title: Reproducibility of tumor uptake heterogeneity characterization through textural feature analysis in 18F-FDG PET.
abstract: (18)F-FDG PET measurement of standardized uptake value (SUV) is increasingly used for monitoring therapy response and predicting outcome. Alternative parameters computed through textural analysis were recently proposed to quantify the heterogeneity of tracer uptake by tumors as a significant predictor of response. The primary objective of this study was to evaluate the reproducibility of these heterogeneity measurements.
  
  
  METHODS
  Double baseline (18)F-FDG PET scans were acquired within 4 d of each other for 16 patients before any treatment was considered. A Bland-Altman analysis was performed on 8 parameters based on histogram measurements and 17 parameters based on textural heterogeneity features after discretization with values between 8 and 128.
  
  
  RESULTS
  The reproducibility of maximum and mean SUV was similar to that in previously reported studies, with a mean percentage difference of 4.7% ± 19.5% and 5.5% ± 21.2%, respectively. By comparison, better reproducibility was measured for some textural features describing local heterogeneity of tracer uptake, such as entropy and homogeneity, with a mean percentage difference of -2% ± 5.4% and 1.8% ± 11.5%, respectively. Several regional heterogeneity parameters such as variability in the intensity and size of regions of homogeneous activity distribution had reproducibility similar to that of SUV measurements, with 95% confidence intervals of -22.5% to 3.1% and -1.1% to 23.5%, respectively. These parameters were largely insensitive to the discretization range.
  
  
  CONCLUSIONS
  Several parameters derived from textural analysis describing heterogeneity of tracer uptake by tumors on local and regional scales had reproducibility similar to or better than that of simple SUV measurements. These reproducibility results suggest that these (18)F-FDG PET-derived parameters, which have already been shown to have predictive and prognostic value in certain cancer models, may be used to monitor therapy response and predict patient outcome.
authors.affiliation: LaTIM, INSERM UMR1101, CHRU Morvan, Brest, France. florent.tixier@univ-brest.fr
authors.forename: Florent
authors.initials: F
authors.lastname: Tixier
authors.forename: Mathieu
authors.initials: M
authors.lastname: Hatt
authors.forename: Catherine Cheze
authors.initials: CC
authors.lastname: Le Rest
authors.forename: Adrien
authors.initials: A
authors.lastname: Le Pogam
authors.forename: Laurent
authors.initials: L
authors.lastname: Corcos
authors.forename: Dimitris
authors.initials: D
authors.lastname: Visvikis
mesh_terms: D001692:Biological Transport; D004938:Esophageal Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism* / Q000628:therapy; D019788:Fluorodeoxyglucose F18 / Q000378:metabolism*; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D049268:Positron-Emission Tomography / Q000379:methods*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D019788:Fluorodeoxyglucose F18