Semiautomatic Volume of Interest Drawing for (18)F-FDG Image Analysis-method and Preliminary Results

Overview

Journal Eur J Nucl Med Mol Imaging

Specialties Biophysics
Nuclear Medicine
Radiology

Date 2007 Oct 3

PMID 17909793

Citations 4

Authors

A J Green

R J Francis

S Baig

R H J Begent

Affiliations

Soon will be listed here.

Abstract

Purpose: Functional imaging of cancer adds important information to the conventional measurements in monitoring response. Serial (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET), which indicates changes in glucose metabolism in tumours, shows great promise for this. However, there is a need for a method to quantitate alterations in uptake of FDG, which accounts for changes in tumour volume and intensity of FDG uptake. Selection of regions or volumes [ROI or volumes of interest (VOI)] by hand drawing, or simple thresholding, suffers from operator-dependent drawbacks.

Materials And Methods: We present a simple, robust VOI growing method for this application. The method requires a single seed point within the visualised tumour and another in relevant normal tissue. The drawn tumour VOI is insensitive to the operator inconsistency and is, thus, a suitable basis for comparative measurements. The method is validated using a software phantom. We demonstrate the use of the method in the assessment of tumour response in 31 patients receiving chemotherapy for various carcinomas.

Results: Valid assessment of tumour response could be made 2-4 weeks after starting chemotherapy, giving information for clinical decision making which would otherwise have taken 9-12 weeks. Survival was predicted from FDG-PET 2-4 weeks after starting chemotherapy (p = 0.04) and after 9-12 weeks FDG-PET gave a better prediction of survival (p = 0.002) than CT or MRI (p = 0.015).

Conclusions: FDG-PET using this method of analysis has potential as a routine tool for optimising use of chemotherapy and improving its cost effectiveness. It also has potential for increasing the accuracy of response assessment in clinical trials of novel therapies.

Citing Articles

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Heterogeneity of intratumoral (111)In-ibritumomab tiuxetan and (18)F-FDG distribution in association with therapeutic response in radioimmunotherapy for B-cell non-Hodgkin's lymphoma.

Hanaoka K, Hosono M, Tatsumi Y, Ishii K, Im S, Tsuchiya N EJNMMI Res. 2015; 5:10.

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References

Couper G, McAteer D, Wallis F, Norton M, Welch A, Nicolson M . Detection of response to chemotherapy using positron emission tomography in patients with oesophageal and gastric cancer. Br J Surg. 1998; 85(10):1403-6. DOI: 10.1046/j.1365-2168.1998.00963.x. View

Simo M, Lomena F, Setoain J, Perez G, Castellucci P, Costansa J . FDG-PET improves the management of patients with suspected recurrence of colorectal cancer. Nucl Med Commun. 2002; 23(10):975-82. DOI: 10.1097/00006231-200210000-00007. View

Kim C, Gupta N, Chandramouli B, Alavi A . Standardized uptake values of FDG: body surface area correction is preferable to body weight correction. J Nucl Med. 1994; 35(1):164-7. View

Lim J, Yun M, Kim M, Hyung W, Park M, Choi J . CT and PET in stomach cancer: preoperative staging and monitoring of response to therapy. Radiographics. 2006; 26(1):143-56. DOI: 10.1148/rg.261055078. View

George Mikhaeel N . Use of FDG-PET to monitor response to chemotherapy and radiotherapy in patients with lymphomas. Eur J Nucl Med Mol Imaging. 2006; 33 Suppl 1:22-6. DOI: 10.1007/s00259-006-0132-4. View

Wahl R, Cody R, Hutchins G, Mudgett E . Primary and metastatic breast carcinoma: initial clinical evaluation with PET with the radiolabeled glucose analogue 2-[F-18]-fluoro-2-deoxy-D-glucose. Radiology. 1991; 179(3):765-70. DOI: 10.1148/radiology.179.3.2027989. View

Kostakoglu L, Goldsmith S . 18F-FDG PET evaluation of the response to therapy for lymphoma and for breast, lung, and colorectal carcinoma. J Nucl Med. 2003; 44(2):224-39. View

Mortelmans L, Nuyts J, Van Pamel G, Van den Maegdenbergh V, De Roo M, Suetens P . A new thresholding method for volume determination by SPECT. Eur J Nucl Med. 1986; 12(5-6):284-90. DOI: 10.1007/BF00251989. View

Fleming J, Bolt L, Stratford J, Kemp P . The specific uptake size index for quantifying radiopharmaceutical uptake. Phys Med Biol. 2004; 49(14):N227-34. DOI: 10.1088/0031-9155/49/14/n03. View

10.

Keyes Jr J . SUV: standard uptake or silly useless value?. J Nucl Med. 1995; 36(10):1836-9. View

11.

Weber W, Ziegler S, Thodtmann R, Hanauske A, Schwaiger M . Reproducibility of metabolic measurements in malignant tumors using FDG PET. J Nucl Med. 1999; 40(11):1771-7. View

12.

Findlay M, Young H, Cunningham D, Iveson A, Cronin B, Hickish T . Noninvasive monitoring of tumor metabolism using fluorodeoxyglucose and positron emission tomography in colorectal cancer liver metastases: correlation with tumor response to fluorouracil. J Clin Oncol. 1996; 14(3):700-8. DOI: 10.1200/JCO.1996.14.3.700. View

13.

Strauss L, Conti P . The applications of PET in clinical oncology. J Nucl Med. 1991; 32(4):623-48; discussion 649-50. View

14.

Bombardieri E . The added value of metabolic imaging with FDG-PET in oesophageal cancer: prognostic role and prediction of response to treatment. Eur J Nucl Med Mol Imaging. 2006; 33(7):753-8. DOI: 10.1007/s00259-006-0147-x. View

15.

Wahl R, Zasadny K, Helvie M, Hutchins G, Weber B, Cody R . Metabolic monitoring of breast cancer chemohormonotherapy using positron emission tomography: initial evaluation. J Clin Oncol. 1993; 11(11):2101-11. DOI: 10.1200/JCO.1993.11.11.2101. View

16.

Okazumi S, Isono K, Enomoto K, Kikuchi T, Ozaki M, Yamamoto H . Evaluation of liver tumors using fluorine-18-fluorodeoxyglucose PET: characterization of tumor and assessment of effect of treatment. J Nucl Med. 1992; 33(3):333-9. View

17.

Kim C, Gupta N . Dependency of standardized uptake values of fluorine-18 fluorodeoxyglucose on body size: comparison of body surface area correction and lean body mass correction. Nucl Med Commun. 1996; 17(10):890-4. DOI: 10.1097/00006231-199610000-00011. View

18.

Francis R, Byrne M, van der Schaaf A, Boucek J, Nowak A, Phillips M . Early prediction of response to chemotherapy and survival in malignant pleural mesothelioma using a novel semiautomated 3-dimensional volume-based analysis of serial 18F-FDG PET scans. J Nucl Med. 2007; 48(9):1449-58. DOI: 10.2967/jnumed.107.042333. View

19.

Fischman A . Positron emission tomography in the clinical evaluation of metastatic cancer. J Clin Oncol. 1996; 14(3):691-6. DOI: 10.1200/JCO.1996.14.3.691. View

20.

Westerterp M, Pruim J, Oyen W, Hoekstra O, Paans A, Visser E . Quantification of FDG PET studies using standardised uptake values in multi-centre trials: effects of image reconstruction, resolution and ROI definition parameters. Eur J Nucl Med Mol Imaging. 2006; 34(3):392-404. DOI: 10.1007/s00259-006-0224-1. View