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Ribeiro T, Marques A, Ferreira G, Castro C, Tavares M, Espírito-Santo A, Moreira C, Mariz J. Semiquantitative analysis of interim 18F-FDG PET is superior in predicting outcome in Hodgkin lymphoma patients compared to visual analysis. Rev Esp Med Nucl Imagen Mol 2021; 40:281-286. [PMID: 34425968 DOI: 10.1016/j.remnie.2020.06.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Accepted: 06/14/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE To investigate the prognostic value of interim PET (PETi) in adult HL patients, comparing visual with semiquantitative analysis. MATERIAL AND METHODS Retrospective analysis of Hodgkin's lymphoma (HL) patients diagnosed between 2012 and 2016 in the Onco-hematology Department of Instituto Português de Oncologia - Porto (median follow-up: 46.5 months [2.6-66.4]). Fifty-eight patients with available PET at diagnosis (PET0) and PETi data were included. PETi scans were analyzed according to Deauville 5-point scale (5-PS), and cut-off values for changes in maximum standardized uptake value [SUVmax], peak SUV [SUVpeak], metabolic tumour volume [MTV] and total lesion glycolysis index [TLG] between PETi and PET0 were computed using ROC analysis. Visual and semiquantitative data were compared with each other in the prediction of patient outcomes. RESULTS Semiquantitative analysis obtained a higher sensitivity for persistent/relapsed disease compared to the 5-PS (70% vs. 10%, respectively), but lower specificity. It also demonstrated better predictive performance for response to first-line therapy (negative predictive value >92%). The positive predictive value was similar for all five measurements. At 60 months of follow-up, there was a significant difference between the progression free survival (PFS) curves of patients with positive and negative PETi according to ΔSUVmax (56.9% vs. 88.0%, p<0.05), ΔSUVpeak (55.9% vs. 88.1%, p<0.05), ΔMTV (35.3% vs. 88.7%, p<0.05), and ΔTLG (42.4% vs. 88.1%, p<0.05). Statistical significance was not reached when considering 5-PS results. DISCUSSION PETi interpretation according to a semiquantitative approach appears to discriminate HL patients better than the visual 5-PS analysis. This could allow better detection of persistent or early relapsed disease, while a negative PETi result could support de-escalating therapy intensity.
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Affiliation(s)
- T Ribeiro
- Onco-Hematology Department, Instituto Português de Oncologia do Porto FG, Street Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal.
| | - A Marques
- Onco-Hematology Department, Instituto Português de Oncologia do Porto FG, Street Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal
| | - G Ferreira
- Nuclear Medicine Department, Instituto Português de Oncologia do Porto FG, Street Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal
| | - C Castro
- Epidemiology Department, Instituto Português de Oncologia do Porto FG, Street Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal
| | - M Tavares
- Onco-Hematology Department, Instituto Português de Oncologia do Porto FG, Street Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal
| | - A Espírito-Santo
- Onco-Hematology Department, Instituto Português de Oncologia do Porto FG, Street Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal
| | - C Moreira
- Onco-Hematology Department, Instituto Português de Oncologia do Porto FG, Street Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal
| | - J Mariz
- Onco-Hematology Department, Instituto Português de Oncologia do Porto FG, Street Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal
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Semiquantitative analysis of interim 18F-FDG PET is superior in predicting outcome in Hodgkin lymphoma patients compared to visual analysis. Rev Esp Med Nucl Imagen Mol 2021. [PMID: 33947644 DOI: 10.1016/j.remn.2020.06.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
