Reproducibility of metabolic measurements in malignant tumors using FDG PET.
PET using 18F-fluorodeoxyglucose (FDG) is increasingly applied to monitor the response of malignant tumors to radiotherapy and chemotherapy. The aim of this study was to assess the reproducibility of serial FDG PET measurements to define objective criteria for the evaluation of treatment-induced changes.


METHODS
Sixteen patients participating in phase I studies of novel antineoplastic compounds were examined twice by FDG PET within 10 d while they were receiving no therapy. Standardized uptake values (SUVs), FDG net influx constants (Ki), glucose normalized SUVs (SUV(gluc)) and influx constants (K(i,gluc)) were determined for 50 separate lesions. The precision of repeated measurements was determined on a lesion-by-lesion and a patient-by-patient basis.


RESULTS
None of the parameters showed a significant increase or decrease at the two examinations. The differences of repeated measurements were approximately normally distributed for all parameters with an SD of the mean percentage difference of about 10%. The 95% normal ranges for spontaneous fluctuations of SUV, SUV(gluc), Ki and K(i,gluc) were determined to be +/-0.91, +/-1.14, +/-0.52 mL/100 g/min and +/-0.64 mL/100 g/min, respectively. Analysis on a lesion-by-lesion basis yielded similar results.


CONCLUSIONS
FDG PET provides several highly reproducible quantitative parameters of tumor glucose metabolism. Changes of a parameter that are outside the 95% normal range determined in this study may be used to define a metabolic response to therapy.
Weber
W A
WA
Nuklearmedizinsche Klinik, Klinikum Rechts der Isar, Technische Universität München, Germany.
Ziegler
S I
SI
Thödtmann
R
R
Hanauske
A R
AR
Schwaiger
M
M
D000970:Antineoplastic Agents / Q000627:therapeutic use; D005260:Female; D005462:Fluorine Radioisotopes; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000378:metabolism; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D014055:Tomography, Emission-Computed
D000970:Antineoplastic Agents; D005462:Fluorine Radioisotopes; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18