Letter to the Editor: It is time for the nuclear medicine community to define a unit for the total lesion glycolysis (TLG) and similar metrics

Duarte, Paulo Schiavom; Sapienza, Marcelo Tatit

doi:10.1007/s00259-021-05190-w

Cited by 3 publications

(3 citation statements)

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“…MTV and TLG are volumetric parameters used to quantify the tumor burden of cancer patients. MTV is usually expressed in milliliters (mL) or cubic centimeters (cm 3 ) [38]. MTV segmentation can be made manually, automatically or using a hybrid method (semiautomatic) [39].…”

Section: Mtv and Tlgmentioning

confidence: 99%

“…There is still no consensus on the best method for MTV calculation [41]. Furthermore, there is no consensus on the unit used for TLG, which could be presented as a dimensionless unit, a mass unit (grams) or a volumetric unit (ml or cm 3 ) [38]. The European Association of Nuclear Medicine (EANM) guidelines for tumor imaging published in 2015 [43] recommends that, whenever possible, MTV and TLG calculated using the threshold of 41% or 50% of SUVmax should be reported.…”

Section: Mtv and Tlgmentioning

confidence: 99%

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Metabolic Volume Measurements in Multiple Myeloma

et al. 2021

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Multiple myeloma (MM) accounts for 10–15% of all hematologic malignancies, as well as 20% of deaths related to hematologic malignant tumors, predominantly affecting bone and bone marrow. Positron emission tomography/computed tomography with 18F-fluorodeoxyglucose (FDG-PET/CT) is an important method to assess the tumor burden of these patients. It is often challenging to classify the extent of disease involvement in the PET scans for many of these patients because both focal and diffuse bone lesions may coexist, with varying degrees of FDG uptake. Different metrics involving volumetric parameters and texture features have been proposed to objectively assess these images. Here, we review some metabolic parameters that can be extracted from FDG-PET/CT images of MM patients, including technical aspects and predicting MM outcome impact. Metabolic tumor volume (MTV) and total lesion glycolysis (TLG) are volumetric parameters known to be independent predictors of MM outcome. However, they have not been adopted in clinical practice due to the lack of measuring standards. CT-based segmentation allows automated, and therefore reproducible, calculation of bone metabolic metrics in patients with MM, such as maximum, mean and standard deviation of the standardized uptake values (SUV) for the entire skeleton. Intensity of bone involvement (IBI) is a new parameter that also takes advantage of this approach with promising results. Other indirect parameters obtained from FDG-PET/CT images, such as visceral adipose tissue glucose uptake and subcutaneous adipose tissue radiodensity, may also be useful to evaluate the prognosis of MM patients. Furthermore, the use and quantification of new radiotracers can address different metabolic aspects of MM and may have important prognostic implications.

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Section: Mtv and Tlgmentioning

confidence: 99%

Section: Mtv and Tlgmentioning

confidence: 99%

Metabolic Volume Measurements in Multiple Myeloma

et al. 2021

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“…

Dear Sir,We read with interest the Letter to the Editor "It is time for the nuclear medicine community to define a unit for the total lesion glycolysis (TLG) and similar metrics" by Duarte and Sapienza [1]. We have had a related reflection in the context of the ongoing accelerated developments in the fields of molecular imaging and theranostics.

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confidence: 99%