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CC BY-NC-ND 4.0 · World J Nucl Med 2019; 18(01): 45-51
DOI: 10.4103/wjnm.WJNM_22_18
Original Article

Tumor volume delineation: A pilot study comparing a digital positron-emission tomography prototype with an analog positron-emission tomography system

Nghi C. Nguyen
0   Department of Radiology, University of Pittsburgh, Pittsburgh, PA 15213
,
Jose Vercher-Conejero
1   Department of Radiology, Case Western Reserve University, University Hospitals Case Medical Center, Cleveland, OH, USA
,
Peter Faulhaber
1   Department of Radiology, Case Western Reserve University, University Hospitals Case Medical Center, Cleveland, OH, USA
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Abstract

We evaluated the potential differences of a digital positron-emission tomography (PET) prototype equipped with photon-counting detectors (D-PET, Philips Healthcare, Cleveland, Ohio, USA) in tumor volume delineation compared with the analog Gemini TF PET system (A-PET, Philips). Eleven oncologic patients first underwent clinical fluorodeoxyglucose (FDG) PET/computed tomography (CT) on A-PET. The D-PET ring was then inserted between the PET and CT scanner of A-PET and the patient was scanned for the second time. Two interpreters reviewed the two sets of PET/CT images for image quality and diagnostic confidence. FDG avid lesions were evaluated for volume measured at 35% and 50% of maximum standard uptake value (SUV) thresholds (35% SUV, 50% SUV), and for SUV gradient as a measure of lesion sharpness. Bland–Altman plots were used to assess the agreement between the two PET scans. Qualitative lesion conspicuity, sharpness, and diagnostic confidence were greater at D-PET than that of A-PET with favorable inter-rater agreements. Median lesion size of the 24 measured lesions was 1.6 cm. The lesion volume at D-PET was smaller at both 35% SUV and 50% SUV thresholds compared with that of A-PET, with a mean difference of − 3680.0 mm3 at 35% SUV and − 835.3 mm3 at 50% SUV. SUV gradient was greater at D-PET than at A-PET by 49.2% (95% confidence interval: 34.1%–60.8%). Given the smaller volume definition, coupled with improved conspicuity and sharpness, digital PET may be more robust and accurate in tumor rendering compared with analog PET not only for radiotherapy planning but also in prognostication and systemic treatment monitoring.

Keywords

Digital positron-emission tomography - direct photon counting - fluorodeoxyglucose positron-emission tomography - tumor volume rendering

Financial support and sponsorship

Nil.




