Abstract
Purpose
In PET/CT, CT-derived attenuation factors may influence standardised uptake values (SUVs) in tumour lesions and organs when compared with stand-alone PET. Therefore, we compared PET/CT-derived SUVs intra-individually in various organs and tumour lesions with stand-alone PET-derived SUVs.
Methods
Thirty-five patients with known or suspected cancer were prospectively included. Sixteen patients underwent FDG PET using an ECAT HR+scanner, and subsequently a second scan using a Biograph Sensation 16PET/CT scanner. Nineteen patients were scanned in the reverse order. All images were reconstructed with an iterative algorithm (OSEM). Suspected lesions were grouped as paradiaphragmatic versus distant from the diaphragm. Mean and maximum SUVs were also calculated for brain, lung, liver, spleen and vertebral bone. The attenuation coefficients (μ values) used for correction of emission data (bone, soft tissue, lung) in the two data sets were determined. A body phantom containing six hot spheres and one cold cylinder was measured using the same protocol as in patients.
Results
Forty-six lesions were identified. There was a significant correlation of maximum and mean SUVs derived from PET and PET/CT for 14 paradiaphragmatic lesions (r=0.97 respectively; p<0.001 respectively) and for 32 lesions located distant from the diaphragm (r=0.87 and r=0.89 respectively; p<0.001 respectively). No significant differences were observed in the SUVs calculated with PET and PET/CT in the lesions or in the organs. In the phantom, radioactivity concentration in spheres calculated from PET and from PET/CT correlated significantly (r=0.99; p<0.001).
Conclusion
SUVs of cancer lesions and normal organs were comparable between PET and PET/CT, supporting the usefulness of PET/CT-derived SUVs for quantification of tumour metabolism.
Similar content being viewed by others
References
Gambhir SS, Czernin J, Schwimmer J, Silverman DH, Coleman RE, Phelps ME. A tabulated summary of the FDG PET literature. J Nucl Med 2001;42:1–93.
Czernin J, Phelps ME. Positron emission tomography scanning: current and future applications. Annu Rev Med 2002;53:89–112.
Römer W, Hanauske AR, Ziegler S, Thodtmann R, Weber W, Fuchs C, et al. Positron emission tomography in non-Hodgkin’s lymphoma: assessment of chemotherapy with fluorodeoxyglucose. Blood 1998;91:4464–71.
Schelling M, Avril N, Nahrig J, Kuhn W, Romer W, Sattler D, et al. Positron emission tomography using [18F]fluorodeoxyglucose for monitoring primary chemotherapy in breast cancer. J Clin Oncol 2000;18(8):1689–95.
Weber WA, Petersen V, Schmidt B, Tyndale-Hines L, Link T, Peschel C, et al. Positron emission tomography in non-small-cell lung cancer: prediction of response to chemotherapy by quantitative assessment of glucose use. J Clin Oncol 2003;21(14):2651–7.
Kostakoglu L, Coleman M, Leonard JP, Kuji I, Zoe H, Goldsmith SJ. PET predicts prognosis after 1 cycle of chemotherapy in aggressive lymphoma and Hodgkin’s disease. J Nucl Med 2002;43(8):1018–27.
Haioun C, Itti E, Rahmouni A, Brice P, Rain JD, Belhadj K, et al. [18F]fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) in aggressive lymphoma: an early prognostic tool for predicting patient outcome. Blood 2005;106(4):1376–81.
Becherer A, Mitterbauer M, Jaeger U, Kalhs P, Greinix HT, Karanikas G, et al. Positron emission tomography with [18F]2-fluoro-D-2-deoxyglucose (FDG-PET) predicts relapse of malignant lymphoma after high-dose therapy with stem cell transplantation. Leukemia 2002;16(2):260–7.
Wieder HA, Brucher BL, Zimmermann F, Becker K, Lordick F, Beer A, et al. Time course of tumour metabolic activity during chemoradiotherapy of esophageal squamous cell carcinoma and response to treatment. J Clin Oncol 2004;22(5):900–8.
Brucher BL, Weber W, Bauer M, Fink U, Avril N, Stein HJ, et al. Neoadjuvant therapy of esophageal squamous cell carcinoma: response evaluation by positron emission tomography. Ann Surg 2001;233(3):300–9.
Weber WA, Ott K, Becker K, Dittler HJ, Helmberger H, Avril NE, et al. Prediction of response to preoperative chemotherapy in adenocarcinomas of the esophagogastric junction by metabolic imaging. J Clin Oncol 2001;19:3058–65.
Bailey DL. Transmission scanning in emission tomography. Eur J Nucl Med 1998;25(7):774–87.
