title: Deep Inspiration Breath Hold [(18)F]FDG PET-CT on 4-rings scanners in evaluating lung lesions: evidences from a phantom and a clinical study.
abstract: OBJECTIVE
  To investigate the clinical feasibility of a Deep Inspiration Breath Hold (DIBH) (18)F-FDG PET-CT acquisition in apnea and compare the results obtained between these acts of acquisition in apnea and in Free Breathing in the evaluation of lung lesions.
  
  
  METHODS
  A pre-clinical phantom study was performed to evaluate the shortest simulated DIBH time according to the minimum detectable lesion that can be detected by our ultrasound scanner. This study was conducted by changing acquisition time and sphere-to-background activity ratio values and by using radioactivity densities similar to those generally found in clinical examinations. In the clinical study, 25 patients with pulmonary lesions underwent a standard whole body (18)F-FDG PET-CT scan in free breathing followed by a 20s single thorax acquisition PET/CT in DIBH acquisition.
  
  
  RESULTS
  The phantom study indicated that a 20-s acquisition time provides an accurate evaluation of smallest sphere shaped lesions. In the clinical study, PET-CT scans obtained in DIBH studies showed a significant reduction of misalignment between the PET and CT scan images and an increase of SUVmax compared to free breathing acquisitions. A correlation between the %BH-index and lesion displacement between PET and CT images in FB acquisition was demonstrated, significantly higher for lesions with a displacement>8mm.
  
  
  CONCLUSIONS
  The single 20s acquisition of DIBH PET-CT is a feasible technique for lung lesion detection in the clinical setting. It only requires a minor increase in examination time without special patient training. 20s DIBH scan provided a more precise measurement of SUVmax, especially for lesions in the lower lung lobes which usually show greater displacement between PET and CT scan images in FB acquisition.
authors.affiliation: Nuclear Medicine Department, Fondazione Poliambulanza Brescia, Italy. Electronic address: fedefournier@libero.it.
authors.forename: Federico
authors.initials: F
authors.lastname: Caobelli
authors.affiliation: Nuclear Medicine Department, Fondazione Poliambulanza Brescia, Italy.
authors.forename: Erinda
authors.initials: E
authors.lastname: Puta
authors.affiliation: Medical Physics Department, Fondazione Poliambulanza Brescia, Italy.
authors.forename: Stefano Ren
authors.initials: SR
authors.lastname: Kaiser
authors.affiliation: Nuclear Medicine Department, Fondazione Poliambulanza Brescia, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Massetti
authors.affiliation: Nuclear Medicine Department, Fondazione Poliambulanza Brescia, Italy.
authors.forename: Michela
authors.initials: M
authors.lastname: Andreoli
authors.affiliation: Nuclear Medicine Department, Fondazione Poliambulanza Brescia, Italy.
authors.forename: Angelica
authors.initials: A
authors.lastname: Mostarda
authors.affiliation: Nuclear Medicine Department, Fondazione Poliambulanza Brescia, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Soffientini
authors.affiliation: Nuclear Medicine Department, Fondazione Poliambulanza Brescia, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Pizzocaro
authors.affiliation: Nuclear Medicine Department, Fondazione Poliambulanza Brescia, Italy.
authors.forename: Ugo Paolo
authors.initials: UP
authors.lastname: Guerra
mesh_terms: D000368:Aged; D062485:Breath Holding; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008171:Lung Diseases / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D019047:Phantoms, Imaging; D049268:Positron-Emission Tomography / Q000295:instrumentation / Q000379:methods*; D019275:Radiopharmaceuticals; D014057:Tomography, X-Ray Computed / Q000295:instrumentation / Q000379:methods*
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: (18)F-FDG PET/CT; Apnea; Deep Inspiration Breath Hold; Desplazamiento; Displacement; Lesiones pulmonares; Lung lesions