Publication History

Received: 00 00 2019

Accepted: 00 00 2019

Article published online:
22 April 2022

© 2019. Sociedade Brasileira de Neurocirurgia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Gill BS, Pai SS, McKenzie S, Beriwal S. Utility of PET for radiotherapy treatment planning. PET Clin 2015;10:541-54.
  • 2 Biehl KJ, Kong FM, Dehdashti F, Jin JY, Mutic S, El Naqa I, et al. 18F-FDG PET definition of gross tumor volume for radiotherapy of non-small cell lung cancer: Is a single standardized uptake value threshold approach appropriate? J Nucl Med 2006;47:1808-12.
  • 3 Price PM, Green MM. Positron emission tomography imaging approaches for external beam radiation therapies: Current status and future developments. Br J Radiol 2011;84:S19-34.
  • 4 Carlier T, Bailly C. State-of-the-art and recent advances in quantification for therapeutic follow-up in oncology using PET. Front Med (Lausanne) 2015;2:18.
  • 5 Surti S, Kuhn A, Werner ME, Perkins AE, Kolthammer J, Karp JS, et al. Performance of Philips Gemini TF PET/CT scanner with special consideration for its time-of-flight imaging capabilities. J Nucl Med 2007;48:471-80.
  • 6 Degenhardt C, Prescher G, Frach T, Thon A, de Gruyter R, Schmitz A, et al. The digital silicon photomultiplier – A novel sensor for the detection of scintillation light. IEEE Nuclear Science Conference Record; 2009. p. 2383-6.
  • 7 Degenhardt C, Rodrigues P, Trindade A, Zwaans B, Mulhens O, Dorscheid R, et al. Performance evaluation of a prototype positron emission tomography scanner using digital photon counters (DPC). IEEE Nuclear Science Conference Record; 2012. p. 2820-4.
  • 8 Adler S, Seidel J, Choyke P, Knopp MV, Binzel K, Zhang J, et al. Minimum lesion detectability as a measure of PET system performance. EJNMMI Phys 2017;4:13.
  • 9 Browne J, de Pierro AB. A row-action alternative to the EM algorithm for maximizing likelihood in emission tomography. IEEE Trans Med Imaging 1996;15:687-99.
  • 10 Surti S, Scheuermann J, El Fakhri G, Daube-Witherspoon ME, Lim R, Abi-Hatem N, et al. Impact of time-of-flight PET on whole-body oncologic studies: A human observer lesion detection and localization study. J Nucl Med 2011;52:712-9.
  • 11 Geets X, Lee JA, Bol A, Lonneux M, Grégoire V. A gradient-based method for segmenting FDG-PET images: Methodology and validation. Eur J Nucl Med Mol Imaging 2007;34:1427-38.
  • 12 Nguyen NC, Vercher-Conejero JL, Sattar A, Miller MA, Maniawski PJ, Jordan DW, et al. Image quality and diagnostic performance of a digital PET prototype in patients with oncologic diseases: Initial experience and comparison with analog PET. J Nucl Med 2015;56:1378-85.
  • 13 Wanet M, Lee JA, Weynand B, De Bast M, Poncelet A, Lacroix V, et al. Gradient-based delineation of the primary GTV on FDG-PET in non-small cell lung cancer: A comparison with threshold-based approaches, CT and surgical specimens. Radiother Oncol 2011;98:117-25.
  • 14 Werner-Wasik M, Nelson AD, Choi W, Arai Y, Faulhaber PF, Kang P, et al. What is the best way to contour lung tumors on PET scans? Multiobserver validation of a gradient-based method using a NSCLC digital PET phantom. Int J Radiat Oncol Biol Phys 2012;82:1164-71.
  • 15 Slomka PJ, Pan T, Berman DS, Germano G. Advances in SPECT and PET hardware. Prog Cardiovasc Dis 2015;57:566-78.
  • 16 Kang J, Choi Y. Simulation study of PET detector configuration with thick light guide and GAPD array having large-area microcells for high effective quantum efficiency. Comput Methods Programs Biomed 2016;131:79-87.
  • 17 Kolb A, Lorenz E, Judenhofer MS, Renker D, Lankes K, Pichler BJ, et al. Evaluation of geiger-mode APDs for PET block detector designs. Phys Med Biol 2010;55:1815-32.
  • 18 Rochas AP, Besse PA, Pantic D, Prijic Z, Popovic RS. Low-noise silicon avalanche photodiodes fabricated in conventional CMOS technologies. IEEE Trans Electron Devices 2002;49:387-94.
  • 19 Daisne JF, Sibomana M, Bol A, Doumont T, Lonneux M, Grégoire V, et al. Tri-dimensional automatic segmentation of PET volumes based on measured source-to-background ratios: Influence of reconstruction algorithms. Radiother Oncol 2003;69:247-50.
  • 20 Surti S. Update on time-of-flight PET imaging. J Nucl Med 2015;56:98-105.
  • 21 Moon SH, Hyun SH, Choi JY. Prognostic significance of volume-based PET parameters in cancer patients. Korean J Radiol 2013;14:1-2.
  • 22 Tixier F, Le Rest CC, Hatt M, Albarghach N, Pradier O, Metges JP, et al. Intratumor heterogeneity characterized by textural features on baseline 18F-FDG PET images predicts response to concomitant radiochemotherapy in esophageal cancer. J Nucl Med 2011;52:369-78.
  • 23 Zhang JW, Bhatia P, Binzel K, Bai C, Maniawski P, Knopp M. Advantage and clinical benefit of 325ps TOF PET for lesion detectability. J Nuclear Med 2017;58 Suppl 1:1325.