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Reproducibility of Standardized Uptake Value Measurements Determined by ¹⁸F-FDG PET in Malignant Tumors

¹ Molecular Imaging and Translational Research, University of Tennessee, Knoxville, Tennessee; and ² Applied Mathematics, University of Western Ontario, London, Ontario

Correspondence: For correspondence or reprints contact: Lindi Wahl, Applied Mathematics, Middlesex College, University of Western Ontario, London, ON N6A 5B7. E-mail: lwahl{at}uwo.ca

¹⁸F-FDG PET is increasingly being used to monitor the early response of malignant tumors to chemotherapy. Understanding the reproducibility of standardized uptake values (SUVs) is an important prerequisite in estimating what constitutes a significant change. Methods: Twenty-six patients were studied on 2 separate occasions (mean interval ± SD, 3 ± 2 d; range, 1–5 d). A static PET/CT scan was performed 94 ± 9 min after the intravenous injection of 383 ± 15 MBq of ¹⁸F-FDG. Mean and maximum SUVs (SUV_mean and SUV_max, respectively) were determined for regions of interest drawn around the tumor on the first study and for the same regions of interest transferred to the second study. Results: SUV_mean in tumors ranged from 1.49 to 17.48 and SUV_max ranged from 2.99 to 24.09. The correlation between SUV_mean determined on the 2 separate visits was 0.99; the mean difference between the 2 measurements was 0.01 ± 0.27 SUV. The 95% confidence limits for the measurements were ±0.53. For SUV_max, the mean difference was –0.05 ± 1.14 SUV. Conclusion: Our study demonstrates that repeated measurements of SUV_mean performed a few days apart are highly reproducible. A decrease of 0.5 in the SUV is statistically significant.

Key Words: ¹⁸F-FDG • cancer • SUV • reproducibility

COPYRIGHT © 2008 by the Society of Nuclear Medicine, Inc.

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