RT Journal Article SR Electronic T1 Reproducibility of Tumor Uptake Heterogeneity Characterization Through Textural Feature Analysis in 18F-FDG PET JF Journal of Nuclear Medicine JO J Nucl Med FD Society of Nuclear Medicine SP jnumed.111.099127 DO 10.2967/jnumed.111.099127 A1 Tixier, Florent A1 Hatt, Mathieu A1 Le Rest, Catherine Cheze A1 Le Pogam, Adrien A1 Corcos, Laurent A1 Visvikis, Dimitris YR 2012 UL http://jnm.snmjournals.org/content/early/2012/03/26/jnumed.111.099127.abstract AB 18F-FDG PET measurement of standardized uptake value (SUV) is increasingly used for monitoring therapy response and predicting outcome. Alternative parameters computed through textural analysis were recently proposed to quantify the heterogeneity of tracer uptake by tumors as a significant predictor of response. The primary objective of this study was to evaluate the reproducibility of these heterogeneity measurements. Methods: Double baseline 18F-FDG PET scans were acquired within 4 d of each other for 16 patients before any treatment was considered. A Bland–Altman analysis was performed on 8 parameters based on histogram measurements and 17 parameters based on textural heterogeneity features after discretization with values between 8 and 128. Results: The reproducibility of maximum and mean SUV was similar to that in previously reported studies, with a mean percentage difference of 4.7% ± 19.5% and 5.5% ± 21.2%, respectively. By comparison, better reproducibility was measured for some textural features describing local heterogeneity of tracer uptake, such as entropy and homogeneity, with a mean percentage difference of −2% ± 5.4% and 1.8% ± 11.5%, respectively. Several regional heterogeneity parameters such as variability in the intensity and size of regions of homogeneous activity distribution had reproducibility similar to that of SUV measurements, with 95% confidence intervals of −22.5% to 3.1% and −1.1% to 23.5%, respectively. These parameters were largely insensitive to the discretization range. Conclusion: Several parameters derived from textural analysis describing heterogeneity of tracer uptake by tumors on local and regional scales had reproducibility similar to or better than that of simple SUV measurements. These reproducibility results suggest that these 18F-FDG PET–derived parameters, which have already been shown to have predictive and prognostic value in certain cancer models, may be used to monitor therapy response and predict patient outcome.