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Reproducibility of Tumor Blood Flow Quantification with ¹⁵O-Water PET

¹ Division of Nuclear Medicine, Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland; and ² Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Johns Hopkins University School of Medicine, Baltimore, Maryland

View larger version (75K): [in this window] [in a new window]   FIGURE 1.  Circular ROIs (diameter, 15 mm) were manually placed over the most metabolically active part of tumor, as seen in last frame of dynamic 18F-FDG images (A). ROIs were defined in 3 adjacent image slices (not shown). This volume of interest was subsequently applied to 2 15O-water image series (B and C) under assumption that patient did not move between 15O-water and 18F-FDG studies.

View larger version (13K): [in this window] [in a new window]   FIGURE 2.  Example time–activity curves for replicate 15O-water studies performed on same patient. Data for first (A) and second (B) administrations are shown. Circles represent (image-derived) input function and squares denote tumor data. Solid line near tumor data is model fit that produced parameter estimates shown in each figure.

View larger version (9K): [in this window] [in a new window]   FIGURE 3.  Bland–Altman analysis of reproducibility of k1 for tumors (TBF). (A) Replicate measures of k1 are plotted against each other. Solid symbols represent data acquired on Advance scanner; open symbols represent data acquired on Discovery RX scanner. (B) Absolute difference between replicate k1 measurements are plotted as function of their mean and show clear proportionality. (C) After log transformation, dsd for k1 was calculated as 0.178. Dashed lines denote 95% CIs on either side of mean (1.96 x dsd).

View larger version (8K): [in this window] [in a new window]   FIGURE 4.  Bland–Altman analysis of reproducibility of k2 for tumors (efflux rate constant). (A) Replicate measures of k2 are plotted against each other. Solid symbols represent data acquired on Advance scanner; open symbols represent data acquired on Discovery RX scanner. (B) Absolute differences between replicate k2 measurements are plotted as function of their mean and show clear proportionality. (C) After log transformation, dsd for k2 was calculated as 0.259. Dashed lines denote 95% CIs on either side of mean (1.96 x dsd).

View larger version (9K): [in this window] [in a new window]   FIGURE 5.  Bland–Altman analysis of reproducibility of Vd for tumors. (A) Replicate measures of Vd are plotted against each other. Solid symbols represent data acquired on Advance scanner; open symbols represent data acquired on Discovery RX scanner. (B) Absolute differences between replicate Vd measurements are plotted as function of their mean and show no clear proportionality. (C) dsd for Vd was calculated as 0.082 mL/g. Dashed lines denote 95% CIs on either side of mean (1.96 x dsd).