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European Journal of Nuclear Medicine and Molecular Imaging

Published in:

01-08-2013 | Original Article

PET-based delineation of tumour volumes in lung cancer: comparison with pathological findings

Authors: Andrea Schaefer, Yoo Jin Kim, Stephanie Kremp, Sebastian Mai, Jochen Fleckenstein, Hendrik Bohnenberger, Hans-Joachim Schäfers, Jan-Martin Kuhnigk, Rainer M. Bohle, Christian Rübe, Carl-Martin Kirsch, Aleksandar Grgic

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 8/2013

Abstract

Purpose

The objective of the study was to validate an adaptive, contrast-oriented thresholding algorithm (COA) for tumour delineation in ¹⁸F-fluorodeoxyglucose (FDG) positron emission tomography (PET) for non-small cell lung cancer (NSCLC) in comparison with pathological findings. The impact of tumour localization, tumour size and uptake heterogeneity on PET delineation results was also investigated.

Methods

PET tumour delineation by COA was compared with both CT delineation and pathological findings in 15 patients to investigate its validity. Correlations between anatomical volume, metabolic volume and the pathology reference as well as between the corresponding maximal diameters were determined. Differences between PET delineations and pathological results were investigated with respect to tumour localization and uptake heterogeneity.

Results

The delineated volumes and maximal diameters measured on PET and CT images significantly correlated with the pathology reference (both r > 0.95, p < 0.0001). Both PET and CT contours resulted in overestimation of the pathological volume (PET 32.5 ± 26.5 %, CT 46.6 ± 27.4 %). CT volumes were larger than those delineated on PET images (CT 60.6 ± 86.3 ml, PET 48.3 ± 61.7 ml). Maximal tumour diameters were similar for PET and CT (51.4 ± 19.8 mm for CT versus 53.4 ± 19.1 mm for PET), slightly overestimating the pathological reference (mean difference CT 4.3 ± 3.2 mm, PET 6.2 ± 5.1 mm). PET volumes of lung tumours located in the lower lobe were significantly different from those determined from pathology (p = 0.037), whereas no significant differences were observed for tumours located in the upper lobe (p = 0.066). Only minor correlation was found between pathological tumour size and PET heterogeneity (r = −0.24).

Conclusion

PET tumour delineation by COA showed a good correlation with pathological findings. Tumour localization had an influence on PET delineation results. The impact of tracer uptake heterogeneity on PET delineation should be considered carefully and individually in each patient. Altogether, PET tumour delineation by COA for NSCLC patients is feasible and reliable with the potential for routine clinical application.

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Title: PET-based delineation of tumour volumes in lung cancer: comparison with pathological findings
Authors: Andrea Schaefer
Yoo Jin Kim
Stephanie Kremp
Sebastian Mai
Jochen Fleckenstein
Hendrik Bohnenberger
Hans-Joachim Schäfers
Jan-Martin Kuhnigk
Rainer M. Bohle
Christian Rübe
Carl-Martin Kirsch
Aleksandar Grgic
Publication date: 01-08-2013
Publisher: Springer Berlin Heidelberg
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 8/2013
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-013-2407-x

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Springer Medicine

PET-based delineation of tumour volumes in lung cancer: comparison with pathological findings

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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