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Lean body mass-based standardized uptake value, derived from a predictive equation, might be misleading in PET studies

Lean body mass-based standardized uptake value, derived from a predictive equation, might be misleading in PET studies,10.1007/s00259-002-0974-3,Europ

Lean body mass-based standardized uptake value, derived from a predictive equation, might be misleading in PET studies   (Citations: 12)
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The standardized uptake value (SUV) has gained recognition in recent years as a semiquantitative evaluation parameter in positron emission tomography (PET) studies. However, there is as yet no consensus on the way in which this index should be determined. One of the confusing factors is the normalisation procedure. Among the proposed anthropometric parameters for normalisation is lean body mass (LBM); LBM has been determined by using a predictive equation in most if not all of the studies. In the present study, we assessed the degree of agreement of various LBM predictive equations with a reference method. Secondly, we evaluated the impact of predicted LBM values on a hypothetical value of 2.5 SUV, normalised to LBM (SUVLBM), by using various equations. The study population consisted of 153 women, aged 32.3&#4511.8 years (mean&#45SD), with a height of 1.61&#450.06 m, a weight of 71.1&#4517.5 kg, a body surface area of 1.77&#450.22 m2 and a body mass index of 27.6&#456.9 kg/m2. LBM (44.2&#456.6 kg) was measured by a dual-energy X-ray absorptiometry (DEXA) method. A total of nine equations from the literature were evaluated, four of them from recent PET studies. Although there was significant correlation between predicted and measured LBM values, 95% limits of agreement determined by the Bland and Altman method showed a wide range of variation in predicted LBM values as compared with DEXA, no matter which predictive equation was used. Moreover, only one predictive equation was not statistically different in the comparison of means (DEXA and predicted LBM values). It was also shown that the predictive equations used in this study yield a wide range of SUVLBM values from 1.78 to 5.16 (29% less or 107% more) for an SUV of 2.5. In conclusion, this study suggests that estimation of LBM by use of a predictive equation may cause substantial error for an individual, and that if LBM is chosen for the SUV normalisation procedure, it should be measured, not predicted.
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    • ...The use of SUV as a classification method for tissue areas as being either benign or malignant is still being discussed by nuclear medicine physicians and oncologists [43,44], and depending on the conditions under which the study has been performed and the data have been preprocessed, the use of SUV can be misleading in PET studies [45]...

    Sotiris Pavlopouloset al. Analysis and interpretation of dynamic FDG PET oncological studies usi...

    • ...To date, the LBM has been calculated using empirical (anthropometric) formulae based on both patient weight and patient height [2, 4, 5]. Recently, large differences between predicted and experimentally determined LBM values were detected [5, 6], so the introduction of accurate experimental determination is considered to be an urgent...
    • ...To date, the LBM has been calculated using empirical (anthropometric) formulae based on both patient weight and patient height [2, 4, 5]. Recently, large differences between predicted and experimentally determined LBM values were detected [5, 6], so the introduction of accurate experimental determination is considered to be an urgent...
    • ...ment [17] and dual-energy X-ray absorption [3, 5]. Thus far, underwater weighing is considered the gold standard method, but it entails a number of problems, especially for seriously ill patients...

    Michael Hentschelet al. Can body volume be determined by PET?

    • ...SUV can also be normalised to body surface area (BSA) or lean body mass (LBM) [62, 63, 64, 65]...

    Nanda C. Kraket al. Measuring response to chemotherapy in locally advanced breast cancer: ...

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