Cheng Monica, Tann Mark
Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA.
Hepatobiliary Surg Nutr. 2022 Oct;11(5):654-661. doi: 10.21037/hbsn-21-554.
Somatostatin receptor (SSTR)-targeted positron emission tomography/computed tomography (PET/CT) imaging has risen to the forefront for neuroendocrine tumor (NET) detection and management, yet the variability of significant uptake variability (SUV) as a semiquantitative measure of disease detection and tumor response to treatment has not been fully explored.
We assess the reproducibility and interscan variability of SUV metrics of normal tissue and NET in serial Ga-DOTA-NOC and Ga-DOTA-TATE PET imaging to clinically monitor disease state. Eighty-one patients were enrolled in this retrospective study.
Both primary and metastatic hepatic lesions demonstrated SUV (SUV 16.5±8.0). The median SUV was 16 for the spleen, 9.7 for the pituitary, 12.6 for the adrenal glands, and 4.8 for the liver. The normal pituitary gland demonstrates focal homogenous uptake with SUV range of 4.5-23. The adrenal gland showed uptake with SUV range of 4.1-29.4, which is more than two times greater than liver uptake (SUV range, 2.3-12.4). Highest physiological uptake seen in the spleen (average SUV of 17.3, range of 5.4-34.4).
The highly variable nature of regional SUV and SUV in both physiologic tissue and lesions suggests the need for incorporation of more reliable quantitative measures for clinical decision making.
以生长抑素受体（SSTR）为靶点的正电子发射断层扫描/计算机断层扫描（PET/CT）成像已成为神经内分泌肿瘤（NET）检测和管理的前沿技术，但作为疾病检测和肿瘤治疗反应半定量指标的最大标准摄取值（SUV）的变异性尚未得到充分研究。
我们评估了连续的镓-多胺基多羧基环肽（Ga-DOTA-NOC）和镓-多胺基多羧基环肽（Ga-DOTA-TATE）PET成像中正常组织和NET的SUV指标的可重复性和扫描间变异性，以临床监测疾病状态。81例患者纳入了这项回顾性研究。
原发性和转移性肝病灶的SUV均为16.5±8.0。脾脏的SUV中位数为16，垂体为9.7，肾上腺为12.6，肝脏为4.8。正常垂体呈局灶性均匀摄取，SUV范围为4.5-23。肾上腺摄取的SUV范围为4.1-29.4，比肝脏摄取（SUV范围为2.3-12.4）高出两倍多。脾脏的生理性摄取最高（平均SUV为17.3，范围为5.4-34.4）。
生理组织和病灶中区域SUV及SUV的高度变异性表明，临床决策需要采用更可靠的定量指标。