PURPOSE To investigate the prognostic value of interim PET (PETi) in adult HL patients, comparing visual with semiquantitative analysis. MATERIAL AND METHODS Retrospective analysis of Hodgkin's Lymphoma (HL) patients diagnosed between 2012 and 2016 in the Onco-Hematology Department of Instituto Português de Oncologia - Porto (median follow-up: 46.5 months [2,6-66,4]). Fifty-eight patients with available PET at diagnosis (PET0) and PETi data were included. PETi scans were analysed according to Deauville 5-point scale (5-PS), and cut-off values for changes in maximum standardized uptake value [SUVmax], peak SUV [SUVpeak], metabolic tumour volume [MTV] and total lesion glycolysis index [TLG] between PETi and PET0 were computed using ROC analysis. Visual and semiquantitative data were compared with each other in the prediction of patient outcomes. RESULTS Semiquantitative analysis obtained a higher sensitivity for persistent/relapsed disease compared to the 5-PS (70% vs. 10%, respectively), but lower specificity. It also demonstrated better predictive performance for response to first-line therapy (negative predictive value > 92%). The positive predictive value was similar for all five measurements. At 60 months of follow-up, there was a significant difference between the progression free survival (PFS) curves of patients with positive and negative PETi according to ΔSUVmax (56.9% vs. 88.0%, p < 0.05), ΔSUVpeak (55.9% vs 88.1%, p< 0.05), ΔMTV (35.3% vs. 88.7%, p< 0.05), and ΔTLG (42.4% vs. 88.1%, p< 0.05). Statistical significance wasn't reached when considering 5-PS results. DISCUSSION PETi interpretation according to a semiquantitative approach appears to discriminate HL patients better than the visual 5-PS analysis. This could allow better detection of persistent or early relapsed disease, while a negative PETi result could support de-escalating therapy intensity.
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Bergesio F, Maggi AD, Coronado M, Pardal E, Plaza R, Hernández AC, Sarandeses MDP, Cortes M, Setoain X, Simó M, Rotger A, Grande C, Caballero MD, Chauvie S. The 18 F phantom clinical trials qualification for 18F-FDG-PET scanning adopted by GELTAMO (Grupo Español de Linfomas/Trasplante Autologo de Médula Ósea). Rev Esp Med Nucl Imagen Mol 2021. [DOI: 10.1016/j.remnie.2020.06.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Bergesio F, De Maggi A, Coronado M, Pardal E, Plaza R, Hernández AC, Sarandeses MDP, Cortes M, Setoain X, Simó M, Rotger A, Grande C, Caballero MD, Chauvie S. The 18F phantom clinical trials qualification for 18F-FDG-PET scanning adopted by GELTAMO (Grupo Español de Linfomas/Trasplante Autólogo de Médula Ósea). Rev Esp Med Nucl Imagen Mol 2021; 40:149-154. [PMID: 33485832 DOI: 10.1016/j.remn.2020.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 06/04/2020] [Accepted: 06/10/2020] [Indexed: 11/25/2022]
Abstract
INTRODUCTION AND OBJECTIVES Since different PET/CT (Positron Emission Tomography/Computed Tomography) scanners give different qualitative readings, a program for clinical trial qualification (CTQ) is mandatory to guarantee a reliable and reproducible use of PET/CT in prospective multi-centre clinical trials. Within this work we will show the results carried out in performing CTQ in Spain. MATERIALS AND METHODS We set up, under the auspices of Grupo Español de Linfomas/Trasplante Autólogo de Médula Osea (GELTAMO), a CTQ program consisting of the acquisition and analysis of 18F uniformity and image quality phantoms for the reduction of inter-scanner variability (ISV). The ISV was estimated on background activity concentration (BAC) and sphere to background ratio (SBR) and defined as their 95% confidence level. RESULTS Twenty-six out of 27 (96%) scanners fulfilled the CTQ requirements. The CTQ was fulfilled at the first round in 27% of the cases, while in 38%, 15% and 20%, two, three or more than three iterations, were required, respectively. The mean CTQ time was (1.8 ± 1.4) months (range: 0.3-4.6). The ISV in BAC and SBR were 20.3% and 67.7%. CONCLUSIONS The CTQ proven to be a reliable tool to reduce ISV. This enabled to set-up clinical trials in which PET/CT was used to evaluate different clinical endpoints.
