Semi-automated volumetric analysis of lymph node metastases in patients with malignant melanoma stage III/IV-A feasibility study

Fabel, M.; Tengg-Kobligk, Hendrik von; Giesel, Frederik L.; Bornemann, L.; Dicken, Volker; Kopp‐Schneider, Annette; Moser, Christine; Delorme, Stefan; Kauczor, Hans‐Ulrich

doi:10.1007/s00330-008-0866-4

Cited by 67 publications

(46 citation statements)

References 19 publications

(20 reference statements)

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“…However, it is generally felt that for assessment of early response, particularly in risk-adapted therapeutic trials, it is preferable to refer to a background tissue (such as the liver) with a higher level of uptake than that of current international criteria that were designed for end-of-treatment evaluation. 13 As recently shown, the reproducibility of lymph node measurements is poorest below 20 mm, which leads to major discrepancies in FDG-PET interpretation 14 as the reference background changes. In 2009, an international workshop on interim FDG-PET 15 took place to reach a consensus on criteria for interim FDG-PET scans.…”

Section: Interpretation Of Pet Scansmentioning

confidence: 99%

Positron Emission Tomographic Scans in Lymphoma: Convention and Controversy

Ansell

Armitage

2012

Mayo Clinic Proceedings

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The use of sensitive and specific imaging techniques for accurate initial staging and evaluation of response to therapy in patients with lymphoma is essential for their optimal management. Fluorine 18 fluorodeoxyglucose (FDG) positron emission tomography (PET) integrated with computed tomography (CT) has emerged as a powerful imaging tool and is being routinely used in staging, response evaluation, and posttreatment surveillance in patients with non-Hodgkin lymphoma and Hodgkin lymphoma. PET/CT is currently widely used in clinical practice, but the established clinical benefit is currently restricted to the posttreatment evaluation of Hodgkin lymphoma, diffuse large B-cell lymphoma, and follicular lymphoma. Although used in other histologic subtypes and in other clinical situations including response assessment, its impact on patient outcome remains to be demonstrated. We performed a literature search of PubMed from 1999 to 2011 using the following keywords: PET scan, FDG-PET, PET/CT, lymphoma. This review addresses the challenges and controversies in the use of PET/CT scans in the management of patients with lymphoma. I n most patients with lymphoma, positron emission tomographic (PET) scans show abnormalities at diagnosis. Normal findings on the scan after therapy is highly predictive of a good prognosis, particularly in patients with diffuse large B-cell lymphoma (DLBCL), follicular lymphoma, and Hodgkin lymphoma. However, the optimal application of PET scans to the management of all patients with lymphoma remains problematic. The major controversies include the optimal timing of PET scans (for staging, during therapy, after completion of therapy, surveillance in remission), standardization of PET scan interpretation (visual interpretation compared with standard uptake value [SUV] calculation), what constitutes a positive PET scan result, and whether PET scans should be used to direct management (eg, does changing therapy in patients with positive findings on PET change outcome, should biopsies of sites with positive PET results be done routinely before a management change). Although a large body of literature addressing these topics exists, the studies are often difficult to compare, making definitive conclusions on all these issues difficult. The previously published studies often used different designs and variable reporting, making interpretation and comparison of the results difficult. In the early studies particularly, heterogeneous populations with different stages of disease and different histologic subtypes were included, making the clinical applicability of the studies' results difficult. More recent studies focusing on efforts to standardize the conduct and interpretation of PET scans and on riskadapted therapies based on interim PET scan results will, it is hoped, improve the management and outcome of patients with lymphoma. A literature search of PubMed from 1999 to 2011 was performed using the following keywords: PET scan, FDG-PET, PET/CT, lymphoma. We highlight the current standard use ...

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Section: Interpretation Of Pet Scansmentioning

confidence: 99%

Positron Emission Tomographic Scans in Lymphoma: Convention and Controversy

Ansell

Armitage

2012

Mayo Clinic Proceedings

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“…All volume and bi-dimensional measurements were therefore converted to diameters as recently published by different groups [16,19,27]. These effec- tive diameters were measured in mm and defined as volumeequivalent and area-equivalent diameters.…”

Section: Response Assessment Response Criteriamentioning

confidence: 99%

“…In the past decade, semi-automatic tumor segmentation and measurement tools have demonstrated their technical feasibility with regard to lung nodule and liver lesion segmentation [13, 20, 32 -34]. Recent studies specifically addressed the aspects of reproducibility and variability between different readers in the semi-automated segmentation of tumor-affected lymph nodes, and found inter-user differences to be reduced by a factor of approximately 1.4 to 3.0 compared to the manual approach [16,19,35]. These feasibility studies are limited by their lack of data on follow-up examinations, whereby inter-user differences could be aggravated, e. g. due to variable lymph node orientation caused by shrinkage.…”

mentioning

confidence: 99%

Therapy Response Evaluation of Malignant Lymphoma in a Multicenter Study: Comparison of Manual and Semiautomatic Measurements in CT

Weßling

Schülke

Koch

et al. 2014

Fortschr Röntgenstr

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Abdomen 768Weßling J et al. Purpose:Comparison of manual one-/bi-dimensional measurements versus semi-automatically derived one-/bi-dimensional and volumetric measurements for therapy response evaluation of malignant lymphoma during CT follow-up examinations in a multicenter setting. Materials and Methods: MSCT data sets of patients with malignant lymphoma were evaluated before (baseline) and after two cycles of chemotherapy (follow-up) at radiological centers of five university hospitals. The long axis diameter (LAD), the short axis diameter (SAD) and the bidimensional WHO of 307 target lymph nodes were measured manually and semi-automatically using dedicated software. Lymph node volumetry was performed semi-automatically only. The therapeutic response was evaluated according to lymphoma-adapted RECIST. Results: Based on a single lymph node, semi-automatically derived multidimensional parameters allowed for significantly more accurate therapy response classification than the manual or the semi-automatic unidimensional parameters. Incorrect classifications were reduced by up to 9.6 %. Compared to the manual approach, the influence of the study center on correct therapy classification is significantly less relevant when using semi-automatic measurements. Conclusion: Semi-automatic volumetry and bi-dimensional WHO significantly reduce the number of incorrectly classified lymphoma patients by approximately 9.6 % in the multicenter setting in comparison to linear parameters. Semi-automatic quantitative software tools may help to significantly reduce wrong classifications that are associated with the manual assessment approach.

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“…Automated volume segmentation has been demonstrated to be accurate in the measurement of volume of organs, tumors, lymph nodes, and pulmonary nodules using various imaging modalities. [8][9][10][11][12][13][14][15] Volume segmentation has specifically been used to accurately determine knee effusion volumes based on T2 MRI images with good interobserver reliability. 3,4 Similar technology has been used to determine intra-articular fluid volume of the first metatarsal phalangeal joint.…”

Section: Introductionmentioning

confidence: 99%