title: Repeatability of quantitative FDG-PET/CT and contrast-enhanced CT in recurrent ovarian carcinoma: test-retest measurements for tumor FDG uptake, diameter, and volume.
abstract: OBJECTIVE
  Repeatability of baseline FDG-PET/CT measurements has not been tested in ovarian cancer. This dual-center, prospective study assessed variation in tumor 2[18F]fluoro-2-deoxy-D-glucose (FDG) uptake, tumor diameter, and tumor volume from sequential FDG-PET/CT and contrast-enhanced computed tomography (CECT) in patients with recurrent platinum-sensitive ovarian cancer.
  
  
  METHODS
  Patients underwent two pretreatment baseline FDG-PET/CT (n = 21) and CECT (n = 20) at two clinical sites with different PET/CT instruments. Patients were included if they had at least one target lesion in the abdomen with a standardized uptake value (SUV) maximum (SUVmax) of ≥ 2.5 and a long axis diameter of ≥ 15 mm. Two independent reading methods were used to evaluate repeatability of tumor diameter and SUV uptake: on site and at an imaging clinical research organization (CRO). Tumor volume reads were only performed by CRO. In each reading set, target lesions were independently measured on sequential imaging.
  
  
  RESULTS
  Median time between FDG-PET/CT was two days (range 1-7). For site reads, concordance correlation coefficients (CCC) for SUVmean, SUVmax, and tumor diameter were 0.95, 0.94, and 0.99, respectively. Repeatability coefficients were 16.3%, 17.3%, and 8.8% for SUVmean, SUVmax, and tumor diameter, respectively. Similar results were observed for CRO reads. Tumor volume CCC was 0.99 with a repeatability coefficient of 28.1%.
  
  
  CONCLUSIONS
  There was excellent test-retest repeatability for FDG-PET/CT quantitative measurements across two sites and two independent reading methods. Cutoff values for determining change in SUVmean, SUVmax, and tumor volume establish limits to determine metabolic and/or volumetric response to treatment in platinum-sensitive relapsed ovarian cancer.
authors.affiliation: Authors' Affiliations: Department of Radiology, St. Bartholomew's Hospital/Barts Health NHS Trust; Department of Medical Oncology, St Bartholomew's Hospital/Barts Health NHS Trust; Department of Nuclear Medicine, Barts Cancer Institute; Centre for Experimental Cancer Medicine, Barts Cancer Institute, Queen Mary University of London; Departments of Oncology and Radiology, Cambridge University Hospitals Foundation Trust; Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre; NIHR Cambridge Biomedical Research Centre; and Cambridge Experimental Cancer Medicine Centre, Cambridge, United Kingdom; Merck and Co, Whitehouse Station; Sanofi, Bridgewater, New Jersey; and Merck Imaging, West Point, Pennsylvania a.rockall@imperial.ac.uk.
authors.forename: Andrea G
authors.initials: AG
authors.lastname: Rockall
authors.affiliation: Authors' Affiliations: Department of Radiology, St. Bartholomew's Hospital/Barts Health NHS Trust; Department of Medical Oncology, St Bartholomew's Hospital/Barts Health NHS Trust; Department of Nuclear Medicine, Barts Cancer Institute; Centre for Experimental Cancer Medicine, Barts Cancer Institute, Queen Mary University of London; Departments of Oncology and Radiology, Cambridge University Hospitals Foundation Trust; Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre; NIHR Cambridge Biomedical Research Centre; and Cambridge Experimental Cancer Medicine Centre, Cambridge, United Kingdom; Merck and Co, Whitehouse Station; Sanofi, Bridgewater, New Jersey; and Merck Imaging, West Point, Pennsylvania.
authors.forename: Norbert
authors.initials: N
authors.lastname: Avril
authors.affiliation: Authors' Affiliations: Department of Radiology, St. Bartholomew's Hospital/Barts Health NHS Trust; Department of Medical Oncology, St Bartholomew's Hospital/Barts Health NHS Trust; Department of Nuclear Medicine, Barts Cancer Institute; Centre for Experimental Cancer Medicine, Barts Cancer Institute, Queen Mary University of London; Departments of Oncology and Radiology, Cambridge University Hospitals Foundation Trust; Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre; NIHR Cambridge Biomedical Research Centre; and Cambridge Experimental Cancer Medicine Centre, Cambridge, United Kingdom; Merck and Co, Whitehouse Station; Sanofi, Bridgewater, New Jersey; and Merck Imaging, West Point, Pennsylvania.
