Primary Tumor Volume Measured by FDG PET and CT in Nasopharyngeal Carcinoma

Hung, Guang-Uei; Wu, Iuan-Sheng; Lee, Hong-Shen; You, Weir-Chiang; Chen, Hui-Chuan; Chen, Mu‐Kuan

doi:10.1097/rlu.0b013e31821738b8

Cited by 12 publications

(19 citation statements)

References 24 publications

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“…From patients' images study, the mean GTV MR was larger than the mean BTV FT by 2.2 folds and BTV SBR by 1.8 folds. This was consistent with previous findings, in which the CT or MRI based GTV in most of the head and neck tumours were usually larger than the BTV by not more than 2 folds [2]- [5] [14] [15]. Danise et al (2004) [2] reported that the manually localized GTV was 1.6 times larger than the BTV, but the BTV had the closest tumour size when compared with the standard pathological specimen.…”

Section: Discussionsupporting

confidence: 91%

Delineation of Biological Tumor Volume from Positron Emission Tomography Images in Nasopharyngeal Carcinoma

Wong¹,

Kwong²,

Khong³

et al. 2014

JBiSE

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Objective: To develop an auto-segmentation method for delineating the biological tumor volume of nasopharyngeal carcinoma from positron emission tomography images. Methods: A phantom consisting of a water tank with fixed background fluorodeoxyglucose [18F-FDG] activity and spheres with diameters ranging from 2.1 to 5 cm with varying activities of FDG were used to simulate tumors of different sizes and FDG uptake. The phantom was scanned with a PET/CT scan at different sphere to background intensity ratios. An optimum fixed percentage threshold (FT) approach and a signal-to-background ratio (SBR) approach were developed to estimate the true size of the spheres from the PET images. Both approaches were further evaluated in patient images for validation. Twenty-two patients with NPC from stage T1 to T4 were included. The PET based biological tumor volumes (BTV) were delineated with both FT (BTVFT) and SBR (BTVSBR) approaches and compared with the gross tumor volume localized from MRI (GTVMR). The mean volumes of BTVFT and BTVSBR were compared and the degree of overlap between GTVMR and both BTVs was evaluated. Paired t-tests were used for statistical analysis. Results: The optimal FT value was 36.5% of maximal intensity, and SBR approach was represented by an inverse linear regression model. The estimated volume of spheres segmented by both approaches shows no significant difference from the true volume of spheres (p > 0.05), but the average absolute errors were smaller from SBR approach than FT approach (p = 0.008). GTVMR was larger than both BTVFT (p = 0.003) and BTVSBR (p < 0.009). The overlapping volume of BTVSBR with GTVMR is significantly larger than with BTVFT * Corresponding authors. K.-W. Wong et al. 858 (0.52 and 0.42 respectively, p < 0.0005). Conclusions: SBR approach is more feasible than FT approach to localize the BTV of NPC from FDG-PET image, and BTV might help to modify the extent of GTVMR for radiotherapy planning purpose.

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Section: Discussionsupporting

confidence: 91%

Delineation of Biological Tumor Volume from Positron Emission Tomography Images in Nasopharyngeal Carcinoma

Wong¹,

Kwong²,

Khong³

et al. 2014

JBiSE

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“…Two-tailed Spearman correlation was used to determine the relations between heterogeneity factor, SUV max corrected for lean body mass (for men, 1.10 × body weight − 120 × [body weight / height] 2 ; for women, 1.07 × body weight − 148 × [body weight / height] 2 ), tumor volume calculated with 40% of SUV max as the threshold [25,26], and International Union Against Cancer TNM category. Multiple ordinal regression was used to determine the independent predictive variables for TNM category.…”

Section: Pet/ct Of Nasopharyngeal Carcinomamentioning

confidence: 99%

Nasopharyngeal Carcinoma: Investigation of Intratumoral Heterogeneity With FDG PET/CT

Huang

Chan

Kwong

et al. 2012

American Journal of Roentgenology

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“…PET-CT derived metabolic tumor volume may have an impact on the management of patients with NPC in terms of prognostication. It was reported that PET-derived primary tumor volumes by a threshold of 50% SUVmax were useful in predicting the patient outcomes with larger metabolic tumor volumes associated with shorter overall survival [ 26 ]. Recently, the volume by a SUV value of 2.5 was also shown to be an independent risk factor in predicting the PFS and OS in metastatic NPC patients by Chan et al [ 35 ].…”