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Affiliation(s)
- Fabrizio Bergesio
- Medical Physics Division, Santa Croce e Carle Hospital, Cuneo, Italia
| | - Adriano De Maggi
- Medical Physics Division, Santa Croce e Carle Hospital, Cuneo, Italia
| | - Mónica Coronado
- Nuclear Medicine Department, Hospital Universitario La Paz, Madrid, España
| | | | - Rafael Plaza
- Radiophysics Unit, Hospital Universitario La Paz, Madrid, España
| | | | | | - Montserrat Cortes
- Nuclear Medicine Department-IDI, Hospital Universitario de Bellvitge-IDIBELL, Barcelona, España
| | - Xavier Setoain
- Nuclear Medicine Department, Hospital Clínic, Barcelona, España
| | - Marc Simó
- Nuclear Medicine Department, Hospital Universitario Vall d́Hebron, Barcelona, España
| | - Amanda Rotger
- Nuclear Medicine Department, Hospital Universitario Gregorio Marañón, Madrid, España
| | - Carlos Grande
- Haematology Department, Hospital Universitario Doce de Octubre, Madrid, España
| | | | - Stephane Chauvie
- Medical Physics Division, Santa Croce e Carle Hospital, Cuneo, Italia.
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Abstract
Lymphoma is a potentially curable disease; however, the clinical challenge lies in further improvement of outcomes. PET with fludeoxyglucose is an effective imaging tool. PET-derived quantitative metrics have raised significant interest to be used as a prognostic factor to complement clinical parameters for treatment decisions. The most optimized use of these quantitative PET metrics, however, will be possible with the standardization of imaging procedures. In this article, we review the technical and methodological considerations related to PET-derived quantitative metrics, and the relevant published data to emphasize the potential value of these metrics in patient prognosis and treatment response in lymphoma.
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Affiliation(s)
- Lale Kostakoglu
- Nuclear Medicine and Molecular Imaging, Department of Radiology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1141, New York, NY 10029, USA.
| | - Stéphane Chauvie
- Department of Medical Physics, 'Santa Croce e Carle' Hospital, Cuneo, Italy
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Abstract
Although visual assessment using the Deauville criteria is strongly recommended by guidelines for treatment response monitoring in all FDG-avid lymphoma histologies, the high rate of false-positives and concerns about interobserver variability have motivated the development of quantitative tools to facilitate objective measurement of tumor response in both routine and clinical trial settings. Imaging studies using functional quantitative measures play a significant role in profiling oncologic processes. These quantitative metrics allow for objective end points in multicenter clinical trials. However, the standardization of imaging procedures including image acquisition parameters, reconstruction and analytic measures, and validation of these methods are essential to enable an individualized treatment approach. A robust quality control program associated with the inclusion of proper scanner calibration, cross-calibration with dose calibrators and across other scanners is required for accurate quantitative measurements. In this section, we will review the technical and methodological considerations related to PET-derived quantitative metrics and the relevant published data to emphasize the potential value of these metrics in the prediction of patient prognosis in lymphoma.
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Affiliation(s)
- Lale Kostakoglu
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY.
