Purpose Respiratory 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. Methods Twelve 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. Results The 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. Conclusions PET/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.
References
[1]
Nehmeh SA, Erdi YE, Pan T, Pevsner A, Rosenzweig KE, et al. (2004) Four-dimensional (4D) PET/CT imaging of the thorax. Med Phys 31(12): 3179–86. doi: 10.1118/1.1809778
[2]
Nehmeh SA, Erdi YE, Ling CC, Rosenzweig KE, Schoder H, et al. (2002) Effect of respiratory gating on quantifying PET images of lung cancer. J Nucl Med 43(7): 876–81.
[3]
Erdi YE, Nehmeh SA, Pan T, Pevsner A, Rosenzweig KE, et al. (2004) The CT motion quantitation of lung lesions and its impact on PET-measured SUVs. J Nucl Med 45(8): 1287–92.
[4]
Liu C, Pierce LA, Alessio AM, Kinahan PE (2009) The impact of respiratory motion on tumor quantification and delineation in static PET/CT imaging. Phys Med Biol 54(24): 7345–62. doi: 10.1088/0031-9155/54/24/007
[5]
Huang TC, Wang YC (2013) Deformation effect on SUVmax changes in thoracic tumors using 4-D PET/CT scan. PLoS One 8(3): e58886. doi: 10.1371/journal.pone.0058886
[6]
Nagamachi S, Wakamatsu H, Kiyohara S, Fujita S, Futami S, et al. (2010) The reproducibility of deep-inspiration breath-hold 18F-FDG PET/CT technique in diagnosing various cancers affected by respiratory motion. Ann Nucl Med 24(3): 171–8. doi: 10.1007/s12149-010-0352-3
[7]
Boucher L, Rodrigue S, Lecomte R, Bénard F (2004) Respiratory gating for 3-dimensional PET of the thorax: feasibility and initial results. J Nucl Med 45(2): 214–9.
[8]
Hamill JJ, Bosmans G, Dekker A (2008) Respiratory-gated CT as a tool for the simulation of breathing artifacts in PET and PET/CT. Med Phys 35(2): 576–85. doi: 10.1118/1.2829875
[9]
Wang YC, Tseng HL, Lin YH, Kao CH, Huang WC, et al. (2013) Improvement of internal tumor volumes of non-small cell lung cancer patients for radiation treatment planning using interpolated average CT in PET/CT. PLoS One 8(5): e64665. doi: 10.1371/journal.pone.0064665
[10]
Nehmeh SA, Erdi YE, Meirelles GS, Squire O, Larson SM, et al. (2007) Deep-inspiration breath-hold PET/CT of the thorax. J Nucl Med 48(1): 22–6. doi: 10.2967/jnumed.106.038034
[11]
Pan T, Mawlawi O, Nehmeh SA, Erdi YE, Luo D, et al. (2005) Attenuation correction of PET images with respiration-averaged CT images in PET/CT. J Nucl Med 46(9): 1481–7. doi: 10.1118/1.2733810
[12]
Huang TC, Mok GS, Wang SJ, Wu TH, Zhang G (2011) Attenuation correction of PET images with interpolated average CT for thoracic tumors. Phys Med Biol 56(8): 2559–67.
[13]
Mok GS, Sun T, Huang TC, Vai MI (2013) Interpolated average CT for attenuation correction in PET–a simulation study. IEEE Trans Biomed Eng 60(7): 1927–34. doi: 10.1109/tbme.2013.2245132
[14]
Sun T, Wu TH, Wang SJ, Yang BH, Wu NY, et al. (2013) Low dose interpolated average CT for thoracic PET/CT attenuation correction using an active breathing controller. Med Phys 40(10): 102507. doi: 10.1118/1.4820976
[15]
Heinzerling JH, Anderson JF, Papiez L, Boike T, Chien S, et al. (2008) Four-dimensional computed tomography scan analysis of tumor and organ motion at varying levels of abdominal compression during stereotactic treatment of lung and liver. Int J Radiat Oncol Biol Phys 70(5): 1571–8. doi: 10.1016/j.ijrobp.2007.12.023
[16]
Bouilhol G, Ayadi M, Rit S, Thengumpallil S, Schaerer J, et al. (2013) Is abdominal compression useful in lung stereotactic body radiation therapy? A 4DCT and dosimetric lobe-dependent study. Phys Med 29(4): 333–40. doi: 10.1016/j.ejmp.2012.04.006
[17]
Bradley J, Thorstad WL, Mutic S, Miller TR, Dehdashti F, et al. (2004) Impact of FDG-PET on radiation therapy volume delineation in non-small-cell lung cancer. Int J Radiat Oncol Biol Phys 59(1): 78–86. doi: 10.1016/j.ijrobp.2003.10.044
[18]
Keall PJ, Mageras GS, Balter JM, Emery RS, Forster KM, et al. (2006) The management of respiratory motion in radiation oncology report of AAPM Task Group 76. Med Phys 33(10): 3874–900.
[19]
Bissonnette JP, Franks KN, Purdie TG, Moseley DJ, Sonke JJ, et al. (2009) Quantifying interfraction and intrafraction tumor motion in lung stereotactic body radiotherapy using respiration-correlated cone beam computed tomography. Int J Radiat Oncol Biol Phys 75(3): 688–95. doi: 10.1016/j.ijrobp.2008.11.066
[20]
Guerrero T, Zhang G, Huang TC, Lin KP (2004) Intrathoracic tumour motion estimation from CT imaging using the 3D optical flow method. Phys Med Biol 49(17): 4147–61. doi: 10.1088/0031-9155/49/17/022
[21]
Aristophanous M, Berbeco RI, Killoran JH, Yap JT, Sher DJ, et al. (2010) Clinical utility of 4D FDG-PET/CT scans in radiation treatment planning. Int J Radiat Oncol Biol Phys 82(1): e99–105. doi: 10.1016/j.ijrobp.2010.12.060
[22]
Callahan J, Binns D, Dunn L, Kron T (2011) Motion effects on SUV and lesion volume in 3D and 4D PET scanning. Australas Phys Eng Sci Med 34(4): 489–95.
[23]
Cervi?o LI, Chao AK, Sandhu A, Jiang SB (2009) The diaphragm as an anatomic surrogate for lung tumor motion. Phys Med Biol 54(11): 3529–41. doi: 10.1088/0031-9155/54/11/017