RESUMEN
OBJECTIVES: Considering the fact that the standardized uptake value (SUV) of a normal lung tissue is expressed as x±SD, x+3×SD could be considered as the threshold value to outline the internal tumor volume (ITV) of a lung neoplasm. METHODS: Three hollow models were filled with 55.0 kBq/mL fluorine-18 fluorodeoxyglucose (18F-FDG) to represent tumors. The models were fixed to a barrel filled with 5.9 kBq/mL 18F-FDG to characterize normal lung tissues as a phantom. The PET/CT images of the phantom were acquired at rest. Then, the barrel was moved periodically to simulate breathing while acquiring PET/CT data. Volume recovery coefficient (VRC) was applied to evaluate the accuracy of ITVs. For statistical analysis, paired t-test and analysis of variance were applied. RESULTS: The VRCs ranged from 0.74 to 0.98 and significantly varied among gross tumor volumes for delineating ITV (P<0.01). In two-dimensional PET scans, the motion distance did not affect VRC (P>0.05), whereas VRC decreased with increasing distance in three-dimensional PET scans (P<0.05). CONCLUSION: The threshold value (x+3×SD) had the potential to delineate the ITV of cancerous tissues, surrounded by lung tissues, particularly in two-dimensional PET images.
RESUMEN
OBJECTIVE: A scheme, named SUV_Shape, for the gross tumor volume (GTV) delineation on positron emission tomography (PET) images was designed by a numerical approximation method, and evaluated during this study. METHODS: Twenty-one vacuous plastic balls of different shapes and sizes, their volumes ranged from 0.56 to 179.50 mL and were confirmed by a BL610 balance (Sartorius, Canada), consisted of four group models. Every group model was filled with a specific activity [18F]-FDG solution (55.1, 38.2, 23.7, and 36.3 kBq/mL) represented tumor, and fixed at the bottom of a barrel which was filled with unlike [18F]-FDG solution (5.4, 6.8, 8.1, and 4.0 kBq/mL, correspondingly) represented the background. The PET data of them were acquired by two-dimensional and three-dimensional mode in a PET/CT scanner (Discovery ST8, GE Healthcare, USA). The volume of each ball was measured by SUV_Shape, and the BL610 balance, labeled as GTVs and GTVt, respectively. Five rabbits implanted VX2 squamous carcinomas were acquired by [18F]-FDG PET/CT. These rabbits were mercy killed within 24 h after PET/CT acquisition. VX2 tumors were surgically removed, and their volumes were measured by SUV_Shape, and caliper, labeled as GTVs and GTVt. The Spearman's ρ between GTVs and GTVt were done. RESULTS: The tumor-background ratios in four groups of phantom models were 10.3, 5.6, 2.9, and 9.0, respectively. The relationship between GTVt and GTVs for phantom models was significant (Spearman's ρ > 0.95, P < 0.01), regardless of the different acquisition modes. Twelve VX2 tumor nodes or masses were measured; their GTVt ranged from 0.11 to 29.26 mL. The relationship between GTVt and GTVs was significant (Spearman's ρ = 0.893, P < 0.01) for animal tumor models. CONCLUSIONS: The SUV_Shape scheme could delineate tumors based on their radiopharmaceutical-avid PET images.