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Research ArticleClinical Investigations

Impact of Tumor Size and Tracer Uptake Heterogeneity in 18F-FDG PET and CT Non–Small Cell Lung Cancer Tumor Delineation

Mathieu Hatt, Catherine Cheze-le Rest, Angela van Baardwijk, Philippe Lambin, Olivier Pradier and Dimitris Visvikis
Journal of Nuclear Medicine November 2011, 52 (11) 1690-1697; DOI: https://doi.org/10.2967/jnumed.111.092767
Mathieu Hatt
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Catherine Cheze-le Rest
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Angela van Baardwijk
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Philippe Lambin
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Olivier Pradier
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Dimitris Visvikis
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  • FIGURE 1.
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    FIGURE 1.

    Illustration of up-sampled PET images (central axial slice). Original PET image with voxel size of 5.31 × 5.31 × 5 mm (A) and PET image up-sampled with voxel size equal to CT (0.98 × 0.98 × 5 mm) (B) using cubic B-spline interpolation.

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    FIGURE 2.

    Correlations with manual delineations on CT (A) and PET (B) and with FLAB delineations on PET (C).

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    FIGURE 3.

    Absolute (in cm) differences (A) and relative (%) errors (B) between pathology measurements and image-based delineations.

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    FIGURE 4.

    Small lesions (<2 cm in diameter) (A) and larger lesions with moderate (COVFLAB = 0.23) (B) and higher (COVFLAB = 0.30) (C) heterogeneity. For readability, A1 contours are not shown in B and C and manual PET contours are not shown in B as they were similar to FLAB and T50. White = manual on CT; blue = T50; purple = A1; green = FLAB.

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    FIGURE 5.

    Heterogeneity estimation for 2 tumors.

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    FIGURE 6.

    Correlation between anatomic volume (A) or uptake heterogeneity (B) and differences between T50 and FLAB volumes.

Tables

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    TABLE 1

    Maximum-Diameter Measurements on Pathology and Image Delineations for All 17 Patients

    Measurement (cm)
    Patient no.PathologicCT1 (manual)CT2 (manual)PET (manual)PET (T50)PET (A1)PET (A2)PET (FLAB)
    16.26.66.75.74.654.85.8
    22.73.33.33.42.83.12.83
    3910.510.18.977.57.79.2
    41.51.81.92.11.31.61.31.5
    51.83.43.421.21.41.31.6
    63.143.93.22.42.62.52.8
    74.355.14.53.83.93.83.9
    83.15.75.75.12.843.73.5
    93.53.943.42.72.933.1
    105.77.67.77.47.54.76.75.4
    1155.15.34.72.732.94.6
    122.83.53.23.22.42.52.62.8
    134.15.25.14.33.23.33.34
    1444.84.93.73.23.43.23.9
    1577.47.45.86.26.56.36.7
    162.32.32.42.11.81.71.92.1
    172.565.94.52.52.72.62.2
    Mean ± SD4.0 ± 2.05.1 ± 2.25.1 ± 2.14.2 ± 1.93.4 ± 1.93.5 ± 1.63.6 ± 1.83.9 ± 2.0
    Median3.55.05.13.72.83.13.03.5
    Range1.5–91.8–10.51.9–10.11.9–8.91.2–7.51.4–7.51.3–7.71.5–9.2
    Pearson r—0.900.910.950.890.950.930.99
    95% CI for r—0.74–0.960.76–0.960.86–0.980.72–0.960.85–0.980.81–0.980.98–1.00
    • CI = confidence interval.

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    TABLE 2

    Tumor Volumes Measured on CT and PET Images (n = 25)

    Tumor volume (cm3) (n = 25)Mean ± SDMedianRange
    CT1 (manual)54.5 ± 74.028.21.9–338.9
    CT2 (manual)55.1 ± 74.829.11.8–339.4
    PET (manual)47.3 ± 76.421.32.1–356.2
    PET (T50)17.7 ± 25.19.28.5–125.8
    PET (A1)22.6 ± 33.211.91.2–166.9
    PET (A2)21.8 ± 33.911.30.9–172.4
    PET (FLAB)39.5 ± 70.515.81.1–345.1
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Journal of Nuclear Medicine: 52 (11)
Journal of Nuclear Medicine
Vol. 52, Issue 11
November 1, 2011
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Impact of Tumor Size and Tracer Uptake Heterogeneity in 18F-FDG PET and CT Non–Small Cell Lung Cancer Tumor Delineation
Mathieu Hatt, Catherine Cheze-le Rest, Angela van Baardwijk, Philippe Lambin, Olivier Pradier, Dimitris Visvikis
Journal of Nuclear Medicine Nov 2011, 52 (11) 1690-1697; DOI: 10.2967/jnumed.111.092767

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Impact of Tumor Size and Tracer Uptake Heterogeneity in 18F-FDG PET and CT Non–Small Cell Lung Cancer Tumor Delineation
Mathieu Hatt, Catherine Cheze-le Rest, Angela van Baardwijk, Philippe Lambin, Olivier Pradier, Dimitris Visvikis
Journal of Nuclear Medicine Nov 2011, 52 (11) 1690-1697; DOI: 10.2967/jnumed.111.092767
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