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Abstract
The zero echo time (ZTE) technique has improved the detection of lung nodules in PET/MRI but respiratory motion remains a challenge in lung scan. We investigated the feasibility and performance of fractionated deep-inspiration breath-hold (FDIBH) three-dimensional (3D) ZTE FDG PET/MRI for assessing lung nodules in patients with proved malignancy. Sixty patients who had undergone ZTE FDG PET/MRI and chest CT within a three-day interval were retrospectively included. Lung nodules less than 2 mm were excluded for analysis. Two physicians checked the adequacy of FDIBH ZTE and compared the lung nodule detection rates of FDIBH 3D ZTE and free-breathing (FB) four-dimensional (4D) ZTE, with chest CT as the reference standard. FDIBH resolved the effect of respiratory motion in 49 patients. The mean number and size of the pulmonary nodules identified in CT were 15 ± 31.3 per patient and 5.9 ± 4.6 mm in diameter. The overall nodule detection rate was 71% for FDIBH 3D ZTE and 70% for FB 4D ZTE (p = 0.73). FDIBH 3D ZTE significantly outperformed FB 4DZTE in detecting lung base nodules (72% and 68%; p = 0.03), especially for detecting those less than 6 mm (61% and 55%; p = 0.03). High inter-rater reliability for FDIBH 3D ZTE and FB 4D ZTE (k = 0.9 and 0.92) was noted. In conclusion, the capability of FDIBH 3D ZTE in respiratory motion resolution was limited with a technical failure rate of 18%. However, it could provide full expansion of the lung in a shorter scan time which enabled better detection of nodules (< 6 mm) in basal lungs, compared to FB 4D ZTE.
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1 Taipei Veterans General Hospital, Department of Nuclear Medicine, Taipei, Taiwan (GRID:grid.278247.c) (ISNI:0000 0004 0604 5314); National Yang Ming Chiao Tung University, Department of Biomedical Imaging and Radiological Sciences, Taipei, Taiwan (GRID:grid.260539.b) (ISNI:0000 0001 2059 7017); National Yang Ming Chiao Tung University, Division of Nuclear Medicine National Yang Ming Chiao Tung University Hospital and School of Medicine, Taipei, Taiwan (GRID:grid.260539.b) (ISNI:0000 0001 2059 7017); National Defense Medical Center, School of Medicine, Taipei, Taiwan (GRID:grid.260565.2) (ISNI:0000 0004 0634 0356)
2 Taipei Veterans General Hospital, Department of Nuclear Medicine, Taipei, Taiwan (GRID:grid.278247.c) (ISNI:0000 0004 0604 5314)
3 National Yang Ming Chiao Tung University, Department of Biomedical Imaging and Radiological Sciences, Taipei, Taiwan (GRID:grid.260539.b) (ISNI:0000 0001 2059 7017); Cheng-Hsin General Hospital, Department of Nuclear Medicine, Taipei, Taiwan (GRID:grid.413846.c) (ISNI:0000 0004 0572 7890)
4 Taipei Veterans General Hospital, Department of Nuclear Medicine, Taipei, Taiwan (GRID:grid.278247.c) (ISNI:0000 0004 0604 5314); National Yang Ming Chiao Tung University, Department of Biomedical Imaging and Radiological Sciences, Taipei, Taiwan (GRID:grid.260539.b) (ISNI:0000 0001 2059 7017)
5 Taipei Veterans General Hospital, Department of Urology, Taipei, Taiwan (GRID:grid.278247.c) (ISNI:0000 0004 0604 5314); National Yang Ming Chiao Tung University, Department of Urology, College of Medicine and Shu-Tien Urological Research Center, Taipei, Taiwan (GRID:grid.260539.b) (ISNI:0000 0001 2059 7017)
6 GE Healthcare, Taipei, Taiwan (GRID:grid.260539.b)
7 National Yang Ming Chiao Tung University, Department of Biomedical Imaging and Radiological Sciences, Taipei, Taiwan (GRID:grid.260539.b) (ISNI:0000 0001 2059 7017)