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2012 ; 12
(2
): 336-44
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Multiparametric PET/CT in oncology
#MMPMID23023069
Singh D
; Miles K
Cancer Imaging
2012[Sep]; 12
(2
): 336-44
PMID23023069
show ga
The standardized uptake value (SUV) and other measurements of tumour uptake of
fluorodeoxyglucose (FDG) on positron emission tomography (PET) can potentially be
supplemented by additional imaging parameters derived either from the PET images
or from the computed tomography (CT) component of integrated PET/CT examinations
including tumour size, CT attenuation, texture (reflecting tumour heterogeneity)
and blood flow. This article illustrates the emerging benefits of such a
multiparametric approach. Example benefits include greater diagnostic accuracy in
characterization of adrenal masses achieved by using both the SUV and measured CT
attenuation. Tumour size combined with the SUV can potentially improve the
prognostic information available from PET/CT in oesophageal and lung cancer.
However, greater improvements may be realized through using CT measurements of
texture instead of size. Studies in breast and lung cancer suggest that combined
PET/CT measurements of glucose metabolism and blood flow provide correlates for
tumour proliferation and angiogenesis, respectively. These combined measurements
can be utilized to determine vascular-metabolic phenotypes, which vary with
tumour type. Uncoupling of blood flow and metabolism suggests a poor prognosis
for larger more advanced tumours, high-grade lesions and tumours responding
poorly to treatment. Vascular-metabolic imaging also has the potential to
subclassify tumour response to treatment. The additional biomarkers described can
be readily incorporated in existing FDG-PET examinations thereby improving the
ability of PET/CT to depict tumour biology, characterize potentially malignant
lesions, and assess prognosis and therapeutic response.
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