Abstract
Various factors have been identified that influence quantitative accuracy and image interpretation in positron emission tomography (PET). Through the continuous introduction of new PET technology—both imaging hardware and reconstruction software—into clinical care, we now find ourselves in a transition period in which traditional and new technologies coexist. The effects on the clinical value of PET imaging and its interpretation in routine clinical practice require careful reevaluation. In this review, we provide a comprehensive summary of important factors influencing quantification and interpretation with a focus on recent developments in PET technology. Finally, we discuss the relationship between quantitative accuracy and subjective image interpretation.
Highlights
The purpose of this review is to provide a state-of-the-art overview of factors influencing common quantitative image parameters in positron emission tomography (PET) as well as image interpretation, which is usually not quantitative
It has been suggested that standardized uptake values (SUV)-based criteria in lymphoma might improve inter-reader agreement because they are unaffected by visual contrast effects [188]
The added value of quantitative uptake parameters for clinical decisions is still not well-defined, it should be kept in mind that even simple quantitative measures such as the SUV are highly variable
Summary
The purpose of this review is to provide a state-of-the-art overview of factors influencing common quantitative image parameters in positron emission tomography (PET) as well as image interpretation, which is usually not quantitative. PET quantification, as defined in this review article, comprises primarily those methodological factors that determine how accurately the radiopharmaceutical with its biodistribution in an individual patient is depicted. It focusses on those aspects that are potentially relevant for daily routine clinical care (Figure 1).
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