STANDARDIZED UPTAKE VALUES OF F-18 FLUORODEOXYGLUCOSE - THE VALUE OF DIFFERENT NORMALIZATION PROCEDURES

While the evident advantages of absolute metabolic rate determinations cannot be equalled by static image analysis of fluorine-18 fluorodeox yglucose positron emission tomographic (FDG PET) studies, various algo rithms for the normalization of static FDG uptake values have been pro posed. This study was performed to compare different normalization pro cedures in terms of dependency on individual patient characteristics. Standardized FDG uptake values (SUVs) were calculated for liver and lu ng tissue in 126 patients studied with whole-body FDG PET. Uptake valu es were normalized for total body weight, lean body mass and body surf ace area. Ranges, means, medians, standard deviations and variation co efficients of these SUV parameters were calculated and their interdepe ndency with total body weight, lean body mass, body surface area, pati ent height and blood sugar levels was calculated by means of regressio n analysis. Standardized FDG uptake values normalized for body surface area were clearly superior to SUV parameters normalized for total bod y weight or lean body mass. Variation and correlation coefficients of body surface area-normalized uptake values were minimal when compared with SUV parameters derived from the other normalization procedures. N ormalization for total body weight resulted in uptake values still dep endent on body weight and blood sugar levels, while normalization for lean body mass did not eliminate the positive correlation with lean bo dy mass and patient height. It is concluded that normalization of FDG uptake values for body surface area is less dependent on the individua l patient characteristics than are FDG uptake values normalized for ot her parameters, and therefore appears to be preferable for FDG PET stu dies in oncology.