Article Figures & Data
Figures
- FIGURE 1.
Whole-body tumor burden quantification on baseline staging 18F-FDG PET/CT using semiautomatic software on patient with non-Hodgkin lymphoma. (A) Maximum-intensity projection shows hypermetabolic lymphoma infiltration in left supraclavicular and cervical lymph nodes, mediastinal lymph nodes, and extensively in abdominopelvic lymph nodes; lung nodules; and bone infiltration. (B) For calculation, liver is set as background reference, and VOIs automatically surround each lymphoma lesion with uptake higher than SUVmean of liver. VOIs also include physiologic areas incorrectly selected as cancer to include metastatic foci with relatively low uptake, such as lung nodule metastasis with mild 18F-FDG uptake in right upper lobe.
- FIGURE 2.
Whole-body tumor burden quantification on staging 18F-FDG PET/CT using CNN. Displayed in red are regions that software excluded from analysis (regions related to physiologic uptake: brain, head and neck, heart, intestines, kidneys, and bladder), and displayed in green are regions that software included in calculation of whole-body tumor burden. In this patient, extensive cervical lymph node bulky mass and mediastinal lymph nodes were included.
- FIGURE 3.
Baseline staging 18F-FDG PET/CT of patient with Hodgkin lymphoma. (A) Maximum-intensity projection reveals cervical hypermetabolic bulky mass. (B) Image displayed with different whole-body tumor burden quantification methods shows that using semiautomatic method, VOIs are delineated in cancer lesions and also in physiologic regions not related to cancer; these regions must be deleted before quantification. Whole-body tumor burden calculation showed semiautomatic wbMTV of 104 and TLG of 1,663; time spent calculating these metrics was 5 min. (C) CNN whole-body tumor burden quantification does not delineate regions nonrelated to cancer and demonstrates similar metrics: CNN + observer wbMTV of 105 and CNN + observer wbTLG of 1,671. Time spent calculating was significantly less (13 s) even though CNN software failed to delineate spleen, which had to be performed manually.
- FIGURE 4.
Baseline staging 18F-FDG PET/CT of Hodgkin lymphoma. (A) Maximum-intensity projection reveals mediastinal hypermetabolic bulky mass and extensive infiltration of cervical lymph nodes, abdominal lymph nodes, and spleen. (B) Semiautomatic quantification reveals semiautomatic wbMTV of 548 and semiautomatic wbTLG of 5,238; time spent calculating was 15 min. (C) CNN whole-body tumor burden quantification demonstrates similar metrics: CNN wbMTV of 570 and CNN wbTLG of 5,213, but time spent calculating was significantly less (14 s). CNN software excludes focal areas of physiologic uptake such as right ureter and includes areas of mild uptake such as left hilar lymph node.
- FIGURE 5.
18F-FDG PET/CT of patient with Hodgkin lymphoma. (A) Maximum-intensity projection reveals mediastinal hypermetabolic bulky mass and cervical, axillary, and inguinal nodes. (B) Semiautomatic VB20 whole-body tumor burden quantification reveals MTV of 194 and TLG of 1,007; time spent calculating these metrics was 30 min because of extent of lesions and need to exclude multiple areas of physiologic uptake. (C) CNN whole-body tumor burden quantification demonstrates similar metrics: MTV of 200 and TLG of 968. However, time spent calculating was significantly less (36 s). CNN software excludes physiologic areas with high uptake such as heart and includes lymph nodes with less uptake adjacent to heart.
Tables
Parameter Variable Number Percentage Sex Female 32 31.4% Male 70 68.6% Lymphoma type Hodgkin 80 78.4% Non-Hodgkin 22 21.6% Clinical final stage 1 8 7.8% 2 34 33.3% 3 34 33.3% 4 26 25.5% Spleen Yes 29 28.4% Disease No 73 71.6% Extranodal sites 0 67 65.7% 1 15 14.7% ≥2 20 19.6% Disease bulk Bulky 63 61.8% Nonbulky 39 38.2% B symptoms Yes 43 43.0% No 57 57.0% LDH High 47 52.8% Normal 42 47.2% Leukocytosis Yes 32 31.7% No 69 68.3% Erythrocyte sedimentation rate Normal 34 52.3% Elevated 31 47.7% Anemia Yes 47 47.5% No 52 52.5% Albumin Yes 27 37.0% No 46 63.0% Bone marrow Diffuse 12 11.9% 18F-FDG Focal 16 15.8% Uptake Negative 73 72.3% Event Yes 10 9.8% No 92 90.2% Status Alive 101 99.0% Dead 1 1.0% - TABLE 2.
Time Spent Quantifying Whole-Body Tumor Burden Metrics on Semiautomatic Software and CNN Software With and Without Observer Input
Time (s) Variable n Mean SD Minimum Median Maximum P Semiautomatic 76 1,301.3 863.5 198.0 1,107.0 3,724.0 <0.0001 CNN + observer 76 221.1 204.4 31.0 155.0 1,176.0 CNN 76 19.6 8.0 11.0 17.0 50.0 - TABLE 3.
Correlation of Whole-Body Tumor Burden Metrics on Semiautomatic Software and CNN-Based Software With and Without Observer Input in 76 Patients
Variable Mean SD Min Median Max ICC 95% CI P MTV 0.960 0.942–0.974 <0.0001 Semiautomatic 242.8 205.9 4.6 149.0 772.6 CNN + observer 254.8 212.8 4.1 178.3 778.3 CNN 234.8 206.9 11.7 147.6 784.4 TLG 0.963 0.947–0.975 <0.0001 Semiautomatic 1,626.4 1,674.6 50.0 894.7 6,963.1 CNN + observer 1,647.3 1,685.8 50.1 902.1 5,963.4 CNN 1,647.7 1,811.2 31.0 871.3 8,218.6 Min = minimum; Max = maximum; ICC = intraclass correlation coefficient.
In this issue
Jump to section
Related Articles
Cited By...
- No citing articles found.