Assessment of a statistical AIF extraction method for dynamic PET studies with 15O water and 18F fluorodeoxyglucose in locally advanced breast cancer patients.

David M Mankoff,Erin Schubert,Finbarr O’Sullivan,Janet N O’Sullivan,Jian Huang,Lanell Peterson,Lisa K Dunnwald,Mark Muzi,Robert Doot

doi:10.1117/1.jmi.5.1.011010

Abstract

.Blood flow-metabolism mismatch from dynamic positron emission tomography (PET) studies with -labeled water () and -labeled fluorodeoxyglucose (FDG) has been shown to be a promising diagnostic for locally advanced breast cancer (LABCa) patients. The mismatch measurement involves kinetic analysis with the arterial blood time course (AIF) as an input function. We evaluate the use of a statistical method for AIF extraction (SAIF) in these studies. Fifty three LABCa patients had dynamic PET studies with and FDG. For each PET study, two AIFs were recovered, an SAIF extraction and also a manual extraction based on a region of interest placed over the left ventricle (LV-ROI). Blood flow-metabolism mismatch was obtained with each AIF, and kinetic and prognostic reliability comparisons were made. Strong correlations were found between kinetic assessments produced by both AIFs. SAIF AIFs retained the full prognostic value, for pathologic response and overall survival, of LV-ROI AIFs.

Highlights

The role for positron emission tomography (PET) imaging in oncology is expanding with a range of clinical protocols under consideration for many specific cancers
This paper presents an assessment of statistical method for AIF extraction (SAIF) in the context of blood flow-metabolism mismatch evaluation for locally advanced breast cancer (LABCa) studies, where classical image-based AIF recovery from manually placed region of interest (ROI) in the left ventricle (LV) by a skilled operator familiar with the anatomy can be technically challenging and difficult to reproduce
Included in this are some of the image-derived time courses produced by the automated data-segmentation procedure during the extraction process

Summary

Introduction

The role for positron emission tomography (PET) imaging in oncology is expanding with a range of clinical protocols under consideration for many specific cancers. Blood flowmetabolism mismatch from dynamic PET studies, e.g., with 15O-labeled water (H2O) and 18F-labeled fluorodeoxyglucose (FDG), has a history in the cardiac applications[1] but has shown potential as a diagnostic biomarker for the management of patients with locally advanced breast cancer (LABCa).[2] Realization of this measurement involves kinetic analysis of dynamically acquired H2O and FDG data with the time courses of the PET tracers in arterial blood (AIF) as input functions. The imaging field of view encompasses the heart, so it is possible to recover an estimate of the AIF by careful placement of a region of interest (ROI) over an appropriate part of the left ventricle (LV). We refer to this as the LV-ROI method.

Methods

Results

Conclusion