Breath Control Device with EKG monitoring (ABCDE) for routine imaging and therapy

Positron emission tomography (PET) has shown an increase in both sensitivity and specificity over computed tomography (CT) in particular for lung cancer. Motion artifacts in the fluoro-2-deoxy-d-glucose (FDG) PET images caused by respiration persists to be an important factor in degrading PET image quality and quantification. A lot of different methods have been developed to overcome this problem using breathing protocols or on-line monitoring systems. We constructed a respiratory gating device that monitor the breathing cycle through a pressure sensor and send the information to the electrocardiography (EKG) connector of our PET/CT system. In this work we will illustrate how this device, named ABCDE, works and discuss its use and limitations. ABCDE was tested on a small cohort of patients to prove the feasibility of the system in clinical practice. This preliminary investigation showed an improvement in the target-to-background ratio and a reduction in apparent lesion volume for all the patients we studied. This work was conducted as a proof of principle gating could improve the quantification and the resolution of PET images and that the system could be of use in clinical practice.