Deep-Inspiration Breath-Hold PET/CT of the Thorax

Journal of Nuclear Medicine

Sadek A. Nehmeh¹  Heiko Schöder¹  John L. Humm¹  Yusuf E. Erdi¹  Olivia Squire¹  Gustavo S.P. Meirelles¹  Steven M. Larson¹ 

关键词: deep-inspiration breath-hold;    PET/CT;    4-dimensional PET/CT;    respiratory gating;   

DOI  :  

学科分类：医学（综合）

来源: Society of Nuclear Medicine

【 摘 要 】

The goal of this study was to describe our initial experience with the deep-inspiration breath-hold (DIBH) technique in combined PET/CT of the thorax. This article presents particular emphasis on the technical aspects required for clinical implementation. Methods: In the DIBH technique, the patient is verbally coached and brought to a reproducible deep inspiration breath-hold level. The first “Hold” period, which refers to the CT session, is considered as the reference. This is followed by 9- to 20-s independent breath-hold PET acquisitions. The goal is to correct for respiratory motion artifacts and, consequently, improve the tumor quantitation and localization on the PET/CT images and inflate the lungs for possible improvement in the detection of subcentimeter pulmonary nodules. A physicist monitors and records patient breathing during PET/CT acquisition using a motion tracker. Patient breathing traces obtained during acquisition are examined on the fly to assess the reproducibility of the technique. Results: Data from 8 patients, encompassing 10 lesions, were analyzed. Visual inspection of fused PET/CT images showed improved spatial matching between the 2 modalities, reduced motion artifacts especially in the diaphragm, and increased the measured standardized uptake value (SUV) attributed to reduced motion blurring, as compared with the standard clinical PET/CT images. Conclusion: The practice of DIBH PET/CT is feasible in a clinical setting. With this technique, consistent lung inflation levels are achieved during PET/CT sessions, as judged by both motion tracker and verification of spatial matching between PET and CT images. Breathing-induced motion artifacts are significantly reduced using DIBH compared with free breathing, enabling better target localization and quantitation. The DIBH technique showed an increase in the median SUV by 32.46%, with a range from 4% to 83%, compared with SUVs measured on the clinical images. The median percentage reduction in the PET-to-CT lesions' centroids was 26.6% (range, 3%–50%).

【 授权许可】

Unknown