Yamaguchi Toshiaki, Ueda Osamu, Hara Hideyuki, Sakai Hiroto, Kida Tohru, Suzuki Kayo, Adachi Shuji, Ishii Kazunari
Radiology Division, Hyogo Cancer Center, Akashi, Hyogo, 673-8558, Japan.
Ann Nucl Med. 2009 Jan;23(1):65-71. doi: 10.1007/s12149-008-0206-4. Epub 2009 Feb 11.
To evaluate the usefulness of a breath-holding (BH) (18)F-2-fluoro-2-deoxy-D-glucose positron emission tomography ((18)F-FDG-PET) technique for PET/computed tomography (CT) scanning of pulmonary lesions near the diaphragm, where image quality is influenced by respiratory motion.
In a basic study, simulated breath-holding PET (sBH-PET) data were acquired by repeating image acquisition eight times with fixation of a phantom at 15 s/bed. Free-breathing PET (FB-PET) was simulated by acquiring data even as moving the phantom at 120 s/bed (sFB-PET). Images with total acquisition times of 15 s, 30 s, 45 s, 60 s, and 120 s were generated for sBHPET. Receiver-operating characteristic (ROC) analyses and determination of the statistical significance of differences between sFB-PET images and sBH-PET images were performed. A total of 22 pulmonary lesions in 21 patients (12 men and 9 women, mean age 61.3 +/- 10.6 years, 10 benign lesions in 9 patients and 12 malignant lesions in 12 patients) were examined by FB-PET and BH-PET). For evaluation of these two acquisition methods, displacement of the lesion between CT and PET was considered to be a translation, and the statistical significance of differences in maximum standardized uptake value (SUV(max)) of the lesion was assessed using the paired t test.
In the basic study, sBH-PET images with acquisition times of 45 s, 60 s, and 120 s had significantly higher diagnostic accuracy than 120-s sFB-PET images (P < 0.05). In clinical cases, translation of the BH-PET images was significantly lower than that of the FB-PET images (benign: 5.29 +/- 4.02 mm vs. 11.79 +/- 8.27 mm, P = 0.005; malignant: 4.29 +/- 3.36 mm vs. 18.26 +/- 12.31 mm, P = 0.003). The SUV(max) of the lesions in the BH-PET images was significantly higher than that in the FB-PET images (benign: 2.40 +/- 0.86 vs. 2.20 +/- 0.85, P = 0.005; malignant: 4.84 +/- 2.16 vs. 3.75 +/- 2.11, P = 0.001).
BH-PET provides images with better diagnostic accuracy, avoids image degradation owing to respiratory motion, and yields more accurate attenuation correction. This method is very useful for overcoming the problem of respiratory motion.
评估屏气（BH）（18）F - 2 - 氟 - 2 - 脱氧 - D - 葡萄糖正电子发射断层扫描（（18）F - FDG - PET）技术在PET/计算机断层扫描（CT）对膈肌附近肺部病变扫描中的应用价值，该部位图像质量受呼吸运动影响。
在一项基础研究中，通过将体模固定15秒/床位重复采集图像八次来获取模拟屏气PET（sBH - PET）数据。通过在120秒/床位移动体模时采集数据来模拟自由呼吸PET（FB - PET）（sFB - PET）。为sBH - PET生成总采集时间为15秒、30秒、45秒、60秒和120秒的图像。进行了受试者操作特征（ROC）分析以及sFB - PET图像与sBH - PET图像之间差异的统计学显著性测定。对21例患者（12例男性和9例女性，平均年龄61.3±10.6岁，9例患者有10个良性病变，12例患者有12个恶性病变）的22个肺部病变进行了FB - PET和BH - PET检查。为评估这两种采集方法，将病变在CT和PET之间的位移视为平移，并使用配对t检验评估病变最大标准化摄取值（SUV(max)）差异的统计学显著性。
在基础研究中，采集时间为45秒、60秒和120秒的sBH - PET图像的诊断准确性显著高于120秒的sFB - PET图像（P < 0.05）。在临床病例中，BH - PET图像的平移显著低于FB - PET图像（良性：5.29±4.02毫米对11.79±8.27毫米，P = 0.005；恶性：4.29±3.36毫米对18.26±12.31毫米，P = 0.003）。BH - PET图像中病变的SUV(max)显著高于FB - PET图像（良性：2.40±0.86对2.20±0.85，P = 0.005；恶性：4.84±2.16对3.75±2.11，P = 0.001）。
BH - PET提供诊断准确性更高的图像，避免了因呼吸运动导致的图像退化，并产生更准确的衰减校正。该方法对于克服呼吸运动问题非常有用。
