Comparison of visual and ROI-based brain tumour grading using 18F-FDG PET : ROC analyses

Several studies have suggested that the use of simple visual interpretation criteria for the investigation of brain tumours by positron emission tomography with fluorine-18 fluorodeoxyglucose (FDG-PET) might be similarly or even more accurate than quantitative or semi-quantitative approaches. We inv...

Full description

Saved in:
Bibliographic Details
Published in:European Journal of Nuclear Medicine 2001-02, Vol.28 (2), p.165-174
Main Authors: MEYER, P. T, SCHRECKENBERGER, M, SPETZGER, U, MEYER, G. F, SABRI, O, SETANI, K. S, ZEGGEL, T, BUELL, U
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Biological and medical sciences
Brain Neoplasms - diagnostic imaging
Female
Fluorodeoxyglucose F18
Humans
Image Interpretation, Computer-Assisted - methods
Magnetic Resonance Imaging
Male
Medical sciences
Middle Aged
Neoplasm Staging - methods
Neurology
Radionuclide Imaging
Radiopharmaceuticals
Regression Analysis
Retrospective Studies
Software
Tumors of the nervous system. Phacomatoses
Citations: Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Several studies have suggested that the use of simple visual interpretation criteria for the investigation of brain tumours by positron emission tomography with fluorine-18 fluorodeoxyglucose (FDG-PET) might be similarly or even more accurate than quantitative or semi-quantitative approaches. We investigated this hypothesis by comparing the accuracy of FDG-PET brain tumour grading using a proposed six-step visual grading scale (VGS; applied by three independent observers unaware of the clinical history and the results of histopathology) and three different region of interest (ROI) ratios (maximal tumour uptake compared with contralateral tissue [Tu/Tis], grey matter [Tu/GM] and white matter [Tu/WM]). The patient population comprised 47 patients suffering from 17 benign (7 gliomas of grade II, 10 non-gliomatous tumours) and 30 malignant (23 gliomas of grade III-IV, 7 non-gliomatous tumours) tumours. The VGS results were highly correlated with the different ROI ratios (R=0.91 for Tu/GM, R=0.82 for Tu/WM, and R=0.79 for Tu/Tis), and high inter-observer agreement was achieved (kappa=0.63, 0.76 and 0.81 for the three observers). The mean ROI ratios and VGS readings of gliomatous and non-gliomatous lesions were not significantly different. For all measures, high-grade lesions showed significantly higher FDG uptake than low-grade lesions (P WM). The VGS yielded the highest Az (+/-SE) value (i.e. area under the ROC curve as a measure of predicted accuracy), 0.97+/-0.03, which showed a strong tendency towards being significantly greater than the Az of Tu/Tis (0.88+/-0.06; P=0.06). Tu/GM (0.92+/-0.04) and Tu/WM (0.91+/-0.05) reached intermediate Az values (not significantly different from any other value). We conclude that the VGS represents a measure at least as accurate as the Tu/GM and Tu/WM ratios. The Tu/Tis ratio is less valid owing to the high dependence on the location of the lesion. Depending on the investigator's experience and the structure of the lesions, the easily used VGS might be the most favourable grad
ISSN:0340-6997
1619-7070
1619-7089
DOI:10.1007/s002590000428