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Cited by 76Medical Imaging Techniques and ApplicationsRadiomics and Machine Learning in Medical ImagingLung Cancer Diagnosis and Treatment

Variance of SUVs for FDG-PET/CT is Greater in Clinical Practice Than Under Ideal Study Settings

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Kumar, Virendra, Nath, Kavindra, Berman, Claudia G., Kim, Jongphil, Tanvetyanon, Tawee, Chiappori, Alberto A., Gatenby, Robert A., Gillies, Robert J. +1 more·2013·Clinical Nuclear Medicine
DOI 10.1097/rlu.0b013e318279ffdfPMC PMC3578161
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Abstract

PURPOSE: Measurement variance affects the clinical effectiveness of PET-based measurement as a semiquantitative imaging biomarker for cancer response in individual patients and for planning clinical trials. In this study, we measured test-retest reproducibility of SUV measurements under clinical practice conditions and recorded recognized deviations from protocol compliance. METHODS: Instrument performance calibration, display, and analyses conformed to manufacture recommendations. Baseline clinical (18)F-FDG PET/CT examinations were performed and then repeated at 1 to 7 days. Intended scan initiation uptake period was to repeat the examinations at the same time for each study after injection of 12 mCi FDG tracer. Avidity of uptake was measured in 62 tumors in 21 patients as SUV for maximum voxel (SUV(max)) and for a mean of sampled tumor voxels (SUV(mean)). RESULTS: The range of SUV(max) and SUV(mean) was 1.07 to 21.47 and 0.91 to 14.69, respectively. Intraclass correlation coefficient between log of SUV(max) and log of SUV(mean) was 0.93 (95% confidence interval [CI], 0.88-0.95) and 0.92 (95% CI, 0.87-0.95), respectively.Correlation analysis failed to show an effect on uptake period variation on SUV measurements between the 2 examinations, suggesting additional sources of noise.The threshold criteria for relative difference from baseline for the 95% CI were ± 49% or ± 44% for SUV(max) or SUV(mean), respectively. CONCLUSIONS: Variance of SUV for FDG-PET/CT in current clinical practice in a single institution was greater than expected when compared with benchmarks reported under stringent efficacy study settings. Under comparable clinical practice conditions, interpretation of changes in tumor avidity in individuals and assumptions in planning clinical trials may be affected.

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  • Lesion SUVs in [18F]FDG-PET show a test-retest variability in the same patient with the same PET scanner of up to 20% and are usually even less comparable between different scanners and centers or under routine clinical conditions.

    “However, lesion SUVs in [18F]FDG-PET show a test-retest variability in the same patient with the same PET scanner of up to 20% [189] and are usually even less comparable between different scanners and centers or under routine clinical conditions [190].”

    From Influences on PET Quantification and Interpretation (2022) · cites this paper as [190]

    The Conclusion reports that SUV test–retest variance in routine clinical practice was greater than benchmarks from stringent study settings, with agreement thresholds approaching 50%. The Discussion cautions about comparisons across institutions, but does not establish that measurements from different scanners or centers are usually less comparable. The 20% same-scanner figure belongs to citation [189], not the citation assessed here. (LLM, conf=0.83)

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  • Using quantitative PET for patient selection is difficult in clinical practice because SUV measurements not obtained in a well-conducted clinical trial are subject to variability due to technical factors such as the PET scanner used and the acquisition and reconstruction parameters.

    “Using quantitative PET for patient selection is difficult in clinical practice because SUV measurements not obtained in a well-conducted clinical trial are subject to variability. This is because of technical factors such as the PET scanner used and the acquisition and reconstruction parameters (23–26).”

    From Quantitative <sup>68</sup> Ga-PSMA-11 PET and Clinical Outcomes in Metastatic Castration-resistant Prostate Cancer Following <sup>177</sup> Lu-PSMA-617 (VISION Trial) (2024) · cites this paper as [25]

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Research works printed but not linked: 1

  1. [49]Doot R Kurland B Kinahan P Considerations for using PET as a response measure in multicenter clinical trials. 2009 Soc Nuclear Med 537 PMC3251737 22104290

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Authors
Kumar, V., Nath, K., Berman, C. G., Kim, J., Tanvetyanon, T., Chiappori, A. A., Gatenby, R. A., Gillies, R. J., & Eikman, E. A.
Affiliations
Moffitt Cancer Center (US)
Corresponding author
  • Kumar, Virendra
  • Nath, Kavindra
  • Gillies, Robert J.
ORCID
Venue
Clinical Nuclear Medicine
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2013-03
Volume
38
Issue
3
Pages
175-182
ISSN
0363-9762 (ISSN-L)
DOI
10.1097/rlu.0b013e318279ffdf
PMC
PMC3578161
OpenAlex
W113645134
Cited by
76
References
62
Citations by year
2025: 4 · 2024: 4 · 2023: 7 · 2022: 6 · 2021: 4 · 2020: 5 · 2019: 8 · 2018: 7 · 2017: 7 · 2016: 12 · 2015: 6 · 2014: 5 · 2013: 1
FWCI
6.20
Type
journal article
Language
en
Open access
Locations
  • Clinical Nuclear Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • Bristol-Myers Squibb
  • Moffitt Cancer Center
  • National Institutes of Health
  • National Cancer Institute (U54CA143970, R01CA125627, U01CA143062, R01CA077575)
Topics
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Medical Imaging Techniques and Applications
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Radiomics and Machine Learning in Medical Imaging
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Lung Cancer Diagnosis and Treatment
Keywords
FDG PET/CT, standardized uptake value, test-retest reproducibility, tumor uptake, protocol adherence, clinical trial design, imaging biomarkers
MeSH terms
Adult, Aged, Analysis of Variance, Biological Transport, Female, Humans, Image Interpretation, Computer-Assisted, Male, Middle Aged, Neoplasms, Retrospective Studies, Tomography, X-Ray Computed, Multicenter Studies as Topic, Fluorodeoxyglucose F18, Guideline Adherence, Positron-Emission Tomography, Multimodal Imaging

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