The Impact of Optimal Respiratory Gating and Image Noise on Evaluation of Intratumor Heterogeneity on 18F-FDG PET Imaging of Lung Cancer

W. Grootjans, F. Tixier, Charlotte Sophie van der Vos, D. Vriens, C.C. Le Rest, J. Bussink, W.J. Oyen, Lioe-Fee de Geus-Oei, D. Visvikis, E.P. Visser

Research output: Contribution to journalArticleAcademicpeer-review

28 Citations (Scopus)
69 Downloads (Pure)

Abstract

Accurate measurement of intratumor heterogeneity using parameters of texture on PET images is essential for precise characterization of cancer lesions. In this study, we investigated the influence of respiratory motion and varying noise levels on quantification of textural parameters in patients with lung cancer. Methods: We used an optimal-respiratory-gating algorithm on the list-mode data of 60 lung cancer patients who underwent 18F-FDG PET. The images were reconstructed using a duty cycle of 35% (percentage of the total acquired PET data). In addition, nongated images of varying statistical quality (using 35% and 100% of the PET data) were reconstructed to investigate the effects of image noise. Several global image-derived indices and textural parameters (entropy, high-intensity emphasis, zone percentage, and dissimilarity) that have been associated with patient outcome were calculated. The clinical impact of optimal respiratory gating and image noise on assessment of intratumor heterogeneity was evaluated using Cox regression models, with overall survival as the outcome measure. The threshold for statistical significance was adjusted for multiple comparisons using Bonferroni correction. Results: In the lower lung lobes, respiratory motion significantly affected quantification of intratumor heterogeneity for all textural parameters (P < 0.007) except entropy (P > 0.007). The mean increase in entropy, dissimilarity, zone percentage, and high-intensity emphasis was 1.3% ± 1.5% (P = 0.02), 11.6% ± 11.8% (P = 0.006), 2.3% ± 2.2% (P = 0.002), and 16.8% ± 17.2% (P = 0.006), respectively. No significant differences were observed for lesions in the upper lung lobes (P > 0.007). Differences in the statistical quality of the PET images affected the textural parameters less than respiratory motion, with no significant difference observed. The median follow-up time was 35 mo (range, 7–39 mo). In multivariate analysis for overall survival, total lesion glycolysis and high-intensity emphasis were the two most relevant image-derived indices and were considered to be independent significant covariates for the model regardless of the image type considered. Conclusion: The tested textural parameters are robust in the presence of respiratory motion artifacts and varying levels of image noise.
Original languageEnglish
Pages (from-to)1692-1698
Number of pages7
JournalJournal of nuclear medicine
Volume57
Issue number11
DOIs
Publication statusPublished - 2016

Fingerprint

Fluorodeoxyglucose F18
Lung Neoplasms
Entropy
Lung
Survival
Glycolysis
Proportional Hazards Models
Artifacts
Noise
Multivariate Analysis
Outcome Assessment (Health Care)
Neoplasms

