A statistical modeling approach to the analysis of spatial patterns of FDG-PET uptake in human sarcoma.
A statistical modeling approach to the analysis of spatial patterns of FDG-PET uptake in human sarcoma.
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DOI：
10.1109/tmi.2011.2160984
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发表时间：
2011-12
影响因子：
10.6
通讯作者：
Eary JF
中科院分区：
文献类型：
--
作者：
O'Sullivan F;Wolsztynski E;O'Sullivan J;Richards T;Conrad EU;Eary JF
使用氟脱氧葡萄糖（FDG）对肉瘤进行正电子发射断层扫描（PET）的临床经验已经确立了肿瘤块内标准化摄取值的空间异质性作为患者生存的关键预后指标。但是，更详细的肿瘤FDG摄取模式的定量可能会为风险提供更多的见解。本工作为此目的开发了一个统计模型。该方法是基于一个管状的肿瘤质量的表示与简化的径向分析的摄取，横向的管状轴。该技术提供了表征肿瘤整体特征的新方法，包括引入测量其发展阶段的方法。相位测量可以区分早期肿瘤和晚期肿块，在早期肿瘤中，核心处的摄取最高，在晚期肿块中，FDG摄取中通常存在中心空隙。从生物学上讲，这些空隙是由坏死和液体、脂肪或软骨积聚引起的。使用开源软件工具实现肿瘤分析技术，并提供临床代表性扫描的插图。来自185名患者的一系列FDG-PET研究被用于正式评估预后益处。从肿瘤谱分析中获得了患者存活和进展预测的显著（p < 0.05）改善。在调整其他因素（包括异质性）后，典型的一个标准差增加（由分析确定）与进展或死亡风险增加近20%相关。这项工作证实，更详细的定量评估肿瘤肿块的PET成像数据的空间模式，超过最大FDG摄取（SUVmax）和以前考虑的异质性措施，提供了改善的预后信息，为未来患者的治疗决策提供潜在的输入。
Clinical experience with positron emission tomography (PET) scanning of sarcoma, using fluorodeoxyglucose (FDG), has established spatial heterogeneity in the standardized uptake values within the tumor mass as a key prognostic indicator of patient survival. But it may be that a more detailed quantitation of the tumor FDG uptake pattern could provide additional insights into risk. The present work develops a statistical model for this purpose. The approach is based on a tubular representation of the tumor mass with a simplified radial analysis of uptake, transverse to the tubular axis. The technique provides novel ways of characterizing the overall profile of the tumor, including the introduction of an approach for the measurement of its phase of development. The phase measure can distinguish between early phase tumors, in which the uptake is highest at the core, and later stage masses, in which there can often be central voids in FDG uptake. Biologically, these voids arise from necrosis and fluid, fat or cartilage accumulations. The tumor profiling technique is implemented using open-source software tools and illustrations are provided with clinically representative scans. A series of FDG-PET studies from 185 patients is used to formally evaluate the prognostic benefit. Significant (p < 0.05) improvements in the prediction of patient survival and progression are obtained from the tumor profiling analysis. After adjustment for other factors including heterogeneity, a typical one standard deviation increase in phase (as determined by the analysis) is associated with close to 20% more risk of progression or death. The work confirms that more detailed quantitative assessments of the spatial pattern of PET imaging data of tumor masses, beyond the maximum FDG uptake (SUVmax) and previously considered measures of heterogeneity, provide improved prognostic information for potential input to treatment decisions for future patients.