1
|
Sayed MHM, Abdelnaim AKM, Mohamadien NRA. Intrapatient variability of 18F-FDG uptake in normal tissues. J Clin Imaging Sci 2022; 12:37. [PMID: 36128350 PMCID: PMC9479622 DOI: 10.25259/jcis_23_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 05/31/2022] [Indexed: 11/08/2022] Open
Abstract
Objectives To investigate the effect of serum glucose level and other confounding factors on the variability of maximum standardized uptake value (SUVmax) in normal tissues within the same patient on two separate occasions and to suggest an ideal reference tissue. Materials and Methods We retrospectively reviewed 334 18F-FDG PET/CT scans of 167 cancer patients including 38 diabetics. All patients had two studies, on average 152 ± 68 days apart. Ten matched volumes of interest were drawn on the brain, right tonsil, blood pool, heart, lung, liver, spleen, bone marrow, fat, and iliopsoas muscle opposite third lumber vertebra away from any pathological 18F-FDG uptake to calculate SUVmax. Results SUVmax of the lungs and heart were significantly different in the two studies (P = 0.003 and P = 0.024 respectively). Only the brain uptake showed a significant moderate negative correlation with the level of blood glucose in diabetic patients (r = −0.537, P = 0.001) in the first study, while the SUVmax of other tissues showed negligible or weak correlation with the level of blood glucose in both studies. The liver showed significant moderate positive correlation with body mass index (BMI) in both studies (r = .416, P = <0.001 versus r = 0.453, P = <0.001, respectively), and blood pool activity showed significant moderate positive correlation with BMI in the first study only (r = 0.414, P = <0.001). The liver and blood pool activities showed significant moderate negative correlation with 18F-FDG uptake time in first study only (r = −0.405, P-value = <0.001; and r = −0.409, P-value = <0.001, respectively). In the multivariate analysis, the liver showed a consistent effect of the injected 18F-FDG dose and uptake duration on its SUVmax on the two occasions. In comparison, spleen and muscle showed consistent effect only of the injected dose on the two occasions. Conclusion The liver, muscle, and splenic activities showed satisfactory test/retest stability and can be used as reference activities. The spleen and muscle appear to be more optimal reference than the liver, as it is only associated with the injected dose of 18F-FDG.
Collapse
Affiliation(s)
- Mohamed Hosny Mohamed Sayed
- Department of Clinical Oncology and Nuclear Medicine, Faculty of Medicine, Assiut University, Assiut, Egypt,
| | - Aya KM Abdelnaim
- Department of Clinical Oncology and Nuclear Medicine, Faculty of Medicine, Assiut University, Assiut, Egypt,
| | - Nsreen RA Mohamadien
- Department of Clinical Oncology and Nuclear Medicine, Faculty of Medicine, Assiut University, Assiut, Egypt,
| |
Collapse
|
2
|
Longitudinal evaluation of five nasopharyngeal carcinoma animal models on the microPET/MR platform. Eur J Nucl Med Mol Imaging 2021; 49:1497-1507. [PMID: 34862520 DOI: 10.1007/s00259-021-05633-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 11/20/2021] [Indexed: 01/18/2023]
Abstract
PURPOSE We longitudinally evaluated the tumour growth and metabolic activity of three nasopharyngeal carcinoma (NPC) cell line models (C666-1, C17 and NPC43) and two xenograft models (Xeno76 and Xeno23) using a micropositron emission tomography and magnetic resonance (microPET/MR). With a better understanding of the interplay between tumour growth and metabolic characteristics of these NPC models, we aim to provide insights for the selection of appropriate NPC cell line/xenograft models to assist novel drug discovery and evaluation. METHODS Mice were imaged by 18F-deoxyglucose ([18F]FDG) microPET/MR twice a week for consecutive 3-7 weeks. [18F]FDG uptake was quantified by standardized uptake value (SUV) and presented as SUVmean tumour-to-liver ratio (SUVRmean). Longitudinal tumour growth patterns and metabolic patterns were recorded. SUVRmean and histological characteristics were compared across the five NPC models. Cisplatin was administrated to one selected optimal tumour model, C17, to evaluate our imaging platform. RESULTS We found variable tumour growth and metabolic patterns across different NPC tumour types. C17 has an optimal growth rate and higher tumour metabolic activity compared with C666-1. C666-1 has a fast growth rate but is low in SUVRmean at endpoint due to necrosis as confirmed by H&E. NPC43 and Xeno76 have relatively slow growth rates and are low in SUVRmean, due to severe necrosis. Xeno23 has the slowest growth rate, and a relative high SUVRmean. Cisplatin showed the expected therapeutic effect in the C17 model in marked reduction of tumour size and metabolism. CONCLUSION Our study establishes an imaging platform that characterizes the growth and metabolic patterns of different NPC models, and the platform is well able to demonstrate drug treatment outcome supporting its use in novel drug discovery and evaluation for NPC.
