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  • 2021년 04월호
    [EJNMMI Res.] Quantitation of cancer treatment response by 2-[ 18 F]FDG PET/CT: multi-center assessment of measurement variability using AUTO-PERCIST™

    Washington University School of Medicine / 오주현, Richard L. Wahl*

  • 출처
    EJNMMI Res.
  • 등재일
    2021 Feb 12
  • 저널이슈번호
    11(1):15. doi: 10.1186/s13550-021-00754-1.
  • 내용

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    Abstract
    Background: The aim of this study was to assess the reader variability in quantitatively assessing pre- and post-treatment 2-deoxy-2-[18F]fluoro-D-glucose positron emission tomography/computed tomography ([18F]FDG PET/CT) scans in a defined set of images of cancer patients using the same semi-automated analytical software (Auto-PERCIST™), which identifies tumor peak standard uptake value corrected for lean body mass (SULpeak) to determine [18F]FDG PET quantitative parameters.

    Methods: Paired pre- and post-treatment [18F]FDG PET/CT images from 30 oncologic patients and Auto-PERCIST™ semi-automated software were distributed to 13 readers across US and international sites. One reader was aware of the relevant medical history of the patients (readreference), whereas the 12 other readers were blinded to history but had access to the correlative images. Auto-PERCIST™ was set up to first automatically identify the liver and compute the threshold for tumor measurability (1.5 × liver mean) + (2 × liver standard deviation [SD]) and then detect all sites with SULpeak greater than the threshold. Next, the readers selected sites they believed to represent tumor lesions. The main performance metric assessed was the percent change in the SULpeak (%ΔSULpeak) of the hottest tumor identified on the baseline and follow-up images.

    Results: The intra-class correlation coefficient (ICC) for the %ΔSULpeak of the hottest tumor was 0.87 (95%CI: [0.78, 0.92]) when all reads were included (n = 297). Including only the measurements that selected the same target tumor as the readreference (n = 224), the ICC for %ΔSULpeak was 1.00 (95%CI: [1.00, 1.00]). The Krippendorff alpha coefficient for response (complete or partial metabolic response, versus stable or progressive metabolic disease on PET Response Criteria in Solid Tumors 1.0) was 0.91 for all reads (n = 380) and 1.00 including for reads with the same target tumor selection (n = 270).

    Conclusion: Quantitative tumor [18F]FDG SULpeak changes measured across multiple global sites and readers utilizing Auto-PERCIST™ show very high correlation. Harmonization of methods to single software, Auto-PERCIST™, resulted in virtually identical extraction of quantitative tumor response data from [18F]FDG PET images when the readers select the same target tumor.

     

     

    Affiliations

    Joo Hyun O  1 , Su Jin Lim  2 , Hao Wang  2 , Jeffrey P Leal  3 , Hui-Kuo G Shu  4 , Richard L Wahl  5   6 , QIN PET Readers
    1 Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
    2 Division of Biostatistics and Bioinformatics, Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
    3 Division of Nuclear Medicine, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
    4 Department of Radiation Oncology, The Emory Clinic, Atlanta, GA, USA.
    5 Mallinckrodt Institute of Radiology, Washington University, St. Louis, MO, USA. rwahl@wustl.edu.
    6 Washington University School of Medicine, Mallinckrodt Institute of Radiology, 510 South Kingshighway Blvd, Campus Box 8131, St. Louis, MO, 63110, USA. rwahl@wustl.edu.

  • 키워드
    Quantification; Response assessment; [18F]FDG PET/CT.
  • 편집위원

    판독자마다 다를수 있는 반응평가 부분의 제한점을 software를 통해 더욱 정확하게 보완할 수 있다는 점이 임상에 더 신뢰를 제공할 수 있을 것 같습니다.

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