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Research ArticleClinical Investigations

Using SUV as a Guide to 18F-FDG Dose Reduction

David W. Cheng, Devrim Ersahin, Lawrence H. Staib, Daniele Della Latta, Assuero Giorgetti and Francesco d’Errico
Journal of Nuclear Medicine December 2014, 55 (12) 1998-2002; DOI: https://doi.org/10.2967/jnumed.114.140129
David W. Cheng
1Sidra Medical and Research Center, Department of Diagnostic Imaging, Doha, Qatar
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Devrim Ersahin
2Yale University School of Medicine, Department of Diagnostic Radiology, New Haven, Connecticut
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Lawrence H. Staib
2Yale University School of Medicine, Department of Diagnostic Radiology, New Haven, Connecticut
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Daniele Della Latta
3Fondazione Toscana Gabriele Monasterio per la Ricerca Medica e di Sanità Pubblica, CNR–Regione Toscana, Massa, Italy; and
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Assuero Giorgetti
4Fondazione Toscana Gabriele Monasterio per la Ricerca Medica e di Sanità Pubblica, CNR–Regione Toscana, Pisa, Italy
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Francesco d’Errico
2Yale University School of Medicine, Department of Diagnostic Radiology, New Haven, Connecticut
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  • FIGURE 1.
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    FIGURE 1.

    Temporal evolution of individual SUVs measured at YNHH for injected 18F-FDG doses of 3.3–4.8 MBq/kg (0.10–0.13 mCi/kg). SUV data are normalized to 180-s time point.

  • FIGURE 2.
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    FIGURE 2.

    Temporal evolution of individual SUVs measured at YNHH for injected 18F-FDG doses of 5.2–8.5 MBq/kg (0.14–0.2 mCi/kg). SUV data are normalized to 180-s time point.

  • FIGURE 3.
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    FIGURE 3.

    Temporal evolution of individual SUVs measured at CNR/FTGM for injected 18F-FDG doses of 4.4–4.8 MBq/kg (0.12–0.13 mCi/kg). SUV data are normalized to 180-s time point.

  • FIGURE 4.
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    FIGURE 4.

    Temporal evolution of all SUVs collectively. Individual SUV at each time point was normalized to SUV at 180-s time point in each group, before determination of SD.

Tables

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    TABLE 1

    Demographics of Patients Examined in Each Phase of This Study

    DemographicPhase 1 (555 MBq) YNHHPhase 2 (370 MBq) YNHHPhase 2 (3.7 MBq/kg) CNR/FTGM
    Sex (F/M)25/2625/1814/12
    Age (y)56.5 ± 18.8 (13–85)63.2 ± 14.1 (20–92)60.8 ± 13.4 (23–79)
    Body mass index (kg/m2)29.0 ± 8.5 (16.4–62.0)27.5 ± 6.6 (16.3–47.8)25.7 ± 3.9 (19.5–31.1)
    Dose
     mCi15.1 ± 1.7 (10.7–19.2)10.4 ± 0.9 (8.4–12.9)8.2 ± 1.3 (5.4–10.6)
     MBq559 ± 62.8 (396–711)383 ± 34.9 (311–478)303 ± 49.1 (201–392)
    Dose/kg
     mCi/kg0.21 ± 0.07 (0.08–0.39)0.14 ± 0.03 (0.09–0.23)0.11 ± 0.01 (0.10–0.16)
     MBq/kg7.8 ± 2.4 (3.1–14.4)5.2 ± 1.3 (3.3–8.5)4.1 ± 0.5 (3.6–5.8)
    Blood glucose (mg/dL)117.5 ± 30.2 (57–226)110.7 ± 16.3 (76–153)100.7 ± 10.6 (77–136)
    Uptake time (min)67.7 ± 10.3 (54–107)66.4 ± 8.0 (50–91)63.6 ± 7.7 (56–80)
    • Data are average ± SD, followed by range in parentheses.

