Reproducibility and uptake time dependency of volume-based parameters on FDG-PET for lung cancer

Kitao, Tomoka; Hirata, Kenji; Shima, Katsumi; Hayashi, Takashi; Sekizawa, Mitsunori; Takei, Toshiki; Ichimura, Wataru; Harada, Masao; Kondo, Keishi; Tamaki, Nagara

doi:10.1186/s12885-016-2624-3

Cited by 25 publications

(21 citation statements)

References 34 publications

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“…Defining the metabolic tumor volume (MTV) and total lesion glycolysis (TLG) was performed as previously described [18][19][20]. To exclude the necrotic regions of the tumor, MTV was defined as the VOI where the [ 18 F]FDG metabolism was at least 30% of the maximum activity, and mean [ 18 F]FDG uptake in MTV was measured as the mean 30% .…”

Section: Pet Imagingmentioning

confidence: 99%

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Influence on [18F]FDG uptake by cancer cells after anti-PD-1 therapy in an enforced-immune activated mouse tumor

et al. 2020

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Background: Anti-programmed cell death 1 (PD-1) antibody is an immune checkpoint inhibitor, and anti-PD-1 therapy improves the anti-tumor functions of T cells and affects tumor microenvironment. We previously reported that anti-PD-1 treatment affected tumor glycolysis by using 2-deoxy-2-[ 18 F]fluoro-D-glucose ([ 18 F]FDG) positron emission tomography (PET). That study showed that anti-PD-1 therapy in a mouse B16F10 melanoma model increased glucose metabolism in cancer cells at the point where anti-PD-1 therapy did not cause a significant inhibition of tumor growth. However, the B16F10 melanoma model is poorly immunogenic, so it is not clear how anti-PD-1 treatment affects glucose metabolism in highly immunogenic cancer models. In this study, we used a cyclic dinucleotide GMP-AMP (cGAMP)-injected B16F10 melanoma model to investigate the effect of anti-PD-1 therapy on [ 18 F]FDG uptake in a highly immune activated tumor in mice. Results: To compare the cGAMP-injected B16F10 model with the B16F10 model, experiments were performed as described in our previous manuscript. [ 18 F]FDG-PET was measured before treatment and 7 days after the start of treatment. In this study, [ 18 F]FDG uptake in tumors in the cGAMP/anti-PD-1 combination group was lower than that in the anti-PD-1 treatment group tumors on day 7, as shown by PET and ex vivo validation. Flow-cytometry was performed to assess immune cell populations and glucose metabolism. Anti-PD-1 and/or cGAMP treatment increased the infiltration level of immune cells into tumors. The cGAMP/anti-PD-1 combination group had significantly lower levels of GLUT1 high cells/hexokinase II high cells in CD45 − cancer cells compared with tumors in the anti-PD-1 treated group. These results suggested that if immune responses in tumors are higher than a certain level, glucose uptake in cancer cells is reduced depending on that level. Such a change of glucose uptake might be caused by the difference in infiltration or activation level of immune cells between the anti-PD-1 treated group and the cGAMP/anti-PD-1 combination group. Conclusions: [ 18 F]FDG uptake in cancer cells after anti-PD-1 treatment might be affected by the tumor immune microenvironment including immune cell infiltration, composition, and activation status.

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Section: Pet Imagingmentioning

confidence: 99%

“…a Illustration of in vivo and ex vivo study timelines. b Tumor growth curves after anti-PD-1 or cGAMP treatment (n =[14][15][16][17][18][19][20][21][22][23][24][25][26][27]. Data of the non-treatment group and anti-PD-1 treated group were quoted from[11].…”

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confidence: 99%

Influence on [18F]FDG uptake by cancer cells after anti-PD-1 therapy in an enforced-immune activated mouse tumor

et al. 2020

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“…The reason for variable results in these studies could be due to the different methods used to obtain MTV. We used the best method proved among all previously, i.e., using SUV of 2.5 or more, which is least sensitive to uptake time and highly reproducibile, as reported by Kitao et al [16]. Nonetheless, as mentioned earlier, none of these studies considered histologic differences in the PET parameters during risk stratification for the survival outcomes.…”

Section: Discussionmentioning

confidence: 99%

Prognostic significance of semi-quantitative FDG-PET parameters in stage I non-small cell lung cancer treated with carbon-ion radiotherapy

