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Association of PET index quantifying skeletal uptake in NaF PET/CT images with overall survival in prostate cancer patients

Lindgren Belal, Sarah LU orcid ; Sadik, May ; Kaboteh, Reza ; Hasani, Nezar ; Enqvist, Olof ; Svärm, Linus ; Kahl, Fredrik ; Simonsen, Jane ; Poulsen, Mads H. and Ohlsson, Mattias , et al. (2017) American Society of Clinical Oncology Genitourinary (ASCO GU) Cancers Symposium In Journal of Clinical Oncology 35(6 Suppl). p.178-178
Abstract
Background: Bone Scan Index (BSI) derived from 2D whole-body bone scans is considered an imaging biomarker of bone metastases burden carrying prognostic information. Sodium fluoride (NaF) PET/CT is more sensitive than bone scan in detecting bone changes due to metastases. We aimed to develop a semi-quantitative PET index similar to the BSI for NaF PET/CT imaging and to study its relationship to BSI and overall survival in patients with prostate cancer.

Methods: NaF PET/CT and bone scans were analyzed in 48 patients (aged 53-92 years) with prostate cancer. Thoracic and lumbar spines, sacrum, pelvis, ribs, scapulae, clavicles, and sternum were automatically segmented from the CT images, representing approximately 1/3... (More)
Background: Bone Scan Index (BSI) derived from 2D whole-body bone scans is considered an imaging biomarker of bone metastases burden carrying prognostic information. Sodium fluoride (NaF) PET/CT is more sensitive than bone scan in detecting bone changes due to metastases. We aimed to develop a semi-quantitative PET index similar to the BSI for NaF PET/CT imaging and to study its relationship to BSI and overall survival in patients with prostate cancer.

Methods: NaF PET/CT and bone scans were analyzed in 48 patients (aged 53-92 years) with prostate cancer. Thoracic and lumbar spines, sacrum, pelvis, ribs, scapulae, clavicles, and sternum were automatically segmented from the CT images, representing approximately 1/3 of the total skeletal volume. Hotspots in the PET images, within the segmented parts in the CT images, were visually classified and hotspots interpreted as metastases were included in the analysis. The PET index was defined as the quotient obtained as the hotspot volume from the PET images divided by the segmented bone tissue volume from the CT images. BSI was automatically calculated using EXINIboneBSI.

Results: The correlation between the PET index and BSI was r2= 0.54. The median BSI was 0.39 (IQR 0.08-2.05). The patients with a BSI ≥ 0.39 had a significantly shorter median survival time than patients with a BSI < 0.39 (2.3 years vs. not reached after 5 years). BSI was significantly associated with overall survival (HR 1.13, 95% CI 1.13 to 1.41; p < 0.001), and the C-index was 0.68. The median PET index was 0.53 (IQR 0.02-2.62). The patients with a PET index ≥ 0.53 had a significantly shorter median survival time than patients with a PET index < 0.53 (2.5 years vs. not reached after 5 years). The PET index was significantly associated with overall survival (HR 1.18, 95% CI 1.01 to 1.30; p < 0.001) and C-index was 0.68.

Conclusions: PET index based on NaF PET/CT images was correlated to BSI and significantly associated with overall survival in patients with prostate cancer. Further studies are needed to evaluate the clinical value of this novel 3D PET index as a possible future imaging biomarker. (Less)
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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Journal of Clinical Oncology
volume
35
issue
6 Suppl
pages
178 - 178
publisher
American Society of Clinical Oncology
conference name
American Society of Clinical Oncology Genitourinary (ASCO GU) Cancers Symposium
conference location
Orlando, United States
conference dates
2017-02-16 - 2017-02-18
ISSN
0732-183X
DOI
10.1200/JCO.2017.35.6_suppl.178
language
English
LU publication?
yes
id
295eebe5-d64e-4aa4-bd2a-d3c281084195
date added to LUP
2022-12-14 13:32:32
date last changed
2022-12-27 11:47:20
@misc{295eebe5-d64e-4aa4-bd2a-d3c281084195,
  abstract     = {{<b>Background:</b> Bone Scan Index (BSI) derived from 2D whole-body bone scans is considered an imaging biomarker of bone metastases burden carrying prognostic information. Sodium fluoride (NaF) PET/CT is more sensitive than bone scan in detecting bone changes due to metastases. We aimed to develop a semi-quantitative PET index similar to the BSI for NaF PET/CT imaging and to study its relationship to BSI and overall survival in patients with prostate cancer.<br/><br/><b>Methods:</b> NaF PET/CT and bone scans were analyzed in 48 patients (aged 53-92 years) with prostate cancer. Thoracic and lumbar spines, sacrum, pelvis, ribs, scapulae, clavicles, and sternum were automatically segmented from the CT images, representing approximately 1/3 of the total skeletal volume. Hotspots in the PET images, within the segmented parts in the CT images, were visually classified and hotspots interpreted as metastases were included in the analysis. The PET index was defined as the quotient obtained as the hotspot volume from the PET images divided by the segmented bone tissue volume from the CT images. BSI was automatically calculated using EXINIboneBSI.<br/><br/><b>Results:</b> The correlation between the PET index and BSI was r2= 0.54. The median BSI was 0.39 (IQR 0.08-2.05). The patients with a BSI ≥ 0.39 had a significantly shorter median survival time than patients with a BSI &lt; 0.39 (2.3 years vs. not reached after 5 years). BSI was significantly associated with overall survival (HR 1.13, 95% CI 1.13 to 1.41; p &lt; 0.001), and the C-index was 0.68. The median PET index was 0.53 (IQR 0.02-2.62). The patients with a PET index ≥ 0.53 had a significantly shorter median survival time than patients with a PET index &lt; 0.53 (2.5 years vs. not reached after 5 years). The PET index was significantly associated with overall survival (HR 1.18, 95% CI 1.01 to 1.30; p &lt; 0.001) and C-index was 0.68.<br/><br/><b>Conclusions:</b> PET index based on NaF PET/CT images was correlated to BSI and significantly associated with overall survival in patients with prostate cancer. Further studies are needed to evaluate the clinical value of this novel 3D PET index as a possible future imaging biomarker.}},
  author       = {{Lindgren Belal, Sarah and Sadik, May and Kaboteh, Reza and Hasani, Nezar and Enqvist, Olof and Svärm, Linus and Kahl, Fredrik and Simonsen, Jane and Poulsen, Mads H. and Ohlsson, Mattias and Høilund–Carlsen, Poul Flemming and Edenbrandt, Lars and Trägårdh, Elin}},
  issn         = {{0732-183X}},
  language     = {{eng}},
  month        = {{03}},
  note         = {{Conference Abstract}},
  number       = {{6 Suppl}},
  pages        = {{178--178}},
  publisher    = {{American Society of Clinical Oncology}},
  series       = {{Journal of Clinical Oncology}},
  title        = {{Association of PET index quantifying skeletal uptake in NaF PET/CT images with overall survival in prostate cancer patients}},
  url          = {{http://dx.doi.org/10.1200/JCO.2017.35.6_suppl.178}},
  doi          = {{10.1200/JCO.2017.35.6_suppl.178}},
  volume       = {{35}},
  year         = {{2017}},
}