Quantification of FDG PET studies using standardised uptake values in multi-centre trials: effects of image reconstruction, resolution and ROI definition parameters

Westerterp, Marinke; Pruim, Jan; Oyen, Wim J.G.; Hoekstra, Otto S.; Paans, Anne M. J.; Visser, Eric P.; Lanschot, Jan van; Sloof, Gerrit W.; Boellaard, Ronald

doi:10.1007/s00259-006-0224-1

Cited by 275 publications

(222 citation statements)

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“…SUV is dependent on parameters such as time after injection, ROI size, plasma glucose/insulin concentration, body weight, instrumental factors, partial volume effect, and the resolution of the PET unit [27]. Differences in any of these parameters might account for differences in the threshold SUV among studies.…”

Section: Discussionmentioning

confidence: 99%

Metabolic Characteristics of Advanced Biliary Tract Cancer Using 18F-Fluorodeoxyglucose Positron Emission Tomography and Their Clinical Implications

Cho

Kim

et al. 2015

The Oncologist

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Section: Discussionmentioning

confidence: 99%

Metabolic Characteristics of Advanced Biliary Tract Cancer Using 18F-Fluorodeoxyglucose Positron Emission Tomography and Their Clinical Implications

Cho

Kim

et al. 2015

The Oncologist

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“…Therefore, SUVs may not only change with different modes of acquisition (2D or 3D mode), but also with the use of different scanners, image reconstruction and data analysis software. A potential problem in the present use of combined PET-CT scanners is that SUVs may not necessarily show the same absolute values and the same degree of reliability as those obtained from stand-alone PET scanners, in which attenuation correction factors are calculated using external 511-keV rod sources (9). Variability in SUV methodology hampers direct comparison of results obtained in different studies and prevents comparison of results obtained in different centers (10).…”

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confidence: 99%

Comparison of standardized uptake values obtained from 18f fluorodeoxyglucose positron emission tomography/computed tomography imaging performed with 2d and 3D modes in oncological cases

Kocabaş¹,

Yapar²,

Reyhan³

et al. 2012

Diagn Interv Radiol

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NUCLEAR MEDICINEORIGINAL ARTICLE PURPOSE We investigated the usability of standardized uptake values (SUV) obtained from both two-and three-dimensional (2D and 3D) positron-emission tomography and computed tomography (PET-CT) imaging, and compared the images obtained from these techniques in terms of image quality, lesion detectability, and the presence of artifacts. MATERIALS AND METHODSImage data from 100 patients, who had undergone two PET imagings obtained in 2D and 3D mode after a low dose CT, were evaluated prospectively. Subjective analysis of 2D and 3D images was performed by two readers evaluating the following criteria: overall image quality, detectability of each identified lesion, and the presence of artifacts. The lesions recognized by the readers were also analyzed quantitatively by measuring SUV values. RESULTSThere was a significant difference between the SUVs obtained in 2D and 3D modes. Regardless if the first scan was performed in 2D or 3D mode, the values obtained from 3D imaging were significantly lower than those obtained from 2D imaging (mean SUV max was 10.48±7.57 for 2D, and 9.66±6.93 for 3D, P < 0.001). Visual analysis did not reveal significant differences regarding lesion detectability between two modes. CONCLUSIONIn oncological PET-CT applications, SUV values are significantly lower in 3D compared with 2D mode. Thus when serial scanning is needed to evaluate response to therapy in the same patient, the imaging modality should be taken into account and performed with the same method to avoid misinterpretation. Additionally, 3D PET-CT imaging can be used instead of 2D PET-CT due to its shorter scanning time without loss of lesion detectability. F-FDG PET is now routinely used in detecting, staging, and evaluating treatment response of various tumors (1-4). The combination of PET and computed tomography (CT) provides the ability to accurately register the metabolic and molecular aspects of disease with anatomical findings, adding further information to the diagnosis and staging of tumors. PET-CT is a fast growing imaging modality worldwide (2).PET scanners from some vendors can acquire data in both two-dimensional (2D) and three-dimensional (3D) modes, whereas others can only acquire data in 3D mode (5). A shorter scan time and improved efficiency of 18 F-FDG use due to higher sensitivity in the 3D mode could theoretically be the main advantage of 3D acquisition compared to standard 2D (6).There are diverse approaches to assess the amount of 18 F-FDG uptake, though standardized uptake values (SUVs) are widely employed as a semi-quantitative index for tumor uptake (7,8). SUV can be affected by various factors, such as time of acquisition after radiopharmaceutical injection, plasma glucose level, partial volume effect, reconstruction parameters, and attenuation correction methods. In addition, SUV is known to depend on acquisition parameters and region of interest (ROI) selection. Therefore, SUVs may not only change with different modes of acquisition (2D or 3D mode), but also with the u...

