Multivariate Analysis of Various Factors Affecting Background Liver and Mediastinal Standardized Uptake Values

Overview

Journal Indian J Nucl Med

Specialty Nuclear Medicine

Date 2013 Apr 20

PMID 23599593

Citations 12

Authors

Manohar Kuruva

Bhagwant Rai Mittal

Mohammed Labeeb Abrar

Raghava Kashyap

Anish Bhattacharya

Affiliations

Soon will be listed here.

Abstract

Purpose Of The Study: Standardized uptake value (SUV) is the most commonly used semi-quantitative PET parameter. Various response assessment criteria grade the tumor uptake relative to liver or mediastinal uptake. However various factors can affect the background SUV values. This prospective study was carried out to assess the variability of liver and mediastinal SUVs normalized to lean body mass (SUL-L, SUL-M), body surface area (SUB-L, SUB-M), and body weight (SUW-L, SUW-M) and their dependence on various factors which can affect SUV values.

Materials And Methods: Eighty-eight patients who underwent F-18 FDG PET/CT for various oncological indications were prospectively included in this study. SUVs of liver and mediastinum were calculated by ROIs drawn as suggested by Wahl, et al., in PERCIST 1.0 criteria. Multivariate linear regression analysis was done to assess for the various factors influencing the SUVs of liver and mediastinum. Factors assessed were age, sex, weight, blood glucose level, diabetic status, and uptake period. A P value less than 0.01 was considered significant.

Results: SUL-L, SUL-M, SUB-L, SUB-M, SUW-L, SUW-M were not affected significantly by age, sex, blood glucose levels, diabetic status. The uptake period had a statistically significant effect on SUL-L (P = 0.007) and SUW-L (P = 0.008) with a progressive decrease with increasing uptake time. Body weight showed a statistically significant effect on SUW-L (P = 0.001) while SUL-L and SUB-L were not dependent on weight. SUB-L was least dependent on weight (P = 0.851) when compared with SUL-L (P = 0.425). However SUL-L was also not affected statistically significantly by variations in body weight (P = 0.425). Mediastinal SUVs were not significantly affected by any of the factors.

Conclusions: As mediastinal SUVs are not affected significantly by any of the factors, it can be considered as background when wide variations occur in uptake times or weight of the patient when comparing two PET/CT studies to evaluate response.

Citing Articles

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Optimized 18F-FDG PET-CT Method to Improve Accuracy of Diagnosis of Metastatic Cancer.

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Braat M, van Roekel C, Lam M, Braat A Diagnostics (Basel). 2022; 12(10).

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Sayed M, Abdelnaim A, Mohamadien N J Clin Imaging Sci. 2022; 12:37.

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References

Zijlstra J, Comans E, Van Lingen A, Hoekstra O, Gundy C, Coebergh J . FDG PET in lymphoma: the need for standardization of interpretation. An observer variation study. Nucl Med Commun. 2007; 28(10):798-803. DOI: 10.1097/MNM.0b013e3282eff2d5. View

Mankoff D, Muzi M, Krohn K . Quantitative positron emission tomography imaging to measure tumor response to therapy: what is the best method?. Mol Imaging Biol. 2003; 5(5):281-5. DOI: 10.1016/j.mibio.2003.09.002. View

Itti E, Juweid M, Haioun C, Yeddes I, Hamza-Maaloul F, El Bez I . Improvement of early 18F-FDG PET interpretation in diffuse large B-cell lymphoma: importance of the reference background. J Nucl Med. 2010; 51(12):1857-62. DOI: 10.2967/jnumed.110.080556. View

Kim C, Gupta N, Chandramouli B, Alavi A . Standardized uptake values of FDG: body surface area correction is preferable to body weight correction. J Nucl Med. 1994; 35(1):164-7. View

Hoekstra C, Paglianiti I, Hoekstra O, Smit E, Postmus P, Teule G . Monitoring response to therapy in cancer using [18F]-2-fluoro-2-deoxy-D-glucose and positron emission tomography: an overview of different analytical methods. Eur J Nucl Med. 2000; 27(6):731-43. DOI: 10.1007/s002590050570. View

