Interobserver and Intraobserver Variability among Measurements of FDG PET/CT Parameters in Pulmonary Tumors.
BACKGROUND
18F-fluorodeoxyglucose (FDG) positron emission tomography computed tomography (PET/CT) provides information about metabolic and morphologic status of malignancies. Tumor size and standardized uptake value (SUV) measurements are crucial for cancer treatment monitoring.


OBJECTIVE
The purpose of our study was to assess the variability of these measurements performed by observers evaluating lung tumors.


METHODS
Retrospective cross-sectional study.


METHODS
FDG PET/CT images of 97 patients with pulmonary tumors were independently evaluated by two experienced nuclear medicine physicians. Primary tumor size (UDCT), maximum SUV (SUVmax), mean SUV (SUVmean) and maximum SUV normalized to liver mean SUV (SUVnliv max) were measured by each observer at two different times with an interval of at least 2 weeks. Interobserver and intraobserver variabilities of measurements were evaluated through statistical methods.


RESULTS
Size of the lesions varied from 0.81 to 13.6 cm (mean 4.29±2.24 cm). Very good agreement was shown with correlation, Bland-Altman and regression analysis for all measured PET/CT parameters. In the interobserver and intraobserver variability analysis, the Pearson correlation coefficients were greater than 0.96 and 0.98, respectively.


CONCLUSIONS
Semi-quantitative measurements of pulmonary tumors were highly reproducible when determined by experienced physicians with clinically available software for routine FDG PET/CT evaluation. Consistency may be improved if the same observer performs serial measurements for any one patient.
Department of Nuclear Medicine, Çukurova University School of Medicine, Adana, Turkey.
Gülgün
G
Büyükdereli
Department of Nuclear Medicine, State Hospital, Niğde, Turkey.
Mehtap
M
Güler
Department of Biostatistics, Çukurova University School of Medicine, Adana, Turkey.
Gülşah
G
Şeydaoğlu
FDG PET/CT; pulmonary tumors; standardized uptake value; variability