Asia Oceania Journal of Nuclear Medicine and Biology

Asia Oceania Journal of Nuclear Medicine and Biology

Effect of Tumor-Pixel Positioning on the Variability of SUV Measurements in PET Images

Document Type : Original Article

Authors
Koji Itagaki
Katsuhiko Mitsumoto
Masaaki Kajisako
Maki Shioji
Shigeto Kawase
Division of Clinical Radiology Service, Kyoto University Hospital, Kyoto, Japan
10.22038/aojnmb.2022.61623.1434
Abstract
Objective(s): The aim of this study was to investigate the effect on standardized uptake value (SUV) measurement variability of the positional relationship between objects of different sizes and the pixel of a positron emission tomography (PET) image.
Methods: We used a NEMA IEC body phantom comprising six spheres with diameters of 10, 13, 17, 22, 28, and 37 mm. The phantom was filled with 18F solution and contained target-to-background ratios (TBRs) of 2, 4, and 8. The PET data were acquired for 30 min using a SIGNA PET/MR scanner. The PET images were reconstructed with the ordered subsets expectation maximization (OSEM) algorithm with and without point-spread function (PSF) correction (OSEM + PSF + Filter and OSEM + Filter, respectively). A Gaussian filter of 4 mm full width at half maximum was applied in all reconstructions, except for one model (OSEM + PSF + no Filter). The matrix sizes were 128×128, 192×192, 256×256 and 384×384. Reconstruction was performed by shifting the reconstruction center position by 1 mm in the range 0 to 3 mm in the upward or rightward direction for each parameter. For all reconstructed images, the SUVmax of each hot sphere was measured. To investigate the resulting variation in the SUVmax, the coefficient of variation (CV) of each SUVmax was calculated.
Results: The CV of the SUVmax increased as the matrix size and the diameter of the hot sphere decreased in all reconstruction settings. With PSF correction, the CV of SUVmax increased as the TBR increased except when the TBR was 2. The CV of the SUVmax measured in the OSEM + PSF + no Filter images were larger than those measured in the OSEM + PSF + Filter images. The amount of this increase was higher for smaller spheres and larger matrix sizes and was independent of TBR.
Conclusions: Shifting the reconstruction center position of the PET image causes variability in SUVmax measurements. To reduce the variability of SUV measurements, it is necessary to use sufficient matrix sizes to satisfy sampling criterion and appropriate filters.
Keywords
PET/MR
SUV measurement
Reproducibility
  1. Fletcher JW, Djulbegovic B, Soares HP, Siegel BA, Lowe VJ, Lyman GH, et al. Recommendations on the use of 18F-FDG PET in oncology. J Nucl Med. 2008; 49(3):480-508.
  2. Johnson SA, Kumar A, Matasar MJ, Schöder H, Rademaker J. Imaging for staging and response assessment in lymphoma. Radiology. 2015; 276(2):323-38.
  3. Lin C, Itti E, Haioun C, Petegnief Y, Luciani A, Dupuis J, et al. Early 18F-FDG PET for prediction of prognosis in patients with diffuse large B-cell lymphoma: SUV-based assessment versus visual analysis. J Nucl Med. 2007; 48(10):1626-32.
  4. Weber BWA, Petersen V, Schmidt B, Tyndale-hines L, Link T, Peschel C. Positron Emission Tomography in Non – Small-Cell Lung Cancer : Prediction of Response to Chemotherapy by Quantitative Assessment of Glucose Use. J Clin Oncol.2003; 21(14): 2651-7.
  5. Adams MC, Turkington TG, Wilson JM, Wong TZ. A systematic review of the factors affecting accuracy of SUV measurements. Am J Roentgenol. 2010; 195(2):310-20.
  6. Benz MR, Evilevitch V, Allen-auerbach MS, Eilber FC, Phelps ME, Czernin J, et al. Treatment Monitoring by 18F-FDG PET / CT in Patients with Sarcomas : Interobserver Variability of Quantitative Parameters in Treatment-Induced Changes in Histopatho- logically Responding and Nonresponding Tumors. J Nucl Med.2008; 49(7): 1038 -46.
  7. Lodge MA, Chaudhry MA, Wahl RL. Noise considerations for PET quantification using maximum and peak standardized uptake value. J Nucl Med. 2012; 53(7):1041-7.
  8. Soret M, Bacharach SL, Buvat I. Partial-volume effect in PET tumor imaging. J Nucl Med. 2007; 48(6):932-45.
  9. Nahmias C, Wahl LM. Reproducibility of standardized uptake value measurements determined by 18F-FDG PET in malignant tumors. J Nucl Med. 2008; 49(11):1804-8.
  10. Krak NC, Boellaard R, Hoekstra OS, Twisk JWR, Hoekstra CJ, Lammertsma AA. Effects of ROI definition and reconstruction method on quantitative outcome and applicability in a response monitoring trial. Eur J Nucl Med Mol Imaging. 2005; 32(3): 294-301.
