ArticleEJNMMI research2025
Pulmonary uptake value (PUV): a new quantification method for lung PET/CT imaging.
Article in EJNMMI research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04942275 (Lung Perfusion PET / CT Using Gallium68-MMA for Preservation of Lung Function During Stereotactic Pulmonary Radiation Therapy), which is not on this map. Not yet cited in PubMed.
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Lung Perfusion PET / CT Using Gallium68-MMA for Preservation of Lung Function During Stereotactic Pulmonary Radiation Therapy
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11 authors.
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Abstract
backgroundA current limitation to the use of lung PET/CT is the absence of a tool that reliably and reproducibly quantifies the intensity of tracer uptake. We aim to develop a quantitative approach for lung perfusion PET/CT imaging. Sixty patients who underwent [68Ga]Ga-MAA PET/CT scans before (M0) and 3 months (M3) after completion of radiotherapy were analyzed. The anatomical lung volume (ALV) was delineated on the CT scan. CT and PET images were co-registered, and the ALV was transferred onto the PET images. The measured activity concentration (kBq/L) in each voxel was converted in three metrics: SUV based on normalizing the measured activity to the patient's weight (kg) and the injected dose (kBq); SUVp by normalizing to the ALV (L) and the injected dose (kBq); pulmonary uptake value (PUV) by normalizing to the ALV (L) and the total activity measured in the ALV (kBq). The mean SUV, SUVp and PUV values within the ALV were measured.
resultsThe mean (SD) SUV in the ALV was 9.90 (5.24) with an inconsistently wide range of values from 0.11 to 22.52. The correlation coefficient between the patient's weight and the ALV was 0.14. The mean (SD) SUVp in the ALV was 0.54 (0.09). The mean (SD) percentage of [68Ga]Ga-MAA lung retention was 58.2% (7.7%), with significant variability both between patients and within repeated scans of the same patient. The mean PUV in the ALV used for normalization was equal to 1. Quantitative methods were tested in challenging scenarios for quantification, including patients exhibiting decorrelation between ALV and patient's weight and patients with different percentage of [68Ga]Ga-MAA lung retention between M0 and M3. In contrast to the SUV and SUVp metrics, the PUV method showed coherent results compared to visual analysis.
conclusionThe patient's weight and the injected activity are not suitable parameters for normalization in lung perfusion quantification. We proposed a quantitative metric for lung perfusion PET/CT imaging, based on normalizing the measured activity to the ALV computed from a co-registered CT scan and to the total activity measured in the ALV.
trial registrationNCT04942275. Registered 19 June 2021.
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