多病灶分子成像的比较分析实用方法：使用 PET/CT 半自动分析程序。
Practical approach for comparative analysis of multilesion molecular imaging using a semiautomated program for PET/CT.
机构信息
Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA.
出版信息
J Nucl Med. 2011 Nov;52(11):1727-32. doi: 10.2967/jnumed.111.089326. Epub 2011 Oct 7.
UNLABELLED
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 (18)F-FDG and (18)F-16β-fluoro-5-dihydrotestosterone ((18)F-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. (18)F-FDG-positive lesion bookmarks were propagated onto (18)F-FDHT studies and then manually accepted or rejected. Discordance-positive (18)F-FDHT lesions were similarly bookmarked. Lesional SUV(max) 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 (18)F-FDG- and (18)F-FDHT-negative sites. Positive-site agreement was 83% and 85%, respectively. Consensus-lesion maximum standardized uptake value (SUV(max)) was highly reproducible (concordance correlation coefficient > 0.98). Receiver-operating-characteristic curves yielded 4 correction factors (SUV(max) 1.8-2.6). A novel scatterplot (Larson-Fox-Gonen plot) depicted tumor burden and change in SUV(max) 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.
目的
我们提出了一种标准化方法，用于对患有多种病变的癌症患者进行定量分子成像（MI）。
方法
20 例去势抵抗性前列腺癌患者接受了（18）F-FDG 和（18）F-16β-氟-5-二氢睾酮（（18）F-FDHT）PET/CT 扫描。使用 5 分置信度量表，2 位读者在工作站上对配准的扫描集进行解读。每扫描（在词汇表中指定）评估 203 个部位。（18）F-FDG 阳性病变书签被传播到（18）F-FDHT 研究中，然后手动接受或拒绝。（18）F-FDHT 病变的不一致性阳性病变书签也被标记。记录病变 SUV（max）。通过 65 个扫描集的接收者操作特征分析计算示踪剂和组织特异性背景校正因子。
结果
读者对（18）F-FDG 和（18）F-FDHT 阴性部位的一致性超过 99%。阳性部位的一致性分别为 83%和 85%。共识病变最大标准化摄取值（SUV（max））具有高度可重复性（一致性相关系数>0.98）。接收者操作特征曲线得出了 4 个校正因子（SUV（max）1.8-2.6）。一种新的散点图（Larson-Fox-Gonen 图）描绘了肿瘤负荷和 SUV（max）变化用于反应评估。
结论
采用包含置信度量表、部位词汇表、半自动 PET 软件、背景校正和 Larson-Fox-Gonen 绘图的 5 步方法优化了多病变分子成像。
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