Dynamic 18F-FDG PET imaging of liver lesions: evaluation of a two-tissue compartment model with dual blood input function

Abstract

Background Dynamic PET with kinetic modeling was reported to be potentially helpful in the assessment of hepatic malignancy. In this study, a kinetic modeling analysis was performed on hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC) from dynamic FDG positron emission tomography/computer tomography (PET/CT) scans. Methods A reversible two-tissue compartment model with dual blood input function, which takes into consideration the blood supply from both hepatic artery and portal vein, was used for accurate kinetic modeling of liver dynamic 18F-FDG PET imaging. The blood input functions were directly measured as the mean values over the VOIs on descending aorta and portal vein respectively. And the contribution of hepatic artery to the blood input function was optimization-derived in the process of model fitting. The kinetic model was evaluated using dynamic PET data acquired on 24 patients with identified hepatobiliary malignancy. 38 HCC or ICC identified lesions and 24 healthy liver regions were analyzed. Results Results showed significant differences in kinetic parameters $${K}_{1}-{k}_{4}$$ K 1 - k 4 , blood supplying fraction $${f}_{A}$$ f A , and metabolic rate constant $${K}_{i}$$ K i between malignant lesions and healthy liver tissue. And significant differences were also observed in $${K}_{1}$$ K 1 , $${k}_{3}$$ k 3 , $${f}_{A}$$ f A and $${K}_{i}$$ K i between HCC and ICC lesions. Further investigations of the effect of SUV measurements on the derived kinetic parameters were conducted. And results showed comparable effectiveness of the kinetic modeling using either SUVmean or SUVmax measurements. Conclusions Dynamic 18F-FDG PET imaging with optimization-derived hepatic artery blood supply fraction dual-blood input function kinetic modeling can effectively distinguish malignant lesions from healthy liver tissue, as well as HCC and ICC lesions.

Kinetic parameter estimation of hepatocellular carcinoma on 18F‐FDG PET/CT based on Bayesian method

“…The blood supply of background liver tissue differs from that of HCCs;background liver tissue is mainly supplied by the portal vein, which accounts for 70%−80% of the total inflow blood flow. 3,12,44 The parameter fa (0.758 ± 0.202 vs. 0.316 ± 0.207) obtained by the proposed Bayesian method is closer to the clinical physiological value than the fa value obtained by the NLLS method (0.724 ± 0.317 vs. 0.205 ± 0.231). The results of the present experiment are consistent with those of previous studies, 3,6 showing a significantly higher fa in HCCs than in background liver tissues.…”

“…Since the liver receives blood from both the hepatic artery and the portal vein, the dual-input threecompartment model provides more accurate kinetic modeling parameters than other models. 3,14 The nonlinear least squares (NLLS) method is the most common method for estimating kinetic parameters 3,6,8,9 ; however, this approach is not suitable for estimating kinetic parameters from clinical data with low signal-to-noise ratios 15 and is prone to falling into local minima. 12,16,17 Deep learning enables output parametric images without requiring the input function, 18,19 but it can only generated image of a single parameter and the construction of the model requires datasets from a large number of samples.…”

“…Liver cancer is a common fatal cancer in East and Southeast Asia, 1 and hepatocellular carcinoma (HCC) is the most common type of liver cancer. 2,3 Computed tomography (CT) and magnetic resonance imaging (MRI) are conventional medical imaging techniques used to diagnose HCC 4 ; however, these methods do not provide tumor metabolic information. 5 18 F-fluorodeoxyglucose positron emission tomography ( 18 F-FDG PET) has been used as a metabolic imaging technique for assessing tumor metabolism.…”

Role of Functional MRI in Liver SBRT: Current Use and Future Directions

“…Positron emission tomography (PET)-CT imaging of liver function using flourine (F) tagged fluoro-D-galactose (FDGal, a galactose analog metabolised by hepatic cells) has also been used to quantify hepatic metabolic function [ 27 , 28 ]. Tracer kinetic modeling of the dynamic signal has been used to also derive quantitative tissue perfusion parameters such as hepatic arterial or portal venous blood flow and volume [ 29 ]. A clinical trial is underway at the Princess Alexandria Hospital in Australia to evaluate the use of F-FDGal PET for liver function assessment and to predict toxicity of liver SBRT ( , accessed on 27 September 2022).…”

Dynamic chaotic gravitational search algorithm-based kinetic parameter estimation of hepatocellular carcinoma on 18F-FDG PET/CT

“…Sarkar et al [ 8 ] demonstrated that dynamic 18 F-FDG PET with tracer kinetic modeling has the potential to diagnose nonalcoholic steatohepatitis. Wang et al [ 9 ] found that dynamic 18 F-FDG PET with optimization-derived blood input function kinetic modeling can effectively distinguish liver lesions. Considering 60-min or more dynamic PET/CT is not easily available in routine clinical settings.…”