{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T06:04:29Z","timestamp":1790575469501,"version":"4.1.0"},"reference-count":55,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,2,15]],"date-time":"2023-02-15T00:00:00Z","timestamp":1676419200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:p>The Metabolic Tumor Volume (MTV) and Tumor Lesion Glycolysis (TLG) has been shown to be independent prognostic predictors for clinical outcome in Diffuse Large B-cell Lymphoma (DLBCL). However, definitions of these measurements have not been standardized, leading to many sources of variation, operator evaluation continues to be one major source. In this study, we propose a reader reproducibility study to evaluate computation of TMV (&amp;amp; TLG) metrics based on differences in lesion delineation. In the first approach, reader manually corrected regional boundaries after automated detection performed across the lesions in a body scan (Reader M using a manual process, or manual). The other reader used a semi-automated method of lesion identification, without any boundary modification (Reader A using a semi- automated process, or auto). Parameters for active lesion were kept the same, derived from standard uptake values (SUVs) over a 41% threshold. We systematically contrasted MTV &amp;amp; TLG differences between expert readers (Reader M &amp;amp; A). We find that MTVs computed by Readers M and A were both concordant between them (concordant correlation coefficient of 0.96) and independently prognostic with a P-value of 0.0001 and 0.0002 respectively for overall survival after treatment. Additionally, we find TLG for these reader approaches showed concordance (CCC of 0.96) and was prognostic for over -all survival (p \u2264 0.0001 for both). In conclusion, the semi-automated approach (Reader A) provides acceptable quantification &amp;amp; prognosis of tumor burden (MTV) and TLG in comparison to expert reader assisted measurement (Reader M) on PET\/CT scans.<\/jats:p>","DOI":"10.3389\/fimmu.2023.994520","type":"journal-article","created":{"date-parts":[[2023,2,15]],"date-time":"2023-02-15T11:32:55Z","timestamp":1676460775000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":10,"title":["Repeatability of metabolic tumor burden and lesion glycolysis between clinical readers"],"prefix":"10.3389","volume":"14","author":[{"given":"Jung W.","family":"Choi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin A.","family":"Dean","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zachary","family":"Thompson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin","family":"Qi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabe","family":"Krivenko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael D.","family":"Jain","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederick L.","family":"Locke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoganand","family":"Balagurunathan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,2,15]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1038\/s41572-020-0189-6","article-title":"Hodgkin Lymphoma","volume":"6","author":"Connors","year":"2020","journal-title":"Nat Rev Dis Primers"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1056\/nejm199807023390104","article-title":"Chemotherapy alone compared with chemotherapy plus radiotherapy for localized intermediate- and high-grade non-hodgkin's lymphoma","volume":"339","author":"Miller","year":"1998","journal-title":"New Engl J Med"},{"key":"B3","volume-title":"Cancer facts & figures: Survival rates & factors that affect prognosis for non-hodgkin lymphoma","year":"2022"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2006.08.2305","article-title":"Use of positron emission tomography for response assessment of lymphoma: consensus of the imaging subcommittee of international harmonization project in lymphoma","volume":"25","author":"Juweid","year":"2007","journal-title":"J Clin Oncol"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2013.53.5229","article-title":"Role of imaging in the staging and response assessment of lymphoma: consensus of the international conference on malignant lymphomas imaging working group","volume":"32","author":"Barrington","year":"2014","journal-title":"J Clin Oncol"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2013.54.8800","article-title":"Recommendations for initial evaluation, staging, and response assessment of Hodgkin and non-Hodgkin lymphoma: the lugano classification","volume":"32","author":"Cheson","year":"2014","journal-title":"J Clin Oncol"},{"key":"B7","article-title":"Position emission tomography