The asphericity of the metabolic tumour volume in NSCLC: correlation with histopathology and molecular markers

Apostolova, Ivayla; Ego, Kilian; Steffen, Ingo G.; Buchert, Ralph; Wertzel, H; Achenbach, H. Jost; Riedel, Sandra; Schreiber, Jens; Schultz, Meinald; Furth, Christian; Derlin, Thorsten; Amthauer, Holger; Hofheinz, Frank; Kalinski, Thomas

doi:10.1007/s00259-016-3452-z

Cited by 50 publications

(48 citation statements)

References 40 publications

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“…However, compared to the present study investigating SSTR-PET, heterogeneity parameters were derived from [ 111 In-DTPA 0 ]octreotide scintigraphy [44], which has a lower affinity to SSTR2A compared to its PET counterparts [45]. Moreover, entropy and asphericity differ in their equations, which also serves as a possible explanation for the different results: The latter one quantitates the deviation from spherical of the shape of the MTV, and it takes both the mean surface S and the mean volume V into account [44,46]. On the contrary, entropy considers I as the voxel value in the ROI and P(I) as the probability of the occurrence of that pixel value [47].…”

Section: Discussionmentioning

confidence: 99%

Pre-therapy Somatostatin Receptor-Based Heterogeneity Predicts Overall Survival in Pancreatic Neuroendocrine Tumor Patients Undergoing Peptide Receptor Radionuclide Therapy

et al. 2018

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Purpose: Early identification of aggressive disease could improve decision support in pancreatic neuroendocrine tumor (pNET) patients prior to peptide receptor radionuclide therapy (PRRT). The prognostic value of intratumoral textural features (TF) determined by baseline somatostatin receptor (SSTR)-positron emission tomography (PET) before PRRT was analyzed. Procedures: Thirty-one patients with G1/G2 pNET were enrolled (G2, n = 23/31). Prior to PRRT with [ 177 Lu]DOTATATE (mean, 3.6 cycles), baseline SSTR-PET computed tomography was performed. By segmentation of 162 (median per patient, 5) metastases, intratumoral TF were computed. The impact of conventional PET parameters (SUV mean/max ), imaging-based TF, and clinical parameters (Ki67, CgA) for prediction of both progression-free survival (PFS) and overall survival (OS) after PRRT were evaluated. Correspondence to: Ralph Bundschuh; e-mail: ralph.bundschuh@ukbonn.deResults: Within a median follow-up of 3.7 years, tumor progression was detected in 21 patients (median, 1.5 years) and 13/31 deceased (median, 1.9 years). In ROC analysis, the TF entropy, reflecting derangement on a voxel-by-voxel level, demonstrated predictive capability for OS (cutoff = 6.7, AUC = 0.71, p = 0.02). Of note, increasing entropy could predict a longer survival (9 6.7, OS = 2.5 years, 17/31), whereas less voxel-based derangement portended inferior outcome (G 6.7, OS = 1.9 years, 14/31). These findings were supported in a G2 subanalysis (9 6.9, OS = 2.8 years, 9/23 vs. G 6.9, OS = 1.9 years, 14/23). Kaplan-Meier analysis revealed a significant distinction between high-and low-risk groups using entropy (n = 31, p G 0.05). For those patients below the ROC-derived threshold, the relative risk of death after PRRT was 2.73 (n = 31, p = 0.04). Ki67 was negatively associated with PFS (p = 0.002); however, SUV mean/max failed in prognostication (n.s.). Conclusions: In contrast to conventional PET parameters, assessment of intratumoral heterogeneity demonstrated superior prognostic performance in pNET patients undergoing PRRT. This novel PET-based strategy of outcome prediction prior to PRRT might be useful for patient risk stratification.

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Section: Discussionmentioning

confidence: 99%

Pre-therapy Somatostatin Receptor-Based Heterogeneity Predicts Overall Survival in Pancreatic Neuroendocrine Tumor Patients Undergoing Peptide Receptor Radionuclide Therapy

et al. 2018

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“…In that context, the appeal of any single parameter that could complement tumor volume to further characterize functional tumor uptakes from PET images and can be relatively quickly implemented in clinical practice is strong. The shape descriptor sphericity has been recently highlighted as one such new measure that could provide complementary prognostic value for patients stratification in both H&N and NSCLC [7][8][9][10]. In addition, it could be also considered as indirectly quantifying uptake heterogeneity.…”

Section: Discussionmentioning

confidence: 99%

“…The use of a 3D shape descriptor named asphericity has been proposed to indirectly assess uptake heterogeneity in FDG PET images with prognostic value in both head and neck and non-small cell lung cancer (NSCLC) [7][8][9]. It was also shown to be correlated with underlying histopathological features and molecular markers [10].…”

Section: Introductionmentioning

confidence: 99%

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Tumour functional sphericity from PET images: prognostic value in NSCLC and impact of delineation method

Hatt

Laurent

Fayad

et al. 2017

Eur J Nucl Med Mol Imaging

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Tumour functional sphericity was found to be dependent on the segmentation method, although the accuracy in retrieving the true sphericity was not dependent on tumour volume. In addition, even accurate segmentation can lead to an inaccurate sphericity value, and vice versa. Sphericity had similar or lower prognostic value than volume alone in the patients with lung cancer, except when determined using the FLAB method for which there was a small improvement in stratification when the parameters were combined.

