title: Reduction of Respiratory Motion During PET/CT by Pulsatile-Flow Ventilation: A First Clinical Evaluation.
abstract: Respiratory motion negatively affects PET/CT image quality and quantitation. A novel Pulsatile-Flow Ventilation (PFV) system reducing respiratory motion was applied in spontaneously breathing patients to induce sustained apnea during PET/CT.
  
  
  METHODS
  Four patients (aged 65 ± 14 y) underwent PET/CT for pulmonary nodule staging (mean, 11 ± 7 mm; range, 5-18 mm) at 63 ± 3 min after (18)F-FDG injection and then at 47 ± 7 min afterward, during PFV-induced apnea (with imaging lasting ≥8.5 min). Anterior-posterior thoracic amplitude, SUVmax, and SUVpeak (SUVmean in a 1-cm-diameter sphere) were compared.
  
  
  RESULTS
  PFV PET/CT reduced thoracic amplitude (80%), increased mean lesion SUVmax (29%) and SUVpeak (11%), decreased lung background SUVpeak (25%), improved lesion detectability, and increased SUVpeak lesion-to-background ratio (54%). On linear regressions, SUVmax and SUVpeak significantly improved (by 35% and 23%, respectively; P ≤ 0.02).
  
  
  CONCLUSIONS
  PFV-induced apnea reduces thoracic organ motion and increases lesion SUV, detectability, and delineation, thus potentially affecting patient management by improving diagnosis, prognostication, monitoring, and external-radiation therapy planning.
authors.affiliation: Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Lausanne, Switzerland.
authors.forename: John O
authors.initials: JO
authors.lastname: Prior
authors.affiliation: Department of Radiation Oncology, Lausanne University Hospital, Lausanne, Switzerland.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Péguret
authors.affiliation: Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Lausanne, Switzerland.
authors.forename: Anastasia
authors.initials: A
authors.lastname: Pomoni
authors.affiliation: Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Lausanne, Switzerland.
authors.forename: Martin
authors.initials: M
authors.lastname: Pappon
authors.affiliation: Department of Medical Physics, Lausanne University Hospital, Lausanne, Switzerland.
authors.forename: Michele
authors.initials: M
authors.lastname: Zeverino
authors.affiliation: Department of Physiotherapy, Lausanne University Hospital, Lausanne, Switzerland.
authors.forename: Bastien
authors.initials: B
authors.lastname: Belmondo
authors.affiliation: Department of Pneumology, Lausanne University Hospital, Lausanne, Switzerland; and.
authors.forename: Alban
authors.initials: A
authors.lastname: Lovis
authors.affiliation: Department of Radiation Oncology, Lausanne University Hospital, Lausanne, Switzerland.
authors.forename: Mahmut
authors.initials: M
authors.lastname: Ozsahin
authors.affiliation: BIRD Institute of Pulmonary Care, Villeneuve-Loubet, France.
authors.forename: Monique
authors.initials: M
authors.lastname: Vienne
authors.affiliation: Department of Radiation Oncology, Lausanne University Hospital, Lausanne, Switzerland jean.bourhis@chuv.ch.
authors.forename: Jean
authors.initials: J
authors.lastname: Bourhis
mesh_terms: D000368:Aged; D001049:Apnea / Q000000981:diagnostic imaging / Q000503:physiopathology; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008168:Lung / Q000000981:diagnostic imaging; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009038:Motion; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D019275:Radiopharmaceuticals; D012121:Respiration, Artificial; D015656:Respiratory Mechanics; D003074:Solitary Pulmonary Nodule / Q000000981:diagnostic imaging
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: HFPV; High-Frequency Percussive Ventilation; PET/CT; Pulsatile-Flow Ventilation; respiratory motion