with or without computed tomography in the primary staging of hodgkin's lymphoma","volume":"91","author":"Hutchings","year":"2006","journal-title":"Haematologica"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdt137","article-title":"The use of FDG-PET in the initial staging of 142 patients with follicular lymphoma: a retrospective study from the FOLL05 randomized trial of the fondazione italiana linfomi","volume":"24","author":"Luminari","year":"2013","journal-title":"Ann Oncol"},{"key":"B9","article-title":"Consensus recommendations for the use of 18F-FDG PET as an indicator of therapeutic response in patients in national cancer institute trials","volume":"47","author":"Shankar","year":"2006","journal-title":"J Nucl Med"},{"key":"B10","article-title":"18F-FDG PET as a candidate for \"qualified biomarker\": functional assessment of treatment response in oncology","volume":"47","author":"Larson","year":"2006","journal-title":"J Nucl Med"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdq428","article-title":"Establishment of a UK-wide network to facilitate the acquisition of quality assured FDG-PET data for clinical trials in lymphoma","volume":"22","author":"Barrington","year":"2011","journal-title":"Ann Oncol"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1007\/s00259-008-0874-2","article-title":"The Netherlands protocol for standardisation and quantification of FDG whole body PET studies in multi-centre trials","volume":"35","author":"Boellaard","year":"2008","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1080\/10428190903040048","article-title":"Report on the first international workshop on interim-PET-Scan in lymphoma","volume":"50","author":"Meignan","year":"2009","journal-title":"Leukemia lymphoma"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V120.21.547.547","article-title":"Involved field radiotherapy versus no further treatment in patients with clinical stages IA and IIA Hodgkin lymphoma and a \u2018Negative\u2019 PET scan after 3 cycles ABVD. results of the UK NCRI RAPID trial","volume":"120","author":"Radford","year":"2012","journal-title":"Blood"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1510093","article-title":"Adapted treatment guided by interim PET-CT scan in advanced hodgkin's lymphoma","volume":"374","author":"Johnson","year":"2016","journal-title":"New Engl J Med"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2016.10.029","article-title":"Chemotherapy response assessment by FDG-PET-CT in early-stage classical Hodgkin lymphoma: Moving beyond the five-point deauville score","volume":"97","author":"Milgrom","year":"2017","journal-title":"Int J Radiat oncology biology Phys"},{"key":"B17","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1016\/j.ejrad.2017.08.001","article-title":"Evaluation of inter-observer variability according to RECIST 1.1 and its influence on response classification in CT measurement of liver metastases","volume":"95","author":"Bellomi","year":"2017","journal-title":"Eur J Radiol"},{"key":"B18","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1016\/j.ejca.2015.10.014","article-title":"Observer variability in RECIST-based tumour burden measurements: a meta-analysis","volume":"53","author":"Yoon","year":"2016","journal-title":"Eur J Cancer"},{"key":"B19","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1186\/s13550-019-0486-9","article-title":"Interobserver variability of image-derived arterial blood SUV in whole-body FDG PET","volume":"9","author":"Hofheinz","year":"2019","journal-title":"EJNMMI Res"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1186\/s40170-021-00244-x","article-title":"Prognostic value of metabolic tumor volume and total lesion glycolysis on preoperative (18)F-FDG PET\/CT in patients with localized primary gastrointestinal stromal tumors","volume":"9","author":"Hwang","year":"2021","journal-title":"Cancer Metab"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21363","article-title":"Prognostic value of metabolic tumor volume as measured by fluorine-18-fluorodeoxyglucose positron emission tomography\/computed tomography in nasopharyngeal carcinoma","volume":"4","author":"Yoon","year":"2014","journal-title":"Int Forum Allergy Rhinology"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.18.19734","article-title":"Prognostic value of volume-based metabolic parameters of 18F-FDG PET\/CT in uterine cervical cancer: A systematic review and meta-analysis","volume":"211","author":"Han","year":"2018","journal-title":"Am J Roentgenology"},{"key":"B23","doi-asserted-by":"publisher","first-page":"23195","DOI":"10.1038\/s41598-021-02734-w","article-title":"Prognostic