RT Journal Article
SR Electronic
T1 Practical Approach for Comparative Analysis of Multilesion Molecular Imaging Using a Semiautomated Program for PET/CT
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP 1727
OP 1732
DO 10.2967/jnumed.111.089326
VO 52
IS 11
A1 Fox, Josef J.
A1 Autran-Blanc, Estelle
A1 Morris, Michael J.
A1 Gavane, Somali
A1 Nehmeh, Sadek
A1 Van Nuffel, André
A1 Gönen, Mithat
A1 Schöder, Heiko
A1 Humm, John L.
A1 Scher, Howard I.
A1 Larson, Steven M.
YR 2011
UL http://jnm.snmjournals.org/content/52/11/1727.abstract
AB We propose a standardized approach to quantitative molecular imaging (MI) in cancer patients with multiple lesions. Methods: Twenty patients with castration-resistant prostate cancer underwent 18F-FDG and 18F-16β-fluoro-5-dihydrotestosterone (18F-FDHT) PET/CT scans. Using a 5-point confidence scale, 2 readers interpreted coregistered scan sets on a workstation. Two hundred three sites per scan (specified in a lexicon) were reviewed. 18F-FDG–positive lesion bookmarks were propagated onto 18F-FDHT studies and then manually accepted or rejected. Discordance-positive 18F-FDHT lesions were similarly bookmarked. Lesional SUVmax was recorded. Tracer- and tissue-specific background correction factors were calculated via receiver-operating-characteristic analysis of 65 scan sets. Results: Readers agreed on more than 99% of 18F-FDG– and 18F-FDHT–negative sites. Positive-site agreement was 83% and 85%, respectively. Consensus-lesion maximum standardized uptake value (SUVmax) was highly reproducible (concordance correlation coefficient > 0.98). Receiver-operating-characteristic curves yielded 4 correction factors (SUVmax 1.8–2.6). A novel scatterplot (Larson-Fox-Gonen plot) depicted tumor burden and change in SUVmax for response assessments. Conclusion: Multilesion molecular imaging is optimized with a 5-step approach incorporating a confidence scale, site lexicon, semiautomated PET software, background correction, and Larson-Fox-Gonen graphing.