Repeatability of SUV in Oncologic 18F-FDG PET

Lodge, Martin A.

doi:10.2967/jnumed.116.186353

Cited by 214Medical Imaging Techniques and ApplicationsRadiomics and Machine Learning in Medical ImagingLung Cancer Diagnosis and Treatment

Repeatability of SUV in Oncologic 18F-FDG PET

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Lodge, Martin A.·2017·Journal of Nuclear Medicine

DOI 10.2967/jnumed.116.186353PMC PMC5373499

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Abstract

F-FDG PET. Growing literature suggests that the difference between SUVs measured before and after treatment can be used to predict tumor response at an early stage. SUV is, however, associated with multiple sources of variability, and to best use SUV for response assessment, an understanding of the repeatability of the technique is required. Test-retest studies involve repeated scanning of the same patient on the same scanner using the same protocol no more than a few days apart and provide basic information on the repeatability of the technique. Multiple test-retest studies have been performed to assess SUV repeatability, although a comparison of reports is complicated by the use of different methodologies and statistical metrics. This article reviews the available data, addressing issues such as different repeatability metrics, relative units, log transformation, and asymmetric limits of repeatability. When acquired with careful attention to protocol, tumor SUV has a within-subject coefficient of variation of approximately 10%. In a response assessment setting, SUV reductions of more than 25% and increases of more than 33% are unlikely to be due to measurement variability. Broader margins may be required for sites with less rigorous protocol compliance, but in general, SUV is a highly repeatable imaging biomarker that is ideally suited to monitoring tumor response to treatment in individual patients.

