Delineation and agreement of FET PET biological volumes in glioblastoma: results of the nuclear medicine credentialing program from the prospective, multi-centre trial evaluating FET PET In Glioblastoma (FIG) study-TROG 18.06
- Author(s)
- Barry, N; Francis, RJ; Ebert, MA; Koh, ES; Rowshanfarzad, P; Hassan, GM; Kendrick, J; Gan, HK; Lee, ST; Lau, E; Moffat, BA; Fitt, G; Moore, A; Thomas, P; Pattison, DA; Akhurst, T; Alipour, R; Thomas, EL; Hsiao, E; Schembri, GP; Lin, P; Ly, T; Yap, J; Kirkwood, I; Vallat, W; Khan, S; Krishna, D; Ngai, S; Yu, C; Beuzeville, S; Yeow, TC; Bailey, D; Cook, O; Whitehead, A; Dykyj, R; Rossi, A; Grose, A; Scott, AM;
- Details
- Publication Year 2023,Volume 50,Issue #13,Page 3970-3981
- Journal Title
- European Journal of Nuclear Medicine and Molecular Imaging
- Publication Type
- Research article
- Abstract
- PURPOSE: The O-(2-[(18)F]-fluoroethyl)-L-tyrosine (FET) PET in Glioblastoma (FIG) trial is an Australian prospective, multi-centre study evaluating FET PET for glioblastoma patient management. FET PET imaging timepoints are pre-chemoradiotherapy (FET1), 1-month post-chemoradiotherapy (FET2), and at suspected progression (FET3). Before participant recruitment, site nuclear medicine physicians (NMPs) underwent credentialing of FET PET delineation and image interpretation. METHODS: Sites were required to complete contouring and dynamic analysis by >/= 2 NMPs on benchmarking cases (n = 6) assessing biological tumour volume (BTV) delineation (3 x FET1) and image interpretation (3 x FET3). Data was reviewed by experts and violations noted. BTV definition includes tumour-to-background ratio (TBR) threshold of 1.6 with crescent-shaped background contour in the contralateral normal brain. Recurrence/pseudoprogression interpretation (FET3) required assessment of maximum TBR (TBR(max)), dynamic analysis (time activity curve [TAC] type, time to peak), and qualitative assessment. Intraclass correlation coefficient (ICC) assessed volume agreement, coefficient of variation (CoV) compared maximum/mean TBR (TBR(max)/TBR(mean)) across cases, and pairwise analysis assessed spatial (Dice similarity coefficient [DSC]) and boundary agreement (Hausdorff distance [HD], mean absolute surface distance [MASD]). RESULTS: Data was accrued from 21 NMPs (10 centres, n >/= 2 each) and 20 underwent review. The initial pass rate was 93/119 (78.2%) and 27/30 requested resubmissions were completed. Violations were found in 25/72 (34.7%; 13/12 minor/major) of FET1 and 22/74 (29.7%; 14/8 minor/major) of FET3 reports. The primary reasons for resubmission were as follows: BTV over-contour (15/30, 50.0%), background placement (8/30, 26.7%), TAC classification (9/30, 30.0%), and image interpretation (7/30, 23.3%). CoV median and range for BTV, TBR(max), and TBR(mean) were 21.53% (12.00-30.10%), 5.89% (5.01-6.68%), and 5.01% (3.37-6.34%), respectively. BTV agreement was moderate to excellent (ICC = 0.82; 95% CI, 0.63-0.97) with good spatial (DSC = 0.84 +/- 0.09) and boundary (HD = 15.78 +/- 8.30 mm; MASD = 1.47 +/- 1.36 mm) agreement. CONCLUSION: The FIG study credentialing program has increased expertise across study sites. TBR(max) and TBR(mean) were robust, with considerable variability in BTV delineation and image interpretation observed.
- Publisher
- Springer Nature
- Keywords
- Humans; *Glioblastoma/diagnostic imaging/pathology; *Ficus; *Brain Neoplasms/diagnostic imaging/pathology; *Nuclear Medicine; Prospective Studies; Australia; Positron-Emission Tomography/methods; Tyrosine; Magnetic Resonance Imaging
- Department(s)
- Cancer Imaging
- PubMed ID
- 37563351
- Publisher's Version
- https://doi.org/10.1007/s00259-023-06371-5
- Open Access at Publisher's Site
https://doi.org/10.1007/s00259-023-06371-5- Terms of Use/Rights Notice
- Refer to copyright notice on published article.
Creation Date: 2023-12-11 11:35:13
Last Modified: 2023-12-11 11:37:04