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Variability of average SUV from several hottest voxels is lower than that of SUVmax and SUVpeak

  • Nuclear Medicine
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

To assess variability of the average standard uptake value (SUV) computed by varying the number of hottest voxels within an 18F-fluorodeoxyglucose (18F-FDG)-positive lesion. This SUV metric was compared with the maximal SUV (SUVmax: the hottest voxel) and peak SUV (SUVpeak: SUVmax and its 26 neighbouring voxels).

Methods

Twelve lung cancer patients (20 lesions) were analysed using PET dynamic acquisition involving ten successive 2.5-min frames. In each frame and lesion, average SUV obtained from the N = 5, 10, 15, 20, 25 or 30 hottest voxels (SUVmax–N ), SUVmax and SUVpeak were assessed. The relative standard deviations (SDrs) from ten frames were calculated for each SUV metric and lesion, yielding the mean relative SD from 20 lesions for each SUV metric (SDr N , SDrmax and SDrpeak), and hence relative measurement error and repeatability (MEr–R).

Results

For each N, SDr N was significantly lower than SDrmax and SDrpeak. SDr N correlated strongly with N: 6.471 × N -0.103 (r = 0.994; P < 0.01). MEr–R of SUVmax-30 was 8.94–12.63 % (95 % CL), versus 13.86–19.59 % and 13.41–18.95 % for SUVmax and SUVpeak respectively.

Conclusions

Variability of SUVmax–N is significantly lower than for SUVmax and SUVpeak. Further prospective studies should be performed to determine the optimal total hottest volume, as voxel volume may depend on the PET system.

Key Points

PET imaging provides functional parameters of 18 F-FDG-positive lesions, such as SUVmax and SUVpeak.

Averaging SUV from several hottest voxels (SUVmax- N ) is a further SUV metric.

Variability of SUVmax– N is significantly lower than SUVmax and SUVpeak variability.

SUVmax– N should improve SUV accuracy for predicting outcome or assessing treatment response.

An optimal total hottest volume should be determined through further prospective studies.

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Abbreviations

MEr:

relative measurement error

MEr–R:

relative measurement error and repeatability

SDr:

relative standard deviation

R:

repeatability

TV:

tumour volume

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Acknowledgements

The scientific guarantor of this publication is Prof. Roger Marthan. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. No complex statistical methods were necessary for this paper. Institutional Review Board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Some study subjects or cohorts have been previously reported in references 20 and 23 of the revised paper.

Methodology: retrospective, as PET images had already been acquired [20, 23], diagnostic or prognostic study, performed at one institution.

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Correspondence to E. Laffon.

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Laffon, E., Lamare, F., de Clermont, H. et al. Variability of average SUV from several hottest voxels is lower than that of SUVmax and SUVpeak. Eur Radiol 24, 1964–1970 (2014). https://doi.org/10.1007/s00330-014-3222-x

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  • DOI: https://doi.org/10.1007/s00330-014-3222-x

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