Section: Discussionmentioning

confidence: 99%

“…The maximal SUV value (SUVmax) and maximal K i value ( K i max) were recorded for each primary NPC lesion. Besides, a series of thresholds, namely, 30%~60% of SUVmax on the static PET images and K i max by dynamic PET scan, were used to delineate the primary NPC lesions from the normal tissues and calculate the tumor volumes as VOL SUV30 ~VOL SUV60 and VOL K i 30 ~VOL K i 60 , respectively [ 26 , 27 ].…”

Section: Methodsmentioning

confidence: 99%

Prognostic Value of¹⁸F-FDG PET-CT in Nasopharyngeal Carcinoma: Is Dynamic Scanning Helpful?

Huang

Wong

Lai

et al. 2015

BioMed Research International

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Objectives. To evaluate the differences in prognostic values of static and dynamic PET-CT in nasopharyngeal carcinoma (NPC). Material and Methods. Forty-five patients who had static scan were recruited. Sixteen had dynamic scan. The primary lesions were delineated from standardized uptake value (SUV) maps from static scan and K i maps from dynamic scan. The average follow-up lasted for 34 months. The patients who died or those with recurrence/residual disease were considered “poor outcome”; otherwise they were considered “good outcome.” Fisher's exact test and ROC analysis were used to evaluate the prognostic value of various factors. Results. Tumor volume thresholded by 40% of maximal SUV (VOLSUV40) significantly predicted treatment outcome (p = 0.024) in the whole cohort. In 16 patients with dynamic scan, all parameters by dynamic scan were insignificant in predicting the outcome. The combination of maximal SUV, maximal K i, VOLSUV40, and VOLKi37 (the tumor volume thresholded by 37% maximal K i) achieved the highest predicting accuracy for treatment outcome with sensitivity, specificity, and accuracy of 100% in these 16 patients; however this improvement compared to VOLSUV40 was insignificant. Conclusion. Tumor volume from static scan is useful in NPC prognosis. However, the role of dynamic scanning was not justified in this small cohort.

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Primary Tumor Volume Measured by FDG PET and CT in Nasopharyngeal Carcinoma

Abstract: PET-derived primary tumor volumes are substantially different from CT-derived tumor volumes, only decent correlation is noted between VolumeCT and Volume2.5. Volume2.5 and Volume50% seem to be reasonable alternatives for VolumeCT in predicting the patient outcomes.

Cited by 12 publications

References 24 publications

Delineation of Biological Tumor Volume from Positron Emission Tomography Images in Nasopharyngeal Carcinoma

Delineation of Biological Tumor Volume from Positron Emission Tomography Images in Nasopharyngeal Carcinoma

Nasopharyngeal Carcinoma: Investigation of Intratumoral Heterogeneity With FDG PET/CT

Prognostic Value of¹⁸F-FDG PET-CT in Nasopharyngeal Carcinoma: Is Dynamic Scanning Helpful?

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Primary Tumor Volume Measured by FDG PET and CT in Nasopharyngeal Carcinoma

Abstract: PET-derived primary tumor volumes are substantially different from CT-derived tumor volumes, only decent correlation is noted between VolumeCT and Volume2.5. Volume2.5 and Volume50% seem to be reasonable alternatives for VolumeCT in predicting the patient outcomes.

Cited by 12 publications

References 24 publications

Delineation of Biological Tumor Volume from Positron Emission Tomography Images in Nasopharyngeal Carcinoma

Delineation of Biological Tumor Volume from Positron Emission Tomography Images in Nasopharyngeal Carcinoma

Nasopharyngeal Carcinoma: Investigation of Intratumoral Heterogeneity With FDG PET/CT

Prognostic Value of18F-FDG PET-CT in Nasopharyngeal Carcinoma: Is Dynamic Scanning Helpful?

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Prognostic Value of¹⁸F-FDG PET-CT in Nasopharyngeal Carcinoma: Is Dynamic Scanning Helpful?