Semiautomatic methods for segmentation of the proliferative tumour volume on sequential FLT PET/CT images in head and neck carcinomas and their relation to clinical outcome

Purpose Radiotherapy of head and neck cancer induces changes in tumour cell proliferation during treatment, which can be depicted by the PET tracer 18 F-fluorothymidine (FLT). In this study, three advanced semiautomatic PET segmentation methods for delineation of the proliferative tumour volume (PV)...

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Veröffentlicht in:	European journal of nuclear medicine and molecular imaging 2014-05, Vol.41 (5), p.915-924
Hauptverfasser:	Arens, Anne I. J., Troost, Esther G. C., Hoeben, Bianca A. W., Grootjans, Willem, Lee, John A., Grégoire, Vincent, Hatt, Mathieu, Visvikis, Dimitris, Bussink, Johan, Oyen, Wim J. G., Kaanders, Johannes H. A. M., Visser, Eric P.
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Schlagworte:	Adult Aged Carcinoma, Squamous Cell - diagnostic imaging Carcinoma, Squamous Cell - pathology Cardiology Clinical outcomes Dideoxynucleosides Drug therapy Female Head & neck cancer Head and Neck Neoplasms - diagnostic imaging Head and Neck Neoplasms - pathology Humans Image Processing, Computer-Assisted - methods Imaging Male Medicine Medicine & Public Health Middle Aged Multimodal Imaging Nuclear Medicine Oncology Original Article Orthopedics Positron-Emission Tomography Prognosis Radiology Radiopharmaceuticals Tomography, X-Ray Computed Tumor Burden Tumors
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creator	Arens, Anne I. J. Troost, Esther G. C. Hoeben, Bianca A. W. Grootjans, Willem Lee, John A. Grégoire, Vincent Hatt, Mathieu Visvikis, Dimitris Bussink, Johan Oyen, Wim J. G. Kaanders, Johannes H. A. M. Visser, Eric P.
description	Purpose Radiotherapy of head and neck cancer induces changes in tumour cell proliferation during treatment, which can be depicted by the PET tracer 18 F-fluorothymidine (FLT). In this study, three advanced semiautomatic PET segmentation methods for delineation of the proliferative tumour volume (PV) before and during (chemo)radiotherapy were compared and related to clinical outcome. Methods The study group comprised 46 patients with 48 squamous cell carcinomas of the head and neck, treated with accelerated (chemo)radiotherapy, who underwent FLT PET/CT prior to treatment and in the 2nd and 4th week of therapy. Primary gross tumour volumes were visually delineated on CT images (GTV CT ). PVs were visually determined on all PET scans (PV VIS ). The following semiautomatic segmentation methods were applied to sequential PET scans: background-subtracted relative-threshold level (PV RTL ), a gradient-based method using the watershed transform algorithm and hierarchical clustering analysis (PV W&C ), and a fuzzy locally adaptive Bayesian algorithm (PV FLAB ). Results Pretreatment PV VIS correlated best with PV FLAB and GTV CT . Correlations with PV RTL and PV W&C were weaker although statistically significant. During treatment, the PV VIS , PV W&C and PV FLAB significant decreased over time with the steepest decline over time for PV FLAB . Among these advanced segmentation methods, PV FLAB was the most robust in segmenting volumes in the third scan (67 % of tumours as compared to 40 % for PV W&C and 27 % for PV RTL ). A decrease in PV FLAB above the median between the pretreatment scan and the scan obtained in the 4th week was associated with better disease-free survival (4 years 90 % versus 53 %). Conclusion In patients with head and neck cancer, FLAB proved to be the best performing method for segmentation of the PV on repeat FLT PET/CT scans during (chemo)radiotherapy. This may potentially facilitate radiation dose adaptation to changing PV.