Keywords

  • IR-103652
  • METIS-318928

Cite this

Grootjans, W., Tixier, F., van der Vos, C. S., Vriens, D., Le Rest, C. C., Bussink, J., ... Visser, E. P. (2016). The Impact of Optimal Respiratory Gating and Image Noise on Evaluation of Intratumor Heterogeneity on 18F-FDG PET Imaging of Lung Cancer. Journal of nuclear medicine, 57(11), 1692-1698. https://doi.org/10.2967/jnumed.116.173112
Grootjans, W. ; Tixier, F. ; van der Vos, Charlotte Sophie ; Vriens, D. ; Le Rest, C.C. ; Bussink, J. ; Oyen, W.J. ; de Geus-Oei, Lioe-Fee ; Visvikis, D. ; Visser, E.P. / The Impact of Optimal Respiratory Gating and Image Noise on Evaluation of Intratumor Heterogeneity on 18F-FDG PET Imaging of Lung Cancer. In: Journal of nuclear medicine. 2016 ; Vol. 57, No. 11. pp. 1692-1698.
@article{287e6556f82a4f2e8f527d648a6cbbd8,
title = "The Impact of Optimal Respiratory Gating and Image Noise on Evaluation of Intratumor Heterogeneity on 18F-FDG PET Imaging of Lung Cancer",
abstract = "Accurate measurement of intratumor heterogeneity using parameters of texture on PET images is essential for precise characterization of cancer lesions. In this study, we investigated the influence of respiratory motion and varying noise levels on quantification of textural parameters in patients with lung cancer. Methods: We used an optimal-respiratory-gating algorithm on the list-mode data of 60 lung cancer patients who underwent 18F-FDG PET. The images were reconstructed using a duty cycle of 35{\%} (percentage of the total acquired PET data). In addition, nongated images of varying statistical quality (using 35{\%} and 100{\%} of the PET data) were reconstructed to investigate the effects of image noise. Several global image-derived indices and textural parameters (entropy, high-intensity emphasis, zone percentage, and dissimilarity) that have been associated with patient outcome were calculated. The clinical impact of optimal respiratory gating and image noise on assessment of intratumor heterogeneity was evaluated using Cox regression models, with overall survival as the outcome measure. The threshold for statistical significance was adjusted for multiple comparisons using Bonferroni correction. Results: In the lower lung lobes, respiratory motion significantly affected quantification of intratumor heterogeneity for all textural parameters (P < 0.007) except entropy (P > 0.007). The mean increase in entropy, dissimilarity, zone percentage, and high-intensity emphasis was 1.3{\%} ± 1.5{\%} (P = 0.02), 11.6{\%} ± 11.8{\%} (P = 0.006), 2.3{\%} ± 2.2{\%} (P = 0.002), and 16.8{\%} ± 17.2{\%} (P = 0.006), respectively. No significant differences were observed for lesions in the upper lung lobes (P > 0.007). Differences in the statistical quality of the PET images affected the textural parameters less than respiratory motion, with no significant difference observed. The median follow-up time was 35 mo (range, 7–39 mo). In multivariate analysis for overall survival, total lesion glycolysis and high-intensity emphasis were the two most relevant image-derived indices and were considered to be independent significant covariates for the model regardless of the image type considered. Conclusion: The tested textural parameters are robust in the presence of respiratory motion artifacts and varying levels of image noise.",
keywords = "IR-103652, METIS-318928",
author = "W. Grootjans and F. Tixier and {van der Vos}, {Charlotte Sophie} and D. Vriens and {Le Rest}, C.C. and J. Bussink and W.J. Oyen and {de Geus-Oei}, Lioe-Fee and D. Visvikis and E.P. Visser",
year = "2016",
doi = "10.2967/jnumed.116.173112",
language = "English",
volume = "57",
pages = "1692--1698",
journal = "Journal of nuclear medicine",
issn = "0161-5505",
publisher = "Society of Nuclear Medicine Inc.",
number = "11",

}

Grootjans, W, Tixier, F, van der Vos, CS, Vriens, D, Le Rest, CC, Bussink, J, Oyen, WJ, de Geus-Oei, L-F, Visvikis, D & Visser, EP 2016, 'The Impact of Optimal Respiratory Gating and Image Noise on Evaluation of Intratumor Heterogeneity on 18F-FDG PET Imaging of Lung Cancer', Journal of nuclear medicine, vol. 57, no. 11, pp. 1692-1698. https://doi.org/10.2967/jnumed.116.173112

The Impact of Optimal Respiratory Gating and Image Noise on Evaluation of Intratumor Heterogeneity on 18F-FDG PET Imaging of Lung Cancer. / Grootjans, W.; Tixier, F.; van der Vos, Charlotte Sophie; Vriens, D.; Le Rest, C.C.; Bussink, J.; Oyen, W.J.; de Geus-Oei, Lioe-Fee; Visvikis, D.; Visser, E.P.

In: Journal of nuclear medicine, Vol. 57, No. 11, 2016, p. 1692-1698.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - The Impact of Optimal Respiratory Gating and Image Noise on Evaluation of Intratumor Heterogeneity on 18F-FDG PET Imaging of Lung Cancer

AU - Grootjans, W.

AU - Tixier, F.

AU - van der Vos, Charlotte Sophie

AU - Vriens, D.

AU - Le Rest, C.C.

AU - Bussink, J.

AU - Oyen, W.J.

AU - de Geus-Oei, Lioe-Fee

AU - Visvikis, D.

AU - Visser, E.P.

