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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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Abstract

A data-driven method for respiratory gating in PET has recently been commercially developed. We sought to compare the performance of the algorithm with an external, device-based system for oncologic 18F-FDG PET/CT imaging. Methods: In total, 144 whole-body 18F-FDG PET/CT examinations were acquired, with a respiratory gating waveform recorded by an external, device-based respiratory gating system. In each examination, 2 of the bed positions covering the liver and lung bases were acquired with a duration of 6 min. Quiescent-period gating retaining approximately 50% of coincidences was then able to produce images with an effective duration of 3 min for these 2 bed positions, matching the other bed positions. For each examination, 4 reconstructions were performed and compared: data-driven gating (DDG) (we use the term DDG-retro to distinguish that we did not use the real-time R-threshold–based application of DDG that is available within the manufacturer’s product), external device-based gating (real-time position management (RPM)–gated), no gating but using only the first 3 min of data (ungated-matched), and no gating retaining all coincidences (ungated-full). Lesions in the images were quantified and image quality scored by a radiologist who was masked to the method of data processing. Results: Compared with the other reconstruction options, DDG-retro increased the SUVmax and decreased the threshold-defined lesion volume. Compared with RPM-gated, DDG-retro gave an average increase in SUVmax of 0.66 ± 0.1 g/mL (n = 87, P < 0.0005). Although the results from the masked image evaluation were most commonly equivalent, DDG-retro was preferred over RPM-gated in 13% of examinations, whereas the opposite occurred in just 2% of examinations. This was a significant preference for DDG-retro (P = 0.008, n = 121). Liver lesions were identified in 23 examinations. Considering this subset of data, DDG-retro was ranked superior to ungated-full in 6 of 23 (26%) cases. Gated reconstruction using the external device failed in 16% of examinations, whereas DDG-retro always provided a clinically acceptable image. Conclusion: In this clinical evaluation, DDG-retro provided performance superior to that of the external device-based system. For most examinations the performance was equivalent, but DDG-retro had superior performance in 13% of examinations, leading to a significant preference overall.

  • respiratory gating
  • PET/CT
  • RPM
  • data-driven gating
  • FDG

Footnotes

  • Published online Apr. 3, 2020.

  • © 2020 by the Society of Nuclear Medicine and Molecular Imaging.
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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
  • PET/CT
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  • data-driven gating
  • FDG
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