title: Is the standard uptake value (SUV) appropriate for quantification in clinical PET imaging? - Variability induced by different SUV measurements and varying reconstruction methods.
abstract: BACKGROUND
  PET quantification using the standard uptake value (SUV) is very prone to variations by technical factors of the scanner system and patient specific characteristics. Aim of the study was to investigate the reproducibility of SUV values between different measures and different reconstruction algorithms in a PET/CT scanner of the newest generation.
  
  
  METHODS
  The time-of-flight PET datasets of 27 consecutive oncological patients were reconstructed with OSEM3D in two different matrix sizes (200 × 200 and 400 × 400) as well as in a matrix size of 400 × 400 and additional point-spread-reconstruction. The standardized uptake values SUVmax, SUVmean and SUVpeak in 60 lesions were compared concerning their variability in the three reconstructions.
  
  
  RESULTS
  The addition of point-spread-reconstruction causes a significant increase of SUV values in comparison to OSEM 3D. SUVpeak showed the highest reproducibility between the different reconstruction algorithms. The variability of SUVmax and SUVmean increases in small lesions <5 ml, while SUVpeak remains more stable.
  
  
  CONCLUSIONS
  SUVmax, SUVmean and SUVpeak can be used for PET quantification in principle. However, quantification of small lesions is difficult. SUVpeak is the most robust method when using varying reconstruction methods, especially in small lesions.
authors.affiliation: Diagnostic and Interventional Radiology, Department of Radiology, Eberhard Karls University, Hoppe-Seyler-Straße 3, 72076 Tuebingen, Germany. Electronic address: cornelia.brendle@med.uni-tuebingen.de.
authors.forename: Cornelia
authors.initials: C
authors.lastname: Brendle
authors.affiliation: Nuclear Medicine, Department of Radiology, Eberhard Karls University, Hoppe-Seyler-Straße 3, 72076 Tuebingen, Germany. Electronic address: juergen.kupferschlaeger@med.uni-tuebingen.de.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Kupferschläger
authors.affiliation: Diagnostic and Interventional Radiology, Department of Radiology, Eberhard Karls University, Hoppe-Seyler-Straße 3, 72076 Tuebingen, Germany. Electronic address: konstantin.nikolaou@med.uni-tuebingen.de.
authors.forename: Konstantin
authors.initials: K
authors.lastname: Nikolaou
authors.affiliation: Nuclear Medicine, Department of Radiology, Eberhard Karls University, Hoppe-Seyler-Straße 3, 72076 Tuebingen, Germany. Electronic address: christian.lafougere@med.uni-tuebingen.de.
authors.forename: Christian
authors.initials: C
authors.lastname: la Fougère
authors.affiliation: Diagnostic and Interventional Radiology, Department of Radiology, Eberhard Karls University, Hoppe-Seyler-Straße 3, 72076 Tuebingen, Germany. Electronic address: sergios.gatidis@med.uni-tuebingen.de.
authors.forename: Sergios
authors.initials: S
authors.lastname: Gatidis
authors.affiliation: Diagnostic and Interventional Radiology, Department of Radiology, Eberhard Karls University, Hoppe-Seyler-Straße 3, 72076 Tuebingen, Germany. Electronic address: christina.pfannenberg@med.uni-tuebingen.de.
authors.forename: Christina
authors.initials: C
authors.lastname: Pfannenberg
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods; D009369:Neoplasms / Q000000981:diagnostic imaging*; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods; D051598:Whole Body Imaging / Q000379:methods
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: PET quantification; PET/CT; Point spread function; ROI; SUV