Assessment of tumour size in PET-CT lung cancer studies: PET- and CT-based methods compared to pathologyReport as inadecuate




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EJNMMI Research

, 2:56

First Online: 03 October 2012Received: 22 August 2012Accepted: 26 September 2012

Abstract

BackgroundPositron emission tomography PET may be useful for defining the gross tumour volume for radiation treatment planning and for response monitoring of non-small cell lung cancer NSCLC patients. The purpose of this study was to compare tumour sizes obtained from CT- and various more commonly available PET-based tumour delineation methods to pathology findings.

MethodsRetrospective non-respiratory gated whole body F-fluoro-2-deoxy-D-glucose PET-CT studies from 19 NSCLC patients were used. Several semi-automatic PET-based tumour delineation methods and manual CT-based delineation were used to assess the maximum tumour diameter.

Results50%, adaptive 41% threshold-based and contrast-oriented delineation methods showed good agreement with pathology after removing two outliers R=0.82. An absolute SUV threshold of 2.5 also showed a good agreement with pathology after the removal of 5 outliers R: 0.79, but showed a significant overestimation in the maximum diameter 19.8 mm, p<0.05. Adaptive 50%, relative threshold level and gradient-based methods did not show any outliers, provided only small, non-significant differences in maximum tumour diameter <4.7 mm, p>0.10, and showed fair correlation R>0.62 with pathology. Although adaptive 70% threshold-based methods showed underestimation compared to pathology 36%, it provided the best precision SD: 14% together with good correlation R=0.81. Good correlation between CT delineation and pathology was observed R=0.77. However, CT delineation showed a significant overestimation compared with pathology 3.8 mm, p<0.05.

ConclusionsPET-based tumour delineation methods provided tumour sizes in agreement with pathology and may therefore be useful to define the metabolically most active part of the tumour for radiotherapy and response monitoring purposes.

KeywordsTumour delineation Tumour diameter FDG PET Non-small cell lung cancer Electronic supplementary materialThe online version of this article doi:10.1186-2191-219X-2-56 contains supplementary material, which is available to authorized users.

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