PY - 2016

Y1 - 2016

N2 - Accurate measurement of intratumor heterogeneity using parameters of texture on PET images is essential for precise characterization of cancer lesions. In this study, we investigated the influence of respiratory motion and varying noise levels on quantification of textural parameters in patients with lung cancer. Methods: We used an optimal-respiratory-gating algorithm on the list-mode data of 60 lung cancer patients who underwent 18F-FDG PET. The images were reconstructed using a duty cycle of 35% (percentage of the total acquired PET data). In addition, nongated images of varying statistical quality (using 35% and 100% of the PET data) were reconstructed to investigate the effects of image noise. Several global image-derived indices and textural parameters (entropy, high-intensity emphasis, zone percentage, and dissimilarity) that have been associated with patient outcome were calculated. The clinical impact of optimal respiratory gating and image noise on assessment of intratumor heterogeneity was evaluated using Cox regression models, with overall survival as the outcome measure. The threshold for statistical significance was adjusted for multiple comparisons using Bonferroni correction. Results: In the lower lung lobes, respiratory motion significantly affected quantification of intratumor heterogeneity for all textural parameters (P < 0.007) except entropy (P > 0.007). The mean increase in entropy, dissimilarity, zone percentage, and high-intensity emphasis was 1.3% ± 1.5% (P = 0.02), 11.6% ± 11.8% (P = 0.006), 2.3% ± 2.2% (P = 0.002), and 16.8% ± 17.2% (P = 0.006), respectively. No significant differences were observed for lesions in the upper lung lobes (P > 0.007). Differences in the statistical quality of the PET images affected the textural parameters less than respiratory motion, with no significant difference observed. The median follow-up time was 35 mo (range, 7–39 mo). In multivariate analysis for overall survival, total lesion glycolysis and high-intensity emphasis were the two most relevant image-derived indices and were considered to be independent significant covariates for the model regardless of the image type considered. Conclusion: The tested textural parameters are robust in the presence of respiratory motion artifacts and varying levels of image noise.

AB - Accurate measurement of intratumor heterogeneity using parameters of texture on PET images is essential for precise characterization of cancer lesions. In this study, we investigated the influence of respiratory motion and varying noise levels on quantification of textural parameters in patients with lung cancer. Methods: We used an optimal-respiratory-gating algorithm on the list-mode data of 60 lung cancer patients who underwent 18F-FDG PET. The images were reconstructed using a duty cycle of 35% (percentage of the total acquired PET data). In addition, nongated images of varying statistical quality (using 35% and 100% of the PET data) were reconstructed to investigate the effects of image noise. Several global image-derived indices and textural parameters (entropy, high-intensity emphasis, zone percentage, and dissimilarity) that have been associated with patient outcome were calculated. The clinical impact of optimal respiratory gating and image noise on assessment of intratumor heterogeneity was evaluated using Cox regression models, with overall survival as the outcome measure. The threshold for statistical significance was adjusted for multiple comparisons using Bonferroni correction. Results: In the lower lung lobes, respiratory motion significantly affected quantification of intratumor heterogeneity for all textural parameters (P < 0.007) except entropy (P > 0.007). The mean increase in entropy, dissimilarity, zone percentage, and high-intensity emphasis was 1.3% ± 1.5% (P = 0.02), 11.6% ± 11.8% (P = 0.006), 2.3% ± 2.2% (P = 0.002), and 16.8% ± 17.2% (P = 0.006), respectively. No significant differences were observed for lesions in the upper lung lobes (P > 0.007). Differences in the statistical quality of the PET images affected the textural parameters less than respiratory motion, with no significant difference observed. The median follow-up time was 35 mo (range, 7–39 mo). In multivariate analysis for overall survival, total lesion glycolysis and high-intensity emphasis were the two most relevant image-derived indices and were considered to be independent significant covariates for the model regardless of the image type considered. Conclusion: The tested textural parameters are robust in the presence of respiratory motion artifacts and varying levels of image noise.

KW - IR-103652

KW - METIS-318928

U2 - 10.2967/jnumed.116.173112

DO - 10.2967/jnumed.116.173112

M3 - Article

VL - 57

SP - 1692

EP - 1698

JO - Journal of nuclear medicine

JF - Journal of nuclear medicine

SN - 0161-5505

IS - 11

ER -