Abstract
PurposeRespiratory motion causes substantial artifacts in reconstructed PET images when using helical CT as the attenuation map in PET/CT imaging. In this study, we aimed to reduce the respiratory artifacts in PET/CT images of patients with lung tumors using an abdominal compression device.MethodsTwelve patients with lung cancer located in the middle or lower lobe of the lung were recruited. The patients were injected with 370 MBq of 18F-FDG. During PET, the patients assumed two bed positions for 1.5 min/bed. After conducting free-breathing imaging, we obtained images of the patients with abdominal compression by applying the same setup used in the free-breathing scan. The differences in the standardized uptake value (SUV)max, SUVmean, tumor volume, and the centroid of the tumors between PET and various CT schemes were measured.ResultsThe SUVmax and SUVmean derived from PET/CT imaging using an abdominal compression device increased for all the lesions, compared with those obtained using the conventional approach. The percentage increases were 18.1% ±14% and 17% ±16.8% for SUVmax and SUVmean, respectively. PET/CT imaging combined with abdominal compression generally reduced the tumor mismatch between CT and the corresponding attenuation corrected PET images, with an average decrease of 1.9±1.7 mm over all the cases.ConclusionsPET/CT imaging combined with abdominal compression reduces respiratory artifacts and PET/CT misregistration, and enhances quantitative SUV in tumor. Abdominal compression is easy to set up and is an effective method used in PET/CT imaging for clinical oncology, especially in the thoracic region.
Highlights
Respiratory motion causes image artifacts in PET/CT images and misalignment between PET and CT
When using CT images to correct for attenuation in PET data, the mismatch between PET and CT images caused by respiration may result in errors in localizing the tumor in PET, leading to an inaccurate standardized uptake value (SUV) because of the large difference in the acquisition time of CT and PET
We demonstrated respiratory motion correction in PET/CT by using an abdominal compression device, and investigated the potential improvement of the results compared with those produced using conventional CT (HCT) on patients with lung cancer
Summary
Respiratory motion causes image artifacts in PET/CT images and misalignment between PET and CT. An overestimation of the volume and underestimation of the SUV of a lung lesion caused by respiratory motion were reported by Nehmeh et al and Erdi et al [2,3]. Liu et al reported the increased uncertainty of the SUV for lung tumors when attenuation correction (AC) was performed using misaligned PET/CT [4]. Huang et al demonstrated that increased tumor motion is closely associated with the SUV maximum (SUVmax) decrease in patients with lung cancer [5]. These artifacts and the misalignment could cause potential misdiagnoses when combined with the PET/CT imaging modality for lung cancer diagnosis [6]
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