Kinahan PE, Townsend DW, Beyer T, Sashin D. Attenuation correction for a combined 3D PET/CT scanner. Med Phys 1998;25(10):2046–53.
Young H, Baum R, Cremerius U, Herholz K, Hoekstra O, Lammertsma AA, et al. Measurement of clinical and subclinical tumour response using [18F]-fluorodeoxyglucose and positron emission tomography: review and 1999 EORTC recommendations. European Organization for Research and Treatment of Cancer (EORTC) PET Study Group. Eur J Cancer 1999;35:1773–82.
Hamacher K, Coenen HH, Stocklin G. Efficient stereospecific synthesis of no-carrier-added 2-[18F]-fluoro-2-deoxy-D-glucose using aminopolyether supported nucleophilic substitution. J Nucl Med 1986;27(2):235–8.
Herzog H, Tellmann L, Hocke C, Pietrzyk U, Casey M, Kuwert T. NEMANU2-2001 guided performance evaluation of four Siemens ECAT PET-scanners. Nuclear Science Symposium Conference Record, 2003 IEEE;4:2836–8.
Xu EZ, Mullani NA, Gould KL, Anderson WL. A segmented attenuation correction for PET. J Nucl Med 1991;32(1):161–5.
Meikle SR, Dahlbom M, Cherry SR. Attenuation correction using count-limited transmission data in positron emission tomography. J Nucl Med 1993;34(1):143–50.
Watson CC. New, faster, image-based scatter correction for 3D PET. IEEE Trans Nucl Sci 2000;47(4):1587–94.
Boellaard R, Krak NC, Hoekstra OS, Lammertsma AA. Effects of noise, image resolution, and ROI definition on the accuracy of standard uptake values: a simulation study. J Nucl Med 2004;45(9):1519–27.
Goerres GW, Kamel E, Heidelberg TN, Schwitter MR, Burger C, von Schulthess GK. PET-CT image co-registration in the thorax: influence of respiration. Eur J Nucl Med Mol Imaging 2002;29(3):351–60.
Beyer T, Antoch G, Blodgett T, Freudenberg LF, Akhurst T, Mueller S. Dual-modality PET/CT imaging: the effect of respiratory motion on combined image quality in clinical oncology. Eur J Nucl Med Mol Imaging 2003;30(4):588–96.
Osman MM, Cohade C, Nakamoto Y, Wahl RL. Respiratory motion artifacts on PET emission images obtained using CT attenuation correction on PET-CT. Eur J Nucl Med Mol Imaging 2003;30(4):603–6.
Visvikis D, Costa DC, Croasdale I, Lonn AH, Bomanji J, Gacinovic S, et al. CT-based attenuation correction in the calculation of semi-quantitative indices of [18F]FDG uptake in PET. Eur J Nucl Med Mol Imaging 2003;30(3):344–53.
Erdi YE, Nehmeh SA, Pan T, Pevsner A, Rosenzweig KE, Mageras G, et al. The CT motion quantitation of lung lesions and its impact on PET-measured SUVs. J Nucl Med 2004;45(8):1287–92.
Goerres GW, Kamel E, Seifert B, Burger C, Buck A, Hany TF, et al. Accuracy of image coregistration of pulmonary lesions in patients with non-small cell lung cancer using an integrated PET/CT system. J Nucl Med 2002;43(11):1469–75.
Schöder H, Erdi YE, Chao K, Gonen M, Larson SM, Yeung HW. Clinical implications of different image reconstruction parameters for interpretation of whole-body PET studies in cancer patients. J Nucl Med 2004;45:559–66.
Nakamoto Y, Osman M, Cohade C, Marshall LT, Links JM, Kohlmyer S, et al. PET/CT: comparison of quantitative tracer uptake between germanium and CT transmission attenuation-corrected images J Nucl Med 2002;43(9):1137–43.
Papathanassiou D, Becker S, Amir R, Meneroux B, Liehn JC. Respiratory motion artefact in the liver dome on FDG PET/CT: comparison of attenuation correction with CT and a caesium external source. Eur J Nucl Med Mol Imaging 2005;32(12):1422–8.
Burger C, Goerres G, Schoenes S, Buck A, Lonn AH, Von Schulthess GK. PET attenuation coefficients from CT images: experimental evaluation of the transformation of CT into PET 511-keV attenuation coefficients. Eur J Nucl Med Mol Imaging 2002;29(7):922–7.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Souvatzoglou, M., Ziegler, S.I., Martinez, M.J. et al. Standardised uptake values from PET/CT images: comparison with conventional attenuation-corrected PET. Eur J Nucl Med Mol Imaging 34, 405–412 (2007). https://doi.org/10.1007/s00259-006-0196-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00259-006-0196-1