Quantitative implications of the updated EARL 2019 PET–CT performance standards

EJNMMI Physics - Tập 6 Số 1 - 2019
Andres Kaalep1, Coreline N. Burggraaff2, Simone Pieplenbosch3, Eline E. Verwer3, Teréz Séra4,5, Josée M. Zijlstra2, Otto S. Hoekstra3, Daniëla E. Oprea-Lager3, Ronald Boellaard6,3,5
1Department of Medical Technology, North Estonia Medical Centre Foundation, Tallinn, Republic of Estonia
2Department of Hematology, Amsterdam UMC, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam, the Netherlands
3Department of Radiology and Nuclear Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam, the Netherlands
4Department of Nuclear Medicine, University of Szeged, Szeged, Hungary
5On behalf of EANM Research Limited (EARL), Vienna, Austria
6Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands

Tóm tắt

Abstract Purpose

Recently, updated EARL specifications (EARL2) have been developed and announced. This study aims at investigating the impact of the EARL2 specifications on the quantitative reads of clinical PET–CT studies and testing a method to enable the use of the EARL2 standards whilst still generating quantitative reads compliant with current EARL standards (EARL1).

Methods

Thirteen non-small cell lung cancer (NSCLC) and seventeen lymphoma PET–CT studies were used to derive four image datasets—the first dataset complying with EARL1 specifications and the second reconstructed using parameters as described in EARL2. For the third (EARL2F6) and fourth (EARL2F7) dataset in EARL2, respectively, 6 mm and 7 mm Gaussian post-filtering was applied. We compared the results of quantitative metrics (MATV, SUVmax, SUVpeak, SUVmean, TLG, and tumor-to-liver and tumor-to-blood pool ratios) obtained with these 4 datasets in 55 suspected malignant lesions using three commonly used segmentation/volume of interest (VOI) methods (MAX41, A50P, SUV4).

Results

We found that with EARL2 MAX41 VOI method, MATV decreases by 22%, TLG remains unchanged and SUV values increase by 23–30% depending on the specific metric used. The EARL2F7 dataset produced quantitative metrics best aligning with EARL1, with no significant differences between most of the datasets (p>0.05). Different VOI methods performed similarly with regard to SUV metrics but differences in MATV as well as TLG were observed. No significant difference between NSCLC and lymphoma cancer types was observed.

Conclusions

Application of EARL2 standards can result in higher SUVs, reduced MATV and slightly changed TLG values relative to EARL1. Applying a Gaussian filter to PET images reconstructed using EARL2 parameters successfully yielded EARL1 compliant data.

Từ khóa


Tài liệu tham khảo

Fletcher JW, Djulbegovic B, Soares HP, Siegel BA, Lowe VJ, Lyman GH, et al. Recommendations on the use of 18F-FDG PET in oncology. J Nucl Med. 2008;49:480–508.

Weber WA. Use of PET for Monitoring Cancer Therapy and for Predicting Outcome. J Nucl Med. 2005;46:983–95.

Borst GR, Belderbos JS, Boellaard R, EFI C, De Jaeger K, Lammertsma A, et al. Standardised FDG uptake: a prognostic factor for inoperable non-small cell lung cancer. Eur J Cancer. 2005;41:1533–41.

Shankar LK, Hoffman JM, Bacharach S, Graham MM, Karp J, Lammertsma AA, et al. Consensus Recommendations for the Use of 18F-FDG PET as an Indicator of Therapeutic Response in Patients in National Cancer Institute Trials. J Nucl Med. 2006;47:1059–66.

Gupta T, Master Z, Kannan S, Agarwal JP, Ghsoh-Laskar S, Rangarajan V, et al. Diagnostic performance of post-treatment FDG PET or FDG PET/CT imaging in head and neck cancer: a systematic review and meta-analysis. Eur J Nucl Med Mol Imaging. 2011;38:2083.

Ung YC, Maziak DE, Vanderveen JA, Smith CA, Gulenchyn K, Lacchetti C, et al. 18Fluorodeoxyglucose positron emission tomography in the diagnosis and staging of lung cancer: A systematic review. J Natl Cancer Inst. 2007;99:1753–67.

Liao S, Penney BC, Wroblewski K, Zhang H, Simon CA, Kampalath R, et al. Prognostic value of metabolic tumor burden on 18F-FDG PET in nonsurgical patients with non-small cell lung cancer. Eur J Nucl Med Mol Imaging. 2012;39:27–38.

Weber WA. Assessing Tumor Response to Therapy. J Nucl Med. 2009;50:1S–0.

Boellaard R. Standards for PET image acquisition and quantitative data analysis. J Nucl Med. 2009;50(Suppl 1):11S–20S.

Thie JA. Understanding the standardized uptake value, its methods, and implications for usage. J Nucl Med. 2004;45:1431–4.

Adams MC, Turkington TG, Wilson JM, Wong TZ. A systematic review of the factors affecting accuracy of SUV measurements. AJR Am J Roentgenol United States. 2010;195:310–20.

Fahey FH, Kinahan PE, Doot RK, Kocak M, Thurston H, Poussaint TY. Variability in PET quantitation within a multicenter consortium. Med Phys United States. 2010;37:3660–6.

Beyer T, Czernin J, Freudenberg LS. Variations in clinical PET/CT operations: results of an international survey of active PET/CT users. J Nucl Med United States. 2011;52:303–10.

