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Open Access 01-12-2012 | Original research

Assessment of tumour size in PET/CT lung cancer studies: PET- and CT-based methods compared to pathology

Authors: Patsuree Cheebsumon, Ronald Boellaard, Dirk de Ruysscher, Wouter van Elmpt, Angela van Baardwijk, Maqsood Yaqub, Otto S Hoekstra, Emile FI Comans, Adriaan A Lammertsma, Floris HP van Velden

Published in: EJNMMI Research | Issue 1/2012

Abstract

Background

Positron emission tomography (PET) may be useful for defining the gross tumour volume for radiation treatment planning and for response monitoring of non-small cell lung cancer (NSCLC) patients. The purpose of this study was to compare tumour sizes obtained from CT- and various more commonly available PET-based tumour delineation methods to pathology findings.

Methods

Retrospective non-respiratory gated whole body [¹⁸F]-fluoro-2-deoxy-D-glucose PET/CT studies from 19 NSCLC patients were used. Several (semi-)automatic PET-based tumour delineation methods and manual CT-based delineation were used to assess the maximum tumour diameter.

Results

50%, adaptive 41% threshold-based and contrast-oriented delineation methods showed good agreement with pathology after removing two outliers (R²=0.82). An absolute SUV threshold of 2.5 also showed a good agreement with pathology after the removal of 5 outliers (R²: 0.79), but showed a significant overestimation in the maximum diameter (19.8 mm, p<0.05). Adaptive 50%, relative threshold level and gradient-based methods did not show any outliers, provided only small, non-significant differences in maximum tumour diameter (<4.7 mm, p>0.10), and showed fair correlation (R²>0.62) with pathology. Although adaptive 70% threshold-based methods showed underestimation compared to pathology (36%), it provided the best precision (SD: 14%) together with good correlation (R²=0.81). Good correlation between CT delineation and pathology was observed (R²=0.77). However, CT delineation showed a significant overestimation compared with pathology (3.8 mm, p<0.05).

Conclusions

PET-based tumour delineation methods provided tumour sizes in agreement with pathology and may therefore be useful to define the (metabolically most) active part of the tumour for radiotherapy and response monitoring purposes.

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Title: Assessment of tumour size in PET/CT lung cancer studies: PET- and CT-based methods compared to pathology
Authors: Patsuree Cheebsumon
Ronald Boellaard
Dirk de Ruysscher
Wouter van Elmpt
Angela van Baardwijk
Maqsood Yaqub
Otto S Hoekstra
Emile FI Comans
Adriaan A Lammertsma
Floris HP van Velden
Publication date: 01-12-2012
Publisher: Springer Berlin Heidelberg
Published in: EJNMMI Research / Issue 1/2012
Electronic ISSN: 2191-219X
DOI: https://doi.org/10.1186/2191-219X-2-56

At a glance: The STEP trials

Springer Medicine

Assessment of tumour size in PET/CT lung cancer studies: PET- and CT-based methods compared to pathology

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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