Reference Range for Intrapatient Variability in Blood-Pool and Liver SUV for 18F-FDG PET
Open accessAbstract
UNLABELLED: (18)F-FDG PET qualitative tumor response assessment or tumor-to-background ratios compare targets against blood-pool or liver activity; standardized uptake value (SUV) semiquantitation has artifacts and is validated by a stable normal-tissue baseline. The aim of this study was to document the normal intrapatient range of scan-to-scan variation in blood-pool SUV and liver SUV and to identify factors that may adversely affect it (increase its spread). METHODS: Between July 2009 and June 2010, 132 oncology patients had 2 PET/CT scans. Patient preparation, acquisition, and reconstruction protocols were held stable, uniform, and reproducible. Mean SUV (body weight) values were obtained from 2-dimensional regions of interest in the aortic arch blood pool and in the right lobe of the liver. RESULTS: Of the 132 patients, 65 had lymphoma. Their mean age was 62.5 y. The group's mean serum glucose level was 6.0 mmol/L at the first visit and 5.9 mmol/L at the second visit. The mean (18)F-FDG dose was 4.1 MBq/kg at the first visit and 4.0 at the second. At the first visit, the group's mean blood-pool SUV was 1.55 (SD, 0.38); at the second, 1.58 (SD, 0.37)-not statistically different. The group's mean liver SUV was 2.17 (SD, 0.44) at the first visit and 2.29 (SD, 0.44) at the second (P = 0.005). Visit-to-visit intrapatient variation in blood-pool and liver SUVs had gaussian distributions. The variation in blood-pool SUV had a mean of 0.03 and SD of 0.42. The variation in liver SUV had a mean of 0.12 and SD of 0.50. Using 95th percentiles, the reference range in our patient population for intrapatient variation was -0.8 to 0.9 for blood pool SUV and -0.9 to 1.1 for liver SUV. Subanalysis by cancer type and chemotherapy suggested that the rise in liver SUV between the 2 visits was largely due to the commencement of chemotherapy, but no factors were identified as systematically affecting intrapatient variation, and no factors were identified as increasing its spread. CONCLUSION: In our patient cohort, the reference range for intrapatient variation in blood-pool and liver SUVs is -0.8 to 0.9 and -0.9 to 1.1, respectively.
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Several studies suggested that the blood pool is a more optimal and stable reference tissue than the liver, as it is much less dependent than the liver on glycemia and other variables.
“Several studies suggested that the blood pool is a more optimal and stable reference tissue than the liver,[1,3,25,39,41] as it is much less dependent than the liver on glycemia and other variables.[10]”
From Intrapatient variability of 18F-FDG uptake in normal tissues (2022) · cites this paper as [41]
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Intrapatient variability of 18F-FDG uptake in normal tissues
Sayed, M. H. M., Abdelnaim, A. K., & Mohamadien, N. R. (2022) · Journal of Clinical Imaging Science · doi:10.25259/jcis_23_2022 · Cited by 2 · see citing works
- Authors
- Boktor, R. R., Walker, G., Stacey, R., Gledhill, S., & Pitman, A. G.
- Affiliations
- Ballarat Health Services (AU)
- St John of God Hospital (AU)
- Monash University (AU)
- Venue
- Journal of Nuclear Medicine
- Publisher
- Society of Nuclear Medicine
- Published
- 2013-03-19
- Volume
- 54
- Issue
- 5
- Pages
- 677-682
- ISSN
- 0161-5505 (ISSN-L)
- 2159-662X
- OpenAlex
- W2114289895
- Cited by
- 90
- References
- 0
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 8 · 2023: 11 · 2022: 10 · 2021: 7 · 2020: 7 · 2019: 7 · 2018: 5 · 2017: 5 · 2016: 4 · 2015: 11 · 2014: 7 · 2013: 1
- FWCI
- 5.95
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Nuclear Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Medical Imaging Techniques and Applications
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Lung Cancer Diagnosis and Treatment
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Radiopharmaceutical Chemistry and Applications
- Keywords
- 18F-FDG PET, standardized uptake value, liver SUV, intrapatient variability, reference values, PET/CT, lymphoma, tumor response assessment, tumor-to-background ratio, serum glucose, right lobe of liver
- MeSH terms
- Adult, Aged, Aged, 80 and over, Biological Transport, Humans, Liver, Middle Aged, Reference Values, Reproducibility of Results, Gated Blood-Pool Imaging, Linear Models, Fluorodeoxyglucose F18, Positron-Emission Tomography, Young Adult
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