value of baseline metabolic tumour volume in advanced-stage hodgkin\u2019s lymphoma","volume":"11","author":"Pinochet","year":"2021","journal-title":"Sci Rep"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2016.34.15_Supplementary7509","article-title":"Baseline total metabolic volume (TMTV) to predict the outcome of patients with advanced Hodgkin lymphoma (HL) enrolled in the AHL2011 LYSA trial","volume":"34","author":"Casasnovas","year":"2016","journal-title":"J Clin Oncol"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2020001900","article-title":"High metabolic tumor volume is associated with decreased efficacy of axicabtagene ciloleucel in large b-cell lymphoma","volume":"4","author":"Dean","year":"2020","journal-title":"Blood Adv"},{"key":"B26","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1007\/s13139-017-0493-6","article-title":"Current methods to define metabolic tumor volume in positron emission tomography: Which one is better","volume":"52","author":"Im","year":"2018","journal-title":"Nucl Med Mol Imaging"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.13.10841","article-title":"Interreader agreement and variability of FDG PET volumetric parameters in human solid tumors","volume":"202","author":"Paidpally","year":"2014","journal-title":"Am J Roentgenology"},{"key":"B28","article-title":"Multi-level otsu method to define metabolic tumor volume in positron emission tomography","volume":"8","author":"Im","year":"2018","journal-title":"Am J Nucl Med Mol Imaging"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1016\/j.annonc.2020.11.019","article-title":"Risk stratification in diffuse large b-cell lymphoma using lesion dissemination and metabolic tumor burden calculated from baseline PET\/CT(\u2020)","volume":"32","author":"Cottereau","year":"2021","journal-title":"Ann Oncol"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1259\/bjr.20210470","article-title":"The optimal use of PET\/CT in the management of lymphoma patients","volume":"94","author":"Milgrom","year":"2021","journal-title":"Br J Radiol"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.2967\/jnumed.115.166280","article-title":"Response assessment criteria and their applications in lymphoma: Part 1","volume":"57","author":"Moghbel","year":"2016","journal-title":"J Nucl Med"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2007-06-097238","article-title":"The role of FDG-PET scans in patients with lymphoma","volume":"110","author":"Seam","year":"2007","journal-title":"Blood"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2016142043","article-title":"Practical PERCIST: A simplified guide to PET response criteria in solid tumors 1.0","volume":"280","author":"JH","year":"2016","journal-title":"Radiology"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1007\/s00259-016-3427-0","article-title":"Characterization of PET\/CT images using texture analysis: the past, the present\u2026 any future","volume":"44","author":"Hatt","year":"2017","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.13.11456","article-title":"FDG PET metabolic tumor volume segmentation and pathologic volume of primary human solid tumors","volume":"202","author":"Sridhar","year":"2014","journal-title":"AJR Am J roentgenology"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.1016\/j.remn.2017.03.004","article-title":"(18)F-FDG PET\/CT in the clinical management of patients with lymphoma","volume":"36","author":"Tamayo","year":"2017","journal-title":"Rev espanola medicina Nucl e imagen Mol"},{"key":"B37","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1186\/s40644-016-0091-3","article-title":"How we read oncologic FDG PET\/CT","volume":"16","author":"Hofman","year":"2016","journal-title":"Cancer Imaging"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopha.2019.109168","article-title":"The impact of infection and inflammation in oncologic (18)F-FDG PET\/CT imaging","volume":"117","author":"Rahman","year":"2019","journal-title":"Biomedicine pharmacotherapy = Biomedecine pharmacotherapie"},{"key":"B39","doi-asserted-by":"crossref","DOI":"10.2307\/2532051","article-title":"A concordance correlation coefficient to evaluate reproducibility","volume":"45","author":"Lin","year":"1989","journal-title":"Biometrics"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.2307\/2987937","article-title":"Measurement in medicine: The analysis of method comparison studies","volume":"32","author":"Altman","year":"1983","journal-title":"J R Stat Soc Ser D (The Statistician)"},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2014-05-552729","article-title":"Current concepts in the diagnosis and management of cytokine release syndrome","volume":"124","author":"Lee","year":"2014","journal-title":"Blood"},{"key":"B42","volume-title":"RStudio: Integrated Development for R","year":"2015"},{"key":"B43","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics10100836","article-title":"Initial and delayed metabolic activity of palatine tonsils measured with the PET\/CT-dedicated parameters","volume":"10","author":"Pietrzak","year":"2020","journal-title":"Diagnostics."