Comparison of SUV and Patlak slope for monitoring of cancer therapy using serial PET scans

• Published in: European journal of nuclear medicine and molecular imaging 2003, Vol.30 (1), p.46-53
• Main Authors: FREEDMAN, Nanette M. T, SUNDARAM, Senthil K, KURDZIEL, Karen, CARRASQUILLO, Jorge A, WHATLEY, Millie, CARSON, Joann M, SELLERS, David, LIBUTTI, Steven K, YANG, James C, BACHARACH, Stephen L
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Carcinoma, Renal Cell - diagnostic imaging; Carcinoma, Renal Cell - drug therapy; Carcinoma, Renal Cell - metabolism; Carcinoma, Renal Cell - secondary; Female; Fluorodeoxyglucose F18 - pharmacokinetics; Humans; Image Interpretation, Computer-Assisted - methods; Interleukin-2 - therapeutic use; Investigative techniques, diagnostic techniques (general aspects); Kidney Neoplasms - diagnostic imaging; Kidney Neoplasms - drug therapy; Kidney Neoplasms - metabolism; Kidneys; Male; Medical sciences; Miscellaneous. Technology; Nephrology. Urinary tract diseases; Radionuclide investigations; Radiopharmaceuticals - pharmacokinetics; Reference Standards; Reproducibility of Results; Sensitivity and Specificity; Tomography, Emission-Computed - methods; Tomography, Emission-Computed - standards; Treatment Outcome; Tumors of the urinary system
• ISSN: 1619-7070; 1619-7089
• DOI: 10.1007/s00259-002-0981-4

The standardized uptake value (SUV) and the slope of the Patlak plot ( K) have both been proposed as indices to monitor the progress of disease during cancer therapy. Although a good correlation has been reported between SUV and K, they are not equivalent, and may not be equally affected by metabolic changes occurring during disease progression or therapy. We wished to compare changes in tumor SUV with changes in K during serial positron emission tomography (PET) scans for monitoring therapy. Thirteen patients enrolled in a protocol to treat renal cell carcinoma metastases were studied. Serial dynamic fluorodeoxyglucose (FDG) PET scans and computed tomography (CT) and magnetic resonance (MR) scans were performed once prior to treatment, once at 36+/-2 days after the start of treatment, and (in 7/13 subjects, 16/27 lesions) a third time at 92+/-9 days after the start of treatment. This resulted in a total of 33 scans, and 70 tumor Patlak and SUV values (one value for each lesion at each time point). SUV and K were measured over one to four predefined tumors/patient at each time point. The input function was obtained from regions of interest over the heart, combined, if necessary, with late blood samples. Over all tumors and scans, SUV and K correlated well ( r=0.97, P