Application of Partial Volume Effect Correction and 4D PET in the Quantification of FDG Avid Lung Lesions

Abstract

Purpose: The aim of this study is to assess a software-based method with semiautomated correction for partial volume effect (PVE) to quantify the metabolic activity of pulmonary malignancies in patients who underwent non-gated and respiratory-gated 2-deoxy-2-[ 18 F]fluoro-D-glucose (FDG)-positron emission tomography (PET)/x-ray computed tomography(CT). Procedures: The study included 106 lesions of 55 lung cancer patients who underwent respiratory-gated FDG-PET/CT for radiation therapy treatment planning. Volumetric PET/CT parameters were determined by using 4D PET/CT and non-gated PET/CT images. We used a semiautomated program employing an adaptive contrast-oriented thresholding algorithm for lesion delineation as well as a lesion-based partial volume effect correction algorithm. We compared respiratory-gated parameters with non-gated parameters by using pairwise comparison and interclass correlation coefficient assessment. In a multivariable regression analysis, we also examined factors, which can affect quantification accuracy, including the size of lesion and the location of tumor. Results: This study showed that quantification of volumetric parameters of 4D PET/CT images using an adaptive contrast-oriented thresholding algorithm and 3D lesion-based partial volume correction is feasible. We observed slight increase in FDG uptake by using PET/CT volumetric parameters in comparison of highest respiratory-gated values with non-gated values. After correction for partial volume effect, the mean standardized uptake value (SUVmean) and total lesion glycolysis (TLG) increased substantially (p value G0.001). However, we did not observe a clinically significant difference between partial volume corrected parameters of respiratory-gated and non-gated PET/CT scans. Regression analysis showed that tumor volume was the main predictor of quantification inaccuracy caused by partial volume effect.Electronic supplementary material The online version of this article (doi:10.1007/s11307-014-0776-6) contains supplementary material, which is available to authorized users.Correspondence to: Abass Alavi; e-mail: abass.alavi@uphs.upenn.edu Conclusions: Based on this study, assessment of volumetric PET/CT parameters and partial volume effect correction for accurate quantification of lung malignant lesions by using respiratory non-gated PET images are feasible and it is comparable to gated measurements. Partial volume correction increased both the respiratory-gated and non-gated values significantly and appears to be the dominant source of quantification error of lung lesions.

Maximum standardized uptake value on FDG-PET predicts survival in stage I non-small cell lung cancer following carbon ion radiotherapy

“…Satoh et al (31) reported that metabolic tumor volume, in addition to SUV max , was significantly associated with outcomes following SBRT in lung cancer. Generally, the SUV max of lung tumors is affected by the partial volume effect due to its respiratory movement, and a previous study (32) has attempted to correct this effect by using four-dimensional PET/CT. Salavati et al (32) demonstrated that semi-automated correction for the partial volume effect improved the accuracy of FDG quantification for malignant lesions of the lung.…”

What can be and what cannot be accomplished with PET to detect and characterize atherosclerotic plaques

“…Particularly, issues related to respiratory cycle are very complicated and cannot be readily overcome by adopting gating approaches described in the literature. 13 In contrast to cardiac cycle, which is regular in nature, respiratory motion is very irregular and varies considerably from breath to breath and therefore, attempts to improve spatial resolution of PET for imaging pulmonary or cardiac disorders have been unsatisfactory. The combination of respiratory motion with cardiac contractions makes it almost impossible to measure precise levels of tracer concentration in coronary arteries.…”

Quantifying [18F]fluorodeoxyglucose uptake in the arterial wall: the effects of dual time-point imaging and partial volume effect correction

“…By targeting arterial plaque glycolysis, a surrogate of arterial inflammation and hypoxia [1,2], 18 F-FDG PET/CT imaging can potentially detect and quantitate arterial inflammation [2,3], evaluate response to treatment [4,5], and predict risk for cardiovascular events [6]. Despite several promising studies in the literature [7][8][9][10], 18 F-FDG PET/CT imaging of arterial inflammation suffers from significant limitations which relates to partial volume effects (PVE) and to the low resolution of PET [11]. PVE is a well-known phenomenon and results in underestimation of the true quantity of radiotracer on PET images.…”

“…We evaluated the impact of PVE correction with contrastenhanced CT (CECT) assistance on quantification of arterial wall 18 F-FDG uptake at different imaging time-points. In addition, we evaluated the correlations between PVE-corrected measurements and other measurement indices of vessel wall 18 F-FDG uptake.…”

“…In addition, we evaluated the correlations between PVE-corrected measurements and other measurement indices of vessel wall 18 F-FDG uptake.…”