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“…First, a calibration factor was calculated by dividing the actual SUV by the measured mean SUV in the phantom background to reduce interinstitutional SUV variability. 17 Second, a recovery coefficient (RC) was calculated as a function of sphere diameter to decrease the dependence of SUV on tumor size. 18 The mean SUV value was only used as a part of the phantom study, although maxSUV values were measured as a significant factor in each patient.…”

Section: Methodsmentioning

confidence: 99%

“…[11][12][13] However, many factors (such as patient preparation procedures, scan acquisition, image reconstruction, and data analysis) affect SUV. 20,21 Westerterp et al 17 reported that an up to 30% variation in SUV quantification among 3 institutions can pose a serious problem when performing multicenter studies. This explains why very few multicenter studies to date have attempted to target SUV on PET.…”

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confidence: 99%

Value of integrated positron emission tomography revised using a phantom study to evaluate malignancy grade of lung adenocarcinoma

Nakayama

Okumura

Daisaki³

et al. 2010

Cancer

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BACKGROUND:The malignant biological behavior of small-sized lung adenocarcinomas remains obscure, although understanding this feature is important for selecting appropriate treatment. In the current study, the authors evaluated malignancy grades of small adenocarcinomas using fluorodeoxyglucose-positron emission tomography/ computed tomography (PET/CT) in addition to high-resolution CT (HRCT) and pathological analysis in a multicenter setting. METHODS: A total of 201 patients with clinical T1N0M0 adenocarcinoma underwent PET/CT and HRCT followed by complete surgical resection. Associations between components of bronchioloalveolar carcinoma (BAC) in specimens and maximum standardized uptake values (maxSUV) on PET/CT and ground-glass opacity (GGO) ratios and tumor disappearance rate (TDR) on HRCT were analyzed, as well as associations between these findings and pathological features of the tumors. Variations in maxSUV among institutions and the underestimations derived from small tumors, which are limitations of PET performed in multicenter studies, were adjusted using a phantom study. RESULTS: The maxSUV, BAC ratio, TDR, and GGO ratio (in that order) reflected the grade of tumor invasiveness and lymph node metastasis. The maxSUV and BAC ratio were found to be significant prognostic predictors derived from disease-free survival curves. Although the BAC ratio was found to be significantly associated with preoperative radiographic parameters, the maxSUV, GGO ratio, and TDR (all P < .0001), the degree of correlation with maxSUV (correlation coefficient [R 2 ] ¼ 0.1699) was much weaker than that reported with the GGO ratio (R 2 ¼ 0.5860) or TDR (R 2 ¼ 0.5082). CONCLUSIONS: Phantom studies can overcome the difficulties of multicenter studies using PET. A higher maxSUV appears to reflect aggressive malignant behavior in clinical T1N0M0 adenocarcinomas, independent of BAC components. Preoperative PET/CT assessment in addition to HRCT could be used to construct hypotheses for a future clinical study of strategies for the treatment of patients with small lung adenocarcinoma. Cancer 2010;116:3170-7.

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Quantification of FDG PET studies using standardised uptake values in multi-centre trials: effects of image reconstruction, resolution and ROI definition parameters

Abstract: Standardisation of acquisition, reconstruction and ROI methods is preferred for SUV quantification in multi-centre trials. Small unavoidable differences in methodology can be accommodated by performing a phantom study to assess inter-institute correction factors.

Cited by 275 publications

References 15 publications

Metabolic Characteristics of Advanced Biliary Tract Cancer Using 18F-Fluorodeoxyglucose Positron Emission Tomography and Their Clinical Implications

Metabolic Characteristics of Advanced Biliary Tract Cancer Using 18F-Fluorodeoxyglucose Positron Emission Tomography and Their Clinical Implications

Comparison of standardized uptake values obtained from 18f fluorodeoxyglucose positron emission tomography/computed tomography imaging performed with 2d and 3D modes in oncological cases

Value of integrated positron emission tomography revised using a phantom study to evaluate malignancy grade of lung adenocarcinoma

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