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Despite common use of SUVmax, SUVpeak and SUVmean have been shown to be slightly less variable under test-retest conditions.
“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 [191]
The Summary of Repeatability Results (page not supplied) reports slightly lower mean test–retest variability for SUVmean and SUVpeak than for SUVmax. However, it says the differences were not statistically significant, and the Discussion says repeatability was generally similar across the three metrics; the claim presents the advantage more firmly than the paper does. (LLM, conf=0.86)
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Dynamic patterns of [68Ga]Ga-PSMA-11 uptake in recurrent prostate cancer lesions
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Interpreting Change in Quantitative Imaging Biomarkers
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Statistical evaluation of test-retest studies in PET brain imaging
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Quantitative Test–Retest Measurement of 68Ga-PSMA-HBED-CC in Tumor and Normal Tissue
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Role of 18F-FDG PET/CT Radiomics Features in the Differential Diagnosis of Solitary Pulmonary Nodules: Diagnostic Accuracy and Comparison between Two Different PET/CT Scanners
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SUV variability in EARL-accredited conventional and digital PET
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Prognostic Value of 18F-FDG PET/CT Metabolic Parameters in Surgically Treated Stage I Lung Adenocarcinoma Patients
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Background parenchymal enhancement and uptake as breast cancer imaging biomarkers: A state-of-the-art review
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Reproducibility and Repeatability of Semiquantitative 18F-Fluorodihydrotestosterone Uptake Metrics in Castration-Resistant Prostate Cancer Metastases: A Prospective Multicenter Study
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Multicentre analysis of PET SUV using vendor-neutral software: the Japanese Harmonization Technology (J-Hart) study
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PET/CT for Lymphoma Post-therapy Response Assessment in Hodgkin Lymphoma and Diffuse Large B-cell Lymphoma
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Variability and Repeatability of Quantitative Uptake Metrics in 18 F-FDG PET/CT of Non–Small Cell Lung Cancer: Impact of Segmentation Method, Uptake Interval, and Reconstruction Protocol
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Repeatability of Quantitative Brown Adipose Tissue Imaging Metrics on Positron Emission Tomography with 18F-Fluorodeoxyglucose in Humans
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Kinetic analysis of HER2-binding ABY-025 Affibody molecule using dynamic PET in patients with metastatic breast cancer
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Repeated social defeat induces transient glial activation and brain hypometabolism: A positron emission tomography imaging study
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Measurement Repeatability of18F-FDG PET/CT Versus18F-FDG PET/MRI in Solid Tumors of the Pelvis
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Repeatability of 18F-FDG PET Radiomic Features in Cervical Cancer
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How we read pediatric PET/CT: indications and strategies for image acquisition, interpretation and reporting
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Semiquantitative Parameters in PSMA-Targeted PET Imaging with [18F]DCFPyL: Intrapatient and Interpatient Variability of Normal Organ Uptake
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Predictive value of 18F-FDG PET/CT for acute exacerbation of interstitial lung disease in patients with lung cancer and interstitial lung disease treated with chemotherapy
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Uptake of Radium-223 Dichloride and Early [18F]NaF PET Response Are Driven by Baseline [18F]NaF Parameters: a Pilot Study in Castration-Resistant Prostate Cancer Patients
Letellier, A., Johnson, A. C., Kit, N. H., Savigny, J.-F., Batalla, A., Parienti, J., & Aide, N. (2017) · Molecular Imaging and Biology · doi:10.1007/s11307-017-1132-4 · Cited by 23 · see citing works
Chemoradiotherapy for locally advanced cervix cancer without aortic lymph node involvement: can we consider metabolic parameters of pretherapeutic FDG-PET/CT for treatment tailoring?
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A systematic review on the use of quantitative imaging to detect cancer therapy adverse effects in normal-appearing brain tissue
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Bone marrow segmentation and radiomics analysis of [18F]FDG PET/CT images for measurable residual disease assessment in multiple myeloma
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Commissioning of a novel PET‐Linac for biology‐guided radiotherapy (BgRT)
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Repeatability of brown adipose tissue measurements on FDG PET/CT following a simple cooling procedure for BAT activation
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Multicenter study of quantitative PET system harmonization using NIST-traceable 68Ge/68Ga cross-calibration kit
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Quantification of Prostate Cancer Metabolism Using 3D Multiecho bSSFP and Hyperpolarized [ 1‐13C ] Pyruvate: Metabolism Differs Between Tumors of the Same Gleason Grade
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Comparison between Two Different Scanners for the Evaluation of the Role of 18F-FDG PET/CT Semiquantitative Parameters and Radiomics Features in the Prediction of Final Diagnosis of Thyroid Incidentalomas
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Predicting tumor response and outcome of second-look surgery with 18F-FDG PET/CT: insights from the GINECO CHIVA phase II trial of neoadjuvant chemotherapy plus nintedanib in stage IIIc-IV FIGO ovarian cancer
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Method to determine the statistical technical variability of SUV metrics
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Measurement Variability in Treatment Response Determination for Non–Small Cell Lung Cancer
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Noise-Induced Variability of Immuno-PET with Zirconium-89-Labeled Antibodies: an Analysis Based on Count-Reduced Clinical Images
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CMBD: a manually curated cancer metabolic biomarker knowledge database
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Accurate total‐body Ki parametric imaging with shortened dynamic 18F‐FDG PET scan durations via effective data processing
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Repeatability of deuterium metabolic imaging of healthy volunteers at 3 T
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Test–retest repeatability of quantitative bone SPECT/CT
