Feasibility and performance of an adaptive contrast-oriented FDG PET/CT quantification technique for global disease assessment of malignant XXXX and a brief review of the literature.

@entity1 @entity5 @entity2615
OBJECTIVE: Treatment of malignant @entity2615 (MPM) remains very challenging. Assessment of response to treatment is necessary for modifying treatment and using new drugs. Global disease assessment (GDA) by implementing image processing methods to extract more information out of positron emission tomography (PET) images may provide reliable information. In this study we show the feasibility of this method of semi-quantification in @entity1 with @entity2615 , and compare it with the conventional methods. We also present a review of the literature about this topic. METHODS: Nineteen subjects with histologically proven MPM who had undergone fluoride-18-fluorodeoxyglucose PET/computed tomography ((18)F-FDG PET/CT) before and after treatment were included in this study. An adaptive contrast-oriented thresholding algorithm was used for the image analysis and semi-quantification. @entity5 volume (MTV), maximum and mean standardized uptake volume (SUVmax, SUVmean) and total lesion glycolysis (TLG) were calculated for each region of interest. The global @entity5 glycolysis (GTG) was obtained by summing up all TLG. Treatment response was assessed by the European Organisation for Research and Treatment of @entity5 (EORTC) criteria and the changes of GTG. Agreement between global disease assessment and conventional method was also determined. RESULTS: In @entity1 with progressive disease based on EORTC criteria, GTG showed an increase of 150.7 but in @entity1 with stable or partial response, GTG showed a decrease of 433.1. The SUVmax of @entity1 before treatment was 5.95 (SD: 2.93) and after the treatment it increased to 6.38 (SD: 3.19). Overall concordance of conventional method with GDA method was 57%. Concordance of progression of disease based on conventional method was 44%, stable disease was 85% and partial response was 33%. Discordance was 55%, 14% and 66%. CONCLUSIONS: Adaptive contrast-oriented thresholding algorithm is a promising method to quantify the whole @entity5 glycolysis in @entity1 with @entity2615 . We are able to assess the total metabolic lesion volume, lesion glycolysis, SUVmax, @entity5 SUVmean and GTG for this particular @entity5 . Also we were able to demonstrate the potential use of this technique in the monitoring of treatment response. More studies comparing this technique with conventional and other global disease assessment methods are needed in order to clarify its role in the assessment of treatment response and prognosis of these @entity1 .
