET/CT with postsurgical histology would be ideal but technically challenging. Evaluation of patient outcomes based on 3D versus 4D PET/CT derived treatment volumes warrants further investigation.

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“…Two in-house experienced radiologists who are specialized in nuclear medicine were invited to perform image assessments; if there is any uncertainty, consensus between two radiologists was required. Lesions with SUV max < 1.0 were considered as non-malignant lesions and discarded from downstream analysis; this threshold value was chosen based on previous studies ( 27 , 28 ). The use of the SUV threshold in tumor volume segmentation eliminates intra-rater and inter-rater segmentation variability, and it is worth noting that all the generated segments in this study were approved by experienced medical oncologists with specialty in nuclear medicine.…”

Section: Methodsmentioning

confidence: 99%

Respiratory 4D-Gating F-18 FDG PET/CT Scan for Liver Malignancies: Feasibility in Liver Cancer Patient and Tumor Quantitative Analysis

Cheung

et al. 2022

Front. Oncol.

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PurposeTo evaluate the potential clinical role and effectiveness of respiratory 4D-gating F-18 FDG PET/CT scan for liver malignancies, relative to routine (3D) F-18 FDG PET/CT scan.Materials and MethodsThis study presented a prospective clinical study of 16 patients who received F-18 FDG PET/CT scan for known or suspected malignant liver lesions. Ethics approvals were obtained from the ethics committees of the Hong Kong Baptist Hospital and The Hong Kong Polytechnic University. Liver lesions were compared between the gated and ungated image sets, in terms of 1) volume measurement of PET image, 2) accuracy of maximum standardized uptake value (SUVmax), mean standardized uptake value (SUVmean), and 3) accuracy of total lesion glycoses (TLG). Statistical analysis was performed by using a two-tailed paired Student t-test and Pearson correlation test.ResultsThe study population consisted of 16 patients (9 males and 7 females; mean age of 65) with a total number of 89 lesions. The SUVmax and SUVmean measurement of the gated PET images was more accurate than that of the ungated PET images, compared to the static reference images. An average of 21.48% (p < 0.001) reduction of the tumor volume was also observed. The SUVmax and SUVmean of the gated PET images were improved by 19.81% (p < 0.001) and 25.53% (p < 0.001), compared to the ungated PET images.ConclusionsWe have demonstrated the feasibility of implementing 4D PET/CT scan for liver malignancies in a prospective clinical study. The 4D PET/CT scan for liver malignancies could improve the quality of PET image by improving the SUV accuracy of the lesions and reducing image blurring. The improved accuracy in the classification and identification of liver tumors with 4D PET image would potentially lead to its increased utilization in target delineation of GTV, ITV, and PTV for liver radiotherapy treatment planning in the future.

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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

Abstract: 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.

Cited by 12 publications

References 21 publications

Feasibility of Systematic Respiratory-Gated Acquisition in Unselected Patients Referred for 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography

Feasibility of Systematic Respiratory-Gated Acquisition in Unselected Patients Referred for 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography

Effectiveness of Respiratory-gated Positron Emission Tomography/Computed Tomography for Radiotherapy Planning in Patients with Lung Carcinoma – A Systematic Review

Respiratory 4D-Gating F-18 FDG PET/CT Scan for Liver Malignancies: Feasibility in Liver Cancer Patient and Tumor Quantitative Analysis

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