| | - Stéphane Chauvie
- Department of Medical Physics, 'Santa Croce e Carle' Hospital, Cuneo, Italy
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Lasnon C, Quak E, Le Roux PY, Robin P, Hofman MS, Bourhis D, Callahan J, Binns DS, Desmonts C, Salaun PY, Hicks RJ, Aide N. EORTC PET response criteria are more influenced by reconstruction inconsistencies than PERCIST but both benefit from the EARL harmonization program. EJNMMI Phys 2017; 4:17. [PMID: 28560574 PMCID: PMC5449363 DOI: 10.1186/s40658-017-0185-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Accepted: 05/19/2017] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND This study evaluates the consistency of PET evaluation response criteria in solid tumours (PERCIST) and European Organisation for Research and Treatment of Cancer (EORTC) classification across different reconstruction algorithms and whether aligning standardized uptake values (SUVs) to the European Association of Nuclear Medicine acquisition (EANM)/EARL standards provides more consistent response classification. MATERIALS AND METHODS Baseline (PET1) and response assessment (PET2) scans in 61 patients with non-small cell lung cancer were acquired in protocols compliant with the EANM guidelines and were reconstructed with point-spread function (PSF) or PSF + time-of-flight (TOF) reconstruction for optimal tumour detection and with a standardized ordered subset expectation maximization (OSEM) reconstruction known to fulfil EANM harmonizing standards. Patients were recruited in three centres. Following reconstruction, EQ.PET, a proprietary software solution was applied to the PSF ± TOF data (PSF ± TOF.EQ) to harmonize SUVs to the EANM standards. The impact of differing reconstructions on PERCIST and EORTC classification was evaluated using standardized uptake values corrected for lean body mass (SUL). RESULTS Using OSEMPET1/OSEMPET2 (standard scenario), responders displayed a reduction of -57.5% ± 23.4 and -63.9% ± 22.4 for SULmax and SULpeak, respectively, while progressing tumours had an increase of +63.4% ± 26.5 and +60.7% ± 19.6 for SULmax and SULpeak respectively. The use of PSF ± TOF reconstruction impacted the classification of tumour response. For example, taking the OSEMPET1/PSF ± TOFPET2 scenario reduced the apparent reduction in SUL in responding tumours (-39.7% ± 31.3 and -55.5% ± 26.3 for SULmax and SULpeak, respectively) but increased the apparent increase in SUL in progressing tumours (+130.0% ± 50.7 and +91.1% ± 39.6 for SULmax and SULpeak, respectively). Consequently, variation in reconstruction methodology (PSF ± TOFPET1/OSEMPET2 or OSEM PET1/PSF ± TOFPET2) led, respectively, to 11/61 (18.0%) and 10/61 (16.4%) PERCIST classification discordances and to 17/61 (28.9%) and 19/61 (31.1%) EORTC classification discordances. An agreement was better for these scenarios with application of the propriety filter, with kappa values of 1.00 and 0.95 compared to 0.75 and 0.77 for PERCIST and kappa values of 0.93 and 0.95 compared to 0.61 and 0.55 for EORTC, respectively. CONCLUSION PERCIST classification is less sensitive to reconstruction algorithm-dependent variability than EORTC classification but harmonizing SULs within the EARL program is equally effective with either.
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Affiliation(s)
- Charline Lasnon
- Nuclear Medicine Department, François Baclesse Cancer Centre, Caen, France
- INSERM U1086 ANTICIPE, BioTICLA, Caen University, Caen, France
| | - Elske Quak
- Nuclear Medicine Department, François Baclesse Cancer Centre, Caen, France
| | - Pierre-Yves Le Roux
- Nuclear Medicine Department and EA 3878 IFR 148, University Hospital, Brest, France
| | - Philippe Robin
- Nuclear Medicine Department and EA 3878 IFR 148, University Hospital, Brest, France
| | - Michael S Hofman
- Cancer Imaging, Peter Mac Callum Cancer Institute, Parkville, Australia
| | - David Bourhis
- Nuclear Medicine Department and EA 3878 IFR 148, University Hospital, Brest, France
| | - Jason Callahan
- Cancer Imaging, Peter Mac Callum Cancer Institute, Parkville, Australia
| | - David S Binns
- Cancer Imaging, Peter Mac Callum Cancer Institute, Parkville, Australia
| | - Cédric Desmonts
- Nuclear Medicine Department, University Hospital, Caen, France
| | - Pierre-Yves Salaun
- Nuclear Medicine Department and EA 3878 IFR 148, University Hospital, Brest, France
| | - Rodney J Hicks
- Cancer Imaging, Peter Mac Callum Cancer Institute, Parkville, Australia
- The Sir Peter MacCallum Department of Oncology, the University of Melbourne, Melbourne, Australia
| | - Nicolas Aide
- INSERM U1086 ANTICIPE, BioTICLA, Caen University, Caen, France.