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SUV Harmonization Between Different Hybrid PET/CT Systems
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Positron emission tomography and magnetic resonance imaging in experimental human malaria to identify organ-specific changes in morphology and glucose metabolism: A prospective cohort study
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A proper protocol for routine 18F-FDG uEXPLORER total-body PET/CT scans
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Efficacy of Bortezomib for Treating Anti-Interferon-Gamma Autoantibody-Associated Adult-Onset Immunodeficiency Syndrome
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Quantitative PET/CT in clinical practice
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How to harmonize SUVs obtained by hybrid PET/CT scanners with and without point spread function correction
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Are lesion features reproducible between 18F-FDG PET/CT images when acquired on analog or digital PET/CT scanners?
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Harmonization based on quantitative analysis of standardized uptake value variations across PET/CT scanners: a multicenter phantom study
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Statistical considerations for repeatability and reproducibility of quantitative imaging biomarkers
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Integrating Imaging and Circulating Tumor DNA Features for Predicting Patient Outcomes
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Establishment of a method for in-vivo SPECT/CT imaging analysis of 111In-labeled exendin-4 pancreatic uptake in mice without the need for nephrectomy or a secondary probe
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The Elusive Link Between Cancer FDG Uptake and Glycolytic Flux Explains the Preserved Diagnostic Accuracy of PET/CT in Diabetes
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Positron Emission Tomography for Response Evaluation in Microenvironment-Targeted Anti-Cancer Therapy
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Day-to-day variability of [68Ga]Ga-PSMA-11 accumulation in primary prostate cancer: effects on tracer uptake and visual interpretation
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Evaluation of Quantitative Ga-68 PSMA PET/CT Repeatability of Recurrent Prostate Cancer Lesions Using Both OSEM and Bayesian Penalized Likelihood Reconstruction Algorithms
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Standardisation of conventional and advanced iterative reconstruction methods for Gallium-68 multi-centre PET-CT trials
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Advancements in Targeted Radiopharmaceuticals: Innovations in Diagnosis and Therapy for Enhanced Cancer Management
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Quality Assessment in FDG-PET/CT Imaging of Head-and-Neck Cancer: One Home Run Is Better Than Two Doubles
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High SUVs Have More Robust Repeatability in Patients with Metastatic Prostate Cancer: Results from a Prospective Test-Retest Cohort Imaged with 18 F-DCFPyL
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PET/CT in Pediatric Oncology
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Relationship between tumor mutational burden and maximum standardized uptake value in 2-[18F]FDG PET (positron emission tomography) scan in cancer patients
Jahromi, A. H., Barkauskas, D. A., Zabel, M. K., Goodman, A. M., Frampton, G. M., Nikanjam, M., Hoh, C. K., & Kurzrock, R. (2020) · EJNMMI Research · doi:10.1186/s13550-020-00732-z · Cited by 13 · see citing works
Improved image reconstruction of 89Zr-immunoPET studies using a Bayesian penalized likelihood reconstruction algorithm
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Quantitative evaluation of lesion response heterogeneity for superior prognostication of clinical outcome
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Deep learning-based whole-body PSMA PET/CT attenuation correction utilizing Pix-2-Pix GAN
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Metabolic Profiling Techniques and Their Application in Cancer Research
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Repeatability of quantitative 18F-FLT uptake measurements in solid tumors: an individual patient data multi-center meta-analysis
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Co-Clinical Imaging Resource Program (CIRP): Bridging the Translational Divide to Advance Precision Medicine
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Cross-validation study between the HRRT and the PET component of the SIGNA PET/MRI system with focus on neuroimaging
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Intra- and Interobserver Agreement of SUV SPECT Quantitative SPECT/CT Processing Software, Applied in Clinical Settings for Patients with Solid Renal Tumors
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Sensitivity of 18F-fluorodihydrotestosterone PET-CT to count statistics and reconstruction protocol in metastatic castration-resistant prostate cancer
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Prognostic value of [ 18 F]FDG PET/CT parameters in surgically resected primary lung adenocarcinoma: a single-center experience
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Measurement of PET Quantitative Bias In Vivo
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Standardized uptake value of normal organs on routine clinical [18F]FDG PET/CT: impact of tumor metabolism and patient-related factors
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Authors: Lodge, M. A.
Affiliations: Johns Hopkins University (US)
Corresponding author: Lodge, Martin A.
ORCID: Lodge, Martin A.
Venue: Journal of Nuclear Medicine
Publisher: Society of Nuclear Medicine
Published: 2017-02-23
Volume: 58
Issue: 4
Pages: 523-532
ISSN: 0161-5505 (ISSN-L)
2159-662X
DOI: 10.2967/jnumed.116.186353
PMC: PMC5373499
OpenAlex: W2590848133
Cited by: 214
References: 47
Citations by year: 2026: 26 · 2025: 21 · 2024: 31 · 2023: 14 · 2022: 18 · 2021: 23 · 2020: 23 · 2019: 23 · 2018: 21 · 2017: 14
FWCI: 3.35
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: Journal of Nuclear Medicine (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Funders: Radiological Society of North America (HHSN268201300071C)
Society of Nuclear Medicine and Molecular Imaging
National Institutes of Health (HHSN268201300071C)
National Cancer Institute (U01CA140204)
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: standardized uptake value, 18F-FDG PET, test-retest repeatability, tumor response assessment, within-subject coefficient of variation, imaging biomarkers, treatment response monitoring, logarithmic transformation, tumor imaging
MeSH terms: Biological Transport, Humans, Neoplasms, Reproducibility of Results, Fluorodeoxyglucose F18, Positron-Emission Tomography

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