Abstract
PurposePositron-emission tomography can be useful in oncology for diagnosis, (re)staging, determining prognosis, and response assessment. However, partial-volume effects hamper accurate quantification of lesions <2–3× the PET system’s spatial resolution, and the clinical impact of this is not evident. This systematic review provides an up-to-date overview of studies investigating the impact of partial-volume correction (PVC) in oncological PET studies.MethodsWe searched in PubMed and Embase databases according to the PRISMA statement, including studies from inception till May 9, 2016. Two reviewers independently screened all abstracts and eligible full-text articles and performed quality assessment according to QUADAS-2 and QUIPS criteria. For a set of similar diagnostic studies, we statistically pooled the results using bivariate meta-regression.ResultsThirty-one studies were eligible for inclusion. Overall, study quality was good. For diagnosis and nodal staging, PVC yielded a strong trend of increased sensitivity at expense of specificity. Meta-analysis of six studies investigating diagnosis of pulmonary nodules (679 lesions) showed no significant change in diagnostic accuracy after PVC (p = 0.222). Prognostication was not improved for non-small cell lung cancer and esophageal cancer, whereas it did improve for head and neck cancer. Response assessment was not improved by PVC for (locally advanced) breast cancer or rectal cancer, and it worsened in metastatic colorectal cancer.ConclusionsThe accumulated evidence to date does not support routine application of PVC in standard clinical PET practice. Consensus on the preferred PVC methodology in oncological PET should be reached. Partial-volume-corrected data should be used as adjuncts to, but not yet replacement for, uncorrected data.
Highlights
Positron-emission tomography (PET) enables in vivo assessment of metabolic and intracellular processes
Quantification of functional tumor characteristics with PET is considered to be useful in clinical oncology, and often uses semi-quantitative analyses, resulting in standardized uptake value (SUV)
This review discusses the clinical impact of partial-volume correction (PVC) and provides recommendations for specific research questions and analyses to be included in future studies applying PVC
Summary
Positron-emission tomography (PET) enables in vivo assessment of metabolic and intracellular processes. PET is predominantly used to qualitatively assess tracer uptake, PET(/computed tomography [CT]) may serve as a surrogate quantitative biomarker of, for example, tumor metabolism and proliferation. The application of quantitative tumor assessment methods for distinguishing benign from malignant lesions, staging, prognostication, and determining or predicting response to therapy has garnered increasing interest [1,2,3,4]. The simplest technique uses recovery coefficients (RC) obtained from phantom experiments under the assumption that true metabolic volume is known and that lesions are spherically shaped with homogeneous uptake. Voxel-wise resolution recovery methods, incorporating the point spread function (PSF) within iterative reconstruction [9] (PSF reconstruction) or performing post-reconstruction iterative deconvolution [10], could improve both qualitative and quantitative reads. Most current clinical quantitative PET studies merely exclude small lesions (e.g.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
