PURPOSE: It has been proposed to use liver as reference organ when assessing tumor response with PET. We investigated whether liver FDG uptake is dependent on clinical, biological, or technical factors. METHODS: Sixty-one women with breast carcinoma had FDG-PET/CT imaging at baseline and then after the second course of neoadjuvant chemotherapy. SUV values were measured over the primary breast tumor and in a region of interest of 30-mm diameter within the liver. RESULTS: Liver SUVmean values for the 61 women were not different before and after the 2 courses of chemotherapy (2.27 vs 2.35; P = 0.18). No significant correlation was found between the delay postinjection and liver SUV. Liver SUVmean increased with blood glucose level (P = 0.007 on baseline PET studies, and P = 0.067 on postchemotherapy studies). Liver SUVmean increased significantly with increasing patient age, which was observed on baseline (P = < 0.001) and postchemotherapy studies (P = 0.002). Again, liver SUVmean increased with body weight (P = 0.037 on baseline studies and 0.003 on postchemotherapy studies). On multivariate analysis, 2 independent variables remained correlated to liver SUV, namely, age and weight. We found no statistically significant correlation between the studied physiological variables and breast tumor SUVmax. However, there was a trend for lower SUVmax with increasing blood glucose level or age. CONCLUSIONS: FDG liver uptake depends on many factors such as age, weight, and blood glucose level. Some of these variables seem to have an opposite impact on tumor SUVmax. These findings challenge the usefulness of liver as reference.
PURPOSE: It has been proposed to use liver as reference organ when assessing tumor response with PET. We investigated whether liver FDG uptake is dependent on clinical, biological, or technical factors. METHODS: Sixty-one women with breast carcinoma had FDG-PET/CT imaging at baseline and then after the second course of neoadjuvant chemotherapy. SUV values were measured over the primary breast tumor and in a region of interest of 30-mm diameter within the liver. RESULTS: Liver SUVmean values for the 61 women were not different before and after the 2 courses of chemotherapy (2.27 vs 2.35; P = 0.18). No significant correlation was found between the delay postinjection and liver SUV. Liver SUVmean increased with blood glucose level (P = 0.007 on baseline PET studies, and P = 0.067 on postchemotherapy studies). Liver SUVmean increased significantly with increasing patient age, which was observed on baseline (P = < 0.001) and postchemotherapy studies (P = 0.002). Again, liver SUVmean increased with body weight (P = 0.037 on baseline studies and 0.003 on postchemotherapy studies). On multivariate analysis, 2 independent variables remained correlated to liver SUV, namely, age and weight. We found no statistically significant correlation between the studied physiological variables and breast tumor SUVmax. However, there was a trend for lower SUVmax with increasing blood glucose level or age. CONCLUSIONS: FDG liver uptake depends on many factors such as age, weight, and blood glucose level. Some of these variables seem to have an opposite impact on tumor SUVmax. These findings challenge the usefulness of liver as reference.
Authors: Agostino Chiaravalloti; Roberta Danieli; Paolo Abbatiello; Barbara Di Pietro; Laura Travascio; Maria Cantonetti; Manlio Guazzaroni; Antonio Orlacchio; Giovanni Simonetti; Orazio Schillaci Journal: Eur J Nucl Med Mol Imaging Date: 2014-02-22 Impact factor: 9.236
Authors: Karel Pacak; David Taïeb; Elise M Blanchet; Sophie Gabriel; Victoria Martucci; Nicolas Fakhry; Clara C Chen; Arnaud Deveze; Corina Millo; Anne Barlier; Morgane Pertuit; Anderson Loundou Journal: Eur J Clin Invest Date: 2014 Impact factor: 4.686