Respiration-Averaged CT for Attenuation Correction of PET Images - Impact on PET Texture Features in Non-Small Cell Lung Cancer Patients.
Respiration-Averaged CT for Attenuation Correction of PET Images - Impact on PET Texture Features in Non-Small Cell Lung Cancer Patients.
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DOI：
10.1371/journal.pone.0150509
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发表时间：
2016
期刊：
影响因子：
3.7
通讯作者：
Yen TC
中科院分区：
文献类型：
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作者：
Cheng NM;Fang YH;Tsan DL;Hsu CH;Yen TC
我们在非小细胞肺癌（NSCLC）患者中比较了PET图像与螺旋CT（PET/HCT）和呼吸平均CT（PET/ACT）的衰减校正，目的是研究呼吸平均CT对18F FDG PET纹理参数的影响。共入组56例患者。使用自适应阈值在预处理PET图像上分割肿瘤。计算了12个不同的纹理参数：标准摄取值（SUV）熵，均匀性，熵，相异性，均匀性，粗糙度，繁忙度，对比度，复杂性，灰度级不均匀性，区域大小不均匀性，高灰度级大区域强调。使用Wilcoxon符号秩检验、组内相关系数和Bland-Altman分析比较PET/HCT和PET/ACT。采用受试者工作特征（ROC）曲线以及单变量和多变量考克斯回归分析来确定与疾病特异性生存（DSS）显著相关的参数。使用最大SUV（T45）45%的固定阈值进行验证。PET/ACT中SUV最大值和总病变糖酵解（TLG）显着较高。然而，PET/ACT和PET/HCT获得的纹理参数显示出高度的一致性。SUV熵（9.7%）和熵（9.8%）在两种模式之间观察到的变化水平最低。PET/ACT和PET/HCT的SUV熵、熵和粗糙度与DSS显著相关。使用T45的验证分析证实了SUV熵和PET/HCT和PET/ACT中的熵对于预测DSS的有用性，但只有PET/ACT的粗糙度达到了统计学显著性阈值。我们的研究结果表明：1）PET/ACT的纹理参数在临床上可用于预测NSCLC患者的生存率，2）SUV熵和熵对衰减校正方法具有鲁棒性。
We compared attenuation correction of PET images with helical CT (PET/HCT) and respiration-averaged CT (PET/ACT) in patients with non-small-cell lung cancer (NSCLC) with the goal of investigating the impact of respiration-averaged CT on 18F FDG PET texture parameters. A total of 56 patients were enrolled. Tumors were segmented on pretreatment PET images using the adaptive threshold. Twelve different texture parameters were computed: standard uptake value (SUV) entropy, uniformity, entropy, dissimilarity, homogeneity, coarseness, busyness, contrast, complexity, grey-level nonuniformity, zone-size nonuniformity, and high grey-level large zone emphasis. Comparisons of PET/HCT and PET/ACT were performed using Wilcoxon signed-rank tests, intraclass correlation coefficients, and Bland-Altman analysis. Receiver operating characteristic (ROC) curves as well as univariate and multivariate Cox regression analyses were used to identify the parameters significantly associated with disease-specific survival (DSS). A fixed threshold at 45% of the maximum SUV (T45) was used for validation. SUV maximum and total lesion glycolysis (TLG) were significantly higher in PET/ACT. However, texture parameters obtained with PET/ACT and PET/HCT showed a high degree of agreement. The lowest levels of variation between the two modalities were observed for SUV entropy (9.7%) and entropy (9.8%). SUV entropy, entropy, and coarseness from both PET/ACT and PET/HCT were significantly associated with DSS. Validation analyses using T45 confirmed the usefulness of SUV entropy and entropy in both PET/HCT and PET/ACT for the prediction of DSS, but only coarseness from PET/ACT achieved the statistical significance threshold. Our results indicate that 1) texture parameters from PET/ACT are clinically useful in the prediction of survival in NSCLC patients and 2) SUV entropy and entropy are robust to attenuation correction methods.