Optimization of diagnostic performance for differentiation of recurrence from radiation necrosis in patients with metastatic brain tumors using tumor volume-corrected 11C-methionine uptake
Abstract Background Tumor to normal tissue ratio (T/N ratio) on 11C-methionine (11C-MET) positron emission tomography/computed tomography (PET/CT) is affected by variable factors. We investigated whether T/N ratio cutoff values corrected according to metabolic tumor volume (MTV) could improve the di...
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| Format: | Article |
| Language: | English |
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SpringerOpen
2017-05-01
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| Series: | EJNMMI Research |
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| Online Access: | http://link.springer.com/article/10.1186/s13550-017-0293-0 |
| _version_ | 1818323849456910336 |
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| author | Tae-Young Jung In-Young Kim Sa-Hoe Lim Ki Seong Park Dong-Yeon Kim Shin Jung Kyung-Sub Moon Woo-Youl Jang Sae-Ryung Kang Sang-Geon Cho Jung-Joon Min Hee-Seung Bom Seong Young Kwon |
| author_facet | Tae-Young Jung In-Young Kim Sa-Hoe Lim Ki Seong Park Dong-Yeon Kim Shin Jung Kyung-Sub Moon Woo-Youl Jang Sae-Ryung Kang Sang-Geon Cho Jung-Joon Min Hee-Seung Bom Seong Young Kwon |
| author_sort | Tae-Young Jung |
| collection | DOAJ |
| description | Abstract Background Tumor to normal tissue ratio (T/N ratio) on 11C-methionine (11C-MET) positron emission tomography/computed tomography (PET/CT) is affected by variable factors. We investigated whether T/N ratio cutoff values corrected according to metabolic tumor volume (MTV) could improve the diagnostic performance of 11C-MET PET/CT for diagnosis of recurrence in patients with metastatic brain tumor. Forty-eight patients with metastatic brain tumors underwent 11C-MET PET/CT for differential diagnosis between recurrence and radiation necrosis after gamma knife radiosurgery (GKR). Both T/N ratio and MTV were estimated in each lesion on 11C-MET PET/CT. The lesions were classified into three groups based on MTV criteria (≤ 0.5 cm3; > 0.5, ≤ 4.0 cm3; and > 4.0 cm3). The optimal cutoff values of the T/N ratio from receiver operating characteristic (ROC) curve were determined in each group (MTV-corrected) as well as total lesions (non-corrected). Finally, diagnostic performance of 11C-MET PET/CT was compared with the MTV-corrected cutoff values. Results Among 77 lesions, 51 were diagnosed with recurrence. The mean T/N ratio was 2.25 (± 1.12) for recurrent lesions and 1.44 (± 0.22) for radiation necrosis (P < 0.001). T/N ratio of 1.61 (non-corrected) provided the best sensitivity, specificity, and diagnostic accuracy (70.6, 80.8, and 74.0%, respectively). Using the MTV criteria, optimal cutoff values of the T/N ratios in each group were 1.23 (MTV ≤ 0.5 cm3), 1.54 (0.5 cm3 < MTV ≤ 4.0 cm3), and 1.85 (MTV > 4.0 cm3). In small-sized lesions (MTV ≤ 0.5 cm3), MTV-corrected cutoff values (1.23) could maintain favorable diagnostic performance with sensitivity, specificity, and diagnostic accuracy (70.0, 80.0, and 73.3%, respectively), compared to non-corrected cutoff values. Conclusions MTV-corrected cutoff values of T/N ratio could maintain the diagnostic performance of 11C-MET PET/CT in small sized, metastatic brain tumors. We expect our results to contribute to reproducible and standardized interpretation of 11C-MET PET/CT. |
| first_indexed | 2024-12-13T11:19:14Z |
| format | Article |
| id | doaj.art-fa40f4657ed94916b6b0e58b1378b623 |
| institution | Directory Open Access Journal |
| issn | 2191-219X |
| language | English |
| last_indexed | 2024-12-13T11:19:14Z |
| publishDate | 2017-05-01 |
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| series | EJNMMI Research |
| spelling | doaj.art-fa40f4657ed94916b6b0e58b1378b6232022-12-21T23:48:33ZengSpringerOpenEJNMMI Research2191-219X2017-05-01711610.1186/s13550-017-0293-0Optimization of diagnostic performance for differentiation of recurrence from radiation necrosis in patients with metastatic brain tumors using tumor volume-corrected 11C-methionine uptakeTae-Young Jung0In-Young Kim1Sa-Hoe Lim2Ki Seong Park3Dong-Yeon Kim4Shin Jung5Kyung-Sub Moon6Woo-Youl Jang7Sae-Ryung Kang8Sang-Geon Cho9Jung-Joon Min10Hee-Seung Bom11Seong Young Kwon12Department of Neurosurgery, Chonnam National University Hwasun HospitalDepartment of Neurosurgery, Chonnam National University Hwasun HospitalDepartment of Neurosurgery, Chonnam National University Hwasun HospitalDepartment of Nuclear Medicine, Chonnam National University Hwasun HospitalDepartment of Nuclear Medicine, Chonnam National University Hwasun HospitalDepartment of