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Glucose-Normalized Standardized Uptake Value from 18F-FDG PET in Classifying Lymphomas

Ching-yee Oliver Wong, MD, PhD1, Joseph Thie, PhD2, Kelly J. Parling-Lynch, MD3, Dana Zakalik, MD3, Jeffrey H. Margolis, MD3, Marianne Gaskill, CNMT1, Jack Hill, PhD4, Feng Qing, MD, PhD1, Darlene Fink-Bennett, MD1 and Conrad Nagle, MD1

1 Nuclear Medicine, William Beaumont Hospital, Royal Oak, Michigan
2 Graduate School of Medicine, University of Tennessee Medical Center, Knoxville, Tennessee
3 Medical Oncology, William Beaumont Hospital, Royal Oak, Michigan
4 Medical Information Service, William Beaumont Hospital, Royal Oak, Michigan



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  		FIGURE 1. (A) g-plot: percentage of correctly classified pathologically proven indolent and aggressive lymphoma grades against g-values, including the entire group and the subgroup with extreme [Glc]. (B) Box plot for entire group (n = 120) for g-value of –0.5. Outliers are identified by {circ} with case numbers. Indolent lymphomas are widely separated from aggressive lymphomas using SUV100 at g-value of –0.5, which may be considered a boundary zone.

 


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  		FIGURE 2. (A) Plot of original SUV without glucose correction against [Glc] for aggressive and indolent lymphomas, with mean reference lines. Boundary zone lies somewhere between these 2 reference lines. (B) Plot of ln (SUV) against ln [Glc], the logarithmic form of SUV against [Glc]g for aggressive and indolent lymphoma grades, with lines indicating mean regression lines and 95% confidence intervals. Graph shows refinement of boundary zone with proposed g-value.

 




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