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Nuklearmedizin 2015; 54(06): 272-285
DOI: 10.3413/Nukmed-0749-15-06
Original article
Schattauer GmbH

A new method for segmentation of FDG PET metabolic tumour volume using the peritumoural halo layer and a 10-step colour scale

A study in patients with papillary thyroid carcinomaNeues Segmentierungsverfahren des metabolischen Tumorvolumens bei der FDG-PET mit Hilfe des peritumoralen Randsaums (Halo) und einer 10-stufigen FarbskalaStudie bei Patienten mit papillärem Schilddrüsenkarzinom
S. Jun
1   Department of Nuclear Medicine, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Korea
,
H. Kim
1   Department of Nuclear Medicine, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Korea
,
H.-Y. Nam
2   Department of Nuclear Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
› Author Affiliations
Further Information

Publication History

received: 10 June 2015

accepted in revised form: 22 September 2015

Publication Date:
31 January 2018 (online)

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Summary

Aim: We observed a layer between tumour activity and background on FDG PET/CT with the 10-step colour scale and the window level set properly. We named the layer peritumoral halo layer (PHL). We performed this study to establish the reliability of metabolic tumor volume (MTV) segmentation using PHL (MTVPHL) in patients with papillary thyroid carcinoma. Patients, methods: Of a total of 140 papillary thyroid carcinoma (PTC) patients, 70 (50.0%) had FDG-avid PTC. In these patients, MTVPHL, MTV segmented according to fixed 50% SUVmax (MTV50%), and fixed SUV with 2.5 to 4.0 (MTV2.5 to MTV4.0) were compared with pathologic tumour volume (PTV). The absolute percentage difference between MTVPHL and PTV was compared in micropapillary carcinoma (MPTC) and non-micropapillary carcinoma (non-MPTC) subgroups. The % SUVmax and SUV thresholds of MTVPHL were compared with tumour SUVmax. Results: Among the MTVs, MTV50% was not correlated with PTV (r = –0.16, p = 0.182) and was not reliable according to the Bland-Altman plot. Although MTV2.5, MTV3.0, MTV3.5, and MTV4.0 correlated with PTV (r = 0.85, 0.86, 0.87, and 0.87, respectively; p < 0.001), these MTVs were not reliable on Bland- Altman analyses. MTVPHL was significantly correlated with PTV (r = 0.80, p < 0.001), and the Bland-Altman plot did not show systemic error. The MTVPHL was more accurate in non-MPTC than in MPTC (p < 0.001), and the absolute % difference was smaller as PTV became larger (σ = –0.65, p < 0.001). The MTVPHL thresholds had correlations with SUVmax (% SUVmax threshold: σ = –0.87, p < 0.001; SUV threshold: r = 0.88, p < 0.001). Conclusions: MTVPHL was more reliable than MTV%SUVmax or MTVSUV. The reliability of MTVPHL improved with larger PTVs. The threshold of the MTVPHL was naturally altered by PHL according to SUVmax.

Zusammenfassung

Peritumoraler Halo, FDG-PET/CT, metabolisches Tumorvolumen, Schilddrüsenkarzinom, Zuverlässigkeitsprüfung Zusammenfassung Ziel: Wir haben anhand einer 10-stufigen Farbskala und entsprechend eingestelltem Fenster in der FDG-PET/CT eine Schicht zwischen Tumoraktivität und Hintergrund beobachtet. Diese Schicht haben wir als peritumoralen Halo (PHL) bezeichnet. Diese Studie wurde durchgeführt, um die Zuverlässigkeit der Segmentierung des metabolischen Tumorvolumens (MTV) anhand des PHL (MTVPHL) bei Patienten mit papillärem Schilddrüsenkarzinom zu untersuchen. Patienten, Methoden: Von insgesamt 140 Patienten mit papillärem Schilddrüsenkarzinom (PTC) hatten 70 (50,0%) ein FDG-avides PTC. Bei diesen Patienten wurden MTVPHL, das MTV, segmentiert nach fixem SUVmax von 50% (MTV50%) und nach fixem SUV von 2,5 bis 4,0 (MTV2.5 bis MTV4.0) mit dem pathologischen Tumorvolumen (PTV) verglichen. Der absolute prozentuale Unterschied zwischen MTVPHL und PTV wurde in den Untergruppen des mikropapillären Karzinoms (MPTC) und des nicht mikropapillären Karzinoms (non-MPTC) verglichen. Die prozentualen Schwellen von SUVmax und SUV des MTVPHL wurden mit dem Tumor-SUVmax verglichen. Ergebnisse: Bei den MTV korrelierte MTV50% nicht mit dem PTV (r = –0,16, p = 0,182) und war daher nach dem Bland-Altman-Diagramm nicht zuverlässig. Obgleich MTV2.5, MTV3.0, MTV3.5 und MTV4.0 mit dem PTV korrelierten (r = 0,85, 0,86, 0,87 bzw. 0,87; p < 0,001), waren diese MTV im Bland-Altman-Diagramm nicht zuverlässig. MTVPHL korrelierte signifikant mit dem PTV (r = 0,80, p < 0,001), und das Bland-Altman-Diagramm zeigte keinen systemischen Fehler. MTVPHL war beim non-MPTC genauer als beim MPTC (p < 0,001), und der absolute prozentuale Unterschied wurde mit zunehmendem PTV kleiner (σ = –0,65, p < 0,001). Die MTVPHL-Schwellen korrelierten mit dem SUVmax (% SUVmax- Schwelle: σ = –0,87, p < 0,001; SUVSchwelle: r = 0,88, p < 0,001). Schlussfolgerungen: MTVPHL war zuverlässiger als MTV%SUVmax oder MTVSUV. MTVPHL war bei größeren PTV zuverlässiger. Die Schwelle des MTVPHL wurde durch den PHL entsprechend SUVmax natürlich verändert.

Keywords

Peritumoural halo layer - FDG PET/CT - metabolic tumour volume - thyroid cancer - reliability test

Schlüsselwörter

Peritumoraler Halo - FDG-PET/CT - metabolisches Tumorvolumen - Schilddrüsenkarzinom - Zuverlässigkeitsprüfung
 

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