Collapse
|
3
|
Prognostic role of positron emission tomography and computed tomography parameters in stage I lung adenocarcinoma. Radiol Oncol 2020; 54:278-284. [PMID: 32463388 PMCID: PMC7409601 DOI: 10.2478/raon-2020-0034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 05/04/2020] [Indexed: 11/20/2022] Open
Abstract
Background According to the current pathological classification, lung adenocarcinoma includes histological subtypes with significantly different prognoses, which may require specific surgical approaches. The aim of the study was to assess the role of CT and PET parameters in stratifying patients with stage I adenocarcinoma according to prognosis. Patients and methods Fifty-eight patients with pathological stage I lung adenocarcinoma who underwent surgical treatment were retrospectively reviewed. Adenocarcinoma in situ and minimally-invasive adenocarcinoma were grouped as non-invasive adenocarcinoma. Other histotypes were referred as invasive adenocarcinoma. CT scan assessed parameters were: ground glass opacity (GGO) ratio, tumour disappearance rate (TDR) and consolidation diameter. The prognostic role of the following PET parameters was also assessed: standardized uptake value (SUV) max, SUVindex (SUVmax to liver SUVratio), metabolic tumour volume (MTV), total lesion glycolysis (TLG). Results Seven patients had a non-invasive adenocarcinoma and 51 an invasive adenocarcinoma. Five-year disease-free survival (DFS) and cancer-specific survival (CSS) for non-invasive and invasive adenocarcinoma were 100% and 100%, 70% and 91%, respectively. Univariate analysis showed a significant difference in SUVmax, SUVindex, GGO ratio and TDR ratio values between non-invasive and invasive adenocarcinoma groups. Optimal SUVmax, SUVindex, GGO ratio and TDR cut-off ratios to predict invasive tumours were 2.6, 0.9, 40% and 56%, respectively. TLG, SUVmax, SUVindex significantly correlated with cancer specific survival. Conclusions CT and PET scan parameters may differentiate between non-invasive and invasive stage I adenocarcinomas. If these data are confirmed in larger series, surgical strategy may be selected on the basis of preoperative imaging.
Collapse
|
4
|
Chen YY, Huang TW. Prognostic factors of patients with pathologic stage I lung adenocarcinoma. J Thorac Dis 2018; 10:S1115-S1118. [PMID: 29850191 DOI: 10.21037/jtd.2018.04.37] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- Ying-Yi Chen
- Division of Thoracic Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei
| | - Tsai-Wang Huang
- Division of Thoracic Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei
| |
Collapse
|
5
|
Liu G, Hu Y, Zhao Y, Yu H, Hu P, Shi H. Variations of the liver standardized uptake value in relation to background blood metabolism: An 2-[18F]Fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography study in a large population from China. Medicine (Baltimore) 2018; 97:e0699. [PMID: 29742723 PMCID: PMC5959431 DOI: 10.1097/md.0000000000010699] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
To investigate the influence of background blood metabolism on liver uptake of 2-[F]fluoro-2-deoxy-D-glucose (F-FDG) and search for an appropriate corrective method.Positron emission tomography/computed tomography (PET/CT) and common serological biochemical tests of 633 healthy people were collected retrospectively. The mean standardized uptake value (SUV) of the liver, liver artery, and portal vein (i.e., SUVL, SUVA, and SUVP) were measured. SUVL/A was calculated as SUVL/SUVA, while SUVL/P was calculated as SUVL/SUVP. SUV of liver parenchyma (SUVLP) was calculated as SUVL - .3 × (.75 × SUVP + .25 × SUVA). The