Tixier Florent, Vriens Dennis, Cheze-Le Rest Catherine, Hatt Mathieu, Disselhorst Jonathan A, Oyen Wim J G, de Geus-Oei Lioe-Fee, Visser Eric P, Visvikis Dimitris
Department of Radiology, Radboud University Medical Center, Nijmegen, The Netherlands DACTIM, Medical School, University of Poitiers, Poitiers, France
Department of Radiology, Leiden University Medical Centre, Leiden, The Netherlands.
J Nucl Med. 2016 Jul;57(7):1033-9. doi: 10.2967/jnumed.115.166918. Epub 2016 Mar 10.
(18)F-FDG PET is well established in the field of oncology for diagnosis and staging purposes and is increasingly being used to assess therapeutic response and prognosis. Many quantitative indices can be used to characterize tumors on (18)F-FDG PET images, such as SUVmax, metabolically active tumor volume (MATV), total lesion glycolysis, and, more recently, the proposed intratumor uptake heterogeneity features. Although most PET data considered within this context concern the analysis of activity distribution using images obtained from a single static acquisition, parametric images generated from dynamic acquisitions and reflecting radiotracer kinetics may provide additional information. The purpose of this study was to quantify differences between volumetry, uptake, and heterogeneity features extracted from static and parametric PET images of non-small cell lung carcinoma (NSCLC) in order to provide insight on the potential added value of parametric images.
Dynamic (18)F-FDG PET/CT was performed on 20 therapy-naive NSCLC patients for whom primary surgical resection was planned. Both static and parametric PET images were analyzed, with quantitative parameters (MATV, SUVmax, SUVmean, heterogeneity) being extracted from the segmented tumors. Differences were investigated using Spearman rank correlation and Bland-Altman analysis.
MATV was slightly smaller on static images (-2% ± 7%), but the difference was not significant (P = 0.14). All derived parameters, including those characterizing tumor functional heterogeneity, correlated strongly between static and parametric images (r = 0.70-0.98, P ≤ 0.0006), exhibiting differences of less than ±25%.
In NSCLC primary tumors, parametric and static baseline (18)F-FDG PET images provided strongly correlated quantitative features for both standard (MATV, SUVmax, SUVmean) and heterogeneity quantification. Consequently, heterogeneity quantification on parametric images does not seem to provide significant complementary information compared with static SUV images.
（18）F - FDG PET在肿瘤学领域已广泛用于诊断和分期，并且越来越多地用于评估治疗反应和预后。许多定量指标可用于在（18）F - FDG PET图像上表征肿瘤，如SUVmax、代谢活性肿瘤体积（MATV）、总病变糖酵解，以及最近提出的肿瘤内摄取异质性特征。尽管在此背景下考虑的大多数PET数据涉及使用单次静态采集获得的图像分析活性分布，但从动态采集生成并反映放射性示踪剂动力学的参数图像可能会提供额外信息。本研究的目的是量化从非小细胞肺癌（NSCLC）的静态和参数PET图像中提取的体积、摄取和异质性特征之间的差异，以便深入了解参数图像的潜在附加价值。
对20例计划进行初次手术切除的未经治疗的NSCLC患者进行动态（18）F - FDG PET/CT检查。分析静态和参数PET图像，从分割的肿瘤中提取定量参数（MATV、SUVmax、SUVmean、异质性）。使用Spearman等级相关性和Bland - Altman分析研究差异。
MATV在静态图像上略小（-2% ± 7%），但差异不显著（P = 0.14）。所有导出参数，包括表征肿瘤功能异质性的参数，在静态和参数图像之间都有很强的相关性（r = 0.70 - 0.98，P ≤ 0.0006），差异小于±25%。
在NSCLC原发性肿瘤中，参数和静态基线（18）F - FDG PET图像为标准（MATV、SUVmax、SUVmean）和异质性量化提供了高度相关的定量特征。因此，与静态SUV图像相比，参数图像上的异质性量化似乎没有提供显著的补充信息。
