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European Journal of Nuclear Medicine and Molecular Imaging

Erschienen in:

01.05.2014 | Original Article

Semiautomatic methods for segmentation of the proliferative tumour volume on sequential FLT PET/CT images in head and neck carcinomas and their relation to clinical outcome

verfasst von: Anne I. J. Arens, Esther G. C. Troost, Bianca A. W. Hoeben, Willem Grootjans, John A. Lee, Vincent Grégoire, Mathieu Hatt, Dimitris Visvikis, Johan Bussink, Wim J. G. Oyen, Johannes H. A. M. Kaanders, Eric P. Visser

Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging | Ausgabe 5/2014

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Abstract

Purpose

Radiotherapy of head and neck cancer induces changes in tumour cell proliferation during treatment, which can be depicted by the PET tracer ¹⁸F-fluorothymidine (FLT). In this study, three advanced semiautomatic PET segmentation methods for delineation of the proliferative tumour volume (PV) before and during (chemo)radiotherapy were compared and related to clinical outcome.

Methods

The study group comprised 46 patients with 48 squamous cell carcinomas of the head and neck, treated with accelerated (chemo)radiotherapy, who underwent FLT PET/CT prior to treatment and in the 2nd and 4th week of therapy. Primary gross tumour volumes were visually delineated on CT images (GTV_CT). PVs were visually determined on all PET scans (PV_VIS). The following semiautomatic segmentation methods were applied to sequential PET scans: background-subtracted relative-threshold level (PV_RTL), a gradient-based method using the watershed transform algorithm and hierarchical clustering analysis (PV_W&C), and a fuzzy locally adaptive Bayesian algorithm (PV_FLAB).

Results

Pretreatment PV_VIS correlated best with PV_FLAB and GTV_CT. Correlations with PV_RTL and PV_W&C were weaker although statistically significant. During treatment, the PV_VIS, PV_W&C and PV_FLAB significant decreased over time with the steepest decline over time for PV_FLAB. Among these advanced segmentation methods, PV_FLAB was the most robust in segmenting volumes in the third scan (67 % of tumours as compared to 40 % for PV_W&C and 27 % for PV_RTL). A decrease in PV_FLAB above the median between the pretreatment scan and the scan obtained in the 4th week was associated with better disease-free survival (4 years 90 % versus 53 %).

Conclusion

In patients with head and neck cancer, FLAB proved to be the best performing method for segmentation of the PV on repeat FLT PET/CT scans during (chemo)radiotherapy. This may potentially facilitate radiation dose adaptation to changing PV.

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Titel: Semiautomatic methods for segmentation of the proliferative tumour volume on sequential FLT PET/CT images in head and neck carcinomas and their relation to clinical outcome
verfasst von: Anne I. J. Arens
Esther G. C. Troost
Bianca A. W. Hoeben
Willem Grootjans
John A. Lee
Vincent Grégoire
Mathieu Hatt
Dimitris Visvikis
Johan Bussink
Wim J. G. Oyen
Johannes H. A. M. Kaanders
Eric P. Visser
Publikationsdatum: 01.05.2014
Verlag: Springer Berlin Heidelberg
Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging / Ausgabe 5/2014
Print ISSN: 1619-7070
Elektronische ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-013-2651-0

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusion

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