Repeatability of [18F]FDG PET/CT total metabolic active tumour volume and total tumour burden in NSCLC patients
Repeatability of [18F]FDG PET/CT total metabolic active tumour volume and total tumour burden in NSCLC patients
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DOI：
10.1186/s13550-019-0481-1
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发表时间：
2019-02-07
期刊：
影响因子：
3.2
通讯作者：
Boellaard, Ronald
中科院分区：
文献类型：
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作者：
Kolinger, Guilherme D.;Garcia, David Vallez;Boellaard, Ronald
背景总代谢活性肿瘤体积（TMATV）和总肿瘤负荷（TTB）作为非小细胞肺癌（NSCLC）患者的预后和预测因素越来越多地被研究。在本研究中，我们研究了 TMATV 和 TTB 的重复性，作为摄取间隔、正电子发射断层扫描/计算机断层扫描 (PET/CT) 图像重建设置和病灶勾画方法的函数。我们使用了六种病灶勾画方法，四种直接源自 PET 图像的勾画方法和两种基于多数投票方法的方法，即两个或多个勾画之间的交集 (MV2) 以及三个或更多勾画之间的交集 (MV3)。为了评估这些方法的准确性，将它们与由三位经验丰富的观察者进行的分割一致获得的参考轮廓进行了比较。 10 名 NSCLC 患者在 3 天内的不同日期接受了两项基线全身 [F-18]2-氟-2-脱氧-2-D-葡萄糖 ([F-18]FDG) PET/CT 研究。每天在注射后 60 分钟和 90 分钟进行两次扫描，以评估示踪剂摄取间隔的影响。 PET/CT 图像按照欧洲核医学研究协会 (EARL) 合规设置和点扩散函数 (PSF) 建模进行重建。确定每天测量之间的重复性，并使用广义估计方程模型评估摄取间隔、重建设置和病灶勾画方法的影响。结果基于带有参考勾画的 Jaccard 指数，MV2 病灶勾画方法是自动病灶分割最成功的方法。 TTB 的最佳整体重复性（最低重复性系数，RC）是通过 EARL 兼容设置重建的 90 分钟示踪剂摄取扫描发现的，并用 41% 的病变最大 SUV 方法描绘（RC=11%）。在大多数情况下，示踪剂摄取时间或重建设置的变化不会显着影响 TMATV 和 TTB 的重复性。然而，一些病灶勾画方法在应用于相同图像时具有显着不同的重复性。结论本研究表明，在某些情况下，TMATV 和 TTB 可重复性受到所使用的病灶勾画方法的显着影响。无论采集和重建设置如何，使用多数投票方法进行描绘都可以提高可靠性，并且不会妨碍可重复性。因此得出的结论是，通过使用基于多数票的肿瘤分割方法，可以以高可靠性和精确度测量 NSCLC 患者的 TMATV 和 TTB。
BackgroundTotal metabolic active tumour volume (TMATV) and total tumour burden (TTB) are increasingly studied as prognostic and predictive factors in non-small cell lung cancer (NSCLC) patients. In this study, we investigated the repeatability of TMATV and TTB as function of uptake interval, positron emission tomography/computed tomography (PET/CT) image reconstruction settings, and lesion delineation method. We used six lesion delineation methods, four direct PET image-derived delineations and two based on a majority vote approach, i.e. intersection between two or more delineations (MV2) and between three or more delineations (MV3). To evaluate the accuracy of those methods, they were compared with a reference delineation obtained from the consensus of the segmentations performed by three experienced observers. Ten NSCLC patients underwent two baseline whole-body [F-18]2-Fluoro-2-deoxy-2-D-glucose ([F-18]FDG) PET/CT studies on separate days, within 3days. Two scans were obtained on each day at 60 and 90min post-injection to assess the influence of tracer uptake interval. PET/CT images were reconstructed following the European Association of Nuclear Medicine Research Ltd. (EARL) compliant settings and with point-spread-function (PSF) modelling. Repeatability between the measurements of each day was determined and the influence of uptake interval, reconstruction settings, and lesion delineation method was assessed using the generalized estimating equations model.ResultsBased on the Jaccard index with the reference delineation, the MV2 lesion delineation method was the most successful method for automated lesion segmentation. The best overall repeatability (lowest repeatability coefficient, RC) was found for TTB from 90min of tracer uptake scans reconstructed with EARL compliant settings and delineated with 41% of lesion's maximum SUV method (RC=11%). In most cases, TMATV and TTB repeatability were not significantly affected by changes in tracer uptake time or reconstruction settings. However, some lesion delineation methods had significantly different repeatability when applied to the same images.ConclusionsThis study suggests that under some circumstances TMATV and TTB repeatability are significantly affected by the lesion delineation method used. Performing the delineation with a majority vote approach improves reliability and does not hamper repeatability, regardless of acquisition and reconstruction settings. It is therefore concluded that by using a majority vote based tumour segmentation approach, TMATV and TTB in NSCLC patients can be measured with high reliability and precision.