Using FDG-PET to Measure Early Treatment Response in Head and Neck Squamous Cell Carcinoma: Quantifying Intrinsic Variability in Order to Understand Treatment-Induced Change

Hoang, Jenny K.; Das, Shiva K.; Choudhury, Kingshuk Roy; Yoo, David S.; Brizel, David M.

doi:10.3174/ajnr.a3412

Cited by 25 publications

(17 citation statements)

References 16 publications

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“…Table 1 shows the articles that were identified and included in this review. Sixteen papers (20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35), published between 1995 and 2016, met the inclusion criteria. All were reports on original research, although there was some overlap in the source data: Nakamoto et al (22) (28) performed a metaanalysis pooling data from 5 previously published cohorts.…”

Section: Suv Repeatability Literaturementioning

confidence: 99%

“…The most common approach was to analyze a single tumor per patient (20)(21)(22)24,25,29,31,33,34). Another approach allowed for the inclusion of a variable number of tumors per patient, analyzing all tumors collectively (21,23,26,27,30,35) or averaging the tumor SUVs for an individual patient and assessing the repeatability of the average SUV (25,32,33,35).…”

Section: Data Acquisitionmentioning

confidence: 99%

“…In general, there have been 3 different VOI approaches, with their corresponding SUVs being SUV max (22,23,(25)(26)(27)(29)(30)(31)(32)(33)(34)(35), SUV mean (21,(23)(24)(25)(26)(27)(29)(30)(31)34,35), and SUV peak (20,22,23,25,27,(32)(33)(34)(35). As is usual, SUV max was derived from the single tumor voxel with the highest uptake.…”

Section: Data Acquisitionmentioning

confidence: 99%

“…These VOIs were usually defined by isocontour thresholding, typically based on a fixed percentage of SUV max (e.g., 50%), occasionally including background correction. Other tumor segmentation approaches were also used, including fuzzy locally adaptive Bayesian methodology (26,27), manual delineation (23,29), and circular regions manually adjusted to the dimensions of the tumor (24). SUV peak has been defined as the average of all voxels within a 1-mL spheric region positioned within the tumor so as to maximize its mean value (1).…”

Section: Data Acquisitionmentioning

confidence: 99%

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Repeatability of SUV in Oncologic ¹⁸F-FDG PET

2017

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Learning Objectives: On successful completion of this activity, participants should be able to (1) describe the way test-retest studies have been used to measure SUV repeatability, (2) summarize the different methodologic approaches and complexities when analyzing SUV test-retest data, and (3) understand the implications of SUV repeatability for the quantitative assessment of tumor response to treatment.Financial Disclosure: This work was partially funded by grants from the National Institutes of Health (HHSN268201300071C and U01CA140204). The author of this article has indicated no other relevant relationships that could be perceived as a real or apparent conflict of interest. CME Credit: SNMMI is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to sponsor continuing education for physicians. SNMMI designates each JNM continuing education article for a maximum of 2.0 AMA PRA category 1 credits. Physicians should claim only credit commensurate with the extent of their participation in the activity. For CE credit, SAM, and other credit types, participants can access this activity through the SNMMI website (http://www.snmmilearningcenter.org) through April 2020.Quantitative analysis can potentially improve the accuracy and consistency of 18 F-FDG PET, particularly for the assessment of tumor response to treatment. Although not without limitations, SUV has emerged as the predominant metric for tumor quantification with 18 F-FDG PET. Growing literature suggests that the difference between SUVs measured before and after treatment can be used to predict tumor response at an early stage. SUV is, however, associated with multiple sources of variability, and to best use SUV for response assessment, an understanding of the repeatability of the technique is required. Test-retest studies involve repeated scanning of the same patient on the same scanner using the same protocol no more than a few days apart and provide basic information on the repeatability of the technique. Multiple test-retest studies have been performed to assess SUV repeatability, although a comparison of reports is complicated by the use of different methodologies and statistical metrics. This article reviews the available data, addressing issues such as different repeatability metrics, relative units, log transformation, and asymmetric limits of repeatability. When acquired with careful attention to protocol, tumor SUV has a withinsubject coefficient of variation of approximately 10%. In a response assessment setting, SUV reductions of more than 25% and increases of more than 33% are unlikely to be due to measurement variability. Broader margins may be required for sites with less rigorous protocol compliance, but in general, SUV is a highly repeatable imaging biomarker that is ideally suited to monitoring tumor response to treatment in individual patients.

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Section: Suv Repeatability Literaturementioning

confidence: 99%

Section: Data Acquisitionmentioning

confidence: 99%

Section: Data Acquisitionmentioning

confidence: 99%

Section: Data Acquisitionmentioning

confidence: 99%

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Repeatability of SUV in Oncologic ¹⁸F-FDG PET

2017

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“…ART is based on reassessment of macroscopic tumor volume (GTV), and of organs at risk (OaRs) (as parotid and submandibular glands) after a specific time from RT start allowing the optimization of plan conformality during treatment. This approach, especially if combined with dose-escalation strategies directed against the residual tumor, could contrast radio-resistance leading to higher Tumor Control Probability (TCP) and reduced rates of severe acute and late effects (13)(14)(15).…”

Section: Fdg-pet and Ct-scan Comparison In Gtv Definition For Rt Planmentioning

confidence: 99%