Impact of attenuation correction on the accuracy of FDG-PET in patients with abdominal tumors: a free-response ROC analysis.
Hustinx, Roland ; ; et al
in European Journal of Nuclear Medicine (2000), 27(9), 1365-71
The aim of this study was to evaluate image quality and lesion detectability with and without attenuation correction in patients with abdominal tumors, using a free-response receiver operating ... [more ▼]
The aim of this study was to evaluate image quality and lesion detectability with and without attenuation correction in patients with abdominal tumors, using a free-response receiver operating characteristic (FROC) methodology. Thirty-four patients with various abdominal tumors were evaluated (11 men, 23 women, median age 48 years). Whole-body emission scans were performed 68 min (35-102 min) after intravenous injection of 4.3 MBq/kg fluorine-18 fluorodeoxyglucose (FDG). Images were reconstructed using the OS-EM algorithm and corrected for attenuation either using postinjection singles transmission (n=27) or by calculation and body outline (n=7). Total scan duration did not exceed 70 min. Studies were read independently by four observers unaware of any clinical data. The uncorrected (UC) images were systematically read before the attenuation-corrected (AC) images. All studies were given an image quality score ranging from 1 (unreadable) to 5 (excellent). Each focus of increased activity was then localized and given a probability of malignancy using a five-point scale. The average image quality score was similar for both UC and AC images. At the time of the positron emission tomography (PET) scans, 127 lesions (63 liver metastases, 9 retroperitoneal lesions, 50 peritoneal or bowel lesions, and 5 pancreatic carcinomas) were revealed by pathological or correlative studies. The areas under the FROC curves were consistently greater for AC images (range 0.8663-0.8867) than for UC images (range 0.7774 -0.8613). Overall, the difference between the AC images and the UC images was significant (P=0.019). In particular, correction for attenuation increased the sensitivity regardless of the location of the lesions. In conclusion, correction for attenuation significantly improves the diagnostic accuracy of FDG-PET for abdominal staging of neoplasms, without impairing the image quality. [less ▲]Detailed reference viewed: 13 (2 ULg)
Nuclear imaging methods for non-invasive drug monitoring.
; Hustinx, Roland ;
in Advanced Drug Delivery Reviews (2000), 41(1), 41-54
Functional imaging techniques provide complimentary information to that provided by structural studies such as MRI and CT. Functional imaging is based upon known parameters such as physiology, metabolism ... [more ▼]
Functional imaging techniques provide complimentary information to that provided by structural studies such as MRI and CT. Functional imaging is based upon known parameters such as physiology, metabolism, biochemistry, pharmacology, and any other biological process. As such, this methodology plays a major role in understanding the basic mechanisms of a multitude of disorders, accurate diagnosis of certain diseases, and developing effective treatment for serious illnesses such as cancer and central nervous system maladies. Although this type of imaging can be performed with various modalities, nuclear procedures have played the leading role in this discipline. Advances made in labeling various radionuclides to biologically important compounds, and development of sophisticated instruments have substantially contributed to the growth of the field of functional imaging. The introduction of positron emission topography (PET), which is based on imaging of compounds labeled with elements such as carbon, nitrogen, and fluorine, has added a major dimension to the evolution of the discipline. This review deals with a brief introduction to the methodologies utilized with radiolabeled tracers and then deals with specific applications of this technology. These applications include assessment of blood flow and metabolism, receptor imaging, elucidating the pathophysiologic process, evaluating role of labeled therapeutic agents, and the potential of these techniques in the development of novel biologic therapies. Functional imaging with radiolabeled tracers will play an increasingly important role in modern medicine, and its impact will be substantial in the management of patients with various disorders. [less ▲]Detailed reference viewed: 13 (0 ULg)
Can the standardized uptake value characterize primary brain tumors on FDG-PET?
Hustinx, Roland ; ; et al
in European Journal of Nuclear Medicine (1999), 26(11), 1501-9
The aim of this study was to evaluate the usefulness of measuring the standardized uptake value (SUV) in primary brain tumors on fluorine-18 fluorodeoxyglucose (FDG) positron emission tomography (PET ... [more ▼]
The aim of this study was to evaluate the usefulness of measuring the standardized uptake value (SUV) in primary brain tumors on fluorine-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) scans. Two groups of patients were studied. Whole-brain glucose cerebral metabolic rates (wCMRs) and SUVs were obtained in 20 normal subjects. Twenty-seven patients with histology-proven malignant primary CNS tumors (high-grade gliomas n=22, primitive neuroectodermal tumors n=3, ependymomas n=2) were also studied. The degree of FDG uptake was assessed by visual inspection and thereafter regions of interest were placed over the lesion, the contralateral cortex and white matter and the whole brain. Average (avg) and maximum (max) pixel values were determined in each site. Based on these measurements, SUV, tumor to cortex (T/C) and tumor to white matter (T/WM) activity ratios were calculated. There was no correlation between wCMRs (4.55+/-0.36 mg min(-1) 100 g(-1)) and wSUVs (5.41+/-0.43) in the normal subjects (r=0.18, P=0.45). In the second group, 17 lesions were described as definitely and seven as probably malignant. However, SUVs in these tumors and in the contralateral cortex were not significantly different. Although the SUVs were generally higher in the tumor than in the contralateral white matter, there was a significant overlap between the values. The range of the SUVs was wide: 2.54-11.8 for the tumors, 2.98-9.96 for the cortex and 1.87-6.76 for the white matter. SUVs in the normal cortex were negatively correlated with blood glucose level at the time of the injection. SUVs in the whole brain and in the cortex were lower in patients previously treated by irradiation, even months after completion of the treatment. No correlation was detectable between any of the SUVs and the age of the patients, tumor type, time post injection, use of dexamethasone, patient weight, dose injected and visual score. With cutoff levels of 1.5 for T max/WM and 0.6 for T max/C, the sensitivity of the activity ratios was 74% and 96% respectively. In conclusion, SUVs do not correlate with CMRs across subjects and appear to be of limited value in characterizing brain tumors. Visual assessment and measurement of the activity ratios currently remain the most reliable methods of analysis. [less ▲]Detailed reference viewed: 15 (2 ULg)