Patro Sai Sradha P, Aland Parag, James Vivek Mathew, Lele Vikram
Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India.
Department of Nuclear Medicine, Infinity Medical Centre, Mumbai, Maharashtra, India.
Indian J Nucl Med. 2024 May-Jun;39(3):177-184. doi: 10.4103/ijnm.ijnm_142_23. Epub 2024 Aug 17.
The blur introduced by breathing motion degrades the diagnostic accuracy of whole-body F-18 fluorodeoxyglucose positron emission tomography-computed tomography (F-FDG PET-CT) in lesions adjacent to the diaphragm by increasing the apparent size and by decreasing their metabolic activity. This study aims to evaluate the efficacy of motion correction by four-dimensional phase-based respiratory-gated (RG) F-FDG PET-CT in improving metabolic parameters of lesions adjacent to the diaphragm (especially in the lungs or liver).
Eighteen patients with known lung or liver lesions underwent conventional F-FDG PET-CT and respiratory-gated PET-CT acquisition of the desired region using a pressure-sensing, phase-based respiratory-gating system. Maximum standardized uptake value (SUV), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were obtained for these lesions from gated and nongated PET-CT images for analysis. Furthermore, a visual analysis of lesions was done.
Statistical significance of the RG image parameters was assessed by the two-tailed paired Student's test and confirmed with the robust nonparametric Wilcoxon's signed-rank test (two-tailed asymptotic).
There was an overall significant increase in SUV ( 0.001) in all gating methods with a percentage increase maximum of about 18.13%. On gating methods, MTV decreased significantly ( = 0.001) than that of nongating method (maximum reduction of about 32.9%). There was a significant difference ( = 0.02) in TLG between gated and nongated methods.
Motion correction with phase-based respiratory gating improves the diagnostic value of F-FDG PET-CT imaging for lung and liver lesions by more accurate delineation of the lesion volume and quantitation of SUV and can thus impact staging, diagnosis as well as management in selected patients.
呼吸运动所引入的模糊会增加病变的表观大小并降低其代谢活性，从而降低全身F-18氟脱氧葡萄糖正电子发射断层扫描-计算机断层扫描（F-FDG PET-CT）对膈肌附近病变的诊断准确性。本研究旨在评估基于四维相位的呼吸门控（RG）F-FDG PET-CT进行运动校正，对改善膈肌附近病变（尤其是肺部或肝脏病变）代谢参数的效果。
18例已知肺部或肝脏病变的患者接受了传统F-FDG PET-CT检查，并使用基于压力感应和相位的呼吸门控系统对所需区域进行呼吸门控PET-CT采集。从门控和非门控PET-CT图像中获取这些病变的最大标准化摄取值（SUV）、代谢肿瘤体积（MTV）和总病变糖酵解（TLG），用于分析。此外，还对病变进行了视觉分析。
通过双尾配对t检验评估RG图像参数的统计学显著性，并用稳健的非参数Wilcoxon符号秩检验（双尾渐近）进行确认。
在所有门控方法中，SUV总体上有显著增加（P<0.001），最大百分比增幅约为18.13%。在门控方法下，MTV比非门控方法显著降低（P = 0.001）（最大降幅约为32.9%）。门控和非门控方法之间的TLG有显著差异（P = 0.02）。
基于相位的呼吸门控运动校正通过更准确地勾勒病变体积以及对SUV进行定量，提高了F-FDG PET-CT对肺部和肝脏病变的诊断价值，从而可以影响特定患者的分期、诊断以及治疗管理。
