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Repeatability of SUV in Oncologic 18F-FDG PET
Open accessAbstract
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 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]
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Metadata
- 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
- 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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