Diagnostic Performance and Image Quality of 20-second Breath-hold Total-body PET/CT Acquisition in Stage Ia Pulmonary Adenocarcinoma

Abstract

\n PurposeThe study is to evaluate the diagnostic performance and image quality of a 20-second breath-hold (BH) 18F-FDG total-body PET acquisition compared with a free-breathing (FB) PET for stage IA pulmonary adenocarcinoma.Materials and MethodsForty-seven patients with confirmed stage IA pulmonary adenocarcinoma were enrolled. All patients underwent total-body 18F–FDG PET/CT and the acquisition time was 300 s, followed by a 20-s BH PET. A 20-s FB PET was extracted from the 300-s PET. The size and volume of lesions were measured on BHCT images. The SUVmax, tumor-to-background ratio (TBR), metabolic tumor volume (MTV), %ΔSUVmax and %ΔTBR of the lesions were measured and recorded. The lesions were further divided by distance from pleura, lesion size, and morphological characteristic for subgroup analysis. ResultsIn the cohort and subgroup analysis, the SUVmax and TBR were significantly increased with 20-BH PET compared with 300-FB PET and 20-FB PET (all p＜0.05). And the %ΔSUVmax and %ΔTBR in D1 groups (≤10 mm in distance) higher than those in D2 and D3 groups (＞10 mm). The diagnostic performance of BH PET was significantly higher than that of FB PET (all p＜0.001). The Bland-Altman plot for agreement on lesion’s volume between BH PET and CT showed good agreement than FB PET.ConclusionThe 20-s BH PET acquisition is more sensitive to quantitative and qualitative analysis for stage IA pulmonary adenocarcinoma. 20-s BH PET/CT acquisition reduces the blurring effect of respiratory motion especially for subpleural nodules (≤10 mm in distance).