FDG PET/CT methodology for evaluation of treatment response in lymphoma: from “graded visual analysis” and “semiquantitative SUVmax” to global disease burden assessment

Interim FDG-PET/CT in Hodgkin lymphoma: the prognostic role of the ratio between target lesion and liver SUVmax (rPET)

“…In this study, 5p-DS and rPET were obtained considering the same reference organ (liver parenchyma). Recent studies demonstrated that also semi-quantitative parameters (such as lesion SUVmax) have a prognostic significance in patients with HL [7,9,10]. In our population, rPET was documented to be a prognostic factor in patients with HL undergoing interim FDG-PET/CT.…”

“…With 5p-DS, target lesion uptake (usually the hottest lesion described) is compared with liver uptake (chosen as standard reference): a target lesion uptake higher than the liver (score 4 or 5) is considered positive and is a marker of aggressive disease [4]. Nevertheless, 5p-DS still shows many of the limits of visual image interpretation (such as inter-observer disagreement) [5,7]. Moreover, it is still being debated which the best intra-patient reference organ is (liver or mediastinal blood pool) [8].…”

Deep learning‐based quantification of PET/CT prostate gland uptake: association with overall survival

“…Moreover, they provide measures of cancer reflecting metabolically active cells. Thus, these measurements may be clinically more relevant than SUVmax or SUVpeak representing only minute volumes of cancerous tissue with high activity, whereas the entire volume of cancer and its overall activity is a conceptually more truthful measure of the cancerous burden (Basu et al, 2014;Boellaard et al, 2015;Ziai et al, 2016). Volumetric analysis by manual processing is not standardized and is a time-consuming clinical application.…”

18F-Fluorodeoxyglucose PET/Computed Tomography for Primary Brain Tumors

“…Several comprehensive reviews covering novel approaches to quantification techniques have been published recently together with letters of concern regarding the current use and misuse of quantification in PET imaging. [58][59][60][61][62][63] It is pertinent to mention here the concept of global disease assessment, which was introduced 20 years ago by Alavi and colleagues 64 for the assessment of brain metabolism. The proposed method combines volumetric and metabolic data into a unique parameter, a global disease activity score based on total lesion glycolysis.…”