OBJECTIVES: Respiratory motion during PET imaging introduces quantitative and diagnostic inaccuracies, which may result in non-optimal patient management. This study investigated the effects of respiratory gating on image quantification using an amplitude-based optimal respiratory gating (ORG) algorithm. METHODS: Whole body FDG-PET/CT was performed in 66 lung cancer patients. The respiratory signal was obtained using a pressure sensor integrated in an elastic belt placed around the patient's thorax. ORG images were reconstructed with 50%, 35%, and 20% of acquired PET data (duty cycle). Lesions were grouped into anatomical locations. Differences in lesion volume between ORG and non-gated images, and mean FDG-uptake (SUVmean) were calculated. RESULTS: Lesions in the middle and lower lobes demonstrated a significant SUVmean increase for all duty cycles and volume decrease for duty cycles of 35% and 20%. Significant increase in SUVmean and decrease in volume for lesions in the upper lobes were observed for a 20% duty cycle. The SUVmean increase for central lesions was significant for all duty cycles, whereas a significant volume decrease was observed for a duty cycle of 20%. CONCLUSIONS: This study implies that ORG could influence clinical PET imaging with respect to response monitoring and radiotherapy planning. KEY POINTS: Quantifying lesion volume and uptake in PET is important for patient management. Respiratory motion artefacts introduce inaccuracies in quantification of PET images. Amplitude-based optimal respiratory gating maintains image quality through selection of duty cycle. The effect of respiratory gating on lesion quantification depends on anatomical location.
OBJECTIVES: Respiratory motion during PET imaging introduces quantitative and diagnostic inaccuracies, which may result in non-optimal patient management. This study investigated the effects of respiratory gating on image quantification using an amplitude-based optimal respiratory gating (ORG) algorithm. METHODS: Whole body FDG-PET/CT was performed in 66 lung cancerpatients. The respiratory signal was obtained using a pressure sensor integrated in an elastic belt placed around the patient's thorax. ORG images were reconstructed with 50%, 35%, and 20% of acquired PET data (duty cycle). Lesions were grouped into anatomical locations. Differences in lesion volume between ORG and non-gated images, and mean FDG-uptake (SUVmean) were calculated. RESULTS: Lesions in the middle and lower lobes demonstrated a significant SUVmean increase for all duty cycles and volume decrease for duty cycles of 35% and 20%. Significant increase in SUVmean and decrease in volume for lesions in the upper lobes were observed for a 20% duty cycle. The SUVmean increase for central lesions was significant for all duty cycles, whereas a significant volume decrease was observed for a duty cycle of 20%. CONCLUSIONS: This study implies that ORG could influence clinical PET imaging with respect to response monitoring and radiotherapy planning. KEY POINTS: Quantifying lesion volume and uptake in PET is important for patient management. Respiratory motion artefacts introduce inaccuracies in quantification of PET images. Amplitude-based optimal respiratory gating maintains image quality through selection of duty cycle. The effect of respiratory gating on lesion quantification depends on anatomical location.
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Authors: Charlotte S van der Vos; Daniëlle Koopman; Sjoerd Rijnsdorp; Albert J Arends; Ronald Boellaard; Jorn A van Dalen; Mark Lubberink; Antoon T M Willemsen; Eric P Visser Journal: Eur J Nucl Med Mol Imaging Date: 2017-07-08 Impact factor: 9.236
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