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Research ArticleImaging

Validation of the Semiautomatic Quantification of 18F-Fluoride PET/CT Whole-Body Skeletal Tumor Burden

Ana E. Brito, Felipe Mourato, Allan Santos, Camila Mosci, Celso Ramos and Elba Etchebehere
Journal of Nuclear Medicine Technology December 2018, 46 (4) 378-383; DOI: https://doi.org/10.2967/jnmt.118.211474
Ana E. Brito
1Real Nuclear of Real Hospital Português de Beneficência em Pernambuco, Recife, Brazil
2Keizo Asami Immunopathology Laboratory, Federal University of Pernambuco, Recife, Brazil
3Division of Nuclear Medicine, Department of Radiology, University of Campinas, Campinas, Brazil; and
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Felipe Mourato
1Real Nuclear of Real Hospital Português de Beneficência em Pernambuco, Recife, Brazil
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Allan Santos
3Division of Nuclear Medicine, Department of Radiology, University of Campinas, Campinas, Brazil; and
4MND Campinas, Campinas, Brazil
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Camila Mosci
3Division of Nuclear Medicine, Department of Radiology, University of Campinas, Campinas, Brazil; and
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Celso Ramos
3Division of Nuclear Medicine, Department of Radiology, University of Campinas, Campinas, Brazil; and
4MND Campinas, Campinas, Brazil
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Elba Etchebehere
3Division of Nuclear Medicine, Department of Radiology, University of Campinas, Campinas, Brazil; and
4MND Campinas, Campinas, Brazil
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  • FIGURE 1.
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    FIGURE 1.

    Example of manual quantification for one patient, with mFTV10 corresponding to sum of all VOIs (81.38 mL) and mTLF10 corresponding to mFTV10 multiplied by average of all SUVmax (1,266.27 g).

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    FIGURE 2.

    (A) After threshold selection (SUVmax of 10), several VOIs are automatically created. (B) On visual inspection, VOIs not related to metastases are deleted. In this patient, as indicated by white arrow in coronal section on CT scan, uptake was noted in calcified portion of liver, which was a sequela of radioablation (L11VOI1); this lesion was manually excluded. (C) Patient’s final saTLF10 was 3,969 g.

  • FIGURE 3.
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    FIGURE 3.

    Graph showing strong correlation between values for mTLF10 and mFTV10 (ρ = 0.8117; P < 0.0001; 95% confidence interval, 0.6905–0.8885).

  • FIGURE 4.
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    FIGURE 4.

    Graph showing strong correlation between values for saTLF10 and saFTV10 (ρ = 0.9234; P < 0.0001; 95% confidence interval, 0.8690–0.9558).

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    FIGURE 5.

    Bland–Altman test showing similarity between manual and semiautomatic quantifications.

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    FIGURE 6.

    Mountain plot showing similarity between manual and semiautomatic quantifications, with peak near zero and small left tail.

Tables

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    TABLE 1

    Correlation of Clinical and Imaging Variables to Overall Survival and Time to Progression on Multivariable Analysis

    Variable95%CIP
    Overall survival
     saTLF101.0003–1.00090.0001
     Visceral metastases1.8334–24.66370.0041
     Age1.0042–1.11480.0342
    Time to progression
     saTLF101.0001–1.00020.0006
     Age0.9359–0.99490.0342
    • CI = confidence interval.

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Journal of Nuclear Medicine Technology: 46 (4)
Journal of Nuclear Medicine Technology
Vol. 46, Issue 4
December 1, 2018
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Validation of the Semiautomatic Quantification of 18F-Fluoride PET/CT Whole-Body Skeletal Tumor Burden
Ana E. Brito, Felipe Mourato, Allan Santos, Camila Mosci, Celso Ramos, Elba Etchebehere
Journal of Nuclear Medicine Technology Dec 2018, 46 (4) 378-383; DOI: 10.2967/jnmt.118.211474

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Validation of the Semiautomatic Quantification of 18F-Fluoride PET/CT Whole-Body Skeletal Tumor Burden
Ana E. Brito, Felipe Mourato, Allan Santos, Camila Mosci, Celso Ramos, Elba Etchebehere
Journal of Nuclear Medicine Technology Dec 2018, 46 (4) 378-383; DOI: 10.2967/jnmt.118.211474
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Keywords

  • NaF PET/CT
  • breast cancer
  • skeletal tumor burden
  • semiautomatic quantification
  • manual quantification
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