- Nuclear Medicine Department, University Hospital, Caen, France.
- Normandy University, Caen, France.
- Nuclear Medicine Department, Caen University Hospital, Avenue Côte de Nacre, 14000, Caen, France.
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Aide N, Lasnon C, Veit-Haibach P, Sera T, Sattler B, Boellaard R. EANM/EARL harmonization strategies in PET quantification: from daily practice to multicentre oncological studies. Eur J Nucl Med Mol Imaging 2017; 44:17-31. [PMID: 28623376 PMCID: PMC5541084 DOI: 10.1007/s00259-017-3740-2] [Citation(s) in RCA: 190] [Impact Index Per Article: 27.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 04/24/2017] [Indexed: 01/18/2023]
Abstract
Quantitative positron emission tomography/computed tomography (PET/CT) can be used as diagnostic or prognostic tools (i.e. single measurement) or for therapy monitoring (i.e. longitudinal studies) in multicentre studies. Use of quantitative parameters, such as standardized uptake values (SUVs), metabolic active tumor volumes (MATVs) or total lesion glycolysis (TLG), in a multicenter setting requires that these parameters be comparable among patients and sites, regardless of the PET/CT system used. This review describes the motivations and the methodologies for quantitative PET/CT performance harmonization with emphasis on the EANM Research Ltd. (EARL) Fluorodeoxyglucose (FDG) PET/CT accreditation program, one of the international harmonization programs aiming at using FDG PET as a quantitative imaging biomarker. In addition, future accreditation initiatives will be discussed. The validation of the EARL accreditation program to harmonize SUVs and MATVs is described in a wide range of tumor types, with focus on therapy assessment using either the European Organization for Research and Treatment of Cancer (EORTC) criteria or PET Evaluation Response Criteria in Solid Tumors (PERCIST), as well as liver-based scales such as the Deauville score. Finally, also presented in this paper are the results from a survey across 51 EARL-accredited centers reporting how the program was implemented and its impact on daily routine and in clinical trials, harmonization of new metrics such as MATV and heterogeneity features.
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Affiliation(s)
- Nicolas Aide
- Nuclear Medicine Department, University Hospital, Caen, France.
- Inserm U1086 ANTICIPE, Caen University, Caen, France.
| | - Charline Lasnon
- Inserm U1086 ANTICIPE, Caen University, Caen, France
- Nuclear Medicine Department, François Baclesse Cancer Centre, Caen, France
| | - Patrick Veit-Haibach
- Department of Nuclear Medicine and Department of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland
- Joint Department Medical Imaging, University Health Network, University of Toronto, Toronto, Canada
| | - Terez Sera
- Nuclear Medicine Department, University of Szeged, Szeged, Hungary
| | - Bernhard Sattler
- Department of Nuclear Medicine, University Hospital of Leipzig, 04103, Leipzig, Germany
| | - Ronald Boellaard
- Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands
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Feasibility of Preoperative FDG PET/CT Total Hepatic Glycolysis in the Remnant Liver for the Prediction of Postoperative Liver Function. AJR Am J Roentgenol 2016; 208:624-631. [PMID: 28026972 DOI: 10.2214/ajr.16.16450] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE The objective of our study was to investigate the prognostic value of total glycolysis of the remnant liver, which reflects both metabolic and anatomic liver function, for predicting postoperative hepatic insufficiency. MATERIALS AND METHODS Patients who underwent 18F-FDG PET/CT and abdominal CT within 1 month of major hepatectomy were retrospectively analyzed. Total liver volume, remnant liver volume, the ratio of the remnant hepatic volume to the preoperative hepatic volume (RFRHV), and mean standardized uptake value (SUVmean) were measured, and total glycolysis of the remnant liver was calculated. Clinical hepatic function reserve values, including the indocyanine green retention rate at 15 minutes, the model for end-stage liver disease (MELD) score, and aspartate aminotransferase to platelet ratio index (APRI), were calculated. Univariate and multivariate analyses were performed, and an optimal model for predicting hepatic insufficiency was developed. ROC curves were used to compare diagnostic performance. RESULTS Of 149 patients, seven patients had hepatic insufficiency. The SUVmean showed the highest sensitivity (100%; specificity, 31.7%) for predicting hepatic insufficiency, and total glycolysis of the remnant liver showed the highest specificity (96.5%; sensitivity, 57.1%) for predicting hepatic insufficiency. On multivariate analysis, the odds ratio of APRI (> 5.4) and total glycolysis of the remnant liver (≤ 625.6) was 46.3 and 82.9, respectively, for predicting hepatic insufficiency. On ROC curve analysis, a new model composed of APRI and total glycolysis of the remnant liver showed a higher area under the ROC curve (Az) value (Az = 0.899) than SUVmean (0.659), MELD score (0.618), APRI (0.693), RFRHV (0.797), and remnant liver volume (0.762). CONCLUSION The total glycolysis of the remnant liver has moderate sensitivity and high specificity for predicting hepatic insufficiency. Combining the total glycolysis of the remnant liver and APRI yielded the best diagnostic performance for predicting hepatic insufficiency.
