Deriving global quantitative tumor response parameters from 18F-FDG PET-CT scans in patients with non-Hodgkin's lymphoma

Nucl Med Commun. 2015 Apr;36(4):328-33. doi: 10.1097/MNM.0000000000000256.

Abstract

Objectives: The aim of the study was to address the need for quantifying the global cancer time evolution magnitude from a pair of time-consecutive positron emission tomography-computed tomography (PET-CT) scans. In particular, we focus on the computation of indicators using image-processing techniques that seek to model non-Hodgkin's lymphoma (NHL) progression or response severity.

Materials and methods: A total of 89 pairs of time-consecutive PET-CT scans from NHL patients were stored in a nuclear medicine station for subsequent analysis. These were classified by a consensus of nuclear medicine physicians into progressions, partial responses, mixed responses, complete responses, and relapses. The cases of each group were ordered by magnitude following visual analysis. Thereafter, a set of quantitative indicators designed to model the cancer evolution magnitude within each group were computed using semiautomatic and automatic image-processing techniques. Performance evaluation of the proposed indicators was measured by a correlation analysis with the expert-based visual analysis.

Results: The set of proposed indicators achieved Pearson's correlation results in each group with respect to the expert-based visual analysis: 80.2% in progressions, 77.1% in partial response, 68.3% in mixed response, 88.5% in complete response, and 100% in relapse. In the progression and mixed response groups, the proposed indicators outperformed the common indicators used in clinical practice [changes in metabolic tumor volume, mean, maximum, peak standardized uptake value (SUV mean, SUV max, SUV peak), and total lesion glycolysis] by more than 40%.

Conclusion: Computing global indicators of NHL response using PET-CT imaging techniques offers a strong correlation with the associated expert-based visual analysis, motivating the future incorporation of such quantitative and highly observer-independent indicators in oncological decision making or treatment response evaluation scenarios.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Disease Progression
  • Fluorodeoxyglucose F18*
  • Humans
  • Image Processing, Computer-Assisted*
  • Lymphoma, Non-Hodgkin / diagnostic imaging*
  • Lymphoma, Non-Hodgkin / pathology
  • Multimodal Imaging*
  • Positron-Emission Tomography*
  • Tomography, X-Ray Computed*
  • Tumor Burden

Substances

  • Fluorodeoxyglucose F18