SUV- standardised uptake values in pet scanning
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SUV- standardised uptake values in pet scanning



SUV’s - A Brief Overview of Silly Useless Values

SUV’s - A Brief Overview of Silly Useless Values



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SUV- standardised uptake values in pet scanning Presentation Transcript

  • 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. 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. 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. Standardised Uptake ValueData courtesy Mount Vernon Hospital Hunter Health Imaging Service
  • 5. Standardised Uptake Value Pre Treatment Post Treatment SUV = 18 SUV = 4 Hunter Health Imaging Service
  • 6. Standardised Uptake Value C /(T ) SUV = dose/bodyweight Where C/(T) = FDG concentration in tissue at time T Hunter Health Imaging Service
  • 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. 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. 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. 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. 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. Summary Overall, recognise SUV’s for what they are: A helpful clue, but not the final answer. Hunter Health Imaging Service
  • 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