Repeatability of Quantitative Whole-Body 18F-FDG PET/CT Uptake Measures as Function of Uptake Interval and Lesion Selection in Non–Small Cell Lung Cancer Patients
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UNLABELLED: Change in (18)F-FDG uptake may predict response to anticancer treatment. The PERCIST suggest a threshold of 30% change in SUV to define partial response and progressive disease. Evidence underlying these thresholds consists of mixed stand-alone PET and PET/CT data with variable uptake intervals and no consensus on the number of lesions to be assessed. Additionally, there is increasing interest in alternative (18)F-FDG uptake measures such as metabolically active tumor volume and total lesion glycolysis (TLG). The aim of this study was to comprehensively investigate the repeatability of various quantitative whole-body (18)F-FDG metrics in non-small cell lung cancer (NSCLC) patients as a function of tracer uptake interval and lesion selection strategies. METHODS: Eleven NSCLC patients, with at least 1 intrathoracic lesion 3 cm or greater, underwent double baseline whole-body (18)F-FDG PET/CT scans at 60 and 90 min after injection within 3 d. All (18)F-FDG-avid tumors were delineated with an 50% threshold of SUVpeak adapted for local background. SUVmax, SUVmean, SUVpeak, TLG, metabolically active tumor volume, and tumor-to-blood and -liver ratios were evaluated, as well as the influence of lesion selection and 2 methods for correction of uptake time differences. RESULTS: The best repeatability was found using the SUV metrics of the averaged PERCIST target lesions (repeatability coefficients < 10%). The correlation between test and retest scans was strong for all uptake measures at either uptake interval (intraclass correlation coefficient > 0.97 and R(2) > 0.98). There were no significant differences in repeatability between data obtained 60 and 90 min after injection. When only PERCIST-defined target lesions were included (n = 34), repeatability improved for all uptake values. Normalization to liver or blood uptake or glucose correction did not improve repeatability. However, after correction for uptake time the correlation of SUV measures and TLG between the 60- and 90-min data significantly improved without affecting test-retest performance. CONCLUSION: This study suggests that a 15% change of SUVmean/SUVpeak at 60 min after injection can be used to assess response in advanced NSCLC patients if up to 5 PERCIST target lesions are assessed. Lower thresholds could be used in averaged PERCIST target lesions (<10%).
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SUV of tumor lesions increases steadily over time after [18F]FDG injection.
“The SUV of tumor lesions, therefore, increases steadily over time after [18F]FDG injection [70,71].”
From Influences on PET Quantification and Interpretation (2022) · cites this paper as [70]
The Uptake Time Correction section (page not available) reports that tumor uptake was significantly higher at 90 minutes than at 60 minutes after injection. Those two measurements support an increase over that interval, but do not establish that SUV increases steadily throughout the time after injection. (LLM, conf=0.84)
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Convolutional Neural Networks for automatic image quality control and EARL compliance of PET imagesPreprint
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Self-citation
- Authors
- Kramer, G. M., Frings, V., Hoetjes, N., Hoekstra, O. S., Smit, E. F., de Langen, A. J., & Boellaard, R.
- Affiliations
- Gemeente Amsterdam (NL)
- The Netherlands Cancer Institute (NL)
- Venue
- Journal of Nuclear Medicine
- Publisher
- Society of Nuclear Medicine
- Published
- 2016-04-21
- Volume
- 57
- Issue
- 9
- Pages
- 1343-1349
- ISSN
- 0161-5505 (ISSN-L)
- 2159-662X
- OpenAlex
- W2335867152
- Cited by
- 65
- References
- 26
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 2 · 2023: 4 · 2022: 7 · 2021: 13 · 2020: 10 · 2019: 4 · 2018: 9 · 2017: 9 · 2016: 3
- FWCI
- 7.23
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Nuclear Medicine (publishedVersion)
- PubMed (publishedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
- Pure Amsterdam UMC (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- 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 › Radiomics and Machine Learning in Medical Imaging
- Keywords
- 18F-FDG PET/CT, non-small cell lung cancer, test-retest repeatability, lesion selection, PERCIST, standardized uptake value, total lesion glycolysis, tumor-to-blood ratio, tumor-to-liver ratio, treatment response assessment
- MeSH terms
- Positron Emission Tomography Computed Tomography, Aged, Carcinoma, Non-Small-Cell Lung, Female, Humans, Image Interpretation, Computer-Assisted, Lung Neoplasms, Male, Metabolic Clearance Rate, Middle Aged, Sensitivity and Specificity, Tissue Distribution, Reproducibility of Results, Radiopharmaceuticals, Fluorodeoxyglucose F18, Whole Body Imaging
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