Need for standardization of 18F-FDG PET/CT for treatment response assessments

Many factors affect standardized uptake values (SUVs) in (18)F-FDG PET/CT. The use of the SUV from a single PET scan in multicenter studies requires the standardization of (18)F-FDG PET/CT procedures. In the context of treatment response assessments (repeated PET scans), many factors may seem to have minor effects on percentage changes in SUVs, provided that imaging procedures are executed in a consistent manner for each subject. However, the use of (18)F-FDG PET/CT in a nonstandardized manner will result in unknown biases and reproducibilities of SUVs and SUV-based response measures. This article provides an overview of the need for standardization in relation to the specific use of SUVs and SUV changes in studies of treatment response assessments.