Influences on PET Quantification and Interpretation

Rogasch, J; Hofheinz, Frank; Heek, Lutz van; Voltin, Conrad-Amadeus; Boellaard, Ronald; Kobe, Carsten

doi:10.3390/diagnostics12020451

Cited by 12 publications

(7 citation statements)

References 212 publications

(306 reference statements)

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“…There is also the possibility that the specified region of interest over which the SUV peak is quantified might include voxels outside of the tumour volume. It’s worth noting also that due to the limited spatial resolution of PET imaging, partial volume effects can affect biomarker quantitation accuracy 36 . This leads to an underestimation of lesion activity because of activity dilution at the borders of the region of interest from volume averaging, and makes the lesion appear larger than it is in reality.…”

Section: Discussionmentioning

confidence: 99%

Quantitative [68Ga]Ga-PSMA-11 PET biomarkers for the analysis of lesion-level progression in biochemically recurrent prostate cancer: a multicentre study

Kendrick,

Francis,

Hassan

et al. 2023

Sci Rep

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Abstract[68Ga]Ga-PSMA-11 PET has become the standard imaging modality for biochemically recurrent (BCR) prostate cancer (PCa). However, its prognostic value in assessing response at this stage remains uncertain. The study aimed to assess the prognostic significance of radiographic patient-level patterns of progression derived from lesion-level biomarker quantitation in metastatic disease sites. A total of 138 BCR PCa patients with both baseline and follow-up [68Ga]Ga-PSMA-11 PET scans were included in this analysis. Tumour response was quantified at the lesion level using commonly used quantitative parameters (SUVmean, SUVmax, SUVpeak, volume), and patients were classified as systemic, mixed, or no-progression based on these response classifications. A total of 328 matched lesions between baseline and follow-up scans were analysed. The results showed that systemic progressors had a significantly higher risk of death than patients with no progression with SUVmean demonstrating the highest prognostic value (HR = 5.70, 95% CI = 2.63–12.37, p < 0.001, C-Index = 0.69). Moreover, progressive disease as measured by SUVmean using the radiographic PSMA PET Progression Criteria (rPPP) was found to be significantly prognostic for patient overall survival (HR = 3.67, 95% CI = 1.82–7.39, p < 0.001, C-Index = 0.65). This work provides important evidence supporting the prognostic utility of PSMA response quantitation in the BCR setting.

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Section: Discussionmentioning

confidence: 99%

Quantitative [68Ga]Ga-PSMA-11 PET biomarkers for the analysis of lesion-level progression in biochemically recurrent prostate cancer: a multicentre study

Kendrick,

Francis,

Hassan

et al. 2023

Sci Rep

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“…Although dual time-point PET scan has been previously investigated by other groups, our study was the first, to our knowledge, to use the Bayesian penalized likelihood (BPL) reconstruction algorithm, which could have contributed to the improved lesion detection. BPL uses a block sequential regularized expectation maximization to improve the algorithm optimization for lesion detection, and its performance is superior to the conventional standard algorithms in small lesion detectability while improving the accuracy of the quantitative parameters [26][27][28]. Parvizi et al [29] suggested BPL may improve the diagnostic performance of 18 F-FDG PET/CT in CRLM patients.…”

Section: Discussionmentioning

confidence: 99%

Detection of Liver Lesions in Colorectal Cancer Patients Using 18F-FDG PET/CT Dual-Time-Point Scan Imaging

Boanova,

Altmayer,

Watte

et al. 2023

Cancers

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Objective: The aim of this study was to evaluate the diagnostic performance of dual-time-point fluorine-18-fluorodeoxyglucose positron emission computed tomography/computed tomography (18F-FDG PET/CT) compared to conventional early imaging for detecting colorectal liver metastases (CRLM) in colorectal cancer (CRC) patients. Methods: One hundred twenty-four consecutive CRC patients underwent dual-time-point imaging scans on a retrospective basis. Histopathological confirmation and/or clinical follow-up were accepted as the gold standard. Standard uptake values (SUV), signal-to-noise ratio (SNR), retention index (RI), tumor-to-normal liver ratio (TNR), and lesion sizes were measured for early and delayed PET scans. The diagnostic performance of early and delayed images was calculated on a per-patient basis and compared using McNemar’s test. Results: Among the 124 patients, 57 (46%) had CRLM, 6 (4.8%) had benign lesions, and 61 (49.2%) had no concerning lesions detected. Smaller CRLM lesions (<5 cm3) showed significantly higher uptake in the delayed scans relative to early imaging (p < 0.001). The SUV and TNR increased significantly in delayed imaging of all metastatic lesions (p < 0.001). The retention index of all CRLM was high (40.8%), especially for small lesions (54.8%). A total of 177 lesions in delayed images and 124 in standard early images were identified. In a per-patient analysis, delayed imaging had significantly higher sensitivity (100% vs. 87.7%) and specificity (91.0% vs. 94.0%) compared to early imaging (p-value = 0.04). Conclusions: The detection of liver lesions using dual-time-point PET/CT scan improves the sensitivity and specificity for the detection of colorectal liver metastasis.

