Abstract
18F-fluoro-2-deoxyglucose (18F-FDG) positron emission tomography (PET) is an important tool in oncology. Its use has greatly progressed from initial diagnosis to staging and patient monitoring. The information derived from 18F-FDG-PET allowed the development of a wide range of PET quantitative analysis techniques ranging from simple semi-quantitative methods like the standardized uptake value (SUV) to “high order metrics” that require a segmentation step and additional image processing. In this review, these methods are discussed, focusing particularly on the available methodologies that can be used in clinical trials as well as their current applications in international consensus for PET interpretation in lymphoma and solid tumors.
Highlights
Positron emission tomography (PET) with 18F-FDG plays a major role in the assessment of therapy response and in patient followup for oncology applications [1,2,3]
This short review provides an overview of the current use of quantitative metrics and discusses promising methodological developments in the context of therapy response and patient follow-up using 18F-FDG PET imaging
This paper focuses on the two most used metrics: SUVmax defined as the standardized uptake value (SUV) value of the maximum intensity voxel within a region of interest (ROI) and SUVpeak defined as the average SUV within a small ROI
Summary
Positron emission tomography (PET) with 18F-FDG plays a major role in the assessment of therapy response and in patient followup for oncology applications [1,2,3]. Beyond the usefulness of quantitative imaging for therapy response or prognosis, those metrics are expected to play a pivotal role for tumor characterization in line with the development of personalized medicine This short review provides an overview of the current use of quantitative metrics and discusses promising methodological developments in the context of therapy response and patient follow-up using 18F-FDG PET imaging. It is impressive that quantitative metrics’ role gains more and more importance in these regularly updated consensual criteria in lymphoma In this respect, the use of 18F-FDG PET in lymphoma can be considered as an “almost perfect world” as far as quantitative approaches are clinically relevant for assessing therapy response in lymphoma. The most recent attempt to standardize interpretation criteria has been proposed by Wahl and colleagues with the PET response criteria in solid tumors (PERCIST) [12], and paves the way toward an unified approach in solid tumors that is not yet used clinically
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