Measuring Total Metabolic Tumor Volume from 18F-FDG PET: A Reality Check

Ronald Boellaard; Gerben J C Zwezerijnen; Irène Buvat; Laurence Champion; Narinée Hovhannisyan-Baghdasarian; Fanny Orlhac; Anne I J Arens; Daphne Lobeek; Filiz Celik; Cristina Mitea; Julia E Huijbregts; Nelleke Tolboom; Bart de Keizer; Roelf Valkema; Floris H P van Velden; Petra Dibbets-Schneider; Sanne E Wiegers; Pieternella J Lugtenburg; Sally F Barrington; Josée M Zijlstra

doi:10.2967/jnumed.124.269271

Measuring Total Metabolic Tumor Volume from 18F-FDG PET: A Reality Check

Ronald Boellaard^*, Gerben J C Zwezerijnen, Irène Buvat, Laurence Champion, Narinée Hovhannisyan-Baghdasarian, Fanny Orlhac, Anne I J Arens, Daphne Lobeek, Filiz Celik, Cristina Mitea, Julia E Huijbregts, Nelleke Tolboom, Bart de Keizer, Roelf Valkema, Floris H P van Velden, Petra Dibbets-Schneider, Sanne E Wiegers, Pieternella J Lugtenburg, Sally F Barrington, Josée M Zijlstra

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Measuring total metabolic tumor volume (TMTV) on F-FDG PET/CT images in clinical practice requires a fast, reliable, and easy-to-perform multilesional segmentation workflow. We conducted a field test to derive total metabolic volumes using 5 representative baseline F-FDG PET/CT scans from patients with diffuse large B-cell lymphoma. The scans were transferred to 10 different sites or readers who used different commercially available software platforms to derive TMTV after a recently proposed benchmark workflow. Observed TMTVs were compared with reference values, and overall analysis times were reported. Our results show that TMTVs can be obtained with reasonable accuracy across readers and platforms (within 10% compared with reference benchmark values for most TMTVs) but that processing times can vary considerably depending on reader experience and the software platform. Our study showed that there is an urgent need to improve TMTV segmentation workflows in clinical practice, requiring closer collaboration between users and software vendors.

Original language	English
Journal	Journal of Nuclear Medicine
DOIs	https://doi.org/10.2967/jnumed.124.269271
Publication status	E-pub ahead of print - 13 Mar 2025

Keywords

TMTV
field test
performance
total metabolic tumor volume
workflow

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10.2967/jnumed.124.269271

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Boellaard, R., Zwezerijnen, G. J. C., Buvat, I., Champion, L., Hovhannisyan-Baghdasarian, N., Orlhac, F., Arens, A. I. J., Lobeek, D., Celik, F., Mitea, C., Huijbregts, J. E., Tolboom, N., de Keizer, B., Valkema, R., van Velden, F. H. P., Dibbets-Schneider, P., Wiegers, S. E., Lugtenburg, P. J., Barrington, S. F., & Zijlstra, J. M. (2025). Measuring Total Metabolic Tumor Volume from 18F-FDG PET: A Reality Check. Journal of Nuclear Medicine. Advance online publication. https://doi.org/10.2967/jnumed.124.269271

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title = "Measuring Total Metabolic Tumor Volume from 18F-FDG PET: A Reality Check",

abstract = "Measuring total metabolic tumor volume (TMTV) on F-FDG PET/CT images in clinical practice requires a fast, reliable, and easy-to-perform multilesional segmentation workflow. We conducted a field test to derive total metabolic volumes using 5 representative baseline F-FDG PET/CT scans from patients with diffuse large B-cell lymphoma. The scans were transferred to 10 different sites or readers who used different commercially available software platforms to derive TMTV after a recently proposed benchmark workflow. Observed TMTVs were compared with reference values, and overall analysis times were reported. Our results show that TMTVs can be obtained with reasonable accuracy across readers and platforms (within 10% compared with reference benchmark values for most TMTVs) but that processing times can vary considerably depending on reader experience and the software platform. Our study showed that there is an urgent need to improve TMTV segmentation workflows in clinical practice, requiring closer collaboration between users and software vendors.",

keywords = "TMTV, field test, performance, total metabolic tumor volume, workflow",

