PET Scan in Hodgkin Lymphoma by Andrea Gallamini

Author:Andrea Gallamini
Language: eng
Format: epub
Publisher: Springer International Publishing, Cham

MTV

The MTV measure the total volume of the metabolically active tumor included within a VOI, both for a single lesion both for multiple lesions and expressed in cm3 or ml. The rationale is the assumption of a metabolic activity higher than the surrounding healthy tissue to be able to accurately define the tumor volume. MTV is slightly affected by noise since it includes hundreds or thousands of voxels.

TLG

The TLG is the product of SUVmean in the defined VOI and the MTV; the rationale is to combine tumor burden and its metabolic activity to obtain an index that is correlated to the tumor volume and the uptake within the entire volume. The routine application of these parameters is challenging because the quantification process requires complex calculations, is conducive to subjective definitions of VOIs, and is rather time consuming. There are several segmentation algorithm definitions, relying on manual (by an expert) or semiautomatic methods for tumor delineation (Table 4.3). With the recent development of software-assisted automated VOI assessments, volume-based metabolic quantitative parameters have become increasingly available. Although these metrics are potentially useful clinical parameters for assessing treatment response and survival, they are not ready for clinical applications at the moment because they are yet to be standardized and validated [8–10]. The advantages and disadvantages of these methods are provided in Table 4.3.Table 4.3Pros and cons of the various categories of PET image segmentation techniques

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