Characteristics of whole-body dynamic F-FDG PET/CT Patlak multi-parametric imaging in lung cancer and the influence of different delineation methods on quantitative parameters.

Background: Dynamic course of flourine-18 fluorodeoxyglucose positron emission tomography/computed tomography (F-FDG PET/CT) Patlak muti-parametric imaging spatial distribution in the targeted tissues may reveal highly useful clinical information about the tissue's metabolic properties. The characteristics of the Patlak multi-parametric imaging in lung cancer and the influence of different delineation methods on quantitative parameters may provide reference for the clinical application of this new technology.

Methods: A total of 27 patients with pathologically diagnosed lung cancer underwent whole-body dynamic F-FDG PET/CT examination before treatment. Parametric images of metabolic rate of FDG (MR) and Patlak intercept (or distribution volume; DV) were generated using Patlak reconstruction. The values of primary lung cancer lesions, target-to-background ratio (TBR), and contrast-to-noise ratio (CNR) were investigated using contour delineation and boundary delineation. Statistical analysis was performed to analyze the relationship between multi-parametric images and clinicopathological features, and to compare the effects of contour delineation and boundary delineation on quantitative parameters.

Results: MR images showed higher TBR and CNR than did standardized uptake value (SUV) images. There were significant differences in MR, MR, and MR among groups with different tumor diameters and pathology types (P<0.05). Moreover, the metabolic parameters of MR were higher in patients with tumor diameters ≥3 cm and squamous carcinoma. The differences of the maximum and peak values of MR and DV were not statistically significant in the different outlining method subgroups (all P>0.05). However, the difference of the mean values of MR and DV were statistically significant in the different outline method groupings (all P<0.05).

Conclusions: Dynamic F-FDG PET/CT Patlak multi-parametric imaging can obtain quantitative values for lung cancer with high TBR and CNR. Moreover, the multi-parameters are various from different pathology types to tumor size. Different delineation methods have a greater influence on the mean value of quantitative parameters.