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Correlation Between SUVmax and CT Radiomic Analysis Using Lymph Node Density in PET/CT-Based Lymph Node Staging.

Frederik L Giesel^1,2, Florian Schneider¹, Clemens Kratochwil¹

¹Department of Nuclear Medicine, University Hospital Heidelberg, Heidelberg, Germany.

Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine

|September 24, 2016

Summary

This summary is machine-generated.

CT density measurements correlate with PET findings for lymph node staging in lung cancer, melanoma, GEP NET, and prostate cancer. This can improve accuracy, especially for indeterminate PET results.

Keywords:

DOTATOC PET/CT FDG PET/CT N staging PSMA PET/CT radiomics

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Area of Science:

Oncology
Radiology
Nuclear Medicine

Background:

Lymph node (LN) staging is crucial for lung cancer (LC), malignant melanoma (MM), gastroenteropancreatic neuroendocrine tumors (GEP NETs), and prostate cancer (PCA).
Current PET/CT imaging (¹⁸F-FDG, ⁶⁸Ga-DOTATOC, ⁶⁸Ga-PSMA) can yield indeterminate findings, necessitating improved methods for evaluating LN infiltration.

Purpose of the Study:

To investigate the correlation between SUV_max from PET imaging and semiautomated CT density measurements of LNs.
To assess the utility of CT density as a surrogate parameter for differentiating malignant from benign LNs.

Main Methods:

Retrospective analysis of 1,022 LNs from 148 patients across four cancer types (LC, MM, GEP NET, PCA).
PET/CT scans were performed before treatment; patients with prior therapy were excluded.
SUV_max was determined from PET, and volumetric CT histogram analyses were performed on unenhanced CT images.

Main Results:

PET-positive LNs exhibited significantly higher CT densities compared to PET-negative LNs, regardless of cancer type.
A correlation was observed between CT density measurements and PET tracer uptake (¹⁸F-FDG, ⁶⁸Ga-DOTATOC, ⁶⁸Ga-PSMA).

Conclusions:

CT density measurements serve as a valuable surrogate parameter for distinguishing malignant from benign LNs in various cancers.
Potential clinical application of CT density thresholds (e.g., 7.5 HU for differentiation, 20 HU for exclusion) could aid in managing PET-indeterminate LNs.