author = "Ronald Boellaard and Zwezerijnen, {Gerben J C} and Ir{\`e}ne Buvat and Laurence Champion and Narin{\'e}e Hovhannisyan-Baghdasarian and Fanny Orlhac and Arens, {Anne I J} and Daphne Lobeek and Filiz Celik and Cristina Mitea and Huijbregts, {Julia E} and Nelleke Tolboom and {de Keizer}, Bart and Roelf Valkema and {van Velden}, {Floris H P} and Petra Dibbets-Schneider and Wiegers, {Sanne E} and Lugtenburg, {Pieternella J} and Barrington, {Sally F} and Zijlstra, {Jos{\'e}e M}",

year = "2025",

month = mar,

day = "13",

doi = "10.2967/jnumed.124.269271",

language = "English",

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Boellaard, R, Zwezerijnen, GJC, Buvat, I, Champion, L, Hovhannisyan-Baghdasarian, N, Orlhac, F, Arens, AIJ, Lobeek, D, Celik, F, Mitea, C, Huijbregts, JE, Tolboom, N, de Keizer, B, Valkema, R, van Velden, FHP, Dibbets-Schneider, P, Wiegers, SE, Lugtenburg, PJ, Barrington, SF & Zijlstra, JM 2025, 'Measuring Total Metabolic Tumor Volume from 18F-FDG PET: A Reality Check', Journal of Nuclear Medicine. https://doi.org/10.2967/jnumed.124.269271

TY - JOUR

T1 - Measuring Total Metabolic Tumor Volume from 18F-FDG PET

T2 - A Reality Check

AU - Boellaard, Ronald

AU - Zwezerijnen, Gerben J C

AU - Buvat, Irène

AU - Champion, Laurence

AU - Hovhannisyan-Baghdasarian, Narinée

AU - Orlhac, Fanny

AU - Arens, Anne I J

AU - Lobeek, Daphne

AU - Celik, Filiz

AU - Mitea, Cristina

AU - Huijbregts, Julia E

AU - Tolboom, Nelleke

AU - de Keizer, Bart

AU - Valkema, Roelf

AU - van Velden, Floris H P

AU - Dibbets-Schneider, Petra

AU - Wiegers, Sanne E

AU - Lugtenburg, Pieternella J

AU - Barrington, Sally F

AU - Zijlstra, Josée M

PY - 2025/3/13

Y1 - 2025/3/13

N2 - Measuring total metabolic tumor volume (TMTV) on F-FDG PET/CT images in clinical practice requires a fast, reliable, and easy-to-perform multilesional segmentation workflow. We conducted a field test to derive total metabolic volumes using 5 representative baseline F-FDG PET/CT scans from patients with diffuse large B-cell lymphoma. The scans were transferred to 10 different sites or readers who used different commercially available software platforms to derive TMTV after a recently proposed benchmark workflow. Observed TMTVs were compared with reference values, and overall analysis times were reported. Our results show that TMTVs can be obtained with reasonable accuracy across readers and platforms (within 10% compared with reference benchmark values for most TMTVs) but that processing times can vary considerably depending on reader experience and the software platform. Our study showed that there is an urgent need to improve TMTV segmentation workflows in clinical practice, requiring closer collaboration between users and software vendors.

AB - Measuring total metabolic tumor volume (TMTV) on F-FDG PET/CT images in clinical practice requires a fast, reliable, and easy-to-perform multilesional segmentation workflow. We conducted a field test to derive total metabolic volumes using 5 representative baseline F-FDG PET/CT scans from patients with diffuse large B-cell lymphoma. The scans were transferred to 10 different sites or readers who used different commercially available software platforms to derive TMTV after a recently proposed benchmark workflow. Observed TMTVs were compared with reference values, and overall analysis times were reported. Our results show that TMTVs can be obtained with reasonable accuracy across readers and platforms (within 10% compared with reference benchmark values for most TMTVs) but that processing times can vary considerably depending on reader experience and the software platform. Our study showed that there is an urgent need to improve TMTV segmentation workflows in clinical practice, requiring closer collaboration between users and software vendors.

KW - TMTV

KW - field test

KW - performance

KW - total metabolic tumor volume

KW - workflow

U2 - 10.2967/jnumed.124.269271

DO - 10.2967/jnumed.124.269271

M3 - Article

SN - 0161-5505

JO - Journal of Nuclear Medicine

JF - Journal of Nuclear Medicine

ER -

Measuring Total Metabolic Tumor Volume from 18F-FDG PET: A Reality Check

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Keywords

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