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European Journal of Nuclear Medicine and Molecular Imaging
Published in: European Journal of Nuclear Medicine and Molecular Imaging 12/2012

01-12-2012 | Original Article

Reproducibility of functional volume and activity concentration in 18F-FDG PET/CT of liver metastases in colorectal cancer

Authors: Linda Heijmen, Lioe-Fee de Geus-Oei, Johannes H. W. de Wilt, Dimitris Visvikis, Mathieu Hatt, Eric P. Visser, Johan Bussink, Cornelis J. A. Punt, Wim J. G. Oyen, Hanneke W. M. van Laarhoven

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 12/2012

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Abstract

Purpose

Several studies showed potential for monitoring response to systemic therapy in metastatic colorectal cancer patients with 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET). Before 18F-FDG PET can be implemented for response evaluation the repeatability should be known. This study was performed to assess the magnitude of the changes in standardized uptake value (SUV), volume and total lesion glycolysis (TLG) in colorectal liver metastases and validate the biological basis of 18F-FDG PET in colorectal liver metastases.

Methods

Twenty patients scheduled for liver metastasectomy underwent two 18F-FDG PET scans within 1 week. Bland-Altman analysis was performed to assess repeatability of SUVmax, SUVmean, volume and TLG. Tumours were delineated using an adaptive threshold method (PETSBR) and a semiautomatic fuzzy locally adaptive Bayesian (FLAB) delineation method.

Results

Coefficient of repeatability of SUVmax and SUVmean were ∼39 and ∼31 %, respectively, independent of the delineation method used and image reconstruction parameters. However, repeatability was worse in recently treated patients. The FLAB delineation method improved the repeatability of the volume and TLG measurements compared to PETSBR, from coefficients of repeatability of over 85 % to 45 % and 57 % for volume and TLG, respectively. Glucose transporter 1 (GLUT1) expression correlated to the SUVmean. Vascularity (CD34 expression) and tumour hypoxia (carbonic anhydrase IX expression) did not correlate with 18F-FDG PET parameters.

Conclusion

In conclusion, repeatability of SUVmean and SUVmax was mainly affected by preceding systemic therapy. The repeatability of tumour volume and TLG could be improved using more advanced and robust delineation approaches such as FLAB, which is recommended when 18F-FDG PET is utilized for volume or TLG measurements. Improvement of repeatability of PET measurements, for instance by dynamic PET scanning protocols, is probably necessary to effectively use PET for early response monitoring.
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Metadata
Title
Reproducibility of functional volume and activity concentration in 18F-FDG PET/CT of liver metastases in colorectal cancer
Authors
Linda Heijmen
Lioe-Fee de Geus-Oei
Johannes H. W. de Wilt
Dimitris Visvikis
Mathieu Hatt
Eric P. Visser
Johan Bussink
Cornelis J. A. Punt
Wim J. G. Oyen
Hanneke W. M. van Laarhoven
Publication date
01-12-2012
Publisher
Springer-Verlag
Published in
European Journal of Nuclear Medicine and Molecular Imaging / Issue 12/2012
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-012-2233-6

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