Repeatability of 18F-FDG Uptake Measurements in Tumors: A Metaanalysis
Repeatability of 18F-FDG Uptake Measurements in Tumors: A Metaanalysis
复制标题
DOI：
10.2967/jnumed.111.095299
复制
发表时间：
2012-05-01
影响因子：
9.3
通讯作者：
Hoekstra, Otto S.
中科院分区：
文献类型：
--
作者：
de Langen, Adrianus J.;Vincent, Andrew;Hoekstra, Otto S.
PET与葡萄糖类似物F-18-FDG越来越多地用于监测肿瘤对治疗的反应。为了使用肿瘤F-18-FDG摄取的定量测量来评估肿瘤反应，需要建立这种定量代谢成像方法的可重复性。因此，我们利用现有数据确定了不同标准化摄取值（SUV）测量的可重复性。方法：通过系统的文献检索，确定F-18-FDG在恶性肿瘤中可重复性的研究。使用广义线性混合效应模型，用可重复性系数评估2个PET摄取测量值（最大SUV （SUVmax）和平均SUV (SUVmean)）的测试值和重测值之间的一致性水平。此外，评估肿瘤体积对重复性的影响。采用主成分变换比较2种不同摄取方法的重复性。结果：该荟萃分析确定了五个队列。对于SUVmax和SUVmean，分别有86例和102例患者的数据集可用。可重复性百分比是吸收水平的函数。SUVmean重复性最佳；对于连续PET扫描，20%和1.2 SUVmean单位的阈值组合是最合适的。在调整摄取率后，肿瘤体积对重复性的影响最小。结论：SUVmean的重复性优于SUVmax。两种测量方法均显示，对于F-18-FDG摄取较低的病变，重复性较差。我们建议通过报告最小的相对变化和绝对变化的组合来评估PET的生物效应，以解释测试重复测试的可变性。
PET with the glucose analog F-18-FDG is increasingly used to monitor tumor response to therapy. To use quantitative measurements of tumor F-18-FDG uptake for assessment of tumor response, the repeatability of this quantitative metabolic imaging method needs to be established. Therefore, we determined the repeatability of different standardized uptake value (SUV) measurements using the available data. Methods: A systematic literature search was performed to identify studies addressing F-18-FDG repeatability in malignant tumors. The level of agreement between test and retest values of 2 PET uptake measures, maximum SUV (SUVmax) and mean SUV (SUVmean), was assessed with the coefficient of repeatability using generalized linear mixed-effects models. In addition, the influence of tumor volume on repeatability was assessed. Principal component transformation was used to compare the reproducibility of the 2 different uptake measures. Results: Five cohorts were identified for this metaanalysis. For SUVmax and SUVmean, datasets of 86 and 102 patients, respectively, were available. Percentage repeatability is a function of the level of uptake. SUVmean had the best repeatability characteristics; for serial PET scans, a threshold of a combination of 20% as well as 1.2 SUVmean units was most appropriate. After adjusting for uptake rate, tumor volume had minimal influence on repeatability. Conclusion: SUVmean had better repeatability performance than SUVmax. Both measures showed poor repeatability for lesions with low F-18-FDG uptake. We recommend the evaluation of biologic effects in PET by reporting a combination of minimal relative and absolute changes to account for test retest variability.