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Repeatability of 18F-FDG Uptake Measurements in Tumors: A Metaanalysis
Open accessAbstract
UNLABELLED: PET with the glucose analog (18)F-FDG is increasingly used to monitor tumor response to therapy. To use quantitative measurements of tumor (18)F-FDG uptake for assessment of tumor response, the repeatability of this quantitative metabolic imaging method needs to be established. Therefore, we determined the repeatability of different standardized uptake value (SUV) measurements using the available data. METHODS: A systematic literature search was performed to identify studies addressing (18)F-FDG repeatability in malignant tumors. The level of agreement between test and retest values of 2 PET uptake measures, maximum SUV (SUV(max)) and mean SUV (SUV(mean)), was assessed with the coefficient of repeatability using generalized linear mixed-effects models. In addition, the influence of tumor volume on repeatability was assessed. Principal component transformation was used to compare the reproducibility of the 2 different uptake measures. RESULTS: Five cohorts were identified for this metaanalysis. For SUV(max) and SUV(mean), datasets of 86 and 102 patients, respectively, were available. Percentage repeatability is a function of the level of uptake. SUV(mean) had the best repeatability characteristics; for serial PET scans, a threshold of a combination of 20% as well as 1.2 SUV(mean) units was most appropriate. After adjusting for uptake rate, tumor volume had minimal influence on repeatability. CONCLUSION: SUV(mean) had better repeatability performance than SUV(max). Both measures showed poor repeatability for lesions with low (18)F-FDG uptake. We recommend the evaluation of biologic effects in PET by reporting a combination of minimal relative and absolute changes to account for test-retest variability.
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“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 [189]
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“Despite the common use of SUVmax in clinical practice, arising from its convenience, SUVpeak and SUVmean have been shown to be slightly less variable under test-retest conditions [189,191].”
From Influences on PET Quantification and Interpretation (2022) · cites this paper as [189]
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Cites
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Barrington, S. F., Mikhaeel, N. G., Kostakoğlu, L., Meignan, M. A., Hutchings, M., Müeller, S., Schwartz, L. H., Zucca, E., Fisher, R. I., Trotman, J., et al. (2014) · Journal of Clinical Oncology · doi:10.1200/jco.2013.53.5229 · Cited by 1,663
Self-citationLeijenaar, R. T. H., Carvalho, S., Velazquez, E. R., van Elmpt, W., Parmar, C., Hoekstra, O. S., Hoekstra, C. J., Boellaard, R., Dekker, A. L. A. J., Gillies, R. J., et al. (2013) · Acta Oncologica · doi:10.3109/0284186x.2013.812798 · Cited by 428
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Repeatability of SUV in Oncologic 18F-FDG PET
Lodge, M. A. (2017) · Journal of Nuclear Medicine · doi:10.2967/jnumed.116.186353 · Cited by 214
Metadata
- Authors
- de Langen, A. J., Vincent, A., Velasquez, L. M., van Tinteren, H., Boellaard, R., Shankar, L. K., Boers, M., Smit, E. F., Stroobants, S., Weber, W. A., & Hoekstra, O. S.
- Affiliations
- Amsterdam UMC Location Vrije Universiteit Amsterdam (NL)
- The Netherlands Cancer Institute (NL)
- Bristol-Myers Squibb (United States) (US)
- National Cancer Institute (US)
- Antwerp University Hospital (BE)
- University of Freiburg (DE)
- Corresponding author
- de Langen, Adrianus J.
- ORCID
- Venue
- Journal of Nuclear Medicine
- Publisher
- Society of Nuclear Medicine
- Published
- 2012-04-10
- Volume
- 53
- Issue
- 5
- Pages
- 701-708
- ISSN
- 0161-5505 (ISSN-L)
- 2159-662X
- OpenAlex
- W2149015860
- Cited by
- 157
- References
- 31
- Citations by year
- 2026: 4 · 2025: 5 · 2024: 4 · 2023: 4 · 2022: 13 · 2021: 7 · 2020: 14 · 2019: 5 · 2018: 9 · 2017: 13 · 2016: 17 · 2015: 22 · 2014: 21 · 2013: 14 · 2012: 5
- FWCI
- 14.97
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Nuclear Medicine (publishedVersion)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (publishedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
- Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- 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
- 18F-FDG PET, standardized uptake value, SUVmax, SUVmean, test-retest repeatability, tumor response assessment, tumor volume, uptake rate, cancer
- MeSH terms
- Biological Transport, Humans, Neoplasms, Reproducibility of Results, Fluorodeoxyglucose F18, Tumor Burden, Positron-Emission Tomography
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