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Research ArticlePhysics and Instrumentation

Data-Driven Respiratory Gating Outperforms Device-Based Gating for Clinical 18F-FDG PET/CT

Matthew D. Walker, Andrew J. Morgan, Kevin M. Bradley and Daniel R. McGowan
Journal of Nuclear Medicine November 2020, 61 (11) 1678-1683; DOI: https://doi.org/10.2967/jnumed.120.242248
Matthew D. Walker
1Radiation Physics and Protection, Oxford University Hospitals NHS FT, Oxford, United Kingdom
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Andrew J. Morgan
1Radiation Physics and Protection, Oxford University Hospitals NHS FT, Oxford, United Kingdom
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Kevin M. Bradley
2Department of Radiology, Churchill Hospital, Oxford, United Kingdom
3Wales Research and Diagnostic PET Imaging Centre, Cardiff University, Cardiff, United Kingdom; and
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Daniel R. McGowan
1Radiation Physics and Protection, Oxford University Hospitals NHS FT, Oxford, United Kingdom
4Department of Oncology, University of Oxford, Oxford, United Kingdom
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  • FIGURE 1.
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    FIGURE 1.

    Depiction of quiescent period gating (QPG), in which part of respiratory cycle associated with relatively little motion is identified and retained in gated image.

  • FIGURE 2.
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    FIGURE 2.

    Box plots showing SUVmax for DDG-retro, minus that obtained from RPM-gated, ungated-matched, or ungated-full. Positive values indicate higher SUVmax in case of DDG-retro. Line on box indicates median.

  • FIGURE 3.
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    FIGURE 3.

    Comparison of clinical scoring between DDG-retro and RPM-gated (A), ungated-matched (B), and ungated-full (C). Lower score indicated preference, and hence negative scores represent preference for DDG-retro.

  • FIGURE 4.
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    FIGURE 4.

    Considering only those studies with visible lesions in liver, comparison of clinical scoring between DDG-retro and RPM-gated (A), ungated-matched (B), and ungated-full (C). Lower score indicated preference, and hence negative scores represent preference for DDG-retro.

  • FIGURE 5.
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    FIGURE 5.

    Coronal slices showing 18F-FDG–avid liver metastasis (indicated by arrows) that is easier to detect and has higher SUVmax on 2 gated reconstructions than without gating. In this example, DDG-retro and RPM-gated images received equal score for overall image quality, and both were considered superior to ungated images. Lesion indicated by arrow was not considered to be definitely visible on ungated-matched image and was borderline-visible on ungated-full image. One can also see reduction in noise in ungated-full image, as compared with other 3 images. Images are on SUV grayscale of 0–6.

  • FIGURE 6.
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    FIGURE 6.

    Comparison of noise scoring across 4 image reconstructions. Error bars represent SEs on mean.

Tables

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    TABLE 1

    Differences in Lesion Quantification Between DDG-Retro and the 3 Other Methods of Gating and Reconstruction

    Difference (DDG-retro – other)
    Parameter/DDG-retro with…Lesions (n)Mean25th, 75th percentilesP
    SUVmax/RPM-gated870.66 ± 0.1 g/mL0.00, 0.87 g/mL<0.0005
    SUVmax/ungated-matched1071.3 ± 0.2 g/mL0.06, 2.0 g/mL<0.0005
    SUVmax/ungated-full1071.6 ± 0.2 g/mL0.38, 2.0 g/mL<0.0005
    SUVmean/RPM-gated540.44 ± 0.1 g/mL−0.01, 0.60 g/mL0.003
    SUVmean/ungated-matched640.97 ± 0.2 g/mL0.01, 1.60 g/mL<0.0005
    SUVmean/ungated-full641.2 ± 0.2 g/mL0.36, 1.59 g/mL<0.0005
    Lesion volume/RPM-gated54−0.30 ± 0.1 cm3−0.52, 0.03 cm30.009
    Lesion volume/ungated-matched64−0.70 ± 0.2 cm3−0.98, −0.01 cm30.005
    Lesion volume/ungated-full64−0.83 ± 0.2 cm3−1.05, −0.03 cm30.001
    • Data are mean differences (with SE on mean difference) and first and third quartiles, along with results from post hoc testing of transformed data. P values are uncorrected for multiple comparisons. Critical P value for statistical significance was 0.017 (lowered from 0.05 to allow for multiple comparisons).

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Journal of Nuclear Medicine: 61 (11)
Journal of Nuclear Medicine
Vol. 61, Issue 11
November 1, 2020
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Data-Driven Respiratory Gating Outperforms Device-Based Gating for Clinical 18F-FDG PET/CT
Matthew D. Walker, Andrew J. Morgan, Kevin M. Bradley, Daniel R. McGowan
Journal of Nuclear Medicine Nov 2020, 61 (11) 1678-1683; DOI: 10.2967/jnumed.120.242248

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Data-Driven Respiratory Gating Outperforms Device-Based Gating for Clinical 18F-FDG PET/CT
Matthew D. Walker, Andrew J. Morgan, Kevin M. Bradley, Daniel R. McGowan
Journal of Nuclear Medicine Nov 2020, 61 (11) 1678-1683; DOI: 10.2967/jnumed.120.242248
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Keywords

  • Respiratory gating
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  • FDG
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