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    TABLE 2

    Distribution of Diagnoses and Lesion Sizes in Each Phase of This Study

    DiagnosisPhase 1 (555 MBq) YNHHPhase 2 (370 MBq) YNHHPhase 2 (3.7 MBq/kg) CNR/FTGM
    Lymphoma1.4 ± 0.5 cm (0.5–2.4 cm), n = 171.3 ± 0.5 cm (0.6–2.5 cm), n = 101.2 ± 0.8 cm (0.6–2.7 cm), n = 6
    Lung cancer1.0 ± 0.4 cm (0.6–1.8 cm), n = 81.7 ± 0.7 cm (0.7–4.0 cm), n = 191.7 ± 0.8 cm (0.7–3.5 cm), n = 18
    Breast cancer2.2 ± 1.3 cm (0.5–4.3 cm), n = 41.4 ± 0.5 cm (0.8–2.9 cm), n = 121.8 ± 1.3 cm (0.9–2.7 cm), n = 2
    Pancreas cancer1.8 ± 0.7 cm (1.2–2.8 cm), n = 31.3 ± 0.9 cm (0.8–2.8 cm), n = 2Not applicable
    Miscellaneous1.4 ± 1.0 cm (0.4–4.5 cm), n = 19Not applicableNot applicable
    • Data are average ± SD, followed by range in parentheses.

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    TABLE 3

    Perceived Quality of PET Images (51 Scans) from Phase 1 of This Study (Prescribed 18F-FDG Dose, 555 MBq [15 mCi]) as Function of Acquisition Time

    Acquisition time (s)Uninterpretable (%)Poor (%)Adequate (%)Unequivocal %
    30652960
    601445410
    900226018
    120022375
    15000694
    180000100
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    TABLE 4

    Perceived Quality of PET Images (69 Scans) from Phase 2 of This Study (Prescribed 18F-FDG Dose, 370 MBq [10 mCi] or 3.7 MBq [0.1 mCi]/kg) as Function of Acquisition Time

    Acquisition time (s)Uninterpretable (%)Poor (%)Adequate (%)Unequivocal (%)
    3093700
    60514090
    90260335
    1200126028
    150002179
    180000100
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    TABLE 5

    SD and P Values for Variance of Normalized SUVmax of All Plots Within Each Subcategory of Acquisition Time and Dose Range

    Dose
    3.3–4.1 MBq/kg (0.09–0.11 mCi/kg)4.4–4.8 MBq/kg (0.12–0.13 mCi/kg)5.2–5.6 MBq/kg (0.14–0.15 mCi/kg)5.9–8.5 MBq/kg (0.16–0.23 mCi/kg)
    Acquisition time (s)σPσPσPσP
    300.181.0E−110.153.0E−90.152.0E−160.111.0E−5
    600.118.0E−80.090.00010.086.0E−110.070.004
    900.050.020.060.040.056.0E−60.040.99
    1200.050.010.050.290.040.0010.040.8
    1500.030.040.020.04
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Journal of Nuclear Medicine: 55 (12)
Journal of Nuclear Medicine
Vol. 55, Issue 12
December 1, 2014
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Using SUV as a Guide to 18F-FDG Dose Reduction
David W. Cheng, Devrim Ersahin, Lawrence H. Staib, Daniele Della Latta, Assuero Giorgetti, Francesco d’Errico
Journal of Nuclear Medicine Dec 2014, 55 (12) 1998-2002; DOI: 10.2967/jnumed.114.140129

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Using SUV as a Guide to 18F-FDG Dose Reduction
David W. Cheng, Devrim Ersahin, Lawrence H. Staib, Daniele Della Latta, Assuero Giorgetti, Francesco d’Errico
Journal of Nuclear Medicine Dec 2014, 55 (12) 1998-2002; DOI: 10.2967/jnumed.114.140129
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Keywords

  • 18F-FDG
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  • acquisition time
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