PET/CT Assessment of Response to Therapy: Tumor Change Measurement, Truth Data, and Error
PET/CT Assessment of Response to Therapy: Tumor Change Measurement, Truth Data, and Error
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DOI：
10.1593/tlo.09223
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发表时间：
2009-12-01
影响因子：
5
通讯作者：
McLennan, Geoffrey
中科院分区：
文献类型：
--
作者：
Kinahan, Paul E.;Doot, Robert K.;McLennan, Geoffrey
我们描述的方法和问题，是相关的测量肿瘤摄取的F-18-氟脱氧葡萄糖（FDG）或其他放射性示踪剂的变化，从正电子发射断层扫描/计算机断层扫描（PET/CT）图像测量，这将如何与PET/CT肿瘤成像作为患者对治疗反应的生物标志物的建立。主要焦点是肺肿瘤对FDG的摄取，但该方法可应用于肺癌以外的疾病和FDG以外的示踪剂。解决的第一个问题是在测量肿瘤摄取FDG的偏差和方差的来源，在我们的知识中仍然存在差距。在测量变化的背景下讨论这些问题，以及这些问题如何与治疗反应的早期检测相关。目前正在进行的一些研究工作，以确定这些来源的错误的幅度进行了说明。此外，我们还介绍了这些调查的资源，这些资源是通过响应项目评估的参考图像数据库提供的。来自PET图像数据的措施，可能是预测患者的反应，以及其他问题，这些指标中的每一个可能遇到的简要描述。个体患者对治疗的反应和多中心试验的效用之间的关系进行了讨论。最后，我们讨论了从评估测量变化到确定PET/CT成像作为反应生物标志物的有效性所需的步骤。
We describe methods and issues that are relevant to the measurement of change in tumor uptake of F-18-fluorodeoxyglucose (FDG) or other radiotracers, as measured from positron emission tomography/computed tomography (PET/CT) images, and how this would relate to the establishment of PET/CT tumor imaging as a biomarker of patient response to therapy. The primary focus is on the uptake of FDG by lung tumors, but the approach can be applied to diseases other than lung cancer and to tracers other than FDG. The first issue addressed is the sources of bias and variance in the measurement of tumor uptake of FDG, and where there are still gaps in our knowledge. These are discussed in the context of measurement variation and how these would relate to the early detection of response to therapy. Some of the research efforts currently underway to identify the magnitude of some of these sources of error are described. In addition, we describe resources for these investigations that are being made available through the Reference Image Database for the Evaluation of Response project. Measures derived from PET image data that might be predictive of patient response as well as the additional issues that each of these metrics may encounter are described briefly. The relationship between individual patient response to therapy and utility for multicenter trials is discussed. We conclude with a discussion of moving from assessing measurement variation to the steps necessary to establish the efficacy of PET/CT imaging as a biomarker for response.