Kallergi Maria, Georgakopoulos Alexandros, Lyra Vassiliki, Chatziioannou Sofia
Department of Biomedical Engineering, University of West Attica, 12243 Athens, Greece.
Division of Nuclear Medicine, Biomedical Research Foundation of the Academy of Athens, 11527 Athens, Greece.
Metabolites. 2022 Mar 24;12(4):285. doi: 10.3390/metabo12040285.
The purpose of this study was to investigate the value of tumor size measurements as prognostic indicators of treatment outcome of Hodgkin's and Non-Hodgkin's lymphomas. F-FDG PET/CT exams before and after treatment were analyzed and metabolic and anatomic parameters-tumor maximum diameter, tumor maximum area, tumor volume, and maximum standardized uptake value (SUVmax)-were determined manually by an expert and automatically by a computer algorithm on PET and CT images. Results showed that the computer algorithm measurements did not correlate well with the expert's standard maximum tumor diameter measurements but yielded better three dimensional metrics that could have clinical value. SUVmax was the strongest prognostic indicator of the clinical outcome after treatment, followed by the automated metabolic tumor volume measurements and the expert's metabolic maximum diameter measurements. Anatomic tumor measurements had poor prognostic value. Metabolic volume measurements, although promising, did not significantly surpass current standard of practice, but automated measurements offered a significant advantage in terms of time and effort and minimized biases and variances in the PET measurements. Overall, considering the limited value of tumor size in predicting response to treatment, a paradigm shift seems necessary in order to identify robust prognostic markers in PET/CT; radiomics, namely combinations of anatomy, metabolism, and imaging, may be an option.
本研究的目的是探讨肿瘤大小测量作为霍奇金淋巴瘤和非霍奇金淋巴瘤治疗结果预后指标的价值。分析了治疗前后的F-FDG PET/CT检查，并由一名专家在PET和CT图像上手动确定代谢和解剖学参数——肿瘤最大直径、肿瘤最大面积、肿瘤体积和最大标准化摄取值（SUVmax），同时通过计算机算法自动确定这些参数。结果表明，计算机算法测量结果与专家的标准最大肿瘤直径测量结果相关性不佳，但产生了可能具有临床价值的更好的三维指标。SUVmax是治疗后临床结果最强的预后指标，其次是自动代谢肿瘤体积测量和专家的代谢最大直径测量。解剖学肿瘤测量的预后价值较差。代谢体积测量虽然有前景，但并未显著超过当前的实践标准，但自动测量在时间和精力方面具有显著优势，并最大限度地减少了PET测量中的偏差和方差。总体而言，考虑到肿瘤大小在预测治疗反应方面的价值有限，为了在PET/CT中识别可靠的预后标志物，似乎有必要进行范式转变；放射组学，即解剖学、代谢和影像学的组合，可能是一种选择。
