ArticleEJNMMI research2016
Fractal and multifractal analysis of PET/CT images of metastatic melanoma before and after treatment with ipilimumab.
Article in EJNMMI research, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 36 citations in OpenAlex.
- The value ofEuropean journal of nuclear medicine and molecular imaging · 2021Pooled it
- Absolute number of new lesions onEuropean journal of nuclear medicine and molecular imaging · 2018Trial
- Development, Application and Utility of a Machine Learning Approach for Melanoma and Non-Melanoma Lesion Classification Using Counting Box Fractal Dimension.Diagnostics (Basel, Switzerland) · 2024Article
- Effects of Cationic and Anionic Surfaces on the Perpendicular and Lateral Forces and Binding ofNanomaterials (Basel, Switzerland) · 2023Article
- Fractal Dimension Analysis of Melanocytic Nevi and Melanomas in Normal and Polarized Light-A Preliminary Report.Life (Basel, Switzerland) · 2022Article
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- Quantitative DynamicCancers · 2021Article
- Kinetic modeling and parametric imaging with dynamic PET for oncological applications: general considerations, current clinical applications, and future perspectives.European journal of nuclear medicine and molecular imaging · 2021Review
- FDG PET/CT for Assessment of Immune Therapy: Opportunities and Understanding Pitfalls.Seminars in nuclear medicine · 2020Review
- Molecular imaging biomarkers for immune checkpoint inhibitor therapy.Theranostics · 2020Review
- The Complexity and Fractal Geometry of Nuclear Medicine Images.Molecular imaging and biology · 2019Review
- Monitoring of patients with metastatic melanoma treated with immune checkpoint inhibitors using PET-CT.Cancer immunology, immunotherapy : CII · 2019Review
- MR imaging based fractal analysis for differentiating primary CNS lymphoma and glioblastoma.European radiology · 2019Article
- New formulation of the Gompertz equation to describe the kinetics of untreated tumors.PloS one · 2019Article
- FDG PET/CT for assessing tumour response to immunotherapy : Report on the EANM symposium on immune modulation and recent review of the literature.European journal of nuclear medicine and molecular imaging · 2019Review
- [Response evaluation in nuclear medicine : Criteria, results and pitfalls].Der Radiologe · 2017Review
- Nuclear Molecular Imaging Strategies in Immune Checkpoint Inhibitor Therapy.Diagnostics (Basel, Switzerland) · 2017Review
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Authors and funding
7 authors at 5 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPET/CT with F-18-fluorodeoxyglucose (FDG) images of patients suffering from metastatic melanoma have been analysed using fractal and multifractal analysis to assess the impact of monoclonal antibody ipilimumab treatment with respect to therapy outcome.
resultsThirty-one cases of patients suffering from metastatic melanoma have been scanned before and after two and after four cycles of treatment. For each patient, we calculated the fractal and multifractal dimensions using the box-counting method on the digitalised PET/CT images of all three studies to assess the therapeutic outcome. We modelled the spreading of malignant cells in the body via kinetic Monte Carlo simulations to address the dynamical evolution of the metastatic process and to predict the spatial distribution of malignant lesions. Our analysis shows that the fractal dimensions which describe the tracer dispersion in the body decrease consistently with the deterioration of the patient's therapeutic outcome condition. In 20 out of 24 cases, the fractal analysis results match those of the treatment outcome as defined by the oncologists, while 7 cases are considered as special cases because the patients had non-tumour-related findings or side effects which affect the results. The decrease in the fractal dimensions with the deterioration of the patient conditions (in terms of disease progression) is attributed to the hierarchical localisation of the tracer which accumulates in the affected lesions and does not spread homogeneously throughout the body. Fractality emerges as a result of the migration patterns which the malignant cells follow for propagating within the body (circulatory system, lymphatic system). Analysis of the multifractal spectrum complements and supports the results of the fractal analysis. In the kinetic Monte Carlo modelling of the metastatic process, a small number of malignant cells diffuse through a fractal medium representing the blood circulatory network. Along their way, the malignant cells engender random metastases (colonies) with a small probability and, as a result, fractal spatial distributions of the metastases are formed similar to the ones observed in the PET/CT images.
conclusionsThe Monte Carlo-generated spatial distribution of metastases changes with time approaching values close to the ones recorded in the metastatic patients. Thus, we propose that fractal and multifractal analyses have potential applications in quantification of the evaluation of PET/CT images to monitor the disease evolution as well as the response to different medical treatments. The proposed approach, being operator independent, can offer new diagnostic tools in parallel to the visual location of the lesions and may improve multiparameter assessment of FDG PET/CT studies.
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