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Journal of Medical Imaging

Method for detecting voxelwise changes in fluorodeoxyglucose-positron emission tomography brain images via background adjustment in cancer clinical trials
Author(s): Lei Qin; Armin Schwartzman; Keisha McCall; Nezamoddin N. Kachouie; Jeffrey T. Yap
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Paper Abstract

An important challenge to using fluorodeoxyglucose-positron emission tomography (FDG-PET) in clinical trials of brain tumor patients is to identify malignant regions whose metabolic activity shows significant changes between pretreatment and a posttreatment scans in the presence of high normal brain background metabolism. This paper describes a semiautomated processing and analysis pipeline that is able to detect such changes objectively with a given false detection rate. Image registration and voxelwise comparison of the pre- and posttreatment images were performed. A key step is adjustment of the observed difference by the estimated background change at each voxel, thereby overcoming the confounding effect of spatially heterogeneous metabolic activity in the brain. Components of the proposed method were validated via phantom experiments and computer simulations. It achieves a false response volume accuracy of 0.4% at a significance threshold of 3 standard deviations. It is shown that the proposed methodology can detect lesion response with 100% accuracy with a tumor-to-background-ratio as low as 1.5, and it is not affected by the background brain glucose metabolism change. We also applied the method to FDG-PET patient images from a clinical trial to assess treatment effects of lapatinib, which demonstrated significant changes in metabolism corresponding to tumor regions.

Paper Details

Date Published: 1 June 2017
PDF: 17 pages
J. Med. Imag. 4(2) 024006 doi: 10.1117/1.JMI.4.2.024006
Published in: Journal of Medical Imaging Volume 4, Issue 2
Show Author Affiliations
Lei Qin, Dana-Farber Cancer Institute (United States)
Armin Schwartzman, Univ. of California, San Diego (United States)
Keisha McCall, Dana-Farber Cancer Institute (United States)
Nezamoddin N. Kachouie, Florida Institute of Technology (United States)
Jeffrey T. Yap, Huntsman Cancer Institute, The Univ. of Utah (United States)

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