Improving Clinical PET/CT Image Quality in Retrospectively Reconstructed Breath-Hold Images

Study Overview
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Brief Summary
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The patient has been referred for an FDG PET/CT scan. FDG is a form of sugar that contains a small amount of radioactivity; it is used to see the size and possible spread of cancer in the body. Pictures of the body are taken on a machine called a PET/CT scanner. The purpose of this current study is to see if we, the investigators, can take clearer pictures of the tumor than we could with our routine scan method. This would allow us to better see how FDG is picked up by the tumor. PET/CT is presently one of the best tools for detecting cancer and determining its spread in the body. However, due to breathing motion, PET and CT images may become blurred and the location of the tumor on CT and PET images may not match. We have developed a new method that enables us to reduce image blurring and to measure the tumor more accurately on PET images. In this study we want to compare two kinds of images: those from the standard PET/CT scan, and the PET/CT scan pictures taken with our new method. If successful, we may use this new method for clinical routine in the future.

Official Title
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Improving Clinical PET/CT Image Quality in Retrospectively Reconstructed Breath-Hold Images

Conditions
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Lung Cancer

Intervention / Treatment
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* Other: Breath-Hold PET/CT image set


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Participant is capable of providing written consent. 18 years of age or older. Patient with a known or suspected FDG-avid malignancy in the torso Exclusion Criteria: none

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Breath-Hold PET/CT image<br>In addition to the standard clinical PET/CT images, we will provide a breath-hold PET/CT image set, using the same PET data for both. | Other: Breath-Hold PET/CT image set<br>* In addition to the standard clinical PET/CT images, we will provide a breath-hold PET/CT image set, using the same PET data for both. In order to spatially match PET, and therefore improve attenuation correction in the PET images, we will acquire a Breath-Hold CT at 310 mA over the same region covered by PET. The normal-organ doses accumulated from the additional 30 mA CT. The patient's breathing signal during CT and the whole body PET will be recorded using a video camera and in house developed software. We will compare the clinical PET/CT and Breath-Hold PET/CT in regards to lesion detection, lesion volume, and SUV quantification.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| To determine if our breath-hold acquisition technique can be implemented in whole-body PET/CT scans. | Because PET events not satisfying the breathing amplitude selection criteria will be dropped off the final image set, it will be necessary to increase the acquisition time for the FOV's covering the thorax area from 3 min/bed to 5 min/bed to compensate for the reduction in statistics. This should result in a total increase of  6 min for the whole body scan. | at the time of scan | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| To determine if whole body PET/CT improves spatial matching of PET and CT | to compare image quality, blurring, PET-to-CT mis-match, and lesion SUV of the standard PET images with the breath-hold ones. | at the time of scan | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Lung, PET/CT scan, 10-054