authors.forename: Raymond
authors.initials: R
authors.lastname: Lam
authors.affiliation: Authors' Affiliations: Department of Radiology, St. Bartholomew's Hospital/Barts Health NHS Trust; Department of Medical Oncology, St Bartholomew's Hospital/Barts Health NHS Trust; Department of Nuclear Medicine, Barts Cancer Institute; Centre for Experimental Cancer Medicine, Barts Cancer Institute, Queen Mary University of London; Departments of Oncology and Radiology, Cambridge University Hospitals Foundation Trust; Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre; NIHR Cambridge Biomedical Research Centre; and Cambridge Experimental Cancer Medicine Centre, Cambridge, United Kingdom; Merck and Co, Whitehouse Station; Sanofi, Bridgewater, New Jersey; and Merck Imaging, West Point, Pennsylvania.
authors.forename: Robert
authors.initials: R
authors.lastname: Iannone
authors.affiliation: Authors' Affiliations: Department of Radiology, St. Bartholomew's Hospital/Barts Health NHS Trust; Department of Medical Oncology, St Bartholomew's Hospital/Barts Health NHS Trust; Department of Nuclear Medicine, Barts Cancer Institute; Centre for Experimental Cancer Medicine, Barts Cancer Institute, Queen Mary University of London; Departments of Oncology and Radiology, Cambridge University Hospitals Foundation Trust; Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre; NIHR Cambridge Biomedical Research Centre; and Cambridge Experimental Cancer Medicine Centre, Cambridge, United Kingdom; Merck and Co, Whitehouse Station; Sanofi, Bridgewater, New Jersey; and Merck Imaging, West Point, Pennsylvania.
authors.forename: P David
authors.initials: PD
authors.lastname: Mozley
authors.affiliation: Authors' Affiliations: Department of Radiology, St. Bartholomew's Hospital/Barts Health NHS Trust; Department of Medical Oncology, St Bartholomew's Hospital/Barts Health NHS Trust; Department of Nuclear Medicine, Barts Cancer Institute; Centre for Experimental Cancer Medicine, Barts Cancer Institute, Queen Mary University of London; Departments of Oncology and Radiology, Cambridge University Hospitals Foundation Trust; Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre; NIHR Cambridge Biomedical Research Centre; and Cambridge Experimental Cancer Medicine Centre, Cambridge, United Kingdom; Merck and Co, Whitehouse Station; Sanofi, Bridgewater, New Jersey; and Merck Imaging, West Point, PennsylvaniaAuthors' Affiliations: Department of Radiology, St. Bartholomew's Hospital/Barts Health NHS Trust; Department of Medical Oncology, St Bartholomew's Hospital/Barts Health NHS Trust; Department of Nuclear Medicine, Barts Cancer Institute; Centre for Experimental Cancer Medicine, Barts Cancer Institute, Queen Mary University of London; Departments of Oncology and Radiology, Cambridge University Hospitals Foundation Trust; Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre; NIHR Cambridge Biomedical Research Centre; and Cambridge Experimental Cancer Medicine Centre, Cambridge, United Kingdom; Merck and Co, Whitehouse Station; Sanofi, Bridgewater, New Jersey; and Merck Imaging, West Point, Pennsylvania.
authors.forename: Christine
authors.initials: C
authors.lastname: Parkinson
authors.affiliation: Authors' Affiliations: Department of Radiology, St. Bartholomew's Hospital/Barts Health NHS Trust; Department of Medical Oncology, St Bartholomew's Hospital/Barts Health NHS Trust; Department of Nuclear Medicine, Barts Cancer Institute; Centre for Experimental Cancer Medicine, Barts Cancer Institute, Queen Mary University of London; Departments of Oncology and Radiology, Cambridge University Hospitals Foundation Trust; Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre; NIHR Cambridge Biomedical Research Centre; and Cambridge Experimental Cancer Medicine Centre, Cambridge, United Kingdom; Merck and Co, Whitehouse Station; Sanofi, Bridgewater, New Jersey; and Merck Imaging, West Point, Pennsylvania.
authors.forename: Donald
authors.initials: D
authors.lastname: Bergstrom
authors.affiliation: Authors' Affiliations: Department of Radiology, St. Bartholomew's Hospital/Barts Health NHS Trust; Department of Medical Oncology, St Bartholomew's Hospital/Barts Health NHS Trust; Department of Nuclear Medicine, Barts Cancer Institute; Centre for Experimental Cancer Medicine, Barts Cancer Institute, Queen Mary University of London; Departments of Oncology and Radiology, Cambridge University Hospitals Foundation Trust; Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre; NIHR Cambridge Biomedical Research Centre; and Cambridge Experimental Cancer Medicine Centre, Cambridge, United Kingdom; Merck and Co, Whitehouse Station; Sanofi, Bridgewater, New Jersey; and Merck Imaging, West Point, Pennsylvania.
