Research ArticleClinical Investigations

Repeatability of Quantitative Whole-Body 18F-FDG PET/CT Uptake Measures as Function of Uptake Interval and Lesion Selection in Non–Small Cell Lung Cancer Patients

Gerbrand Maria Kramer, Virginie Frings, Nikie Hoetjes, Otto S. Hoekstra, Egbert F. Smit, Adrianus Johannes de Langen and Ronald Boellaard
Journal of Nuclear Medicine September 2016, 57 (9) 1343-1349; DOI: https://doi.org/10.2967/jnumed.115.170225

Article Figures & Data

Figures

  • FIGURE 1.
    FIGURE 1.

    SUVpeak values of test scan plotted against those of retest scan (A and D), corresponding Bland–Altman plots for all lesions (B and E), and for averaged PERCIST target lesions per patient (C and F) are shown. Upper and lower plots represent 60-min data (A–C) and 90-min data (D–F), respectively. B and E also show influence of PERCIST lesion selection criteria on repeatability. PERCIST target lesions = 5 hottest lesions per patient; maximum 2 per organ; SUVmax > 1.5 × mean liver SUV + 2 SDs.

  • FIGURE 2.
    FIGURE 2.

    Box plots of percentage differences between test and retest scans as obtained from 60- (dark) and 90- (light) min data. Effect of lesion selection and averaging on different 18F-FDG uptake metrics is shown.

  • FIGURE 3.
    FIGURE 3.

    SUVpeak (A) and MATV (B) values of data obtained 60 min after injection plotted against data obtained 90 min after injection.

  • FIGURE 4.
    FIGURE 4.

    Different uptake time corrections applied on SUVpeak of 90-min data plotted against 60-min data of the test scan.

Tables

  • TABLE 1

    Descriptive Statistics of Study Population

    CharacteristicMedianScan 1Scan 2P
    Age (y)61 (45–66)
    Patients11
    Tumor type
     Adenocarcinoma8
     Squamous cell carcinoma3
    Tumor stage
     IIIb4
     IV7
    Lesions (n)
     Intrathoracal41
     Extrathoracal19
    Time between scans (d)1 (1–2)
    Length (cm)173 (162–197)
    Weight (kg)75 (57–110)74 (57–114)0.60
    Glucose (mmol/L)5.6 (4.9–6.5)5.9 (4.5–7.1)0.62
    Uptake time target 60 min60 (60–67)60 (60–63)0.35
    Uptake time target 90 min93 (90–97)90 (90–95)0.15
    Injected activity (MBq)252 (194–377)238 (192–329)0.86
    Residual dose (MBq)0.16 (0.07–1.7)0.3 (0.02–3.22)0.33

    • Data are median, with range in parentheses, P values from Wilcoxon signed-rank test.

  • TABLE 2

    Descriptive Statistics of Uptake Measures for Several Tissues

    PET/CT 60 min after injectionPET/CT 90 min after injection
    TissueTestRetestTestRetest
    Aorta
     SUVmean1.29 ± 0.201.24 ± 0.151.10 ± 0.171.03 ± 0.19
    Liver
     SUVmean1.69 ± 0.281.69 ± 0.241.64 ± 0.281.60 ± 0.26
    Tumor
     SUVmax8.52 ± 5.408.54 ± 5.509.87 ± 6.439.88 ± 6.54
     SUVpeak6.09 ± 4.536.11 ± 4.536.96 ± 5.297.00 ± 5.38
     SUVmean5.03 ± 3.295.08 ± 3.365.76 ± 3.915.77 ± 4.00
     TLG175.29 ± 628.50179.29 ± 642.73202.51 ± 728.88202.84 ± 731.88
     MATV21.12 ± 56.9420.92 ± 54.7721.00 ± 56.4020.60 ± 54.21

    • Data are mean ± SD.

  • TABLE 3

    Mean Relative Differences and RCs for Several Uptake Metrics and Influence of Different Uptake Times and Lesion Selection

    All lesionsPERCISTPERCIST-averaged
    Uptake timeMean difference (%)RC (%)Mean difference (%)RC (%)Mean difference (%)RC (%)
    60 min after injection2.226.6−1.813.8−1.57.3
     SUVmax
     SUVmean0.718.1−1.713.7−1.36.6
     SUVpeak0.819.9−1.615.6−0.77.5
     TLG−1.529.0−1.619.1−0.114.7
     MATV−2.230.90.021.4−0.214.9
    90 min after injection−0.623.3−1.116.0−1.28.4
     SUVmax
     SUVmean−0.317.8−1.011.9−1.36.9
     SUVpeak−0.615.8−0.411.4−0.57.6
     TLG−1.123.7−0.315.10.99.6
     MATV−0.830.70.620.70.112.9

    • PERCIST = 5 hottest lesions, maximum 2 per organ and minimum SUV > 1.5 × mean liver SUV + 2 SDs.

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