Assessment of Quantitative Analysis Methods for Lung F-18-Fluorodeoxyglucose PET

Kim, Joon Young; Choi, Yong; Choi, Joon Young; Kim, Sang Eun; Choe, Yearn Seong; Lee, Kyung Han; Kim, Yong Jin; Kim, Byung Tae

Abstract

PURPOSE: The purpose of this study was to assess the diagnostic accuracy of various quantitation methods using F-18-fluorodeoxyglucose (FDG) in patients with malignant or benign lung lesion.
MATERIALS AND METHODS
22 patients (13 malignant including 5 bronchoalverolar cell cancer; 9 benign lesions including 1 hamartoma and 8 active inflammation) were studied after overnight fasting. We performed dynamic PET imaging for 56 min after injection of 370 MBq (10 mCi) of FDG. Standardized uptake values normalized to patients body weight and plasma glucose concentration (SUVglu) were calculated. The uptake rate constant of FDG and glucose metabolic rate were quantified using Patlak graphical analysis (Kpat and Mrpat), three compartment-five parameter model (K5p, MR5p), and six parameter model taking into account heterogeneity of tumor tissue (K6p, MR6p), Areas under receiver operating charac-teristic curves (ROC) were calculated for each method.
RESULTS
There was no significant difference of rate constant or glucose metabolic rate measured by various quantitation methods between malignant and benign lesions. The area under ROC curve were 0.73 for SUVglu, 0.66 for Kpat, 0.77 for Mrpat, 0.71 for KSp, 0.73 for MRSp, 0.70 for K6p, and 0.78 for MR6p, No significant difference of area under the ROC curve between these rnethods v;as observed except the area between Kpat vs. Mrpat (p<0.05).
CONCLUSION
Quantitative methods did not improve diagnostic accuracy in comparison with nonkinetic methods. However, the clinical utility of these methods needs to be evaluated further in patients with low pretest likelihood of active inflammation or bronchoalveolar cell carcinoma.