Cheung Anson H Y, Wu Vincent W C, Cheung Andy L Y, Cai Jing
Department of Health Technology & Informatics, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China.
Radiotherapy and Oncology Department, Hong Kong Baptist Hospital, Hong Kong, Hong Kong SAR, China.
Front Oncol. 2022 Feb 9;12:789506. doi: 10.3389/fonc.2022.789506. eCollection 2022.
To evaluate the potential clinical role and effectiveness of respiratory 4D-gating F-18 FDG PET/CT scan for liver malignancies, relative to routine (3D) F-18 FDG PET/CT scan.
This study presented a prospective clinical study of 16 patients who received F-18 FDG PET/CT scan for known or suspected malignant liver lesions. Ethics approvals were obtained from the ethics committees of the Hong Kong Baptist Hospital and The Hong Kong Polytechnic University. Liver lesions were compared between the gated and ungated image sets, in terms of 1) volume measurement of PET image, 2) accuracy of maximum standardized uptake value (SUV), mean standardized uptake value (SUV), and 3) accuracy of total lesion glycoses (TLG). Statistical analysis was performed by using a two-tailed paired Student -test and Pearson correlation test.
The study population consisted of 16 patients (9 males and 7 females; mean age of 65) with a total number of 89 lesions. The SUV and SUV measurement of the gated PET images was more accurate than that of the ungated PET images, compared to the static reference images. An average of 21.48% (p < 0.001) reduction of the tumor volume was also observed. The SUV and SUV of the gated PET images were improved by 19.81% (p < 0.001) and 25.53% (p < 0.001), compared to the ungated PET images.
We have demonstrated the feasibility of implementing 4D PET/CT scan for liver malignancies in a prospective clinical study. The 4D PET/CT scan for liver malignancies could improve the quality of PET image by improving the SUV accuracy of the lesions and reducing image blurring. The improved accuracy in the classification and identification of liver tumors with 4D PET image would potentially lead to its increased utilization in target delineation of GTV, ITV, and PTV for liver radiotherapy treatment planning in the future.
评估呼吸四维门控F-18 FDG PET/CT扫描相对于常规（三维）F-18 FDG PET/CT扫描在肝脏恶性肿瘤中的潜在临床作用和有效性。
本研究为一项前瞻性临床研究，对16例已知或疑似肝脏恶性病变的患者进行了F-18 FDG PET/CT扫描。获得了香港浸信会医院和香港理工大学伦理委员会的伦理批准。对门控和非门控图像集的肝脏病变进行了比较，包括：1）PET图像的体积测量；2）最大标准化摄取值（SUV）、平均标准化摄取值（SUV）的准确性；3）总病变糖酵解（TLG）的准确性。采用双尾配对t检验和Pearson相关检验进行统计分析。
研究人群包括16例患者（9例男性和7例女性；平均年龄65岁），共有89个病变。与静态参考图像相比，门控PET图像的SUV和SUV测量比非门控PET图像更准确。还观察到肿瘤体积平均减少了21.48%（p<0.001）。与非门控PET图像相比，门控PET图像的SUV和SUV分别提高了19.81%（p<0.001）和25.53%（p<0.001）。
我们在一项前瞻性临床研究中证明了对肝脏恶性肿瘤实施四维PET/CT扫描的可行性。肝脏恶性肿瘤的四维PET/CT扫描可通过提高病变的SUV准确性和减少图像模糊来提高PET图像质量。四维PET图像在肝脏肿瘤分类和识别方面提高的准确性可能会导致其在未来肝脏放射治疗计划中GTV、ITV和PTV的靶区勾画中得到更多应用。
