FDG PET/CT in cancer therapy monitoring

Summary

Objectives: We developed and tested a software tool for computer-assisted analysis of FDG-PET/CT in cancer therapy monitoring. The tool provides automatic semi-quantitative analysis of a baseline scan together with up to two follow-up scans (standardized uptake values, glycolytic volume). The tool also supports visual analysis by local spatial registration which allows display of tumor lesions with the same orientation in all scans. The tool’s stability and accuracy was tested at typical everyday image quality. Patients, methods: Ten unselected cancer patients in whom three FDG PET/CT scans had been performed were included. A total of 18 lesions were analyzed. Results: Automatic lesion tracking worked properly in all lesions but one. In this lesion local coregistration had to be adjusted manually tuwhich, however, is easily performed with the tool. Semi-automatic lesion segmentation and fully automatic semi-quantitative analysis worked properly in all cases. Computer-assisted analysis was significantly less time consuming than manual analysis. Conclusions: The novel software tool appears useful for analysis of FDGPET/ CT in cancer therapy monitoring in clinical routine patient care.

Zusammenfassung

Um den Einsatz der FDG PET/CT in der Therapiekontrolle bei Tumorpatienten zu unterstützen, entwickelten wir ein Software-Tool für die automatische semiquantitative Analyse von FDG PET/CTs (verschiedene SUV-Maße, glykolytisches Volumen). Das Tool erlaubt die gleichzeitige Auswertung von bis zu drei Untersuchungen eines Patienten, d. h. Ausgangsuntersuchung plus zwei Verlaufsuntersuchungen. Darüber hinaus unterstützt das Tool die visuelle Verlaufsbeurteilung durch Darstellung der Tumorläsion mit weitgehend gleicher Schnittführung und SUV-basierter Aussteuerung der Farbtafel in allen drei Untersuchungen. Patienten, Methodik: Das neue Tool wurde an zehn unselektionierten Tumorpatienten mit je 3 FDG PET/CTs evaluiert. Insgesamt wurden 18 Läsionen ausgewertet. Ergebnisse: Die Computer-unterstützte Analyse erwies sich als sehr nutzerfreundlich. Sie war schnell zu erlernen und leicht zu bedienen. Die automatische Nachverfolgung einer in der Ausgangsuntersuchung per Mausklick ausgewählten Läsion in den beiden Verlaufsuntersuchungen funktionierte in allen außer in einem Fall, in dem die Identifikation der Läsion in den Verlaufsuntersuchungen manuell durchgeführt werden musste. Halb-automatische Segmentierung und automatische semi-quantitative Auswertung funktionierten in allen Läsionen ohne Probleme. Die computer-unterstützte Auswertung führte zu einer signifikanten Zeitersparnis gegenüber der manuellen Auswertung. Schlussfolgerung: Das neue Software-Tool ist eine sinnvolle Unterstützung für die Auswertung von FDG PET/CTs in der Tumortherapie-Kontrolle in der klinischen Patientenversorgung.

Keywords

Cancer - therapy response - PET/CT - follow-up - SUV - glycolytic volume - computer-assisted

Schlüsselwörter

Tumor - Therapie - PET/CT - Verlaufsuntersuchung - SUV - glykolytisches Volumen - Computerunterstütze Auswertung

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