Assessment of pulmonary nodules using [18F]-FDG PET/CT in deep inspiration breath-hold

Revista espanola de medicina nuclear e imagen molecular Pub Date : 2025-03-01 DOI:10.1016/j.remnie.2024.500074

M.S. Casallas Cepeda, S. Salcedo Córtes, I. Gómez Fernández, J. Orcajo Rincón, L. Reguera Berenguer, E.J. Ardila Manjarrez, J.J. Ardila Mantilla, V. Castillo Morales, J. Gúzman Cruz, D. Zamudio Rodríguez, A. Marí Hualde, J.E. Montalvá Pastor, S. Álvarez Lara, J.C. Alonso Farto

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Abstract

The characterization of pulmonary nodules (PN) is a primary indication for [¹⁸F]-FDG PET/CT. However, respiratory movements hinder this characterization, especially for PN located in the lower lobes. Various methods have been developed to improve image resolution.

Objective

Our objective was to compare the diagnostic efficacy of [¹⁸F]-FDG PET/CT in deep inspiration breath-hold (DIBH) versus free-breathing corrected by software, in the evaluation of PN.

Methods

We prospectively analyzed 51 patients to assess PN using [¹⁸F]-FDG PET/CT in DIBH and free-breathing corrected by software. A total of 84 nodules with an average size of 10 mm were analyzed, with pathological anatomy or medical treatment decide by a multidisciplinary tumor board used as reference.

Results

A total of 84 PN were evaluated, comparing those in DIBH versus free-breathing, finding statistically significant differences in SUVmax values P(< 0.05) (mean SUVmax 3.7 in free-breathing vs. 5.33 in DIBH). When analyzed by location in lobes, we did not find statistically significant differences, though there was a trend towards higher SUVmax values in the lower lobes. [¹⁸F]-FDG PET/CT in DIBH showed high sensitivity (95%) and negative predictive value (NPV) (92%), indicating it may be a promising tool for PN characterization.

Conclusions

The acquisition of [¹⁸F]-FDG PET/CT in DIBH significantly improves the sensitivity and diagnostic efficacy in the assessment of PN. Although no statistically significant differences were found based on location, there is a potential benefit for the lower lobes. These findings could support its use in clinical practice.

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在深吸气时使用 [18F]-FDG PET/CT 评估肺结节。

肺结节（PN）的定性是[18F]-FDG PET/CT 的主要适应症。然而，呼吸运动阻碍了这一特征的确定，尤其是位于下叶的肺结节。目前已开发出多种方法来提高图像分辨率：我们的目的是比较[18F]-FDG PET/CT 在深吸气屏气（DIBH）状态下与经软件校正的自由呼吸状态下对 PN 的诊断效果：我们对 51 例患者进行了前瞻性分析，使用 DIBH 和经软件校正的自由呼吸[18F]-FDG PET/CT 评估 PN。共分析了 84 个平均大小为 10 毫米的结节，并以多学科肿瘤委员会的病理解剖或医学治疗决定作为参考：结果：共评估了 84 个 PN，比较了 DIBH 和自由呼吸下的 PN，发现两者的 SUVmax 值（p 18F]-FDG PET/CT 在 DIBH 下显示出较高的灵敏度（95%）和阴性预测值（NPV）（92%），表明它可能是 PN 特征描述的一种有前途的工具：结论：在 DIBH 中采集[18F]-FDG PET/CT 可显著提高 PN 评估的灵敏度和诊断效果。虽然根据部位的不同没有发现明显的统计学差异，但下叶有潜在的获益。这些发现可支持其在临床实践中的应用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Revista espanola de medicina nuclear e imagen molecular

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