Willem Grootjans1, Edwin A Usmanij2, Wim J G Oyen3, Erik H F M van der Heijden4, Eric P Visser2, Dimitris Visvikis5, Mathieu Hatt5, Johan Bussink6, Lioe-Fee de Geus-Oei7. 1. Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: W.Grootjans@lumc.nl. 2. Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands. 3. Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands; The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust, London, UK. 4. Department of Pulmonary Medicine, Radboud University Medical Center, The Netherlands. 5. INSERM, UMR 1101 Laboratoire de Traitement de l'information Médicale (LaTIM), Brest, France. 6. Department of Radiation Oncology, Radboud University Medical Center, Nijmegen, The Netherlands. 7. Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands; Biomedical Photonic Imaging Group, MIRA Institute, University of Twente, Enschede, The Netherlands.
Abstract
BACKGROUND AND PURPOSE: This study evaluated the use of total lesion glycolysis (TLG) determined by different automatic segmentation algorithms, for early response monitoring in non-small cell lung cancer (NSCLC) patients during concomitant chemoradiotherapy. MATERIALS AND METHODS: Twenty-seven patients with locally advanced NSCLC treated with concomitant chemoradiotherapy underwent (18)F-fluorodeoxyglucose (FDG) PET/CT imaging before and in the second week of treatment. Segmentation of the primary tumours and lymph nodes was performed using fixed threshold segmentation at (i) 40% SUVmax (T40), (ii) 50% SUVmax (T50), (iii) relative-threshold-level (RTL), (iv) signal-to-background ratio (SBR), and (v) fuzzy locally adaptive Bayesian (FLAB) segmentation. Association of primary tumour TLG (TLGT), lymph node TLG (TLGLN), summed TLG (TLGS=TLGT+TLGLN), and relative TLG decrease (ΔTLG) with overall-survival (OS) and progression-free survival (PFS) was determined using univariate Cox regression models. RESULTS: Pretreatment TLGT was predictive for PFS and OS, irrespective of the segmentation method used. Inclusion of TLGLN improved disease and early response assessment, with pretreatment TLGS more strongly associated with PFS and OS than TLGT for all segmentation algorithms. This was also the case for ΔTLGS, which was significantly associated with PFS and OS, with the exception of RTL and T40. CONCLUSIONS: ΔTLGS was significantly associated with PFS and OS, except for RTL and T40. Inclusion of TLGLN improves early treatment response monitoring during concomitant chemoradiotherapy with FDG-PET.
BACKGROUND AND PURPOSE: This study evaluated the use of total lesion glycolysis (TLG) determined by different automatic segmentation algorithms, for early response monitoring in non-small cell lung cancer (NSCLC) patients during concomitant chemoradiotherapy. MATERIALS AND METHODS: Twenty-seven patients with locally advanced NSCLC treated with concomitant chemoradiotherapy underwent (18)F-fluorodeoxyglucose (FDG) PET/CT imaging before and in the second week of treatment. Segmentation of the primary tumours and lymph nodes was performed using fixed threshold segmentation at (i) 40% SUVmax (T40), (ii) 50% SUVmax (T50), (iii) relative-threshold-level (RTL), (iv) signal-to-background ratio (SBR), and (v) fuzzy locally adaptive Bayesian (FLAB) segmentation. Association of primary tumour TLG (TLGT), lymph node TLG (TLGLN), summed TLG (TLGS=TLGT+TLGLN), and relative TLG decrease (ΔTLG) with overall-survival (OS) and progression-free survival (PFS) was determined using univariate Cox regression models. RESULTS: Pretreatment TLGT was predictive for PFS and OS, irrespective of the segmentation method used. Inclusion of TLGLN improved disease and early response assessment, with pretreatment TLGS more strongly associated with PFS and OS than TLGT for all segmentation algorithms. This was also the case for ΔTLGS, which was significantly associated with PFS and OS, with the exception of RTL and T40. CONCLUSIONS: ΔTLGS was significantly associated with PFS and OS, except for RTL and T40. Inclusion of TLGLN improves early treatment response monitoring during concomitant chemoradiotherapy with FDG-PET.
Authors: Abhinav K Jha; Esther Mena; Brian Caffo; Saeed Ashrafinia; Arman Rahmim; Eric Frey; Rathan M Subramaniam Journal: J Med Imaging (Bellingham) Date: 2017-03-03
Authors: Andrei Iantsen; Marta Ferreira; Francois Lucia; Vincent Jaouen; Caroline Reinhold; Pietro Bonaffini; Joanne Alfieri; Ramon Rovira; Ingrid Masson; Philippe Robin; Augustin Mervoyer; Caroline Rousseau; Frédéric Kridelka; Marjolein Decuypere; Pierre Lovinfosse; Olivier Pradier; Roland Hustinx; Ulrike Schick; Dimitris Visvikis; Mathieu Hatt Journal: Eur J Nucl Med Mol Imaging Date: 2021-03-27 Impact factor: 9.236