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“…Among parameters from positron emission tomography/computed tomography with [ 18 F] uorodeoxyglucose (FDG-PET/CT), asphericity (ASP) is a parameter that re ects shape irregularity of the primary tumor's metabolic tumor volume (MTV), combining metric and metabolic features of the primary tumor. Three retrospective studies con rmed its independent prognostic value for progression-free (PFS) and overall survival (OS) in patients with NSCLC (13)(14)(15). The largest study (311 patients, UICC stage I-III) further showed that ASP, with an optimal cut-off of > 19.5%, could identify patients with UICC stage II treated by surgery and adjuvant chemotherapy with high ASP and reduced PFS (median, 11 months vs. not reached) and OS (22 months vs. not reached) (15).…”

Section: Introductionmentioning

confidence: 99%

Asphericity of Tumor FDG Uptake in Non-Small Cell Lung Cancer: Reproducibility and Implications for Harmonization in Multicenter Studies

Rogasch

Furth

Bluemel

et al. 2020

Preprint

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Background Asphericity (ASP) of the primary tumor’s metabolic tumor volume (MTV) in FDG-PET/CT is independently predictive for survival in patients with non-small cell lung cancer (NSCLC). However, comparability between PET systems may be limited. Therefore, reproducibility of ASP was evaluated at varying image reconstruction and acquisition times to assess feasibility of ASP assessment in multicenter studies. Methods Retrospective study of 50 patients with NSCLC (female, 20; median age, 69 years) undergoing pretherapeutic FDG-PET/CT (median, 3.7 MBq/kg; 180 s/bed position). Reconstruction used OSEM with TOF4/16 (iterations, 4; subsets, 16; in-plane filter, 2.0, 6.4 or 9.5 mm), TOF4/8 (4 it; 8 ss; filter, 2.0/6.0/9.5 mm), PSF + TOF2/17 (2 it; 17 ss; filter, 2.0/7.0/10.0 mm) or Bayesian penalized likelihood (Q.Clear; beta, 600/1750/4000). Resulting reconstructed spatial resolution (FWHM) was determined from hot sphere inserts of a NEMA IEC phantom. Data with approx. 5 mm FWHM were retrospectively smoothed to achieve 7 mm FWHM. List mode data were rebinned for acquisition times of 120/90/60 s. Threshold-based delineation of primary tumor MTV was followed by evaluation of relative ASP/SUVmax/MTV differences between datasets and resulting proportions of discordantly classified cases. Results Reconstructed resolution for narrow/medium/wide in-plane filter (or low/medium/high beta) was approx. 5/7/9 mm FWHM. Comparing different pairs of reconstructed resolution between TOF4/8, PSF + TOF2/17, Q.Clear and the reference algorithm TOF4/16, ASP differences were lowest at FWHM of 7 vs. 7 mm. Proportions of discordant cases (ASP > 19.5% vs. ≤19.5%) were also lowest at 7 mm (TOF4/8, 2%; PSF + TOF2/17, 4%; Q.Clear, 10%). Smoothing of 5 mm data to 7 mm FWHM significantly reduced discordant cases (TOF4/8, 38% reduced to 2%; PSF + TOF2/17, 12–4%; Q.Clear, 10–6%) resulting in proportions comparable to original 7 mm data. Shorter acquisition time only increased proportions of discordant cases at < 90 s. Conclusions ASP differences were mainly determined by reconstructed spatial resolution, and multicenter studies should aim at comparable FWHM (e.g., 7 mm; determined by in-plane filter width). This reduces discordant cases (high vs. low ASP) to an acceptable proportion for TOF and PSF + TOF of < 5% (Q.Clear: 10%). Data with better resolution (i.e. lower FWHM) could be retrospectively smoothed to the desired FWHM resulting in a comparable number of discordant cases.

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The asphericity of the metabolic tumour volume in NSCLC: correlation with histopathology and molecular markers

Abstract: The ASP of primary NSCLCs on FDG PET images is associated with tumour dimensions and molecular markers of proliferation and angiogenesis.

Cited by 50 publications

References 40 publications

Pre-therapy Somatostatin Receptor-Based Heterogeneity Predicts Overall Survival in Pancreatic Neuroendocrine Tumor Patients Undergoing Peptide Receptor Radionuclide Therapy

Pre-therapy Somatostatin Receptor-Based Heterogeneity Predicts Overall Survival in Pancreatic Neuroendocrine Tumor Patients Undergoing Peptide Receptor Radionuclide Therapy

Tumour functional sphericity from PET images: prognostic value in NSCLC and impact of delineation method

Asphericity of Tumor FDG Uptake in Non-Small Cell Lung Cancer: Reproducibility and Implications for Harmonization in Multicenter Studies

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