TY - JOUR T1 - Gated <sup>18</sup>F-FDG PET/CT of the Lung Using a Respiratory Spirometric Gating Device: A Feasibility Study JF - Journal of Nuclear Medicine Technology JO - J. Nucl. Med. Technol. SP - 227 LP - 232 DO - 10.2967/jnmt.118.223339 VL - 47 IS - 3 AU - Cyril Jaudet AU - Thomas Filleron AU - Kathleen Weyts AU - David Didierlaurent AU - Delphine Vallot AU - Mounia Ouali AU - Slimane Zerdoud AU - O. Lawrence Dierickx AU - Olivier Caselles AU - Frédéric Courbon Y1 - 2019/09/01 UR - http://tech.snmjournals.org/content/47/3/227.abstract N2 - Spirometric gating devices (SGDs) can measure the respiratory signal with high temporal resolution and accuracy. The primary objective of this study was to assess the feasibility and tolerance of a gated lung PET/CT acquisition using an SGD. The secondary objective was to compare the technical quality, accuracy, and interoperability of the SGD with that of a standard respiratory gating device, Real-Time Position Management (RPM), based on measurement of vertical thoracoabdominal displacement. Methods: A prospective phase I monocentric clinical study was performed on patients undergoing 18F-FDG PET/CT for assessment of a solitary lung nodule, staging of lung malignancy, or planning of radiotherapy. After whole-body PET/CT, a centered gated acquisition of both PET and CT was simultaneously obtained with the SGD and RPM during normal breathing. Results: Of the 46 patients who were included, 6 were prematurely excluded (1 because of hyperglycemia and 5 because of distant metastases revealed by whole-body PET/CT, leading to an unjustified extra gated acquisition). No serious adverse events were observed. Of the 40 remaining patients, the gated acquisition was prematurely stopped in 1 patient because of mask discomfort (2.5%; confidence interval [CI], 0.1%–13.2%). This event was considered patient tolerance failure. The SGD generated accurately gated PET/CT images, with more than 95% of the breathing cycle detected and high temporal resolution, in 34 of the 39 patients (87.2%; 95% CI, 60.0%–100.0%) and failed to generate a biologic tumor volume in 1 of 21 patients with increased 18F-FDG uptake (4.8%; 95% CI, 0.1%–26.5%). The quality and accuracy of respiratory signal detection and synchronization were significantly better than those obtained with RPM (P &lt; 0.05). Conclusion: This trial supports the use of an SGD for gated lung PET/CT because of its high patient tolerance and accuracy. Although this technique seems to technically outperform RPM for gated PET/CT, further assessment of its superiority and the clinical benefit is warranted. We believe that this technique could be used as a gold standard to develop innovative approaches to eliminate respiration-induced blurring artifacts. ER -