Messerli Michael, Liberini Virginia, Grünig Hannes, Maurer Alexander, Skawran Stephan, Lohaus Niklas, Husmann Lars, Orita Erika, Trinckauf Josephine, Kaufmann Philipp A, Huellner Martin W
Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland.
University of Zurich, Zurich, Switzerland.
Br J Radiol. 2021 Oct 1;94(1126):20201350. doi: 10.1259/bjr.20201350. Epub 2021 Sep 14.
To evaluate the impact of fully automatic motion correction by data-driven respiratory gating (DDG) on positron emission tomography (PET) image quality, lesion detection and patient management.
A total of 149 patients undergoing PET/CT for cancer (re-)staging were retrospectively included. Patients underwent a PET/CT on a digital detector scanner and for every patient a PET data set where DDG was enabled (PET) and as well as where DDG was not enabled (PET) was reconstructed. All PET data sets were evaluated by two readers which rated the general image quality, motion effects and organ contours. Further, both readers reviewed all scans on a case-by-case basis and evaluated the impact of PET on additional apparent lesion, change of report, and change of management.
In 85% ( = 126) of the patients, at least one bed position was acquired using DDG, resulting in mean scan time increase of 4:37 min per patient in the whole study cohort ( = 149). General image quality was not rated differently for PET and PET images ( = 1.000) while motion effects ( indicating general blurring) was rated significantly lower in PET images and organ contours, including liver and spleen, were rated significantly sharper using PET as compared to PET (all < 0.001). In 27% of patients, PET resulted in a change of the report and in a total of 12 cases (8%), PET resulted in a change of further clinical management.
Deviceless DDG provided reliable fully automatic motion correction in clinical routine and increased lesion detectability and changed management in a considerable number of patients.
DDG enables PET/CT with respiratory gating to be used routinely in clinical practice without external gating equipment needed.
评估数据驱动呼吸门控（DDG）的全自动运动校正对正电子发射断层扫描（PET）图像质量、病变检测及患者管理的影响。
回顾性纳入149例因癌症（再）分期接受PET/CT检查的患者。患者在数字探测器扫描仪上接受PET/CT检查，对每位患者重建启用DDG的PET数据集（PET）以及未启用DDG的PET数据集（PET）。两名阅片者对所有PET数据集进行评估，对总体图像质量、运动效应和器官轮廓进行评分。此外，两名阅片者逐例审查所有扫描图像，评估PET对额外明显病变、报告变化及管理变化的影响。
85%（n = 126）的患者至少有一个床位使用了DDG，整个研究队列（n = 149）中每位患者的平均扫描时间增加了4分37秒。PET和PET图像的总体图像质量评分无差异（P = 1.000），而PET图像的运动效应（表示总体模糊）评分显著更低，与PET相比，使用PET时包括肝脏和脾脏在内的器官轮廓评分显著更清晰（均P < 0.001）。27%的患者中，PET导致报告改变，总共12例（8%）患者中，PET导致进一步临床管理改变。
无设备的DDG在临床常规中提供了可靠的全自动运动校正，提高了病变可检测性，并在相当数量的患者中改变了管理方式。
DDG使带呼吸门控的PET/CT无需外部门控设备即可在临床实践中常规使用。
