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Impact of PET/CT image reconstruction methods and liver uptake normalization strategies on quantitative image analysis

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

An Erratum to this article was published on 19 October 2015

Abstract

Background

In oncological imaging using PET/CT, the standardized uptake value has become the most common parameter used to measure tracer accumulation. The aim of this analysis was to evaluate ultra high definition (UHD) and ordered subset expectation maximization (OSEM) PET/CT reconstructions for their potential impact on quantification.

Patients and methods

We analyzed 40 PET/CT scans of lung cancer patients who had undergone PET/CT. Standardized uptake values corrected for body weight (SUV) and lean body mass (SUL) were determined in the single hottest lesion in the lung and normalized to the liver for UHD and OSEM reconstruction. Quantitative uptake values and their normalized ratios for the two reconstruction settings were compared using the Wilcoxon test. The distribution of quantitative uptake values and their ratios in relation to the reconstruction method used were demonstrated in the form of frequency distribution curves, box-plots and scatter plots. The agreement between OSEM and UHD reconstructions was assessed through Bland-Altman analysis.

Results

A significant difference was observed after OSEM and UHD reconstruction for SUV and SUL data tested (p < 0.0005 in all cases). The mean values of the ratios after OSEM and UHD reconstruction showed equally significant differences (p < 0.0005 in all cases). Bland-Altman analysis showed that the SUV and SUL and their normalized values were, on average, up to 60 % higher after UHD reconstruction as compared to OSEM reconstruction.

Conclusion

OSEM and HD reconstruction brought a significant difference for SUV and SUL, which remained constantly high after normalization to the liver, indicating that standardization of reconstruction and the use of comparable SUV measurements are crucial when using PET/CT.

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Compliance with Ethical Standards

All procedures performed in our analysis were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For our type of study formal consent is not required.

Conflict of interests

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Nuclear Medicine, University Hospital of Cologne, Kerpener Str. 62, 50937, Cologne, Germany

    Georg Kuhnert, Sergej Sterzer, Deniz Kahraman, Markus Dietlein, Alexander Drzezga & Carsten Kobe

  2. Department of Radiology and Nuclear Medicine, VU University Medical Centre, Amsterdam, The Netherlands

    Ronald Boellaard

  3. Lung Cancer Group Cologne, Department I of Internal Medicine, Center for Integrated Oncology Cologne Bonn, University Hospital of Cologne, Cologne, Germany

    Matthias Scheffler & Jürgen Wolf

Authors
  1. Georg Kuhnert
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  2. Ronald Boellaard
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  4. Deniz Kahraman
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  9. Carsten Kobe
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Correspondence to Carsten Kobe.

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Kuhnert, G., Boellaard, R., Sterzer, S. et al. Impact of PET/CT image reconstruction methods and liver uptake normalization strategies on quantitative image analysis. Eur J Nucl Med Mol Imaging 43, 249–258 (2016). https://doi.org/10.1007/s00259-015-3165-8

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  • DOI: https://doi.org/10.1007/s00259-015-3165-8

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