Document Detail

Variance of SUVs for FDG-PET/CT is greater in clinical practice than under ideal study settings.
MedLine Citation:
PMID:  23354032     Owner:  NLM     Status:  MEDLINE    
PURPOSE: Measurement variance affects the clinical effectiveness of PET-based measurement as a semiquantitative imaging biomarker for cancer response in individual patients and for planning clinical trials. In this study, we measured test-retest reproducibility of SUV measurements under clinical practice conditions and recorded recognized deviations from protocol compliance.
METHODS: Instrument performance calibration, display, and analyses conformed to manufacture recommendations. Baseline clinical (18)F-FDG PET/CT examinations were performed and then repeated at 1 to 7 days. Intended scan initiation uptake period was to repeat the examinations at the same time for each study after injection of 12 mCi FDG tracer. Avidity of uptake was measured in 62 tumors in 21 patients as SUV for maximum voxel (SUV(max)) and for a mean of sampled tumor voxels (SUV(mean)).
RESULTS: The range of SUV(max) and SUV(mean) was 1.07 to 21.47 and 0.91 to 14.69, respectively. Intraclass correlation coefficient between log of SUV(max) and log of SUV(mean) was 0.93 (95% confidence interval [CI], 0.88-0.95) and 0.92 (95% CI, 0.87-0.95), respectively.Correlation analysis failed to show an effect on uptake period variation on SUV measurements between the 2 examinations, suggesting additional sources of noise.The threshold criteria for relative difference from baseline for the 95% CI were ± 49% or ± 44% for SUV(max) or SUV(mean), respectively.
CONCLUSIONS: Variance of SUV for FDG-PET/CT in current clinical practice in a single institution was greater than expected when compared with benchmarks reported under stringent efficacy study settings. Under comparable clinical practice conditions, interpretation of changes in tumor avidity in individuals and assumptions in planning clinical trials may be affected.
Virendra Kumar; Kavindra Nath; Claudia G Berman; Jongphil Kim; Tawee Tanvetyanon; Alberto A Chiappori; Robert A Gatenby; Robert J Gillies; Edward A Eikman
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical nuclear medicine     Volume:  38     ISSN:  1536-0229     ISO Abbreviation:  Clin Nucl Med     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-02-18     Completed Date:  2013-07-30     Revised Date:  2014-03-06    
Medline Journal Info:
Nlm Unique ID:  7611109     Medline TA:  Clin Nucl Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  175-82     Citation Subset:  IM    
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MeSH Terms
Analysis of Variance
Biological Transport
Fluorodeoxyglucose F18 / diagnostic use*,  metabolism*
Guideline Adherence
Image Interpretation, Computer-Assisted
Middle Aged
Multicenter Studies as Topic
Multimodal Imaging / methods*
Neoplasms / metabolism,  radionuclide imaging
Positron-Emission Tomography*
Retrospective Studies
Tomography, X-Ray Computed*
Grant Support
R01 CA077575/CA/NCI NIH HHS; U01 CA143062/CA/NCI NIH HHS; U54 CA143970/CA/NCI NIH HHS
Reg. No./Substance:
0Z5B2CJX4D/Fluorodeoxyglucose F18

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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