authors.forename: Evis
authors.initials: E
authors.lastname: Sala
authors.affiliation: Authors' Affiliations: Department of Radiology, St. Bartholomew's Hospital/Barts Health NHS Trust; Department of Medical Oncology, St Bartholomew's Hospital/Barts Health NHS Trust; Department of Nuclear Medicine, Barts Cancer Institute; Centre for Experimental Cancer Medicine, Barts Cancer Institute, Queen Mary University of London; Departments of Oncology and Radiology, Cambridge University Hospitals Foundation Trust; Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre; NIHR Cambridge Biomedical Research Centre; and Cambridge Experimental Cancer Medicine Centre, Cambridge, United Kingdom; Merck and Co, Whitehouse Station; Sanofi, Bridgewater, New Jersey; and Merck Imaging, West Point, Pennsylvania.
authors.forename: Shah-Jalal
authors.initials: SJ
authors.lastname: Sarker
authors.affiliation: Authors' Affiliations: Department of Radiology, St. Bartholomew's Hospital/Barts Health NHS Trust; Department of Medical Oncology, St Bartholomew's Hospital/Barts Health NHS Trust; Department of Nuclear Medicine, Barts Cancer Institute; Centre for Experimental Cancer Medicine, Barts Cancer Institute, Queen Mary University of London; Departments of Oncology and Radiology, Cambridge University Hospitals Foundation Trust; Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre; NIHR Cambridge Biomedical Research Centre; and Cambridge Experimental Cancer Medicine Centre, Cambridge, United Kingdom; Merck and Co, Whitehouse Station; Sanofi, Bridgewater, New Jersey; and Merck Imaging, West Point, PennsylvaniaAuthors' Affiliations: Department of Radiology, St. Bartholomew's Hospital/Barts Health NHS Trust; Department of Medical Oncology, St Bartholomew's Hospital/Barts Health NHS Trust; Department of Nuclear Medicine, Barts Cancer Institute; Centre for Experimental Cancer Medicine, Barts Cancer Institute, Queen Mary University of London; Departments of Oncology and Radiology, Cambridge University Hospitals Foundation Trust; Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre; NIHR Cambridge Biomedical Research Centre; and Cambridge Experimental Cancer Medicine Centre, Cambridge, United Kingdom; Merck and Co, Whitehouse Station; Sanofi, Bridgewater, New Jersey; and Merck Imaging, West Point, Pennsylvania.
authors.forename: Iain A
authors.initials: IA
authors.lastname: McNeish
authors.affiliation: Authors' Affiliations: Department of Radiology, St. Bartholomew's Hospital/Barts Health NHS Trust; Department of Medical Oncology, St Bartholomew's Hospital/Barts Health NHS Trust; Department of Nuclear Medicine, Barts Cancer Institute; Centre for Experimental Cancer Medicine, Barts Cancer Institute, Queen Mary University of London; Departments of Oncology and Radiology, Cambridge University Hospitals Foundation Trust; Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre; NIHR Cambridge Biomedical Research Centre; and Cambridge Experimental Cancer Medicine Centre, Cambridge, United Kingdom; Merck and Co, Whitehouse Station; Sanofi, Bridgewater, New Jersey; and Merck Imaging, West Point, PennsylvaniaAuthors' Affiliations: Department of Radiology, St. Bartholomew's Hospital/Barts Health NHS Trust; Department of Medical Oncology, St Bartholomew's Hospital/Barts Health NHS Trust; Department of Nuclear Medicine, Barts Cancer Institute; Centre for Experimental Cancer Medicine, Barts Cancer Institute, Queen Mary University of London; Departments of Oncology and Radiology, Cambridge University Hospitals Foundation Trust; Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre; NIHR Cambridge Biomedical Research Centre; and Cambridge Experimental Cancer Medicine Centre, Cambridge, United Kingdom; Merck and Co, Whitehouse Station; Sanofi, Bridgewater, New Jersey; and Merck Imaging, West Point, PennsylvaniaAuthors' Affiliations: Department of Radiology, St. Bartholomew's Hospital/Barts Health NHS Trust; Department of Medical Oncology, St Bartholomew's Hospital/Barts Health NHS Trust; Department of Nuclear Medicine, Barts Cancer Institute; Centre for Experimental Cancer Medicine, Barts Cancer Institute, Queen Mary University of London; Departments of Oncology and Radiology, Cambridge University Hospitals Foundation Trust; Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre; NIHR Cambridge
authors.forename: James D
authors.initials: JD
authors.lastname: Brenton
mesh_terms: D000328:Adult; D000368:Aged; D003287:Contrast Media; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D010051:Ovarian Neoplasms / Q000175:diagnosis*; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*; D047368:Tumor Burden
chemical_list: D003287:Contrast Media; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18