  11. Beyer T, Czernin J, Freudenberg LS. Variations in clinical PET/CT operations: results of an international survey of active PET/CT users. J Nucl Med. 2011; 52(2): 303-10.
  12. Young H, Baum R, Cremerius U, Herholz K, Hoekstra O, Lammertsma AA, et al. Measurement of clinical and subclinical tumour response using [18F]-fluorodeoxy-glucose and positron emission tomography: review and 1999 EORTC recommendations. European Organization for Research and Treatment of Cancer (EORTC) PET Study Group. Eur J Cancer. 1999; 35(13):1773-82.
  13. Nakamoto Y, Zasadny KR, Minn H, Wahl RL. Reproducibility of common semiquantitative parameters for evaluating lung cancer glucose metabolism with positron emission tomography using 2-deoxy-2-[18F]fluoro-D-glucose. Mol Imaging Biol. 2002; 4(2):171-8.
  14. Velasquez LM, Boellaard R, Kollia G, Hayes W, Hoekstra OS, Lammertsma AA, et al. Repeatability of 18F-FDG PET in a multicenter phase I study of patients with advanced gastrointestinal malignancies. J Nucl Med. 2009; 50(10):1646-54.
  15. Hashimoto N, Morita K, Tsutsui Y, Himuro K, Baba S, Sasaki M. Time-of-flight information improved the detectability of subcentimeter spheres using a clinical PET/CT scanner. J Nucl Med Technol. 2018; 46(3):268-73.
  16. Rahmim A, Qi J, Sossi V. Resolution modeling in PET imaging: Theory, practice, benefits, and pitfalls. Med Phys. 2013; 40(6):064301.
  17. Kidera D, Kihara K, Akamatsu G, Mikasa S, Taniguchi T, Tsutsui Y, et al. The edge artifact in the point-spread function-based PET reconstruction at different sphere-to-background ratios of radioactivity. Ann Nucl Med. 2016; 30(2):97-103.
  18. Jaskowiak CJ, Bianco JA, Perlman SB, Fine JP. Influence of reconstruction iterations on 18F-FDG PET/CT standardized uptake values. J Nucl Med. 2005; 46(3):424-8.
  19. Maebatake A, Morita K, Akamatsu G, Tsutsui Y, Himuro K, Baba S, et al. The influence of minimal misalignment on the repeatability of PET images examined by the repositioning of point sources. J Nucl Med Technol. 2019; 47(1):55-9.
  20. Fukukita H, Suzuki K, Matsumoto K, Terauchi T, Daisaki H, Ikari Y, et al. Japanese guideline for the oncology FDG-PET/CT data acquisition protocol: Synopsis of Version 2.0. Ann Nucl Med. 2014; 28(7): 693-705.
  21. Munk OL, Tolbod LP, Hansen SB, Bogsrud T V. Point-spread function reconstructed PET images of sub-centimeter lesions are not quantitative. EJNMMI Phys. 2017; 4(1):1–12.
  22. Rogasch JMM, Hofheinz F, Lougovski A, Furth C, Ruf J, Großer OS, et al. The influence of different signal-to-background ratios on spatial resolution and 18F-FDG-PET quanti-fication using point spread function and time-of-flight reconstruction. EJNMMI Phys. 2014; 1(1):1-16.
  23. Thielemans K, Asma E, Ahn S, Manjeshwar RM, Deller T, Ross SG, et al. Impact of PSF modelling on the convergence rate and edge behaviour of em images in PET. IEEE Nucl Sci Symp Conf Rec. 2010; 3267-72.
  24. Tong S, Alessio AM, Kinahan PE. Noise and signal properties in PSF-based fully 3D PET image reconstruction: An experimental evaluation. Phys Med Biol. 2010; 55(5): 1453-73.
  25. Morey AM, Noo F, Kadrmas DJ. Effect of using 2mm voxels on observer performance for PET lesion detection. IEEE Trans Nucl Sci. 2016; 63(3):1359-66.
  26. Akamatsu G, Mitsumoto K, Taniguchi T, Tsutsui Y, Baba S, Sasaki M. Influences of point-spread function and time-of-flight reconstructions on standardized uptake value of lymph node metastases in FDG-PET. Eur J Radiol. 2014; 83(1):226–30.
  27. Adler S, Seidel J, Choyke P, Knopp M V, Binzel K, Zhang J, et al. Minimum lesion detectability as a measure of PET system performance. EJNMMI Phys. 2017; 4:13.
  28. Boellaard R, Krak NC, Hoekstra OS, Lammertsma AA. Effects of noise, image resolution, and ROI definition on the accuracy of standard uptake values: A simulation study. J Nucl Med. 2004; 45(9): 1519-27.
  29. Koopman D, van Dalen JA, Lagerweij MCM, Arkies H, de Boer J, Oostdijk AHJ, et al. Improving the detection of small lesions using a state-of-the-art time-of-flight PET/CT system and small-voxel recon-structtions. J Nucl Med Technol. 2015; 43(1):21-7.
  30. Wahl RL, Jacene H, Kasamon Y, Lodge MA. From RECIST to PERCIST: Evolving considerations for PET response criteria in solid tumors. J Nucl Med. 2009; 50(SUPPL. 1):122-50.
  31. Kinahan PE, Perlman ES, Sunderland JJ, Subramaniam R, Wollenweber SD, Turkington TG, et al. The QIBA profile for FDG PET/CT as an imaging biomarker measuring response to cancer therapy. Radiology. 2020; 294(2):647-57.
Asia Oceania Journal of Nuclear Medicine and Biology
Volume 11, Issue 1
January 2023
Pages 71-81