Assessment of pulmonary nodules using [18F]-FDG PET/CT in deep inspiration breath-hold

Introduction: The characterization of pulmonary nodules (PN) is a primary indication for [F-18]-FDG PET/CT. However, respiratory movements hinder this characterization, especially for PN located in the lower lobes. Various methods have been developed to improve image resolution. Objective: Our objective was to compare the diagnostic efficacy of [F-18]-FDG PET/CT in deep inspiration breath-hold (DIBH) versus free-breathing corrected by software, in the evaluation of PN. Methods: We prospectively analyzed 51 patients to assess PN using [F-18]-FDG PET/CT in DIBH and free-breathing corrected by software. A total of 84 nodules with an average size of 10 mm were analyzed, with pathological anatomy or medical treatment decisions by a multidisciplinary tumor board used as reference. Results: A total of 84 PN were evaluated, comparing those in DIBH versus free-breathing, finding statistically significant differences in SUVmax values (P<.05) (mean SUVmax 3.7 in free-breathing vs. 5.33 in DIBH). When analyzed by location in lobes, we did not find statistically significant differences, though there was a trend towards higher SUVmax values in the lower lobes. [18F]-FDG PET/CT in DIBH showed high sensitivity (95%) and negative predictive value (NPV) (92%), indicating it may be a promising tool for PN characterization. Conclusions: The acquisition of [F-18]-FDG PET/CT in DIBH significantly improves the sensitivity and diagnostic efficacy in the assessment of PN. Although no statistically significant differences were found based on location, there is a potential benefit for the lower lobes. These findings could support its use in clinical practice. (c) 2024 Sociedad Espanola de Medicina Nuclear e Imagen Molecular. Published by Elsevier Espana, S.L.U. All rights are reserved, including those for text and data mining, AI training, and similar technologies.