Measuring Total Metabolic Tumor Volume from 18F-FDG PET: A Reality Check

Ronald Boellaard, Gerben J.C. Zwezerijnen, Irène Buvat, Laurence Champion, Narinée Hovhannisyan-Baghdasarian, Fanny Orlhac, Anne I.J. Arens, Daphne Lobeek, Filiz Celik, Cristina Mitea, Julia E. Huijbregts, Nelleke Tolboom, Bart de Keizer, Roelf Valkema, Floris H.P. van Velden, Petra Dibbets-Schneider, Sanne E. Wiegers, Pieternella J. Lugtenburg, Sally F. Barrington, Josée M. Zijlstra
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Abstract

Measuring total metabolic tumor volume (TMTV) on 18F-FDG PET/CT images in clinical practice requires a fast, reliable, and easy-to-perform multilesional segmentation workflow. We conducted a field test to derive total metabolic volumes using 5 representative baseline 18F-FDG PET/CT scans from patients with diffuse large B-cell lymphoma. The scans were transferred to 10 different sites or readers who used different commercially available software platforms to derive TMTV after a recently proposed benchmark workflow. Observed TMTVs were compared with reference values, and overall analysis times were reported. Our results show that TMTVs can be obtained with reasonable accuracy across readers and platforms (within 10% compared with reference benchmark values for most TMTVs) but that processing times can vary considerably depending on reader experience and the software platform. Our study showed that there is an urgent need to improve TMTV segmentation workflows in clinical practice, requiring closer collaboration between users and software vendors.

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从18F-FDG PET测量总代谢肿瘤体积:现实检查
在临床实践中,在18F-FDG PET/CT图像上测量总代谢肿瘤体积(TMTV)需要一个快速、可靠、易于执行的多病灶分割工作流程。我们通过对弥漫性大b细胞淋巴瘤患者进行5次代表性基线18F-FDG PET/CT扫描,进行了现场测试,以获得总代谢量。扫描结果被转移到10个不同的站点或阅读器上,这些站点或阅读器使用不同的商业软件平台,在最近提出的基准工作流程之后获得TMTV。比较观察到的tmtv参考值,并报告总分析次数。我们的研究结果表明,tmtv可以在阅读器和平台上以合理的精度获得(大多数tmtv与参考基准值相比在10%以内),但处理时间可能会因读者体验和软件平台而有很大差异。我们的研究表明,迫切需要在临床实践中改进TMTV分割工作流程,需要用户和软件供应商之间更密切的合作。
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