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A pilot study on lung cancer detection based on regional metabolic activity distribution in digital low-dose 18F-FDG PET


Messerli, Michael; Muehlematter, Urs J; Fassbind, Saskia; Franzen, Daniel; Ferraro, Daniela A; Huellner, Martin W; Treyer, Valerie; Curioni-Fontecedro, Alessandra; Burger, Irene A (2021). A pilot study on lung cancer detection based on regional metabolic activity distribution in digital low-dose 18F-FDG PET. British Journal of Radiology, 94(1119):20200244.

Abstract

Objectives: To investigate the potential of automatic lung cancer detection on submillisievert dose 18F-fludeoxyglucose (18F-FDG) scans using different positron emission tomography (PET) parameters, as a primary step towards a potential new indication for 18F-FDG PET in lung cancer screening.

Methods: We performed a retrospective cohort analysis with 83 patients referred for 18F-FDG PET/CT, including of 34 patients with histology-proven lung cancer and 49 patients without lung disease. Aside clinical standard PET images (PET100%) two additional low-dose PET reconstructions were generated, using only 15 s and 5 s of the 150 s list mode raw data of the full-dose PET, corresponding to 10% and 3.3% of the original 18F-FDG activity. The lungs were subdivided into three segments on each side, and each segment was classified as normal or containing cancer. The following standardized uptake values (SUVs) were extracted from PET per lung segment: SUVmean, SUVhot5, SUVmedian, SUVstd and SUVtotal. A multivariate linear regression model was used and cross-validated. The accuracy for lung cancer detection was tested with receiver operating characteristics analysis and T-statistics was used to calculate the weight of each parameter.

Results: The T-statistics showed that SUVstd was the most important discriminative factor for lung cancer detection. The multivariate model achieved an area under the curve of 0.97 for full-dose PET, 0.85 for PET10% with PET3.3% reconstructions resulting in a still high sensitivity the PET10% reconstruction of 80%.

Conclusion: This pilot study indicates that segment-based, quantitative PET parameters of low-dose PET reconstructions could be used to automatically detect lung cancer with high sensitivity.

Advances in knowledge: Automated assessment of PET parameters in low-dose PET may aid for an early detection of lung cancer.

Abstract

Objectives: To investigate the potential of automatic lung cancer detection on submillisievert dose 18F-fludeoxyglucose (18F-FDG) scans using different positron emission tomography (PET) parameters, as a primary step towards a potential new indication for 18F-FDG PET in lung cancer screening.

Methods: We performed a retrospective cohort analysis with 83 patients referred for 18F-FDG PET/CT, including of 34 patients with histology-proven lung cancer and 49 patients without lung disease. Aside clinical standard PET images (PET100%) two additional low-dose PET reconstructions were generated, using only 15 s and 5 s of the 150 s list mode raw data of the full-dose PET, corresponding to 10% and 3.3% of the original 18F-FDG activity. The lungs were subdivided into three segments on each side, and each segment was classified as normal or containing cancer. The following standardized uptake values (SUVs) were extracted from PET per lung segment: SUVmean, SUVhot5, SUVmedian, SUVstd and SUVtotal. A multivariate linear regression model was used and cross-validated. The accuracy for lung cancer detection was tested with receiver operating characteristics analysis and T-statistics was used to calculate the weight of each parameter.

Results: The T-statistics showed that SUVstd was the most important discriminative factor for lung cancer detection. The multivariate model achieved an area under the curve of 0.97 for full-dose PET, 0.85 for PET10% with PET3.3% reconstructions resulting in a still high sensitivity the PET10% reconstruction of 80%.

Conclusion: This pilot study indicates that segment-based, quantitative PET parameters of low-dose PET reconstructions could be used to automatically detect lung cancer with high sensitivity.

Advances in knowledge: Automated assessment of PET parameters in low-dose PET may aid for an early detection of lung cancer.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Nuclear Medicine
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:1 March 2021
Deposited On:22 Feb 2021 15:01
Last Modified:22 Feb 2021 15:02
Publisher:British Institute of Radiology
ISSN:0007-1285
OA Status:Closed
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.1259/bjr.20200244
PubMed ID:33529052

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