SUV variability in EARL-accredited conventional and digital PET
Daniëlle Koopman, Pieter L Jager, Cornelis H Slump, Siert Knollema, Jorn A van Dalen, Daniëlle Koopman, Pieter L Jager, Cornelis H Slump, Siert Knollema, Jorn A van Dalen
Abstract
Background: A high SUV-reproducibility is crucial when different PET scanners are in use. We evaluated the SUV variability in whole-body FDG-PET scans of patients with suspected or proven cancer using an EARL-accredited conventional and digital PET scanner. In a head-to-head comparison we studied images of 50 patients acquired on a conventional scanner (cPET, Ingenuity TF PET/CT, Philips) and compared them with images acquired on a digital scanner (dPET, Vereos PET/CT, Philips). The PET scanning order was randomised and EARL-compatible reconstructions were applied. We measured SUVmean, SUVpeak, SUVmax and lesion diameter in up to 5 FDG-positive lesions per patient. The relative difference ΔSUV between cPET and dPET was calculated for each SUV-parameter. Furthermore, we calculated repeatability coefficients, reflecting the 95% confidence interval of ΔSUV.
Results: We included 128 lesions with an average size of 19 ± 14 mm. Average ΔSUVs were 6-8% with dPET values being higher for all three SUV-parameters (p < 0.001). ΔSUVmax was significantly higher than ΔSUVmean (8% vs. 6%, p = 0.002) and than ΔSUVpeak (8% vs. 7%, p = 0.03). Repeatability coefficients across individual lesions were 27% (ΔSUVmean and ΔSUVpeak) and 33% (ΔSUVmax) (p < 0.001).
Conclusions: With EARL-accredited conventional and digital PET, we found a limited SUV variability with average differences up to 8%. Furthermore, only a limited number of lesions showed a SUV difference of more than 30%. These findings indicate that EARL standardisation works.
Trial registration: This prospective study was registered on the 31th of October 2017 at ClinicalTrials.cov. URL: https://ichgcp.net/clinical-trials-registry/NCT03457506?id=03457506&rank=1.
Keywords: Cancer; Conventional PET; Digital PET; EARL-accreditation; FDG-PET.
Conflict of interest statement
This work was supported by a research agreement between the Department of Nuclear Medicine, Isala, and Philips Healthcare regarding new PET technologies. The content of the article was solely the responsibility of the authors. The authors declare that they have no competing interests.
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Source: PubMed