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. 2025 May 12;15(1):56.
doi: 10.1186/s13550-025-01249-z.

Test-retest repeatability of quantitative organ and tissue uptake using 20-minute dynamic multiparametric whole-body [18F]FDG PET/CT in patients with type 2 diabetes

Jonathan M Baier  1   2 , Kristian L Funck  2   3 , Anna Dons-Jensen  2 , Ole L Munk  1   4 , Lars P Tolbod  1   4 , Esben Laugesen  2   5 , Per L Poulsen  1   2 , Lars C Gormsen  1   4 , André H Dias  6
Affiliations

Test-retest repeatability of quantitative organ and tissue uptake using 20-minute dynamic multiparametric whole-body [18F]FDG PET/CT in patients with type 2 diabetes

Jonathan M Baier et al. EJNMMI Res. .

Abstract

Background: Recently developed dynamic whole-body PET/CT (D-WB PET/CT) protocols allow for measurements of potentially more precise metabolic parameters than the commonly used semiquantitative SUV. Most notable is the metabolic rate of FDG uptake (MRFDG), which reflects quantitative glucose uptake into tissues and organs. However, data on the reproducibility of MRFDG measurements are scarce, particularly in patients with perturbed glucose homeostasis such as type 2 diabetes. We therefore aimed to evaluate the test-retest repeatability of both MRFDG and SUV in these patients.

Results: Fifteen participants (mean age 71 ± 7 years; 2 females) with type 2 diabetes underwent a short 20-minute [18F]FDG D-WB PET/CT after 6 h fasting on two consecutive days. Both SUV and MRFDG images were reconstructed from D-WB PET/CT data obtained 60-80 min post-injection of [18F]FDG. MRFDG and SUV data were measured in organs and tissues, and repeatability was assessed with Bland-Altman analysis, intraclass correlation coefficients (ICC), repeatability coefficients (RPC) and coefficients of variation (wCV). There was high repeatability of both SUVmean and MRFDG-mean in all measured organs (ICC range: 0.65-0.95 for SUVmean and 0.66-0.94 for MRFDG-mean). SUVmean generally demonstrated higher reliability (ICC) and lower variability (%RPC and %wCV) when compared to MRFDG-mean. However, MRFDG test-retest variation was < 19% in most analysed tissues, demonstrating that MRFDG may be used as a precise marker of treatment response.

Conclusion: This study demonstrates that MRFDG calculated from D-WB PET/CT exhibit high repeatability, comparable to SUVs across most organs in patients with type 2 diabetes.

Keywords: Diabetes; Dynamic whole-body PET; FDG; PET/CT; Parametric imaging; Test-retest.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Approval for the study was obtained from the ethics committee at Region Midtjylland (1-10-72-345-21). All methods were carried out in accordance with relevant guidelines and regulations. Informed consent was obtained from each patient before inclusion into the study. Consent for publication: Publication consent was obtained from all study participants. Competing interests: The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Correlation plots (A and C) and Bland–Altman plots (B and D) demonstrating the repeatability of SUV(60–80) mean (A and B) and MRFDG-mean (C and D) in the aortic wall. In the correlation plots, the dashed lines indicate the lines of identity, whereas the solid lines represent the linear regression fit. In the Bland–Altman plots, the solid line marks the mean difference between the test and retest results, while the dashed lines represent the 95% upper and lower limits of agreement. The limits of agreement of log-transformed data are transformed back to original scale
Fig. 2
Fig. 2
Correlation plots (A and C) and Bland–Altman plots (B and D) demonstrating the repeatability of SUV(60–80)mean (A and B) and MRFDG-mean (C and D) in the left ventricular myocardium. In the correlation plots, the dashed lines indicate the lines of identity, whereas the solid lines represent the linear regression fit. In the Bland–Altman plots, the solid line marks the mean difference between the test and retest results, while the dashed lines represent the 95% upper and lower limits of agreement. The limits of agreement of log-transformed data are transformed back to original scale
Fig. 3
Fig. 3
Correlation plots (A and C) and Bland–Altman plots (B and D) demonstrating the repeatability of SUV(60–80)mean (A and B) and MRFDG-mean (C and D) in the liver. In the correlation plots, the dashed lines indicate the lines of identity, whereas the solid lines represent the linear regression fit. In the Bland–Altman plots, the solid line marks the mean difference between the test and retest results, while the dashed lines represent the 95% upper and lower limits of agreement. The limits of agreement of log-transformed data are transformed back to original scale
Fig. 4
Fig. 4
Correlation plots (A and C) and Bland–Altman plots (B and D) demonstrating the repeatability of SUV(60–80)mean (A and B) and MRFDG-mean (C and D) in the spleen. In the correlation plots, the dashed lines indicate the lines of identity, whereas the solid lines represent the linear regression fit. In the Bland–Altman plots, the solid line marks the mean difference between the test and retest results, while the dashed lines represent the 95% upper and lower limits of agreement. The limits of agreement of log-transformed data are transformed back to original scale
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References

    1. Keyes JW. Jr. SUV: standard uptake or silly useless value? J Nucl Med. 1995;36:1836–9. - PubMed
    1. Adams MC, Turkington TG, Wilson JM, Wong TZ. A systematic review of the factors affecting accuracy of SUV measurements. AJR Am J Roentgenol. 2010;195. 10.2214/AJR.10.4923. - PubMed
    1. Boellaard R. Standards for PET image acquisition and quantitative data analysis. J Nucl Med. 2009;50(Suppl 1):s11–20. 10.2967/jnumed.108.057182. - PubMed
    1. Boellaard R, Delgado-Bolton R, Oyen WJ, Giammarile F, Tatsch K, Eschner W, et al. FDG PET/CT: EANM procedure guidelines for tumour imaging: version 2.0. Eur J Nucl Med Mol Imaging. 2015;42:328–54. 10.1007/s00259-014-2961-x. - PMC - PubMed
    1. Karakatsanis NA, Lodge MA, Tahari AK, Zhou Y, Wahl RL, Rahmim A. Dynamic whole-body PET parametric imaging: I. Concept, acquisition protocol optimization and clinical application. Phys Med Biol. 2013;58:7391–418. 10.1088/0031-9155/58/20/7391. - PMC - PubMed

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