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Test-retest repeatability and interobserver variation of healthy tissue metabolism using 18F-FDG PET/CT of the thorax among lung cancer patients

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OBJECTIVES: The aim of this study was to assess the test-retest repeatability and interobserver variation in healthy tissue (HT) metabolism using 2-deoxy-2-[18F]fluoro-d-glucose (18F-FDG) PET/computed tomography (PET/CT) of the thorax in lung cancer patients.

METHODS: A retrospective analysis was conducted in 22 patients with non-small cell lung cancer who had two PET/CT scans of the thorax performed 3 days apart with no interval treatment. The maximum, mean and peak standardized uptake values (SUVs) in different HTs were measured by a single observer for the test-retest analysis and two observers for interobserver variation. Bland-Altman plots were used to assess the repeatability and interobserver variation. Intrasubject variability was evaluated using within-subject coefficients of variation (wCV).

RESULTS: The wCV of test-retest SUVmean measurements in mediastinal blood pool, bone marrow, skeletal muscles and lungs was less than 20%. The left ventricle (LV) showed higher wCV (>60%) in all SUV parameters with wide limits of repeatability. High interobserver agreement was found with wCV of less than 10% in SUVmean of all HT, but up to 22% was noted in the LV.

CONCLUSION: HT metabolism is stable in a test-retest scenario and has high interobserver agreement. SUVmean was the most stable metric in organs with low FDG uptake and SUVpeak in HTs with moderate uptake. Test-retest measurements in LV were highly variable irrespective of the SUV parameters used for measurements.

Original languageEnglish
JournalNuclear Medicine Communications
Issue number5
Pages (from-to)549-559
Number of pages11
Publication statusPublished - 1 May 2022

Bibliographical note

Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc.

    Research areas

  • Carcinoma, Non-Small-Cell Lung/diagnostic imaging, Fluorodeoxyglucose F18/metabolism, Humans, Lung Neoplasms/diagnostic imaging, Observer Variation, Positron Emission Tomography Computed Tomography/methods, Positron-Emission Tomography/methods, Radiopharmaceuticals, Reproducibility of Results, Retrospective Studies, Thorax/diagnostic imaging

ID: 79860151