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Chauvie S, Bergesio F. The Strategies to Homogenize PET/CT Metrics: The Case of Onco-Haematological Clinical Trials. Biomedicines 2016; 4:biomedicines4040026. [PMID: 28536393 PMCID: PMC5344268 DOI: 10.3390/biomedicines4040026] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2016] [Revised: 11/06/2016] [Accepted: 11/08/2016] [Indexed: 12/19/2022] Open
Abstract
Positron emission tomography (PET) has been a widely used tool in oncology for staging lymphomas for a long time. Recently, several large clinical trials demonstrated its utility in therapy management during treatment, paving the way to personalized medicine. In doing so, the traditional way of reporting PET based on the extent of disease has been complemented by a discrete scale that takes in account tumour metabolism. However, due to several technical, physical and biological limitations in the use of PET uptake as a biomarker, stringent rules have been used in clinical trials to reduce the errors in its evaluation. Within this manuscript we will describe shortly the evolution in PET reporting, examine the main errors in uptake measurement, and analyse which strategy the clinical trials applied to reduce them.
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Affiliation(s)
- Stephane Chauvie
- Medical Physics Unit, Santa Croce e Carle Hospital, Cuneo 12100, Italy.
| | - Fabrizio Bergesio
- Medical Physics Unit, Santa Croce e Carle Hospital, Cuneo 12100, Italy.
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18F-FDG PET/CT heterogeneity quantification through textural features in the era of harmonisation programs: a focus on lung cancer. Eur J Nucl Med Mol Imaging 2016; 43:2324-2335. [DOI: 10.1007/s00259-016-3441-2] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Accepted: 06/08/2016] [Indexed: 12/16/2022]
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Chauvie S, Bergesio F, Fioroni F, Brambilla M, Biggi A, Versari A, Guerra L, Storto G, Musto P, Luminari S, Cabras MG, Balzarotti M, Rigacci L, Martelli M, Vitolo U, Federico M, Gallamini A. The 68 Ge phantom-based FDG-PET site qualification program for clinical trials adopted by FIL (Italian Foundation on Lymphoma). Phys Med 2016; 32:651-6. [DOI: 10.1016/j.ejmp.2016.04.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Revised: 03/10/2016] [Accepted: 04/13/2016] [Indexed: 01/01/2023] Open
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Multicenter evaluation of single-photon emission computed tomography quantification with third-party reconstruction software. Nucl Med Commun 2016; 37:983-7. [PMID: 27128824 DOI: 10.1097/mnm.0000000000000538] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Reliable and reproducible quantification is essential in many clinical situations. Previously, single-photon emission computed tomography (SPECT) has not been considered a quantitative imaging modality, but recent advances in reconstruction algorithm development have made SPECT quantitative. In this study, we investigate the reproducibility of SPECT quantification with phantoms in a multicenter setting using novel third-party reconstruction software. A total of five hospitals and eight scanners (three GE scanners and five Siemens scanners) participated in the study. A Jaszczak phantom without inserts was used to calculate counts to activity concentration conversion factors. The quantitative accuracy was tested using the NEMA-IEC phantom with six spherical inserts (diameters from 10 to 37 mm) filled to an 8 : 1 insert-background concentration ratio. Phantom studies were reconstructed at one central location using HERMES HybridRecon applying corrections for attenuation, collimator-detector response, and scatter. Spherical volumes of interest with the same diameter as the inserts were drawn on the images and recovery coefficients for the spheres were calculated. The coefficient of variation (CoV) of the NEMA-IEC phantom recovery coefficients ranged from ∼19 to 5% depending on the insert diameter so that the lowest CoV was obtained with the largest spheres. The intersite CoV was almost equal to intrasite CoV. In conclusion, quantitative SPECT is reproducible in a multicenter setting with third-party reconstruction software.
