Research ArticleOncology

Repeatability of 18F-FLT PET in a Multicenter Study of Patients with High-Grade Glioma

Martin A. Lodge, Matthias Holdhoff, Jeffrey P. Leal, Asim K. Bag, L. Burt Nabors, Akiva Mintz, Glenn J. Lesser, David A. Mankoff, Arati S. Desai, James M. Mountz, Frank S. Lieberman, Joy D. Fisher, Serena Desideri, Xiaobu Ye, Stuart A. Grossman, David Schiff and Richard L. Wahl
Journal of Nuclear Medicine March 2017, 58 (3) 393-398; DOI: https://doi.org/10.2967/jnumed.116.178434

Article Figures & Data

Figures

  • FIGURE 1.
    FIGURE 1.

    Example 18F-FLT PET transaxial images for 2 different patients, acquired at 4 different time points: day 1, 1 h (A and C) and 3 h (B and D); day 2, 1 h (E and G) and 3 h (F and H). Images are shown in a common (inverse) gray scale. Isocontour tumor VOIs and normal background VOIs are shown in color.

  • FIGURE 2.
    FIGURE 2.

    T-to-B ratio for 4 different tumor SUVs: SUVmean_30% (A), SUVmean_gradient (B), SUVmax (C), and SUVpeak (D). Labels Early and Delayed refer to data acquired at approximately 1 and 3 h after injection. Horizontal markers indicate mean T-to-B ratios.

  • FIGURE 3.
    FIGURE 3.

    Bland–Altman plots for SUV data acquired at 1 h after injection. Data for 4 different VOI schemes are shown: SUVmean_30% (A), SUVmean_gradient (B), SUVmax (C), and SUVpeak (D). Note data are plotted on both primary (left) and secondary (right) y-axes as open circles and smaller solid circles, respectively. Dashed lines indicate 95% limits of repeatability. Quantity μ was expressed as SUV average for clarity.

  • FIGURE 4.
    FIGURE 4.

    Bland–Altman plots for SUV data acquired at 3 h after injection. Data for 4 different VOI schemes are shown: SUVmean_30% (A), SUVmean_gradient (B), SUVmax (C), and SUVpeak (D). The data are plotted on both primary (left) and secondary (right) y-axes as open circles and smaller solid circles, respectively. Dashed lines indicate 95% limits of repeatability. Quantity μ was expressed as SUV average for clarity.

Tables

  • TABLE 1

    Repeatability Metrics for Various SUV Parameters

    ParameterwCV (%) 1 hRC (%) 1 hwCV (%) 3 hRC (%) 3 h
    SUVmean_30%8.122.58.122.4
    SUVmean_gradient8.623.89.025.0
    SUVmax8.423.29.927.3
    SUVpeak6.718.58.523.6
    SUVnormal5.014.06.718.4
  • TABLE 2

    Repeatability Metrics for Various SUV and Other Tumor Parameters

    ParameterwCV (%)RC (%)
    SUVmean_30%7.921.9
    SUVmean_gradient8.724.0
    SUVmax9.025.0
    SUVpeak7.721.4
    T-to-B ratio (SUVmean_30%/SUVnormal)7.320.1
    T-to-B ratio (SUVmean_gradient/SUVnormal)8.323.1
    T-to-B ratio (SUVmax/SUVnormal)8.122.6
    T-to-B ratio (SUVpeak/SUVnormal)6.016.5
    Volume (30% isocontour)11.5 *32.0 *
    Volume (gradient)28.8 *79.9 *
    SUVmean_30% × volume (30% isocontour)8.222.6
    SUVmean_gradient × volume (gradient)28.9 *80.1 *

    • ↵* Data that were not consistent with the normal distribution (Shapiro–Wilk test).

    • For each tumor parameter, difference data D obtained at 1 and 3 h after injection were combined and analyzed as single dataset to increase statistical power.

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