Added Value of a Single Fast 20-second Deep-Inspiration Breath-hold Acquisition in FDG PET/CT in the Assessment of Lung Nodules
Added Value of a Single Fast 20-second Deep-Inspiration Breath-hold Acquisition in FDG PET/CT in the Assessment of Lung Nodules
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DOI：
10.1148/radiol.2017160534
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发表时间：
2018-01-01
期刊：
影响因子：
19.7
通讯作者：
Faraggi, Marc
中科院分区：
文献类型：
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作者：
Balamoutoff, Nicolas;Serrano, Benjamin;Faraggi, Marc
目的：比较单次20秒深吸气屏气（DIBH）在氟脱氧葡萄糖（FDG）正电子发射断层扫描（PET）/计算机断层扫描（CT）中与常规自由呼吸（FB）全身PET/CT在呼吸运动模糊效应方面对肺部病变的评估、表征和量化的准确性。材料和方法：获得了机构审查委员会的批准，并免除了获得知情同意书的要求。在19名患者的测试人群中进行了临床前研究，以评价DIBH技术与基于相位的呼吸门控（PBRG）相比的可行性和一致性。然后前瞻性纳入了115例肺部病变患者，并使用FB PET/CT进行评估，随后进行20秒DIBH PET/CT。报告每次采集的最大标准化摄取值（SUVmax）、峰值标准化摄取值（SUVpeak）以及结节数量和大小，然后与组织病理学检查和/或临床放射学随访结果进行比较。结果：在受试人群中，DIBH PET和PBRG PET获得的数据显示密切相关（r = 0.94，P <0.001，SUV最大值和r = 0.98，P <0.001，SUV峰值）。在临床人群中，与FB相比，DIBH的SUVmax和SUVpeak均显著增加（分别为5.60 +/-4.20 vs 3.11 +/-1.80和2.25 +/-1.75 vs 1.71 +/-0.96; P <0.001）。与FB PET/CT相比，DIBH PET/CT检测到的肺部病变数量明显更多（P <0.001），检测到70个额外的结节，更准确的共配准为84个。根据SUVpeak的受试者工作特征曲线下的面积，DIBH表现出更高的准确性水平比FB（P = 0.039）。结论：DIBH PET/CT技术是可行的，在常规临床实践中，是更敏感的定量测量和病变定位。该技术减少了呼吸运动的模糊效应，从而提高了对肺结节的诊断准确性。(C)RSNA，2017
Purpose: To compare the accuracy of a single 20-second deep-inspiration breath hold (DIBH) in fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) to that with conventional free-breathing (FB) whole-body PET/CT for the assessment, characterization, and quantification of lung lesions in terms of the blurring effect of respiratory motion.Materials and Methods: Institutional review board approval was obtained, and the requirement to obtain informed consent was waived. A preclinical study was performed in a test population of 19 patients to evaluate the feasibility and consistency of DIBH techniques compared with phase-based respiratory gating (PBRG). One hundred fifteen patients with lung lesions were then prospectively included and assessed with FB PET/CT followed by 20-second DIBH PET/CT. Maximum standardized uptake value (SUVmax), peak standardized uptake value (SUVpeak), and number and size of nodules were reported for each acquisition and then compared with findings from histopathologic examination and/or clinical-radiologic follow-up. Statistical analysis was performed with the t test, chi(2) test, Pearson correlation coefficient, and receiver operating characteristic analysis.Results: In the test population, data obtained with DIBH PET and PBRG PET showed close correlation (r = 0.94, P < .001 for SUVmax and r = 0.98, P < .001 for SUVpeak). In the clinical population, both SUVmax and SUVpeak were significantly increased with DIBH compared with FB (5.60 +/- 4.20 vs 3.11 +/- 1.80 and 2.25 +/- 1.75 vs 1.71 +/- 0.96, respectively; P < .001). A significantly greater number of lung lesions was detected with DIBH PET/CT compared with FB PET/CT (P < .001), with the detection of 70 additional nodules and more accurate coregistration of 84. According to the area under the receiver operating characteristic curve for SUVpeak, DIBH demonstrated a higher level of accuracy than did FB (P = .039).Conclusion: The DIBH PET/CT technique is feasible in routine clinical practice and is more sensitive for quantitative measurements and lesion localization. This technique reduces the blurring effect of respiratory motion, thus improving the diagnostic accuracy for lung nodules. (C) RSNA, 2017