Influence of scan time point and volume of intravenous contrast administration on blood-pool and liver SUV_max and SUV_mean in [¹⁸F] FDG PET/CT

Summary

Aim: To investigate the influence of scan time point and volume of intravenous contrast material in 18F-FDG PET/CT on maximum and mean standardized uptake values (SUV_max/_mean) in bloodpool and liver. Methods: In 120 patients scheduled for routine whole-body 18F-FDG PET/CT the maximum and mean standardized uptake values (SUV_max/SUV_mean) in the liver and blood pool were measured after varying scan time-point (delay 0 s-140 s post injectionem) and volume of contrast material (CM; 0 ml, 80 ml, 100 ml of 300 mg/ml of Iodine). Six groups of 20 patients were investigated: (1) without intravenous CM, (2-5) injection of 100 ml CM with a delay of 80 s (2), 100 s (3), 120 s (4), 140 s (5), and 80 ml CM and a delay of 100 s (6). SUV_max, SUV_mean, maximum Hounsfield units (HU_max) and average Hounsfield units (HU_av) were calculated with the use of manually drawn regions of interests (ROIs) over the aortic arch and healthy liver tissue. Results: SUV_max in bloodpool was significantly higher in group 3, 4 and 6 compared to group 1. Groups 2 and 5 also showed higher mean values of SUV_max, but the difference was not significant. SUV_mean in bloodpool was also higher in groups 2, 3, 4, 5 and 6 compared to group 1, but the differences were only statistically significant in group 3. Both SUV_max and SUV_mean in healthy liver tissue did not show significant differences when compared to the non contrast-enhanced control group. Conclusion: SUV_max and to a lesser extent SUV_mean measured in CM enhanced FDG PET/CT in blood pool could be significantly altered in high contrast CT examinations. This should be kept in mind in PET/CT protocols and evaluation relying on SUV_max and SUV_mean, for example when used in the assessment of therapy response, especially in highly vascularized tumor lesions.

Zusammenfassung

Ziel: Das Ziel dieser Studie war den Einfluss von unterschiedlichen Messzeitpunkten und Volumina bei der Gabe von intravenösem Kontrastmittel in der 18F-FDG PET/CT auf SUV_max und SUV_mean im Blutpool und Lebergewebe zu untersuchen. Methoden: In 120 Patienten, geplant für eine Ganzkörper 18F-FDG -PET/CT, wurden die maximalen und durchschnittlichen standardisierten Aufnahmewerte (SUV_max/SUV_mean) in der Leber und im Blutpool, jeweils nach unterschiedlichen Messzeitpunkten (Verzögerung 0 s-140 s post injectionem) und verschiedenen Volumina von Kontrastmittel (KM; 0 ml, 80 ml, 100 ml mit einer Konzentration von 300 mg/ml Jod) gemessen. Sechs Gruppen von je 20 Patienten wurden untersucht: (1) ohne intravenöses KM, (2–5) Injektion von 100 ml KM mit einer Verzögerung von 80 s (2), 100 s (3), 120 s (4), 140 s (5), und 80 ml KM mit einer Verzögerung von 100 s (6). Es wurden jeweils die SUV_max, SUV_mean, die maximalen and die durchschnittlichen Hounsfield Einheiten (HU_av, HU_max) anhand manuell gezeichneter Bereiche von Interesse (ROIs) im Aortenbogen und im gesunden Lebergewebe berechnet. Ergebnisse: Die SUV_max im Blutpool waren im Vergleich zur Gruppe 1 signifikant höher in Gruppe 3, 4 und 6. Die Gruppen 2 und 5 zeigten ebenfalls höhere Durchschnittswerte von SUV_max, der Unterschied war jedoch nicht signifikant. Die SUV_mean im Blutpool waren im Vergleich zur Gruppe 1 ebenfalls höher in den Gruppen 2, 3, 4, 5 und 6, allerdings waren die Unterschiede nur in Gruppe 3 statistisch signifikant. Im Lebergewebe zeigten sowohl SUV_max, als auch SUV_mean keine signifikanten Unterschiede im Vergleich zu der nativen Kontrollgruppe. Schlussfolgerungen: In der Kontrastmittel-gestützten FDG PET/CT können die SUV_max und in geringerem Ausmaß auch SUV_mean im Blutpool durch Hochkontrast-CT Untersuchungen signifikant beeinflusst werden. Dies sollte bei PET/CT Protokollen bzw. Auswertungen, die auf SUV_max und SUV_mean beruhen, berücksichtigt werden, zum Beispiel bei der Beurteilung des Therapieansprechens insbesondere bei stark vaskularisiertem Tumorgewebe.

Keywords

Intravenous contrast administration - delay - volume - SUV_max - SUV_mean - SUR

Schlüsselwörter

Intravenöse Kontrastmittelapplikation - Messzeitpunkt - Volumen - SUV_max - SUV_mean - PET/CT

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