Department of Nuclear Medicine (internal postal code 444), Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500, HB, Nijmegen, The Netherlands.
Eur J Nucl Med Mol Imaging. 2010 Jul;37(7):1408-25. doi: 10.1007/s00259-009-1306-7. Epub 2009 Nov 20.
This review aims to provide insight into the factors that influence quantification of glucose metabolism by FDG PET images in oncology as well as their influence on repeated measures studies (i.e. treatment response assessment), offering improved understanding both for clinical practice and research.
Structural PubMed searches have been performed for the many factors affecting quantification of glucose metabolism by FDG PET. Review articles and references lists have been used to supplement the search findings.
Biological factors such as fasting blood glucose level, FDG uptake period, FDG distribution and clearance, patient motion (breathing) and patient discomfort (stress) all influence quantification. Acquisition parameters should be adjusted to maximize the signal to noise ratio without exposing the patient to a higher than strictly necessary radiation dose. This is especially challenging in pharmacokinetic analysis, where the temporal resolution is of significant importance. The literature is reviewed on the influence of attenuation correction on parameters for glucose metabolism, the effect of motion, metal artefacts and contrast agents on quantification of CT attenuation-corrected images. Reconstruction settings (analytical versus iterative reconstruction, post-reconstruction filtering and image matrix size) all potentially influence quantification due to artefacts, noise levels and lesion size dependency. Many region of interest definitions are available, but increased complexity does not necessarily result in improved performance. Different methods for the quantification of the tissue of interest can introduce systematic and random inaccuracy.
This review provides an up-to-date overview of the many factors that influence quantification of glucose metabolism by FDG PET.
本综述旨在深入探讨影响 FDG PET 图像肿瘤葡萄糖代谢定量的因素及其对重复测量研究（即治疗反应评估）的影响，以期提高临床实践和研究的认识。
对影响 FDG PET 葡萄糖代谢定量的多种因素进行了结构型 PubMed 搜索。综述文章和参考文献列表被用来补充搜索结果。
生物学因素如空腹血糖水平、FDG 摄取期、FDG 分布和清除、患者运动（呼吸）和患者不适（应激）等均会影响定量。应调整采集参数以最大限度地提高信噪比，同时避免患者受到高于绝对必要的辐射剂量。这在药代动力学分析中尤为具有挑战性，因为时间分辨率非常重要。本文综述了衰减校正对葡萄糖代谢参数的影响、运动、金属伪影和对比剂对 CT 衰减校正图像定量的影响。重建设置（分析与迭代重建、后重建滤波和图像矩阵大小）都可能由于伪影、噪声水平和病变大小依赖性而影响定量。有许多感兴趣区域的定义，但增加复杂性不一定能提高性能。对感兴趣组织的不同量化方法可能会引入系统和随机的不准确性。
本综述提供了 FDG PET 葡萄糖代谢定量的许多影响因素的最新概述。