coefficients of variation (CV) of SUVL, SUVL/A, SUVL/P, and SUVLP were compared to assess their interindividual variations. Univariate and multivariate analyses were performed to identify vulnerabilities of these SUV indexes to common factors assessed using serological liver functional tests.SUVLP was significantly larger than SUVL (2.19 ± .497 vs 1.88 ± .495, P < .001), while SUVL/P was significantly smaller than SUVL (1.72 ± .454 vs 1.88 ± .495, P < .001). The difference between SUVL/A and SUVL was not significant (1.83 ± .500 vs 1.88 ± .495, P = .130). The CV of SUVLP (22.7%) was significantly smaller than that of SUVL (22.7%:26.3%, P < .001), while the CVs of SUVL/A (27.2%) and SUVL/P (26.4%) were not different from that of SUVL (P = .429 and .929, respectively). Fewer variables independently influenced SUVLP than influenced SUVL, SUVL/A, and SUVL/P; Only aspartate aminotransferase, body mass index, and total cholesterol, all P-values <.05.The activity of background blood influences the variation of liver SUV. SUVLP might be an alternative corrective method to reduce this influence, as its interindividual variation and vulnerability to effects from common factors of serological liver functional tests are relatively lower than the commonly used SUVL.
Collapse
|
6
|
Brandt WS, Bouabdallah I, Tan KS, Park BJ, Adusumilli PS, Molena D, Bains MS, Huang J, Isbell JM, Bott MJ, Jones DR. Factors associated with distant recurrence following R0 lobectomy for pN0 lung adenocarcinoma. J Thorac Cardiovasc Surg 2018; 155:1212-1224.e3. [PMID: 29246549 PMCID: PMC5816702 DOI: 10.1016/j.jtcvs.2017.09.151] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Revised: 09/05/2017] [Accepted: 09/18/2017] [Indexed: 12/25/2022]
Abstract
OBJECTIVE We investigated factors associated with distant recurrence, disease-free survival (DFS), and overall survival (OS) following R0 lobectomy for pathologic node-negative (pN0) lung adenocarcinoma. METHODS We performed a retrospective analysis of a prospectively maintained database of patients with pT1-3N0M0 non-small cell lung cancer. Exclusion criteria included metachronous lung cancer, sublobar/incomplete resection, nonadenocarcinoma histology, and induction/adjuvant therapy. The primary outcome was distant recurrence; secondary outcomes were DFS and OS. Associations between variables and outcomes were assessed by Fine-Gray competing-risk regression for distant recurrence and Cox proportional hazard models for DFS and OS. RESULTS Of 2392 patients identified with pT1-3N0M0 lung adenocarcinoma, 893 met the inclusion criteria. Median follow-up was 35.0 months (range, 0.1-202 months). Thirteen percent of patients developed recurrence (n = 115), of which 86% (n = 99) were distant. The 5-year cumulative incidence of distant recurrence was 14% (95% confidence interval [CI], 11%-17%). On multivariable analysis, pT2a (hazard ratio [HR], 2.84; 95% CI, 1.56-5.16; P = .001) and pT2b/3 (HR, 6.53; 95% CI, 3.17-13.5; P < .001) tumors were associated with distant recurrence. Recent surgery was associated with decreased distant recurrence (HR, 0.43; 95% CI, 0.20-0.91; P = .028), and lymphovascular invasion was strongly associated with distant recurrence (HR, 1.62; 95% CI, 1.00-2.63; P = .05). DFS was independently associated with pT stage (P < .001) and lymphovascular invasion (P = .004). CONCLUSIONS In patients undergoing R0 lobectomy with pN0 lung adenocarcinoma, pT stage and lymphovascular invasion were associated with distant recurrence and decreased DFS. These observations support the inclusion of these patients in future clinical trials investigating adjuvant targeted and immunotherapies.
