Evaluation of 18F-FDG uptake in lung parenchyma compensating for tissue fraction: Comparison between non-enhanced low dose CT and intravenous contrast-enhanced diagnostic CT

Sabine Garpered; David Minarik; Sophia Frantz; Sven Valind; Per Wollmer

doi:10.1055/a-1038-9933

Nuklearmedizin - NuclearMedicine, Inhaltsverzeichnis

Nuklearmedizin 2020; 59(01): 20-25
DOI: 10.1055/a-1038-9933

Original Article

Evaluation of ¹⁸F-FDG uptake in lung parenchyma compensating for tissue fraction: Comparison between non-enhanced low dose CT and intravenous contrast-enhanced diagnostic CT

Bewertung der ¹⁸F-FDG-Aufnahme im Lungenparenchym unter Berücksichtigung des Gewebeanteils: Vergleich zwischen nicht-verstärkter Niedrigdosis-CT und intravenöser kontrastverstärkter diagnostischer CT

Sabine Garpered

¹Department of Clinical Physiology and Nuclear Medicine, Lunds universitet Medicinska fakulteten, Malmö, Sweden

,

David Minarik

²Department of Radiation physics, Lunds universitet Medicinska fakulteten, Malmö, Sweden

,

Sophia Frantz

¹Department of Clinical Physiology and Nuclear Medicine, Lunds universitet Medicinska fakulteten, Malmö, Sweden

,

Sven Valind

¹Department of Clinical Physiology and Nuclear Medicine, Lunds universitet Medicinska fakulteten, Malmö, Sweden

,

Per Wollmer

¹Department of Clinical Physiology and Nuclear Medicine, Lunds universitet Medicinska fakulteten, Malmö, Sweden

› Institutsangaben

Abstract

Aim To determine how the presence of intravenous (IV) contrast-enhanced CT influences SUV measurements corrected for both attenuation and tissue fraction.

Material and Methods Eighteen patients with different malignancies, free from lung disorders, lung cancer or metastasis, were prospectively recruited when referred for staging with combined ¹⁸F-FDG-PET/CT examination. A non-enhanced low-dose CT over the chest was immediately followed by a whole-body IV contrast-enhanced diagnostic CT and finally the PET acquisition. PET data were reconstructed with attenuation correction based on the two CT data sets. The lungs were segmented in the CT images and lung density was measured. Uptake of ¹⁸F-FDG in lung parenchyma was recorded using both non-enhanced and IV contrast-enhanced CT as well as with and without compensation for lung aeration. A comparison of SUV values of corrected and uncorrected PET images was performed.

Results There was no significant difference between low dose PET/CT and IV contrast-enhanced PET/CT when removing the impact of air fraction (p = 0.093 for the right lung and p = 0.085 for the left lung). When tissue fraction was not corrected for, there was a significant difference between low dose PET/CT and IV contrast enhanced PET/CT used for attenuation correction (p = 0.006 for the right lung and p = 0.015 for the left lung).

Conclusion There was only a marginal effect on the assessement of SUV in the lung tissue when using IV contrast enhanced CT for attenuation correction when the air fraction was accounted for.

Zusammenfassung

Ziel Bestimmung, inwiefern die intravenöse (IV) kontrastverstärkte CT Einfluss auf die SUV-Messungen mit Korrektur von beiden, der Schwächung und des Gewebeanteils, hat.

Material und Methoden Es wurden 18 Patienten mit verschiedenen Malignomen, ohne Lungenerkrankungen, Lungenkarzinome oder Metastasen, prospektiv rekrutiert, bei denen ein Staging mittels kombinierter 18F-FDG-PET/CT-Untersuchung durchgeführt wurde. Auf eine nicht-verstärkte Niedrigdosis-CT der Brust folgte unmittelbar darauf eine Ganzkörper IV kontrastverstärkte diagnostische CT und schließlich die PET-Akquisition. Die PET-Daten wurden mit Schwächungskorrektur auf Basis der beiden CT-Datensätze rekonstruiert. Die Lungen wurden in den CT-Aufnahmen segmentiert und die Lungendichte gemessen. Die Aufnahme von 18F-FDG in das Lungenparenchym wurde sowohl mit nicht-verstärkter als auch mit IV kontrastverstärkter CT sowie mit und ohne Kompensation der Lungenbelüftung erfasst. Die SUV-Werte der korrigierten und nicht-korrigierten PET-Bilder wurden verglichen.

Ergebnisse Es gab keinen signifikanten Unterschied zwischen Niedrigdosis PET/CT und IV kontrastverstärkter PET/CT wenn man den Einfluss der Luftfraktion entfernt (p = 0,093 für die rechte Lunge und p = 0,085 für die linke Lunge). Wenn nicht nach Gewebeanteil korrigiert wurde, gab es einen signifikanten Unterschied beim Einsatz von Niedigdosis PET/CT und IV kontrastverstärkter PET/CT zur Schwächungskorrektur (p = 0,006 für die rechte Lunge und p = 0,015 für die linke Lunge).

Schlussfolgerung Es gab es nur einen marginalen Effekt auf die Beurteilung des SUV im Lungengewebe bei Verwendung von IV kontrastverstärkter CT zur Schwächungskorrektur, wenn der Luftanteil berücksichtigt wurde.

Key words

PET/CT - attenuation correction - lung parenchyma - IV contrast agent

Schlüsselwörter

PET/CT - Schwächungskorrektur - Lungenparenchym - IV Kontrastmittel

Volltext

Referenzen

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