SU-D-BRB-04：FDG-PET直方图距离：肿瘤对放化疗反应的新型预测指标。

SU-D-BRB-04: FDG-PET Histogram Distances: Novel Predictors of Tumor Response to Chemoradiotherapy.

作者信息

Tan S, Zhang H, Kligerman S, Chen W, Kim G, Feigenberg S, D'Souza W, Suntharalingam M, Lu W

机构信息

Huazhong University of Science and Technology, Wuhan, China.

University of Maryland School of Medicine, Baltimore, MD.

出版信息

Med Phys. 2012 Jun;39(6Part3):3615. doi: 10.1118/1.4734676.

DOI:10.1118/1.4734676

PMID:28517413

Abstract

PURPOSE

To examine the accuracy of FGD-PET histogram distances as predictors of pathologic tumor response to chemo-radiotherapy (CRT) in esophageal cancer.

METHODS

Twenty patients were included. A rigid registration was used to align the post-CRT PET/CT with the pre-CRT PET/CT images. The primary tumor was delineated using a region-growing algorithm with a threshold of SUV = 2.5 on the pre-CRT PET. Two histograms of SUVs within the tumor were constructed on the pre-CRT PET and registered post-CRT PET, respectively. The differences between the two histograms reflected changes in the SUV distribution and were therefore potential predictors of tumor response. The differences were quantitatively measured by histogram distances using 12 bin-to-bin and 8 cross-bin algorithms. The accuracy of histogram distances in predicting pathologic tumor response to CRT was measured using the area under ROC curve (AUC), prediction accuracy, and the Mann-Whitney tests, in comparison with traditional PET response measures and texture features.

RESULTS

Cross-bin histogram distances were shown to be significant (p<0.05) predictors of pathologic tumor response. They were more accurate than bin- to-bin histogram distances (not significant). The most accurate cross-bin histogram distances were: Quadratic-Chi distance (AUC=0.89, accuracy=80%, p=0.003), Earth Mover distance (AUC=0.83,accuracy=80%, p=0.014), diffusion distance (AUC = 0.82, accuracy=85%, p=0.02) and Match distance (AUC = 0.79, accuracy=80%, p=0.03). This family of novel predictors were more accurate than traditional PET response measures using SUVmax (AUC=0.76, accuracy=75%, p=0.05), SUVpeak (AUC=0.74, accuracy=70%, p=0.08), Total Glycolytic Volume (AUC=0.76, accuracy=70%, p=0.05), as well as texture features based on the cooccurrence matrix (Inertia: AUC=0.85, accuracy=80%, p=0.01).

CONCLUSIONS

The cross-bin histogram distances characterized changes in the SUV distribution within a tumor and showed high accuracy for the prediction of pathologic response to CRT in esophageal cancer. This workwas supported in part by the National Cancer Institute Grant R21 CA131979.

摘要

目的

探讨氟代脱氧葡萄糖正电子发射断层扫描（FGD-PET）直方图距离作为食管癌化疗放疗（CRT）后病理肿瘤反应预测指标的准确性。

方法

纳入20例患者。采用刚性配准将CRT后PET/CT与CRT前PET/CT图像对齐。在CRT前PET图像上使用区域生长算法，以SUV = 2.5为阈值勾勒出原发肿瘤。分别在CRT前PET和配准后的CRT后PET上构建肿瘤内SUV的两个直方图。两个直方图之间的差异反映了SUV分布的变化，因此是肿瘤反应的潜在预测指标。使用12个bin-to-bin和8个cross-bin算法通过直方图距离对差异进行定量测量。与传统PET反应指标和纹理特征相比，使用ROC曲线下面积（AUC）、预测准确性和Mann-Whitney检验来测量直方图距离预测CRT后病理肿瘤反应的准确性。

结果

Cross-bin直方图距离被证明是病理肿瘤反应的显著（p<0.05）预测指标。它们比bin-to-bin直方图距离更准确（不显著）。最准确的cross-bin直方图距离为：二次卡方距离（AUC = 0.89，准确性 = 80%，p = 0.003）、推土机距离（AUC = 0.83，准确性 = 80%，p = 0.014）、扩散距离（AUC = 0.82，准确性 = 85%，p = 0.02）和匹配距离（AUC = 0.79，准确性 = 80%，p = 0.03）。这一系列新的预测指标比使用SUVmax（AUC = 0.76，准确性 = 75%，p = 0.05）、SUVpeak（AUC = 0.74，准确性 = 70%，p = 0.08）、总糖酵解体积（AUC = 0.76，准确性 = 70%，p = 0.05）的传统PET反应指标以及基于共生矩阵的纹理特征（惯性：AUC = 0.85，准确性 = 80%，p = 0.01）更准确。