MND Campinas, Campinas, Brazil.
Division of Nuclear Medicine, Department of Radiology, University of Campinas, Campinas, Brazil.
J Nucl Med Technol. 2020 Mar;48(1):30-35. doi: 10.2967/jnmt.119.231118. Epub 2019 Oct 11.
Quantification of metabolic tumor volume (MTV) and total lesion glycolysis (TLG) can be time-consuming. We evaluated the performance of an automatic multifocal segmentation (MFS) method of quantification in patients with different stages of Hodgkin lymphoma, using the multiple VOI (MV) method as reference. This prospective bicentric study included 50 patients with Hodgkin lymphoma who underwent staging F-FGD PET/CT. The examinations were centrally reviewed and processed with commercial MFS software to obtain MTV and TLG using 2 fixed relative thresholds (40% and 20% of SUV) for each lesion. All PET/CT scans were processed using the MV and MFS methods. Interclass correlation coefficients and Bland-Altman plots were used for statistical analysis. Repeated calculations of MTV and TLG values by 2 observers with different degrees of PET/CT imaging experience were used to ascertain interobserver agreement on the MFS method. The means and SDs obtained for the MTV with MV and MFS were, respectively, 736 ± 856 mL and 660 ± 699 mL for the 20% threshold and 313 ± 359 mL and 372 ± 434 mL for the 40% threshold. The time spent calculating the MTV was much shorter with the MFS method than with the MV method (median time, 11.6 min [range, 1-30 min] and 64.4 min [range, 1-240 min], respectively), especially in patients with advanced disease. Time spent was similar in patients with localized disease. There were no statistical differences between the MFS values obtained by the 2 different observers. MTV and TLG calculations using MFS are reproducible, generate similar results to those obtained with MV, and are much less timing-consuming. Main differences between the 2 methods were related to difficulties in avoiding overlay of VOIs in the MV technique. MV and MFS perform equally well in patients with a small number of lesions.
代谢肿瘤体积（MTV）和总病变糖酵解（TLG）的定量可能很耗时。我们评估了一种自动多焦点分割（MFS）定量方法在不同分期霍奇金淋巴瘤患者中的性能，以多容积（MV）方法为参考。这项前瞻性的双中心研究纳入了 50 例接受分期 F-FDG PET/CT 的霍奇金淋巴瘤患者。检查由中心进行回顾性分析，并使用商业 MFS 软件进行处理，以获得每个病灶的 40%和 20% SUV 两种固定相对阈值的 MTV 和 TLG。所有 PET/CT 扫描均采用 MV 和 MFS 方法进行处理。使用组内相关系数和 Bland-Altman 图进行统计学分析。2 位具有不同 PET/CT 成像经验的观察者重复计算 MTV 和 TLG 值，以确定 MFS 方法的观察者间一致性。MV 和 MFS 获得的 MTV 的平均值和标准差分别为 20%阈值时的 736±856mL 和 660±699mL，40%阈值时的 313±359mL 和 372±434mL。与 MV 方法相比，MFS 方法计算 MTV 的时间要短得多（中位数时间分别为 11.6 分钟[范围，1-30 分钟]和 64.4 分钟[范围，1-240 分钟]），尤其是在晚期疾病患者中。局限性疾病患者的时间相似。2 位不同观察者获得的 MFS 值之间无统计学差异。使用 MFS 计算的 MTV 和 TLG 具有可重复性，产生的结果与 MV 相似，并且耗时更少。这两种方法之间的主要差异与在 MV 技术中避免重叠 VOI 时遇到的困难有关。MV 和 MFS 在病变数量较少的患者中表现相当。
