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Cited by 109Medical Imaging Techniques and ApplicationsLung Cancer Diagnosis and TreatmentRadiation Dose and Imaging

Novel penalised likelihood reconstruction of PET in the assessment of histologically verified small pulmonary nodules

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Teoh, Eugene J., McGowan, Daniel R., Bradley, Kevin M., Belcher, Elizabeth, Black, Edward, Gleeson, Fergus V.·2016·European Radiology
DOI 10.1007/s00330-015-3832-yPMC PMC4551414
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Abstract

OBJECTIVES: Investigate the effect of a novel Bayesian penalised likelihood (BPL) reconstruction algorithm on analysis of pulmonary nodules examined with 18F-FDG PET/CT, and to determine its effect on small, sub-10-mm nodules. METHODS: 18F-FDG PET/CTs performed for nodule evaluation in 104 patients (121 nodules) were retrospectively reconstructed using the new algorithm, and compared to time-of-flight ordered subset expectation maximisation (OSEM) reconstruction. Nodule and background parameters were analysed semi-quantitatively and visually. RESULTS: BPL compared to OSEM resulted in statistically significant increases in nodule SUVmax (mean 5.3 to 8.1, p < 0.00001), signal-to-background (mean 3.6 to 5.3, p < 0.00001) and signal-to-noise (mean 24 to 41, p < 0.00001). Mean percentage increase in SUVmax (%ΔSUVmax) was significantly higher in nodules ≤10 mm (n = 31, mean 73%) compared to >10 mm (n = 90, mean 42 %) (p = 0.025). Increase in signal-to-noise was higher in nodules ≤10 mm (224%, mean 12 to 27) compared to >10 mm (165%, mean 28 to 46). When applying optimum SUVmax thresholds for detecting malignancy, the sensitivity and accuracy increased using BPL, with the greatest improvements in nodules ≤10 mm. CONCLUSION: BPL results in a significant increase in signal-to-background and signal-to-noise compared to OSEM. When semi-quantitative analyses to diagnose malignancy are applied, higher SUVmax thresholds may be warranted owing to the SUVmax increase compared to OSEM. KEY POINTS: • Novel Bayesian penalised likelihood PET reconstruction was applied for lung nodule evaluation. • This was compared to current standard of care OSEM reconstruction. • The novel reconstruction generated significant increases in lung nodule signal-to-background and signal-to-noise. • These increases were highest in small, sub-10-mm pulmonary nodules. • Higher SUV max thresholds may be warranted when using semi-quantitative analyses to diagnose malignancy.

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  • PL reconstruction has repeatedly been shown to increase conspicuity and detection rates of pulmonary lesions, even compared to OSEM with PSF and/or TOF.

    “PL reconstruction has repeatedly been shown to increase conspicuity and detection rates of pulmonary lesions, even compared to OSEM with PSF and/or TOF [112,113,164,173,174].”

    From Influences on PET Quantification and Interpretation (2022) · cites this paper as [173]

    The Results (Visual analysis of FDG uptake; Diagnostic performance, page unavailable) show higher nodule signal and modestly higher sensitivity with penalised-likelihood reconstruction than with time-of-flight OSEM. However, the Methods (PET reconstructions) and Discussion show that this study did not compare against OSEM with PSF modelling. The Results also found no statistically significant difference in ROC performance, so the claim of improved detection needs qualification. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • Teoh et al. retrospectively investigated diagnostic accuracy of OSEM + TOF and PL reconstruction using SUVmax and visual reading in 121 pulmonary nodules with histological verification; diagnostic sensitivity and accuracy were similar with both algorithms, while specificity tended to be lower with PL than with OSEM + TOF, especially in lesions >10 mm diameter.

    “As an exception, Teoh et al. retrospectively investigated the diagnostic accuracy of OSEM + TOF and PL reconstruction using SUVmax and visual reading in 121 pulmonary nodules. Here, histological verification was available. Diagnostic sensitivity and accuracy were similar with both algorithms, while specificity tended to be lower with PL than with OSEM + TOF, especially in lesions >10 mm diameter [”

    From Influences on PET Quantification and Interpretation (2022) · cites this paper as [173]

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Research works printed but not linked: 22

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Sorted by citations

Authors
Teoh, E. J., McGowan, D. R., Bradley, K. M., Belcher, E., Black, E., & Gleeson, F. V.
Affiliations
  • Churchill Hospital (GB)
  • John Radcliffe Hospital (GB)
Corresponding author
Teoh, Eugene J.
ORCID
Venue
European Radiology
Publisher
Springer Science and Business Media LLC
Published
2015-05-20
Volume
26
Issue
2
Pages
576-584
ISSN
  • 0938-7994 (ISSN-L)
  • 1432-1084
DOI
10.1007/s00330-015-3832-y
PMC
PMC4551414
OpenAlex
W1540985874
Cited by
109
References
0
Citations by year
2026: 2 · 2025: 8 · 2024: 2 · 2023: 10 · 2022: 11 · 2021: 20 · 2020: 16 · 2019: 12 · 2018: 7 · 2017: 8 · 2016: 9 · 2015: 2 · 2012: 1
FWCI
7.02
Type
journal article
Language
en
Open access
Licence
Locations
  • European Radiology (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • ORCA Online Research @Cardiff (Cardiff University) (acceptedVersion)
Funders
  • Cancer Research UK (16466)
  • National Institute for Health and Care Research (NIHR-HCS-D12-03-13)
  • NIHR Oxford Biomedical Research Centre
Topics
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Medical Imaging Techniques and Applications
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Lung Cancer Diagnosis and Treatment
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Radiation Dose and Imaging
Keywords
PET image reconstruction, pulmonary nodules, small pulmonary nodules, 18F-FDG PET/CT, SUVmax, signal-to-background ratio, signal-to-noise ratio, OSEM comparison, SUVmax threshold
MeSH terms
Adult, Aged, Aged, 80 and over, Algorithms, Bayes Theorem, Solitary Pulmonary Nodule, Female, Humans, Image Processing, Computer-Assisted, Lung, Lung Neoplasms, Male, Middle Aged, Retrospective Studies, Tomography, X-Ray Computed, Radiopharmaceuticals, Fluorodeoxyglucose F18, Positron-Emission Tomography, Young Adult, Multimodal Imaging

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