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Rapid Standardized CT-Based Method to Determine Lean Body Mass SUV for PET-A Significant Improvement Over Prediction
Terence A Riauka1, Vickie E Baracos2, Rebecca Reif3
1Division of Medical Physics, Department of Oncology, University of Alberta, Edmonton, AB, Canada.
Frontiers in Oncology
|July 25, 2022
Summary
Commonly used equations for estimating lean body mass (LBM) in cancer patients are inadequate. CT-derived LBM provides more accurate 18F-FDG PET measurements for assessing tumor metabolic activity and treatment response.
Area of Science:
- Nuclear Medicine
- Radiology
- Oncology
Background:
- Standardized uptake value (SUV) in 18F-FDG PET is influenced by body composition.
- Lean body mass (LBM) correction (SUL) improves SUV accuracy but LBM is often estimated.
- Accurate quantitative PET parameters are crucial for monitoring cancer treatment response.
Purpose of the Study:
- To evaluate the accuracy of commonly used equations for estimating LBM against CT-derived LBM.
- To assess the impact of equation-based LBM estimation on 18F-FDG PET measurements.
Main Methods:
- Retrospective analysis of whole-body 18F-FDG PET/CT scans from 195 adult cancer patients.
- Comparison of equation-estimated LBM and SUL with CT-derived LBM (LBM_CT) and SUL (SUL_CT).
- Bland and Altman plots used to assess differences between SUV and SUL.
Main Results:
- Existing equations for LBM estimation showed weak correlation with body mass and CT-derived LBM.
- Both James' and Janmahasatian's equations demonstrated significant bias, overestimating LBM.
- SUV and SUL_CT showed weak correlations in both men and women.
Conclusions:
- Equation-based LBM estimation is inadequate for accurate 18F-FDG PET quantification in cancer patients.
- CT-derived LBM provides a more accurate measure of body composition for PET analysis.
- Accurate LBM determination using CT enhances comparability of PET scans and supports clinical trial criteria like PERCIST.
