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International Benchmark for Total Metabolic Tumor Volume Measurement in Baseline 18 F-FDG PET/CT of Lymphoma Patients: A Milestone Toward Clinical Implementation

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  • Additional Information
    • Contributors:
      Amsterdam University Medical Centers (Amsterdam UMC); Cancer Center Amsterdam; Laboratoire d'Imagerie Translationnelle en Oncologie (LITO); Institut Curie Paris -Institut National de la Santé et de la Recherche Médicale (INSERM); Università della Svizzera italiana = University of Italian Switzerland (USI); Swiss Neuroradiology Institute Zurich, Suisse (SNRI); Institute Of Oncology Research Bellinzona, Switzerland (IOL); Université Paris Cité (UPCité); Hôpital Cochin AP-HP; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP); Fondazione IRCCS San Gerardo dei Tintori Monza, Italy; Università degli Studi di Milano-Bicocca = University of Milano-Bicocca (UNIMIB); University of Melbourne; St. Vincent's Hospital, Sydney; Centre de Recherches en Cancérologie de Toulouse (CRCT); Université Toulouse III - Paul Sabatier (UT3); Communauté d'universités et établissements de Toulouse (Comue de Toulouse)-Communauté d'universités et établissements de Toulouse (Comue de Toulouse)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS); University Hospital of Cologne Cologne; Copenhagen University Hospital Denmark = Københavns Universitetshospital Danmark (KUH); Memorial Sloan Kettering Cancer Center (MSKCC); Azienda Unità Sanitaria Locale della Romagna (AUSL della Romagna); Guy's and St Thomas' Hospital London; King‘s College London; Centre de Lutte contre le Cancer Antoine Lacassagne Nice (UNICANCER/CAL); UNICANCER-Université Côte d'Azur (UniCA); Aalborg Universitetshospital - Aalborg University Hospital Aalborg (AUH); Odense University Hospital (OUH); West German Cancer Center Essen, Germany; University Hospital Essen (AöR); Universität Duisburg-Essen = University of Duisburg-Essen Essen; Santa Croce e Carle Hospital Cuneo, Italy; The Lymphoma Academic Research Organisation Lyon (LYSARC); Centre Hospitalier Lyon Sud CHU - HCL (CHLS); Hospices Civils de Lyon (HCL); Oncology Institute of Southern Switzerland (IOSI); Imaging Science and Biomedical Engineering, School of Cancer and Imaging Sciences; University of Manchester Manchester
    • Publication Information:
      CCSD
      Society of Nuclear Medicine
    • Publication Date:
      2024
    • Collection:
      HAL Université Côte d'Azur
    • Abstract:
      International audience ; Total metabolic tumor volume (TMTV) is prognostic in lymphoma. However, cutoff values for risk stratification vary markedly, according to the tumor delineation method used. We aimed to create a standardized TMTV benchmark dataset allowing TMTV to be tested and applied as a reproducible biomarker. Methods: Sixty baseline 18F-FDG PET/CT scans were identified with a range of disease distributions (20 follicular, 20 Hodgkin, and 20 diffuse large B-cell lymphoma). TMTV was measured by 12 nuclear medicine experts, each analyzing 20 cases split across subtypes, with each case processed by 3-4 readers. LIFEx or ACCURATE software was chosen according to reader preference. Analysis was performed stepwise: TMTV1 with automated preselection of lesions using an SUV of at least 4 and a volume of at least 3 cm3 with single-click removal of physiologic uptake; TMTV2 with additional removal of reactive bone marrow and spleen with single clicks; TMTV3 with manual editing to remove other physiologic uptake, if required; and TMTV4 with optional addition of lesions using mouse clicks with an SUV of at least 4 (no volume threshold). Results: The final TMTV (TMTV4) ranged from 8 to 2,288 cm3, showing excellent agreement among all readers in 87% of cases (52/60) with a difference of less than 10% or less than 10 cm3 In 70% of the cases, TMTV4 equaled TMTV1, requiring no additional reader interaction. Differences in the TMTV4 were exclusively related to reader interpretation of lesion inclusion or physiologic high-uptake region removal, not to the choice of software. For 5 cases, large TMTV differences (>25%) were due to disagreement about inclusion of diffuse splenic uptake. Conclusion: The proposed segmentation method enabled highly reproducible TMTV measurements, with minimal reader interaction in 70% of the patients. The inclusion or exclusion of diffuse splenic uptake requires definition of specific criteria according to lymphoma subtype. The publicly available proposed benchmark allows comparison of ...
    • Relation:
      info:eu-repo/semantics/altIdentifier/pmid/39089812; PUBMED: 39089812; PUBMEDCENTRAL: PMC11372260
    • Accession Number:
      10.2967/jnumed.124.267789
    • Online Access:
      https://inserm.hal.science/inserm-04783144
      https://inserm.hal.science/inserm-04783144v1/document
      https://inserm.hal.science/inserm-04783144v1/file/1343.full.pdf
      https://doi.org/10.2967/jnumed.124.267789
    • Rights:
      https://creativecommons.org/licenses/by/4.0/ ; info:eu-repo/semantics/OpenAccess
    • Accession Number:
      edsbas.70849D1