Repeatability of Quantitative 18F-NaF PET: A Multicenter Study
Repeatability of Quantitative 18F-NaF PET: A Multicenter Study
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DOI：
10.2967/jnumed.116.177295
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发表时间：
2016-12-01
影响因子：
9.3
通讯作者：
Jeraj, Robert
中科院分区：
文献类型：
--
作者：
Lin, Christie;Bradshaw, Tyler;Jeraj, Robert
F-18-NaF是一种骨转换的PET放射性示踪剂，已显示出作为评估骨转移瘤对治疗的反应的成像生物标志物的潜力。本研究旨在多中心研究中评价F-18-NaF PET衍生SUV成像指标在患者单个骨病变中的可重复性。方法：对35例去势耐受前列腺癌多发转移患者进行2次全身(复测)F-18-NaF PET/CT扫描，扫描时间为3+/-2d，共3个显像点。使用15g/mL的SUV阈值，自动分割了总共411个大于1.5 cm(3)的骨病变。进行了两个层次的分析：病变级别，其中测量从单个病变感兴趣区域(ROI)中提取；以及患者级别，其中患者内的所有病变被分组到患者感兴趣区域中进行分析。摄取用最大摄取速度、平均摄取速度和总摄取速度进行量化。用Bland Altman分析、组内相关系数(ICC)、变异系数、临界百分比差异和重复性系数评价重测重复性。计算了测试和重测测量之间的95%的一致性极限(LOA)。结果：在病变水平，最大血流速度、平均血流速度和总血流速度的变异系数分别为14.1%、6.6%和25.5%。在患者层面，这一比例略低：分别为12.0%、5.3%和18.5%。在所有SUV指标中，ICC都是优秀的(>；0.95)。病变平面95%LOA分别为(0.76，1.32)，(0.88，1.14)，(0.63，1.71)。患者水平95%的LOA略窄，分别为(0.79，1.26)，(0.89，1.10)和(0.70，1.44)。我们观察到不同成像部位的病变水平和患者水平测量的方差和样本均值有显著差异。结论：F-18-NaF PET/CT的SUVmax、SUVean和SUVTotal的可重复性在病变ROI和患者水平的ROI之间相似。我们发现病变水平和患者水平在不同部位的分布有显著差异。这些结果可用于建立基于F-18-NaF PET的标准，用于评估皮损和患者水平的治疗反应。F-18-NaF PET显示了可重复性水平，可用于临床量化骨损伤对治疗的反应。
F-18-NaF, a PET radiotracer of bone turnover, has shown potential as an imaging biomarker for assessing the response of bone metastases to therapy. This study aimed to evaluate the repeatability of F-18-NaF PET-derived SUV imaging metrics in individual bone lesions from patients in a multicenter study. Methods: Thirty-five castration-resistant prostate cancer patients with multiple metastases underwent 2 whole-body (test-retest) F-18-NaF PET/CT scans 3 +/- 2 d apart from 1 of 3 imaging sites. A total of 411 bone lesions larger than 1.5 cm(3) were automatically segmented using an SUV threshold of 15 g/mL. Two levels of analysis were performed: lesion-level, in which measures were extracted from individual-lesion regions of interest (ROI), and patient-level, in which all lesions within a patient were grouped into a patient ROI for analysis. Uptake was quantified with SUVmax, SUVmean, and SUVtotal. Test-retest repeatability was assessed using Bland Altman analysis, intraclass correlation coefficient (ICC), coefficient of variation, critical percentage difference, and repeatability coefficient. The 95% limit of agreement (LOA) of the ratio between test and retest measurements was calculated. Results: At the lesion level, the coefficient of variation for SUVmax, SUVmean, and SUVtotal was 14.1%, 6.6%, and 25.5%, respectively. At the patient level, it was slightly smaller: 12.0%, 5.3%, and 18.5%, respectively. ICC was excellent (>0.95) for all SUV metrics. Lesion-level 95% LOA for SUVmax SUVmean, and SUVtotal was (0.76, 1.32), (0.88, 1.14), and (0.63, 1.71), respectively. Patient-level 95% LOA was slightly narrower, at (0.79, 1.26), (0.89, 1.10), and (0.70, 1.44), respectively. We observed significant differences in the variance and sample mean of lesion-level and patient-level measurements between imaging sites. Conclusion: The repeatability of SUVmax, SUVmean, and SUVtotal for F-18-NaF PET/CT was similar between lesion-arid patient-level ROIs. We found significant differences in lesion-level and patient-level distributions between sites. These results can be used to establish F-18-NaF PET-based criteria for assessing treatment response at the lesion and patient levels. F-18-NaF PET demonstrates repeatability levels useful for clinically quantifying the response of bone lesions to therapy.