The quarterly journal of nuclear medicine and molecular imaging : official publication of the Italian Association of Nuclear Medicine (AIMN) [and] the International Association of Radiopharmacology (IAR), [and] Section of the Society of... · 2024
[18F]DOPA PET for lesion definition and contouring using different thresholds in patients with gliomas.
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Garelli Gloria, Rovera Guido, Levis Mario, Lesca Adriana, Pellerino Alessia, Bruno Francesco, Agosti Alessandra, Mangia Maria L, Cioffi Martina, Coccarelli Alessandro, Morana Giovanni, Ricardi Umberto, Rudà Roberta, Morbelli Silvia, Zotta Michela
Аннотация
BACKGROUND: Amino-acid (AA) PET has recently been endorsed by the ESTRO-EANO guidelines for RT-planning in glioblastomas, with recommended lesion-to-brain-ratio thresholds (1.6-1.8) derived from a biopsy-controlled FET-PET study. We aimed to compare target definition at [18F]DOPA-PET between the ESTRO-EANO thresholds and other biological-tumor-volume (BTV) thresholds (derived from the striatum) typically used in [18F]DOPA-PET.
METHODS: A retrospective analysis was conducted on glioma patients scanned with [18F]DOPA-PET/CT at our center between April 2021 and January 2024. 3D BTV was semi-automatically computed using a dedicated workstation (Philips HealthCare) with four thresholds: 1.6xSUV<inf>mean</inf> of background, 1.8xSUV<inf>mean</inf> of background, SUV<inf>mean</inf> and SUV<inf>max</inf> of the contralateral striatum. The delineation accuracy of different thresholds was visually evaluated and a t-test was used to compare the different VOIs volumes (0.05 significance-level).
RESULTS: 50 patients were included (36 previously received surgery). Volume definition based on the striatum SUV<inf>max</inf> was significantly smaller compared to other thresholds (2.1 cm3), resulting in inaccurate VOIs at visual inspection in 21/50 patients. No significant differences were highlighted in BTV defined based on 1.6 or 1.8xSUV<inf>mean</inf> of background (15.7 vs. 12.7 cm3; VOIs accurate in 49/50 and 46/50 patients, respectively). BTV based on striatum SUV<inf>mean</inf> was significantly smaller compared to the 1.6xSUV<inf>mean</inf> threshold only in surgically-treated patients (P=0.04), while no significant differences were highlighted compared to the 1.8xSUV<inf>mean</inf> threshold regardless of the patients' group.
CONCLUSIONS: The ESTRO-EANO FET-PET thresholds proved to be interchangeable in patients scanned with [18F]DOPA-PET, while the use of a threshold based on the contralateral-striatum SUV<inf>mean</inf> provided partially overlapping results prompting further investigation.
METHODS: A retrospective analysis was conducted on glioma patients scanned with [18F]DOPA-PET/CT at our center between April 2021 and January 2024. 3D BTV was semi-automatically computed using a dedicated workstation (Philips HealthCare) with four thresholds: 1.6xSUV<inf>mean</inf> of background, 1.8xSUV<inf>mean</inf> of background, SUV<inf>mean</inf> and SUV<inf>max</inf> of the contralateral striatum. The delineation accuracy of different thresholds was visually evaluated and a t-test was used to compare the different VOIs volumes (0.05 significance-level).
RESULTS: 50 patients were included (36 previously received surgery). Volume definition based on the striatum SUV<inf>max</inf> was significantly smaller compared to other thresholds (2.1 cm3), resulting in inaccurate VOIs at visual inspection in 21/50 patients. No significant differences were highlighted in BTV defined based on 1.6 or 1.8xSUV<inf>mean</inf> of background (15.7 vs. 12.7 cm3; VOIs accurate in 49/50 and 46/50 patients, respectively). BTV based on striatum SUV<inf>mean</inf> was significantly smaller compared to the 1.6xSUV<inf>mean</inf> threshold only in surgically-treated patients (P=0.04), while no significant differences were highlighted compared to the 1.8xSUV<inf>mean</inf> threshold regardless of the patients' group.
CONCLUSIONS: The ESTRO-EANO FET-PET thresholds proved to be interchangeable in patients scanned with [18F]DOPA-PET, while the use of a threshold based on the contralateral-striatum SUV<inf>mean</inf> provided partially overlapping results prompting further investigation.