Details

Autor(en) / Beteiligte

• Garcia Vicente, AM
• Soriano Castrejon, AM
• Talavera Rubio, MP
• Leon Martin, AA
• Palomar Munoz, AM
• Pilkington Woll, JP
• Poblete Garcia, VM

Titel

super(18)F-FDG PET-CT respiratory gating in characterization of pulmonary lesions: approximation towards clinical indications

Ist Teil von

• Annals of nuclear medicine, 2010-04, Vol.24 (3), p.207-214

Erscheinungsjahr

2010

Quelle

SpringerLink

Beschreibungen/Notizen

• Aim: To evaluate the effect of the 18F-FDG PET-CT respiratory gating (4D) study in the correct documentation of pulmonary lesions with faint uptake in standard PET-CT. Methods: Forty-two pulmonary lesions with a low or no detectable uptake of FDG (SUV sub(max)<2.5) in 3D PET-CT were prospectively evaluated in 28 patients (19 males and 9 females), mean age 66.5years (41-81). 22 patients had neoplastic background. A conventional PET-CT (3D) total body scan was performed approximately 60min after iv injection of a mean dose of 370MBq. Furthermore, a 4D PET-CT (synchronized with respiratory movement) thorax study was acquired. SUV sub(max) was determined for each lesion in both studies. For the 4D studies, we selected the SUV sub(max) in respiratory period with the highest uptake ('best bin'). We calculated the SUV sub(max) percentage difference between 3D and 4D PET-CT (% difference=SUV sub(max)4D& #x00A0; -SUV sub(max)3D/SUV sub(max)3D100) and the relation of this value with the size and locations of the lesions. In 4D study, any lesion with SUV sub(max) greater than or equal to 2.5 was classified as malignant. We assessed the changes of lesion classification (from benign to malignant) applying the 4D technique. The final diagnosis was obtained by histological assessment or clinical and radiological follow-up longer than 12months. Results: Forty out of 42 lesions showed an increase of SUV sub(max) in the 4D study with respect to 3D. The mean SUV sub(max) in the 3D and 4D PET-CT studies were 1.33 ( plus or minus 0.59) and 2.26 ( plus or minus 0.87), respectively. The SUV sub(max) percentage difference mean between both techniques was 83.3% ( plus or minus 80.81).The smaller the lesion the greater was the SUV sub(max) percentage difference (P<0.05). No differences were observed depending on the location of the lesion. In 40% of cases, there was a change in the final classification of lesions from benign to malignant. In the final diagnosis, 24 lesions were malignant. 4D PET-CT diagnosed correctly the 52% of them. Conclusions: The 4D PET-CT study permitted a better characterization of malignant lung lesions compared with the standard PET-CT, because of its higher sensitivity. 4D PET-CT is a recommendable technique in the early diagnosis of malignant lesions.