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| Hauptseite > Publikationsdatenbank > JS01.3.A FULLY AUTOMATED EVALUATION OF FET PET IN BRAIN TUMOR PATIENTS - AN INTERNATIONAL, MULTICENTER STUDY |
| Hauptseite > Publikationsdatenbank > JS01.3.A FULLY AUTOMATED EVALUATION OF FET PET IN BRAIN TUMOR PATIENTS - AN INTERNATIONAL, MULTICENTER STUDY |
| Abstract | FZJ-2026-01530 |
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2025
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Please use a persistent id in citations: doi:10.1093/neuonc/noaf193.001
Abstract: Neuro-Oncology 27:iii1–iii190, 2025.https://doi.org/10.1093/neuonc/noaf193ORAL PRESENTATIONSJS01 EANO YOUNGSTERS-CSNO: IMAGING AND RESPONSEASSESSMENT - PRESENT AND FUTUREABSTRACT CITATION ID: NOAF193.001JS01.3.A FULLY AUTOMATED EVALUATION OF FET PET IN BRAINTUMOR PATIENTS - AN INTERNATIONAL, MULTICENTER STUDYK. Ciantar1,2, S. D. Grega3, N. J. Smith3, M. E. Larson4, M. Tann3,W. Territo3, B. D. Graner3, S. Sidenbender3, M. A. Green3, J. G. Parker3,C. P. Filss1,5, G. Stoffels1,5, N. Judov1, J. Hilgers1, C. Régio Brambilla1,C. W. Lerche1, N. Shah1,6, F. M. Mottaghy5,7, V. Schulz2, N. Galldiks1,8,K. Langen1,5, M. C. Veronesi4, P. Lohmann1,5; 1Institute of Neuroscienceand Medicine (INM-3, INM-4), Research Center Juelich, Juelich, Germany,2Institute of Imaging and Computer Vision, RWTH Aachen University,Aachen, Germany,3Department of Radiology and Imaging Sciences, IndianaUniversity School of Medicine, Indianapolis, IN, United States, 4Departmentof Radiology, University of Wisconsin School of Medicine and PublicHealth, Madison, WI, United States, 5Department of Nuclear Medicine,RWTH Aachen University Hospital, Aachen, Germany,6Departmentof Neurology, RWTH University Hospital Aachen, Aachen, Germany,7Department of Radiology and Nuclear Medicine, Maastricht UniversityMedical Center, Maastricht, Netherlands, 8Department of Neurology,Faculty of Medicine and University Hospital Cologne, Cologne, Germany.BACKGROUND: Amino acid PET using the tracer O-(2-[18F]fluoroethyl)-L-tyrosine (FET) has become a valuable modality for brain tumor diagnostics,complementing MRI. Despite existing guidelines, variations persist in the as-sessment of quantitative metrics such as the maximum and mean tumor-to-brain ratios (TBRmax; TBRmean) and the metabolic tumor volume (MTV).To address this, we developed a fully automated workflow for the evaluationof FET PET and compared the performance to human experts in a multicentersetting. MATERIAL AND METHODS: A total of 817 FET PET scans from672 patients were evaluated. These comprised 740 scans from two institutionsin Germany (3 scanners; 65% glioma; 54% male; median injected activity 222MBq), and 77 scans from one institution in the USA (1 scanner, 74% glio-blastoma; 66% male; median injected activity 703 MBq). Our approach buildson the previously developed Juelich Segmentation Tool for Brain Tumor PET(JuST_BrainPET, PMID: 37562802) to derive the initial tumor mask, followedby post-processing of the brain-extracted scan to obtain a reference region. Withthese, SUV-based thresholding is applied, and diagnostic metrics are computedon the summed images from 20 to 40 minutes post injection. The mean back-ground SUV (BG-SUVmean), TBRmean, TBRmax, and MTV were calculatedand compared with the available expert-rated parameters, using Pearson correl-ation coefficients and Bland-Altman plots for assessing bias. Detection accuracywas measured by taking the physician findings a s r eference s tandard. R E-SULTS: Automated assessment on the German dataset obtained a sensitivity of92% and an F1-score of 93%. In this process, 106 lesions with an MTV below0.5 mL were classified as non-measurable disease according to PET RANO 1.0and were therefore not included in further evaluation. The correctly identifiedlesions showed a high correlation between automated and expert assessment forBG-SUVmean, TBRmean and TBRmax (Pearson correlation, 0.98; 0.86; 0.96,respectively), with a slight bias towards overestimation (mean bias, 0.01; 0.10;0.17, respectively). For the USA dataset, the workflow obtained a sensitivity of92% and an F1-score of 95%, with a high correlation between the automatedand manual assessment of the MTV as well as TBRmax (Pearson correlation,0.95; 0.83, respectively). A slight bias towards underestimation was noted forboth MTV and TBRmax (mean bias, 4.30 mL; 0.38, respectively). CONCLU-SION: The presented fully automated workflow demonstrated its value for ro-bust and standardized evaluation of FET PET scans in brain tumor patientson different scanners from multiple institutions. FUNDING: This work wassupported by project 428090865 (SPP2177) of the German Research Foun-dation (DFG).
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