Abstract
PurposeTo 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.Materials and MethodsThis 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 (SUVmax), mean standardized uptake value (SUVmean), and 3) accuracy of total lesion glycoses (TLG). Statistical analysis was performed by using a two-tailed paired Student t-test and Pearson correlation test.ResultsThe study population consisted of 16 patients (9 males and 7 females; mean age of 65) with a total number of 89 lesions. The SUVmax and SUVmean 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 SUVmax and SUVmean 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.ConclusionsWe 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.
Highlights
Positron emission tomography/computed tomography (PET/ CT) has been proven irreplaceable in providing anatomical and functional radiological information
Studies have shown that the sensitivity of detecting liver malignancies with F-18 FDG PET image ranged from 90% to 95% [3,4,5]
Twenty-five patients who were scheduled for receiving F-18 FDG PET/CT scan for known or suspected liver malignant diseases were recruited
Summary
Positron emission tomography/computed tomography (PET/ CT) has been proven irreplaceable in providing anatomical and functional radiological information. Primary and secondary liver malignancies typically show increased glucose uptake and metabolism. Tumors consume FDG as a glucose analogue and display a strong uptake in PET images [1]. Studies have shown that the sensitivity of detecting liver malignancies with F-18 FDG PET image ranged from 90% to 95% [3,4,5]. The acquisition of PET/CT images consists of two parts: first, CT data are acquired by scanning the entire patient body in a few seconds. PET data are acquired by using PET ring detectors; a range of 6–7 bed position acquisition is typically used for an adult scan, and the acquisition time can be up to several minutes per bed
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