Changes of [18F]FDG-PET/CT quantitative parameters in tumor lesions by the Bayesian penalized-likelihood PET reconstruction algorithm and its influencing factors

Abstract Background To compare the changes in quantitative parameters and the size and degree of 18F-fluorodeoxyglucose ([18F]FDG) uptake of malignant tumor lesions between Bayesian penalized-likelihood (BPL) and non-BPL reconstruction algorithms. Methods Positron emission tomography/computed tomography images of 86 malignant tumor lesions were reconstructed using the algorithms of ordered subset expectation maximization (OSEM), OSEM + time of flight (TOF), OSEM + TOF + point spread function (PSF), and BPL. [18F]FDG parameters of maximum standardized uptake value (SUVmax), SUVmean, metabolic tumor volume (MTV), total lesion glycolysis (TLG), and signal-to-background ratio (SBR) of these lesions were measured. Quantitative parameters between the different reconstruction algorithms were compared, and correlations between parameter variation and lesion size or the degree of [18F]FDG uptake were analyzed. Results After BPL reconstruction, SUVmax, SUVmean, and SBR were significantly increased, MTV was significantly decreased. The difference values of %ΔSUVmax, %ΔSUVmean, %ΔSBR, and the absolute value of %ΔMTV between BPL and OSEM + TOF were 40.00%, 38.50%, 33.60%, and 33.20%, respectively, which were significantly higher than those between BPL and OSEM + TOF + PSF. Similar results were observed in the comparison of OSEM and OSEM + TOF + PSF with BPL. The %ΔSUVmax, %ΔSUVmean, and %ΔSBR were all significantly negatively correlated with the size and degree of [18F]FDG uptake in the lesions, whereas significant positive correlations were observed for %ΔMTV and %ΔTLG. Conclusion The BPL reconstruction algorithm significantly increased SUVmax, SUVmean, and SBR and decreased MTV of tumor lesions, especially in small or relatively hypometabolic lesions.

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Evaluation and Optimization of a New PET Reconstruction Algorithm, Bayesian Penalized Likelihood Reconstruction, for Lung Cancer Assessment According to Lesion Size

American Journal of Roentgenology ◽

10.2214/ajr.18.20478 ◽

2019 ◽

Vol 213 (2) ◽

pp. W50-W56 ◽

Cited By ~ 4

Author(s):

Tomoaki Otani ◽

Makoto Hosono ◽

Mitsunori Kanagaki ◽

Yasuyuki Onishi ◽

Naoko Matsubara ◽

...

Keyword(s):

Lung Cancer ◽

Penalized Likelihood ◽

Reconstruction Algorithm ◽

Lesion Size ◽

Pet Reconstruction

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Tumor metabolic volume by 18F-FDG-PET as a prognostic predictor of first-line pembrolizumab for NSCLC patients with PD-L1 ≥ 50%

Scientific Reports ◽

10.1038/s41598-020-71735-y ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Ou Yamaguchi ◽

Kyoichi Kaira ◽

Kosuke Hashimoto ◽

Atsuto Mouri ◽

Ayako Shiono ◽

...

Keyword(s):

Objective Response ◽

Prognostic Significance ◽

Standardized Uptake Value ◽

Progression Free Survival ◽

Predictive Marker ◽

Distant Metastases ◽

Metabolic Tumor Volume ◽

First Line ◽

Prognostic Predictor ◽

Fdg Uptake

Abstract There is a lack of markers for predicting favorable outcomes after pembrolizumab therapy in patients with non-small cell lung cancer (NSCLC) with programmed death ligand-1 (PD-L1) expression ≥ 50%. This retrospective study examined the prognostic significance of 2-deoxy-2-[18F] fluoro-d-glucose (18F-FDG) uptake as a predictive marker of first-line pembrolizumab. Forty-eight patients with previously untreated NSCLC and PD-L1 expression levels ≥ 50% who underwent 18F-FDG-positron emission tomography (PET) just before administration of pembrolizumab monotherapy were eligible and underwent assessment of metabolic tumor volume (MTV), total lesion glycolysis (TLG), and maximum of standardized uptake value (SUVmax) on 18F-FDG uptake. The objective response rate, median progression-free survival, and median overall survival were 51.1%, 7.1 months, and 18.6 months, respectively. In univariate survival analyses, high MTV was barely a significant prognostic predictor and was confirmed as an independent factor linked to worse outcomes in multivariate analysis, predominantly in patients with a histological diagnosis of adenocarcinoma. A high MTV was significantly associated with distant metastases (especially bone metastasis), C-reactive protein (CRP) level, and PD-L1 expression ≥ 75%. Metabolic tumor activity assessed as MTV from 18F-FDG uptake predicted the prognosis after first-line pembrolizumab treatment in patients with NSCLC and PD-L1 expression ≥ 50%, especially for adenocarcinoma.

