Deep-inspiration breath-hold PET/CT: Clinical findings with a new technique for detection and characterization of thoracic lesions Journal Article


Authors: Meirelles, G. S. P.; Erdi, Y. E.; Nehmeh, S. A.; Squire, O. D.; Larson, S. M.; Humm, J. L.; Schoder, H.
Article Title: Deep-inspiration breath-hold PET/CT: Clinical findings with a new technique for detection and characterization of thoracic lesions
Abstract: Respiratory motion during PET/CT acquisition can cause misregistration and inaccuracies in calculation of standardized uptake values (SUVs). Our aim was to compare the detection and characterization of thoracic lesions on PET/CT with and without a deep-inspiration protocol. Methods: We studied 15 patients with suspected pulmonary lesions who underwent clinical PET/CT, followed by deep-inspiration breath-hold (BH) PET/CT. In BH CT, the whole chest of the patient was scanned in 15 s at the end of deep inspiration. For BH PET, patients were asked to hold their breath 9 times for 20-s intervals. One radiologist reviewed images, aiming to detect and characterize pulmonary, nodal, and skeletal abnormalities. Clinical CT and BH CT were compared for number, size, and location of lesions. Lesion SUVs were compared between clinical PET and BH PET. Images were also visually assessed for accuracy of fusion and registration. Results: All patients had lesions on clinical CT and BH CT. Pulmonary BH CT detected more lesions than clinical CT in 13 of 15 patients (86.7%). The total number of lung lesions detected increased from 53 with clinical CT to 82 with BH CT (P < 0.001). Eleven patients showed a total of 31 lesions with abnormal 18F-FDG uptake. BH PET/CT had the advantage of reducing misregistration and permitted a better localization of sites with 18F-FDG uptake. A higher SUV was noted in 22 of 31 lesions on BH PET compared with clinical PET, with an average increase in SUV of 14%. Conclusion: BH PET/CT enabled an increased detection and better characterization of thoracic lesions compared with a standard PET/CT protocol, in addition to more precise localization and quantification of the findings. The technique is easy to implement in clinical practice and requires only a minor increase in the examination time.
Keywords: adult; clinical article; controlled study; aged; middle aged; positron emission tomography; methodology; sensitivity and specificity; reproducibility; reproducibility of results; computer assisted tomography; image interpretation, computer-assisted; tomography, x-ray computed; algorithms; thoracic neoplasms; algorithm; computer assisted diagnosis; evaluation; image enhancement; image subtraction; subtraction technique; fluorodeoxyglucose f 18; positron-emission tomography; imaging; artifact; thorax injury; thorax tumor; artifacts; respiratory mechanics; pet/ct; inhalation; breathing mechanics; breath-hold; 18f-fdg; lung injury; breathing; inspiratory capacity; skeleton malformation
Journal Title: Journal of Nuclear Medicine
Volume: 48
Issue: 5
ISSN: 0161-5505
Publisher: Society of Nuclear Medicine  
Date Published: 2007-05-01
Start Page: 712
End Page: 719
Language: English
DOI: 10.2967/jnumed.106.038034
PUBMED: 17475958
PROVIDER: scopus
DOI/URL:
Notes: --- - "Cited By (since 1996): 36" - "Export Date: 17 November 2011" - "CODEN: JNMEA" - "Source: Scopus"
Altmetric
Citation Impact
BMJ Impact Analytics
MSK Authors
  1. Heiko Schoder
    543 Schoder
  2. Sadek Nehmeh
    69 Nehmeh
  3. John Laurence Humm
    433 Humm
  4. Yusuf E Erdi
    118 Erdi
  5. Steven M Larson
    958 Larson
  6. Olivia D Squire
    32 Squire