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Whole-body PET/MRI of Pediatric Patients: The Details That Matter
Published on: December 19, 2017
Standardized uptake values for [¹⁸F] FDG in normal organ tissues: comparison of whole-body PET/CT and PET/MRI
Philipp Heusch1, Christian Buchbender, Karsten Beiderwellen
1Univ Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, D-40225 Dusseldorf, Germany.
Purpose:
To compare maximum and mean standardized uptake values (SUVmax/mean) of normal organ tissues derived from [(18)F]-fluoro-desoxyglucose (FDG) positron emission tomography/magnetic resonance imaging (PET/MRI) using MR attenuation correction (MRAC) (DIXON-based 4-segment μ-map) with [(18)F]-FDG positron emission tomography/computed tomography (PET/CT) using CT-based attenuation correction (CTAC).
Methods And Materials:
In 25 oncologic patients (15 men, 10 women; age 57 ± 13 years) after routine whole-body FDG-PET/CT (60 min after injection of 290 ± 40 MBq [(18)F]-FDG) a whole-body PET/MRI was performed (Magnetom Biograph mMR, Siemens Healthcare, Erlangen, Germany). Volumes of interest of 1.0 cm(3) were drawn in 7 physiological organ sites in MRAC-PET and the corresponding CTAC-PET images manually. Spearman correlation coefficients were calculated to compare MRAC- and CTAC based SUV values; Wilcoxon-Matched-Pairs signed ranks test was performed to test for potential differences.
Results:
The mean delay between FDG-PET/CT and PET/MRI was 92 ± 18 min. Excellent correlations of SUV values were found for the heart muscle (SUVmax/mean: R=0.97/0.97); reasonably good correlations were found for the liver (R=0.65/0.72), bone marrow (R=0.42/0.41) and the SUVmax of the psoas muscle (R=0.41). For subcutaneous fat, the correlation coefficient was 0.66 for SUVmean (p<0.05). Correlations between MRAC and CTAC were non-significant for SUVmean of the psoas muscle, SUVmax of subcutaneous fat, SUVmax and SUVmean of the lungs, SUVmax and SUVmean of the blood-pool. The median SUVmax and SUVmean in MRAC-PET were lower than the respective CTAC values in all organs (p<0.05) but heart (SUVmax) and the bone marrow (SUVmean).
Conclusion:
In conclusion, in oncologic patients examined with PET/CT and PET/MRI SUVmax and SUVmean values generally correlate well in normal organ tissues, except the lung, subcutaneous fat and the blood pool. SUVmax and SUVmean derived from PET/MRI can be used reliably in clinical routine.
Insights
Standardized uptake values (SUVmax/mean) from [(18)F]-FDG PET/MRI with MR attenuation correction (MRAC) generally correlate well with PET/CT values in normal organs. These PET/MRI SUVmax/mean values can be reliably used in clinical routine for oncologic patients.
Area of Science:
- Nuclear Medicine
- Radiology
- Oncology
Background:
- Standardized uptake values (SUV) are crucial for quantitative analysis in [(18)F]-fluoro-desoxyglucose (FDG) positron emission tomography (PET).
- Comparing SUV values derived from PET/magnetic resonance imaging (PET/MRI) with MR attenuation correction (MRAC) to those from PET/computed tomography (PET/CT) with CT attenuation correction (CTAC) is essential for clinical integration.
Purpose of the Study:
- To compare maximum and mean standardized uptake values (SUVmax/mean) of normal organ tissues obtained from FDG PET/MRI with MRAC to those from FDG PET/CT with CTAC.
- To assess the reliability of SUV measurements from PET/MRI in oncologic patients.
Main Methods:
- Twenty-five oncologic patients underwent both routine FDG PET/CT and subsequent whole-body FDG PET/MRI.
- Volumes of interest (1.0 cm³) were manually placed in 7 physiological organ sites on both MRAC-PET and CTAC-PET images.
- Spearman correlation coefficients and Wilcoxon-Matched-Pairs signed ranks tests were used to compare SUV values.
Main Results:
- Excellent correlations (R=0.97) were observed for SUVmax/mean in the heart muscle.
- Reasonably good correlations were found for the liver and bone marrow, while correlations for subcutaneous fat and psoas muscle varied.
- Median SUVmax and SUVmean in MRAC-PET were generally lower than CTAC values, with non-significant correlations noted for lungs, subcutaneous fat, and blood pool.
Conclusions:
- FDG PET/MRI with MRAC demonstrates good correlation of SUVmax/mean with FDG PET/CT in most normal organ tissues, excluding lungs, subcutaneous fat, and blood pool.
- The findings suggest that SUVmax and SUVmean derived from PET/MRI can be reliably utilized in clinical oncology practice.
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