title: Standardized Uptake Values in 2-Deoxy-2-[18F]Fluoro-D-Glucose with Positron Emission Tomography. Clinical Significance of Iterative Reconstruction and Segmented Attenuation Compared with Conventional Filtered Back Projection and Measured Attenuation Correction.
abstract: OBJECTIVE
  To evaluate the clinical significance of differences in 2-deoxy-2-[18F]fluoro-D-glucose positron emission tomography (FDG-PET) lymph node standardized uptake values (SUV) in human immunodeficiency virus (HIV) infection using iterative reconstruction with segmented attenuation correction (IR SAC) compared to filtered back-projection with measured attenuation correction (FBP MAC).
  
  
  METHODS
  Seven patients with HIV infection and multiple focal lymph node abnormalities were investigated with whole-body FDG-PET. Mean and maximum SUVs from lymph node regions of interest (n = 961) were compared for quantitative differences between reconstruction techniques.
  
  
  RESULTS
  IR MAC resulted in significantly lower mean SUV [0.06; 95% (confidence interval (CI)) = 0.04-0.07] and maximum SUV (0.82; 95% CI = 0.77-0.88) values compared to FBP MAC. With IR, segmentation of attenuation correction (AC) resulted in significantly higher mean SUV (0.12; 95% CI = 0.11-0.13) and maximum SUV (0.21; 95% CI = 0.18-0.23) values compared to IR MAC. The overall effect of both IR and SAC was a slight but significant increase in mean SUV (0.06; 95% CI = 0.06-0.08; bias = 2.1%) and a significant decrease in maximum SUV (0.62; 95% CI = 0.56-0.67) compared to FBP MAC.
  
  
  CONCLUSIONS
  With our reconstruction parameters, significant differences in mean and maximum SUV values were observed. The magnitude of the mean SUV difference, however, was small. IR SAC is a promising method to accurately quantify standardized uptake values for clinical use.
authors.affiliation: Johns Hopkins School of Medicine, Department of Radiology, Division of Nuclear Medicine, Baltimore, MD 21287, USA. bchin@jhmi.edu
authors.forename: Bennett B
authors.initials: BB
authors.lastname: Chin
authors.forename: Sujatha
authors.initials: S
authors.lastname: Lyengar
authors.forename: Beulah Perdue
authors.initials: BP
authors.lastname: Sabundayo
authors.forename: David
authors.initials: D
authors.lastname: Schwartz