Horning S, Juweid M, Schoder H, Wiseman G, McMillan A, Swinnen L . Interim positron emission tomography scans in diffuse large B-cell lymphoma: an independent expert nuclear medicine evaluation of the Eastern Cooperative Oncology Group E3404 study. Blood. 2009; 115(4):775-7. PMC: 2815514. DOI: 10.1182/blood-2009-08-234351. View

Boellaard R . Standards for PET image acquisition and quantitative data analysis. J Nucl Med. 2009; 50 Suppl 1:11S-20S. DOI: 10.2967/jnumed.108.057182. View

Weber W, Ziegler S, Thodtmann R, Hanauske A, Schwaiger M . Reproducibility of metabolic measurements in malignant tumors using FDG PET. J Nucl Med. 1999; 40(11):1771-7. View

Minn H, Zasadny K, Quint L, Wahl R . Lung cancer: reproducibility of quantitative measurements for evaluating 2-[F-18]-fluoro-2-deoxy-D-glucose uptake at PET. Radiology. 1995; 196(1):167-73. DOI: 10.1148/radiology.196.1.7784562. View

10.

Hoekstra C, Hoekstra O, Stroobants S, Vansteenkiste J, Nuyts J, Smit E . Methods to monitor response to chemotherapy in non-small cell lung cancer with 18F-FDG PET. J Nucl Med. 2002; 43(10):1304-9. View

11.

Takahashi Y, Oriuchi N, Otake H, Endo K, Murase K . Variability of lesion detectability and standardized uptake value according to the acquisition procedure and reconstruction among five PET scanners. Ann Nucl Med. 2008; 22(6):543-8. DOI: 10.1007/s12149-008-0152-1. View

12.

Kanstrup I, Klausen T, Bojsen-Moller J, Magnusson P, Zerahn B . Variability and reproducibility of hepatic FDG uptake measured as SUV as well as tissue-to-blood background ratio using positron emission tomography in healthy humans. Clin Physiol Funct Imaging. 2008; 29(2):108-13. DOI: 10.1111/j.1475-097X.2008.00846.x. View

13.

Wahl R, Jacene H, Kasamon Y, Lodge M . From RECIST to PERCIST: Evolving Considerations for PET response criteria in solid tumors. J Nucl Med. 2009; 50 Suppl 1:122S-50S. PMC: 2755245. DOI: 10.2967/jnumed.108.057307. View

14.

Torizuka T, Tamaki N, Inokuma T, Magata Y, Sasayama S, Yonekura Y . In vivo assessment of glucose metabolism in hepatocellular carcinoma with FDG-PET. J Nucl Med. 1995; 36(10):1811-7. View

15.

Kim C, Gupta N . Dependency of standardized uptake values of fluorine-18 fluorodeoxyglucose on body size: comparison of body surface area correction and lean body mass correction. Nucl Med Commun. 1996; 17(10):890-4. DOI: 10.1097/00006231-199610000-00011. View

16.

Stahl A, Ott K, Schwaiger M, Weber W . Comparison of different SUV-based methods for monitoring cytotoxic therapy with FDG PET. Eur J Nucl Med Mol Imaging. 2004; 31(11):1471-8. DOI: 10.1007/s00259-004-1626-6. View

17.

Paquet N, Albert A, Foidart J, Hustinx R . Within-patient variability of (18)F-FDG: standardized uptake values in normal tissues. J Nucl Med. 2004; 45(5):784-8. View

18.

PATLAK C, Blasberg R, Fenstermacher J . Graphical evaluation of blood-to-brain transfer constants from multiple-time uptake data. J Cereb Blood Flow Metab. 1983; 3(1):1-7. DOI: 10.1038/jcbfm.1983.1. View

19.

Gjedde A . Calculation of cerebral glucose phosphorylation from brain uptake of glucose analogs in vivo: a re-examination. Brain Res. 1982; 257(2):237-74. DOI: 10.1016/0165-0173(82)90018-2. View

20.

Westerterp M, Pruim J, Oyen W, Hoekstra O, Paans A, Visser E . Quantification of FDG PET studies using standardised uptake values in multi-centre trials: effects of image reconstruction, resolution and ROI definition parameters. Eur J Nucl Med Mol Imaging. 2006; 34(3):392-404. DOI: 10.1007/s00259-006-0224-1. View