},{"key":"B44","doi-asserted-by":"publisher","DOI":"10.22037\/uj.v0i0.4065","article-title":"Detection of the prostate cancer bone metastases: Is it feasible to compare 18F-fluorocholine PET\/CT, 18F-fluorodeoxyglucose PET\/CT and 99mTc-methyl diphosphonate bone scintigraphy","volume":"15","author":"Pietrzak","year":"2018","journal-title":"Urol J"},{"key":"B45","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1016\/j.ejrad.2019.01.031","article-title":"Predictive value of quantitative diffusion-weighted imaging and 18-F-FDG-PET in head and neck squamous cell carcinoma treated by (chemo)radiotherapy","volume":"113","author":"Martens","year":"2019","journal-title":"Eur J Radiol"},{"key":"B46","doi-asserted-by":"publisher","DOI":"10.1007\/s00259-020-05112-2","article-title":"EANM\/SNMMI practice guideline for [(18)F]FDG PET\/CT external beam radiotherapy treatment planning in uterine cervical cancer v1.0","volume":"48","author":"Adam","year":"2021","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"B47","doi-asserted-by":"publisher","DOI":"10.1007\/s00259-022-05780-2","article-title":"Joint EANM\/SNMMI\/ANZSNM practice guidelines\/procedure standards on recommended use of [(18)F]FDG PET\/CT imaging during immunomodulatory treatments in patients with solid tumors version 1.0","volume":"49","author":"Lopci","year":"2022","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"B48","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2015142088","article-title":"Imaging for staging and response assessment in lymphoma","volume":"276","author":"Johnson","year":"2015","journal-title":"Radiology"},{"key":"B49","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2021005385","article-title":"Pretherapy metabolic tumor volume is associated with response to CD30 CAR T cells in Hodgkin lymphoma","volume":"6","author":"Voorhees","year":"2022","journal-title":"Blood Adv"},{"key":"B50","doi-asserted-by":"publisher","DOI":"10.1007\/s00259-013-2429-4","article-title":"High FDG activity in focal fat necrosis: a pitfall in interpretation of posttreatment PET\/CT in patients with non-Hodgkin lymphoma","volume":"40","author":"Kashyap","year":"2013","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"B51","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2016.03.081","article-title":"RECIST 1.1-update and clarification: From the RECIST committee","volume":"62","author":"Schwartz","year":"2016","journal-title":"Eur J Cancer"},{"key":"B52","doi-asserted-by":"publisher","DOI":"10.1259\/bjr\/32785946","article-title":"Response assessment in solid tumours: a comparison of WHO, SWOG and RECIST guidelines","volume":"81","author":"Julka","year":"2008","journal-title":"Br J Radiol"},{"key":"B53","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.09.4110","article-title":"Revised RECIST guideline version 1.1: What oncologists want to know and what radiologists need to know","volume":"195","author":"Nishino","year":"2010","journal-title":"AJR Am J roentgenology"},{"key":"B54","doi-asserted-by":"publisher","DOI":"10.1200\/cci.19.00165","article-title":"Quantitative imaging informatics for cancer research","volume":"4","author":"Fedorov","year":"2020","journal-title":"JCO Clin Cancer Inf"},{"key":"B55","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1148\/radiol.13122697","article-title":"Quantitative imaging in cancer evolution and ecology","volume":"269","author":"Gatenby","year":"2013","journal-title":"Radiology"}],"container-title":["Frontiers in Immunology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2023.994520\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,2,15]],"date-time":"2023-02-15T11:32:59Z","timestamp":1676460779000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2023.994520\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,15]]},"references-count":55,"alternative-id":["10.3389\/fimmu.2023.994520"],"URL":"https:\/\/doi.org\/10.3389\/fimmu.2023.994520","relation":{},"ISSN":["1664-3224"],"issn-type":[{"value":"1664-3224","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2,15]]},"article-number":"994520"}}