ArticleClinical nuclear medicine2017
18F-FDG PET/CT Metabolic Tumor Volume and Intratumoral Heterogeneity in Pancreatic Adenocarcinomas: Impact of Dual-Time Point and Segmentation Methods.
Article in Clinical nuclear medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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15 citing papers in PubMed.
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- Need for Objective Task-Based Evaluation of Image Segmentation Algorithms for Quantitative PET: A Study with ACRIN 6668/RTOG 0235 Multicenter Clinical Trial Data.Journal of nuclear medicine : official publication, Society of Nuclear Medicine · 2024Article
- Need for objective task-based evaluation of AI-based segmentation methods for quantitative PET.Proceedings of SPIE--the International Society for Optical Engineering · 2023Article
- Diagnosis and prognostic predictive value of delineation methods fromAmerican journal of nuclear medicine and molecular imaging · 2023Article
- The prognostic value ofCancer imaging : the official publication of the International Cancer Imaging Society · 2022Article
- Intact SMAD-4 is a predictor of increased locoregional recurrence in upfront resected pancreas cancer receiving adjuvant therapy.Journal of gastrointestinal oncology · 2021Article
- The exploration of quantitative intra-tumoral metabolic heterogeneity in dual-timeAbdominal radiology (New York) · 2021Article
- A Bayesian approach to tissue-fraction estimation for oncological PET segmentation.Physics in medicine and biology · 2021Article
- A physics-guided modular deep-learning based automated framework for tumor segmentation in PET.Physics in medicine and biology · 2020Article
- Development and validation of anEuropean radiology · 2020Article
- High metabolic heterogeneity on baseline 18FDG-PET/CT scan as a poor prognostic factor for newly diagnosed diffuse large B-cell lymphoma.Blood advances · 2020Article
- Textural features and SUV-based variables assessed by dual time point 18F-FDG PET/CT in locally advanced breast cancer.Annals of nuclear medicine · 2017Article
- No-gold-standard evaluation of image-acquisition methods using patient data.Proceedings of SPIE--the International Society for Optical Engineering · 2017Article
- Practical no-gold-standard evaluation framework for quantitative imaging methods: application to lesion segmentation in positron emission tomography.Journal of medical imaging (Bellingham, Wash.) · 2017Article
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Abstract
objectivesWe aimed to determine the consistency of quantitative PET measurements of metabolic tumor volume (MTV) and intratumoral heterogeneity index for primary untreated pancreatic adenocarcinomas, when using dual-time point F-FDG PET/CT imaging.
methodsThis is an institutional review board-approved, retrospective study including 71 patients with pancreatic adenocarcinoma, who underwent dual-time point F-FDG PET/CT imaging, at approximately 1 hour (early) and 2 hours (delayed), after injection. Automated gradient-based and 50% SUVmax-threshold segmentation methods were used to assess the primary tumor MTV and metabolic intratumoral heterogeneity index, calculated as the area under cumulative SUV-volume histograms (AUC-CSH), with lower AUC-CHS indexes corresponding to higher degrees of tumor heterogeneity. We defined that more than a ±10% change in MTV or AUC-CSH, compared with baseline, as clinically significant.
resultsSeventy-one FDG-avid pancreatic tumors were identified, with an average tumor diameter of 3.4 ± 0.9 cm (range, 1.5-6.4 cm). Metabolic tumor volume values remained consistent between early and delayed imaging when using the gradient PET segmentation method (P = 0.086), whereas statistically significant change was seen when using 50% SUVmax-threshold segmentation (P < 0.001). A decrease in more than 10% change in MTV (% ΔMTV) was observed in 70.4% (50/71) tumors, and 7.0% (5/71) of the tumors showed an increase more than 10 % ΔMTV, when using the 50% SUVmax-threshold segmentation. AUC-CSH indexes showed statistically significant differences between early and delayed time points (P < 0.001), when using the gradient segmentation. AUC-CSH index decreased by 10% or greater in 40.8% (29/71) of the tumors. AUC-CSH index remained stable between early and delayed when using the 50% SUVmax-threshold segmentation (P = 0.148) with percentage of change of less than 10% for all tumors.
conclusionsMetabolic tumor volume was relatively stable between early and delayed time points when PET gradient segmentation was used but changed greater than 10% in 77.4% of the tumors at delayed time point when threshold segmentation was used. The tumor heterogeneity index (AUC-CSH) changed greater than 10% in 40.8% of tumors at delayed imaging, when gradient segmentation was used but remained stable when threshold segmentation was used. It is important to standardize uptake time and segmentation methods to use FDG PET MTV and heterogeneity index as imaging biomarkers.
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