Whole tumor kinetics analysis of <SUP>18</SUP>F-fluoromisonidazole dynamic PET scans of non-small cell lung cancer patients, and correlations with perfusion CT blood flow



McGowan, Daniel R, Skwarski, Michael, Papiez, Bartlomiej W, Macpherson, Ruth E, Gleeson, Fergus V, Schnabel, Julia A, Higgins, Geoff S and Fenwick, John D
(2018) Whole tumor kinetics analysis of <SUP>18</SUP>F-fluoromisonidazole dynamic PET scans of non-small cell lung cancer patients, and correlations with perfusion CT blood flow. EJNMMI RESEARCH, 8 (1). 73-.

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Abstract

<h4>Background</h4>To determine the relative abilities of compartment models to describe time-courses of 18F-fluoromisonidazole (FMISO) tumor uptake in patients with advanced stage non-small cell lung cancer (NSCLC) imaged using dynamic positron emission tomography (dPET), and study correlations between values of the blood flow-related parameter K<sub>1</sub> obtained from fits of the models and an independent blood flow measure obtained from perfusion CT (pCT). NSCLC patients had a 45-min dynamic FMISO PET/CT scan followed by two static PET/CT acquisitions at 2 and 4-h post-injection. Perfusion CT scanning was then performed consisting of a 45-s cine CT. Reversible and irreversible two-, three- and four-tissue compartment models were fitted to 30 time-activity-curves (TACs) obtained for 15 whole tumor structures in 9 patients, each imaged twice. Descriptions of the TACs provided by the models were compared using the Akaike and Bayesian information criteria (AIC and BIC) and leave-one-out cross-validation. The precision with which fitted model parameters estimated ground-truth uptake kinetics was determined using statistical simulation techniques. Blood flow from pCT was correlated with K<sub>1</sub> from PET kinetic models in addition to FMISO uptake levels.<h4>Results</h4>An irreversible three-tissue compartment model provided the best description of whole tumor FMISO uptake time-courses according to AIC, BIC, and cross-validation scores totaled across the TACs. The simulation study indicated that this model also provided more precise estimates of FMISO uptake kinetics than other two- and three-tissue models. The K<sub>1</sub> values obtained from fits of the irreversible three-tissue model correlated strongly with independent blood flow measurements obtained from pCT (Pearson r coefficient = 0.81). The correlation from the irreversible three-tissue model (r = 0.81) was stronger than that from than K<sub>1</sub> values obtained from fits of a two-tissue compartment model (r = 0.68), or FMISO uptake levels in static images taken at time-points from tracer injection through to 4 h later (maximum at 2 min, r = 0.70).<h4>Conclusions</h4>Time-courses of whole tumor FMISO uptake by advanced stage NSCLC are described best by an irreversible three-tissue compartment model. The K<sub>1</sub> values obtained from fits of the irreversible three-tissue model correlated strongly with independent blood flow measurements obtained from perfusion CT (r = 0.81).

Item Type: Article
Uncontrolled Keywords: FMISO, NSCLC, Dynamic PET, Kinetics analysis, Perfusion CT
Depositing User: Symplectic Admin
Date Deposited: 27 Sep 2018 11:40
Last Modified: 13 Oct 2023 11:02
DOI: 10.1186/s13550-018-0430-4
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3026820