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Limitations of dual time point FDG-PET imaging in the evaluation of focal abdominal lesions

Nuklearmedizin ◽

10.1055/s-0038-1625195 ◽

2004 ◽

Vol 43 (05) ◽

pp. 143-149 ◽

Cited By ~ 22

Author(s):

N. Hamscho ◽

C. Menzel ◽

L. Neuss ◽

A. F. Kovács ◽

F. Grünwald ◽

...

Keyword(s):

Pet Imaging ◽

Malignant Tumors ◽

Standardized Uptake Value ◽

Delayed Imaging ◽

Ct Guided ◽

Fdg Uptake ◽

Diagnostic Potential ◽

Dual Time Point ◽

Abdominal Lesions ◽

Time Point

Summary:Aim: For the evaluation of the diagnostic potential of dual time point FDG positron emission tomography (PET) in patients with suspicious focal abdominal up-take, dual time point PET imaging was compared with clinical findings. Patients, methods: In a prospective study, 56 patients exhibiting a solitary suspicious, intense abdominal FDG uptake, underwent dual time point PET imaging for staging or restaging of different malignant tumors, maximal standardized uptake value (SUVmax) measurements included. The first acquisition was started 64.8 ± 19.5, the second 211.3 ± 52.5 min after FDG injection. The final diagnosis based on CT or MRT imaging and a follow-up period of 12.6 ± 2.8 months. Additionally, colonoscopy was done in 6 patients. In another 6 patients histopathology was obtained from CT guided biopsy. Results: Malignant focal abdominal lesions with a SUVmax <2.5 (n = 4) showed an uptake increase of ≥30%. In the remaining malignant cases with an uptake of ≥2.5 (n = 11), up-take increased in 64% and decreased in 36%. Malignant lesions showing FDG uptake decrease (n = 4) had an initial SUVmax value ≥2.5 and remained with a SUVmax ≥2.5 in the second imaging. In benign lesions with an initial SUVmax ≥2.5 (n = 31), the uptake increased in 17 patients (55%) and decreased in 14 patients (45%). All lesions which changed configuration (33%) were confirmed as benign (n = 5). Conclusion: Using dual time point PET abdominal lesions show a very hetergenous uptake pattern regardless of their dignity. Malignancy can only be reliably excluded in lesions which change their configuration and in lesions with an initial SUVmax value <2.5 combined with an SUV decrease in the delayed imaging. Particularly abdominal lesions which show an initial SUVmax ≥2.5 combined with a SUV increase in the delayed imaging are suspicious for malignancy and need further clarification.

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Prognostic significance of bone marrow FDG uptake in patients with gynecological cancer

Scientific Reports ◽

10.1038/s41598-021-81298-1 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Kotaro Shimura ◽

Seiji Mabuchi ◽

Naoko Komura ◽

Eriko Yokoi ◽

Katsumi Kozasa ◽

...

Keyword(s):

Ovarian Cancer ◽

Bone Marrow ◽

Poor Prognosis ◽

Gynecological Cancer ◽

Prognostic Significance ◽

Standardized Uptake Value ◽

Suppressor Cells ◽

Underlying Mechanism ◽

Fdg Uptake

AbstractWe investigated the prognostic significance and the underlying mechanism of increased bone marrow (BM) 2-(18F) fluoro-2-deoxy-D-glucose as a tracer (FDG)-uptake in patients with gynecological cancer. A list of patients diagnosed with cervical, endometrial, and ovarian cancer from January 2008 to December 2014 were identified. Then, through chart reviews, 559 patients who underwent staging by FDG-positron emission tomography (PET)/computed tomography (CT) and subsequent surgical resection were identified, and their clinical data were reviewed retrospectively. BM FDG-uptake was evaluated using maximum standardized uptake value (SUVmax) and BM-to-aorta uptake ratio (BAR). As a result, we have found that increased BAR was observed in 20 (8.7%), 21 (13.0%), 21 (12.6%) of cervical, endometrial, and ovarian cancer, respectively, and was associated with significantly shorter survival. Increased BAR was also closely associated with increased granulopoiesis. In vitro and in vivo experiments revealed that tumor-derived granulocyte colony-stimulating factor (G-CSF) was involved in the underlying causative mechanism of increased BM FDG-uptake, and that immune suppression mediated by G-CSF-induced myeloid-derived suppressor cells (MDSCs) is responsible for the poor prognosis of this type of cancer. In conclusion, increased BM FDG-uptake, as represented by increased BAR, is an indicator of poor prognosis in patients with gynecological cancer.

