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Robustness of intratumour 18F-FDG PET uptake heterogeneity quantification for therapy response prediction in oesophageal carcinoma

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Abstract

Purpose

Intratumour uptake heterogeneity in PET quantified in terms of textural features for response to therapy has been investigated in several studies, including assessment of their robustness for reconstruction and physiological reproducibility. However, there has been no thorough assessment of the potential impact of preprocessing steps on the resulting quantification and its predictive value. The goal of this work was to assess the robustness of PET heterogeneity in textural features for delineation of functional volumes and partial volume correction (PVC).

Methods

This retrospective analysis included 50 patients with oesophageal cancer. PVC of each PET image was performed. Tumour volumes were determined using fixed and adaptive thresholding, and the fuzzy locally adaptive Bayesian algorithm, and heterogeneity was quantified using local and regional textural features. Differences in the absolute values of the image-derived parameters considered were assessed using Bland-Altman analysis. The impact on their predictive value for the identification of patient nonresponders was assessed by comparing areas under the receiver operating characteristic curves.

Results

Heterogeneity parameters were more dependent on delineation than on PVC. The parameters most sensitive to delineation and PVC were regional ones (intensity variability and size zone variability), whereas local parameters such as entropy and homogeneity were the most robust. Despite the large differences in absolute values obtained from different delineation methods or after PVC, these differences did not necessarily translate into a significant impact on their predictive value.

Conclusion

Parameters such as entropy, homogeneity, dissimilarity (for local heterogeneity characterization) and zone percentage (for regional characterization) should be preferred. This selection is based on a demonstrated high differentiation power in terms of predicting response, as well as a significant robustness with respect to the delineation method used and the partial volume effects.

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Conflicts of interest

None.

Financial support

French Research Ministry PhD grant.

Author information

Authors and Affiliations

  1. INSERM, UMR 1101, LaTIM, CHRU Morvan, 2 avenue Foch, 29609, Brest, France

    Mathieu Hatt, Florent Tixier & Dimitris Visvikis

  2. Nuclear Medicine, CHU Milétrie, Poitiers, France

    Catherine Cheze Le Rest

  3. Radiotherapy, CHRU Morvan, Brest, France

    Olivier Pradier

Authors
  1. Mathieu Hatt
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  2. Florent Tixier
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  3. Catherine Cheze Le Rest
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  4. Olivier Pradier
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  5. Dimitris Visvikis
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Corresponding author

Correspondence to Mathieu Hatt.

Additional information

Mathieu Hatt and Florent Tixier contributed equally to this work.

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Hatt, M., Tixier, F., Cheze Le Rest, C. et al. Robustness of intratumour 18F-FDG PET uptake heterogeneity quantification for therapy response prediction in oesophageal carcinoma. Eur J Nucl Med Mol Imaging 40, 1662–1671 (2013). https://doi.org/10.1007/s00259-013-2486-8

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  • DOI: https://doi.org/10.1007/s00259-013-2486-8

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