Standardization and Quantification in FDG-PET/CT Imaging for Staging and Restaging of Malignant Disease

Gámez-Cenzano, Cristina; Pino-sorroche, F.

doi:10.1016/j.cpet.2013.10.003

Cited by 14 publications

(13 citation statements)

References 42 publications

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“…The SUV is the concentration measured within a region or voxel normalized to the patient weight and the injected activity. This is the most common parameter measured clinically for PET because of its simplicity, despite its dependency on metabolism in other organs, body mass, and other confounding factors (44,45). The SUV is also affected by air within ROIs.…”

Section: Analysis Methods and Their Applications In Lung Diseases Quamentioning

confidence: 99%

“…Reconstruction algorithms used to generate PET images can have a significant impact on quantification accuracy, including issues with nonlinearity and underconvergence when using iterative algorithms (45). Most research in this area has focused on detecting lung cancers, which have high signal relative to the lungs.…”

Section: Analysis Methods and Their Applications In Lung Diseases Quamentioning

confidence: 99%

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Quantification of Lung PET Images: Challenges and Opportunities

et al. 2017

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Section: Analysis Methods and Their Applications In Lung Diseases Quamentioning

confidence: 99%

Section: Analysis Methods and Their Applications In Lung Diseases Quamentioning

confidence: 99%

Quantification of Lung PET Images: Challenges and Opportunities

et al. 2017

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“…An accurate quantification of tracer uptake is essential to increase the reliability of Positron Emission Tomography (PET) in conjunction with Computed Tomography (CT) on many advanced applications. 1,2 Standardized Uptake Values (SUV) or its variants are frequently used to provide a semiquantitative measure of tracer uptake. 3 When iterated to SUV convergence, Maximum-Likelihood Expectation Maximization (MLEM) or Ordered Subset Expectation Maximization (OSEM) algorithms produce noisy images due to a problem of ill-conditioning, that is, the results have a large dependence on small changes in the initial data.…”

Section: Introductionmentioning

confidence: 99%

Phantom, clinical, and texture indices evaluation and optimization of a penalized‐likelihood image reconstruction method (Q.Clear) on a BGO PET/CT scanner

et al. 2018

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“…The comparability of studies and cross-correlation of SUV would be simplified, which becomes important when the care of patients is transferred to a different institution and their treatment response needs to be established (18). Additionally, many data collection studies and quantitative image analysis techniques would have greater universal applicability, which might help advance PET applications more rapidly (19). A longer uptake time before imaging would lead to fewer misleading SUV measurements and likely less misidentification and equivocation.…”

Section: Discussionmentioning

confidence: 99%

Optimizing ¹⁸F-FDG Uptake Time Before Imaging Improves the Accuracy of PET/CT in Liver Lesions

Al-faham

Jolepalem

Rydberg

et al. 2016

J. Nucl. Med. Technol.

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Beaumont Health System, Royal Oak, Michigan 18 F-FDG PET/CT has emerged as one of the fastest-growing imaging modalities. A shorter protocol results in a lower targetto-background ratio, which can increase the challenge of identifying mildly 18 F-FDG-avid lesions and differentiating inflammatory or physiologic activity from malignant activity. The purpose of this study was to determine the delay between radiotracer injection and imaging that optimizes target-to-background ratio while maintaining counts high enough to ensure scan sensitivity. Methods: The study included 140 patients (66 male and 74 female; age range, 42-95 y) with suspected hepatic lesions as seen on an 18 F-FDG PET scan. SUV was determined as regionof-interest activity/(dose/total body weight). Results: The mean injected dose was 610 ± 66.6 MBq (16.5 ±1.8 mCi), with a mean glucose level of 107 ± 26.6 mg/dL (standardized to 90 mg/dL). The uptake time before imaging ranged from 61 to 158 min, with a mean of 108.8 ± 24.8 min. The P values for the correlation of SUV to time were 0.004, 0.003, and 0.0001 for malignant lesions, benign lesions, and background hepatic tissue, respectively. Conclusion: An approximately 90-min time window from 18 F-FDG injection to PET imaging would significantly improve target-to-background ratio and, thus, quantitation and visual interpretation. This benefit outweighs the minimal loss in patient throughput. Int egrated 18 F-FDG PET/CT has emerged as one of the fastest-growing imaging modalities. The recent expansion of coverage from the Centers for Medicare and Medicaid Services has made its use even more feasible for communitybased hospitals and independent imaging centers. To maximize throughput, many of these centers use a 50-to 60-min uptake time after 18 F-FDG injection while arguing that the counting statistics are improved using this protocol (1-3). However, this shorter protocol results in a lower targetto-background ratio, which can increase the challenge of identifying mildly 18 F-FDG-avid lesions and differentiating inflammatory or physiologic activity from malignant activity (4-6).The purpose of this study was to determine the delay between radiotracer injection and imaging that optimizes target-to-background ratio while maintaining counts high enough to ensure scan sensitivity. Hepatic lesions and background hepatic tissue were chosen as the test and control tissues because 18 F-FDG has a relatively predictable parabolic uptake pattern in the liver (7,8). Additionally, the heterogeneous or mottled appearance of the liver often presents a challenge during image interpretation by producing areas of benign focal uptake or masking uptake within a malignant lesion (6). MATERIALS AND METHODSThe study was approved by the human investigation committee at William Beaumont Hospital (study 2012-226). The population comprised 140 patients (66 male and 74 female; age range, 42-95 y) with suspected hepatic lesions as seen on an 18 F-FDG PET scan. All enrolled patients had a primary malignancy and either had been referred...

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Standardization and Quantification in FDG-PET/CT Imaging for Staging and Restaging of Malignant Disease

Cited by 14 publications

References 42 publications

Quantification of Lung PET Images: Challenges and Opportunities

Quantification of Lung PET Images: Challenges and Opportunities

Phantom, clinical, and texture indices evaluation and optimization of a penalized‐likelihood image reconstruction method (Q.Clear) on a BGO PET/CT scanner

Optimizing ¹⁸F-FDG Uptake Time Before Imaging Improves the Accuracy of PET/CT in Liver Lesions

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Standardization and Quantification in FDG-PET/CT Imaging for Staging and Restaging of Malignant Disease

Cited by 14 publications

References 42 publications

Quantification of Lung PET Images: Challenges and Opportunities

Quantification of Lung PET Images: Challenges and Opportunities

Phantom, clinical, and texture indices evaluation and optimization of a penalized‐likelihood image reconstruction method (Q.Clear) on a BGO PET/CT scanner

Optimizing 18F-FDG Uptake Time Before Imaging Improves the Accuracy of PET/CT in Liver Lesions

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Optimizing ¹⁸F-FDG Uptake Time Before Imaging Improves the Accuracy of PET/CT in Liver Lesions