The Impact of Semiautomatic Segmentation Methods on Metabolic Tumor Volume, Intensity, and Dissemination Radiomics in 18 F-FDG PET Scans of Patients with Classical Hodgkin Lymphoma

The Journal of Nuclear Medicine

article

Julia Driessen¹  Gerben J.C. Zwezerijnen²  Heiko Schöder³  Esther E.E. Drees⁴  Marie José Kersten¹  Alison J. Moskowitz⁵  Craig H. Moskowitz⁶  Jakoba J. Eertink⁷  Henrica C.W. de Vet⁸  Otto S. Hoekstra²  Josée M. Zijlstra⁷  Ronald Boellaard² 

[1] Department of Hematology, Amsterdam UMC, University of Amsterdam, LYMMCARE ,(Lymphoma and Myeloma Center, Amsterdam), Cancer Center Amsterdam;Department of Radiology and Nuclear Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Cancer Center Amsterdam;Department of Molecular Imaging and Therapy Service, Memorial Sloan Kettering Cancer Center;Department of Pathology, Amsterdam UMC, Vrije Universiteit Amsterdam, Cancer Center Amsterdam;Department of Medicine, Memorial Sloan Kettering Cancer Center;Department of Medicine, Sylvester Comprehensive Cancer Center;Department of Hematology, Amsterdam UMC, Vrije Universiteit Amsterdam, Cancer Center Amsterdam;Department of Epidemiology and Data Science, Amsterdam Public Health research institute

关键词: Hodgkin lymphoma;    segmentation methods;    18F-FDG PET/CT;    outcome prediction;    radiomics;   

DOI  :  10.2967/jnumed.121.263067

学科分类：医学（综合）

来源: Society of Nuclear Medicine

【 摘 要 】

Consensus about a standard segmentation method to derive metabolic tumor volume (MTV) in classical Hodgkin lymphoma (cHL) is lacking, and it is unknown how different segmentation methods influence quantitative PET features. Therefore, we aimed to evaluate the delineation and completeness of lesion selection and the need for manual adaptation with different segmentation methods, and to assess the influence of segmentation methods on the prognostic value of MTV, intensity, and dissemination radiomics features in cHL patients. Methods: We analyzed a total of 105 18F-FDG PET/CT scans from patients with newly diagnosed (n = 35) and relapsed/refractory (n = 70) cHL with 6 segmentation methods: 2 fixed thresholds on SUV4.0 and SUV2.5, 2 relative methods of 41% of SUVmax (41max) and a contrast-corrected 50% of SUVpeak (A50P), and 2 combination majority vote (MV) methods (MV2, MV3). Segmentation quality was assessed by 2 reviewers on the basis of predefined quality criteria: completeness of selection, the need for manual adaptation, and delineation of lesion borders. Correlations and prognostic performance of resulting radiomics features were compared among the methods. Results: SUV4.0 required the least manual adaptation but tended to underestimate MTV and often missed small lesions with low 18F-FDG uptake. SUV2.5 most frequently included all lesions but required minor manual adaptations and generally overestimated MTV. In contrast, few lesions were missed when using 41max, A50P, MV2, and MV3, but these segmentation methods required extensive manual adaptation and overestimated MTV in most cases. MTV and dissemination features significantly differed among the methods. However, correlations among methods were high for MTV and most intensity and dissemination features. There were no significant differences in prognostic performance for all features among the methods. Conclusion: A high correlation existed between MTV, intensity, and most dissemination features derived with the different segmentation methods, and the prognostic performance is similar. Despite frequently missing small lesions with low 18F-FDG avidity, segmentation with a fixed threshold of SUV4.0 required the least manual adaptation, which is critical for future research and implementation in clinical practice. However, the importance of small, low 18F-FDG–avidity lesions should be addressed in a larger cohort of cHL patients.

【 授权许可】

CC BY