Collapse
Affiliation(s)
- Whitney S Brandt
- Thoracic Surgery Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Ilies Bouabdallah
- Thoracic Surgery Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Kay See Tan
- Department of Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Bernard J Park
- Thoracic Surgery Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Prasad S Adusumilli
- Thoracic Surgery Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Daniela Molena
- Thoracic Surgery Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Manjit S Bains
- Thoracic Surgery Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - James Huang
- Thoracic Surgery Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - James M Isbell
- Thoracic Surgery Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Matthew J Bott
- Thoracic Surgery Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - David R Jones
- Thoracic Surgery Service, Memorial Sloan Kettering Cancer Center, New York, NY.
| |
Collapse
|
7
|
SUV navigator enables rapid [ 18F]-FDG PET/CT image interpretation compared with 2D ROI and 3D VOI evaluations. Jpn J Radiol 2017; 35:398-403. [PMID: 28497349 DOI: 10.1007/s11604-017-0645-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Accepted: 04/23/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE Positron emission tomography (PET) and the maximum standardized uptake value (SUVmax) is a useful technique for assessing malignant tumors. Measurements of SUVmax in multiple lesions per patient frequently require many time-consuming procedures. To address this issue, we designed a novel interface named SUV Navigator (SUVnavi), and the purpose of this study was to investigate its utility. MATERIALS AND METHODS We measured SUVmax in 661 lesions from 100 patients with malignant tumors. Diagnoses and SUVmax measurements were made with SUVnavi, 2D, and 3D measurements. SUV measurement accuracy in each method were also evaluated. RESULTS The average reduction in time with SUVnavi versus 2D was 53.8% and 3D was 37.5%; time required with SUVnavi was significantly shorter than with 2D and 3D (P < 0.001 and P < 0.001, respectively). The time reduction and lesion number had a positive correlation (P < 0.001 and P < 0.001, respectively). SUVmax agreed with precise SUVmax in all lesions measured with SUVnavi and 3D but in only 466 of 661 lesions (70.5%) measured with 2D. CONCLUSION SUVnavi may be useful for rapid [18F]-fluorodeoxyglucose positron emission tomography/computed tomography ([18F]-FDG PET/CT) image interpretation without reducing the accuracy of SUVmax measurement.
Collapse
|
8
|
Ibuki Y, Tsutani Y, Miyata Y, Nakayama H, Okumura S, Yoshimura M, Okada M. Preoperative predictors of distant recurrence in patients with clinical stage IA lung adenocarcinoma undergoing complete resection. Jpn J Clin Oncol 2017; 47:157-163. [PMID: 28173177 DOI: 10.1093/jjco/hyw162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 09/07/2016] [Accepted: 10/07/2016] [Indexed: 11/14/2022] Open
Abstract
Objective We aimed to identify patients with clinical Stage IA lung adenocarcinoma who are at high risk for distant recurrence to preoperatively organize treatment strategies. Methods We analyzed correlations between preoperative clinical factors and the incidence of distant recurrence in 609 patients with clinical Stage IA lung adenocarcinoma that had been completely resected at four institutions. We excluded 24 patients with only locoregional recurrence and analyzed data from 585 patients. Results Distant recurrence after complete resection was identified in 34 patients during a median follow-up period of 41.4 months. Multivariate Cox analysis identified solid tumor size on high-resolution computed tomography and the maximum standardized uptake value on F-18-fluorodeoxyglucose positron emission tomography/computed tomography as independent predictors for distant recurrence-free survival. Receiver operating characteristic analyses showed that solid tumor size ≥1.7 cm and the maximum standardized uptake value ≥3.3 were optimal criteria with which to detect patients at high risk for distant recurrence. In fact, 3-year distant recurrence rates were higher in patients who met the criteria for high risk (n = 85) than those who did not (n = 500) (28.1% vs. 3.7%; P < 0.001). A similar trend was also found in patients with pathological node negative. Conclusions Solid tumor size on high-resolution computed tomography and the maximum standardized uptake value on F-18-fluorodeoxyglucose positron emission tomography/computed tomography were clinical predictors of distant recurrence among patients with clinical Stage IA lung adenocarcinoma. Our findings might be useful to determine personalized therapeutic strategies including systemic therapy.
