Quantification of metabolic tumor activity and burden in patients with non-small-cell lung cancer: Is manual adjustment of semiautomatic gradient-based measurements necessary?
Quantification of metabolic tumor activity and burden in patients with non-small-cell lung cancer: Is manual adjustment of semiautomatic gradient-based measurements necessary?
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DOI：
10.1097/mnm.0000000000000317
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发表时间：
2015-08-01
影响因子：
1.5
通讯作者：
Pu, Yonglin
中科院分区：
文献类型：
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作者：
Obara, Piotr;Liu, Haiping;Pu, Yonglin
目的研究代谢肿瘤负荷(MTB)对非小细胞肺癌(NSCLC)患者预后的影响。MTB的计算通常利用软件半自动地在肿瘤周围绘制感兴趣的体积，随后由放射科医生手动调整以包括整个肿瘤。手动调整步骤可能非常耗时且依赖于观察者。我们比较了在非小细胞肺癌患者中使用半自动方法获得的MTB值是否与手动调整的一致性。方法这项IRB批准的前瞻性研究包括134例经组织学证实的非小细胞肺癌患者，他们接受了氟-18氟脱氧葡萄糖PET/CT检查。原发肿瘤的MTB是由两位放射科医生使用MIM PETedge工具用半自动梯度法(半自动梯度法)和手动调整(手动调整的半自动梯度法)测量的。用配对t检验、Wilcoxon符号等级检验和一致性相关系数(CCC)来评价两种方法获得的MTB测量结果之间的一致性，以及两位放射科医生对每种方法的一致性。两种方法的标化摄取峰值、代谢性肿瘤体积和总病灶糖酵解值比较，差异无统计学意义(P分别为0.23、0.45和0.37)。在CCC方面，两种方法之间有很好的一致性(CCC>；所有测量方法均为0.98)。观察者间的可靠性在所有指标上都很好(CCC>；0.90)。结论基于半自动梯度的肿瘤分割方法可以用于原发非小细胞肺癌肿瘤的MTB量化，而不需要额外的手动调整步骤。
PurposeMetabolic tumor burden (MTB) measurements including metabolic tumor volume and total lesion glycolysis have been shown to have prognostic value in non-small-cell lung cancer (NSCLC). The calculation of MTB typically utilizes software to semiautomatically draw volumes of interest around the tumor, which are subsequently manually adjusted by the radiologist to include the entire tumor. The manual adjustment step can be time-consuming and observer-dependent. We compared the agreement of MTB values obtained using the semiautomatic method with and without manual adjustment in NSCLC patients.MethodsThis IRB-approved prospective study included 134 patients with histologically proven NSCLC who underwent fluorine-18 fluorodeoxyglucose PET/computed tomography. The MTB of the primary tumor was measured with a semiautomatic gradient-based method without manual adjustment (the semiautomatic gradient method) and with manual adjustment (the manually adjusted semiautomatic gradient method) by two radiologists using the MIM PETedge tool. The paired t-test, Wilcoxon signed-rank test, and concordance correlation coefficient (CCC) were calculated to evaluate the agreement between MTB measures obtained with these two methods, as well as agreement between the two radiologists for each method.ResultsMaximum standardized uptake value was identical between the two methods. No statistically significant difference was present for peak standardized uptake value, metabolic tumor volume, and total lesion glycolysis values between the two methods (P=0.23, 0.45, and 0.37, respectively). Excellent agreement between the two methods was found in terms of CCC (CCC>0.98 for all measures). Interobserver reliability was excellent for all measures (CCC>0.90).ConclusionThe semiautomatic gradient-based tumor-segmentation method can be used without the additional manual adjustment step for MTB quantification of primary NSCLC tumors.