Shrestha

Higuchi

Shirai

et al. 2019

Eur J Nucl Med Mol Imaging

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Purpose Prognostic significance of volumetric 18 F-fluorodeoxyglucose (FDG) positron emission tomography/computer tomography (PET/CT) parameters in carbon-ion radiotherapy (C-ion RT) treated stage I non-small cell lung cancer, and need of histology-wise separate cutoff values for risk stratification were assessed. Methods Thirty-nine patients (29 men and 10 women, 71.9 ± 8.3 years) who underwent FDG PET/CT examinations before Cion RT were retrospectively evaluated. FDG-PET parameters: standardized uptake values (SUVmax, SUVpeak, and SUVmean), metabolic tumor volume (MTV), and total lesion glycolysis (TLG), and clinicopathological variables were assessed for prognosis using Cox proportional hazards regression analysis. Mann-Whitney test compared medians of significant parameters between adenocarcinoma (AC) and squamous cell carcinoma (SCC), and Kaplan-Meier curves were plotted for median-based low-and high-risk groups. Results Median follow-up period was 44.8 months. 1/2/3-year overall survival (OS), progression-free survival (PFS) and local control (LC) rates were 94.

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“…Although SUV is most commonly calculated as the radioactivity concentration normalized to injection dosage and body weight, other de nitions include the radioactivity concentration normalized to the body surface area [6], to lean body mass [5], and to blood glucose [7]. While metabolic tumor volume and total lesion glycolysis have been extensively investigated in recent studies [8,9], SUVmax is still superior to them in terms of its extremely high inter-operator reproducibility. Many lines of evidence have demonstrated the usefulness of SUVmax for differential diagnosis, treatment response prediction, and prognosis [10].…”

Section: Introductionmentioning

confidence: 99%

SUVmax of FDG PET-CT Can Be Used As An Identifier of Lesion for AI To Interpret Radiology Reports

Hirata

Manabe

Magota

et al. 2020

Preprint

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Background Radiology reports contribute not only to the particular patient, but also to constructing massive training dataset in the era of artificial intelligence (AI). The maximum standardized uptake value (SUVmax) is often described in daily radiology reports of FDG PET-CT. If SUVmax can be used as an identifier of lesion, that would greatly help AI interpret radiology reports. We aimed to clarify whether the lesion can be localized using SUVmax written in radiology reports.Methods The institutional review board approved this retrospective study. We investigated a total of 112 lesions from 30 FDG PET-CT images acquired with 3 different scanners. SUVmax was calculated from DICOM files based on the latest Quantitative Imaging Biomarkers Alliance (QIBA) publication. The voxels showing the given SUVmax were exhaustively searched in the whole-body images and counted. SUVmax was provided with 5 different degrees of precision: integer (e.g., 3), 1st decimal places (DP) (3.1), 2nd DP (3.14), 3rd DP (3.142), and 4th DP (3.1416). For instance, when SUVmax=3.14 was given, the voxels with 3.135≤SUVmax<3.145 were extracted. We also evaluated whether local maximum restriction could improve the identifying performance, where only the voxels showing the highest intensity within some neighborhood were considered. We defined that “identical detection” was achieved when only single voxel satisfied the criterion.Results A total of 112 lesions from 30 FDG PET-CT images were investigated. SUVmax ranged from 1.3 to 49.1 (median = 5.6, IQR = 5.2). Generally, when larger and more precise SUVmax values were given, fewer voxels satisfied the criterion. The local maximum restriction was very effective. When SUVmax was determined to 4 decimal places (e.g., 3.1416) and the local maximum restriction was applied, identical detection was achieved in 33.3% (lesions with SUVmax<2), 79.5% (2≤SUVmax<5), and 97.8% (5≤SUVmax) of lesions.Conclusions SUVmax of FDG PET-CT can be used as an identifier to localize the lesion if precise SUVmax is provided and local maximum restriction was applied, although the lesions showing SUVmax<2 were difficult to identify. The proposed method may have potential to make use of radiology reports retrospectively for constructing training datasets for AI.

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Reproducibility and uptake time dependency of volume-based parameters on FDG-PET for lung cancer

Cited by 25 publications

References 34 publications

Influence on [18F]FDG uptake by cancer cells after anti-PD-1 therapy in an enforced-immune activated mouse tumor

Influence on [18F]FDG uptake by cancer cells after anti-PD-1 therapy in an enforced-immune activated mouse tumor

Prognostic significance of semi-quantitative FDG-PET parameters in stage I non-small cell lung cancer treated with carbon-ion radiotherapy

SUVmax of FDG PET-CT Can Be Used As An Identifier of Lesion for AI To Interpret Radiology Reports

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