SUV- standardised uptake values in pet scanning


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SUV’s - A Brief Overview of Silly Useless Values

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SUV- standardised uptake values in pet scanning

  1. 1. SUV’s - A Brief Overview of Silly Useless Values. Todd Charge Senior Technologist Nuclear Medicine and PET Centre Hunter Health Imaging Service Hunter Health Imaging Service
  2. 2. Standardised Uptake Values Quantification has always held a pervasive allure for Nuclear Medicine. There is a sense that anything that can be quantified should be. J.W. Keyes Jr. PET Centre North Carolina USA Journal Nuclear Medicine 1995; 36:1836-1839 Hunter Health Imaging Service
  3. 3. What are SUV’s? A measure of FDG uptake as a function of time Quantitative evaluation of tumour metabolism Often used as a measure of malignancy vs. benignancy of lesion Hunter Health Imaging Service
  4. 4. Standardised Uptake ValueData courtesy Mount Vernon Hospital Hunter Health Imaging Service
  5. 5. Standardised Uptake Value Pre Treatment Post Treatment SUV = 18 SUV = 4 Hunter Health Imaging Service
  6. 6. Standardised Uptake Value C /(T ) SUV = dose/bodyweight Where C/(T) = FDG concentration in tissue at time T Hunter Health Imaging Service
  7. 7. Standardised Uptake Value Tracer concentration is usually determined from the image pixel that shows the highest lesion activity Average concentration was once used but is not routinely in use now Hunter Health Imaging Service
  8. 8. Assumptions of SUV’s Negligible free FDG in tissue at time of PET scan Equilibrium reached between plasma and free FDG in tissue All tissues are affected in the same way by glucose levels Hunter Health Imaging Service
  9. 9. Variables Influencing SUV’s Large number of variables which need to be taken into account. Patient size Measurement times Plasma Glucose ROI Partial Volume Effect Camera specifications Hunter Health Imaging Service
  10. 10. Summary Use of Lean Body Mass instead of true weight Take plasma glucose levels into account, tumour type & possible treatment effects Standardise uptake time, attenuation correction, scatter correction and filtering Consider ROI placement and use of max pixel Hunter Health Imaging Service
  11. 11. Summary Only use SUV within institution and even camera specific Be careful when using SUV threshold to distinguish tumour from normal tissue Consider SUV in conjunction with a subjective analysis of a lesion. Hunter Health Imaging Service
  12. 12. Summary Overall, recognise SUV’s for what they are: A helpful clue, but not the final answer. Hunter Health Imaging Service
  13. 13. References DiChiro G, Brooks RA. “PET quantitation: Blessing and Curse.” J Nucl Med 1988:29;1603-1604 S Meikle “Quantitative Methods and Factors Affecting SUV Calculation” ANZSNM PET Workshop 2003 JW Keyes “SUV: Standard Uptake or Silly Useless Value?” J Nucl Med 36:1836-1839, 1995 Hunter Health Imaging Service