Neurosurgery, Chonnam National University Hwasun HospitalDepartment of Neurosurgery, Chonnam National University Hwasun HospitalDepartment of Neurosurgery, Chonnam National University Hwasun HospitalDepartment of Nuclear Medicine, Chonnam National University Hwasun HospitalDepartment of Nuclear Medicine, Chonnam National University Hwasun HospitalDepartment of Nuclear Medicine, Chonnam National University Hwasun HospitalDepartment of Nuclear Medicine, Chonnam National University Hwasun HospitalDepartment of Nuclear Medicine, Chonnam National University Hwasun HospitalAbstract Background Tumor to normal tissue ratio (T/N ratio) on 11C-methionine (11C-MET) positron emission tomography/computed tomography (PET/CT) is affected by variable factors. We investigated whether T/N ratio cutoff values corrected according to metabolic tumor volume (MTV) could improve the diagnostic performance of 11C-MET PET/CT for diagnosis of recurrence in patients with metastatic brain tumor. Forty-eight patients with metastatic brain tumors underwent 11C-MET PET/CT for differential diagnosis between recurrence and radiation necrosis after gamma knife radiosurgery (GKR). Both T/N ratio and MTV were estimated in each lesion on 11C-MET PET/CT. The lesions were classified into three groups based on MTV criteria (≤ 0.5 cm3; > 0.5, ≤ 4.0 cm3; and > 4.0 cm3). The optimal cutoff values of the T/N ratio from receiver operating characteristic (ROC) curve were determined in each group (MTV-corrected) as well as total lesions (non-corrected). Finally, diagnostic performance of 11C-MET PET/CT was compared with the MTV-corrected cutoff values. Results Among 77 lesions, 51 were diagnosed with recurrence. The mean T/N ratio was 2.25 (± 1.12) for recurrent lesions and 1.44 (± 0.22) for radiation necrosis (P < 0.001). T/N ratio of 1.61 (non-corrected) provided the best sensitivity, specificity, and diagnostic accuracy (70.6, 80.8, and 74.0%, respectively). Using the MTV criteria, optimal cutoff values of the T/N ratios in each group were 1.23 (MTV ≤ 0.5 cm3), 1.54 (0.5 cm3 < MTV ≤ 4.0 cm3), and 1.85 (MTV > 4.0 cm3). In small-sized lesions (MTV ≤ 0.5 cm3), MTV-corrected cutoff values (1.23) could maintain favorable diagnostic performance with sensitivity, specificity, and diagnostic accuracy (70.0, 80.0, and 73.3%, respectively), compared to non-corrected cutoff values. Conclusions MTV-corrected cutoff values of T/N ratio could maintain the diagnostic performance of 11C-MET PET/CT in small sized, metastatic brain tumors. We expect our results to contribute to reproducible and standardized interpretation of 11C-MET PET/CT.http://link.springer.com/article/10.1186/s13550-017-0293-011C-methionine PET/CTMetabolic tumor volumeMetastatic brain tumorRecurrenceRadiation necrosis |
| spellingShingle | Tae-Young Jung In-Young Kim Sa-Hoe Lim Ki Seong Park Dong-Yeon Kim Shin Jung Kyung-Sub Moon Woo-Youl Jang Sae-Ryung Kang Sang-Geon Cho Jung-Joon Min Hee-Seung Bom Seong Young Kwon Optimization of diagnostic performance for differentiation of recurrence from radiation necrosis in patients with metastatic brain tumors using tumor volume-corrected 11C-methionine uptake EJNMMI Research 11C-methionine PET/CT Metabolic tumor volume Metastatic brain tumor Recurrence Radiation necrosis |
| title | Optimization of diagnostic performance for differentiation of recurrence from radiation necrosis in patients with metastatic brain tumors using tumor volume-corrected 11C-methionine uptake |
| title_full | Optimization of diagnostic performance for differentiation of recurrence from radiation necrosis in patients with metastatic brain tumors using tumor volume-corrected 11C-methionine uptake |
| title_fullStr | Optimization of diagnostic performance for differentiation of recurrence from radiation necrosis in patients with metastatic brain tumors using tumor volume-corrected 11C-methionine uptake |
| title_full_unstemmed | Optimization of diagnostic performance for differentiation of recurrence from radiation necrosis in patients with metastatic brain tumors using tumor volume-corrected 11C-methionine uptake |
| title_short | Optimization of diagnostic performance for differentiation of recurrence from radiation necrosis in patients with metastatic brain tumors using tumor volume-corrected 11C-methionine uptake |
| title_sort | optimization of diagnostic performance for differentiation of recurrence from radiation necrosis in patients with metastatic brain tumors using tumor volume corrected 11c methionine uptake |
| topic | 11C-methionine PET/CT Metabolic tumor volume Metastatic brain tumor Recurrence Radiation necrosis |
| url | http://link.springer.com/article/10.1186/s13550-017-0293-0 |
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