Collapse
Affiliation(s)
- Yuta Ibuki
- Department of Surgical Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Yasuhiro Tsutani
- Department of Surgical Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Yoshihiro Miyata
- Department of Surgical Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Haruhiko Nakayama
- Department of Thoracic Surgery, Kanagawa Cancer Centre, Yokohama, Japan
| | - Sakae Okumura
- Department of Thoracic Surgery, Cancer Institute Hospital, Tokyo, Japan
| | | | - Morihito Okada
- Department of Surgical Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| |
Collapse
|
9
|
Shin S, Pak K, Kim IJ, Kim BS, Kim SJ. Prognostic Value of Tumor-to-Blood Standardized Uptake Ratio in Patients with Resectable Non-Small-Cell Lung Cancer. Nucl Med Mol Imaging 2016; 51:233-239. [PMID: 28878849 DOI: 10.1007/s13139-016-0456-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2016] [Revised: 09/17/2016] [Accepted: 10/14/2016] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES Previously published studies showed that the standard tumor-to-blood standardized uptake value (SUV) ratio (SUR) was a more accurate prognostic method than tumor maximum standardized uptake value (SUVmax). This study evaluated and compared prognostic value of positron emission tomography (PET) parameters and normalized value of PET parameters by blood pool SUV in non-small-cell lung cancer (NSCLC) patients who received curative surgery. METHODS Seventy-seven patients who underwent curative resection for NSCLC between January 2010 to December 2013 were enrolled in this study. 18Fluorine-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) was performed before surgery. The mean standardized uptake value (SUVmean), SUVmax, metabolic tumor volume (MTV), and total lesion glycolysis (TLG) of each lesion was measured, on the workstation. SURmean, SURmax, and TLGSUR were calculated by dividing each of them by descending aorta SUVmean. Cox proportional hazards regression was used to analyze the effect of age, sex, pathological parameters, and PET parameters on recurrence and death. RESULTS In Cox regression analysis, N stage predicted for both recurrence (p < 0.0001) and death (p < 0.0001). SURmax predicted recurrence (p = 0.0014), not death. Area under the receiver operating characteristic curve of SURmax was 0.759 with cutoff value 4.004. However, SUVmax, SUVmean, MTV, TLG, SURmean, and TLGSUR predicted neither recurrence nor death. CONCLUSIONS Among PET parameters, SURmax was the independent predictor of recurrence in NSCLC patients who received curative surgery. N stage was the independent prognostic factor for both recurrence and death. Both parameters could be used to stratify the risk of NSCLC patients.
Collapse
Affiliation(s)
- Seunghyeon Shin
- Department of Nuclear Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Kyoungjune Pak
- Department of Nuclear Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - In Joo Kim
- Department of Nuclear Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Bum Soo Kim
- Department of Nuclear Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Seong Jang Kim
- Department of Nuclear Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| |
Collapse
|
10
|
Hofheinz F, Bütof R, Apostolova I, Zöphel K, Steffen IG, Amthauer H, Kotzerke J, Baumann M, van den Hoff J. An investigation of the relation between tumor-to-liver ratio (TLR) and tumor-to-blood standard uptake ratio (SUR) in oncological FDG PET. EJNMMI Res 2016; 6:19. [PMID: 26936768 PMCID: PMC4775714 DOI: 10.1186/s13550-016-0174-y] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Accepted: 02/12/2016] [Indexed: 11/29/2022] Open
Abstract
