PT  - JOURNAL ARTICLE
AU  - Prateek Katiyar
AU  - Mathew R. Divine
AU  - Ursula Kohlhofer
AU  - Leticia Quintanilla-Martinez
AU  - Bernhard Schölkopf
AU  - Bernd J. Pichler
AU  - Jonathan A. Disselhorst
TI  - Spectral Clustering Predicts Tumor Tissue Heterogeneity Using Dynamic <sup>18</sup>F-FDG PET: A Complement to the Standard Compartmental Modeling Approach
AID  - 10.2967/jnumed.116.181370
DP  - 2017 Apr 01
TA  - Journal of Nuclear Medicine
PG  - 651--657
VI  - 58
IP  - 4
4099  - http://jnm.snmjournals.org/content/58/4/651.short
4100  - http://jnm.snmjournals.org/content/58/4/651.full
SO  - J Nucl Med2017 Apr 01; 58
AB  - In this study, we described and validated an unsupervised segmentation algorithm for the assessment of tumor heterogeneity using dynamic 18F-FDG PET. The aim of our study was to objectively evaluate the proposed method and make comparisons with compartmental modeling parametric maps and SUV segmentations using simulations of clinically relevant tumor tissue types. Methods: An irreversible 2-tissue-compartmental model was implemented to simulate clinical and preclinical 18F-FDG PET time–activity curves using population-based arterial input functions (80 clinical and 12 preclinical) and the kinetic parameter values of 3 tumor tissue types. The simulated time–activity curves were corrupted with different levels of noise and used to calculate the tissue-type misclassification errors of spectral clustering (SC), parametric maps, and SUV segmentation. The utility of the inverse noise variance– and Laplacian score–derived frame weighting schemes before SC was also investigated. Finally, the SC scheme with the best results was tested on a dynamic 18F-FDG measurement of a mouse bearing subcutaneous colon cancer and validated using histology. Results: In the preclinical setup, the inverse noise variance–weighted SC exhibited the lowest misclassification errors (8.09%–28.53%) at all noise levels in contrast to the Laplacian score–weighted SC (16.12%–31.23%), unweighted SC (25.73%–40.03%), parametric maps (28.02%–61.45%), and SUV (45.49%–45.63%) segmentation. The classification efficacy of both weighted SC schemes in the clinical case was comparable to the unweighted SC. When applied to the dynamic 18F-FDG measurement of colon cancer, the proposed algorithm accurately identified densely vascularized regions from the rest of the tumor. In addition, the segmented regions and clusterwise average time–activity curves showed excellent correlation with the tumor histology. Conclusion: The promising results of SC mark its position as a robust tool for quantification of tumor heterogeneity using dynamic PET studies. Because SC tumor segmentation is based on the intrinsic structure of the underlying data, it can be easily applied to other cancer types as well.