Quantification of FDG PET studies using standardised uptake values in multi-centre trials: effects of image reconstruction,resolution and ROI definition parameters |
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Authors: | Marinke Westerterp Jan Pruim Wim Oyen Otto Hoekstra Anne Paans Eric Visser Jan van Lanschot Gerrit Sloof Ronald Boellaard |
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Institution: | (1) Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands;(2) Department of Nuclear Medicine, Academic Medical Center, Amsterdam, The Netherlands;(3) Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, The Netherlands;(4) Department of Nuclear Medicine, University Medical Centre Nijmegen, Nijmegen, The Netherlands;(5) Department of Nuclear Medicine and PET Research, VU University Medical Centre, Amsterdam, The Netherlands |
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Abstract: | Purpose Standardised uptake values (SUVs) depend on acquisition, reconstruction and region of interest (ROI) parameters. SUV quantification
in multi-centre trials therefore requires standardisation of acquisition and analysis protocols. However, standardisation
is difficult owing to the use of different scanners, image reconstruction and data analysis software. In this study we evaluated
whether SUVs, obtained at three different institutes, may be directly compared after calibration and correction for inter-institute
differences.
Methods First, an anthropomorphic thorax phantom containing variously sized spheres and activities, simulating tumours, was scanned
and processed in each institute to evaluate differences in scanner calibration. Secondly, effects of image reconstruction
and ROI method on recovery coefficients were studied. Next, SUVs were derived for tumours in 23 subjects. Of these 23 patients,
four and ten were scanned in two institutes on an HR+ PET scanner and nine were scanned in one institute on an ECAT EXACT
PET scanner. All phantom and clinical data were reconstructed using iterative reconstruction with various iterations, with
both measured (MAC) and segmented attenuation correction (SAC) and at various image resolutions. Activity concentrations (AC)
or SUVs were derived using various ROI isocontours.
Results Phantom data revealed differences in SUV quantification of up to 30%. After application-specific calibration, recovery coefficients
obtained in each institute were equal to within 15%. Varying the ROI isocontour value resulted in a predictable change in
SUV (or AC) for both phantom and clinical data. Variation of image resolution resulted in a predictable change in SUV quantification
for large spheres/tumours (>5 cc) only. For smaller tumours (<2 cc), differences of up to 40% were found between high (7 mm)
and low (10 mm) resolution images. Similar differences occurred when data were reconstructed with a small number of iterations.
Finally, no significant differences between MAC and SAC reconstructed data were observed, except for tumours near the diaphragm.
Conclusion Standardisation of acquisition, reconstruction and ROI methods is preferred for SUV quantification in multi-centre trials.
Small unavoidable differences in methodology can be accommodated by performing a phantom study to assess inter-institute correction
factors. |
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Keywords: | Standardised uptake value PET Multi-centre Quantification Standardisation |
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