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Comparison between silicon photomultiplier-based and conventional PET/CT in patients with suspected lung cancer—a pilot study

EJNMMI Research ◽

10.1186/s13550-019-0504-y ◽

2019 ◽

Vol 9 (1) ◽

Cited By ~ 1

Author(s):

Johan Economou Lundeberg ◽

Jenny Oddstig ◽

Ulrika Bitzén ◽

Elin Trägårdh

Keyword(s):

Lung Cancer ◽

Expectation Maximization ◽

Image Interpretation ◽

Imaging Study ◽

Reconstruction Algorithm ◽

Tnm Staging ◽

Reconstruction Algorithms ◽

Silicon Photomultiplier ◽

Standardized Uptake Values ◽

Pet Ct

Abstract Background Lung cancer is one of the most common cancers in the world. Early detection and correct staging are fundamental for treatment and prognosis. Positron emission tomography with computed tomography (PET/CT) is recommended clinically. Silicon (Si) photomultiplier (PM)-based PET technology and new reconstruction algorithms are hoped to increase the detection of small lesions and enable earlier detection of pathologies including metastatic spread. The aim of this study was to compare the diagnostic performance of a SiPM-based PET/CT (including a new block-sequential regularization expectation maximization (BSREM) reconstruction algorithm) with a conventional PM-based PET/CT including a conventional ordered subset expectation maximization (OSEM) reconstruction algorithm. The focus was patients admitted for 18F-fluorodeoxyglucose (FDG) PET/CT for initial diagnosis and staging of suspected lung cancer. Patients were scanned on both a SiPM-based PET/CT (Discovery MI; GE Healthcare, Milwaukee, MI, USA) and a PM-based PET/CT (Discovery 690; GE Healthcare, Milwaukee, MI, USA). Standardized uptake values (SUV) and image interpretation were compared between the two systems. Image interpretations were further compared with histopathology when available. Results Seventeen patients referred for suspected lung cancer were included in our single injection, dual imaging study. No statically significant differences in SUVmax of suspected malignant primary tumours were found between the two PET/CT systems. SUVmax in suspected malignant intrathoracic lymph nodes was 10% higher on the SiPM-based system (p = 0.026). Good consistency (14/17 cases) between the PET/CT systems were found when comparing simplified TNM staging. The available histology results did not find any obvious differences between the systems. Conclusion In a clinical setting, the new SiPM-based PET/CT system with a new BSREM reconstruction algorithm provided a higher SUVmax for suspected lymph node metastases compared to the PM-based system. However, no improvement in lung cancer detection was seen.

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Performance Analysis of Surface Reconstruction Algorithms in Vertical Scanning Interferometry Based on Coherence Envelope Detection

Micromachines ◽

10.3390/mi12020164 ◽

2021 ◽

Vol 12 (2) ◽

pp. 164

Author(s):

Dongxu Wu ◽

Fusheng Liang ◽

Chengwei Kang ◽

Fengzhou Fang

Keyword(s):

Surface Reconstruction ◽

Measurement Accuracy ◽

Experimental Studies ◽

Reconstruction Algorithm ◽

Low Noise ◽

Surface Measurement ◽

Reconstruction Algorithms ◽

Centroid Method ◽

Envelope Detection ◽

Vertical Scanning Interferometry

Optical interferometry plays an important role in the topographical surface measurement and characterization in precision/ultra-precision manufacturing. An appropriate surface reconstruction algorithm is essential in obtaining accurate topography information from the digitized interferograms. However, the performance of a surface reconstruction algorithm in interferometric measurements is influenced by environmental disturbances and system noise. This paper presents a comparative analysis of three algorithms commonly used for coherence envelope detection in vertical scanning interferometry, including the centroid method, fast Fourier transform (FFT), and Hilbert transform (HT). Numerical analysis and experimental studies were carried out to evaluate the performance of different envelope detection algorithms in terms of measurement accuracy, speed, and noise resistance. Step height standards were measured using a developed interferometer and the step profiles were reconstructed by different algorithms. The results show that the centroid method has a higher measurement speed than the FFT and HT methods, but it can only provide acceptable measurement accuracy at a low noise level. The FFT and HT methods outperform the centroid method in terms of noise immunity and measurement accuracy. Even if the FFT and HT methods provide similar measurement accuracy, the HT method has a superior measurement speed compared to the FFT method.