doi_str_mv	10.1007/s00259-013-2651-0
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J. ; Troost, Esther G. C. ; Hoeben, Bianca A. W. ; Grootjans, Willem ; Lee, John A. ; Grégoire, Vincent ; Hatt, Mathieu ; Visvikis, Dimitris ; Bussink, Johan ; Oyen, Wim J. G. ; Kaanders, Johannes H. A. M. ; Visser, Eric P.</creator><creatorcontrib>Arens, Anne I. J. ; Troost, Esther G. C. ; Hoeben, Bianca A. W. ; Grootjans, Willem ; Lee, John A. ; Grégoire, Vincent ; Hatt, Mathieu ; Visvikis, Dimitris ; Bussink, Johan ; Oyen, Wim J. G. ; Kaanders, Johannes H. A. M. ; Visser, Eric P.</creatorcontrib><description>Purpose Radiotherapy of head and neck cancer induces changes in tumour cell proliferation during treatment, which can be depicted by the PET tracer 18 F-fluorothymidine (FLT). In this study, three advanced semiautomatic PET segmentation methods for delineation of the proliferative tumour volume (PV) before and during (chemo)radiotherapy were compared and related to clinical outcome. Methods The study group comprised 46 patients with 48 squamous cell carcinomas of the head and neck, treated with accelerated (chemo)radiotherapy, who underwent FLT PET/CT prior to treatment and in the 2nd and 4th week of therapy. Primary gross tumour volumes were visually delineated on CT images (GTV CT ). PVs were visually determined on all PET scans (PV VIS ). The following semiautomatic segmentation methods were applied to sequential PET scans: background-subtracted relative-threshold level (PV RTL ), a gradient-based method using the watershed transform algorithm and hierarchical clustering analysis (PV W&C ), and a fuzzy locally adaptive Bayesian algorithm (PV FLAB ). Results Pretreatment PV VIS correlated best with PV FLAB and GTV CT . Correlations with PV RTL and PV W&C were weaker although statistically significant. During treatment, the PV VIS , PV W&C and PV FLAB significant decreased over time with the steepest decline over time for PV FLAB . Among these advanced segmentation methods, PV FLAB was the most robust in segmenting volumes in the third scan (67 % of tumours as compared to 40 % for PV W&C and 27 % for PV RTL ). A decrease in PV FLAB above the median between the pretreatment scan and the scan obtained in the 4th week was associated with better disease-free survival (4 years 90 % versus 53 %). Conclusion In patients with head and neck cancer, FLAB proved to be the best performing method for segmentation of the PV on repeat FLT PET/CT scans during (chemo)radiotherapy. This may potentially facilitate radiation dose adaptation to changing PV.</description><identifier>ISSN: 1619-7070</identifier><identifier>EISSN: 1619-7089</identifier><identifier>DOI: 10.1007/s00259-013-2651-0</identifier><identifier>PMID: 24346414</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adult ; Aged ; Carcinoma, Squamous Cell - diagnostic imaging ; Carcinoma, Squamous Cell - pathology ; Cardiology ; Clinical outcomes ; Dideoxynucleosides ; Drug therapy ; Female ; Head & neck cancer ; Head and Neck Neoplasms - diagnostic imaging ; Head and Neck Neoplasms - pathology ; Humans ; Image Processing, Computer-Assisted - methods ; Imaging ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Multimodal Imaging ; Nuclear Medicine ; Oncology ; Original Article ; Orthopedics ; Positron-Emission Tomography ; Prognosis ; Radiology ; Radiopharmaceuticals ; Tomography, X-Ray Computed ; Tumor Burden ; Tumors</subject><ispartof>European journal of nuclear medicine and molecular imaging, 2014-05, Vol.41 (5), p.915-924</ispartof><rights>Springer-Verlag Berlin Heidelberg 2013</rights><rights>Springer-Verlag Berlin Heidelberg 2014</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c405t-fdf0f31b4eb6787d99c67bc621b09c742d975ed22d6fd06e68c1ef4b60f125e03</citedby><cites>FETCH-LOGICAL-c405t-fdf0f31b4eb6787d99c67bc621b09c742d975ed22d6fd06e68c1ef4b60f125e03</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00259-013-2651-0$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00259-013-2651-0$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27923,27924,41487,42556,51318</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24346414$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Arens, Anne I. J.</creatorcontrib><creatorcontrib>Troost, Esther G. C.</creatorcontrib><creatorcontrib>Hoeben, Bianca A. W.</creatorcontrib><creatorcontrib>Grootjans, Willem</creatorcontrib><creatorcontrib>Lee, John A.</creatorcontrib><creatorcontrib>Grégoire, Vincent</creatorcontrib><creatorcontrib>Hatt, Mathieu</creatorcontrib><creatorcontrib>Visvikis, Dimitris</creatorcontrib><creatorcontrib>Bussink, Johan</creatorcontrib><creatorcontrib>Oyen, Wim J. G.</creatorcontrib><creatorcontrib>Kaanders, Johannes H. A. M.</creatorcontrib><creatorcontrib>Visser, Eric P.