Variations induced by body weight and background lesion normalization in standardized uptake value estimated by...

Area of Science:

• Nuclear medicine imaging
• Oncology
• Radiopharmacology

Background:

• Standardized Uptake Value (SUV) is a common metric in F18-FDG PET/CT for assessing metabolic activity.
• Accurate SUV measurements are crucial for staging, treatment response assessment, and prognosis in lymphoma.
• Various normalization methods exist, including those based on body weight, body mass index (BMI), body surface area (BSA), and lean body mass (LBM), each potentially affecting results.

Purpose of the Study:

• To evaluate the impact of different SUV variants (mean and maximum) on lymphoma patients.
• To compare various normalization methods (body weight, BMI, BSA, LBM) for SUV measurements.
• To determine which normalization strategy yields the most consistent and reliable SUV data in lymphoma.

Main Methods:

• Retrospective analysis of 69 lymphoma patients who underwent F18-FDG PET/CT.
• Determination of SUVmean and SUVmax in lesions and background sites (liver, aorta, muscle).
• Normalization of SUV values using body weight, BMI, BSA, LBM, and background sites; comparison of resulting variations.

Main Results:

• Significant differences in SUV measurements were observed between background sites (liver, aorta, muscle).
• SUV values normalized to BSA and BMI exhibited the lowest variation.
• Normalization to body weight resulted in the highest variation, while lean body mass normalization showed intermediate results.

Conclusions:

• SUVmax and SUVmean demonstrate lower variance when normalized to specific background regions.
• Normalization to BSA and certain lean body mass methods (Janma, James) resulted in less variation.
• SUV normalization to lean body mass (James, Janma) and BSA showed significant independence from body weight, suggesting improved reliability.