A pilot study on lung cancer detection based on regional metabolic activity distribution in digital low-dose 18F-FDG PET

M. Messerli*, U.J. Muehlematter, S. Fassbind, D. Franzen, D.A. Ferraro, M.W. Huellner, V. Treyer, A. Curioni-Fontecedro, I.A. Burger

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Objectives To investigate the potential of automatic lung cancer detection on submillisievert dose F-18-flude-oxyglucose (F-18-FDG) scans using different positron emission tomography (PET) parameters, as a primary step towards a potential new indication for F-18-FDG PET in lung cancer screening.Methods We performed a retrospective cohort analysis with 83 patients referred for F-18-FDG PET/CT, including of 34 patients with histology-proven lung cancer and 49 patients without lung disease. Aside clinical standard PET images (PET100%) two additional low-dose PET reconstructions were generated, using only 15 s and 5 s of the 150 s list mode raw data of the full-dose PET, corresponding to 10% and 3.3% of the original F-18-FDG activity. The lungs were subdivided into three segments on each side, and each segment was classified as normal or containing cancer. The following standardized uptake values (SUVs) were extracted from PET per lung segment: SUVmean, SUVhot5, SUVmedian, SUVstd and SUVtotal. A multivariate linear regression model was used and cross-validated. The accuracy for lung cancer detection was tested with receiver operating characteristics analysis and T-statistics was used to calculate the weight of each parameter.Results The T-statistics showed that SUVstd was the most important discriminative factor for lung cancer detection. The multivariate model achieved an area under the curve of 0.97 for full-dose PET, 0.85 for PET10% with PET3.3% reconstructions resulting in a still high sensitivity the PET10% reconstruction of 80%.Conclusion This pilot study indicates that segment-based, quantitative PET parameters of low-dose PET reconstructions could be used to automatically detect lung cancer with high sensitivity.Advances in knowledge Automated assessment of PET parameters in low-dose PET may aid for an early detection of lung cancer.
Original languageEnglish
Article number20200244
Number of pages6
JournalBritish Journal of Radiology
Volume94
Issue number1119
DOIs
Publication statusPublished - 2021

Keywords

  • POSITRON-EMISSION-TOMOGRAPHY
  • PULMONARY NODULE
  • F-18-FDG PET
  • FDG-PET/CT

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