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European Radiology

Erschienen in:

01.09.2015 | Nuclear Medicine

Quantification of tumour ¹⁸ F-FDG uptake: Normalise to blood glucose or scale to liver uptake?

verfasst von: Georgia Keramida, Sabina Dizdarevic, Janice Bush, A. Michael Peters

Erschienen in: European Radiology | Ausgabe 9/2015

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Abstract

Purpose

To compare normalisation to blood glucose (BG) with scaling to hepatic uptake for quantification of tumour ¹⁸ F-FDG uptake using the brain as a surrogate for tumours.

Methods

Standardised uptake value (SUV) was measured over the liver, cerebellum, basal ganglia, and frontal cortex in 304 patients undergoing ¹⁸ F-FDG PET/CT. The relationship between brain FDG clearance and SUV was theoretically defined.

Results

Brain SUV decreased exponentially with BG, with similar constants between cerebellum, basal ganglia, and frontal cortex (0.099–0.119 mmol/l⁻¹) and similar to values for tumours estimated from the literature. Liver SUV, however, correlated positively with BG. Brain-to-liver SUV ratio therefore showed an inverse correlation with BG, well-fitted with a hyperbolic function (R = 0.83), as theoretically predicted. Brain SUV normalised to BG (nSUV) displayed a nonlinear correlation with BG (R = 0.55); however, as theoretically predicted, brain nSUV/liver SUV showed almost no correlation with BG. Correction of brain SUV using BG raised to an exponential power of 0.099 mmol/l⁻¹ also eliminated the correlation between brain SUV and BG.

Conclusion

Brain SUV continues to correlate with BG after normalisation to BG. Likewise, liver SUV is unsuitable as a reference for tumour FDG uptake. Brain SUV divided by liver SUV, however, shows minimal dependence on BG.

Key Points

• FDG standard uptake value in tumours helps clinicians assess response to treatment.

• SUV is influenced by blood glucose; normalisation to blood glucose is recommended.

• An alternative approach is to scale tumour SUV to liver SUV.

• The brain used as a tumour surrogate shows that neither approach is valid.

• Applying both approaches, however, appropriately corrects for blood glucose.

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Titel: Quantification of tumour 18 F-FDG uptake: Normalise to blood glucose or scale to liver uptake?
verfasst von: Georgia Keramida
Sabina Dizdarevic
Janice Bush
A. Michael Peters
Publikationsdatum: 01.09.2015
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 9/2015
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-015-3659-6

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Quantification of tumour ¹⁸ F-FDG uptake: Normalise to blood glucose or scale to liver uptake?

Abstract

Purpose

Methods

Results

Conclusion

Key Points

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Springer Medizin

Abstract

Purpose

Methods

Results

Conclusion

Key Points

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