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• W2172171057 abstract "In lung cancer, ¹⁸F-FDG PET, CT, and ¹⁸F-FDG PET/CT are used for noninvasive staging and therapy planning. Even with improved image registration techniques—especially in the modern hybrid PET/CT scanners—inaccuracies in the fusion process may occur, leading to errors in image interpretation. The aim of this study was to investigate by an intraindividual analysis whether, in comparison with a rigid algorithm, a nonrigid registration algorithm improves the quality of fusion between ¹⁸F-FDG PET and CT. <b>Methods:</b> Sixteen patients with histologically proven non–small cell lung cancer underwent a thoracic ¹⁸F-FDG PET acquisition in radiotherapy treatment position and 3 CT acquisitions (expiration, inspiration, and mid breath-hold) on the same day. All scans were registered with rigid and nonrigid procedures, resulting in 6 fused datasets: rigid inspiration, rigid expiration, rigid mid breath-hold, nonrigid inspiration, nonrigid expiration, and nonrigid mid breath-hold. The quality of alignment was assessed by 3 experienced readers at 8 anatomic landmarks: lung apices, aortic arch, heart, spine, sternum, carina, diaphragm, and tumor using an alignment score ranging from 1 (no alignment) to 5 (exact alignment). <b>Results:</b> Nonrigid PET/CT showed better alignment than rigid PET/CT (3.5 ± 0.7 vs. 3.3 ± 0.7, <i>P</i> < 0.001). Regarding the breathing maneuver, no difference between nonrigid mid breath-hold and rigid mid breath-hold was observed. In contrast, the alignment quality significantly improved from rigid expiration to nonrigid expiration (3.4 ± 0.7 vs. 3.6 ± 0.7, <i>P</i> < 0.001) and from rigid inspiration to nonrigid inspiration (3.1 ± 0.7 vs. 3.3 ± 0.7, <i>P</i> < 0.001). With regard to individual landmarks, an improvement in fusion quality through the use of nonrigid registration was obvious at the lung apices, carina, and aortic arch. <b>Conclusion:</b> The alignment quality of thoracic ¹⁸F-FDG PET/CT exhibits a marked dependence on the breathing maneuver performed during the CT acquisition, as demonstrated in an intraindividual comparison. Nonrigid registration is a significant improvement over rigid registration if the CT is performed during full inspiration or full expiration. The best fusion results are obtained with the CT performed at mid breath-hold using rigid registration, without an improvement using nonrigid algorithms." @default.
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• W2172171057 date "2009-11-12" @default.
• W2172171057 modified "2023-09-27" @default.
• W2172171057 title "Nonrigid Versus Rigid Registration of Thoracic ¹⁸F-FDG PET and CT in Patients with Lung Cancer: An Intraindividual Comparison of Different Breathing Maneuvers" @default.
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• W2172171057 doi "https://doi.org/10.2967/jnumed.109.065649" @default.
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