Nakamoto Yuji, Zasadny Kenneth R, Minn Heikki, Wahl Richard L
Division of Nuclear Medicine, Johns-Hopkins University, Baltimore, MD, USA
Mol Imaging Biol. 2002 Mar;4(2):171-8. doi: 10.1016/s1536-1632(01)00004-x.
Positron emission tomography (PET) with 2-deoxy-2-[18F]fluoro-D-glucose (FDG) has been used for various cancers, but reproducibility of common utilized semi-quantitative parameters, such as the maximal single pixel standardized uptake value (SUV) and effective glycolytic volume (EGV), remains unknown. Knowledge of precision is essential for applying these parameters to treatment monitoring. The purpose of this investigation was to assess the precision of PET results obtained by repeated examinations of patients with untreated lung cancer.
Ten patients with lung cancer underwent two PET examinations within a week with no intervening treatment. The reproducibility of three parameters:((1) maximal SUV of 1 x 1 pixel anywhere in the tumor, calculated on the basis of predicted lean body mass [SULmax]; (2) highest average SUV at 4 x 4 pixels in the tumor adjusted by predicted lean body mass [SULmean]; and (3) EGV calculated by multiplying SUL by tumor volume), using PET images obtained at 50-60 min post-injection, were examined. Plasma glucose, insulin and free fatty acid levels were also monitored.
The SULmax, SULmean, and EGV were measured with a mean +/- S.D. difference of 11.3% +/- 8.0, 10.1% +/- 8.2, and 10.1% +/- 8.0%, respectively. By multiplying SUL by plasma glucose concentration, the mean differences were slightly reduced to 7.2% +/- 5.8, 6.7% +/- 6.2, and 9.5% +/- 8.2, respectively.
These data indicate that commonly used semi-quantitative indices of glucose metabolism on PET show high reproducibly. This supports their use in sequential quantitative analysis in PET, such as in treatment response monitoring.
正电子发射断层扫描（PET）联合2-脱氧-2-[18F]氟-D-葡萄糖（FDG）已应用于多种癌症，但常用的半定量参数，如最大单像素标准化摄取值（SUV）和有效糖酵解体积（EGV）的可重复性仍不清楚。了解精度对于将这些参数应用于治疗监测至关重要。本研究的目的是评估未经治疗的肺癌患者重复检查获得的PET结果的精度。
10例肺癌患者在一周内接受了两次PET检查，期间无干预治疗。使用注射后50 - 60分钟获得的PET图像，检查三个参数的可重复性：（1）肿瘤内任意位置1×1像素的最大SUV，根据预测瘦体重计算[SULmax]；（2）肿瘤内4×4像素的最高平均SUV，经预测瘦体重调整[SULmean]；（3）通过将SUL乘以肿瘤体积计算的EGV。同时监测血浆葡萄糖、胰岛素和游离脂肪酸水平。
SULmax、SULmean和EGV测量的平均±标准差差异分别为11.3%±8.0%、10.1%±8.2%和10.1%±8.0%。将SUL乘以血浆葡萄糖浓度后，平均差异分别略有降低至7.2%±5.8%、6.7%±6.2%和9.5%±8.2%。
这些数据表明，PET上常用的葡萄糖代谢半定量指标具有较高的可重复性。这支持了它们在PET的序贯定量分析中的应用，如治疗反应监测。