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Lasnon C, Houdu B, Kammerer E, Salomon T, Devreese J, Lebasnier A, Aide N. Patient’s weight: a neglected cause of variability in SUV measurements? A survey from an EARL accredited PET centre in 513 patients. Eur J Nucl Med Mol Imaging 2015; 43:197-199. [DOI: 10.1007/s00259-015-3214-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Accepted: 10/01/2015] [Indexed: 11/28/2022]
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Dharmarajan KV, Wexler LH, Gavane S, Fox JJ, Schoder H, Tom AK, Price AN, Meyers PA, Wolden SL. Positron emission tomography (PET) evaluation after initial chemotherapy and radiation therapy predicts local control in rhabdomyosarcoma. Int J Radiat Oncol Biol Phys 2012; 84:996-1002. [PMID: 22560547 DOI: 10.1016/j.ijrobp.2012.01.077] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2011] [Revised: 01/24/2012] [Accepted: 01/25/2012] [Indexed: 01/14/2023]
Abstract
PURPOSE 18-fluorodeoxyglucose positron emission tomography (PET) is already an integral part of staging in rhabdomyosarcoma. We investigated whether primary-site treatment response characterized by serial PET imaging at specific time points can be correlated with local control. PATIENTS AND METHODS We retrospectively examined 94 patients with rhabdomyosarcoma who received initial chemotherapy 15 weeks (median) before radiotherapy and underwent baseline, preradiation, and postradiation PET. Baseline PET standardized uptake values (SUVmax) and the presence or absence of abnormal uptake (termed PET-positive or PET-negative) both before and after radiation were examined for the primary site. Local relapse-free survival (LRFS) was calculated according to baseline SUVmax, PET-positive status, and PET-negative status by the Kaplan-Meier method, and comparisons were tested with the log-rank test. RESULTS The median patient age was 11 years. With 3-year median follow-up, LRFS was improved among postradiation PET-negative vs PET-positive patients: 94% vs 75%, P=.02. By contrast, on baseline PET, LRFS was not significantly different for primary-site SUVmax≤7 vs >7 (median), although the findings suggested a trend toward improved LRFS: 96% for SUVmax≤7 vs 79% for SUVmax>7, P=.08. Preradiation PET also suggested a statistically insignificant trend toward improved LRFS for PET-negative (97%) vs PET-positive (81%) patients (P=.06). CONCLUSION Negative postradiation PET predicted improved LRFS. Notably, 77% of patients with persistent postradiation uptake did not experience local failure, suggesting that these patients could be closely followed up rather than immediately referred for intervention. Negative baseline and preradiation PET findings suggested statistically insignificant trends toward improved LRFS. Additional study may further understanding of relationships between PET findings at these time points and outcome in rhabdomyosarcoma.
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Affiliation(s)
- Kavita V Dharmarajan
- Department of Radiation Oncology, Memorial Sloan-Kettering, New York, New York 10065, USA.
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