Effects of data-driven respiratory gating on visualization and quantification of breast and upper abdominal cancers in FDG PET/CT examinations

Abstract

Objective

Data-driven respiratory gating (DDG) has recently been introduced to improve image quality in the PET portion of PET/CT examinations. The latest DDG system does not require any external equipment or extended examination time. In this study, we investigated the effects of the new DDG system on the visualization and quantification of breast and upper abdominal cancers, comparing the results with those obtained using the standard free-breathing (STD) PET protocol.

Methods

A total of 223 cancer lesions (138 breast and 85 upper abdominal) evaluated with FDG PET/CT were included in this study. PET images were reconstructed using the STD and DDG algorithms. Lesion blurring and conspicuity were each visually graded on a three-point scale. The longest diameter (LD), SUVmax, and metabolic tumor volume (MTV) of the lesions were used for quantitative analysis. % change in SUVmax or MTV was calculated from the metrics in STD and DDG images. Fifty-six texture features (TFs) were also evaluated. Visual scores and quantitative metrics were compared between STD and DDG images. % change in SUVmax or MTV was compared in the lesion location groups or in the high and low groups based on LD, SUVmax, or MTV in STD images.

Results

Visual scores for lesion blurring and conspicuity were both significantly higher in DDG than in STD PET images. SUVmax and MTV were significantly higher and lower, respectively, in DDG than in STD images. An increase in SUVmax and a decrease in MTV were observed in 96% and 86% of all lesions, respectively. Group analysis revealed that % change in SUVmax was greater in the upper abdominal than the breast lesions and % change in MTV was greater in the high LD and high MTV groups than in the low LD and low MTV groups, respectively. Quantitative changes in TFs were observed between STD and DDG images for most of the features.

Conclusion

This study demonstrated that DDG improved visualization and quantification of breast and upper abdominal cancers in FDG PET/CT examinations. DDG PET images exhibited an increase in SUVmax, a decrease in MTV, and changes in TFs.