A method to improve the semi-quantification of 18F-fluorodeoxyglucose uptake : reliability of the estimated lean body mass using a limited field of acquisition, low dose CT from PET/CT.

A method to improve the semi-quantification of 18F-fluorodeoxyglucose uptake : reliability of the estimated lean body mass using a limited field of acquisition, low dose CT from PET/CT.

J Nucl Med. 2015 Dec 30;

Authors: Decazes P, Métivier D, Rouquette A, Talbot JN, Kerrou K

Abstract
The Standardized Uptake Lean mass (SUL), calculated using lean body mass (LBM), is essential for the semiquantification of (18)F-fluorodeoxyglucose (FDG) uptake using Positron Emission Tomography coupled with Computed Tomography (PET/CT) to avoid a bias linked to the adipose mass. It allows evaluating a response to therapy according the PET response criteria in solid tumors (PERCIST) 1.0. The aim of this study was to evaluate the reliability of a method for the estimation of the LBM using the data of the low-dose CT from PET/CT acquired over standard acquisition fields (from skull base to ischia, from vertex to ischia, from skull base to mid-thigh, from vertex to mid-thigh).
METHODS: We wrote an automated program which determined the LBM from a CT with limited fields of acquisition and applied this method in a large (184 patients) and heterogeneous population. Its results were compared with the measurement of LBM from whole body CT (reference standard) and the results of 5 predictive equations described in the literature.
RESULTS: The results of LBM measurement evaluated with this technique were much closer to the reference standard than those obtained by the mathematical formulas. The Intraclass Correlations (ICC) of this technique compared to the reference standard were excellent (the best ICC being obtained for the largest acquisition field, from vertex to mid-thigh : ICC 0.994, IC 95% [0.992-0.995], P < 0.0001), much better than the ICC obtained with the mathematical formulas (the best ICC for a mathematical formula was 0.841, CI 95% [0.714;0.903], P < 0.0001). Moreover, the analysis with the Bland-Altman plot showed that the differences in mean lean masses between the studied technique and the reference standard was the smallest for the proposed technique (for the largest acquisition field, mean difference 0.2 kg with the narrowest 95% CI [-1.8 to 2.2 kg]).
CONCLUSION: This technique could be easily implemented on computers used in practice to allow a more reliable assessment of the SUL in clinical practice notably for the therapeutic evaluations following PERCIST 1.0.

PMID: 26719376 [PubMed - as supplied by publisher]

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