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Multiple PET tracers for use in the classification of gliomas according to the 2016 WHO criteria

Neuro-Oncology Advances ◽

10.1093/noajnl/vdaa172 ◽

2020 ◽

Author(s):

Keisuke Miyake ◽

Kenta Suzuki ◽

Tomoya B Ogawa ◽

Daisuke Ogawa ◽

Tetsuhiro Hatakeyama ◽

...

Keyword(s):

Who Classification ◽

Standardized Uptake Value ◽

Metabolic Tumor Volume ◽

Who Criteria ◽

Pet Tracers ◽

Pet Tracer ◽

Positron Emission ◽

18F Fdg ◽

Classification Of Gliomas

Abstract Background The molecular diagnosis of gliomas such as isocitrate dehydrogenase (IDH) status (wild-type [wt] or mutation [mut]) is especially important in the 2016 WHO classification. Positron emission tomography (PET) has afforded molecular and metabolic diagnostic imaging. The present study aimed to define the interrelationship between the 2016 WHO classification of gliomas and the integrated data from PET images using multiple tracers, including 18F-fluorodeoxyglucose ( 18F-FDG), 11C-methionine ( 11C-MET), 18F-fluorothymidine ( 18F-FLT), and 18F-fluoromisonidazole ( 18F-FMISO). Methods This retrospective, single-center study comprised 113 patients with newly diagnosed glioma based on the 2016 WHO criteria. Patients were divided into four glioma subtypes (Mut, Codel, Wt, and glioblastoma multiforme [GBM]). Tumor standardized uptake value (SUV) divided by mean normal cortical SUV (tumor-normal tissue ratio [TNR]) was calculated for 18F-FDG, 11C-MET, and 18F-FLT. Tumor-blood SUV ratio (TBR) was calculated for 18F-FMISO. To assess the diagnostic accuracy of PET tracers in distinguishing glioma subtypes, a comparative analysis of TNRs and TBR as well as the metabolic tumor volume (MTV) were calculated by Scheffe’s multiple comparison procedure for each PET tracer following the Kruskal–Wallis test. Results The differences in mean 18F-FLT TNR and 18F-FMISO TBR were significant between GBM and other glioma subtypes (p < 0.001). Regarding the comparison between Gd-T1WI volumes and 18F-FLT MTVs or 18F-FMISO MTVs, we identified significant differences between Wt and Mut or Codel (p < 0.01). Conclusion Combined administration of four PET tracers might aid in the preoperative differential diagnosis of gliomas according to the 2016 WHO criteria.

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High Basal Maximal Standardized Uptake Value (SUVmax) in Follicular Lymphoma Identifies Patients with a Low Risk of Long-Term Relapse

Cancers ◽

10.3390/cancers13122876 ◽

2021 ◽

Vol 13 (12) ◽

pp. 2876

Author(s):

Giovanni Manfredi Assanto ◽

Giulia Ciotti ◽

Mattia Brescini ◽

Maria Lucia De Luca ◽

Giorgia Annechini ◽

...

Keyword(s):

Risk Factors ◽

Follicular Lymphoma ◽

Standardized Uptake Value ◽

Metabolic Tumor Volume ◽

Late Relapse ◽

Prognostic Role ◽

Pet Ct ◽

Group A ◽

Group B

Background: Despite that the unfavorable prognostic role of a high Total Metabolic Tumor Volume (TMTV) in Follicular Lymphoma has been demonstrated, the role of SUVmax alone at baseline PET/CT could have a different prognostic role. Patients and Methods: We performed a retrospective observational monocentric cohort study. All patients affected by FL who underwent a basal PET/CT were included. Two subgroups were identified and compared in terms of PFS and OS: (A) Basal SUVmax ≤ 6; and (B) Basal SUVmax > 6. Results: Ninety-four patients were included, 34 in group A (36.2%) and 60 in group B (63.8%). The PFS at two years was comparable in the two groups (97%). The five-year PFS was 73.5% for group A and 95% for group B (p 0.005). The five-year PFS in the whole cohort was 87.5%. A clear advantage was confirmed in group A in the absence of other risk factors. Patients with SUVmax ≤ 6 and no risk factors showed a 5-year PFS of 73% against 83% for patients with SUVmax > 6 and at least two risk factors. Conclusion: A high FDG uptake favorably correlated with PFS. A low basal SUVmax reflected a higher rate of late relapse requiring a prolonged follow-up. The basal SUVmax is an approachable parameter with prognostic implications.

