Lopci Egesta, Grizzi Fabio, Russo Carlo, Toschi Luca, Grassi Ilaria, Cicoria Gianfranco, Lodi Filippo, Mattioli Sandro, Fanti Stefano
aResearch Doctorate Course in Specialized Medical Sciences, Alma Mater Studiorum - University of Bologna bPET Unit cDivision of Thoracic Surgery, University Hospital S. Orsola-Malpighi, Bologna dDepartment of Nuclear Medicine eDepartment of Inflammation and Immunology fDepartment of Medical Oncology, Humanitas Clinical and Research Hospital, Rozzano gMichele Rodriguez Foundation, Milan, Italy.
Nucl Med Commun. 2017 Apr;38(4):340-346. doi: 10.1097/MNM.0000000000000656.
The aim of this study was to analyse early and delayed acquisition on copper-64 diacetyl-bisN4-methylthiosemicarbazone (Cu-ATSM) PET/CT in a small cohort of patients by comparing semiquantitative and computer-aided fractal geometry analyses.
Five cancer patients, including non-small-cell lung cancer and head and neck cancer, were investigated with Cu-ATSM PET/CT. Participants received an intravenous injection of Cu-ATSM according to body size and were imaged 60 min (early) and 16 h (delayed) later on hybrid PET/CT. Reconstructed images were visualized on advanced workstations for the definition of semiquantitative parameters: standardized uptake value (SUV)max, SUVratio-to-muscle, SUVmean, hypoxic volume (HV) and hypoxic burden (HB=HV×SUVmean). DICOM data retrieved from both scans were analysed using an ad-hoc computer program to determine the mean intensity value, SD, relative dispersion, three-dimensional histogram fractal dimension and three-dimensional fractal dimension.
All tumour lesions showed increased uptake of Cu-ATSM at early evaluation, with a median SUVratio-to-muscle of 4.42 (range: 1.58-5.62), a median SUVmax of 5.3 (range: 1.9-7.3), a median SUVmean of 2.8 (range: 1.5-3.9), a median HV of 41.6 cm (range: 2.8-453.7) and a median HB of 161.5 cm (range: 4.4-1112.5). All semiquantitative data obtained at 1 h were consistent with the parameters obtained on delayed imaging (P>0.05). A borderline statistically significant difference was found only for SUVmax of the muscle (P=0.045). Fractal geometry analysis on DICOM images showed that all parameters at early imaging showed no statistically significant difference with late acquisition (P>0.05).
Our findings support the consistency of Cu-ATSM PET/CT images obtained at early and delayed acquisition for the assessment of tumour lesions.
本研究旨在通过比较半定量分析和计算机辅助分形几何分析，对一小群患者进行铜-64双乙酰双N4-甲基硫代半卡巴腙（Cu-ATSM）PET/CT早期和延迟采集的情况进行分析。
对5例癌症患者进行了Cu-ATSM PET/CT检查，其中包括非小细胞肺癌和头颈癌患者。参与者根据体重静脉注射Cu-ATSM，并于60分钟（早期）和16小时（延迟）后在PET/CT混合成像仪上进行成像。重建后的图像在先进的工作站上进行可视化处理，以确定半定量参数：最大标准化摄取值（SUV）max、SUV与肌肉比值、平均SUV、缺氧体积（HV）和缺氧负荷（HB=HV×SUVmean）。使用专门的计算机程序对从两次扫描中获取的DICOM数据进行分析，以确定平均强度值、标准差、相对离散度、三维直方图分形维数和三维分形维数。
在早期评估时，所有肿瘤病灶均显示Cu-ATSM摄取增加，SUV与肌肉比值中位数为4.42（范围：1.58 - 5.62），SUVmax中位数为5.3（范围：1.9 - 7.3），SUVmean中位数为2.8（范围：1.5 - 3.9），HV中位数为41.6 cm（范围：2.8 - 453.7），HB中位数为161.5 cm（范围：4.4 - 1112.5）。1小时时获得的所有半定量数据与延迟成像时获得的参数一致（P>0.05）。仅在肌肉的SUVmax方面发现了边缘性统计学显著差异（P=0.045）。对DICOM图像的分形几何分析表明，早期成像时的所有参数与延迟采集时相比均无统计学显著差异（P>0.05）。
我们的研究结果支持Cu-ATSM PET/CT图像在早期和延迟采集时对于评估肿瘤病灶的一致性。
