Controlling Familywise Error Rate for Matched Subspace Detection in Dynamic FDG PET

Detection of small lesions in fluorodeoxyglucose (FDG) positron emission tomography (PET) is limited by image resolution and low signal to noise ratio. We have previously described a matched subspace detection method that uses the time activity curve to distinguish tumors from background in dynamic FDG PET. Applying this algorithm on a voxel by voxel basis throughout the dynamic image produces a test statistic image or ldquomaprdquo which on thresholding indicates the potential locations of secondary or metastatic tumors. In this paper, we describe a thresholding method that controls familywise error rate (FWER) for the matched subspace detection statistical map. The method involves three steps. First, the PET image is segmented into several homogeneous regions. Then, the statistical map is normalized to a zero mean unit variance Gaussian random field. Finally, the images are thresholded at a fixed FWER by estimating their spatial smoothness and applying a random field theory maximum statistic approach. We evaluate this thresholding method using digital phantoms generated from clinical dynamic images. We also present an application of the proposed approach to clinical PET data from a breast cancer patient with metastatic disease.