Background The standardized uptake value (SUV) is the nearly exclusive means for quantitative evaluation of clinical [18F-]fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) whole body investigations. However, the SUV methodology has well-known shortcomings. In this context, it has been recognized that at least part of the problems can be eliminated if tumor SUV is normalized to the SUV of a reference region in the liver (tumor-to-liver [TLR] ratio). In recent publications, we have systematically investigated the tumor-to-blood SUV ratio (SUR) for normalization of tumor SUVs which in our view offers principal advantages in comparison to TLR. The aim of this study was a comprehensive comparison of TLR and SUR in terms of quantification of tumor lesions. Methods 18F-FDG PET/CT was performed in 424 patients (557 scans) with different tumor entities prior to radio(chemo)therapy. In the PET images, SUVmax of the primary tumor was determined. SUVliver was calculated in the inferior right lobe of the liver. SUVblood was determined by manually delineating the aorta in the low-dose CT. TLR and SUR were computed and scan time corrected to 60 min p.i. (TLRtc and SURtc). Correlation analysis was performed for SUVliver vs. SUVblood, TLR vs. SUR, SUVliver/SUVblood vs. SUVblood,SURtc/TLR vs. SURtc, and SURtc/TLRtc vs. SURtc. Variability of the respective ratios was assessed via histogram analysis. The prognostic value of TLR and TLRtc for distant metastases-free survival (DM) was investigated with univariate Cox regression in a homogeneous subgroup (N = 130) and compared to previously published results for SUV and SURtc. Results Correlation analysis revealed a linear correlation of SUVliver vs. SUVblood (R 2=0.83) and of TLR vs. SURtc (R2=0.92). The SUVliver/SUVblood ratio (mean ± s.d.) was 1.47 ± 0.18. For the SURtc/TLR ratio, we obtained 1.14 ± 0.21 and for the SURtc/TLRtc ratio 1.38 ± 0.17. Survival analysis revealed TLR and TLRtc as significant prognostic factors for DM (hazard ratio [HR] = 3.3 and HR = 3, respectively). Both hazard ratios are lower than that of SURtc (HR = 4.1) although this reduction does not reach statistical significance for the given limited group size. HRs of TLR and SURtc are both significantly higher than HR of SUV (HR = 2.2). Conclusions Suitability of the liver as surrogate of arterial tracer supply for SUV normalization via TLR computation is limited. Further studies in sufficiently large patient groups are required to better characterize the relative performance of SUV, TLR, and SUR in different settings.
Collapse
Affiliation(s)
- Frank Hofheinz
- Helmholtz-Zentrum Dresden-Rossendorf, PET Center, Institute of Radiopharmaceutical Cancer Research, Bautzner Landstraße, Dresden, Germany.
| | - Rebecca Bütof
- Department of Radiation Oncology, University Hospital Carl Gustav Carus, Technische Universität, Dresden, Germany. .,OncoRay - National Center for Radiation Research in Oncology, Dresden, Germany.
| | - Ivayla Apostolova
- Klinik für Radiologie und Nuklearmedizin, Universitätsklinikum Magdeburg A.ö.R., Magdeburg, Germany.
| | - Klaus Zöphel
- OncoRay - National Center for Radiation Research in Oncology, Dresden, Germany. .,Department of Nuclear Medicine, University Hospital Carl Gustav Carus, Technische Universität, Dresden, Germany.
| | - Ingo G Steffen
- Klinik für Radiologie und Nuklearmedizin, Universitätsklinikum Magdeburg A.ö.R., Magdeburg, Germany.
| | - Holger Amthauer
- Klinik für Radiologie und Nuklearmedizin, Universitätsklinikum Magdeburg A.ö.R., Magdeburg, Germany.
| | - Jörg Kotzerke
- Helmholtz-Zentrum Dresden-Rossendorf, PET Center, Institute of Radiopharmaceutical Cancer Research, Bautzner Landstraße, Dresden, Germany. .,Department of Nuclear Medicine, University Hospital Carl Gustav Carus, Technische Universität, Dresden, Germany.
| | - Michael Baumann
- Department of Radiation Oncology, University Hospital Carl Gustav Carus, Technische Universität, Dresden, Germany. .,OncoRay - National Center for Radiation Research in Oncology, Dresden, Germany. .,German Cancer Consortium (DKTK), Dresden, Germany. .,German Cancer Research Center (DKFZ), Heidelberg, Germany. .,Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiooncology, Dresden, Germany.
| | - Jörg van den Hoff
- Helmholtz-Zentrum Dresden-Rossendorf, PET Center, Institute of Radiopharmaceutical Cancer Research, Bautzner Landstraße, Dresden, Germany. .,Department of Nuclear Medicine, University Hospital Carl Gustav Carus, Technische Universität, Dresden, Germany.
