A semi-automated technique determining the liver standardized uptake value reference for tumor delineation in FDG PET-CT.
A semi-automated technique determining the liver standardized uptake value reference for tumor delineation in FDG PET-CT.
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DOI：
10.1371/journal.pone.0105682
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发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
Huang SC
中科院分区：
文献类型：
--
作者：
Hirata K;Kobayashi K;Wong KP;Manabe O;Surmak A;Tamaki N;Huang SC
18F-氟脱氧葡萄糖（FDG）正电子发射断层扫描（PET）-计算机断层扫描（CT）已成为肿瘤学中的一种基本模式。我们提出了一种半自动算法，以客观地确定肝脏标准化摄取值（SUV），这是作为一个阈值的肿瘤划定。手动放置一个大的球形感兴趣体积（VOI），以大致包围肝脏右叶（RL）。对于该VOI中的每个体素，针对半径d/2内的相邻体素计算体素值的变异系数（CVv）。然后选择具有最小CVv的体素，其中根据PERCIST标准在该体素处放置30 mm球形VOI。两名核医学医生在62名患者的124项研究中手动定义了30 mm VOI，以生成标准值，并将新方法的结果与标准值进行比较。半自动方法成功确定了所有研究中两位医生之间一致的肝脏SUV（d = 80 mm）。 通过新的半自动方法（3.12±0.61）确定的肝脏SUV阈值（30 mm VOI内的平均值+3 SD）与通过手动方法（医生-1：3.14±0.58，医生-2：3.15±0.58）确定的肝脏SUV阈值无统计学差异。半自动化方法产生的肿瘤体积与专家手动操作的肿瘤体积没有统计学差异。此外，两项连续研究中半自动和手动方法的体积变化无统计学差异。我们的半自动方法可以将肝脏SUV稳健地定义为根据PERCIST用于肿瘤体积测量的阈值。该方法可以避免手动肝脏VOI放置的可能的主观偏差，因此有望提高基于体积的参数预测癌症治疗反应的临床性能。
18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)-computed tomography (CT) has been an essential modality in oncology. We propose a semi-automated algorithm to objectively determine liver standardized uptake value (SUV), which is used as a threshold for tumor delineation. A large spherical volume of interest (VOI) was placed manually to roughly enclose the right lobe (RL) of the liver. For each voxel in this VOI, a coefficient of variation of voxel values (CVv) was calculated for neighboring voxels within a radius of d/2. The voxel with the minimum CVv was then selected, where a 30-mm spherical VOI was placed at that voxel in accordance with PERCIST criteria. Two nuclear medicine physicians independently defined 30-mm VOIs manually on 124 studies in 62 patients to generate the standard values, against which the results from the new method were compared. The semi-automated method was successful in determining the liver SUV that was consistent between the two physicians in all the studies (d = 80 mm). The liver SUV threshold (mean +3 SD within 30-mm VOI) determined by the new semi-automated method (3.12±0.61) was not statistically different from those determined by the manual method (Physician-1: 3.14±0.58, Physician-2: 3.15±0.58). The semi-automated method produced tumor volumes that were not statistically different from those by experts' manual operation. Furthermore, the volume change in the two sequential studies had no statistical difference between semi-automated and manual methods. Our semi-automated method could define the liver SUV robustly as the threshold value used for tumor volume measurements according to PERCIST. The method could avoid possible subjective bias of manual liver VOI placement and is thus expected to improve clinical performance of volume-based parameters for prediction of cancer treatment response.
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