Title: Correcting tumour SUV for enhanced bone marrow uptake: retrospective 18F-FDG PET/CT studies
Abstract: Purpose The concentration of 18F-FDG in the bone marrow is usually low. One common cause of high uptake is due to bone marrow stimulating drugs administered in conjunction with chemotherapy or radiation therapy. It has been hypothesized that the sequestration of 18F-FDG to the bone marrow may reduce the standardized uptake value (SUV) of a tumour. We tested this hypothesis by quantifying total 18F-FDG uptake in the bone marrow of patients with visibly enhanced bone marrow uptake and computing its effect on tumour SUV. Methods Total 18F-FDG in bone marrow was measured in two groups of PET/CT studies: one (n=19) with visibly enhanced bone marrow, the other (n=5), a baseline group with ‘normal’ levels of uptake. To measure the 18F-FDG in bone marrow, the entire skeleton in the CT was segmented from surrounding tissue, and the resulting volume applied to the PET image. Using kinetic analysis we show that the predicted correction factor to tumour SUV is given by (1−q0/Q)/(1−q/Q), where Q is the injected dose, and q and q0 are enhanced and baseline bone marrow uptake (MBq). Results The enhanced bone marrow uptake averaged 8.9±3.2% of injected dose (15.2% max) vs. 4.2±0.4% (4.6% max) at baseline. This resulted in a predicted artificial decrease in tumour SUV of up to 11.5% (4.9±4.3%, on average). Conclusion Enhanced bone marrow uptake is predicted to reduce tumour SUVs by as much as 11.5% in our patient group and is a potential confounding factor in using SUV for monitoring tumour response to therapy.
Publication Year: 2008
Publication Date: 2008-04-01
Language: en
Type: article
Indexed In: ['crossref', 'pubmed']
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Cited By Count: 12
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