Comparison of PET/CT SUV metrics across different clinical software platforms

To assess the agreement of SUV metrics across the different clinical PET reading software platforms available at our institution.

PET/CT images were reviewed on four different FDA-approved software platforms: syngoMMWP VE36A and syngo.via VB30A (Siemens), Intellispace Portal 9.0 (Philips), and Encore 6.7 (MIM Software). A total of thirty SUV measurements were derived from ten 18F-FDG PET/CT oncology studies. A volume of interest (VOI) was drawn around the primary tumor to determine lesion SUV_max and a 3 cm diameter spherical VOI was placed in the right lobe of the liver to determine liver SUV_mean and liver SUV_max.

For lesion SUV_max, statistically significant differences were found for syngoMMWP VE36A vs syngo.via VB30A (p = 0.002), syngoMMWP VE36A vs Intellispace Portal 9.0 (p = 0.002), and syngoMMWP VE36A vs Encore 6.7 (p = 0.001), respectively. For liver SUV_max, a statistically significant difference was found for syngoMMWP VE36A vs syngo.via VB30A (p = 0.033) only, whereas for liver SUV_mean, no statistically significant differences were determined. A small systematic bias was found between syngoMMWP VE36A and all other platforms for lesion SUV_max.

Significant differences and systematic biases were observed when measuring lesion SUV_max using different reader software systems. Although these differences may not be clinically significant, this bias could confound outcomes for quantitative, precision-research protocols. Hence, it is important for nuclear medicine departments to take SUV metric agreement into consideration, especially when transitioning to a new clinical platform.