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Repeatability of SUV measurements in serial PET.

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Title: Repeatability of SUV measurements in serial PET.
Authors: Schwartz, J.1, Humm, J. L.1, Gonen, M.2, Kalaigian, H.1, Schoder, H.3, Larson, S. M.3, Nehmeh, S. A.1
Source: Medical Physics. May2011, Vol. 38 Issue 5, p2629-2638. 10p.
Subjects: Deoxy sugars, Cancer patients, Imaging phantoms, Positron emission tomography, Diagnostic ultrasonic imaging, Medical physics, Quantitative research
Abstract: Purpose: The standardized uptake value (SUV) is a quantitative measure of FDG tumor uptake frequently used as a tool to monitor therapeutic response. This study aims to (i) assess the reproducibility and uncertainty of SUVmax and SUVmean, due to purely statistical, i.e., nonbiological, effects and (ii) to establish the minimum uncertainty below which changes in SUV cannot be expected to be an indicator of physiological changes. Methods: Three sets of measurements were made using a GE Discovery STE PET/CT Scanner in 3D mode: (1) A uniform 68Ge 20 cm diameter cylindrical phantom was imaged. Thirty serial frames were acquired for durations of 3, 6, 10, 15, and 30 min. (2) Esser flangeless phantom (Data Spectrum, ∼6.1 L) with fillable thin-walled cylinders inserts (diameters: 8, 12, 16, and 25 mm; height: ∼3.8 mm) was scanned for five consecutive 3 min runs. The cylinders were filled with 18FDG with a 37 kBq/cc concentration, and with a target-to-background ratio (T/BKG) of 3/1. (3) Eight cancer patients with healthy livers were scanned ∼1.5 h post injection. Three sequential 3 min scans were performed for one bed position covering the liver, with the patient and bed remaining at the same position for the entire length of the scan. Volumes of interest were drawn on all images using the corresponding CT and then transferred to the PET images. For each study (1-3), the average percent change in SUVmean and SUVmax were determined for each run pair. Moreover, the repeatability coefficient was calculated for both the SUVmean and SUVmax for each pair of runs. Finally, the overall ROI repeatability coefficient was determined for each pair of runs. Results: For the 68Ge phantom the average percent change in SUVmax and SUVmean decrease as a function of increasing acquisition time from 4.7 ± 3.1 to 1.1 ± 0.6%, and from 0.14 ± 0.09 to 0.04 ± 0.03%, respectively. Similarly, the coefficients of repeatability also decrease between the 3 and 30 min acquisition scans, in the range of 10.9 ± 3.9% - 2.6 ± 0.9%, and 0.3 ± 0.1% - 0.10 ± 0.04%, for the SUVmax and SUVmean, respectively. The overall ROI repeatability decreased from 18.9 ± 0.2 to 6.0 ± 0.1% between the 3 and 30 min acquisition scans. For the 18FDG phantom, the average percent change in SUVmax and SUVmean decreases with target diameter from 3.6 ± 2.0 to 1.5 ± 0.8% and 1.5 ± 1.3 to 0.26 ± 0.15%, respectively, for targets from 8 - 25 mm in diameter and for a region in the background (BKG). The coefficients of repeatability for SUVmax and SUVmean also decrease as a function of target diameter from 7.1 ± 2.5 to 2.4 ± 0.9 and 4.2 ± 1.5 to 0.6 ± 0.2, respectively, for targets from 8 mm to BKG in diameter. Finally, overall ROI repeatability decreased from 12.0 ± 4.1 to 13.4 ± 0.5 targets from 8 mm to BKG in diameter. Finally, for the measurements in healthy livers the average percent change in SUVmax and SUVmean were in the range of 0.5 ± 0.2% - 6.2 ± 3.9% and 0.4 ± 0.1 and 1.6 ± 1%, respectively. The coefficients of repeatability for SUVmax and SUVmean are in the range of 0.6 ± 0.7% - 9.5 ± 12% and 0.6 ± 0.7% - 2.9 ± 3.6%, respectively. The overall target repeatability varied between 27.9 ± 0.5% and 41.1 ± 1.0%. Conclusions: The statistical fluctuations of the SUVmean are half as large as those of the SUVmax in the absence of biological or physiological effects. In addition, for clinically applicable scan durations (i.e., ∼3 min) and FDG concentrations, the SUVmax and SUVmean have similar amounts of statistical fluctuation for small regions. However, the statistical fluctuations of the SUVmean rapidly decrease with respect tothe SUVmax as the statistical power of the data grows either due to longer scanning times or as the target regions encompass a larger volume. [ABSTRACT FROM AUTHOR]
Copyright of Medical Physics is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Repeatability of SUV measurements in serial PET.
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  Data: <searchLink fieldCode="JN" term="%22Medical+Physics%22">Medical Physics</searchLink>. May2011, Vol. 38 Issue 5, p2629-2638. 10p.
