title: Usefulness of a deep-inspiration breath-hold 18F-FDG PET/CT technique in diagnosing liver, bile duct, and pancreas tumors.
abstract: BACKGROUND
  The deep-inspiration breath-hold F-fluorodeoxyglucose PET/computed tomography (DIBH F-FDG PET/CT) technique improves the limitations of diagnosing a lesion located in an area influenced by respiratory motion that brings about spatial misregistration caused by respiration between PET and CT. However, its clinical effectiveness with regard to abdominal lesions has not been elucidated. The influence of respiratory motion for calculating the maximal standardized uptake value (SUVmax) and metabolic volume (MV) in DIBH F-FDG PET/CT has not been investigated either.
  
  
  OBJECTIVE
  The purpose of this study was to investigate the usefulness of the DIBH F-FDG PET/CT technique in diagnosing liver tumors, bile duct cancers, and pancreas tumors. In addition, we compared the values of SUVmax and MV between DIBH and nonbreath-hold (NBH).
  
  
  METHODS
  Forty patients with various abdominal malignancies including liver tumors, bile duct cancers, and pancreas tumors were enrolled. In total, the patients had 47 abdominal lesions. All patients showed a misregistered image in the early whole-body image taken 50 min after intravenous F-FDG infusions. We added the delayed images 40 min after the first image. On the delayed image, we carried out both conventional techniques with normal respiration (NBH) and the DIBH technique. Finally, we compared two kinds of images in each patient. At the same time, we compared both SUVmax and MV of cancer obtained by the two kinds of imaging methods.
  
  
  RESULTS
  In 14 lesions (29.8%), we corrected the anatomical tumor location, from the incorrect to the correct organ, by the DIBH technique. In 22 lesions (46.8%), we corrected the tumor location within the organ. Consequently, tumor staging also changed in 11 patients (23.4%) after correction by the DIBH technique. Regarding the SUVmax value by DIBH, it showed an increase of approximately 15.0-58.6% compared with that measured by NBH. In contrast, the value of MV by DIBH showed a decrease of 20% compared with that measured by NBH.
  
  
  CONCLUSIONS
  The DIBH F-FDG PET/CT technique is feasible for accurate localization when diagnosing of liver tumors, bile duct cancers, and pancreas cancers. The DIBH technique also improves the inaccurate quantification of both SUVmax and MV.
authors.affiliation: Department of Radiology, Miyazaki University, Miyazaki Prefecture, Japan. snagama@med.miyazaki-u.ac.jp
authors.forename: Shigeki
authors.initials: S
authors.lastname: Nagamachi
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Wakamatsu
authors.forename: Shogo
authors.initials: S
authors.lastname: Kiyohara
authors.forename: Seigo
authors.initials: S
authors.lastname: Fujita
authors.forename: Shigemi
authors.initials: S
authors.lastname: Futami
authors.forename: Hideo
authors.initials: H
authors.lastname: Arita
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Nishii
authors.forename: Shozo
authors.initials: S
authors.lastname: Tamura
authors.forename: Keiichi
authors.initials: K
authors.lastname: Kawai
mesh_terms: D000328:Adult; D000368:Aged; D001650:Bile Duct Neoplasms / Q000000981:diagnostic imaging*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D001239:Inhalation; D008175:Lung Neoplasms / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D009068:Movement; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging*; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D014057:Tomography, X-Ray Computed
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18