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Glucose corrected standardized uptake value (SUVgluc) in the evaluation of brain lesions with 18F-FDG PET

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

To retrospectively assess the utility of 18F fluorodeoxyglucose (FDG) positron emission tomography (PET) images of standardized uptake values corrected for blood glucose (SUVgluc), and to compare this to various quantitative methods to identify the presence or absence of high grade malignancy.

Methods

A retrospective review in 42 patients, found 81 central nervous system (CNS) lesions. Fifty one were malignant and 30 were benign or post treatment changes based on pathology (n = 32) and on clinical outcome (n = 49). Dynamic FDG PET scans were processed to generate parametric images of SUVgluc, SUV, glucose metabolic rate (GMR), and lesion to cerebellum ratios (SUVRc), and contralateral white matter ratios (SUVRw). The SUVgluc was calculated from \( {{{\mathrm{SU}{{\mathrm{V}}_{\max }}*\mathrm{BG}}} \left/ {{\left[ {100\,\mathrm{mg}/\mathrm{dl}} \right]}} \right.} \), where SUVmax is the maximum SUV and BG is the blood glucose level (mg/dL).

Results

Using a malignant threshold for SUVgluc of 4.5 and GMR of 13.0 μmole/min/100 g, the accuracies were similar for the SUVgluc (80 %) and GMR (81 %) and were higher than the conventional SUVmax (73 %). The area under the receiver operating characteristic (ROC) curve for the SUVgluc (0.8661) was better than that for the SUVmax (0.7955) (p < 0.02) and was similar to those of the GMR (0.8694), SUVRc (0.8278), and SUVRw (0.8559).

Conclusion

These results suggest that the SUVgluc may assist in the interpretation of FDG PET brain images in patients with CNS lesions. The SUVgluc method avoids the complexity of kinetic modeling and the definition of a reference region.

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Acknowledgments

This work was supported in part by the Wagner Torizuka Fellowship Program to A. Nozawa and by grants from National Institute of Health (NIH 3P30CA023100-25S8) and from UC San Diego Brain Cancer Research Funds to S. Kesari.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Radiology, UC San Diego, La Jolla, CA, USA

    Asae Nozawa, Ali Hosseini Rivandi & Carl K. Hoh

  2. Department of Neurosciences, UC San Diego, La Jolla, CA, USA

    Santosh Kesari

  3. Translational Neuro-Oncology Laboratories, Moores Cancer Center, UC San Diego Health System, La Jolla, CA, USA

    Santosh Kesari

  4. UCSD Medical Center, 200 W. Arbor Drive, San Diego, CA, 92103-8758, USA

    Carl K. Hoh

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  1. Asae Nozawa
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  2. Ali Hosseini Rivandi
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Correspondence to Carl K. Hoh.

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Nozawa, A., Rivandi, A.H., Kesari, S. et al. Glucose corrected standardized uptake value (SUVgluc) in the evaluation of brain lesions with 18F-FDG PET. Eur J Nucl Med Mol Imaging 40, 997–1004 (2013). https://doi.org/10.1007/s00259-013-2396-9

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  • DOI: https://doi.org/10.1007/s00259-013-2396-9

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