Reproducibility of [18F]FDG PET/CT liver SUV as reference or normalisation factor

Area of Science:

• Nuclear Medicine
• Oncology
• Radiology

Background:

• Quantitative assessments in [18F]FDG PET/CT often use liver uptake as a reference.
• Lack of consensus exists for standardized measurement of [18F]FDG liver uptake.
• This variability impacts diagnostic accuracy and treatment monitoring.

Purpose of the Study:

• To evaluate variations in liver standardized uptake value (SUV) measurements in lymphoma [18F]FDG PET/CT studies.
• To identify the most reproducible liver uptake metric for quantitative analysis.
• To inform consistent application of liver uptake in PET/CT interpretation.

Main Methods:

• Analysis of PET/CT scans from 34 lymphoma patients.
• Calculation of SUVmax, SUVpeak, and SUVmean liver uptake.
• Assessment of SUV variations based on VOI size, location, imaging time point, and MTV.
• Evaluation of reconstruction protocol and noise impact on liver SUV.

Main Results:

• SUVmax and SUVpeak were significantly higher than SUVmean.
• SUVmean demonstrated minimal variability with VOI size and location.
• Reconstruction protocols and image noise substantially affected SUVmax and SUVpeak.
• Liver uptake metrics showed variations with imaging time points and total MTV.

Conclusions:

• SUVmean is the most robust and reproducible metric for liver uptake in [18F]FDG PET/CT.
• Standardized measurement using SUVmean, even with commonly recommended VOI sizes, ensures reliability.
• This promotes consistent quantitative analysis in lymphoma staging and response assessment.