Feasibility of 4-minute respiratory-gated total-body PET/CT in patients with malignancies
10.12025/j.issn.1008-6358.2026.20251657
- VernacularTitle:4 min呼吸门控全身PET/CT应用于恶性肿瘤患者的可行性
- Author:
Xiaoguang HOU
1
;
Shuguang CHEN
1
;
Yimeng SHI
1
;
Haojun YU
1
;
Pengcheng HU
1
;
Guobing LIU
1
Author Information
1. Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai 200032, China;Institute of Nuclear Medicine, Fudan University, Shanghai 200032, China;Shanghai Institute of Medical Imaging, Shanghai 200032, China.
- Publication Type:Originalarticle
- Keywords:
respiratory gating;
total-body PET/CT;
tumor imaging;
image quality
- From:
Chinese Journal of Clinical Medicine
2026;33(3):452-460
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the feasibility and image quality of respiratory-gated total-body 18F-FDG PET/CT imaging with a 4-minute acquisition in patients with malignant tumors. Methods Sixty-two patients with pathologically confirmed malignant tumors (118 lesions measured) who underwent total-body 18F-FDG PET/CT examination were consecutively enrolled at the Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, from September 23, 2021 to November 23, 2021, and their clinical and imaging data were retrospectively collected. PET data was acquired over 12 minutes with simultaneous respiratory waveform recorded. The data were reconstructed into four image sets: gated-12 group and gated-4 group (using all counts and the first 4-minute counts, respectively) and ungated-12 group and ungated-6 group (using all counts and the first 6-minute counts, respectively) reconstructed with respiratory gating that retained counts corresponding to the half respiratory window near end-expiration. Image quality assessment and quantitative analysis of lesions were performed and compared among the four image sets, and subgroup analyses were performed according to lesion location, size, and metabolic activity. Results The effective counts of 4 sets of PET images were highest in ungated-12 group, followed by ungated-6 group and gated-12 group, and lowest in gated-4 group (P＜0.001). Regardless of the metabolic level and size of the lesions, compared with the ungated-12 group and the ungated-6 group, the lesions in the gated-12 group showed higher maximum, average, and peak standardized uptake values (SUVmax, SUVmean, and SUVpeak), tumor liver uptake ratio, tumor blood pool uptake ratio, and smaller metabolic volume (P＜0.05); There was no statistically significant difference in the above indicators between the gate-12 group and the gate-4 group. The background noise of gate-4 group images is slightly higher than that of gate-12 group images (Liver SUVSD: [0.17＋0.05] vs [0.14＋0.04]); Blood pool SUVSD: (0.08 ± 0.03) vs (0.06 ± 0.03). There was a statistically significant difference in subjective scores of PET image quality among the four groups (P＜0.001). The subjective scores of image quality in the gated-12 group (4.79 ± 0.41) were not significantly different from those in the non gated-12 group (4.97 ± 0.17) and non gated-6 group (4.79 ± 0.45), but were higher than those in the gated-4 group ([4.17 ± 0.45], P＜0.001)， And the scores have good consistency (Kappa＞0.75). Conclusion In total-body PET/CT imaging for malignant tumors, 4-minute respiratory-gated acquisition can achieve comparable quantitative performance to longer respiratory gating imaging while significantly shortening acquisition time. This approach demonstrates promising potential for clinical application.
