TY - JOUR

T1 - Test-retest repeatability and interobserver variation of healthy tissue metabolism using F-18-FDG PET/CT of the thorax among lung cancer patients

AU - Malaih, Afnan A.

AU - Dunn, Joel T.

AU - Nygard, Lotte

AU - Kovacs, David G.

AU - Andersen, Flemming L.

AU - Barrington, Sally F.

AU - Fischer, Barbara M.

PY - 2022/5

Y1 - 2022/5

N2 - Objectives The aim of this study was to assess the test-retest repeatability and interobserver variation in healthy tissue (HT) metabolism using 2-deoxy-2-[F-18]fluoro-d-glucose (F-18-FDG) PET/computed tomography (PET/CT) of the thorax in lung cancer patients. Methods A retrospective analysis was conducted in 22 patients with non-small cell lung cancer who had two PET/CT scans of the thorax performed 3 days apart with no interval treatment. The maximum, mean and peak standardized uptake values (SUVs) in different HTs were measured by a single observer for the test-retest analysis and two observers for interobserver variation. Bland-Altman plots were used to assess the repeatability and interobserver variation. Intrasubject variability was evaluated using within-subject coefficients of variation (wCV). Results The wCV of test-retest SUVmean measurements in mediastinal blood pool, bone marrow, skeletal muscles and lungs was less than 20%. The left ventricle (LV) showed higher wCV (>60%) in all SUV parameters with wide limits of repeatability. High interobserver agreement was found with wCV of less than 10% in SUVmean of all HT, but up to 22% was noted in the LV. Conclusion HT metabolism is stable in a test-retest scenario and has high interobserver agreement. SUVmean was the most stable metric in organs with low FDG uptake and SUVpeak in HTs with moderate uptake. Test-retest measurements in LV were highly variable irrespective of the SUV parameters used for measurements.

AB - Objectives The aim of this study was to assess the test-retest repeatability and interobserver variation in healthy tissue (HT) metabolism using 2-deoxy-2-[F-18]fluoro-d-glucose (F-18-FDG) PET/computed tomography (PET/CT) of the thorax in lung cancer patients. Methods A retrospective analysis was conducted in 22 patients with non-small cell lung cancer who had two PET/CT scans of the thorax performed 3 days apart with no interval treatment. The maximum, mean and peak standardized uptake values (SUVs) in different HTs were measured by a single observer for the test-retest analysis and two observers for interobserver variation. Bland-Altman plots were used to assess the repeatability and interobserver variation. Intrasubject variability was evaluated using within-subject coefficients of variation (wCV). Results The wCV of test-retest SUVmean measurements in mediastinal blood pool, bone marrow, skeletal muscles and lungs was less than 20%. The left ventricle (LV) showed higher wCV (>60%) in all SUV parameters with wide limits of repeatability. High interobserver agreement was found with wCV of less than 10% in SUVmean of all HT, but up to 22% was noted in the LV. Conclusion HT metabolism is stable in a test-retest scenario and has high interobserver agreement. SUVmean was the most stable metric in organs with low FDG uptake and SUVpeak in HTs with moderate uptake. Test-retest measurements in LV were highly variable irrespective of the SUV parameters used for measurements.

KW - 2-deoxy-2-[F-18]fluoro-d-glucose

KW - healthy tissues

KW - interobserver variation

KW - PET-computed tomography

KW - repeatability

KW - standardized uptake value

KW - thorax

KW - POSITRON-EMISSION-TOMOGRAPHY

KW - STANDARDIZED UPTAKE VALUES

KW - INTERREADER AGREEMENT

KW - MYOCARDIAL-METABOLISM

KW - FDG UPTAKE

KW - VARIABILITY

KW - TUMOR

KW - SUV

KW - LIVER

KW - REPRODUCIBILITY

U2 - 10.1097/MNM.0000000000001537

DO - 10.1097/MNM.0000000000001537

M3 - Journal article

C2 - 35081091

VL - 43

SP - 549

EP - 559

JO - Nuclear Medicine Communications

JF - Nuclear Medicine Communications

SN - 0143-3636

IS - 5

ER -