| |
Collapse
|
11
|
Mahmud MH, Nordin AJ, Ahmad Saad FF, Azman AZF. Impacts of biological and procedural factors on semiquantification uptake value of liver in fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography imaging. Quant Imaging Med Surg 2015; 5:700-7. [PMID: 26682140 DOI: 10.3978/j.issn.2223-4292.2015.05.02] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Increased metabolic activity of fluorodeoxyglucose (FDG) in tissue is not only resulting of pathological uptake, but due to physiological uptake as well. This study aimed to determine the impacts of biological and procedural factors on FDG uptake of liver in whole body positron emission tomography/computed tomography (PET/CT) imaging. METHODS Whole body fluorine-18 ((18)F) FDG PET/CT scans of 51 oncology patients have been reviewed. Maximum standardized uptake value (SUVmax) of lesion-free liver was quantified in each patient. Pearson correlation was performed to determine the association between the factors of age, body mass index (BMI), blood glucose level, FDG dose and incubation period and liver SUVmax. Multivariate regression analysis was established to determine the significant factors that best predicted the liver SUVmax. Then the subjects were dichotomised into four BMI groups. Analysis of variance (ANOVA) was established for mean difference of SUVmax of liver between those BMI groups. RESULTS BMI and incubation period were significantly associated with liver SUVmax. These factors were accounted for 29.6% of the liver SUVmax variance. Statistically significant differences were observed in the mean SUVmax of liver among those BMI groups (P<0.05). CONCLUSIONS BMI and incubation period are significant factors affecting physiological FDG uptake of liver. It would be recommended to employ different cut-off value for physiological liver SUVmax as a reference standard for different BMI of patients in PET/CT interpretation and use a standard protocol for incubation period of patient to reduce variation in physiological FDG uptake of liver in PET/CT study.
Collapse
Affiliation(s)
- Mohd Hafizi Mahmud
- 1 Faculty of Medicine and Health Sciences, 2 Centre for Diagnostic Nuclear Imaging, Universiti Putra Malaysia, Selangor, Malaysia ; 3 Department of Medical Imaging, Faculty of Health Sciences, Universiti Teknologi MARA Puncak Alam Campus, Selangor, Malaysia ; 4 Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
| | - Abdul Jalil Nordin
- 1 Faculty of Medicine and Health Sciences, 2 Centre for Diagnostic Nuclear Imaging, Universiti Putra Malaysia, Selangor, Malaysia ; 3 Department of Medical Imaging, Faculty of Health Sciences, Universiti Teknologi MARA Puncak Alam Campus, Selangor, Malaysia ; 4 Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
| | - Fathinul Fikri Ahmad Saad
- 1 Faculty of Medicine and Health Sciences, 2 Centre for Diagnostic Nuclear Imaging, Universiti Putra Malaysia, Selangor, Malaysia ; 3 Department of Medical Imaging, Faculty of Health Sciences, Universiti Teknologi MARA Puncak Alam Campus, Selangor, Malaysia ; 4 Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
| | - Ahmad Zaid Fattah Azman
- 1 Faculty of Medicine and Health Sciences, 2 Centre for Diagnostic Nuclear Imaging, Universiti Putra Malaysia, Selangor, Malaysia ; 3 Department of Medical Imaging, Faculty of Health Sciences, Universiti Teknologi MARA Puncak Alam Campus, Selangor, Malaysia ; 4 Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
| |
Collapse
|
12
|
Shiono S, Yanagawa N, Abiko M, Sato T. Noninvasive Differential Diagnosis of Pulmonary Nodules Using the Standardized Uptake Value Index. Ann Thorac Cardiovasc Surg 2015; 21:236-41. [PMID: 25740450 DOI: 10.5761/atcs.oa.14-00241] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES We previously showed that the standardized uptake value (SUV) index, which was defined as the ratio of the maximum SUV of the tumor to mean SUV of the liver, was a surrogate marker of lung cancer aggressiveness. In this study of patients with pulmonary nodules (PNs), we explored whether the SUV index could be used to differentiate small malignant from small benign PNs. METHODS A total of 284 patients with solitary PNs ≤2 cm in size underwent positron emission tomography/computed tomography and surgery. The associations between pathological findings and clinical factors were evaluated. RESULTS The median SUV indices of lung cancer, metastatic PNs and benign nodules were 1.2, 1.5, and 0.6, respectively (P <0.01). A SUV index cut-off value of 1.2 was used to differentiate benign from malignant nodules. When patients were grouped according to SUV index cut-off values of <1.2 or ≥1.2, the following cases were false-negative: lung adenocarcinoma (P <0.01), kidney as primary site (P <0.01), and metastatic PNs with long disease-free survival (P = 0.02). CONCLUSIONS As a noninvasive diagnostic marker, the SUV index was found to be useful for differentiating benign from malignant small PNs.
