Dataset Information

Validation of nonrigid registration in pretreatment and follow-up PET/CT scans for quantification of tumor residue in lung cancer patients.

ABSTRACT: Nonrigid registrations of pre- and postradiotherapy (RT) PET/CT scans of NSCLC patients were performed with different algorithms and validated tracking internal landmarks. Dice overlap ratios (DR) of high FDG-uptake areas in registered PET/CT scans were then calculated to study patterns of relapse. For 22 patients, pre- and post-RT PET/CT scans were registered first rigidly and then nonrigidly. For three patients, two types (based on Demons or Morphons) of nonrigid registration algorithms each with four different parameter settings were applied and assessed using landmark validation. The two best performing methods were tested on all patients, who were then classified into three groups: large (Group 1), minor (Group2) or insufficient improvement (Group 3) of registration accuracy. For Group 1 and 2, DRs between high FDG-uptake areas in pre- and post-RT PET scans were determined. Distances between corresponding landmarks on deformed pre-RT and post-RT scans decreased for all registration methods. Differences between Demons and Morphons methods were smaller than 1 mm. For Group 1, landmark distance decreased from 9.5 ± 2.1 mm to 3.8 ± 1.2 mm (mean ± 1 SD, p < 0.001), and for Group 3 from 13.6 ± 3.2 mm to 8.0 ± 2.2 mm (p = 0.025). No significant change was observed for Group 2 where distances decreased from 5.6± 1.3 mm to 4.5 ± 1.1 mm (p = 0.093). DRs of high FDG-uptake areas improved significantly after nonrigid registration for most patients in Group 1. Landmark validation of nonrigid registration methods for follow-up CT imaging in NSCLC is necessary. Nonrigid registration significantly improves matching between pre- and post-RT CT scans for a subset of patients, although not in all patients. Hence, the quality of the registration needs to be assessed for each patient individually. Successful nonrigid registration increased the overlap between pre- and post-RT high FDG-uptake regions.

SUBMITTER: Spijkerman J

PROVIDER: S-EPMC5875523 | biostudies-literature | 2014 Jul

REPOSITORIES: biostudies-literature

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Validation of nonrigid registration in pretreatment and follow-up PET/CT scans for quantification of tumor residue in lung cancer patients.

Spijkerman Jolanda J Fontanarosa Davide D Das Marco M Van Elmpt Wouter W

Journal of applied clinical medical physics 20140708 4

Nonrigid registrations of pre- and postradiotherapy (RT) PET/CT scans of NSCLC patients were performed with different algorithms and validated tracking internal landmarks. Dice overlap ratios (DR) of high FDG-uptake areas in registered PET/CT scans were then calculated to study patterns of relapse. For 22 patients, pre- and post-RT PET/CT scans were registered first rigidly and then nonrigidly. For three patients, two types (based on Demons or Morphons) of nonrigid registration algorithms each w ...[more]

PMID: 25207414

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Project description:The Centers for Medicare and Medicaid Services coverage includes 3 posttherapy 18F-FDG PET/CT scans per patient and per tumor type. Any additional follow-up 18F-FDG PET/CT scans will be reimbursed at the discretion of a local Medicare administrator, if deemed medically necessary. This study aimed to investigate common clinical indications for performing a fourth or additional follow-up 18F-FDG PET/CT scans that could affect the management of patients. Methods: This was a retrospective institutional review of 433 oncology patients (203 men; mean age, 55 y), including a total of 1,659 fourth or subsequent follow-up PET/CT scans after completion of primary treatment. Twelve indications for performing a fourth or subsequent follow-up PET/CT scan were determined, and the impact of each of the 12 indications on patients' management was evaluated. Results: The primary tumors were breast cancer (92 patients, 426 scans), non-Hodgkin lymphoma (77 patients, 208 scans), Hodgkin disease (41 patients, 182 scans), colorectal cancer (70 patients, 286 scans), melanoma (69 patients, 271 scans), and lung cancer (84 patients, 286 scans). The indications were categorized in 4 groups: PET/CT for diagnosis of tumor recurrence (303/1,659, 18.3%), PET/CT before starting therapy for tumor recurrence (64/1,659, 3.9%), PET/CT to assess therapy response for tumor recurrence (507/1,659, 30.6%), and follow-up PET/CT after completion of treatment for tumor recurrence (785/1,659, 47.3%). Overall, fourth and subsequent follow-up 18F-FDG PET/CT scans resulted in change in management in 31.6% of the scans (356 of 1,128) when the scans were obtained for medical necessities (indications 1-11), and in 5.6% of the scans (30/531) when the scans were obtained without any medical necessity (indication 12). Conclusion: The fourth and subsequent PET/CT scans obtained after completion of primary treatment led to a change in management in 31.6% of the scans when acquired for appropriate clinical reasons. Performing follow-up PET/CT without appropriate medical reason had a low impact on patients' management and should be avoided.

