Comparison of tumor volumes as determined by pathologic examination and FDG-PET/CT images of non-small-cell lung cancer: A pilot study Journal Article


Authors: Yu, J.; Li, X.; Xing, L.; Mu, D.; Fu, Z.; Sun, X.; Yang, G.; Zhang, B.; Ling, C. C.
Article Title: Comparison of tumor volumes as determined by pathologic examination and FDG-PET/CT images of non-small-cell lung cancer: A pilot study
Abstract: Purpose: To determine the cut-off standardized uptake value (SUV) on <sup>18</sup>F fluoro-2-deoxy-glucose (FDG) positron emission tomography/computed tomography (FDG-PET/CT) images that generates the best volumetric match to pathologic gross tumor volume (GTV<sub>path</sub>) for non-small-cell lung cancer (NSCLC). Methods and Materials: Fifteen patients with NSCLC who underwent FDG-PET/CT scans followed by lobectomy were enrolled. The surgical specimen was dissected into 5-7-μm sections at approximately 4-mm intervals and stained with hematoxylin and eosin. The tumor-containing area was outlined slice by slice and the GTV<sub>path</sub> determined by summing over all the slices, taking into account the interslice thickness and fixation-induced volume reduction. The gross tumor volume from the PET images, GTV<sub>PET</sub>, was determined as a function of cut-off SUV. The optimal threshold or optimal absolute SUV was defined as the value at which the GTV<sub>PET</sub> was the same as the GTV<sub>path</sub>. Results: The fixation process induced a volumetric reduction to 82% ± 10% (range, 62-100%) of the original. The maximal SUV was 10.1 ± 3.6 (range, 4.2-18.7). The optimal threshold and absolute SUV were 31% ± 11% and 3.0 ± 1.6, respectively. The optimal threshold was inversely correlated with GTV<sub>path</sub> and tumor diameter (p &lt; 0.05), but the optimal absolute SUV had no significant correlation with GTV<sub>path</sub> or tumor diameter (p &gt; 0.05). Conclusion: This study evaluated the use of GTV<sub>path</sub> as a criterion for determining the optimal cut-off SUV for NSCLC target volume delineation. Confirmatory studies including more cases are being performed. © 2009 Elsevier Inc.
Keywords: adult; clinical article; controlled study; aged; middle aged; surgical technique; radiation dose; positron emission tomography; diagnostic accuracy; prospective studies; radiopharmaceuticals; tumor localization; tumor volume; lung non small cell cancer; carcinoma, non-small-cell lung; lung neoplasms; tomography, x-ray computed; pathology; diagnostic imaging; dissection; diagnostic value; tumors; pilot study; pilot projects; tumor burden; fluorodeoxyglucose f 18; computer assisted emission tomography; fluorodeoxyglucose f18; positron-emission tomography; tumor volumes; glucose; eosin; hematoxylin; lobectomy; biological organs; fluorodeoxyglucose; non-small-cell lung cancer; cone beam computed tomography; optimization; pathologic tumor volume; pet/ct imaging; standardized uptake value; cut-off; fixation process; gross tumor volume; non small cell lung cancer; optimal threshold; pet images; pilot studies; positron emission tomography/computed tomographies; standardized uptake values; surgical specimens; target volume delineation; volume reductions
Journal Title: International Journal of Radiation Oncology, Biology, Physics
Volume: 75
Issue: 5
ISSN: 0360-3016
Publisher: Elsevier Inc.  
Date Published: 2009-12-01
Start Page: 1468
End Page: 1474
Language: English
DOI: 10.1016/j.ijrobp.2009.01.019
PUBMED: 19464822
PROVIDER: scopus
DOI/URL:
Notes: --- - "Cited By (since 1996): 4" - "Export Date: 30 November 2010" - "CODEN: IOBPD" - "Source: Scopus"
Altmetric Score
MSK Authors
  1. Ligang Xing
    15 Xing
  2. Xiaorong Sun
    19 Sun
  3. C Clifton Ling
    323 Ling