Collapse
Affiliation(s)
- Satoshi Shiono
- Departments of Thoracic Surgery, Yamagata Prefectural Central Hospital,Yamagata, Yamagata, Japan
| | | | | | | |
Collapse
|
13
|
Duan XY, Wang W, Li M, Li Y, Guo YM. Predictive significance of standardized uptake value parameters of FDG-PET in patients with non-small cell lung carcinoma. ACTA ACUST UNITED AC 2015; 48:267-72. [PMID: 25651460 PMCID: PMC4381948 DOI: 10.1590/1414-431x20144137] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Accepted: 10/22/2014] [Indexed: 12/30/2022]
Abstract
18F-fluoro-2-deoxyglucose (FDG) positron emission tomography
(PET)/computed tomography (CT) is widely used to diagnose and stage non-small cell
lung cancer (NSCLC). The aim of this retrospective study was to evaluate the
predictive ability of different FDG standardized uptake values (SUVs) in 74 patients
with newly diagnosed NSCLC. 18F-FDG PET/CT scans were performed and
different SUV parameters (SUVmax, SUVavg, SUVT/L,
and SUVT/A) obtained, and their relationship with clinical characteristics
were investigated. Meanwhile, correlation and multiple stepwise regression analyses
were performed to determine the primary predictor of SUVs for NSCLC. Age, gender, and
tumor size significantly affected SUV parameters. The mean SUVs of squamous cell
carcinoma were higher than those of adenocarcinoma. Poorly differentiated tumors
exhibited higher SUVs than well-differentiated ones. Further analyses based on the
pathologic type revealed that the SUVmax, SUVavg, and
SUVT/L of poorly differentiated adenocarcinoma tumors were higher than
those of moderately or well-differentiated tumors. Among these four SUV parameters,
SUVT/L was the primary predictor for tumor differentiation. However, in
adenocarcinoma, SUVmax was the determining factor for tumor
differentiation. Our results showed that these four SUV parameters had predictive
significance related to NSCLC tumor differentiation; SUVT/L appeared to be
most useful overall, but SUVmax was the best index for adenocarcinoma
tumor differentiation.
Collapse
Affiliation(s)
- X-Y Duan
- PET-CT Center, The First Affiliated Hospital of Xi'an, Jiaotong University, Xi'an, Shaanxi, China
| | - W Wang
- PET-CT Center, The First Affiliated Hospital of Xi'an, Jiaotong University, Xi'an, Shaanxi, China
| | - M Li
- PET-CT Center, The First Affiliated Hospital of Xi'an, Jiaotong University, Xi'an, Shaanxi, China
| | - Y Li
- PET-CT Center, The First Affiliated Hospital of Xi'an, Jiaotong University, Xi'an, Shaanxi, China
| | - Y-M Guo
- PET-CT Center, The First Affiliated Hospital of Xi'an, Jiaotong University, Xi'an, Shaanxi, China
| |
Collapse
|
14
|
Shiono S, Yanagawa N, Abiko M, Sato T. Detection of non-aggressive stage IA lung cancer using chest computed tomography and positron emission tomography/computed tomography. Interact Cardiovasc Thorac Surg 2014; 19:637-43. [DOI: 10.1093/icvts/ivu188] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
15
|
Higuchi M, Hasegawa T, Osugi J, Suzuki H, Gotoh M. Prognostic Impact of FDG-PET in Surgically Treated Pathological Stage I Lung Adenocarcinoma. Ann Thorac Cardiovasc Surg 2014; 20:185-91. [DOI: 10.5761/atcs.oa.12.02219] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
16
|
Shiono S, Abiko M, Sato T. Limited resection for clinical Stage IA non-small-cell lung cancers based on a standardized-uptake value index. Eur J Cardiothorac Surg 2012; 43:e7-e12. [DOI: 10.1093/ejcts/ezs573] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
17
|
Fukumoto K, Taniguchi T, Ishikawa Y, Kawaguchi K, Fukui T, Kato K, Matsuo K, Yokoi K. The utility of [18F]-fluorodeoxyglucose positron emission tomography-computed tomography in thymic epithelial tumours. Eur J Cardiothorac Surg 2012; 42:e152-6. [DOI: 10.1093/ejcts/ezs527] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|