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  Data: <searchLink fieldCode="DE" term="%22Deoxy+sugars%22">Deoxy sugars</searchLink><br /><searchLink fieldCode="DE" term="%22Cancer+patients%22">Cancer patients</searchLink><br /><searchLink fieldCode="DE" term="%22Imaging+phantoms%22">Imaging phantoms</searchLink><br /><searchLink fieldCode="DE" term="%22Positron+emission+tomography%22">Positron emission tomography</searchLink><br /><searchLink fieldCode="DE" term="%22Diagnostic+ultrasonic+imaging%22">Diagnostic ultrasonic imaging</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+physics%22">Medical physics</searchLink><br /><searchLink fieldCode="DE" term="%22Quantitative+research%22">Quantitative research</searchLink>
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  Data: Purpose: The standardized uptake value (SUV) is a quantitative measure of FDG tumor uptake frequently used as a tool to monitor therapeutic response. This study aims to (i) assess the reproducibility and uncertainty of SUVmax and SUVmean, due to purely statistical, i.e., nonbiological, effects and (ii) to establish the minimum uncertainty below which changes in SUV cannot be expected to be an indicator of physiological changes. Methods: Three sets of measurements were made using a GE Discovery STE PET/CT Scanner in 3D mode: (1) A uniform 68Ge 20 cm diameter cylindrical phantom was imaged. Thirty serial frames were acquired for durations of 3, 6, 10, 15, and 30 min. (2) Esser flangeless phantom (Data Spectrum, ∼6.1 L) with fillable thin-walled cylinders inserts (diameters: 8, 12, 16, and 25 mm; height: ∼3.8 mm) was scanned for five consecutive 3 min runs. The cylinders were filled with 18FDG with a 37 kBq/cc concentration, and with a target-to-background ratio (T/BKG) of 3/1. (3) Eight cancer patients with healthy livers were scanned ∼1.5 h post injection. Three sequential 3 min scans were performed for one bed position covering the liver, with the patient and bed remaining at the same position for the entire length of the scan. Volumes of interest were drawn on all images using the corresponding CT and then transferred to the PET images. For each study (1-3), the average percent change in SUVmean and SUVmax were determined for each run pair. Moreover, the repeatability coefficient was calculated for both the SUVmean and SUVmax for each pair of runs. Finally, the overall ROI repeatability coefficient was determined for each pair of runs. Results: For the 68Ge phantom the average percent change in SUVmax and SUVmean decrease as a function of increasing acquisition time from 4.7 ± 3.1 to 1.1 ± 0.6%, and from 0.14 ± 0.09 to 0.04 ± 0.03%, respectively. Similarly, the coefficients of repeatability also decrease between the 3 and 30 min acquisition scans, in the range of 10.9 ± 3.9% - 2.6 ± 0.9%, and 0.3 ± 0.1% - 0.10 ± 0.04%, for the SUVmax and SUVmean, respectively. The overall ROI repeatability decreased from 18.9 ± 0.2 to 6.0 ± 0.1% between the 3 and 30 min acquisition scans. For the 18FDG phantom, the average percent change in SUVmax and SUVmean decreases with target diameter from 3.6 ± 2.0 to 1.5 ± 0.8% and 1.5 ± 1.3 to 0.26 ± 0.15%, respectively, for targets from 8 - 25 mm in diameter and for a region in the background (BKG). The coefficients of repeatability for SUVmax and SUVmean also decrease as a function of target diameter from 7.1 ± 2.5 to 2.4 ± 0.9 and 4.2 ± 1.5 to 0.6 ± 0.2, respectively, for targets from 8 mm to BKG in diameter. Finally, overall ROI repeatability decreased from 12.0 ± 4.1 to 13.4 ± 0.5 targets from 8 mm to BKG in diameter. Finally, for the measurements in healthy livers the average percent change in SUVmax and SUVmean were in the range of 0.5 ± 0.2% - 6.2 ± 3.9% and 0.4 ± 0.1 and 1.6 ± 1%, respectively. The coefficients of repeatability for SUVmax and SUVmean are in the range of 0.6 ± 0.7% - 9.5 ± 12% and 0.6 ± 0.7% - 2.9 ± 3.6%, respectively. The overall target repeatability varied between 27.9 ± 0.5% and 41.1 ± 1.0%. Conclusions: The statistical fluctuations of the SUVmean are half as large as those of the SUVmax in the absence of biological or physiological effects. In addition, for clinically applicable scan durations (i.e., ∼3 min) and FDG concentrations, the SUVmax and SUVmean have similar amounts of statistical fluctuation for small regions. However, the statistical fluctuations of the SUVmean rapidly decrease with respect tothe SUVmax as the statistical power of the data grows either due to longer scanning times or as the target regions encompass a larger volume. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
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  Data: <i>Copyright of Medical Physics is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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