Toward Reliable Uptake Metrics in Large Vessel Vasculitis Studies

Praagh, Gijs D van; Nienhuis, P.H.; Jong, Daniel M de; Reijrink, Melanie; Geest, Kornelis S M van der; Brouwer, Elisabeth; Glaudemans, Andor W J M; Sinha, Bhanu; Willemsen, Antoon T. M.; Slart, Riemer H. J. A.

doi:10.3390/diagnostics11111986

Cited by 5 publications

(5 citation statements)

References 26 publications

(31 reference statements)

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“…This is because FDG was injected in proportion to the body weight, and although the body weight depends on fat, the uptake of FDG in fat is small. Lean body weight was defined according to a previous study [22].…”

Section: Discussionmentioning

confidence: 99%

Semi-automated histogram analysis of normal bone marrow using 18F-FDG PET/CT: correlation with clinical indicators

et al. 2022

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Background 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) is increasingly applied to the diagnosis of bone marrow failure such as myeloproliferative neoplasm, aplastic anemia, and myelodysplastic syndrome, as well as malignant lymphoma and multiple myeloma. However, few studies have shown a normal FDG uptake pattern. This study aimed to establish a standard of bone marrow FDG uptake by a reproducible quantitative method with fewer steps using deep learning-based organ segmentation. Methods Bone marrow PET images were obtained using segmented whole-spine and pelvic bone marrow cavity CT as mask images using a commercially available imaging workstation that implemented an automatic organ segmentation algorithm based on deep learning. The correlation between clinical indicators and quantitative PET parameters, including histogram features, was evaluated. Results A total of 98 healthy adults were analyzed. The volume of bone marrow PET extracted in men was significantly higher than that in women (p < 0.0001). Univariate and multivariate regression analyses showed that mean of standardized uptake value corrected by lean body mass (SULmean) and entropy in both men and women were inversely correlated with age (all p < 0.0001), and SULmax in women were also inversely correlated with age (p = 0.011). Conclusion A normal FDG uptake pattern was demonstrated by simplified FDG PET/CT bone marrow quantification.

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Section: Discussionmentioning

confidence: 99%

Semi-automated histogram analysis of normal bone marrow using 18F-FDG PET/CT: correlation with clinical indicators

et al. 2022

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“…The highest [ 18 F]FDG uptake measured in a maximum standardized uptake value corrected for lean body mass (SULmax) was recorded for each artery on the SAT and LAT scans. Semi-quantitative analysis also included 7 scans that were included twice, as described above [ 19 , 20 ].…”

Section: Methodsmentioning

confidence: 99%

Comparing Diagnostic Performance of Short and Long [18F]FDG-PET Acquisition Times in Giant Cell Arteritis

Nienhuis,

van Nieuwland,

van Praagh

et al. 2023

Diagnostics

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(1) Background: In giant cell arteritis (GCA), the assessment of cranial arteries using [18F]fluorodeoxyglucose ([18F]FDG) positron emission tomography (PET) combined with low-dose computed tomography (CT) may be challenging due to low image quality. This study aimed to investigate the effect of prolonged acquisition time on the diagnostic performance of [18F]FDG PET/CT in GCA. (2) Methods: Patients with suspected GCA underwent [18F]FDG-PET imaging with a short acquisition time (SAT) and long acquisition time (LAT). Two nuclear medicine physicians (NMPs) reported the presence or absence of GCA according to the overall image impression (gestalt) and total vascular score (TVS) of the cranial arteries. Inter-observer agreement and intra-observer agreement were assessed. (3) Results: In total, 38 patients were included, of whom 20 were diagnosed with GCA and 18 were without it. Sensitivity and specificity for GCA on SAT scans were 80% and 72%, respectively, for the first NMP, and 55% and 89% for the second NMP. On the LAT scans, these values were 65% and 83%, and 75% and 83%, respectively. When using the TVS, LAT scans showed especially increased specificity (94% for both NMPs). Observer agreement was higher on the LAT scans compared with that on the SAT scan. (4) Conclusions: LAT combined with the use of the TVS may decrease the number of false-positive assessments of [18F]FDG PET/CT. Additionally, LAT and TVS may increase both inter and intra-observer agreement.

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“…The SUV of a region of interest (ROI) can be averaged (SUV mean ) or the maximum determined (SUV max ). However, SUV measurements can be influenced by several factors such as the size of the volume of interest, image noise, concentration of glucose in plasma and body habitus [16]. SUV metrics were used instead of target-to-blood pool ratio as liver is a more common reference point as discussed in Section 2.3.1: In both cases, the radiomic features were extracted from the entire segmented 3D volume of the aorta in the PET image [35].…”

Section: Feature Extractionmentioning

confidence: 99%

“…SUV 90th Percentile demonstrated the most diagnostic utility from all the explored SUV metrics and did so in all three cohorts. In future work, it may be worth investigating the effect of adjusting for lean body mass rather than body weight, as is the case for SUV metrics, as the results from van Praagh et al suggest that this could be more reliable [16]. Several individual radiomic features produced high AUC values and met the minimum accuracy values.…”

Section: Multi-centre Transferabilitymentioning

confidence: 99%

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An Automated Method for Artifical Intelligence Assisted Diagnosis of Active Aortitis Using Radiomic Analysis of FDG PET-CT Images

et al. 2023

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The aim of this study was to develop and validate an automated pipeline that could assist the diagnosis of active aortitis using radiomic imaging biomarkers derived from [18F]-Fluorodeoxyglucose Positron Emission Tomography-Computed Tomography (FDG PET-CT) images. The aorta was automatically segmented by convolutional neural network (CNN) on FDG PET-CT of aortitis and control patients. The FDG PET-CT dataset was split into training (43 aortitis:21 control), test (12 aortitis:5 control) and validation (24 aortitis:14 control) cohorts. Radiomic features (RF), including SUV metrics, were extracted from the segmented data and harmonized. Three radiomic fingerprints were constructed: A—RFs with high diagnostic utility removing highly correlated RFs; B used principal component analysis (PCA); C—Random Forest intrinsic feature selection. The diagnostic utility was evaluated with accuracy and area under the receiver operating characteristic curve (AUC). Several RFs and Fingerprints had high AUC values (AUC > 0.8), confirmed by balanced accuracy, across training, test and external validation datasets. Good diagnostic performance achieved across several multi-centre datasets suggests that a radiomic pipeline can be generalizable. These findings could be used to build an automated clinical decision tool to facilitate objective and standardized assessment regardless of observer experience.

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Toward Reliable Uptake Metrics in Large Vessel Vasculitis Studies

Cited by 5 publications

References 26 publications

Semi-automated histogram analysis of normal bone marrow using 18F-FDG PET/CT: correlation with clinical indicators

Semi-automated histogram analysis of normal bone marrow using 18F-FDG PET/CT: correlation with clinical indicators

Comparing Diagnostic Performance of Short and Long [18F]FDG-PET Acquisition Times in Giant Cell Arteritis

An Automated Method for Artifical Intelligence Assisted Diagnosis of Active Aortitis Using Radiomic Analysis of FDG PET-CT Images

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