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Quantitative, Dynamic 18F-FDG PET/CT in Monitoring of Smoldering Myeloma: A Case Report

Diagnostics ◽

10.3390/diagnostics11040649 ◽

2021 ◽

Vol 11 (4) ◽

pp. 649

Author(s):

Christos Sachpekidis ◽

Matthias Türk ◽

Antonia Dimitrakopoulou-Strauss

Keyword(s):

Bone Marrow ◽

Plasma Cells ◽

Autologous Transplantation ◽

Standardized Uptake Value ◽

Focal Lesions ◽

Fdg Uptake ◽

Pet Ct ◽

18F Fdg ◽

Smoldering Myeloma

We report on a 52-year-old patient with an initial diagnosis of smoldering myeloma (SMM), who was monitored by means of dynamic and static positron emission tomography/computed tomography (PET/CT) with the radiotracer 1⁸F-fluorodeoxyglucose (18F-FDG). Baseline PET/CT revealed no pathological signs. Six months later, a transition to symptomatic, multiple myeloma (MM) was diagnosed. The transition was not accompanied by focal, hypermetabolic lesions on PET/CT. However, a diffusely increased 18F-FDG uptake in the bone marrow, accompanied by a marked increase of semi-quantitative (standardized uptake value, SUV) and quantitative, pharmacokinetic 18F-FDG parameters, was demonstrated. After successful treatment, including tandem autologous transplantation, the diffuse uptake in the bone marrow as well as the semi-quantitative and quantitative parameters showed a marked remission. This response was also confirmed by the clinical follow-up of the patient. These findings suggest that in MM a diffuse 18F-FDG uptake in the bone marrow may indeed reflect an actual bone marrow infiltration by plasma cells. Moreover, SUV values and kinetic parameters, not only from myeloma lesions but also from random bone marrow samples, may be used for MM monitoring. This could be particularly helpful in the follow-up of myeloma patients negative for 18F-FDG-avid focal lesions.

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Manual kidney stone size measurements in computed tomography are most accurate using multiplanar image reformatations and bone window settings

Scientific Reports ◽

10.1038/s41598-021-95962-z ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Robert Peter Reimer ◽

Konstantin Klein ◽

Miriam Rinneburger ◽

David Zopfs ◽

Simon Lennartz ◽

...

Keyword(s):

Computed Tomography ◽

Treatment Decision ◽

Reconstruction Algorithm ◽

Slice Thickness ◽

Reconstruction Algorithms ◽

Stone Size ◽

Bone Window ◽

3D Printed ◽

Measurement Strategies ◽

Digital Caliper

AbstractComputed tomography in suspected urolithiasis provides information about the presence, location and size of stones. Particularly stone size is a key parameter in treatment decision; however, data on impact of reformatation and measurement strategies is sparse. This study aimed to investigate the influence of different image reformatations, slice thicknesses and window settings on stone size measurements. Reference stone sizes of 47 kidney stones representative for clinically encountered compositions were measured manually using a digital caliper (Man-M). Afterwards stones were placed in a 3D-printed, semi-anthropomorphic phantom, and scanned using a low dose protocol (CTDIvol 2 mGy). Images were reconstructed using hybrid-iterative and model-based iterative reconstruction algorithms (HIR, MBIR) with different slice thicknesses. Two independent readers measured largest stone diameter on axial (2 mm and 5 mm) and multiplanar reformatations (based upon 0.67 mm reconstructions) using different window settings (soft-tissue and bone). Statistics were conducted using ANOVA ± correction for multiple comparisons. Overall stone size in CT was underestimated compared to Man-M (8.8 ± 2.9 vs. 7.7 ± 2.7 mm, p < 0.05), yet closely correlated (r = 0.70). Reconstruction algorithm and slice thickness did not significantly impact measurements (p > 0.05), while image reformatations and window settings did (p < 0.05). CT measurements using multiplanar reformatation with a bone window setting showed closest agreement with Man-M (8.7 ± 3.1 vs. 8.8 ± 2.9 mm, p < 0.05, r = 0.83). Manual CT-based stone size measurements are most accurate using multiplanar image reformatation with a bone window setting, while measurements on axial planes with different slice thicknesses underestimate true stone size. Therefore, this procedure is recommended when impacting treatment decision.

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