John O Prior1, Nicolas Péguret2, Anastasia Pomoni1, Martin Pappon1, Michele Zeverino3, Bastien Belmondo4, Alban Lovis5, Mahmut Ozsahin2, Monique Vienne6, Jean Bourhis7. 1. Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Lausanne, Switzerland. 2. Department of Radiation Oncology, Lausanne University Hospital, Lausanne, Switzerland. 3. Department of Medical Physics, Lausanne University Hospital, Lausanne, Switzerland. 4. Department of Physiotherapy, Lausanne University Hospital, Lausanne, Switzerland. 5. Department of Pneumology, Lausanne University Hospital, Lausanne, Switzerland; and. 6. BIRD Institute of Pulmonary Care, Villeneuve-Loubet, France. 7. Department of Radiation Oncology, Lausanne University Hospital, Lausanne, Switzerland jean.bourhis@chuv.ch.
Abstract
UNLABELLED: Respiratory motion negatively affects PET/CT image quality and quantitation. A novel Pulsatile-Flow Ventilation (PFV) system reducing respiratory motion was applied in spontaneously breathing patients to induce sustained apnea during PET/CT. METHODS: Four patients (aged 65 ± 14 y) underwent PET/CT for pulmonary nodule staging (mean, 11 ± 7 mm; range, 5-18 mm) at 63 ± 3 min after (18)F-FDG injection and then at 47 ± 7 min afterward, during PFV-induced apnea (with imaging lasting ≥8.5 min). Anterior-posterior thoracic amplitude, SUVmax, and SUVpeak (SUVmean in a 1-cm-diameter sphere) were compared. RESULTS: PFV PET/CT reduced thoracic amplitude (80%), increased mean lesion SUVmax (29%) and SUVpeak (11%), decreased lung background SUVpeak (25%), improved lesion detectability, and increased SUVpeak lesion-to-background ratio (54%). On linear regressions, SUVmax and SUVpeak significantly improved (by 35% and 23%, respectively; P ≤ 0.02). CONCLUSION: PFV-induced apnea reduces thoracic organ motion and increases lesion SUV, detectability, and delineation, thus potentially affecting patient management by improving diagnosis, prognostication, monitoring, and external-radiation therapy planning.
UNLABELLED: Respiratory motion negatively affects PET/CT image quality and quantitation. A novel Pulsatile-Flow Ventilation (PFV) system reducing respiratory motion was applied in spontaneously breathing patients to induce sustained apnea during PET/CT. METHODS: Four patients (aged 65 ± 14 y) underwent PET/CT for pulmonary nodule staging (mean, 11 ± 7 mm; range, 5-18 mm) at 63 ± 3 min after (18)F-FDG injection and then at 47 ± 7 min afterward, during PFV-induced apnea (with imaging lasting ≥8.5 min). Anterior-posterior thoracic amplitude, SUVmax, and SUVpeak (SUVmean in a 1-cm-diameter sphere) were compared. RESULTS:PFV PET/CT reduced thoracic amplitude (80%), increased mean lesion SUVmax (29%) and SUVpeak (11%), decreased lung background SUVpeak (25%), improved lesion detectability, and increased SUVpeak lesion-to-background ratio (54%). On linear regressions, SUVmax and SUVpeak significantly improved (by 35% and 23%, respectively; P ≤ 0.02). CONCLUSION:PFV-induced apnea reduces thoracic organ motion and increases lesion SUV, detectability, and delineation, thus potentially affecting patient management by improving diagnosis, prognostication, monitoring, and external-radiation therapy planning.
Authors: Delphine L Chen; Joseph Cheriyan; Edwin R Chilvers; Gourab Choudhury; Christopher Coello; Martin Connell; Marie Fisk; Ashley M Groves; Roger N Gunn; Beverley F Holman; Brian F Hutton; Sarah Lee; William MacNee; Divya Mohan; David Parr; Deepak Subramanian; Ruth Tal-Singer; Kris Thielemans; Edwin J R van Beek; Laurence Vass; Jeremy W Wellen; Ian Wilkinson; Frederick J Wilson Journal: J Nucl Med Date: 2017-01-12 Impact factor: 10.057