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“…We limited the influence of decay by choosing time points within the closest range from each of the centers for the SUV measurements at the biopsy locations (i.e., 120, 145, and 160 min after injection), and we chose those time points for which the time-activity curves showed a near-plateau phase of tracer uptake. Second, it is well known that the PET reconstruction method can influence the outcome of SUV measurements (40,41), and these differed across centers. Therefore, we also performed correlational analyses per tracer or center.…”

Section: Discussionmentioning

confidence: 99%

PET Imaging and Protein Expression of Prostate-Specific Membrane Antigen in Glioblastoma: A Multicenter Inventory Study

van Lith,

Pruis,

Tolboom

et al. 2023

J Nucl Med

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Upregulation of prostate-specific membrane antigen (PSMA) in neovasculature has been described in glioblastoma multiforme (GBM), whereas vasculature in nonaffected brain shows hardly any expression of PSMA. It is unclear whether PSMA-targeting tracer uptake on PET is based on PSMA-specific binding to neovasculature or aspecific uptake in tumor. Here, we quantified uptake of various PSMA-targeting tracers in GBM and correlated this with PSMA expression in tumor biopsy samples from the same patients. Methods: Fourteen patients diagnosed with de novo (n 5 8) or recurrent (n 5 6) GBM underwent a preoperative PET scan after injection of 1.5 MBq/kg [ 68 Ga]Ga-PSMA-11 (n 5 7), 200 MBq of [ 18 F]DCFpyl (n 5 3), or 200 MBq of [ 18 F]PSMA-1007 (n 5 4). Uptake in tumor and tumor-to-background ratios, with contralateral nonaffected brain as background, were determined. In a subset of patients, PSMA expression levels from different regions in the tumor tissue samples (n 5 40), determined using immunohistochemistry (n 5 35) or RNA sequencing (n 5 13), were correlated with tracer uptake on PET. Results: Moderate to high (SUV max , 1.3-20.0) heterogeneous uptake was found in all tumors irrespective of the tracer type used. Uptake in nonaffected brain was low, resulting in high tumor-tobackground ratios (6.1-359.0) calculated by dividing SUV max of tumor by SUV max of background. Immunohistochemistry showed variable PSMA expression on endothelial cells of tumor microvasculature, as well as on dispersed individual cells (of unknown origin), and granular staining of the neuropil. No correlation was found between in vivo uptake and PSMA expression levels (for immunohistochemistry, r 5 20.173, P 5 0.320; for RNA, r 5 20.033, P 5 0.915). Conclusion: Our results indicate the potential use of various PSMA-targeting tracers in GBM. However, we found no correlation between PSMA expression levels on immunohistochemistry and uptake intensity on PET. Whether this may be explained by methodologic reasons, such as the inability to measure functionally active PSMA with immunohistochemistry, tracer pharmacokinetics, or the contribution of a disturbed blood-brain barrier to tracer retention, should still be investigated.

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Influences on PET Quantification and Interpretation

Cited by 12 publications

References 212 publications

Quantitative [68Ga]Ga-PSMA-11 PET biomarkers for the analysis of lesion-level progression in biochemically recurrent prostate cancer: a multicentre study

Quantitative [68Ga]Ga-PSMA-11 PET biomarkers for the analysis of lesion-level progression in biochemically recurrent prostate cancer: a multicentre study

Detection of Liver Lesions in Colorectal Cancer Patients Using 18F-FDG PET/CT Dual-Time-Point Scan Imaging

PET Imaging and Protein Expression of Prostate-Specific Membrane Antigen in Glioblastoma: A Multicenter Inventory Study

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