title: Feasibility and performance of novel software to quantify metabolically active volumes and 3D partial volume corrected SUV and metabolic volumetric products of spinal bone marrow metastases on 18F-FDG-PET/CT.
abstract: Our aim was to assess feasibility and performance of novel semi-automated image analysis software called ROVER to quantify metabolically active volume (MAV), maximum standardized uptake value-maximum (SUV(max)), 3D partial volume corrected mean SUV (cSUV(mean)), and 3D partial volume corrected mean MVP (cMVP(mean)) of spinal bone marrow metastases on fluorine-18 fluorodeoxyglucose-positron emission tomography/computerized tomography ((18)F-FDG-PET/CT). We retrospectively studied 16 subjects with 31 spinal metastases on FDG-PET/CT and MRI. Manual and ROVER determinations of lesional MAV and SUV(max), and repeated ROVER measurements of MAV, SUV(max), cSUV(mean) and cMVP(mean) were made. Bland-Altman and correlation analyses were performed to assess reproducibility and agreement. Our results showed that analyses of repeated ROVER measurements revealed MAV mean difference (D)=-0.03±0.53cc (95% CI(-0.22, 0.16)), lower limit of agreement (LLOA)=-1.07cc, and upper limit of agreement (ULOA)=1.01cc; SUV(max) D=0.00±0.00 with LOAs=0.00; cSUV(mean) D=-0.01±0.39 (95% CI(-0.15, 0.13)), LLOA=-0.76, and ULOA=0.75; cMVP(mean) D=-0.52±4.78cc (95% CI(-2.23, 1.23)), LLOA=-9.89cc, and ULOA=8.86cc. Comparisons between ROVER and manual measurements revealed volume D= -0.39±1.37cc (95% CI (-0.89, 0.11)), LLOA=-3.08cc, and ULOA=2.30cc; SUV(max) D=0.00±0.00 with LOAs=0.00. Mean percent increase in lesional SUV(mean) and MVP(mean) following partial volume correction using ROVER was 84.25±36.00% and 84.45±35.94% , respectively. In conclusion, it is feasible to estimate MAV, SUV(max), cSUV(mean), and cMVP(mean) of spinal bone marrow metastases from (18)F-FDG-PET/CT quickly and easily with good reproducibility via ROVER software. Partial volume correction is imperative, as uncorrected SUV(mean) and MVP(mean) are significantly underestimated, even for large lesions. This novel approach has great potential for practical, accurate, and precise combined structural-functional PET quantification of disease before and after therapeutic intervention.
authors.affiliation: Department of Radiology, Hospital of the University of Pennsylvania 3400 Spruce Street, Philadelphia, PA 19104, USA. Drew.Torigian@uphs.upenn.edu
authors.forename: Drew A
authors.initials: DA
authors.lastname: Torigian
authors.forename: Rosa Fernandez
authors.initials: RF
authors.lastname: Lopez
authors.forename: Sridevi
authors.initials: S
authors.lastname: Alapati
authors.forename: Geetha
authors.initials: G
authors.lastname: Bodapati
authors.forename: Frank
authors.initials: F
authors.lastname: Hofheinz
authors.forename: Joerg
authors.initials: J
authors.lastname: van den Hoff
authors.forename: Babak
authors.initials: B
authors.lastname: Saboury
authors.forename: Abass
authors.initials: A
authors.lastname: Alavi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001692:Biological Transport; D019046:Bone Marrow Neoplasms / Q000175:diagnosis / Q000378:metabolism* / Q000473:pathology* / Q000556:secondary; D005240:Feasibility Studies; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000378:metabolism; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D012189:Retrospective Studies; D012984:Software; D013125:Spinal Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000556:secondary*; D014057:Tomography, X-Ray Computed; D047368:Tumor Burden; D055815:Young Adult
chemical_list: D019788:Fluorodeoxyglucose F18