Intra-tumour 18F-FDG uptake heterogeneity decreases the reliability on target volume definition with positron emission tomography/computed tomography imaging
Intra-tumour 18F-FDG uptake heterogeneity decreases the reliability on target volume definition with positron emission tomography/computed tomography imaging
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DOI：
10.1111/1754-9485.12289
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发表时间：
2015-06-01
影响因子：
1.6
通讯作者：
Xing, Ligang
中科院分区：
文献类型：
--
作者：
Dong, Xinzhe;Wu, Peipei;Xing, Ligang
本研究旨在探讨非小细胞肺癌（NSCLC）和食管鳞状细胞癌（SCEC）患者肿瘤内F-18-氟脱氧葡萄糖（FDG）摄取的异质性是否影响FDG正电子发射断层扫描/计算机断层扫描（PET/CT）成像靶区定义的可靠性。本回顾性研究包括治疗前的CT扫描。通过视觉评分、标准化摄取值（SUV）的变异系数（COV）和图像纹理特征（熵）评估肿瘤内FDG摄取异质性。在CT图像（GTV（CT））、融合PET/CT图像（GTV（PET-CT））和PET图像上描绘肿瘤体积（大体肿瘤体积（GTV）），使用40% SUVmax（GTV（PET40%））或SUV截止值2.5（GTV（PET2.5））的阈值。结果NSCLC和SCEC的FDG摄取异质性参数与肿瘤体积、SUV、GTV（PET-CT）、GTV（PET40%）和GTV（PET2.5）之间均存在明显的相关性。三种异质性参数具有一致性，且相互之间存在密切的相关性。GTV定义的四种方法之间存在实质性差异。GTV之间的差异与NSCLC和SCEC.ConclusionsIn肿瘤具有高FDG摄取异质性，GTV轮廓差异较大，应结合先进的图像分割算法处理示踪剂摄取不均匀性，治疗计划系统
IntroductionThis study aims to explore whether the intra-tumour F-18-fluorodeoxyglucose (FDG) uptake heterogeneity affects the reliability of target volume definition with FDG positron emission tomography/computed tomography (PET/CT) imaging for nonsmall cell lung cancer (NSCLC) and squamous cell oesophageal cancer (SCEC).MethodsPatients with NSCLC (n=50) or SCEC (n=50) who received F-18-FDG PET/CT scanning before treatments were included in this retrospective study. Intra-tumour FDG uptake heterogeneity was assessed by visual scoring, the coefficient of variation (COV) of the standardised uptake value (SUV) and the image texture feature (entropy). Tumour volumes (gross tumour volume (GTV)) were delineated on the CT images (GTV(CT)), the fused PET/CT images (GTV(PET-CT)) and the PET images, using a threshold at 40% SUVmax (GTV(PET40%)) or the SUV cut-off value of 2.5 (GTV(PET2.5)). The correlation between the FDG uptake heterogeneity parameters and the differences in tumour volumes among GTV(CT,) GTV(PET-CT), GTV(PET40%) and GTV(PET2.5) was analysed.ResultsFor both NSCLC and SCEC, obvious correlations were found between uptake heterogeneity, SUV or tumour volumes. Three types of heterogeneity parameters were consistent and closely related to each other. Substantial differences between the four methods of GTV definition were found. The differences between the GTV correlated significantly with PET heterogeneity defined with the visual score, the COV or the textural feature-entropy for NSCLC and SCEC.ConclusionsIn tumours with a high FDG uptake heterogeneity, a larger GTV delineation difference was found. Advance image segmentation algorithms dealing with tracer uptake heterogeneity should be incorporated into the treatment planning system.