Respiratory Gating Enhances Imaging of Pulmonary Nodules and Measurement of Tracer Uptake in FDG PET/CT

The aim of this study was to evaluate prospectively the effects of respiratory gating during FDG PET/CT on the determination of lesion size and the measurement of tracer uptake in patients with pulmonary nodules in a clinical setting. Eighteen patients with known pulmonary nodules (nine women, nine...

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Bibliographic Details
Published in:	American journal of roentgenology (1976) Vol. 193; no. 6; pp. 1640 - 1645
Main Authors:	Werner, Matthias K, Parker, J. Anthony, Kolodny, Gerald M, English, Jeffrey R, Palmer, Matthew R
Format:	Journal Article
Language:	English
Published:	Reston, VA Am Roentgen Ray Soc 01-12-2009 American Roentgen Ray Society
Subjects:	Adult Aged Aged, 80 and over Biological and medical sciences Female Fluorodeoxyglucose F18 Humans Image Enhancement - methods Image Processing, Computer-Assisted Investigative techniques, diagnostic techniques (general aspects) Lymphatic Metastasis Male Medical sciences Middle Aged Pneumology Positron-Emission Tomography - methods Prospective Studies Radiopharmaceuticals Respiratory-Gated Imaging Techniques - methods Sensitivity and Specificity Solitary Pulmonary Nodule - diagnostic imaging Statistics, Nonparametric Tomography, X-Ray Computed - methods Tumors of the respiratory system and mediastinum Radionuclide study Respiratory tract Lung disease Nuclear medicine Radiodiagnosis Respiratory disease Lung nodule Radiology Medical imagery Computerized axial tomography Positron emission tomography Emission tomography
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Summary:	The aim of this study was to evaluate prospectively the effects of respiratory gating during FDG PET/CT on the determination of lesion size and the measurement of tracer uptake in patients with pulmonary nodules in a clinical setting. Eighteen patients with known pulmonary nodules (nine women, nine men; mean age, 61.4 years) underwent conventional FDG PET/CT and respiratory-gated PET acquisitions during their scheduled staging examinations. Maximum, minimum, and average standardized uptake values (SUVs) and lesion size and volume were determined with and without respiratory gating. The results were then compared using the two-tailed Student's t test and the nonparametric Wilcoxon's test to assess the effects of respiratory gating on PET acquisitions. Respiratory gating reduced the measured area of lung lesions by 15.5%, the axial dimension by 10.3%, and the volume by 44.5% (p = 0.014, p = 0.007, and p = 0.025, respectively). The lesion volumes in gated studies were closer to those assessed by standard CT (difference decreased by 126.6%, p = 0.025). Respiratory gating increased the measured maximum SUV by 22.4% and average SUV by 13.3% (p < 0.001 and p = 0.002). Our findings suggest that the use of PET respiratory gating in PET/CT results in lesion volumes closer to those assessed by CT and improved measurements of tracer uptake for lesions in the lungs.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0361-803X 1546-3141
DOI:	10.2214/AJR.09.2516