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Proceedings Paper

A pilot study of the prognostic significance of metabolic tumor size measurements in PET/CT imaging of lymphomas
Author(s): Maria Kallergi; Maria Botsivali; Nikolaos Politis; Dimitrios Menychtas; Alexandros Georgakopoulos; Sofia Chatziioannou
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Paper Abstract

This study explores changes in metabolic tumor volume, metabolic tumor diameter, and maximum standardized uptake value (SUVmax), for earlier and more accurate identification of lymphomas’ response to treatment using 18F- FDG PET/CT. Pre- and post-treatment PET/CT studies of 20 patients with Hodgkin disease (HL) and 7 patients with non- Hodgkin lymphoma (NHL) were retrospectively selected for this study. The diameter and volume of the metabolic tumor was determined by an in-house developed adaptive local thresholding technique based on a 50% threshold of the maximum pixel value within a region. Statistical analysis aimed at exploring associations between metabolic size measurements and SUVmax and the ability of the three biomarkers to predict the patients’ response to treatment as defined by the four classes in the European Organization for Research and Treatment of Cancer (EORTC) guidelines. Results indicated moderate correlations between % change in metabolic tumor volume and % change in metabolic tumor maximum diameter (R=0.51) and between % change in maximum diameter and % change in SUVmax (R=0.52). The correlation between % change in tumor volume and % change in SUVmax was weak (R=0.24). The % change in metabolic tumor size, either volume or diameter, was a “very strong” predictor of response to treatment (R=0.89), stronger than SUVmax (R=0.63). In conclusion, metabolic tumor volume could have important prognostic value, possibly higher than maximum metabolic diameter or SUVmax that are currently the standard of practice. Volume measurements, however, should be based on robust and standardized segmentation methodologies to avoid variability. In addition, SUV-peak or lean body mass corrected SUV-peak may be a better PET biomarker than SUVmax when SUV-volume combinations are considered.

Paper Details

Date Published: 19 March 2015
PDF: 6 pages
Proc. SPIE 9417, Medical Imaging 2015: Biomedical Applications in Molecular, Structural, and Functional Imaging, 941710 (19 March 2015); doi: 10.1117/12.2081877
Show Author Affiliations
Maria Kallergi, Technological Educational Institute of Athens (Greece)
Biomedical Research Foundation of the Academy of Athens (Greece)
Maria Botsivali, Technological Educational Institute of Athens (Greece)
Nikolaos Politis, Technological Educational Institute of Athens (Greece)
Dimitrios Menychtas, Technological Educational Institute of Athens (Greece)
Alexandros Georgakopoulos, Biomedical Research Foundation of the Academy of Athens (Greece)
Sofia Chatziioannou, Biomedical Research Foundation of the Academy of Athens (Greece)
National and Kapodistrian Univ. of Athens (Greece)


Published in SPIE Proceedings Vol. 9417:
Medical Imaging 2015: Biomedical Applications in Molecular, Structural, and Functional Imaging
Barjor Gimi; Robert C. Molthen, Editor(s)

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