Hounsfield units and fractal dimension (test HUFRA) for determining PET positive/negative lymph nodes in pediatric Hodgkin's lymphoma patients

PLoS One. 2020 Mar 19;15(3):e0229859. doi: 10.1371/journal.pone.0229859. eCollection 2020.

Abstract

Objectives: We had developed a method that can help detect and identify lymph nodes affected by the neoplastic process. Our group evaluated the fractal dimension (FD) and X-ray attenuation (XRA) of lymph nodes in HL and compared to their metabolic activity as measured by 18F-FDG-PET examination.

Methods: The training set included 72 lymph nodes from 31 consecutive patients, and the tested set of 71 lymph nodes from next 19 patients. The measurement of FD of each lymph node was performed before the start of therapy using original software. X-ray attenuation (XRA) expressed in HU (Hounsfield Units) from CT scans was compared with the metabolic activity of the lymphatic nodes, measured by 18F-FDG-PET examination.

Results: Significant differences were observed between XRAmax and FDmax values in assessing the PET(+) and PET(-) nodes. All nodes were scored from 0 to 2. The HUFRA test properly qualified 95% with a score of 2 and 0 points as PET(+) or PET(-).

Conclusion: The HUFRA test can differentiate about 70-80% of lymph nodes as PET(+) or PET(-) based solely on the CT examination. It can be useful in patients who were not subjected to 18FFDG-PET/CT examination before the treatment, or who had an unreliable result of 18F-FDG-PET/CT with further research requirements.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Child
  • Female
  • Fluorodeoxyglucose F18 / pharmacology
  • Fractals
  • Hodgkin Disease / diagnosis*
  • Hodgkin Disease / diagnostic imaging
  • Hodgkin Disease / pathology
  • Humans
  • Lymph Nodes / diagnostic imaging*
  • Lymph Nodes / pathology
  • Lymphatic Metastasis / diagnosis*
  • Lymphatic Metastasis / diagnostic imaging
  • Lymphatic Metastasis / pathology
  • Male
  • Positron-Emission Tomography*
  • Radiopharmaceuticals / pharmacology

Substances

  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18

Grants and funding

Foundation "On the Rescue of Children with Cancer" Wroclaw. Poland Award Number: Poland-grant number FNRD.C200.14.005 | Recipient: Radosław Chaber The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.