Practical Approach for Comparative Analysis of Multilesion Molecular Imaging Using a Semiautomated Program for PET/CT

Journal of Nuclear Medicine

Mithat Gönen¹  André Van Nuffel¹  Heiko Schöder¹  John L. Humm¹  Somali Gavane¹  Howard I. Scher¹  Josef J. Fox¹  Steven M. Larson¹  Estelle Autran-Blanc¹  Sadek Nehmeh¹  Michael J. Morris¹ 

关键词: molecular imaging;    PET/CT;    ¹⁸F-FDG;    ¹⁸F-FDHT;    semi-automated;   

DOI  :  10.2967/jnumed.111.089326

学科分类：医学（综合）

来源: Society of Nuclear Medicine

【 摘 要 】

We propose a standardized approach to quantitative molecular imaging (MI) in cancer patients with multiple lesions. Methods: Twenty patients with castration-resistant prostate cancer underwent 18F-FDG and 18F-16β-fluoro-5-dihydrotestosterone (18F-FDHT) PET/CT scans. Using a 5-point confidence scale, 2 readers interpreted coregistered scan sets on a workstation. Two hundred three sites per scan (specified in a lexicon) were reviewed. 18F-FDG–positive lesion bookmarks were propagated onto 18F-FDHT studies and then manually accepted or rejected. Discordance-positive 18F-FDHT lesions were similarly bookmarked. Lesional SUVmax was recorded. Tracer- and tissue-specific background correction factors were calculated via receiver-operating-characteristic analysis of 65 scan sets. Results: Readers agreed on more than 99% of 18F-FDG– and 18F-FDHT–negative sites. Positive-site agreement was 83% and 85%, respectively. Consensus-lesion maximum standardized uptake value (SUVmax) was highly reproducible (concordance correlation coefficient > 0.98). Receiver-operating-characteristic curves yielded 4 correction factors (SUVmax 1.8–2.6). A novel scatterplot (Larson-Fox-Gonen plot) depicted tumor burden and change in SUVmax for response assessments. Conclusion: Multilesion molecular imaging is optimized with a 5-step approach incorporating a confidence scale, site lexicon, semiautomated PET software, background correction, and Larson-Fox-Gonen graphing.

【 授权许可】

Unknown