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Exploratory evaluation of two-dimensional and three-dimensional methods of FDG PET quantification in pediatric anaplastic astrocytoma: a report from the Pediatric Brain Tumor Consortium (PBTC)

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

The rationale of this study was to investigate the feasibility of three-dimensional (3D) methods to analyze 18F-fluoro-deoxy-glucose (FDG) uptake in children with anaplastic astrocytoma (AA) in a multi-institutional trial, to compare 3D and two-dimensional (2D) methods and explore data associations with progression-free survival (PFS).

Methods

3D tumor volumes from pretreatment MR images (fluid attenuation inversion recovery and postgadolinium) of children with recurrent AA on a phase I trial of imatinib mesylate were coregistered to FDG positron emission tomography (PET) images. PET data were normalized. Four metrics were defined: the maximum ratio (maximum pixel value within the 3D tumor volume, normalized), the total ratio (cumulative pixel values within the tumor volume, normalized) and tumor mean ratio (total pixel value divided by volume, normalized). 2D analysis methods were compared. Cox proportional hazards models were used to estimate the association between these methods and PFS.

Results

Strongest correlations between 2D and 3D methods were with analyses using postcontrast T1 images for volume of interest (VOI). The analyses suggest 3D maximum tumor and mean tumor ratios, whether normalized by gray matter or white matter, were associated with PFS.

Conclusions

This study of a series of pretreatment AA patients suggests that 3D PET methods using VOIs based on postcontrast T1 correlate with 2D methods and are related to PFS. These methods yield an estimate of metabolically active tumor burden and may add prognostic information after tumor grade is determined. Future rigorous multi-institutional protocols with larger numbers of patients will be required for validation.

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Acknowledgments

This work was supported in part by NIH grant U01 A81457 for the Pediatric Brain Tumor Consortium (PBTC), The Pediatric Brain Tumor Foundation of the United States (PBTFUS), and American Lebanese Syrian Associated Charities. We acknowledge the site PET physicians including Dr. Abass Alavi (Children’s Hospital of Philadelphia), Dr. Randall Hawkins (UCSF), Dr. James Mountz (Children’s Hospital of Pittsburgh), Dr. Terence Wong (Duke), Dr. Satoshi Minoshima (Seattle Children’s Hospital), Dr. David Earl-Graef (Children’s National), Dr. Stewart Spies (Children’s Memorial), Dr. John Butman (NIH), and Dr. Barry Shulkin (St. Jude Children’s Research Hospital).

Conflict of interest statement

There are no financial disclosures or other relationships that would create a conflict of interest for the authors.

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Authors and Affiliations

  1. Joint Program in Nuclear Medicine, Children’s Hospital Boston, Harvard Medical School, Boston, MA, USA

    Gethin Williams, Frederic H. Fahey & S. Ted Treves

  2. St Jude Children’s Research Hospital, Memphis, TN, USA

    Mehmet Kocak, James M. Boyett & Larry E. Kun

  3. Children’s Hospital Pittsburgh, Pittsburgh, PA, USA

    Ian F. Pollack

  4. Division of Nuclear Medicine, Department of Radiology, Children’s Hospital Boston, Harvard Medical School, 300 Longwood Avenue, Boston, MA, 02115, USA

    Frederic H. Fahey

  5. Division of Neuroradiology, Department of Radiology, Children’s Hospital Boston, Harvard Medical School, 300 Longwood Avenue, Boston, MA, 02115, USA

    Tina Young Poussaint

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  1. Gethin Williams
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  2. Frederic H. Fahey
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  3. S. Ted Treves
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  4. Mehmet Kocak
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  5. Ian F. Pollack
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  7. Larry E. Kun
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  8. Tina Young Poussaint
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Correspondence to Frederic H. Fahey.

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Williams, G., Fahey, F.H., Treves, S.T. et al. Exploratory evaluation of two-dimensional and three-dimensional methods of FDG PET quantification in pediatric anaplastic astrocytoma: a report from the Pediatric Brain Tumor Consortium (PBTC). Eur J Nucl Med Mol Imaging 35, 1651–1658 (2008). https://doi.org/10.1007/s00259-008-0780-7

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  • DOI: https://doi.org/10.1007/s00259-008-0780-7

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