The impact of data-driven respiratory gating in clinical F-18 FDG PET/CT: comparison of free breathing and deep-expiration breath-hold CT protocol
The impact of data-driven respiratory gating in clinical F-18 FDG PET/CT: comparison of free breathing and deep-expiration breath-hold CT protocol
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DOI：
10.1007/s12149-020-01574-4
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发表时间：
2021-01-15
影响因子：
2.6
通讯作者：
Kim, Bom Sahn
中科院分区：
文献类型：
--
作者：
Kang, Seo Young;Moon, Byung Seok;Kim, Bom Sahn
背景
呼吸运动可降低正电子发射断层扫描（PET）图像质量，并导致病变定量不准确。数据驱动门控（DDG）作为一种有效的PET呼吸门控技术近期被引入。在本研究中，我们探讨了DDG对氟 - 18 - 氟脱氧葡萄糖（F - 18 - FDG）PET/CT中呼吸运动的临床影响。
方法
收集每个受试者的PET列表模式数据，并使用DDG软件提取呼吸波形。分别使用Q.clear和Q.clear + DDG重建PET图像。我们评估了最大标准摄取值（SUVmax）、平均标准摄取值（SUVmean）、变异系数（CoV）、代谢肿瘤体积（MTV）以及使用累积SUV直方图曲线下面积（AUC - CSH）评估的肿瘤异质性。比较了每种重建方法之间代谢参数的变化。在CT扫描中引入深呼气屏气（DEBH）方案以校正PET和CT之间的空间错位，并与常规自由呼吸进行比较。DEBH和自由呼吸（FB）方案的比较是在一个单独的匹配队列中使用倾向核心匹配进行的，而不是在同一患者中进行。
结果
总共使用了147次呼吸运动过度的PET/CT扫描来研究DDG介导的校正。应用DDG后，肺部和上腹部病变的SUVmax（P < 0.0001；8.15 ± 4.77对比9.03 ± 5.02）和SUVmean（P < 0.0001；4.91 ± 2.44对比5.49 ± 2.68）升高，而MTV显著降低（P < 0.0001；7.07 ± 15.46对比6.58 ± 15.14）。此外，下肺病变的SUV变化百分比高于上叶病变。同样，下叶病变的MTV降低幅度明显更大。在肝脏病变中未观察到因位置不同而产生的显著差异。与常规自由呼吸相比，DEBH介导的CT呼吸校正对病变代谢参数没有产生显著差异。
结论
这些结果表明，DDG校正能够对位于肺部和上腹部的病变因呼吸运动进行更准确的定量。因此，我们建议在F - 18 - FDG PET/CT成像过程中，DDG值得作为一种标准方案使用。
Background Respiratory motion can diminish PET image quality and lead to inaccurate lesion quantifications. Data-driven gating (DDG) was recently introduced as an effective respiratory gating technique for PET. In the current study, we investigated the clinical impact of DDG on respiratory movement in F-18-FDG PET/CT.Method PET list-mode data were collected for each subject and DDG software was utilized for extracting respiratory waveforms. PET images was reconstructed using Q.clear and Q.clear + DDG, respectively. We evaluated SUVmax, SUVmean, the coefficient of variance (CoV), metabolic tumor volume (MTV), and tumor heterogeneity using the area under the curve of cumulative SUV histogram (AUC-CSH). Metabolic parameter changes were compared between each reconstruction method. The Deep-Expiration Breath Hold (DEBH) protocol was introduced for CT scans to correct spatial misalignment between PET and CT and compared with conventional free breathing. The DEBH and free breathing (FB) protocol comparison was made in a separate matching cohort using propensity core matching rather than the same patient.Results Total 147 PET/CT scans with excessive respiratory movements were used to study DDG-mediated correction. After DDG application, SUVmax (P < 0.0001; 8.15 +/- 4.77 vs. 9.03 +/- 5.02) and SUVmean (P < 0.0001; 4.91 +/- 2.44 vs. 5.49 +/- 2.68) of lung and upper abdomen lesions increased, while MTV significantly decreased (P < 0.0001; 7.07 +/- 15.46 vs. 6.58 +/- 15.14). In addition, the percent change of SUVs was greater in lower lung lesions compared to upper lobe lesions. Likewise, the MTV reduction was significantly greater in lower lobe lesions. No significant difference dependent on location was observed in liver lesions. DEBH-mediated CT breathing correction did not make a significant difference in lesion metabolic parameters compared to conventional free breathing.Conclusions These results suggest that DDG correction enables more corrected quantification from respiratory movements for lesions located in the lung and upper abdomen. Therefore, we suggest that DDG is worth using as a standard protocol during F-18-FDG PET/CT imaging.