</creatorcontrib><title>Semiautomatic methods for segmentation of the proliferative tumour volume on sequential FLT PET/CT images in head and neck carcinomas and their relation to clinical outcome</title><title>European journal of nuclear medicine and molecular imaging</title><addtitle>Eur J Nucl Med Mol Imaging</addtitle><addtitle>Eur J Nucl Med Mol Imaging</addtitle><description>Purpose Radiotherapy of head and neck cancer induces changes in tumour cell proliferation during treatment, which can be depicted by the PET tracer 18 F-fluorothymidine (FLT). In this study, three advanced semiautomatic PET segmentation methods for delineation of the proliferative tumour volume (PV) before and during (chemo)radiotherapy were compared and related to clinical outcome. Methods The study group comprised 46 patients with 48 squamous cell carcinomas of the head and neck, treated with accelerated (chemo)radiotherapy, who underwent FLT PET/CT prior to treatment and in the 2nd and 4th week of therapy. Primary gross tumour volumes were visually delineated on CT images (GTV CT ). PVs were visually determined on all PET scans (PV VIS ). The following semiautomatic segmentation methods were applied to sequential PET scans: background-subtracted relative-threshold level (PV RTL ), a gradient-based method using the watershed transform algorithm and hierarchical clustering analysis (PV W&C ), and a fuzzy locally adaptive Bayesian algorithm (PV FLAB ). Results Pretreatment PV VIS correlated best with PV FLAB and GTV CT . Correlations with PV RTL and PV W&C were weaker although statistically significant. During treatment, the PV VIS , PV W&C and PV FLAB significant decreased over time with the steepest decline over time for PV FLAB . Among these advanced segmentation methods, PV FLAB was the most robust in segmenting volumes in the third scan (67 % of tumours as compared to 40 % for PV W&C and 27 % for PV RTL ). A decrease in PV FLAB above the median between the pretreatment scan and the scan obtained in the 4th week was associated with better disease-free survival (4 years 90 % versus 53 %). Conclusion In patients with head and neck cancer, FLAB proved to be the best performing method for segmentation of the PV on repeat FLT PET/CT scans during (chemo)radiotherapy. 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J.</au><au>Troost, Esther G. C.</au><au>Hoeben, Bianca A. W.</au><au>Grootjans, Willem</au><au>Lee, John A.</au><au>Grégoire, Vincent</au><au>Hatt, Mathieu</au><au>Visvikis, Dimitris</au><au>Bussink, Johan</au><au>Oyen, Wim J. G.</au><au>Kaanders, Johannes H. A. M.</au><au>Visser, Eric P.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Semiautomatic methods for segmentation of the proliferative tumour volume on sequential FLT PET/CT images in head and neck carcinomas and their relation to clinical outcome</atitle><jtitle>European journal of nuclear medicine and molecular imaging</jtitle><stitle>Eur J Nucl Med Mol Imaging</stitle><addtitle>Eur J Nucl Med Mol Imaging</addtitle><date>2014-05-01</date><risdate>2014</risdate><volume>41</volume><issue>5</issue><spage>915</spage><epage>924</epage><pages>915-924</pages><issn>1619-7070</issn><eissn>1619-7089</eissn><abstract>Purpose Radiotherapy of head and neck cancer induces changes in tumour cell proliferation during treatment, which can be depicted by the PET tracer 18 F-fluorothymidine (FLT). In this study, three advanced semiautomatic PET segmentation methods for delineation of the proliferative tumour volume (PV) before and during (chemo)radiotherapy were compared and related to clinical outcome. Methods The study group comprised 46 patients with 48 squamous cell carcinomas of the head and neck, treated with accelerated (chemo)radiotherapy, who underwent FLT PET/CT prior to treatment and in the 2nd and 4th week of therapy. Primary gross tumour volumes were visually delineated on CT images (GTV CT ). PVs were visually determined on all PET scans (PV VIS ). The following semiautomatic segmentation methods were applied to sequential PET scans: background-subtracted relative-threshold level (PV RTL ), a gradient-based method using the watershed transform algorithm and hierarchical clustering analysis (PV W&C ), and a fuzzy locally adaptive Bayesian algorithm (PV FLAB ). Results Pretreatment PV VIS correlated best with PV FLAB and GTV CT . Correlations with PV RTL and PV W&C were weaker although statistically significant. During treatment, the PV VIS , PV W&C and PV FLAB significant decreased over time with the steepest decline over time for PV FLAB . Among these advanced segmentation methods, PV FLAB was the most robust in segmenting volumes in the third scan (67 % of tumours as compared to 40 % for PV W&C and 27 % for PV RTL ). A decrease in PV FLAB above the median between the pretreatment scan and the scan obtained in the 4th week was associated with better disease-free survival (4 years 90 % versus 53 %). Conclusion In patients with head and neck cancer, FLAB proved to be the best performing method for segmentation of the PV on repeat FLT PET/CT scans during (chemo)radiotherapy. This may potentially facilitate radiation dose adaptation to changing PV.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>24346414</pmid><doi>10.1007/s00259-013-2651-0</doi><tpages>10</tpages></addata></record>
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subjects	Adult Aged Carcinoma, Squamous Cell - diagnostic imaging Carcinoma, Squamous Cell - pathology Cardiology Clinical outcomes Dideoxynucleosides Drug therapy Female Head & neck cancer Head and Neck Neoplasms - diagnostic imaging Head and Neck Neoplasms - pathology Humans Image Processing, Computer-Assisted - methods Imaging Male Medicine Medicine & Public Health Middle Aged Multimodal Imaging Nuclear Medicine Oncology Original Article Orthopedics Positron-Emission Tomography Prognosis Radiology Radiopharmaceuticals Tomography, X-Ray Computed Tumor Burden Tumors
title	Semiautomatic methods for segmentation of the proliferative tumour volume on sequential FLT PET/CT images in head and neck carcinomas and their relation to clinical outcome
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