ArticlePhysical and engineering sciences in medicine2023
Automated detection, delineation and quantification of whole-body bone metastasis using FDG-PET/CT images.
Article in Physical and engineering sciences in medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.
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Who cites it
5 citing papers in PubMed, 1 synthesis or guideline pooled it, 5 citations in OpenAlex.
- Head-to-head comparative study of [Frontiers in oncology · 2026Pooled it
- Evaluation of 2D and 3D nnU-Net models with two-label and three-label strategies for automatic segmentation and total metabolic tumor volume estimation of metastatic differentiated thyroid carcinoma on FDG-PET/CT.Japanese journal of radiology · 2026Article
- AI-Guided Delineation of Gross Tumor Volume for Body Tumors: A Systematic Review.Diagnostics (Basel, Switzerland) · 2025Review
- Platelet/Neutrophil Count Ratio (PNR) and Fibrinogen/Lymphocyte Count Ratio (FLR) Can Be Used as Predictive Indicators of Bone Metastasis in Non-Smoking Patients with Lung Cancer, but Not in Smoking Patients.International journal of general medicine · 2025Article
- Immune mediated support of metastasis: Implication for bone invasion.Cancer communications (London, England) · 2024Review
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7 authors at 5 institutions in 1 country.
Funding
Abstract
Non-small cell lung cancer (NSCLC) patients with the metastatic spread of disease to the bone have high morbidity and mortality. Stereotactic ablative body radiotherapy increases the progression free survival and overall survival of these patients with oligometastases. FDG-PET/CT, a functional imaging technique combining positron emission tomography (PET) with 18 F-fluorodeoxyglucose (FDG) and computer tomography (CT) provides improved staging and identification of treatment response. It is also associated with reduction in size of the radiotherapy tumour volume delineation compared with CT based contouring in radiotherapy, thus allowing for dose escalation to the target volume with lower doses to the surrounding organs at risk. FDG-PET/CT is increasingly being used for the clinical management of NSCLC patients undergoing radiotherapy and has shown high sensitivity and specificity for the detection of bone metastases in these patients. Here, we present a software tool for detection, delineation and quantification of bone metastases using FDG-PET/CT images. The tool extracts standardised uptake values (SUV) from FDG-PET images for auto-segmentation of bone lesions and calculates volume of each lesion and associated mean and maximum SUV. The tool also allows automatic statistical validation of the auto-segmented bone lesions against the manual contours of a radiation oncologist. A retrospective review of FDG-PET/CT scans of more than 30 candidate NSCLC patients was performed and nine patients with one or more metastatic bone lesions were selected for the present study. The SUV threshold prediction model was designed by splitting the cohort of patients into a subset of 'development' and 'validation' cohorts. The development cohort yielded an optimum SUV threshold of 3.0 for automatic detection of bone metastases using FDG-PET/CT images. The validity of the derived optimum SUV threshold on the validation cohort demonstrated that auto-segmented and manually contoured bone lesions showed strong concordance for volume of bone lesion (r = 0.993) and number of detected lesions (r = 0.996). The tool has various applications in radiotherapy, including but not limited to studies determining optimum SUV threshold for accurate and standardised delineation of bone lesions and in scientific studies utilising large patient populations for instance for investigation of the number of metastatic lesions that can be treated safety with an ablative dose of radiotherapy without exceeding the normal tissue toxicity.
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