Boellaard R. Need for standardization of 18F-FDG PET/CT for treatment response assessments. J. Nucl. Med. [Internet]. 2011;52 Suppl 2:93S-100S. Available from: http://jnm.snmjournals.org/content/52/Supplement_2/93S.full

Westerterp M, Pruim J, Oyen W, Hoekstra O, Paans A, Visser E, et al. Quantification of FDG PET studies using standardised uptake values in multi-centre trials: Effects of image reconstruction, resolution and ROI definition parameters. Eur J Nucl Med Mol Imaging. 2007;34:392–404.

Boellaard R, Delgado-Bolton R, Oyen WJG, Giammarile F, Tatsch K, Eschner W, et al. FDG PET/CT: EANM procedure guidelines for tumour imaging: version 2.0. Eur J Nucl Med Mol Imaging. 2014;42:328–54.

Delbeke D, Coleman RE, Guiberteau MJ, Brown ML, Royal HD, Siegel B, et al. Procedure guideline for tumor imaging with 18F-FDG PET/CT 1.0. J Nucl Med. 2006;47:885–95.

Graham MM, Wahl RL, Hoffman JM, Yap JT, Sunderland JJ, Boellaard R, et al. Summary of the UPICT protocol for 18F-FDG PET/CT imaging in oncology clinical trials. J Nucl Med. 2015;56:955–61.

Scheuermann JS, Saffer JR, Karp JS, Levering AM, Siegel A. Qualification of PET Scanners for Use in Multicenter Cancer Clinical Trials: The American College of Radiology Imaging Network Experience. J Nucl Med. 2010;50:1187–93.

Kinahan P, Wahl R, Shao L, Frank R, Perlman E. The QIBA profile for quantitative FDG-PET/CT oncology imaging. J Nucl Med. 2014;55:1520.

Sunderland JJ, Christian PE. Quantitative PET/CT Scanner Performance Characterization Based Upon the Society of Nuclear Medicine and Molecular Imaging Clinical Trials Network Oncology Clinical Simulator Phantom. J Nucl Med. 2015;56:145–52.

Kaalep A, Sera T, Oyen W, Krause BJ, Chiti A, Liu Y, et al. EANM/EARL FDG-PET/CT accreditation - summary results from the first 200 accredited imaging systems. Eur J Nucl Med Mol Imaging European Journal of Nuclear Medicine and Molecular Imaging. 2018;45:412–22.

van der Vos CS, Koopman D, Rijnsdorp S, Arends AJ, Boellaard R, van Dalen JA, et al. Quantification, improvement, and harmonization of small lesion detection with state-of-the-art PET. Eur J Nucl Med Mol Imaging European Journal of Nuclear Medicine and Molecular Imaging. 2017;44:4–16.

Kuhnert G, Boellaard R, Sterzer S, Kahraman D, Scheffler M, Wolf J, et al. Impact of PET/CT image reconstruction methods and liver uptake normalization strategies on quantitative image analysis. Eur. J. Nucl. Med. Mol. Imaging [Internet]. 2016;43:249–58. Available from: https://doi.org/10.1007/s00259-015-3165-8

Barrington SF, Sulkin T, Forbes A, Johnson PWM. All that glitters is not gold - new reconstruction methods using Deauville criteria for patient reporting. Eur. J. Nucl. Med. Mol. Imaging [Internet]. 2018;45:316–7. Available from: https://doi.org/10.1007/s00259-017-3893-z

Kaalep A, Sera T, Rijnsdorp S, Yaqub M, Talsma A, Lodge MA, et al. Feasibility of state of the art PET/CT systems performance harmonisation. Eur J Nucl Med Mol Imaging European Journal of Nuclear Medicine and Molecular Imaging. 2018;45:1344–61.

Lasnon C, Salomon T, Desmonts C, Dô P, Oulkhouir Y, Madelaine J, et al. Generating harmonized SUV within the EANM EARL accreditation program: software approach versus EARL-compliant reconstruction. Ann Nucl Med. 2017.

Boellaard R. Quantitative oncology molecular analysis suite: ACCURATE. J. Nucl. Med. [Internet]. 2018;59:1753. Available from: http://jnm.snmjournals.org/content/59/supplement_1/1753.abstract

EANM EARL website [Internet]. Available from: http://earl.eanm.org

Frings V, van Velden FHP, Velasquez LM, Hayes W, van de Ven PM, Hoekstra OS, et al. Repeatability of Metabolically Active Tumor Volume Measurements with FDG PET/CT in Advanced Gastrointestinal Malignancies: A Multicenter Study. Radiology [Internet]. Radiological Society of North America; 2014;273:539–48. Available from: https://doi.org/10.1148/radiol.14132807

Wahl RL, Jacene H, Kasamon Y, Lodge MA. From RECIST to PERCIST: Evolving considerations for PET response criteria in solid tumors. J Nucl Med. 2009.

Cheebsumon P, Yaqub M, Van Velden FHP, Hoekstra OS, Lammertsma AA, Boellaard R. Impact of [ 18F]FDG PET imaging parameters on automatic tumour delineation: Need for improved tumour delineation methodology. Eur J Nucl Med Mol Imaging. 2011.

Armstrong IS, Kelly MD, Williams HA, Matthews JC. Impact of point spread function modelling and time of flight on FDG uptake measurements in lung lesions using alternative filtering strategies. EJNMMI Phys. 2014;1:99.

Ly J, Minarik D, Edenbrandt L, Wollmer P, Trägårdh E. The use of a proposed updated EARL harmonization of 18F-FDG PET-CT in patients with lymphoma yields significant differences in Deauville score compared with current EARL recommendations. EJNMMI Res. 2019.