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A contrast-oriented algorithm for FDG-PET-based delineation of tumour volumes for the radiotherapy of lung cancer: derivation from phantom measurements and validation in patient data

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

Abstract

Purpose

An easily applicable algorithm for the FDG-PET-based delineation of tumour volumes for the radiotherapy of lung cancer was developed by phantom measurements and validated in patient data.

Methods

PET scans were performed (ECAT-ART tomograph) on two cylindrical phantoms (phan1, phan2) containing glass spheres of different volumes (7.4–258 ml) which were filled with identical FDG concentrations. Gradually increasing the activity of the fillable background, signal-to-background ratios from 33:1 to 2.5:1 were realised. The mean standardised uptake value (SUV) of the region-of-interest (ROI) surrounded by a 70% isocontour (mSUV70) was used to represent the FDG accumulation of each sphere (or tumour). Image contrast was defined as:\(C = {{\left( {{\text{mSUV}}_{{\text{70}}} - {\text{BG}}} \right)} \mathord{\left/ {\vphantom {{\left( {{\text{mSUV}}_{{\text{70}}} - {\text{BG}}} \right)} {{\text{BG}}}}} \right. \kern-\nulldelimiterspace} {{\text{BG}}}}\) where BG is the mean background − SUV. For the spheres of phan1, the threshold SUVs (TS) best matching the known sphere volumes were determined. A regression function representing the relationship between TS/(mSUV70 − BG) and C was calculated and used for delineation of the spheres in phan2 and the gross tumour volumes (GTVs) of eight primary lung tumours. These GTVs were compared to those defined using CT.

Results

The relationship between TS/(mSUV70 − BG) and C is best described by an inverse regression function which can be converted to the linear relationship \({\text{TS}} = a \times {\text{mSUV}}_{70} + b \times {\text{BG}}\). Using this algorithm, the volumes delineated in phan2 differed by only −0.4 to +0.7 mm in radius from the true ones, whilst the PET-GTVs differed by only −0.7 to +1.2 mm compared with the values determined by CT.

Conclusion

By the contrast-oriented algorithm presented in this study, a PET-based delineation of GTVs for primary tumours of lung cancer patients is feasible.

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Acknowledgement

We gratefully acknowledge the valuable help of Dipl. Ing. P. Donsch who constructed the phantoms. Furthermore, we thank Andrew Page for his help in the wording of the manuscript.

Conflict of interest statement

None of the authors has any conflict between his or his family’s financial interest and the content of this manuscript.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Saarland University Medical Center, 66421, Homburg, Germany

    Andrea Schaefer, Dirk Hellwig, Carl-Martin Kirsch & Ursula Nestle

  2. Department of Radiotherapy, Saarland University Medical Center, 66421, Homburg, Germany

    Stephanie Kremp & Christian Rübe

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  1. Andrea Schaefer
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Correspondence to Andrea Schaefer.

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Schaefer, A., Kremp, S., Hellwig, D. et al. A contrast-oriented algorithm for FDG-PET-based delineation of tumour volumes for the radiotherapy of lung cancer: derivation from phantom measurements and validation in patient data. Eur J Nucl Med Mol Imaging 35, 1989–1999 (2008). https://doi.org/10.1007/s00259-008-0875-1

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