Repeatability of quantitative18F-FLT uptake measurements in solid tumors: an individual patient data multi-center meta-analysis
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Published version
Author(s)
Type
Journal Article
Abstract
INTRODUCTION: 3'-deoxy-3'-[18F]fluorothymidine (18F-FLT) positron emission tomography (PET) provides a non-invasive method to assess cellular proliferation and response to antitumor therapy. Quantitative18F-FLT uptake metrics are being used for evaluation of proliferative response in investigational setting, however multi-center repeatability needs to be established. The aim of this study was to determine the repeatability of18F-FLT tumor uptake metrics by re-analyzing individual patient data from previously published reports using the same tumor segmentation method and repeatability metrics across cohorts. METHODS: A systematic search in PubMed, EMBASE.com and the Cochrane Library from inception-October 2016 yielded five18F-FLT repeatability cohorts in solid tumors.18F-FLT avid lesions were delineated using a 50% isocontour adapted for local background on test and retest scans. SUVmax, SUVmean, SUVpeak, proliferative volume and total lesion uptake (TLU) were calculated. Repeatability was assessed using the repeatability coefficient (RC = 1.96 × SD of test-retest differences), linear regression analysis, and the intra-class correlation coefficient (ICC). The impact of different lesion selection criteria was also evaluated. RESULTS: Images from four cohorts containing 30 patients with 52 lesions were obtained and analyzed (ten in breast cancer, nine in head and neck squamous cell carcinoma, and 33 in non-small cell lung cancer patients). A good correlation was found between test-retest data for all18F-FLT uptake metrics (R2 ≥ 0.93; ICC ≥ 0.96). Best repeatability was found for SUVpeak(RC: 23.1%), without significant differences in RC between different SUV metrics. Repeatability of proliferative volume (RC: 36.0%) and TLU (RC: 36.4%) was worse than SUV. Lesion selection methods based on SUVmax ≥ 4.0 improved the repeatability of volumetric metrics (RC: 26-28%), but did not affect the repeatability of SUV metrics. CONCLUSIONS: In multi-center studies, differences ≥ 25% in18F-FLT SUV metrics likely represent a true change in tumor uptake. Larger differences are required for FLT metrics comprising volume estimates when no lesion selection criteria are applied.
Date Issued
2018-06-01
Online Publication Date
2018-06-01
Date Acceptance
2017-12-26
ISSN
1619-7070
Publisher
Springer Verlag
Start Page
951
End Page
961
Journal / Book Title
European Journal of Nuclear Medicine and Molecular Imaging
Volume
45
Issue
6
Copyright Statement
© The Author(s) 2018. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
Source Database
pubmed
Sponsor
National Institute for Health Research
Commission of the European Communities
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/29362858
10.1007/s00259-017-3923-x
Grant Number
NIHR/CS/009/009
115151
Subjects
Science & Technology
Life Sciences & Biomedicine
Radiology, Nuclear Medicine & Medical Imaging
Flt
Repeatability
PET
Oncology
CELL LUNG-CANCER
POSITRON-EMISSION-TOMOGRAPHY
VOLUME MEASUREMENTS
FDG-PET/CT
REPRODUCIBILITY
PROLIFERATION
CHEMOTHERAPY
PERCIST
QuIC-ConCePT consortium
1103 Clinical Sciences
0299 Other Physical Sciences
Nuclear Medicine & Medical Imaging
Publication Status
Published
Country
Germany
Date Publish Online
2018-01-23