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Variations in (18)F-FDG uptake in breast cancer depending on PET/CT acquisition position

 J.H. Lee  ;  T.J. Jeon  ;  S.G. Ahn  ;  J. Jeong  ;  J.W. Seok  ;  Y.H. Ryu 
 CLINICAL RADIOLOGY, Vol.71(1) : 86-91, 2016 
Journal Title
Issue Date
Adult ; Aged ; Breast Neoplasms/diagnostic imaging* ; Breast Neoplasms/pathology ; Female ; Fluorodeoxyglucose F18 ; Humans ; Lymphatic Metastasis ; Middle Aged ; Multimodal Imaging* ; Neoplasm Staging ; Patient Positioning* ; Positron-Emission Tomography/methods* ; Radiographic Image Interpretation, Computer-Assisted ; Radiopharmaceuticals ; Retrospective Studies ; Tomography, X-Ray Computed/methods*
AIM: To evaluate the variability of quantitative 2-[(18)F]-fluoro-2-deoxy-d-glucose (FDG) positron-emission tomography (PET) combined with computed tomography (CT) parameters depending on acquisition position in a dual-position protocol for breast cancers. MATERIALS AND METHODS: For initial staging work-up, whole-body PET/CT was first acquired in a supine position, and then followed by a regional breast scan in a prone position. The maximum standardised uptake value (SUVmax), metabolic tumour volume (MTV), and total lesion glycolysis (TLG) were measured on both acquisition positions. MTV50 and TLG50 were calculated with a threshold set to be 50% of SUVmax, and MTV2.5 and TLG2.5 with a fixed SUV threshold of 2.5. RESULTS: The median SUVmax of breast cancers measured on the supine scans was 4.88, and 4.49 on the prone images (p<0.05). MTV and TLG also yielded significantly lower values from supine images. Regarding the tendency for the acquisition position to yield different results, a significant disagreement was observed between SUVmax and MTV50 and between SUVmax and TLG50 (kappa = -0156 and -0.001, respectively), while MTV2.5 and TLG2.5 showed a fair to moderate agreement with SUVmax (kappa = 0.311 and 0.416, respectively). CONCLUSIONS: SUVmax, MTV, and TLG yielded lower values when acquired in the prone position compared to in the supine position. This observation could be due to the partial volume effect. When using 50% of SUVmax as a threshold, there was a significant discordance between SUVmax and volumetric parameters. Thus, acquisition position may affect quantitative PET/CT parameters and the clinical implications.
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1. College of Medicine (의과대학) > Dept. of Nuclear Medicine (핵의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Ahn, Sung Gwe(안성귀) ORCID logo https://orcid.org/0000-0002-8778-9686
Ryu, Young Hoon(유영훈) ORCID logo https://orcid.org/0000-0002-9000-5563
Lee, Jae Hoon(이재훈) ORCID logo https://orcid.org/0000-0002-9898-9886
Jeon, Tae Joo(전태주) ORCID logo https://orcid.org/0000-0002-7574-6734
Jeong, Joon(정준) ORCID logo https://orcid.org/0000-0003-0397-0005
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