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The Impact of Semiautomatic Segmentation Methods on Metabolic Tumor Volume, Intensity, and Dissemination Radiomics in 18F-FDG PET Scans of Patients with Classical Hodgkin Lymphoma
The Journal of Nuclear Medicine ( IF 9.3 ) Pub Date : 2022-09-01 , DOI: 10.2967/jnumed.121.263067
Julia Driessen 1 , Gerben J C Zwezerijnen 2 , Heiko Schöder 3 , Esther E E Drees 4 , Marie José Kersten 1 , Alison J Moskowitz 5 , Craig H Moskowitz 6 , Jakoba J Eertink 7 , Henrica C W de Vet 8 , Otto S Hoekstra 2 , Josée M Zijlstra 7 , Ronald Boellaard 9
Affiliation  

Consensus about a standard segmentation method to derive metabolic tumor volume (MTV) in classical Hodgkin lymphoma (cHL) is lacking, and it is unknown how different segmentation methods influence quantitative PET features. Therefore, we aimed to evaluate the delineation and completeness of lesion selection and the need for manual adaptation with different segmentation methods, and to assess the influence of segmentation methods on the prognostic value of MTV, intensity, and dissemination radiomics features in cHL patients. Methods: We analyzed a total of 105 18F-FDG PET/CT scans from patients with newly diagnosed (n = 35) and relapsed/refractory (n = 70) cHL with 6 segmentation methods: 2 fixed thresholds on SUV4.0 and SUV2.5, 2 relative methods of 41% of SUVmax (41max) and a contrast-corrected 50% of SUVpeak (A50P), and 2 combination majority vote (MV) methods (MV2, MV3). Segmentation quality was assessed by 2 reviewers on the basis of predefined quality criteria: completeness of selection, the need for manual adaptation, and delineation of lesion borders. Correlations and prognostic performance of resulting radiomics features were compared among the methods. Results: SUV4.0 required the least manual adaptation but tended to underestimate MTV and often missed small lesions with low 18F-FDG uptake. SUV2.5 most frequently included all lesions but required minor manual adaptations and generally overestimated MTV. In contrast, few lesions were missed when using 41max, A50P, MV2, and MV3, but these segmentation methods required extensive manual adaptation and overestimated MTV in most cases. MTV and dissemination features significantly differed among the methods. However, correlations among methods were high for MTV and most intensity and dissemination features. There were no significant differences in prognostic performance for all features among the methods. Conclusion: A high correlation existed between MTV, intensity, and most dissemination features derived with the different segmentation methods, and the prognostic performance is similar. Despite frequently missing small lesions with low 18F-FDG avidity, segmentation with a fixed threshold of SUV4.0 required the least manual adaptation, which is critical for future research and implementation in clinical practice. However, the importance of small, low 18F-FDG–avidity lesions should be addressed in a larger cohort of cHL patients.



中文翻译:

半自动分割方法对经典霍奇金淋巴瘤患者 18F-FDG PET 扫描中代谢肿瘤体积、强度和扩散放射组学的影响

缺乏关于在经典霍奇金淋巴瘤 (cHL) 中推导代谢肿瘤体积 (MTV) 的标准分割方法的共识,并且不知道不同的分割方法如何影响定量 PET 特征。因此,我们旨在评估病灶选择的描述和完整性以及使用不同分割方法进行手动调整的必要性,并评估分割方法对 cHL 患者的 MTV、强度和传播放射组学特征的预后价值的影响。方法:我们分析了来自新诊断(n = 35)和复发/难治性n= 70) cHL 具有 6 种分割方法:SUV4.0 和 SUV2.5 上的 2 个固定阈值,41% SUV 最大值( 41max) 和对比校正 50% SUV峰值(A50P) 的相对方法,以及 2 种组合多数表决 (MV) 方法(MV2、MV3)。分割质量由 2 位评审员根据预定义的质量标准进行评估:选择的完整性、手动调整的需要以及病变边界的描绘。在这些方法中比较了所得放射组学特征的相关性和预后表现。结果: SUV4.0 需要最少的手动适应,但往往会低估 MTV,并且经常错过低18的小病灶F-FDG 吸收。SUV2.5 最常包括所有病变,但需要较小的手动调整,并且通常高估了 MTV。相比之下,使用 41max、A50P、MV2 和 MV3 时几乎没有遗漏病变,但这些分割方法在大多数情况下需要大量的手动调整和高估 MTV。MTV 和传播特征在这些方法之间存在显着差异。然而,对于 MTV 和大多数强度和传播特征,方法之间的相关性很高。这些方法的所有特征在预后表现上没有显着差异。结论: MTV、强度和不同分割方法得到的大多数传播特征之间存在高度相关性,预后性能相似。尽管经常漏掉低度的小病灶18F -FDG 亲和力,固定阈值 SUV4.0 的分割需要最少的手动调整,这对于未来的研究和临床实践的实施至关重要。然而,小的、低18 F-FDG 亲和力病变的重要性应该在更大的 cHL 患者队列中得到解决。

更新日期:2022-09-01
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