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01-09-2021 | Computed Tomography | Original Article

Motion-compensated FDG PET/CT for oesophageal cancer

Authors: Francine E. M. Voncken, MD PhD, Erik Vegt, MD PhD, Johanna W. van Sandick, MD PhD, Jolanda M. van Dieren, MD PhD, Cecile Grootscholten, MD PhD, Annemarieke Bartels-Rutten, MD PhD, Steven L. Takken, RTT, Jan-Jakob Sonke, PhD, Jeroen B. van de Kamer, PhD, Berthe M. P. Aleman, MD PhD

Published in: Strahlentherapie und Onkologie | Issue 9/2021

Abstract

Purpose

Respiratory-induced motion of oesophageal tumours and lymph nodes can influence positron-emission tomography/computed tomography (PET/CT). The aim was to compare standard three-dimensional (3D) and motion-compensated PET/CT regarding standardized uptake value (SUV), metabolic tumour volume (MTV) and detection of lymph node metastases.

Methods

This prospective observational study (NCT02424864) included 37 newly diagnosed oesophageal cancer patients. Diagnostic PET/CT was reconstructed in 3D and motion-compensated PET/CT. MTVs of the primary tumour were calculated using an automated region-growing algorithm with SUV thresholds of 2.5 (MTV2.5) and ≥ 50% of SUVmax (MTV50%). Blinded for reconstruction method, a nuclear medicine physician assessed all lymph nodes showing ¹⁸F‑fluorodeoxyglucose uptake for their degree of suspicion.

Results

The mean (95% CI) SUVmax of the primary tumour was 13.1 (10.6–15.5) versus 13.0 (10.4–15.6) for 3D and motion-compensated PET/CT, respectively. MTVs were also similar between the two techniques. Bland–Altman analysis showed mean differences between both measurements (95% limits of agreement) of 0.08 (−3.60–3.75), −0.26 (−2.34–1.82), 4.66 (−29.61–38.92) cm³ and −0.95 (−19.9–18.0) cm³ for tumour SUVmax, lymph node SUVmax, MTV2.5 and MTV50%, respectively. Lymph nodes were classified as highly suspicious (30/34 nodes), suspicious (20/22) and dubious (66/59) for metastases on 3D/motion-compensated PET/CT. No additional lymph node metastases were found on motion-compensated PET/CT. SUVmax of the most intense lymph nodes was similar for both scans: mean (95% CI) 6.6 (4.3–8.8) and 6.8 (4.5–9.1) for 3D and motion-compensated, respectively.

Conclusion

SUVmax of the primary oesophageal tumour and lymph nodes was comparable on 3D and motion-compensated PET/CT. The use of motion-compensated PET/CT did not improve lymph node detection.

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Title: Motion-compensated FDG PET/CT for oesophageal cancer
Authors: Francine E. M. Voncken, MD PhD
Erik Vegt, MD PhD
Johanna W. van Sandick, MD PhD
Jolanda M. van Dieren, MD PhD
Cecile Grootscholten, MD PhD
Annemarieke Bartels-Rutten, MD PhD
Steven L. Takken, RTT
Jan-Jakob Sonke, PhD
Jeroen B. van de Kamer, PhD
Berthe M. P. Aleman, MD PhD
Publication date: 01-09-2021
Publisher: Springer Berlin Heidelberg
Keywords: Computed Tomography
Metastasis
Computed Tomography
Published in: Strahlentherapie und Onkologie / Issue 9/2021
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-021-01761-w

At a glance: The STEP trials

Springer Medicine

Motion-compensated FDG PET/CT for oesophageal cancer

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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