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European Radiology
Published in: European Radiology 8/2014

01-08-2014 | Nuclear Medicine

Variability of average SUV from several hottest voxels is lower than that of SUVmax and SUVpeak

Authors: E. Laffon, F. Lamare, H. de Clermont, I. A. Burger, R. Marthan

Published in: European Radiology | Issue 8/2014

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Abstract

Objectives

To assess variability of the average standard uptake value (SUV) computed by varying the number of hottest voxels within an 18F-fluorodeoxyglucose (18F-FDG)-positive lesion. This SUV metric was compared with the maximal SUV (SUVmax: the hottest voxel) and peak SUV (SUVpeak: SUVmax and its 26 neighbouring voxels).

Methods

Twelve lung cancer patients (20 lesions) were analysed using PET dynamic acquisition involving ten successive 2.5-min frames. In each frame and lesion, average SUV obtained from the N = 5, 10, 15, 20, 25 or 30 hottest voxels (SUVmax–N ), SUVmax and SUVpeak were assessed. The relative standard deviations (SDrs) from ten frames were calculated for each SUV metric and lesion, yielding the mean relative SD from 20 lesions for each SUV metric (SDr N , SDrmax and SDrpeak), and hence relative measurement error and repeatability (MEr–R).

Results

For each N, SDr N was significantly lower than SDrmax and SDrpeak. SDr N correlated strongly with N: 6.471 × N -0.103 (r = 0.994; P < 0.01). MEr–R of SUVmax-30 was 8.94–12.63 % (95 % CL), versus 13.86–19.59 % and 13.41–18.95 % for SUVmax and SUVpeak respectively.

Conclusions

Variability of SUVmax–N is significantly lower than for SUVmax and SUVpeak. Further prospective studies should be performed to determine the optimal total hottest volume, as voxel volume may depend on the PET system.

Key Points

• PET imaging provides functional parameters of 18 F-FDG-positive lesions, such as SUVmax and SUVpeak.
• Averaging SUV from several hottest voxels (SUVmax- N ) is a further SUV metric.
• Variability of SUVmax– N is significantly lower than SUVmax and SUVpeak variability.
• SUVmax– N should improve SUV accuracy for predicting outcome or assessing treatment response.
• An optimal total hottest volume should be determined through further prospective studies.
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Metadata
Title
Variability of average SUV from several hottest voxels is lower than that of SUVmax and SUVpeak
Authors
E. Laffon
F. Lamare
H. de Clermont
I. A. Burger
R. Marthan
Publication date
01-08-2014
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 8/2014
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-014-3222-x

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