Prior John O, Péguret Nicolas, Pomoni Anastasia, Pappon Martin, Zeverino Michele, Belmondo Bastien, Lovis Alban, Ozsahin Mahmut, Vienne Monique, Bourhis Jean
Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Lausanne, Switzerland.
Department of Radiation Oncology, Lausanne University Hospital, Lausanne, Switzerland.
J Nucl Med. 2016 Mar;57(3):416-9. doi: 10.2967/jnumed.115.163386. Epub 2015 Dec 3.
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.
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.
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).
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.
呼吸运动对PET/CT图像质量和定量分析有负面影响。一种新型的脉动流通气（PFV）系统可减少呼吸运动，该系统应用于自主呼吸的患者，以在PET/CT检查期间诱导持续呼吸暂停。
4例患者（年龄65±14岁）在注射（18）F-FDG后63±3分钟接受PET/CT检查以进行肺结节分期（平均直径11±7mm；范围5-18mm），然后在PFV诱导的呼吸暂停期间（成像持续≥8.5分钟），于之后47±7分钟再次接受检查。比较前后胸廓幅度、SUVmax和SUVpeak（直径1cm球体中的SUVmean）。
PFV PET/CT降低了胸廓幅度（80%），增加了平均病变SUVmax（29%）和SUVpeak（11%），降低了肺部背景SUVpeak（25%），提高了病变的可检测性，并增加了SUVpeak病变与背景比值（54%）。在线性回归分析中，SUVmax和SUVpeak显著改善（分别提高35%和23%；P≤0.02）。
PFV诱导的呼吸暂停可减少胸部器官运动，增加病变的SUV、可检测性和边界清晰度，从而可能通过改善诊断、预后评估、监测和外照射放疗计划来影响患者的治疗管理。
