Classification of thresholded regions based on selective use of PET, CT and PET-CT image features

Fluorodeoxyglucose positron emission tomography - computed tomography (FDG PET-CT) is the preferred image modality for lymphoma diagnosis. Sites of disease generally appear as foci of increased FDG uptake. Thresholding methods are often applied to robustly separate these regions. However, its main limitation is that it also includes sites of FDG excretion and physiological FDG uptake regions, which we define as FEPU - sites of FEPU include the bladder, renal, papillae, ureters, brain, heart and brown fat. FEPU can make image interpretation problematic. The ability to identify and label FEPU sites and separate them from abnormal regions is an important process that could improve image interpretation. We propose a new method to automatically separate and label FEPU sites from the thresholded PET images. Our method is based on the selective use of features extracted from data types comprising of PET, CT and PET-CT. Our FEPU classification of 43 clinical lymphoma patient studies revealed higher accuracy when compared to non-selective image features.