Page 111 - 18F-FDG PET as biomarker in aggressive lymphoma; technical and clinical validation

Workflow optimization of MTV in DLBCL
Ease of Use
Time to complete Workflow B ranged from 1 to 15 min (mean 7.3, Table 2). Preselected MTVs were rated as successful in seven, three, and four patients by the observers, respectively. They were classified as failures in zero, four, and six patients respectively.
Workflow C; Manual Modification
Effect of Manual Modification
After manual modification of the preselected volumes the ICC of the final MTV was 0.92 (95%CI 0.82–0.98, Table 1). Mean CoV for the final MTV was 16.7 %. Results for TLG again were similar, with excellent ICC values and good to excellent ICC values for MTV. The total time to perform this workflow ranged from 5 to 62 min (mean 22.2, Table 2).
Fig. 1. Scatterplot of MTV for Workflow A (user-defined selection with SUV≥4.0) and Workflow B (automated preselection).
PET images represent examples of different MTV interpretations between the workflows. Top left images (patient 10): Workflow B contains only lymphoma lesions around the large vessels (left), while in Workflow A, the liver and spleen were also included in the lesion selection (right). Bottom right images (patient 8): in Workflow B, the large lesion was selected (left), while it was interpreted as not being lymphoma in Workflow A (right).
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