Concordance of FDG PET/CT metabolic tumour volume versus DW-MRI functional tumour volume with T2-weighted anatomical tumour volume in cervical cancer

BMC Cancer

Research Article

Jose A. U. Perucho¹  Edward S. Hui¹  Elaine Y. P. Lee¹  Xiaopei Xu¹  Alta Y. T. Lai² 

[1] Department of Diagnostic Radiology, Queen Mary Hospital, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Room 406, Block K, 102 Pokfulam Road, High West, Hong Kong Special Administrative Region, China;Department of Radiology, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong Special Administrative Region, China;

关键词: Uterine cervical neoplasms;    Positron-emission tomography;    Fluorodeoxyglucose F18;    Radiation oncology;    Image-guided radiotherapy;    Intensity-modulated radiotherapy;   

DOI  :  10.1186/s12885-017-3800-9

 received in 2017-03-16, accepted in 2017-11-20,  发布年份 2017

来源: Springer

【 摘 要 】

Background18F–fluoro-deoxyglucose positron emission tomography with computed tomography (FDG PET/CT) has been employed to define radiotherapy targets using a threshold based on the standardised uptake value (SUV), and has been described for use in cervical cancer. The aim of this study was to evaluate the concordance between the metabolic tumour volume (MTV) measured on FDG PET/CT and the anatomical tumour volume (ATV) measured on T2-weighted magnetic resonance imaging (T2W-MRI); and compared with the functional tumour volume (FTV) measured on diffusion-weighted MRI (DW-MRI) in cervical cancer, taking the T2W-ATV as gold standard.MethodsConsecutive newly diagnosed cervical cancer patients who underwent FDG PET/CT and DW-MRI were retrospectively reviewed from June 2013 to July 2017.Volumes of interest was inserted to the focal hypermetabolic activity corresponding to the cervical tumour on FDG PET/CT with automated tumour contouring and manual adjustment, based on SUV 20%–80% thresholds of the maximum SUV (SUVmax) to define the MTV20–80, with intervals of 5%.Tumour areas were manually delineated on T2W-MRI and multiplied by slice thickness to calculate the ATV.FTV were derived by manually delineating tumour area on ADC map, multiplied by the slice thickness to determine the FTV(manual). Diffusion restricted areas was extracted from b0 and ADC map using K-means clustering to determine the FTV(semi-automated).The ATVs, FTVs and the MTVs at different thresholds were compared using the mean and correlated using Pearson’s product-moment correlation.ResultsTwenty-nine patients were evaluated (median age 52 years). Paired difference of mean between ATV and MTV was the closest and not statistically significant at MTV30 (−2.9cm3, −5.2%, p = 0.301). This was less than the differences between ATV and FTV(semi-automated) (25.0cm3, 45.1%, p < 0.001) and FTV(manual) (11.2cm3, 20.1%, p = 0.001). The correlation of MTV30 with ATV was excellent (r = 0.968, p < 0.001) and better than that of the FTVs.ConclusionsOur study demonstrated that MTV30 was the only parameter investigated with no statistically significant difference with ATV, had the least absolute difference from ATV, and showed excellent positive correlation with ATV, suggesting its superiority as a functional imaging modality when compared with DW-MRI and supporting its use as a surrogate for ATV for radiotherapy tumour contouring.

【 授权许可】

CC BY   
© The Author(s). 2017