The role of quantitative PET in predicting cancer treatment outcomes

Abstract Recent years have witnessed increasing use of positron emission tomography (PET) in cancer staging and monitoring. In particular, 18F-fluoro-2-deoxy-d-glucose (FDG) has frequently been used in clinical practice for tumor detection, staging, and gross tumor volume definition in different cancer sites. More recently, there has been accumulating evidence that pre- and intra-treatment FDG uptake could be used as a prognostic factor for predicting cancer treatment outcomes. Typically, quantitative analysis of FDG uptake is based on observed changes in the standardized uptake value (SUV). However, SUV descriptors themselves might be influenced by the initial FDG uptake intensity, radiotracer distribution, and changes in tumor volume. These factors and others might make this approach prone to significant intra- and inter-observer variability. Alternatively, more recent efforts have been directed toward the use of advanced image feature analysis techniques as part of the emerging field of radiomics. In this work, we review recent advances and discuss current challenges regarding the use of PET imaging for predicting cancer outcomes. We discuss issues related to image feature extraction, statistical modeling, tracer type, and combination with other imaging modalities for the purpose of developing robust PET-based models of treatment outcomes. We provide examples based on our experience, and that of others, of PET imaging used alone or with other complement...
Source: Clinical and Translational Imaging - Category: Radiology Source Type: research