Project description:PurposeTo measure reader agreement in determining whether lung nodules detected at baseline screening computed tomography (CT) had changed at subsequent screening examinations and to evaluate the variability in recommendations for further follow-up.Materials and methodsAll subjects were enrolled in the National Lung Screening Trial (NLST), and each participant consented to the use of their de-identified images for research purposes. The authors randomly selected 100 cases of nodules measuring at least 4.0 mm at 1-year screening CT that were considered by the original screening CT reader to be present on baseline CT scans; nodules considered by the original reader to have changed were oversampled. Selected images from each case showing the entire nodule at both examinations were preloaded on a picture archiving and communication system workstation. Nine radiologists served as readers, and they evaluated whether the nodule was present at baseline and recorded the bidimensional measurements and nodule characteristics at each examination, presence or absence of change, results of screening CT, and follow-up recommendations (high-level follow-up, low-level follow-up, no follow-up).ResultsOn the basis of reviews during case selection, five nodules seen at follow-up were judged not to have been present at baseline; for 19 of the remaining 95 cases, at least one reader judged the nodule not to have been present at baseline. For the 76 nodules that were unanimously considered to have been present at baseline, 21%-47% (mean ± standard deviation, 30% ± 9) were judged to have grown. The κ values were similar for growth (κ = 0.55) and a positive screening result (κ = 0.51) and were lower for a change in margins and attenuation (κ = 0.27-0.31). The κ value in the recommendation of high- versus low-level follow-up was high (κ = 0.66).ConclusionReader agreement on nodule growth and screening result was moderate to substantial. Agreement on follow-up recommendations was lower.

Project description:The primary aim of this study is to investigate the performance difference of rigid and nonrigid registration schemes in matching corresponding pulmonary nodules depicted on sequential chest computed tomography (CT) examinations.A gradient descent based rigid registration algorithm with scaling was developed and it handled the involved geometric transformations (i.e., translation, rescaling, shearing, and rotation) separately instead of optimizing them in a single pass. Given two lung CT examinations, the scaling and translation parameters were simply estimated from the lung volume dimensions (e.g., size and mass center), while the rotation parameters were optimized progressively using gradient descent. To investigate the performance difference of rigid and nonrigid schemes in pulmonary nodule registration, the well-known nonrigid Demons algorithm was implemented and tested along with the developed schemes against 60 diverse low-dose clinical lung CT examinations with average 2-yr follow-up scans. A verified cancer and its correspondence in the follow-up scan as well as their spatial locations (mass center) were identified in each examination. In addition to the computational efficiency, the accuracy of these registration procedures was assessed by computing the Euclidean distances between the corresponding nodules after the registration. To demonstrate the advantage of the developed algorithm, the authors also implemented a fast iterative closest point (ICP) based rigid algorithm and compared their performance.Our experiments on the collected chest CT examinations showed that the nodule registration errors in 3D Euclidean distance for the developed rigid affine approach, the traditional ICP algorithm, and the refining nonrigid Demons algorithm were 9.6, 9.8, and 10.0 mm, respectively, and the corresponding computational costs in time were 5, 300, and 55 s, respectively.A rigid solution may be preferred in practice for the pulmonary nodule registration in longitudinal studies because of its relatively high efficiency and sufficient accuracy for the clinical need.

Dataset Information

Validation of nonrigid registration in pretreatment and follow-up PET/CT scans for quantification of tumor residue in lung cancer patients.

Publications

Validation of nonrigid registration in pretreatment and follow-up PET/CT scans for quantification of tumor residue in lung cancer patients.

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